5101:2-16-39 Copayment for publicly funded child care benefits.

 

 

 

5101:2-16-39               Family copayment requirement.

 

 

 

(A)    Each family with a monthly income of ten dollars or more shall be assessed a monthly copayment based on family size and the family's gross monthly income. The copayment shall be based on the calculation of total monthly income, pursuant to paragraph (G)(3) of rule 5101:2-16-34 of the Administrative Code, whenever partial or no income is received for the month and child care services are used for the month. The family's monthly child care copayment is a per child-in-care copayment with a copayment cap for two children in care and shall be determined according to the "Child Care Copay Copayment Table" that appears in appendix A of this rule. A family's monthly copayment shall not exceed ten per cent of the family's monthly income.

 

(B)   The initial determination of the family's child care copayment shall be established at the time the family submits an application and supporting documentation. The family's child care copayment shall be reviewed and adjusted, including increases to the copayment if necessary, at the sixth month of the twelve month eligibility period by utilizing one of the following:

 

(1)   Information regarding family composition and income reported by the caretaker since the last redetermination and contained in the case record; or

 

(2)   Information regarding family composition and income obtained at the six month review as required by the eligibility determiner.

 

(C)   A redetermination of the family's copayment shall be completed by the end of the twelve month eligibility period at the time the family submits a newly completed and signed application and supporting documentation. Determination of the family's child care copayment shall be in effect for each entire six month period unless any of the following occurs:

 

(1)   The caretaker requests that the copayment be reduced due to changes in family income, family size, or both, and the eligibility determiner approves the reduction.

 

(2)    At the time of the initial eligibility determination, a documented increase in family income occurs within the first thirty days of eligibility.

 

(3)   An incorrect copayment was assessed by the eligibility determiner 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 family ceases to be eligible for publicly funded child care benefits.

 

 

 

(D)     All copayments are established on a calendar month basis, and all changes in copayment amount shall be made effective the first of a calendar month.

(E)   Notice and hearing requirements contained in division-level designation 5101:6 of the Administrative Code shall apply to changes to a family's copayment. When the eligibility determiner intends to increase the copayment, the family shall be provided prior written notice of the action. The eligibility determiner shall use the JFS 04065 "Prior Notice of Right to a State Hearing", and the notice shall be mailed or personally delivered no less than fifteen calendar days prior to the proposed action. The eligibility determiner shall issue notice of a change in child care benefits to the family within ten days from the date the change of circumstance was reported by the caretaker.

(F)   The family's monthly child care copayment may be paid prior to service delivery.

(G)   All families shall pay a copayment for child care services unless it is the policy of the CDJFS that families eligible for protective child care benefits, in accordance with paragraph (K) (J) of rule 5101:2-16-30 of the Administrative Code, shall not pay a copayment.

(H)    A family shall not be required to pay any part of the family monthly copayment which exceeds the total cost of care. For for any month that child care services are provided, including the initial month of eligibility when the family shall pay the copayment or the cost of care, whichever is less.

(I) A family shall not be required to pay fees to the child care provider which are the responsibility of the CDJFS, pursuant to rule 5101:2-16-41 of the Administrative Code and the terms agreed to in paragraph 4 of the JFS 01224 "Purchase of Child Care Services Contract", including the difference between the reimbursement ceiling and the provider's customary charge to the public when the customary charge is higher.

(J)      In addition to the monthly child care copayment established by the eligibility determiner pursuant to paragraph (A) of this rule, the family may be required to pay fees which are not the responsibility of the CDJFS upon satisfactory arrangements with the child care provider. These types of fees include, but are not limited to, the following:

(1)   Late fees;

(2)   Activity fees;

(3)   Transportation fees;

(4)   Fees charged for absentee days which exceed those reimbursed by the CDJFS;

(5)   Fees charged by the provider for child care services which exceed the hours and days authorized by the eligibility determiner.

(K)   The copayment amount for which the family is responsible shall be subtracted from the provider's reimbursement prior to payment by the CDJFS.

(L)   Collection of the family's required copayment and fees listed in paragraph (J) of this rule shall be the responsibility of the provider who is providing child care services for the family.

(M)    The eligibility determiner shall inform the provider of the copayment to be paid by the caretaker.

(N)   The provider shall establish a written copayment and fee schedule, signed by both the provider and the caretaker, to which the caretaker must shall adhere.

(O)   When the caretaker's copayment is delinquent more than ten days from the due date established in the caretaker/provider written copayment schedule, a record of delinquent copayments shall be submitted by the provider to the eligibility determiner no later than fifteen days from the due date established in the caretaker/provider written copayment schedule.

(P)    Upon determination by the eligibility determiner that the caretaker's copayment is delinquent, notice of termination of child care benefits shall be terminated after the family has been provided prior written notice of the action. The eligibility determiner shall use the JFS 04065 "Prior Notice of Right to a State Hearing", and the notice shall be mailed or personally delivered no less than fifteen calendar days

prior to the proposed action Administrative Code.

mailed in accordance with rule 5101:6-2-04 of the

(Q)      Ineligibility for child care benefits will shall continue as long as delinquent copayments are owed, unless satisfactory arrangements are made to pay delinquent copayments. Arrangements to pay delinquent copayments must shall be satisfactory to both the caretaker and the provider.

Effective:                                07/18/2003 R.C. 119.032 review dates:                           11/30/2006

CERTIFIED ELECTRONICALLY

Certification

07/08/2003

Date

Promulgated Under:   119.03

Statutory Authority:   5104.38, 5104.34

Rule Amplifies:           5104.01, 5104.30, 5104.34,

5104.341, 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