This category contains the following information:
Calculating the Copayment
Effective May 28, 2004
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WAC 170-290-0075 What steps
does the WCCC program take to determine my family's WCCC eligibility
and copayment amount?
- The WCCC program takes the following steps to determine your WCCC
income eligibility and copayment:
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Determine your family size (under WAC 170-290-0015); and
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Determine your countable income (under WAC 170-290-0065).
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If your family's countable income falls
within the range below, then your copayment is:
| YOUR INCOME: |
YOUR COPAYMENT IS: |
| At or below 82% of the FPL |
$15 |
| From 82% to 137.5% of the FPL |
$50 |
| From 137.5% to 200% of the FPL |
The dollar amount equal to subtracting 137.5% of
FPL from countable income, multiplying by 44%, then adding $50. |
| Income above 200% of the FPL, you are not eligible
for WCCC benefits. |
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We do not pro rate the copayment when you use care for part of a month.
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Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
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Clarifying Information
WCCC requires all families pay
a portion of the child care costs. This is called a "copayment".
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The minimum copayment is $15 per month and varies according to the family size and income.
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The copayment does not vary with:
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The number of children in care;
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The amount of care they need; or
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The type of care they choose to use.
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SSPS automatically deducts the copayment from the DSHS payment.
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The consumer is responsible for the copayment.
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A consumer becomes ineligible for WCCC if they:
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Fail to pay the copayment to the provider;
or
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Fail to make satisfactory arrangements with the provider to pay.
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EXAMPLE
Kim has two children. Her expected average monthly
income is $2,500. She pays $300 in child support for a child who does
not live with her. Take the following steps to determine the child
care copayment:
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$2,500 is the "expected average monthly
income". Kim's countable income is $2,200 or ($2,500 - $300).
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Use Kim's countable income, $2,200, to determine her monthly copayment amount. Since her countable income is over 137.5% ($1,968) and less than 200% ($2,862) of the FPL for a family of three, Kim's copayment is calculated by subtracting 137.5% of the FPL from the countable income, multiplying by 44%, and then adding $50. ($2,200 - $1,968) x 44% + $50). Kim's regular monthly copayment to her child care provider is $152.
NOTE: This computation is automatically computed by the WCAP; you do not need to compute this manually.
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WORKER RESPONSIBILITIES
If you need to process a reimbursement for an incorrect copayment amount, refer to the Reimbursement section of the manual. If the provider tells you the consumer has not paid their copayment, give the client a 10-day notice of termination. If they make satisfactory payment arrangements with the provider (current or previous) and remain otherwise eligible, you can re-open child care.
Effective May 28, 2004
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WAC 170-290-0085 When might my
WCCC copayment change?
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Once we determine that you are
eligible for WCCC benefits, your copayment could change when:
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Your monthly income decreases;
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Your family size increases;
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We make an error in your copayment
computation;
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You did not report all income,
activity and household information;
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You are no longer eligible for the minimum copayment under WAC
170-290-0090;
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We make a mass change in benefits due
to a change in law or program funding; or
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You are approved for a new eligibility
period.
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If your copayment changes during your
eligibility period, the change is effective the first of the month
following our becoming aware of the change.
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We do not increase your copayment during
your current eligibility period when your countable income remains
at or below two hundred percent of the FPL, and:
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Your monthly countable income
increases; or
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Your family size decreases.
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Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
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CLARIFYING INFORMATION
A consumer may have an income increase or family size decrease that does not change their copayment. If they are still under 200% of the FPL do NOT increase the copayment during their current eligibility period.
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EXAMPLE 1
You authorized Jean for child care June 1st - Nov. 30th with a $50 copayment. She receives a $1.00 an hour raise on July 1st. You recalculate Jean's new countable income and it does not exceed 200% of the FPL. Jean's situation does not meet any of the criteria in
WAC 170-290-0085 for refiguring her
copayment. The copayment remains $50 until the end of her eligibility period, Nov. 30th, unless future changes require a copayment change.
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EXAMPLE 2
December 29 - You authorized Jason's children for child care from January 1st to May 31st with a $75 copayment.
March 13th - Jason reported he was married on March 2nd. His new wife, who is working, has one child who needs child care.
Using the new household size and income, the countable income does not exceed 200% of the FPL. The copayment remains $75 until the end of their eligibility period, May 31st, unless future changes require a copayment change.
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EXAMPLE 3
April 29 - You established a consumer's copayment at $50 for 5/1 to 10/31.
July 15 - You discover you incorrectly calculated the copayment. It should have been $250 per month. Increase the copayment to $250 effective 8/1 and send advance and adequate notice to the consumer. Establish an overpayment to the consumer for the months of May, June and July.
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EXAMPLE 4
July 15 - You re-approved a consumer for 8/1-1/31 with a $50 copayment.
July 25 - The consumer reports he will be starting a new job 8/1. Redetermine the consumer's eligibility based on the new income information. The new income would cause the copayment to be $125 instead of the $50. Do not increase the copayment since the consumer did not withhold this information as he did not know he had a new job at the time he reapplied. Since you already established the eligibility period, the copayment remains at $50 until 1/31 unless the consumer meets the criteria in WAC 170-290-0085 for a copayment change. |
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EXAMPLE 5
February 17 - You approved Daisy for WCCC until July 31, with a $200 copayment.
May 15 - Daisy reported she received a raise effective April 10th. Daisy's increase in income makes her ineligible for WCCC. Send Daisy a termination notice, following advance and adequate notice procedures. You establish an overpayment from April 10th, the date she began receiving the raise. |
Minimum Copayments
Effective May 28, 2004
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WAC 170-290-0090 When do I pay
the minimum copayment?
You pay the minimum copayment :
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If your countable monthly
income is at or below eighty two percent of the FPL;
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If you are a minor parent,
and are:
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Receiving TANF; or
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Part of your parent's or
relative's TANF assistance unit.
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For the first full month
following the month you get a job or apply for WCCC and we pay
benefits;
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If there is a break of at
least thirty days in your WCCC benefits due to your activity ending;
or
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If you received child care
benefits within the last thirty days immediately prior to the
eligibility period and you do not meet the qualifications in
subsections (1) through (4) of this section, your copayment will be
computed according to WAC
170-290-0075.
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Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
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CLARIFYING INFORMATION
The intent of applying the minimum copayment for the first full month
following the month of application/benefits to the WCCC program is to
provide relief to families just applying for WCCC or the newly employed.
Although the WAC language does not directly specify, the intent is also to
allow for the minimum copayment in the first month of benefits.
The rule is not intended as a one-time lifetime limit for families. You can apply the minimum copayment rule again if a consumer has a break in their WCCC of more than 30 days due to their approved activity ending.
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EXAMPLE 1
April 1 - You determined Mrs. Jones (non-TANF) eligible with an eligibility period of April 1 - August 31. She received the $15 copayment in April (her first month) and May (the first full month following her eligibility according to WAC 170-290-0090(3)).
July 31 - You sent her a reapplication packet and asked her to return it on or before August 15th.
August 31 - You terminated the case effective 8/31 because Mrs. Jones didn't return the packet.
October 10 - Mrs. Jones sends the reapplication packet. From the reapplication packet, you see she has not worked for 45 days but now has new employment. You determine Mrs. Jones is eligible for WCCC and you allow the minimum copayment again for October and November.
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EXAMPLE 2
Same example as above, but Mrs. Jones remained at her same place of
employment. Her break in WCCC was due to her not returning her
reapplication information. She is not eligible for the minimum
copayment. |
Non-TANF minor parents
You can assess to non-TANF minor parents a copayment above the minimum amount. See WAC 170-290-0075. You verify and count toward eligibility and the copayment all non-exempt income, as with other non-TANF families.
Third Party Copayments
The consumer may make arrangements for someone else, (a "third party"), to pay a portion or all of the copayment directly to the child care provider.
We do not count this payment made directly to the provider as income received by the parent. We do not count it towards household income.
Copayments and the Social
Service Authorization (DSHS 14-154)
SSPS only deducts the copayment from
the overall child care payment when it is included on a Social Services
Authorization (DSHS 14-154) that has other service lines specific to payment
for care.
For this reason, many workers set up the copayment(s) to be on the first
several lines, followed by a payment for daily care. WCAP defaults to
entering the copayment on the first line of an authorization. See the figure below as
an example.
Splitting Copayments
- The WCCC program does not support splitting copayments between providers as a normal practice. However, there may be unusual circumstances in a child care case that call for splitting the copayment. A consumer may also request their copayment be split among providers.
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EXAMPLE
You determined Juanita eligible for WCCC with a $250 copayment. She has 2 children who need care; a school-age child and an infant.
The school-age child needs half-day care only in the afternoon at an after-school program.
Compute:
16 days per month X $10.36 per day = $165.76
The infant needs half-day care at a center.
Compute:
16 days per month X $13.86 per day = $221.76
The copayment may be split:
|
| School-age Child (Authorization #1) |
| Line 1 |
2963 |
$125.00/ea |
1 |
$125.00 |
| Line 2 |
2947 |
$10.36/da |
16 |
$165.76 |
| Infant (Authorization #2) |
| Line 1 |
2963 |
$125.00/ea |
1 |
$125.00 |
| Line 2 |
2947 |
$13.86/da |
16 |
$221.76 |
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If a consumer has both a licensed and in-home / relative care provider, you do not need to split the copayment unless the consumer specifically requests it. Also, you don't have to assign the copayment to the licensed provider only. Give the consumer a choice of assigning the copayment to either provider.
Adjusting Copayments
The copayment should never exceed the actual cost of care. If the consumer only uses a small amount of care the copayment may be more than the cost of care.
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EXAMPLE
Liv has one three year old child. You authorize 22 full-days from 1/1 to 6/30 at the State rate of $23.00. The copayment is $200 per month. On May 5th Liv was laid off and no longer needs child care. The provider is eligible to bill for absent days. Using the May calendar the provider can bill 9 days $207.00 (9 X $23.00). The family used 5 days and is responsible to pay $115.00 ($23.00 X 5). WCCC will pay $92.00 ($23.00 X 4) for the absent days.
The provider receives a total of $207.00 ($115.00 from the consumer for the copayment and $92.00 from the State) for all 9 days.
The authorization will look like:
Line 1 2963 $115.00 (Not $200) 1 $115.00
Line 2 2948 $23.00/day 9 $92.00 ($207.00-$115.00=$92.00)
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