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Family Share Copayment

The copayment is the amount the household is responsible for paying the child care provider each month. The provider is responsible for collecting this copay each month.

How the copayment works?

The cost of care a child uses in a month must exceed the copay amount in order for DHS to make a payment. DHS pays the provider the contracted rate for the cost of care not covered by the copayment. When the household owes a copayment, the copayment amount is applied to the cost of care used before DHS pays for care. For example, if the copayment is $200 and the DHS rate is $25 per day, DHS will start paying the provider on the 9th day the child attends.

When the client pays his or her copayment and then does not use that much care, the provider must reimburse the client. When provider refuses to reimburse the client, notify Child Care Subsidy.

How do we determine the copayment?

The household’s countable income and family size determine the copayment amount based on the amounts listed on the Appendix C-4. If the family’s income is low enough or a child is predetermined eligible, the copayment may be zero.

One copayment per case

The system only calculates one copayment per case. It covers all children in the household who need care, and it is paid to a single child care provider.

The system coding determines which provider collects the copayment. When a household uses more than one provider, we assign the full copayment to the provider who provides the most costly care. Identify which provider delivers the most costly care. Consult the Appendix C-4-B to determine the cost of care for each child. Cost of care varies depending on the child's age, unit type, star status, and provider type. Add the cost for each child in care with a provider and then add these totals together.

In FACS, the co-pay exempt field (K78) determines which provider will collect the copayment. Use K-78 “N-NOT CO-PAY EXEMPT” for the provider responsible for the copayment and “S-SECOND PROVIDER FOR THIS CASE (CO-PAY EXEMPT)” for the other providers.

Step-by-step instructions are available here.

Locked-in

The family’s copayment amount is set at approval. Anticipated changes based on the verification you have at approval will take effect. An example is when household income is not available at approval but verification shows it becomes available in the second or third month of eligibility. Use the unfinished issuance process at the initial application or the Remedy process at renewal to ensure the system correctly considers the household’s income. See the Quest instructions for these processes here.

Once you address all verified changes from the approval, the copayment does not increase during the eligibility period. When the household verifies a decrease in household income, the system will lower the copayment, but increases in income will not raise the copayment until the renewal.

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