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.
(E)When shall the
county agency waive the copayment?
The county agency shall waive the copayment for families eligible
for protective or homeless 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.
(1)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.
(2)The family shall not be required to pay
the copayment when only absent days or professional development days are reported,
with no attendance in the week.
(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: 12/16/2018
Five Year Review (FYR) Dates: 3/7/2018 and 12/16/2023
Certification: CERTIFIED ELECTRONICALLY
Date: 12/06/2018
Promulgated Under: 119.03
Statutory Authority: 5104.34, 5104.38
Rule Amplifies: 5104.01, 5104.30, 5104.34, 5104.38
Prior Effective Dates: 04/01/1990 (Emer.), 06/22/1990, 05/01/1991
(Emer.), 07/01/1991, 11/01/1991 (Emer.), 01/20/1992, 07/06/1992 (Emer.), 10/01/1992,
06/01/1993 (Emer.), 07/02/1993 (Emer.), 08/20/1993, 10/02/1995 (Emer.), 12/26/1995,
10/01/1997 (Emer.), 12/30/1997, 01/01/1999, 02/14/2002, 06/09/2003, 02/01/2005 (Emer.),
04/01/2005, 07/01/2005 (Emer.), 10/01/2005, 07/01/2006, 02/01/2007, 07/01/2007,
07/01/2008, 07/23/2009 (Emer.), 10/21/2009, 05/28/2010, 07/01/2011 (Emer.), 09/29/2011,
06/23/2013, 03/02/2014, 09/14/2014, 09/28/2015, 12/31/2016, 10/01/2017