01.02.04 - Parent Income & Copay Calculation Worksheet

Effective Date: 01/01/2014; 07/01/15

Revisions: 08/08/2019, XX/XX/2020, 07/01/2021
Reference: 89 Ill. Adm. Code, Chapter IV, §50.235 


Parent Income & Copay Calculation Worksheet

Income Calculation Worksheet (xlsx)

*The Parent Income Calculation Worksheet has four (4) spreadsheet tabs - See the tabs at the bottom of the spreadsheet screen:

"Instructions" Tab

Please review the instruction on the first tab to assist you with completing the worksheet correctly.

"Co-payment Calculator" Tab 

The Copayment Calculator tab allows users to input basic income information from pay documentation to calculate income that will be used to determine eligibility for the Child Care Assistance Program (CCAP) and assess the amount the family will be required to pay the provider (co-payment). Please Note: The results are considered an estimate and require a CCAP Specialist's review.

If you have any questions about how to use the Parent Income Calculation Worksheet, please contact the CCAP Policy Unit at: DHS.CCAP.Policy@illinois.gov.

How to Complete a Parent Income Calculation Worksheet

The following step-by step instructions must be used when completing the Parent Income Calculation Worksheet.  Each number below refers to the field numbers listed on the worksheet.

  1. Upon opening the document, the current date will appear.
  2. Enter the client's first and last name.
  3. Enter the client's CCMS case number.
  4. Enter the Net Self-employment Income from client's documentation according to payment frequency.
    1. Net self-employment income is calculated by subtracting allowable business expenses from gross income.  See CCAP Policy 01.03.02 II for additional information.
  5. Enter the Net Self-employment Income from other family member(s) documentation according to payment frequency.
  6. The worksheet will convert the amounts entered to Monthly Self-employment Income by multiplying Net Self-employment Income according to pay frequency using the formulas below:
  • If Weekly Amount: by 4.333
  • If Bi-weekly Amount: by 2.1666
  • If Semi-Monthly Amount: by 2
  • If Monthly Amount: by 1
  1. The worksheet will calculate  the Adjusted Monthly Self-employment Income for each pay frequency.
  2. Worksheet will calculate and enter the Total Monthly Self-employment Income.
  3. Enter the Date (xx/xx/xxxx) and Gross salary (hourly rate of pay x number of hours + tips + commission) from the Client's earliest pay stub according to pay frequency.
  4. Enter the Date and Gross Wages and Salary (hourly rate of pay x number of hours + tips + commission) from the Client's latest pay stub according to pay frequency.
  5. Enter the Date and Gross Wages and Salary (hourly rate of pay x number of hours + tips + commission) from the 2nd parent/stepparent's earliest pay stub according to pay frequency.
  6. Enter the Date and Gross Wages and Salary (hourly rate of pay x number of hours + tips + commission) from the 2nd parent/stepparent's latest pay stub according to pay frequency.
  7. Enter the Date and the combined Gross Wages and Salary (hourly rate of pay x number of hours + tips + commission) of all other adults, 21 years of age and older, counted in the family size - Use earliest dated pay stub according to pay frequency.
  8. Enter the Date and  the combined Gross Wages and Salary (hourly rate of pay x number of hours + tips + commission) of all other adults, 21 years of age and older, counted in the family size - Use latest dated pay stub according to pay frequency.
  9. The worksheet computes the Gross Wages and Salary Sub-Total for the income amounts entered in each of the four columns: Weekly, Bi-weekly, Semi-monthly, and Monthly.
  10. The worksheet averages the two pay stubs by dividing the results by (2).
  11. The worksheet converts the entered income to Monthly Base Income from Wages and Salary by multiplying the Averaged Income from Wages according to pay frequency using the Formulas below:
  • If Weekly: by 4.333
  • If Bi-weekly: by 2.1666
  • If Semi-monthly: by 2
  • If Monthly: by 1
  1. The worksheet enters the Monthly Base Income from Wages and Salary.
  2. The worksheet calculates and enters the Prospective Monthly Base Wages for the family by adding the Weekly, Bi-Weekly, Semi-Monthly, and Monthly columns.

 20a. Enter all Monthly Child Support received for the family.

 20b. Enter all Monthly TANF Cash Assistance received for the family.

 20c. Enter all Monthly Other Federal Cash Assistance received for the family.

 20d. Enter all Other Monthly Income received for the family.

  1. Enter Monthly Child Support Paid by Applicant and Other Family Members included in the family size.
  2. The worksheet calculates and enters the Total Additional Income per Month by adding lines 20a-20d, then subtract Line 21.
  3. The worksheet calculates and enters Combined Gross Monthly Base Income for Family by adding the Total Self-employment Income (line 8), Prospective Monthly Income from Base W/S (line 19), and Total Additional Income per Month (line 24).
  4. Enter the Family Size as indicated on the application.  See CCAP Policy 01.01.02 - Family Composition.
  5. Indicate whether this calculation is for an Initial Application or a Redetermination.
    1. There are different income levels for new applications and for cases having their eligibility redetermined within 30 days of the last approval.
  6. The worksheet will assess and enter the Table A (Full-Time) Parent Co-payment. If the applicant is not eligible, this will display "Over Income".  If the calculation is for a Redetermination and the applicant's income qualifies the case for Graduated Phase Out, this field will display "Grad. Phase Out" along with the full-time copayment amount.

  To convert the Table A Copayment (full-time) amount to a Table B Copayment (part-time) amount, divide the Table A  Copayment amount by 2. Refer to CCAP Policy 04.02.01 for more information on assessing the monthly copayment.

"New Application (200%)" Tab

The chart on this tab shows the co-payment amount that will be assessed by the worksheet based on family size and total income amount.  The worksheet automatically refers to this chart when the sheet is completed and "initial" is selected as the Application Type in box 26.

"Rede (250%)" Tab

The chart on this tab shows the co-payment amount that will be assessed by the worksheet based on family size and total income amount.  The worksheet automatically refers to this chart when the sheet is completed, and "redetermination" is selected as the Application Type in box 26.