3.1 Family Co-payments

Lead Agencies must establish and periodically revise a sliding-fee scale for families receiving CCDF services that varies based on income and the size of the family to determine each family’s contribution (i.e., co-payment) and does not create a barrier to receiving CCDF assistance. In addition to income and the size of the family, the Lead Agency may use other factors as appropriate when determining family contributions/co-payments. Lead Agencies may not use price of care or amount of subsidy payment in determining co-payments. Lead Agencies must ensure that the total payment to a child care provider is not reduced because of family’s lowered or waived co-payment. 3.1.1 Family co-payment Lead Agencies may not charge any family more than 7% of a family’s gross income, regardless of the number of children participating in CCDF. a. What is the maximum percent of a family’s gross income any family could be charged as a co-payment? Copayments have been waived for all families since 2021. The Lead Agency originally used CRRSA funds to waive copayments and when those funds expired we transitioned to using state funding. State funding will expire on September 30, 2024. Families will be expected to pay their copayments beginning on October 1, 2024. DCC anticipates the copayment will be capped at 7% of a family's monthly income due to upcoming changes that are in place. The Lead Agency will request a waiver if there are delays in implementing that change to the copayment chart. b. Does the Lead Agency certify that their sliding fee scales are always based on income and family size (regardless of how many different scales they may use)? [x] Yes. [ ] No. If no, describe: 3.1.2 Sliding fee scale Provide the CCDF co-payments for eligible families in the table(s) below according to family size for one child in care. a. Is the sliding fee scale set statewide? [x] Yes. [ ] No. If no, describe how the sliding fee scale is set: b. Complete the table below. If the sliding fee scale is not set statewide, complete the table for the most populous locality: -- A B C D E F Family Size Lowest monthly income at initial eligibility where the family is first charged a co-pay (greater than $0). What is the monthly co-payment for a family of this size based on the income level in (A)? What percentage of income is the co- payment in (B)? Highest monthly income at initial eligibility where a family is charged a co-pay before a family is no longer eligible. What is the monthly co- payment for a family of this size based on the income level in (D)? What percentage of income is this co- payment in (E)? 1 1.00 1.00 1.00 1.00 1.00 1.00 2 1400.00 130.00 9.00 4639.00 260.00 5.00 3 1400.00 108.00 7.00 5731.00 281.00 5.00 4 1400.00 108.00 7.00 6822.00 325.00 4.00 5 1400.00 86.00 6.00 7914.00 541.00 6.00 c. What is the effective date of the sliding-fee scale(s)? October 1, 2021 d. Provide the link(s) to the sliding-fee scale(s): The new co-payment chart that will be in effect October 1, 2024, will be added to the CCAP VIII section MS 5015. To locate the co- payment sliding-fee scale, please search for the "MS 5015". A specific page number is not provided because the page number for this document change often. https://www.chfs.ky.gov/agencies/dcbs/dfs/Documents/omvolviii.pdf e. Does the Lead Agency allow providers to charge families additional amounts above the required co-payment in instances where the provider’s price exceeds the subsidy payment? [ ] No. [x] Yes. If yes: i. Provide the rationale for the Lead Agency’s policy to allow providers to charge families additional amounts above the required co-payment, including a demonstration of how the policy does not provide a barrier and promotes affordability and access for families: The Division of Child Care received a non- compliance notice on December 13, 2021 because child care providers are given an option to charge families the difference in the payment rate and rates charged to families. DCC clarified that a provider cannot charge CCAP families more than the private pay families pay, but that can result in CCAP families having to pay an overage. DCC will supply data to see how many families are having to pay the overage, and how many providers charge the overage. This non-compliance needs additional time to be addressed and additional technical assistance. Because child care providers receiving CCAP subsidies are required to charge CCAP families the same amount as private pay families, we wanted to remove the barrier of providers not being able to keep up with the cost of services. Capping CCAP family’s rates at the state max rate could deter providers from wanting to participate in CCAP. ii. Provide data (including data on the size and frequency of such amounts) on the extent to which CCDF providers charge additional amounts to families: Kentucky has 1878 CCAP child care providers, of which 774 (41%) charge more than the State Max Rate. The data for CCAP Child Care Providers is for daily rates. The average overage amount per day for those providers charging above the State Max Rate is $8.52 This data was captured in January 2024.