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

(A) How is a family copayment determined?

(1) Each family with a monthly income of ten 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 ten per cent of the FPL shall have a weekly copayment based on family size and gross monthly income.

(3) The family copayment shall not exceed ten per cent of the family's gross monthly income.

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

(5) To calculate the family's copayment, the county department of job and family services (CDJFS) shall:

(a) Determine the family's monthly income pursuant to rule 5101:2-16-34 of the Administrative Code.

(b) Divide the family's monthly 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 to determine the maximum monthly income, rounding to the nearest dollar.

(e) Using the chart in appendix A to this rule, multiply the maximum monthly income as determined in paragraph (A)(4)(c) 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 long is a family copayment effective?

The copayment shall be assigned at the time the CDJFS determines eligibility and the copayment amount shall be in effect for the entire twelve month 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 CDJFS 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.

(C) When is a copayment recalculated?

The copayment shall be recalculated for any reason listed in paragraph (B) of this rule and as part of the annual redetermination or reinstatement of eligibility. Any change to the copayment made at the time of the redetermination or reinstatement shall be effective from the first day of the new eligibility period or at the time of the reinstatement approval.

(D) When shall the CDJFS waive the copayment?

The CDJFS shall waive the copayment for families eligible for protective child care benefits as described in rule 5101:2-16-30 of the Administrative Code.

(E) How is a copayment distributed?

The copayment amount will be equally distributed among all authorizations within a week. The caretaker will be notified of the copayment amounts.

(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 CDJFS.

(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 CDJFS no later than three weeks from the date the copayment was due.

(b) If the CDJFS 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 CDJFS 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.

Replaces: 5101:2-16-39

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Effective: 03/02/2014
R.C. 119.032 review dates: 03/01/2019
Promulgated Under: 119.03
Statutory Authority: 5104.34 , 5104.38
Rule Amplifies: 5104.01 , 5104.30 , 5104.34 , 5104.341
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