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? Pennsylvania’s subsidized child care regulation states that a co-payment shall be at least $5, unless waived due to domestic violence, experiencing homelessness or in cases of prospective employment until the first pay is received. Therefore, there are rare situations where a family may be required to pay a co-payment of $5 a week which may be greater than 7% of their income. Except in this rare circumstance, a family’s co- payment does not exceed 7% of the income. Pennsylvania has requested a waiver until regulatory and system changes can be made for Pennsylvania to be in complete compliance. 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 22.00 2200.00 2510.00 165.00 6.60 2 1.00 22.00 2200.00 3407.00 221.00 6.50 3 1.00 22.00 2200.00 4303.00 281.00 6.50 4 1.00 22.00 2200.00 5200.00 338.00 6.50 5 1.00 22.00 2200.00 6097.00 398.00 6.50 c. What is the effective date of the sliding-fee scale(s)? 5/6/2024 d. Provide the link(s) to the sliding-fee scale(s): https://www.pacodeandbulletin.gov/Display/pabull?file=/secure/pabulletin/data/vol54/5 4-19/659.html 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: If a parent or caretaker selects a provider whose published rate exceeds the subsidy rate, which includes any quality tiered reimbursement or non-traditional add-on rate, the provider may charge the parent or caretaker the difference between these two amounts, in addition to the weekly copayment. Providers cannot charge subsidy families more than they charge private pay families. This regulation was established to encourage providers who otherwise would not participate with the subsidized child care program because the reimbursement rates are lower, to serve subsidy families. OCDEL continues to work towards increasing the base payment rates. As rates get closer to the 75th percentile, OCDEL will continue to re-evaluate the regulation that allows providers to charge the difference between the subsidy payment rate and their private pay rates. 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: Respondents to the 2022 Market Rate Survey indicated that of providers with a CCW agreement, half (50.1%) indicated that they do not typically require CCW families to pay any difference between the private tuition rate and the subsidy payment amount (MCCA plus applicable Keystone STAR tiered imbursement and non-traditional add-on rate). About one-third (31.8%) of providers with a CCW agreement typically charge families the full difference, while 7.3% require families to pay more than the subsidy payment amount but less than the full difference. Another 7.2% reported no difference between the subsidy payment amount and their private pay tuition. Family and Group Child Care Homes are more likely to require CCW families to pay the difference between the subsidy reimbursement amount than Child Care Centers. An analysis of the average full difference charged to families per day by region, care level and provider type is included below. It is important to note that these data points are from 2022. In March 2023, OCDEL increased the MCCA rates to maintain 60th percentile floor, effectively reducing the gap between the subsidy reimbursement rate and the tuition charged by providers. Additionally, approximately half of the 31.8% of providers charging the full difference to families reported private pay rates equal to or less than the MCCA rates and were not actively charging any differential. Infant YT OT Pre SA REGION 1 CHILD CARE CENTER $10.30 $6.27 $6.27 $7.17 $8.13 FAMILY CHILD CARE HOME $7.57 $7.13 $6.80 $7.62 $6.79 GROUP CHILD CARE HOME $8.70 $5.97 $6.30 $5.07 $5.60 REGION 2 CHILD CARE CENTER $7.50 $6.73 $5.62 $6.00 $6.24 FAMILY CHILD CARE HOME $2.79 $2.80 $3.06 $3.06 $3.07 GROUP CHILD CARE HOME $5.61 $5.61 $5.61 $5.61 $9.00 REGION 3 CHILD CARE CENTER $14.68 $13.53 $13.73 $14.46 $12.62 FAMILY CHILD CARE HOME $12.00 $9.97 $9.30 $8.67 $8.67 GROUP CHILD CARE HOME $9.50 $10.50 $11.00 $12.00 $5.50 REGION 4 CHILD CARE CENTER $15.15 $14.86 $14.90 $13.60 $14.35 FAMILY CHILD CARE HOME $13.38 $13.38 $10.88 $8.38 $8.38 GROUP CHILD CARE HOME $2.00 $3.00 $1.79 $0.02 REGION 5 CHILD CARE CENTER $17.07 $16.59 $17.03 $17.62 $15.45 FAMILY CHILD CARE HOME $11.75 $11.25 $12.75 $13.75 $13.75 GROUP CHILD CARE HOME $8.98 $8.48 $7.20 $3.76 $4.00 REGION 6 CHILD CARE CENTER $5.94 $5.16 $5.79 $5.69 $4.91 FAMILY CHILD CARE HOME $6.25 $6.00 $5.25 $4.75 $4.17 GROUP CHILD CARE HOME $2.42 $2.61 $2.88 $3.84 $2.20 REGION 7 CHILD CARE CENTER $8.08 $6.54 $4.95 $3.78 $6.91 FAMILY CHILD CARE HOME $7.00 $5.33 $4.25 $4.25 $5.50 GROUP CHILD CARE HOME $1.00 $1.00 $1.00 $5.00 REGION 8 CHILD CARE CENTER $10.85 $11.42 $8.16 $5.34 $13.00 FAMILY CHILD CARE HOME $6.00 $5.00 $4.60 $4.60 $5.00 GROUP CHILD CARE HOME $4.61 $5.61 $6.02 $3.71 $4.83 REGION 9 CHILD CARE CENTER $14.64 $14.47 $14.55 $12.14 $13.21 FAMILY CHILD CARE HOME $12.38 $10.13 $11.29 $10.36 $10.64 GROUP CHILD CARE HOME $29.00 $14.63 $12.17 $13.67 $8.75 REGION 10 CHILD CARE CENTER $13.04 $13.29 $11.60 $11.18 $14.87 FAMILY CHILD CARE HOME $7.50 $6.22 $7.16 $7.48 $8.05 GROUP CHILD CARE HOME $11.40 $10.00 $11.20 $8.00 $6.83 REGION 11 CHILD CARE CENTER $11.66 $9.36 $9.51 $8.68 $8.67 FAMILY CHILD CARE HOME $9.60 $8.00 $6.02 $6.88 $6.59 GROUP CHILD CARE HOME $8.32 $10.16 $8.11 $7.57 $8.20 REGION 12 CHILD CARE CENTER $15.26 $11.77 $10.86 $8.79 $7.27 FAMILY CHILD CARE HOME $5.67 $6.08 $6.08 $7.50 $9.12 GROUP CHILD CARE HOME $10.40 $6.17 $6.29 $6.43 $7.00 REGION 13 CHILD CARE CENTER $14.60 $14.22 $12.92 $11.92 $14.15 FAMILY CHILD CARE HOME $16.50 $15.00 $15.00 $14.00 $14.00 GROUP CHILD CARE HOME $8.56 $8.48 $4.11 $8.00 $7.50 REGION 14 CHILD CARE CENTER $14.99 $13.14 $13.68 $12.47 $11.57 FAMILY CHILD CARE HOME $15.06 $11.91 $11.01 $9.87 $10.01 GROUP CHILD CARE HOME $13.00 $14.00 $16.00 $14.00 $26.00 REGION 15 CHILD CARE CENTER $14.51 $13.57 $14.07 $14.30 $11.86 FAMILY CHILD CARE HOME $2.00 $3.00 $2.50 $3.00 $3.50 GROUP CHILD CARE HOME $15.00 $8.75 $9.75 $9.50 $12.50 REGION 16 CHILD CARE CENTER $13.63 $13.09 $13.72 $9.50 $9.11 GROUP CHILD CARE HOME $17.00 $13.50 $15.10 $16.70 REGION 17 CHILD CARE CENTER $16.31 $15.13 $15.77 $12.81 $14.81 FAMILY CHILD CARE HOME $16.00 $13.43 $13.43 $13.60 $12.20 GROUP CHILD CARE HOME $4.00 $1.50 REGION 18 CHILD CARE CENTER $13.83 $15.06 $14.65 $13.70 $12.37 FAMILY CHILD CARE HOME $17.65 $16.70 $16.19 $15.41 $15.34 GROUP CHILD CARE HOME $14.74 $13.87 $14.16 $13.62 $14.84 REGION 19 CHILD CARE CENTER $10.20 $11.09 $10.72 $11.67 $17.42 FAMILY CHILD CARE HOME $7.00 $7.00 $8.00 $7.00 $7.00 GROUP CHILD CARE HOME $22.00 $13.00 $10.00 $9.00