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436 (07/2026) Chapter 2:Eligibility • Section 6: Non-financial eligibility If a provider notifies DPU that a caretaker did not satisfy their copay requirement, DPU takes the following steps: • DPU sends the caretaker the Copay Agreement notice (CM00893) and records the report internally through the remainder of the certification period. • If DPU records show the copay requirement is still not satisfied in the final month of the certification period, DPU changes the copay met variable to “N” on the DPCS screen. This interfaces with ONE overnight and adds the Copay Not Met disqualification. • When a caretaker renews or reapplies for ERDC, an RFI is issued if an unmet copay remains and the copay payment or other satisfactory arrangements are required as an eligibility factor. This allows the caretaker time to resolve the unmet copay through payment or other satisfactory arrangements with the provider. If unresolved within the 45-day processing period, their request is denied. Unpaid copay information is available in ONE by viewing the View Disqualification and Notice Reason hyperlinks within the details section of the Authorization History screens. This information is also available on ONE on the Program Compliance screen, when viewing the caretaker’s Individual Summary screen. The period of ineligibility ends in any of the following circumstances: • On the first day of the month in which the caretaker makes the copayment or makes satisfactory arrangements with the provider, • On the first day of the month after three years have lapsed from the date the caretaker failed to make payment, or • On the first day of the month the family is approved for Categorical ERDC or Expanded Child Welfare (EXP-CW).

Determining when payment arrangements are satisfactory and removal of unmet copay coding One of the following must be met to prevent a Copay Not Met disqualification from being applied to the family’s case in the final month of their certification, or to clear a Copay Not Met disqualification at renewal or reapplication: • The provider agrees the copay has been met or satisfactory arrangements have been made. • The caretaker submits evidence to DPU that payment has been made, such as a receipt or a canceled check. DPU may contact the provider for verbal verification. • The caretaker verifies the debt was discharged by a bankruptcy filing. • The caretaker has attempted to pay the provider, but the provider refuses payment. This can happen when the copay is part of a larger bill that includes charges above the maximum rates. The case can be reopened if the caretaker presents evidence of an attempt to pay the full copay. • The caretaker attempted to pay the provider but was unable to locate them. • The caretaker is approved for Categorical ERDC or Expanded Child Welfare (EXP-CW), which exempts them from the Copay Not Met disqualification.