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? 10% DCDEE recognizes that 10% is not compliant with CCDF requirements. DCDEE needs additional time to request legislative authority and to make functionality adjustments within NC FAST to fully implement this change. 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 0.10 10.00 2430.00 243.00 10.00 2 1.00 0.10 10.00 3287.00 329.00 10.00 3 1.00 0.10 10.00 4143.00 414.00 10.00 4 1.00 0.10 10.00 5000.00 500.00 10.00 5 1.00 0.10 10.00 5857.00 586.00 10.00 c. What is the effective date of the sliding-fee scale(s)? 7/1/2023 d. Provide the link(s) to the sliding-fee scale(s): https://ncchildcare.ncdhhs.gov/Services/Financial-Assistance/Do-I-Qualify 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 Lead Agency’s policy to allow providers to charge families additional amounts above the required co-payment is grounded in balancing affordability, access, and program sustainability. Although providers are allowed to charge additional amounts, families are allowed to choose a different provider if they do not want to or cannot afford the additional amounts. Data gathered from the 2023 Market Rate Study indicates that 20.9% of centers and 6.9% of homes charge families additional amounts in NC. The data also indicates that these providers are located throughout the state and are not concentrated in one geographic region. Because of this, families can successfully find providers in their county/geographic region that do not charge additional amounts above the required co-payment. This policy also encourages provider participation in the program which ultimately expands access and options for families. Without this policy, some providers would not opt to participate which would decrease options and access for families. To further reduce the financial burden to families and child care providers, the Lead Agency has requested to increase reimbursement rates to those recommended in the 2023 Market Rate Study and to implement a statewide subsidy rate floor. 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: Based on the results of the 2023 Market Rate Study, 396 (20.9%) centers and 46 (6.9%) homes are charging families the difference between the approved subsidy rate and their private pay rate. The average amount collected in centers is $186.00 with 3-star rated licenses, $190.30 with 4-star rated licenses, and $211.00 with 5- star rated licenses. The average amounts collected in home is $295.00 with 3-star rate licenses, $168.70 with 4-star rated licenses, and $118.70 with 5-star rated licenses.