Effective Date: 11/01/04
Revised: 5/1/10, 6/15/10, 4/1/11, 7/1/12, 7/1/13
Reference: 89 Ill. Adm. Code, Chapter IV, §50.310; 45 CFR Part II, Subpart E, §98.42;
All participants must share in the cost of child care except relatives (other than parents) who receive a child-only TANF or GA benefit for children needing care due to the relatives' employment.
These procedures apply to CCR&Rs and Site Administered Providers.
Use WAG 25-03-14-a: Table A Copayments for all families for the service months of June, July and August.
For the service months of September through May, use Table A for all families not covered by WAG 25-03-14-a: Table B Copayments.
Use WAG 25-03-14-a: Table B Copayments during September through May only when all of the children in care are school age (age 5 or older as of the month of September of each school year) and are approved for less than 5 hours of care. This also applies to families whose children are in year-round school.
I. General Guidelines for Assessing the Monthly Copayment
The parent's copayment is based on the family's gross monthly income and family size. In addition to the copayment, the parent is responsible for all other costs charged by the provider that are not reimbursed by CCAP. Refer to Policy 04.03.01 for other potential costs to the parent.
- To determine the monthly copayment, include income from all sources unless the income is on the exempt income list. (see section 01.02.03)
- In general, the copayment shall be allocated to the child having the highest reimbursement from the state to avoid the need to allocate a portion of the copayment to multiple children or multiple providers.
- When the family has only one provider, the copayment shall be allocated to the youngest child first. If the copayment exceeds the approved cost of care for the youngest child, the remaining amount shall be allocated to the next oldest child. This method shall be used until the full parent copayment has been allocated. For CCR&Rs or site providers entering cases, the child care tracking system will allocate the copayment automatically.
- Payment will not be made by the State if the monthly copayment exceeds the approved cost of care for all eligible children. Add the following language to the approval notice until the form can be permanently changed: "If the assessed copayment exceeds the actual cost of care, then the parent pays the actual cost of care and no payment is made by the state."
- Parents are responsible for paying the copayment directly to the provider. IDHS considers the collection of the monthly copayment to be between the parent and the provider.
- Use WAG 25-03-14-a: Table B Copayments only if:
- All of the children in care are school-age (age 5 or older as of the month of September of each school year), and
- All of the children in care are approved for part-day/school age rate (less than 5 hours per day) unless full time days are needed to cover week days the school is not in session (holidays, in-service days, snow days...). If any full time days are approved based on the client's activity schedule, chart A must be used,and
- The care is provided during the months of September through May.
- Use WAG 25-03-14-a: Table A Copayments in all other instances.
Example 1: Ms. A has one school age child, and one child who is age 3. Use Table A Copayment for family size of 3 for all months of care.
Example 2: Mr. B has 3 school age children who receive care during the month of April. Use Table B Copayment for family size of 4 for April and May. Use the Table A copayment for care provided in June, July and August.
Example 3: Ms. C has 2 school age children who attend a school with a year-round schedule. School is in session in June, but not in December. Use Table A copayment for family size of 3 for care provided in June, July, and August. Use the Table B copayment for care provided in September through May including December.
II. How to Assess the Copayment when the Parent has More Than One Provider
If a family has more than one child care provider, only one provider is assessed and collects the copayment.
- If all of the providers are paid through the CCR&R, the CCR&R shall assign the copayment to the provider receiving the highest reimbursement from IDHS, taking into account the amount of the copayment and the amount of the child care charges. The provider(s) not collecting a copayment will be reimbursed the full amount of the child care charges up to the maximum state rate.
- If the family has both a Site Administered Provider and a provider paid through the CCR&R, the copayment shall be assigned to the Site Administered Provider. The Site Provider must give the CCR&R a copy of the Approval Notice for the case record.
- If the family uses two Site Administered Providers, the copayment shall be assigned to the Site receiving the highest reimbursement from IDHS, taking into account the amount of the copayment and the amount of the child care charges. The Site not collecting a copayment will be reimbursed the full amount of the child care charges up to the maximum state rate. This should be determined while the Sites are completing the Shared Case forms.
- If the copay exceeds the amount charged to the first provider, the second provider shall be assessed the remainder. This situation doesn't happen very often.
III. Changes in the Copayment Assessment
The copayment shall be calculated at the time of application and when a redetermination is conducted.
- If you receive new earned income information due to a change in a family member's hourly rate or number of hours worked, recalculate the income to ensure the case remains eligible and case note the date you received the new information along with the new total monthly income amount. Do not change the copay or increase the earned income amount in the CCTS until the next eligibility period UNLESS THE INCREASE IN INCOME IS DUE TO A NEW JOB OR AN INCREASE IN UNEARNED INCOME. If the increase is due to an error in a prior calculation, a new job, or an increase in unearned income, adjust the copay accordingly (refer to C. below). Sites using DEFs do not need to submit a Change of Information to CCELIG if the co-payment is not being changed. Case note the file and include them with the next redetermination. There are other events that will increase the copayment during the eligibility period. Some of these events are identified in Section E of this part.
- Families continue to be subject to the gross income limit and shall report all increases in income within 10 calendar days even if the change does not immediately affect the copayment. If the parent is determined to be over income, cancel the case giving 10 calendar days notice in accordance with Policy 02.07.01.
- A change in the monthly copayment shall be implemented on the first of the month following the month in which the change is reported and documented. Parents who report a decrease in income must provide written documentation to support the reduction in copayment.
- Do not adjust the copayment for vacation, illness, center closure, or when care begins or ends mid-month. The State is responsible for the costs in excess of the assessed copayment up to the state maximum rates. See example in section IV. (C) of this part. The parent is responsible for additional costs charged by the provider that are not reimbursed by CCAP.
- Following are some situations that may increase a parent's copay during the current eligibility period (this list is not all inclusive):
- adding a spouse and spouse's income,
- adding a second job or changing jobs,
- changing the need for care (i.e. the parent stops going to school and starts a new job),
- returning to work from a medical or maternity leave or after a job search,
- adding or increasing other non-exempt income.
IV. Collecting the Copayment
- All providers in the IDHS Child Care program are required to collect the monthly copayment and keep records of this collection. IDHS may ask for copies of records of parent copayment collection.
- Providers are encouraged to collect the fees before the service is given or use fee collection policies developed for private pay parents.
- IDHS automatically deducts the assessed monthly copayment for each family from the total charges billed on the Child Care Certificate or Monthly Enrollment Report during the payment process.
A provider should still submit the Certificate or MER for billing purposes even if the copayment exceeds the payment amount so the provider can be paid for any additional add-on fees for which the provider is eligible.
Example: Eligibility begins on 4-29-10. The monthly copayment is calculated to be $200. The provider bills the state for 2 days of care at $24.00 per day. The total charge for the month of April is $48.00. Since the copayment of $200 exceeds $48, the provider should only collect $48 from the parent for the first month of care. The state will pay the provider for the other fees such as QRS, Infant/Toddler, etc. for which they are eligible.
V. Changing Providers
- Managing the copay
Families shall pay their monthly co-payment to the provider that is approved on the first day of the month. Consequently, if a family changes providers anytime after the first day of the month, the first provider shall collect the whole monthly copayment. If charges for care are less than the monthly copayment, the provider shall collect the smaller of the two amounts. The new provider will not collect a copayment until the first of the following month.
Example A: A family's monthly co-payment is $100.00. Provider A is the current provider and charges $25.00 a day. If the last day of care at Provider A is July 2, the parent will pay Provider A $50.00 ($25.00 x 2 days of care). The charges for care used are less than the monthly co-payment. The new provider will not collect a co-payment during the month of the change but will begin collecting $100 on August 1.
Example B: A family's monthly co-payment is $100.00. Provider A is the current provider and charges $25.00 a day. If the last day of care with Provider A falls on July 10, the family will pay their full monthly co-pay to Provider A and will pay nothing to the new provider for July (the month of the change). On August 1 the new provider should collect $100.
- Effective Date of Change
Parents are responsible for reporting all changes within 10 calendar days (whether via phone, walk in, fax, mail, etc.). The CCR&R shall issue the COP form to the parent (if initial report of change was not in writing via a COP form), and the parent has 10 business days to complete and return the form. If the provider change is not reported within 10 calendar days and documented in writing with the COP form within 10 business days, the change will take effect the month the documentation is received.
Example C: Client calls the CCR&R to report a COP on June 1. The new provider started on May 28. CCR&R sends client the COP form and client returns the COP form within 10 business days. The effective date of the change will be May 28.
Example D: Client calls the CCR&R to report a COP on June 1. The new provider started on May 28. CCR&R sends the client the COP form, but the CCR&R doesn't receive the COP form until September 15. Meanwhile, the case was canceled on June 15, because the client did not document the COP within 10 business days. In this example, the client would be required to complete a new application.
Example E: Client calls the CCR&R to report a COP on June 1. The new provider started on May 28. The CCR&R sends the client the COP form. The CCR&R receives the COP on July 7. The case was canceled on June 15, because the client did not document the COP within 10 business days. Since the case has not been closed for more than 30 days, the CCR&R will process the COP. Even though the change was reported via telephone timely, the paperwork to process the change was not received timely. Therefore, the effective date of the change will be July 1.
- A representative payee (RPY) of a child who receives a TANF or GA benefit who is not a parent/stepparent who works outside the home is exempt from making a copayment. See 01.03.04 for additional information regarding RPYs.
- Single parent households called to active duty and two-parent households having both parents called to active duty at the same time shall have the copayment waived during the time the parents are deployed. Active duty does not include routine, one weekend per month reserve duty. See 01.03.07.