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: Subsidized Child Care Services Manual Chapter 8 IV.B.4. "Should a parent/responsible adult choose a provider who charges more than the rate the LPA is allowed to pay, the parent/responsible adult may pay the difference between the provider's charge and the rate paid by the LPA. The parent /responsible adult may not be required to pay the difference; however, if the parent/responsible adult is unable or unwilling to pay the difference in this situation, another provider must be selected by the parent/responsible adult." DCDEE recognizes that this could be a barrier in some parts of the state and has requested the NC General Assembly to implement a statewide subsidy rate floor which would help eliminate providers’ financial need to charge the difference. 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.