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6 5.10 Provider Fraud, Repayment, Disqualification & Appeals ................................................................................... 148 A. Overpayment Due to Fraud .................................................................................................................................................. 148 B. Non-Fraud Overpayment ...................................................................................................................................................... 148 C. Appeals of VDOE and VDSS Actions ...................................................................................................................................... 149 SECTION 6. APPENDICES ....................................................................................................................................... 150 Appendix A. State Income Eligibility Scale for Child Care Subsidy ............................................................................. 152 Appendix B. Per-Child Copayment Scale for Families ................................................................................................ 153 Child Care Subsidy Program Per-Child Copayment Amounts (by monthly income) ....................................................................... 154 Appendix C. Child Care Program Budget Lines .......................................................................................................... 156 Appendix D. Child Care Program Cost Code Descriptions .......................................................................................... 157 Appendix E. Maximum Reimbursable Rates per Type of Provider ............................................................................ 159 Appendix F. Level 1 Maximum Reimbursable Rates ................................................................................................. 160 VDSS Central Region | Center Child Care | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 161 VDSS Eastern Region | Center Child Care | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 162 VDSS Northern Region | Center Child Care | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 163 VDSS Piedmont Region | Center Child Care | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 165 VDSS Western Region | Center Child Care | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 167 VDSS Central Region | Family Day Home | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 168 VDSS Eastern Region | Family Day Home | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 170 VDSS Northern Region | Family Day Home | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 171 VDSS Piedmont Region | Family Day Home | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 173 VDSS Western Region | Family Day Home | Maximum Reimbursable Rates – Level 1 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 174 Appendix G. Level 2 Maximum Reimbursable Rates ................................................................................................. 175 VDSS Central Region | Center Child Care | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 176 VDSS Eastern Region | Center Child Care | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 177 VDSS Northern Region | Center Child Care | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 178 VDSS Piedmont Region | Center Child Care | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 180 VDSS Western Region | Center Child Care | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 181 VDSS Central Region | Family Day Home | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 182 VDSS Eastern Region | Family Day Home | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 184 VDSS Northern Region | Family Day Home | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 185 VDSS Piedmont Region | Family Day Home | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 187 VDSS Western Region | Family Day Home | Maximum Reimbursable Rates – Level 2 | Effective 07/01/2023 | Full Day, Part Day Rate ................................................................................................................................................................................................ 188 Appendix H. Barrier Crimes for Child Day Programs ................................................................................................. 189 Appendix I. Forms Used in the Child Care Subsidy Program .................................................................................... 199 Appendix J. Child Care Subsidy Service Application and Redetermination Form Instructions .................................. 201 NUMBER ......................................................................................................................................................................................... 201 PURPOSE OF FORM ........................................................................................................................................................................ 201 USE OF FORM ................................................................................................................................................................................. 201 COPIES ............................................................................................................................................................................................ 201 INSTRUCTIONS FOR PREPARING THE FORM .................................................................................................................................. 201