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? The maximum percent of a family's gross income is 7% 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 1256.00 5.00 0.40 4915.00 344.05 7.00 2 1705.00 5.00 0.29 6428.00 449.96 7.00 -- 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)? 3 2153.00 5.00 0.23 7940.00 555.80 7.00 4 2601.00 5.00 0.19 9453.00 661.71 7.00 5 3050.00 5.00 0.16 10965.00 767.55 7.00 c. What is the effective date of the sliding-fee scale(s)? July 1, 2024 d. Provide the link(s) to the sliding-fee scale(s): www.nheasy.nh.gov www.nh-connections.org/families/child-care-scholarship 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: NH allows DHHS-enrolled child care providers the choice to charge the family the difference between the DHHS paid amount and their actual rate. The BCDHSC does not have the authority to require child care providers to accept the DHHS weekly standard rate as payment in full, it would be considered an unwanted directive. DHHS strives to increase program participation in the NH Child Care Scholarship Program. Parent access and choice is valued and the BCDHSC does not want to limit access to higher quality child care programs due to increased regulation. The DHHS Commissioner, Legislature, and Governor would not likely support this as a business practice. NH has now implemented Pay by Enrollment to allow child care providers to be able to budget the weekly amount that they will receive for each child. 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: Surveying families regarding charging the difference of what the state did not pay (copayment) it shows that more than 60% of providers charge the family an additional charge amount so they receive the full cost of care. 30% of child care providers charge just the cost share and the other 10% have either their own scholarship funding or do not charge the families any amount. NH was sited as non-compliant on May 23rd 2024 due to not collecting information regarding the amounts being charged above NH's established rates for the Scholarship Program. We believe the survey conducted did not provide sufficient and accurate information on the additional fees that providers charge to families. NH is currently analyzing data from a profile update on 9/11/24. NH will amend the state plan once data is analyzed.