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? 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 1373.17 90.00 6.50 1706.06 90.00 5.30 2 1795.69 90.00 5.00 2231.00 90.00 3.90 3 2218.20 90.00 4.00 2755.95 90.00 3.30 4 2640.71 90.00 3.40 3280.89 90.00 2.70 5 3063.23 90.00 2.90 3805.83 90.00 2.40 c. What is the effective date of the sliding-fee scale(s)? October 1, 2024 d. Provide the link(s) to the sliding-fee scale(s): Updated link is not yet available. The new chart will be posted here: https://dwss.nv.gov/Care/General-Documents/. 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 child care scholarship program operates using a parent-choice model. Parents can choose any participating provider to care for their child, including license-exempt providers. Providers are not required to participate and serve children receiving a child care scholarship. Due to significantly limited child care capacity in Nevada, the Lead Agency allows all participating child care providers to determine their own prices, which may be greater than the max daily rate paid by the state, to encourage more providers to participate. Providers may not charge families using a child care scholarship a price greater than what they charge private-pay families. By supporting family choice of provider in an open way, the Lead Agency increases access to providers statewide. 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: In addition to the price of tuition, providers also charge a variety of fees including a one-time initial registration fee (average of $126), annual fees (average of $109), materials and supplies (average of $138 generally charged annually or biannually), meals (average of $8/meal charged daily or monthly), field trips (average of $58/trip), and late payments (average of $28 per occurrence). DWSS/CCDP is paying child care providers a rate between the 55th and 93rd percentiles depending on the age of child served. This indicates that especially for the lowest percentile group, infant/toddler center, the state rate does not cover the price of care. According to the 2022 Market Rate Survey, 82% of responding providers charge parents when the subsidy rate is lower than their price. For infant care, there is a $3 difference between the average statewide price charged by providers and the base subsidy reimbursement rate. For toddler care, there is a negligible ($0.50) difference between the average statewide price charged by providers and the base subsidy reimbursement rate. There is no difference between the average statewide price charged by providers and the base subsidy reimbursement rate for preschoolers and school-aged children.