5101:2-16-39 Appendix A -Copayment Calculation Table

(A)      How is a family copayment determined?

(1)      Each family with a monthly income of one hundred per cent or less of the federal poverty level (FPL) shall have a weekly copayment of zero dollars.

(2)      Each family with a monthly income of more than one hundred per cent of the FPL shall have a weekly copayment based on family size and gross monthly income.

(3)      The family copayment schedule will be published annually in a child care procedure letter.

(4)      To calculate the family's copayment, the county agency shall:

(a)      Determine the family's monthly income pursuant to rule 5101:2-16-34 of the Administrative Code, and multiply by twelve to calculate the family's annual income.

(b)      Divide the family's annual income by one hundred per cent of the FPL that corresponds to the family size to determine the family's FPL. The FPL guidelines are published annually in a child care procedure letter pursuant to rule 5101:2-16-30 of the Administrative Code.

(c)      Round the family's FPL determined in paragraph (A)(4)(b) of this rule up to the next five per cent (for example, one hundred two per cent FPL is rounded to one hundred five per cent FPL).

(d)      Using the FPL determined in paragraph (A)(4)(c) of this rule, multiply by one hundred per cent of the FPL for the corresponding family size and divide by twelve, rounding up to the nearest dollar to determine the maximum monthly income.

(e)      Using the chart in appendix A to this rule, multiply the maximum monthly income as determined in paragraph (A)(4)(d) of this rule by the appropriate copay multiplier, round to the nearest whole dollar, multiply by twelve, and divide by the number of weeks in the current state fiscal year to determine the family's weekly copay.

(B)      How is a copayment distributed?

(1)      The copayment amount shall be equally distributed among all authorizations each week.

(2)      The distributed copayments shall be rounded down to the nearest whole dollar.

(3)      The caretaker shall be notified of the copayment amounts.

(C)     How long is a family copayment effective?

The copayment shall be assigned at the time the county agency determines eligibility and the copayment amount shall be in effect for the entire eligibility period unless any of the following occurs:

(1)      The caretaker reports a change in family income, family size, or both, that reduces the amount of the copayment.

(2)      A documented increase in family income or a reduction in family size occurs within the first thirty calendar days of the date of eligibility determination.

(3)      An incorrect copayment was assessed by the county agency as a result of agency error, recipient error, or recipient fraud, resulting in corrective action to reduce or increase the family's copayment.

(4)      The Ohio department of job and family services (ODJFS) requires a change in the copayment.

(5)      The caretaker is no longer receiving protective child care as described in rule 5101:2-16-30 of the Administrative Code.

(D)     When is a copayment recalculated?

(1)      The copayment shall be recalculated for any reason listed in paragraph (C) of this rule and as part of the annual redetermination, reinstatement of eligibility, or continuation of eligibility due to the loss of a qualifying activity.

(2)      Any change to the copayment made at the time of the redetermination, extension of eligibility due to loss of qualifying activity, or reinstatement shall be effective from the first day of the new corresponding eligibility period.

(3)      Copayments may increase at the time of redetermination, or reinstatement approval, and the addition of an activity after an eligibility continuation for loss of activity pursuant to rule 5101:2-16-30 of the Administrative Code.

(E)      When shall the county agency waive the copayment?

The county agency shall waive the copayment for families eligible for protective child care benefits pursuant to rule 5101:2-16-30 of the Administrative Code.

(F)      Is a copayment adjusted if the caretaker does not utilize all of the authorized hours?

A family shall be required to pay the copayment assigned for a child's authorization or the child's cost of care for the week, whichever amount is lower. The child's cost of care for the week includes payment to the provider for absent days.

(G)     Is a provider required to collect the copayment?

The provider will be notified of the amount of the copayment that is assigned for a child's authorization and shall be responsible for collecting all assigned copayments.

(H)     What happens if the caretaker does not pay the copayment?

(1)      The provider shall establish a written agreement for payment of the copayment. The agreement shall be signed and dated by both the caretaker and the provider.

(2)      The provider shall give a copy of the written agreement to the caretaker and shall retain a copy for review by the county agency.

(a)      If an assigned copayment is delinquent more than two weeks from the date established in the written copayment agreement, the provider shall submit a record of the delinquent copayment to the county agency no later than three weeks from the date the copayment was due.

(b)      If the county agency has verified that the copayment is delinquent, child care benefits shall be terminated after the caretaker has been provided prior written notice of the action. The county agency shall notify the caretaker by sending the JFS 4065 "Prior Notice of Right to a State Hearing" (rev. 05/2001) or its computer-generated equivalent.

(c)      A caretaker shall be ineligible for child care benefits if a delinquent copayment is owed, unless satisfactory arrangements are made to pay the delinquent copayment. Arrangements to pay a delinquent copayment shall be satisfactory to both the caretaker and the provider.

Effective: 10/1/2017

Five Year Review (FYR) Dates: 3/1/2019

Certification: CERTIFIED ELECTRONICALLY

Date: 09/15/2017

Promulgated Under: 119.03

Statutory Authority: 5104.34, 5104.38

Rule Amplifies: 5104.01, 5104.30, 5104.34, 5104.38

Prior Effective Dates: 4/1/90 (Emer.), 6/22/90, 5/1/91 (Emer.), 7/1/91, 11/1/91 (Emer.), 1/20/92, 7/6/92 (Emer.), 10/1/92, 6/1/93 (Emer.), 7/2/93 (Emer.), 8/20/93, 10/2/95 (Emer.), 12/26/95, 10/1/97 (Emer.), 12/30/97, 1/1/99, 2/14/02, 6/9/03, 2/1/05 (Emer.), 4/1/05, 7/1/05 (Emer.), 10/1/05, 7/1/06, 2/1/07, 7/1/07, 7/1/08, 7/23/09 (Emer.), 10/21/09, 5/28/10, 7/1/11 (Emer.), 9/29/11, 6/23/13, 3/2/14, 9/14/14, 9/28/15, 12/31/2016