CHAPTER 3042. SUBSIDIZED CHILD CARE ELIGIBILITY
GENERAL PROVISIONS Sec.
3042.1. Purpose.
3042.2. Scope.
3042.3. Definitions.
3042.4. Nondiscrimination.
GENERAL BENEFITS
3042.11. Provision of subsidized child care.
3042.12. Parent choice.
3042.13. Subsidy benefits.
3042.14. Payment of provider charges.
3042.15. Subsidy limitations.
3042.16. Prohibition of additional conditions and charges.
3042.17. Attendance.
3042.18. Absence.
3042.19. Subsidy continuation.
3042.20. Subsidy suspension.
3042.21. Subsidy disruption.
3042.22. Subsidy termination.
ELIGIBILITY REQUIREMENTS
3042.31. Financial eligibility.
3042.32. Residence.
3042.33. Work, education and training.
3042.34. Prospective work, education and training.
3042.35. Immunization.
3042.36. Citizenship.
3042.37. Eligibility of households including a parent or caretaker with a disability.
DETERMINING FAMILY SIZE AND INCOME
3042.41. Family size.
3042.42. Income counted.
3042.43. Income adjustment.
3042.44. Estimating income.
ELIGIBILITY DETERMINATION
3042.51. Application.
3042.52. Initial determination of eligibility.
3042.53. Effective date of coverage.
3042.54. Notification of eligibility status and availability of funding.
3042.55. Period of eligibility.
3042.56. Personal interview.
3042.57. Waiting list.
SELF-CERTIFICATION AND VERIFICATION
3042.61. General verification requirements.
3042.62. Collateral contact.
3042.63. Self-certification.
3042.64. Self-declaration.
3042.65. Verification of income.
3042.66. Verification of residence.
3042.67. Verification of work, education and training.
3042.68. Verification of circumstances relating to a decrease in copayment.
3042.69. Verification of identity.
3042.70. Verification of inability to work due to a disability.
3042.71. Verification of family size.
3042.72. Verification of a child’s incapability of caring for himself.
3042.73. Verification of care and control.
3042.74. Verification of foster child status.
ELIGIBILITY AGENCY RESPONSIBILITIES
3042.81. Eligibility agency.
3042.82. Eligibility determination.
3042.83. Confidentiality.
3042.84. Family file.
3042.85. Record retention.
3042.86. Change reporting and processing.
3042.87. Voluntary request to terminate subsidized child care.
3042.88. Child abuse reporting.
COPAYMENT AND PAYMENT BY THE DEPARTMENT
3042.91. General copayment requirements.
3042.92. Department’s payment.
3042.93. Adjusted copayment for prospective work.
3042.94. Parent or caretaker copayment requirements.
3042.95. Delinquent copayment.
3042.96. Eligibility agency responsibilities regarding copayment.
3042.97. Use of the Federal Poverty Income Guidelines and State Median Income.
3042.98. Copayment determination.
3042.99. Copayment exceeding monthly payment for care.
ELIGIBILITY REDETERMINATION
3042.101. Eligibility redetermination.
3042.102. Procedures for redetermination.
FORMER TANF FAMILIES
3042.111. General provisions for former TANF families.
3042.112. General requirements for former TANF families.
3042.113. Notification requirements for former TANF families.
3042.114. Personal interview requirements for former TANF families.
3042.115. Reporting requirements for former TANF families.
3042.116. Verification of transfer of TANF benefits.
3042.117. Failure to contact the eligibility agency following the transfer.
3042.118. Payment authorization for former TANF families.
3042.119. Retroactive payment for former TANF families.
3042.120. Transfer from other states.
3042.121. Expiration of TANF benefits.
3042.122. Verification of expiration of TANF benefits.
HEAD START
3042.131. General provisions for Head Start.
3042.132. Eligibility determination for Head Start.
3042.133. Eligibility redetermination for Head Start.
WAIVERS AND PERIODS OF PRESUMPTIVE ELIGIBILITY
3042.141. General waiver requirements.
3042.142. Time frame for waiver determinations.
3042.143. General verification requirements for waivers.
3042.144. General notification requirements for waivers.
3042.145. Domestic and other violence.
3042.146. Homelessness.
3042.147. Presumptive continued eligibility at redetermination.
NOTIFICATION AND RIGHT TO APPEAL
3042.151. General notification requirements.
3042.152. Notice of right to appeal.
3042.153. Notice of eligibility.
3042.154. Notice of ineligibility.
3042.155. Notice of adverse action.
3042.156. Notice confirming voluntary withdrawal.
3042.157. Notice confirming a change in benefits.
3042.158. Notice confirming a change in copayment.
3042.159. Notice of overpayment.
APPEAL AND HEARING PROCEDURES
3042.161. Appealable actions.
3042.162. Discontinuation of subsidy during the appeal process.
3042.163. Subsidy continuation during the appeal process.
3042.164. Parent or caretaker rights and responsibilities regarding appeal.
3042.165. Eligibility agency responsibilities regarding appeal.
3042.166. Hearing procedures.
OVERPAYMENT AND DISQUALIFICATION
3042.171. Overpayment.
3042.172. Eligibility agency responsibilities regarding overpayment.
3042.173. Delaying recoupment.
3042.174. Notifying the Department.
3042.175. Repayment.
3042.176. Collection.
3042.177. Copayment increase related to overpayment.
3042.178. Collection for a family whose child is no longer in care.
3042.179. Disqualification.
Appx.
A. Income to be Included, Deducted and Excluded in Determining Gross Monthly Income.
B. Copayment Chart.
C. Stepparent Deduction Chart.Authority The provisions of this Chapter 3042 added under sections 201(2), 403(b) and 403.1 of the Human Services Code (62 P.S. § § 201(2), 403(b) and 403.1), unless otherwise noted.
Source The provisions of this Chapter 3042 added December 15, 2023, effective December 16, 2023, 53 Pa.B. 7827, unless otherwise noted.
GENERAL PROVISIONS
§ 3042.1. Purpose.
This chapter establishes the requirements for a family to receive subsidized child care. Subsidized child care is a nonentitlement benefit made available through limited Federal and State funds.
§ 3042.2. Scope.
This chapter applies to child care eligibility agencies, child care providers, and parents and caretakers requesting or receiving subsidized child care.
§ 3042.3. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Adjusted family income—Gross countable family income, minus allowable deductions.
Annual income—The family’s adjusted monthly income, multiplied by 12 months.
Appeal—A written or oral request by a parent, caretaker or individual acting on behalf of a parent or caretaker for a hearing under Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings), indicating disagreement with a Departmental or eligibility agency action or failure to act that affects the family’s eligibility for subsidized child care.
Application—A signed, dated request by a parent, caretaker or individual acting on behalf of a parent or caretaker for subsidized child care.
CAO—County Assistance Office—The local office of the Department responsible for the determination of eligibility and service delivery in the Cash Assistance, Medical Assistance and Supplemental Nutrition Assistance Programs.
CRNP—Certified registered nurse practitioner.
Caretaker—An individual who has legal custody of the child or any one of the following individuals who lives with and exercises care and control of the child:(i) A foster parent.
(ii) A grandparent.
(iii) A great-grandparent.
(iv) An aunt.
(v) An uncle.
(vi) A sibling who is 18 years of age or older.
Child care—Care instead of parental care for part of a 24-hour day.
Collateral contact—A form of verification in which the eligibility agency obtains information from a third party.
Copayment—The weekly amount the family pays for subsidized child care.
Department—The Department of Human Services of the Commonwealth.
Disability—A physical or mental impairment that precludes a parent or caretaker from participating in work, education or training.
Disqualification—The prohibition against receipt of subsidized child care that results from fraud or an intentional program violation.
Domestic and other violence (domestic violence)—Includes one of the following:(i) A physical act that results in, or threatens to result in, physical injury to the individual.
(ii) Mental abuse, including stalking, threats to kidnap, kill or otherwise harm people or property, threats to commit suicide, repeated use of degrading or coercive language, controlling access to food or sleep, and controlling or withholding access to economic and social resources.
(iii) Sexual abuse.
(iv) Sexual activity involving a dependent child.
(v) Being forced as the caretaker or relative of a dependent child to engage in nonconsensual sexual acts or activities.
(vi) A threat of, or attempt at, physical or sexual abuse.
(vii) Neglect or deprivation of medical care.
Education—An elementary school, middle school, junior high or high school program including a GED program, an HSE degree, charter school, cyber school and any other program approved by the school district or the Department of Education.
Eligibility agency—The entity designated by the Department with authority to purchase subsidized child care and determine a family’s eligibility and copayment.
Eligibility determination—A decision regarding whether a family qualifies for the subsidized child care program and a determination of the copayment.
Eligibility redetermination—An annual review by the eligibility agency to determine if a family continues to qualify for subsidized child care, including a review of the copayment.
Employment—Working for another individual or entity for income.
FPIG—Federal Poverty Income Guidelines—The income levels published annually in the Federal Register by the United States Department of Health and Human Services.
Family—The child or children for whom subsidized child care is requested and the following individuals who live with that child or children in the same household:(i) A parent of the child.
(ii) A caretaker and a caretaker’s spouse.
(iii) A biological, adoptive or foster child or stepchild of the parent or caretaker who is under 18 years of age and not emancipated by marriage or by the court.
(iv) An unrelated child under the care and control of the parent or caretaker, who is under 18 years of age and not emancipated by marriage or by the court.
(v) A child who is 18 years of age or older but under 22 years of age who meets both of the following:
(A) Is enrolled in at least one of the following:
(I) Adult basic education.
(II) English as a second language course work.
(III) A high school or a GED program.
(IV) An HSE degree.
(V) An internship, clinical placement, apprenticeship, lab work or field work required by a training institution.
(VI) A post-secondary program leading to a degree, diploma or certificate.
(B) Is wholly or partially dependent upon the income of the parent or caretaker or spouse of the parent or caretaker.
Fraud—The intentional act of a parent or caretaker, at the time of application or redetermination, that results in obtaining, continuing or increasing child care subsidy for which the family is not eligible and that involves any of the following:(i) A false or misleading statement.
(ii) The failure to disclose information.
GED—A general educational development program approved by a school district or the Department of Education.
HSE—A high school equivalency degree approved by the school district or the Department of Education.
Head Start—Refers to Early Head Start or Head Start as follows:(i) Early Head Start—A program that serves families with at-risk children from birth to 3 years of age.
(ii) Head Start—A program designed to prepare at-risk children, 3 years of age or older but under 5 years of age, for school success.
Homelessness—Refers to a child who lacks a fixed, regular and adequate nighttime residence as specified in section 725(2) of the McKinney-Vento Homeless Assistance Act (42 U.S.C. § 11434a(2)), or the child’s parent or caretaker. The term includes:(i) Children and youth who are sharing the housing of other persons due to loss of housing, economic hardship or a similar reason; are living in motels or hotels due to the lack of alternative accommodations; are living in emergency or transitional shelters; or are abandoned in hospitals.
(ii) Children and youth who have a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings.
(iii) Children and youth who are living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings.
(iv) Migratory children who qualify as homeless for the purposes of this chapter because the children are living in circumstances described in subparagraphs (i)—(iii).
(v) Parents and caretakers of children who are living in circumstances described in subparagraphs (i)—(iv).
Income—Includes the following:(i) Earned income, including gross wages from work, cash and income from self-employment.
(ii) Unearned income or benefits, including cash and contributions received by an individual for which the individual does not provide a service.
Maximum child care allowance—The highest amount the Department will pay for child care services provided to families eligible for subsidized child care.
Overpayment—The receipt of subsidy for a child for which the family is not or was not eligible or an amount in excess of the amount for which the family was eligible.
Parent—The biological or adoptive mother or father, or stepmother or stepfather, who exercises care and control of the child for whom subsidy is requested.
Period of presumptive continued eligibility—A temporary period of eligibility established at redetermination as specified in § 3042.147 (relating to presumptive continued eligibility at redetermination).
Period of presumptive eligibility—A temporary period of eligibility established at application for families experiencing homelessness as specified in § 3042.146 (relating to homelessness).
Personal interview—An informational meeting or discussion between the eligibility agency and the parent or caretaker, which takes place in person, by telephone or by other means approved by the Department.
Prospective work, education or training—Future employment, education or training that has a begin date and is verified by the employer, school official or training official.
Provider—An organization or individual that directly delivers child care services.
Published rate—A provider’s daily charge for a child who does not receive subsidized child care.
Recoupment—Recovery of an overpayment by increasing the copayment or other payment arrangement.
SMI—State Median Income—An income figure that represents the midpoint in the range of State household income.
Self-certification—A written statement provided by a parent or caretaker for the purpose of establishing selected factors of nonfinancial eligibility.
Self-declaration—A written statement that is signed, dated and provided by the parent or caretaker for the purpose of establishing financial or nonfinancial eligibility pending verification as described in § 3042.64 (relating to self-declaration).
Self-employment—Operating one’s own business, trade or profession for profit.
Subsidized child care—Child care service paid for in part with Federal or State funds.
Subsidy suspension—A temporary lapse of subsidized child care that does not affect the family’s eligibility status.
TANF—Temporary Assistance for Needy Families Program—As follows:(i) A Federal nonentitlement program under sections 401—419 of the Social Security Act (42 U.S.C. § § 601—619) that provides cash assistance to families including dependent children and an adult.
(ii) The term includes extended TANF benefits that are received beyond the 5-year TANF period.
Tiered-reimbursement—An amount the Department sets and adds to a provider’s payment rate if the provider meets additional quality standards, based on the level of quality the provider maintains and the amount of time the child receives care from the provider in a day.
Training—As follows:(i) Instruction that provides the skills or qualifications necessary for a specific vocation or field of employment.
(ii) The term includes adult basic education, English as a second language, a GED program, an HSE degree, a postsecondary program leading to a degree, diploma or certificate, an internship, clinical placement, apprenticeship, lab work and field work required by the training institution.
Verification—As follows:(i) The process of confirming information needed to determine eligibility for subsidized child care.
(ii) The term includes documentary evidence or information obtained through collateral contacts, self-certification and self-declaration.
Waiting list—A record maintained by the eligibility agency of the names of families and their children determined eligible to receive subsidized child care, but for whom funding is not currently available.
Work—Employment or self-employment.
Cross References This section cited in 55 Pa. Code § 3042.41 (relating to family size); 55 Pa. Code § 3042.63 (relating to self-certification); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.4. Nondiscrimination.
(a) An eligibility agency may not discriminate against applicants for or recipients of Federal or State subsidized funds on the basis of age, race, sex, color, religious creed, national or ethnic origin, ancestry, sexual orientation, gender identity, or physical or mental disability.
(b) An eligibility agency shall offer child care subsidy within the provisions of applicable civil rights laws and regulations, including all of the following:
(1) The Pennsylvania Human Relations Act (43 P.S. § § 951—963).
(2) The Age Discrimination Act of 1975 (42 U.S.C. § § 6101—6107).
(3) Title VI of the Civil Rights Act of 1964 (42 U.S.C. § § 2000d— 2000d-7).
(4) Title VII of the Civil Rights Act of 1964 (42 U.S.C. § § 2000e— 2000e-17).
(5) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794).
(6) The Americans with Disabilities Act of 1990 (42 U.S.C. § § 12101—12213).
GENERAL BENEFITS
§ 3042.11. Provision of subsidized child care.
(a) Subsidized child care is provided for a child whose family meets financial and nonfinancial eligibility requirements.
(b) Subsidized child care is available to an otherwise eligible child who is under 13 years of age.
(c) Subsidized child care will continue until the eligibility agency completes the family’s next scheduled annual redetermination when a child turns 13 years of age between redeterminations.
(d) Subsidized child care is available to an otherwise eligible child who is 13 years of age or older but under 19 years of age and who is physically or mentally incapable of self-care.
(e) A former TANF family is eligible for a child care subsidy under this chapter as specified in § § 3042.111—3042.122 (relating to former TANF families).
(f) The Department, through the Department’s contract with the eligibility agency, will direct funding for various populations, including individuals who formerly received TANF benefits and foster children.
Cross References This section cited in 55 Pa. Code § 3042.72 (relating to verification of child’s incapability of caring for himself); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.12. Parent choice.
(a) A family that is eligible for subsidized child care shall have the right to choose care from a provider that agrees to comply with the Department’s standards for provider participation, subject to subsections (b) and (c).
(b) The Department may suspend a subsidy benefit when a parent or caretaker uses a provider who has received a Departmental notice to revoke or refuse to renew the provider’s certificate of compliance.
(c) Providers eligible to participate include:
(1) A child care center certified under Chapter 3270 (relating to child care centers).
(2) A group child care home certified under Chapter 3280 (relating to group child care homes).
(3) A family child care home certified under Chapter 3290 (relating to family child care homes).
(4) A grandparent, great-grandparent, aunt, uncle or sibling of the child who is 18 years of age or older and does not reside within the same household as the child.
Cross References This section cited in 55 Pa. Code § 3042.99 (relating to copayment exceeding monthly payment for care); 55 Pa. Code § 3042.112 (relating to general requirements for former TANF families); and 55 Pa. Code § 3042.119 (relating to retroactive payment for former TANF families).
§ 3042.13. Subsidy benefits.
A subsidy-eligible family may receive child care during the hours that the child needs care if the parent or caretaker:
(1) Works or attends education or training, including travel between the parent’s or caretaker’s work, education or training and the child care facility.
(2) Requires uninterrupted sleep time following the completion of an overnight work shift.
Cross References This section cited in 55 Pa. Code § 3042.17 (relating to attendance).
§ 3042.14. Payment of provider charges.
(a) A provider participating in the subsidized child care program is eligible to receive payment from the eligibility agency for services provided to a subsidy-eligible child.
(b) The eligibility agency may not pay child care costs that exceed the maximum child care allowance minus the family copayment for the type of care the child received from the provider, except when the Department provides tiered-reimbursement to providers that are eligible based on their participation in the Department’s Quality Rating and Improvement System.
(c) The Department may provide tiered-reimbursement based on the availability of funding.
(d) If a parent or caretaker selects a provider whose published rate exceeds the Department’s payment rate, the provider may charge the parent or caretaker the difference between these two amounts.
(e) A change in a parent’s or caretaker’s need for child care and the resulting adjustment in the amount of payment to the provider shall begin on the date the parent or caretaker reports the change or on the date the change begins, whichever is later.
(f) When additional funding becomes available, the Department may direct any additional funding to providers that offer child care services during non-traditional hours.
(g) The eligibility agency will not make retroactive payments for child care costs incurred more than 30 days prior to the issuance of an enrollment authorization, with the exception of a former TANF family as specified in § 3042.119 (relating to retroactive payment for former TANF families).
(h) The Department will not permit subsidy enrollments at a provider for whom the Department has issued a revocation or refusal to renew.
§ 3042.15. Subsidy limitations.
(a) A family in which a parent or caretaker is receiving funds from the TANF cash assistance program is not eligible for subsidized child care under this chapter.
(b) Subsidized child care may not be used as a substitute for a publicly funded educational program, such as kindergarten or a specialized treatment program. At the parent’s or caretaker’s request, a subsidy-eligible, kindergarten-age child is permitted 1 additional school year to be enrolled in kindergarten.
(c) A child receiving care in a child care facility that is owned by the child’s parent or caretaker is not eligible for subsidized child care.
(d) A child is ineligible for subsidized child care if not enrolled with an eligible child care provider within 30 calendar days following the date the eligibility agency notifies the parent or caretaker that funding is available to enroll the child unless the eligibility agency determines that enrollment has been delayed because of circumstances outside of a parent’s or caretaker’s control. The following apply:
(1) If a parent or caretaker fails to provide a circumstance outside the parent’s or caretaker’s control, the child is ineligible.
(2) If a parent or caretaker provides a circumstance outside of a parent’s or caretaker’s control, the child will remain eligible.
§ 3042.16. Prohibition of additional conditions and charges.
The eligibility agency may not:
(1) Impose eligibility conditions other than conditions listed in this chapter.
(2) Require the parent or caretaker to select a particular provider or combination of providers as a condition of eligibility.
§ 3042.17. Attendance.
(a) When the parent or caretaker enrolls a child in subsidized child care, the parent or caretaker shall specify, in writing to the eligibility agency, the days for which the parent or caretaker requests child care.
(b) A child must attend child care at the provider on all days for which the parent or caretaker requests child care as specified in § 3042.13 (relating to subsidy benefits), unless the provisions specified in § 3042.20 (relating to subsidy suspension) apply.
§ 3042.18. Absence.
(a) Upon notification from the provider that a child has been absent more than 5 consecutive days for which the child is scheduled to attend child care, the eligibility agency shall send the parent or caretaker a notice confirming the suspension of the child’s enrollment and payment to the provider.
(b) Upon notification from a parent or caretaker that a child has been or will be absent more than 5 consecutive days for which the child is scheduled to attend child care, the eligibility agency shall send the parent or caretaker a notice confirming the suspension of the child’s enrollment and payment to the provider.
(c) The notice shall inform the parent or caretaker of all of the following:
(1) The responsibility of the parent or caretaker to report to the eligibility agency the date of the child’s return to care.
(2) Payment shall resume on the date the child returns to care.
(d) If a child’s absences exceed 40 total enrollment days in the State’s fiscal year, the parent or caretaker is responsible to pay to the provider the provider’s verified published daily rate for each day of absence starting with the 41st day of absence. A child is considered absent only once during an enrollment day. Suspended days of service as specified in § 3042.20 (relating to subsidy suspension) are not considered days of absence.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); 55 Pa. Code § 3042.146 (relating to homelessness); and 55 Pa. Code § 3042.161 (relating to appealable actions).
§ 3042.19. Subsidy continuation.
(a) A family’s eligibility and payment for subsidized child care continues during a break in or following the loss of work, education or training for the remainder of the child’s current 12-month eligibility period.
(b) A child’s eligibility and payment for subsidized child care continues for the remainder of the child’s current 12-month eligibility period when there is a change in the child’s primary parent or caretaker. The substitute caretaker must meet only the requirement that the family’s annual income does not exceed 85% of the SMI.
(c) Subsidized child care will continue at the same level until the family’s next scheduled annual redetermination, unless one of the following situations occurs:
(1) The family’s income exceeds 85% of the SMI.
(2) The provisions specified in § 3042.22 (relating to subsidy termination) apply.
(3) The provisions specified in § 3042.86 (relating to change reporting and processing) apply.
Cross References This section cited in 55 Pa. Code § 3042.22 (relating to subsidy termination).
§ 3042.20. Subsidy suspension.
(a) The eligibility agency shall suspend subsidy if a child is unable to attend child care for more than 5 consecutive days for which the child is scheduled to attend.
(b) At the parent’s or caretaker’s request, the eligibility agency shall suspend subsidy for a child who is expected to be absent more than 5 consecutive days.
Cross References This section cited in 55 Pa. Code § 3042.17 (relating to attendance); 55 Pa. Code 3042.18 (relating to absence); and 55 Pa. Code § 3042.161 (relating to appealable actions).
§ 3042.21. Subsidy disruption.
Subsidy to a child may be disrupted if the eligibility agency cannot continue to subsidize the number of children enrolled in subsidized child care due to insufficient Federal or State funding. The following apply:
(1) Subsidy for children whose family’s income is at the highest percentage of the FPIG is disrupted first.
(2) A child whose subsidy is disrupted under this section is placed on the waiting list according to the date of the initial eligibility for subsidized child care.
Cross References This section cited in 55 Pa. Code § 3042.161 (relating to appealable actions); and 55 Pa. Code § 3042.162 (relating to discontinuation of subsidy during the appeal process).
§ 3042.22. Subsidy termination.
(a) Notwithstanding § 3042.19 (relating to subsidy continuation), the eligibility agency shall terminate subsidy to a child prior to the next redetermination in any of the following circumstances:
(1) The child has been absent for 60 consecutive days of unexplained non-attendance in care, provided the eligibility agency has attempted at least three times to contact the parent or caretaker regarding the child’s absences.
(2) The child no longer resides in this Commonwealth.
(3) The parent or caretaker committed substantiated fraud or an intentional program violation that invalidates a prior determination of eligibility.
(4) The parent or caretaker voluntarily requests discontinuance of the subsidy.
(b) If the eligibility agency moves to terminate the subsidy as described in subsection (a), the eligibility agency shall send notification to the family as provided under § 3042.155 (relating to notice of adverse action).
Cross References This section cited in 55 Pa. Code § 3042.19 (relating to subsidy continuation); and 55 Pa. Code § 3042.161 (relating to appealable actions).
ELIGIBILITY REQUIREMENTS
§ 3042.31. Financial eligibility.
(a) At initial application, annual family income may not exceed 200% of the FPIG.
(b) Following an initial determination of eligibility, a family shall remain financially eligible for subsidized child care as long as the family’s annual income does not exceed 85% of the SMI.
(c) At redetermination, the family’s annual income may not exceed 235% of the FPIG or 85% of the SMI, whichever is less.
(d) The eligibility agency shall inform the parent or caretaker of the annual family income that will exceed 235% of the FPIG or 85% of the SMI and will cause the family to be ineligible for subsidized child care.
(e) A family is ineligible for subsidized child care when the family’s assets exceed $1 million at application or redetermination.
Cross References This section cited in 55 Pa. Code § 3042.101 (relating to eligibility redetermination); 55 Pa. Code § 3042.132 (relating to eligibility determination for Head Start); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.32. Residence.
(a) Family members shall be residents of this Commonwealth.
(b) The parent or caretaker shall apply to the eligibility agency that is responsible for the geographic area that includes the zip code of the family’s residence.
(c) A parent or caretaker experiencing domestic violence or homelessness may use an alternate address for receipt of mail or telephone number for receipt of telephone calls.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.33. Work, education and training.
(a) The parent or caretaker shall work at least 20 hours per week.
(b) The eligibility agency shall average a parent’s or caretaker’s work hours in cases where hours of work vary from week to week.
(c) The eligibility agency shall consider a parent or caretaker as meeting the work-hour requirement specified in subsection (a), under any one of the following circumstances:
(1) A parent or caretaker is under 22 years of age and does not have a high school, GED or HSE diploma, but is enrolled in and attending education on a full-time basis.
(2) A parent or caretaker attends training and works at least 10 hours per week. The time spent in training counts toward the 20-hour per week work requirement.
Cross References This section cited in 55 Pa. Code § 3042.37 (relating to eligibility of households including a parent or caretaker with a disability); 55 Pa. Code § 3042.112 (relating to general requirements for former TANF families); 55 Pa. Code § 3042.132 (relating to eligibility determination for Head Start); 55 Pa. Code § 3042.145 (relating to domestic and other violence); 55 Pa. Code § 3042.146 (relating to homelessness); and 55 Pa. Code § 3042.147 (relating to presumptive continued eligibility at redetermination).
§ 3042.34. Prospective work, education and training.
(a) A family in which a parent or caretaker has prospective work, education or training may be eligible for subsidized child care if all of the following requirements are met:
(1) The work, education or training will begin no later than 30 calendar days following the date the parent or caretaker signs and dates the application for subsidized child care.
(2) Verification of prospective work, education or training is provided as specified in § 3042.67 (relating to verification of work, education or training).
(b) Subsidized child care may not begin until the parent or caretaker begins work, education or training.
(c) The parent or caretaker shall notify the eligibility agency of the actual amount of income no later than 10 calendar days after receiving the first income for work.
§ 3042.35. Immunization.
(a) A child receiving subsidized child care shall be up to date with immunizations as recommended by the Advisory Committee on Immunization Practices. For facilities subject to certification by the Department, immunizations shall be provided as specified in § § 3270.131, 3280.131 and 3290.131 (relating to health information). The eligibility agency shall grant exemption from the immunization requirement under one of the following circumstances:
(1) A child’s parent or caretaker objects to immunizations on religious grounds or strong personal objection equated to a religious belief must be documented by a written, signed and dated statement from the child’s parent or guardian. The statement shall be kept in the child’s record.
(2) A child’s physician, physician’s assistant or CRNP signs and dates a written statement indicating that a child’s medical condition contraindicates immunization. The statement shall be kept in the child’s record.
(b) If an otherwise eligible child is not up to date with immunizations and not exempt from immunization, the eligibility agency shall authorize the family for subsidy and give the parent or caretaker 60 days from the date of enrollment, or if the child is experiencing homelessness or is a foster child, then 90 calendar days from the date of enrollment to obtain up to date immunizations or provide documentation of exemption from the immunization requirement.
§ 3042.36. Citizenship.
A child receiving subsidized child care shall be a United States citizen or an alien lawfully admitted for permanent residence or otherwise lawfully and permanently residing in the United States.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.37. Eligibility of households including a parent or caretaker with a disability.
(a) At application or redetermination, a single parent or caretaker who is unable to meet the work, education and training requirements due to a disability is not eligible for subsidized child care services.
(b) Following the determination of eligibility for subsidized child care, a single parent or caretaker who is unable to meet the work, education and training requirements is excused from the work, education and training requirements until the family’s next scheduled annual redetermination.
(c) At application or redetermination, a two-parent or two-caretaker family who are both unable to meet the work, education and training requirements due to a disability are not eligible for subsidized child care services.
(d) Following the determination of eligibility for subsidized child care, a two-parent or two-caretaker family where both parents are unable to meet the work, education and training requirements is excused from the work, education and training requirements until the family’s next scheduled annual redetermination.
(e) A two-parent or two-caretaker family may be eligible for subsidized child care if all of the following conditions are met:
(1) One parent or caretaker is satisfying the work requirement as specified in § 3042.33 (relating to work, education and training) at the time of application and at each subsequent redetermination.
(2) The parent or caretaker that is not working has a disability that is verified as specified in § 3042.70 (relating to verification of inability to work due to a disability) at the time of application and at each subsequent redetermination.
(3) The parent or caretaker with the disability is unable to work or participate in education or training and is unable to care for the child for whom the family requested subsidy, or has a need to attend treatment for the disability and is unable to care for the child.
(f) A two-parent or two-caretaker family may be eligible for subsidized child care if both of the following conditions are met:
(1) One parent or caretaker is satisfying the work requirement as specified in § 3042.33.
(2) A court order or safety plan issued by a children and youth agency prohibits the other parent or caretaker from caring for the child for whom the family requested subsidy.
DETERMINING FAMILY SIZE AND INCOME
§ 3042.41. Family size.
(a) Individuals included in the definition of family as specified in § 3042.3 (relating to definitions) shall be counted when determining family size.
(b) A foster child may be counted as a family of one or may be included in a family as defined in this chapter.
Cross References This section cited in 55 Pa. Code § 3042.98 (relating to copayment determination); and 55 Pa. Code § 3042.131 (relating to general provisions for Head Start).
§ 3042.42. Income counted.
The eligibility agency shall include the income of the following family members when determining financial eligibility:
(1) The parent or caretaker of the child for whom subsidy is sought, excluding a teenage parent’s earned income.
(2) A parent’s or caretaker’s spouse.
(3) Children for whom the parent or caretaker receives unearned income.
Cross References This section cited in 55 Pa. Code § 3042.43 (relating to income adjustment); and 55 Pa. Code § 3042.98 (relating to copayment determination).
§ 3042.43. Income adjustment.
To determine adjusted family income, the eligibility agency shall:
(1) Determine gross income as specified in Appendix A, Part I (relating to income to be included, deducted and excluded in determining gross monthly income) for each family member listed in § 3042.42 (relating to income counted).
(2) Estimate monthly income from each income source in accordance with § 3042.44 (relating to estimating income).
(3) Convert weekly, biweekly, semimonthly and other pay periods to gross monthly amounts using the Conversion Table in Appendix A, Part I.
(4) Calculate the total gross monthly income.
(5) Determine the stepparent deduction as specified in Appendix C (relating to stepparent deduction chart).
(6) Determine other allowable deductions listed in Appendix A, Part II (relating to income to be included, deducted and excluded in determining gross monthly income) for each source of income.
(7) Determine adjusted family income by subtracting the total monthly deductions specified in paragraphs (5) and (6) from the total gross monthly income specified in paragraph (4).
(8) Multiply adjusted family income by 12 to determine annual family income.
Cross References This section cited in 55 Pa. Code § 3042.98 (relating to copayment determination).
§ 3042.44. Estimating income.
(a) The eligibility agency shall use its best estimate of monthly income based upon circumstances at the time of application or redetermination as specified in Appendix A, Part I (relating to income to be included, deducted and excluded in determining gross monthly income) for the table used to convert weekly, biweekly, semimonthly and other pay periods to monthly amounts.
(b) For parents or caretakers who are working and have received pay at the time they apply for subsidized child care, the eligibility agency shall estimate income based upon verified, actual amounts already received by the family prior to application or redetermination.
(c) The eligibility agency shall adjust its estimate of monthly income to reflect recent or anticipated changes and unusual circumstances that are not expected to recur, such as overtime not likely to continue.
(d) When an applicant anticipates starting work within the next 30 days or has not yet received a first paycheck, income eligibility is established based on verified anticipated income.
Cross References This section cited in 55 Pa. Code § 3042.43 (relating to income adjustment); and 55 Pa. Code § 3042.98 (relating to copayment determination).
ELIGIBILITY DETERMINATION
§ 3042.51. Application.
(a) The eligibility agency shall make applications for subsidized child care available to any person upon request.
(b) A parent or caretaker may file a signed application for subsidized child care under this chapter, including an electronically signed online application, on any day and at any time.
(c) A parent or caretaker may submit an application by mail, hand-delivery, facsimile or electronically.
§ 3042.52. Initial determination of eligibility.
(a) The eligibility agency shall stamp the date and time of receipt on the signed application on the same day the eligibility agency receives the application by mail, hand-delivery, facsimile or electronically.
(b) The eligibility agency shall determine a family’s eligibility and authorize payment for subsidized child care no later than 10 calendar days following verification of all factors of eligibility. The eligibility agency may not delay a determination of eligibility beyond 30 calendar days following receipt of a signed application from the parent or caretaker.
(c) The eligibility agency shall determine a family eligible retroactive to the date the family submitted a signed application if the eligibility agency has received all information necessary to complete the application and the verification provided by the parent or caretaker establishes eligibility.
§ 3042.53. Effective date of coverage.
(a) If the eligibility agency determines a family eligible for subsidized child care and if funding is available, coverage of child care costs is retroactive to the date the family submitted a signed application.
(b) If the eligibility agency places a child on a waiting list following the determination of eligibility, coverage of child care costs must begin on the date funding is available.
§ 3042.54. Notification of eligibility status and availability of funding.
(a) The eligibility agency shall notify the parent or caretaker of the family’s eligibility status within 30 calendar days of receiving a signed application.
(b) If the eligibility agency determines a family eligible for subsidized child care, the eligibility agency shall notify the family’s child care provider when funding becomes available to enroll the child.
§ 3042.55. Period of eligibility.
A family receiving subsidy remains eligible until determined ineligible.
§ 3042.56. Personal interview.
(a) If the eligibility agency determines a family eligible for subsidized child care and if funding is available, the parent or caretaker shall attend a personal interview with the eligibility agency no later than 30 calendar days following the date the eligibility agency notifies the family of eligibility for subsidized child care.
(b) If the eligibility agency determines a family eligible for subsidized child care and if funding is not available, the parent or caretaker shall attend a personal interview with the eligibility agency no later than 30 calendar days following the date the first child from a family is enrolled in subsidized child care.
(c) The eligibility agency shall accommodate the parent’s or caretaker’s work hours in scheduling the personal interview.
(d) The eligibility agency may extend the 30-day time frame for the personal interview if, on or before the 30th calendar day, the parent or caretaker claims hardship due to conflicts with the parent’s or caretaker’s working hours, or illness of the parent or caretaker or another family member. When the parent or caretaker claims hardship, the eligibility agency may grant an additional 30 days from the date the hardship is claimed for the meeting.
(e) The eligibility agency may waive the requirement for the personal interview if the parent or caretaker has completed a personal interview with the eligibility agency within the previous 12 months.
Cross References This section cited in 55 Pa. Code § 3042.63 (relating to self-certification).
§ 3042.57. Waiting list.
(a) If funds are not available to enroll a child following determination of the family’s eligibility for subsidy, the eligibility agency shall place an eligible child on a waiting list based on priority and a first-come, first-served basis. The Department will post its method for priority on its web site. An order of priority may include foster children, children enrolled in PA Pre-K Counts, Head Start, Early Head Start or other program, newborn siblings, children of teen parents, children experiencing homelessness, or other circumstances or vulnerable populations as identified by the Department.
(b) If a parent or caretaker requests subsidized child care for an additional child following the date the family was initially determined eligible for subsidized child care, the eligibility agency shall place the additional child on the waiting list according to the date and time that the parent or caretaker requests care for the additional child.
(c) A child is ineligible for subsidized child care if not enrolled with an eligible child care provider within 30 calendar days following the date the eligibility agency notifies the parent or caretaker that funding is available to enroll the child unless the eligibility agency determines that enrollment has been delayed because of circumstances outside of a parent’s or caretaker’s control. The following apply:
(1) If a parent or caretaker fails to provide a circumstance outside the parent’s or caretaker’s control, the child is ineligible.
(2) If a parent or caretaker provides a circumstance outside of a parent’s or caretaker’s control, the child will remain eligible.
Cross References This section cited in 55 Pa. Code § 3042.132 (relating to eligibility determination for Head Start).
SELF-CERTIFICATION AND VERIFICATION
§ 3042.61. General verification requirements.
(a) The parent or caretaker shall be the primary source of verification in establishing and maintaining eligibility for subsidized child care.
(b) The eligibility agency shall assist parents and caretakers in obtaining verification, including making a collateral contact.
(c) The eligibility agency may not impose requirements for verification beyond the requirements of this chapter.
(d) At the time of application for subsidized child care, the eligibility agency shall obtain consent from the parent or caretaker and the parent’s or caretaker’s spouse permitting the eligibility agency to obtain verification of eligibility information.
(e) The eligibility agency shall retain the signed consent in the family’s file.
(f) The consent shall remain in effect for as long as the family receives subsidy.
(g) The eligibility agency may not deny or terminate subsidy to a family when the parent or caretaker has cooperated in the verification process and needed verification is pending or cannot be obtained due to circumstances beyond the parent’s or caretaker’s control.
(h) The eligibility agency may not require a parent or caretaker to reverify information unless the eligibility agency has information that indicates the subsidy status of the family has changed.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.62. Collateral contact.
(a) The eligibility agency shall make a collateral contact on behalf of the parent or caretaker.
(b) The eligibility agency shall obtain from the parent or caretaker a list of sources of reliable collateral contact information.
(c) The eligibility agency shall cooperate with a source who acts as a collateral contact.
(d) Sources of reliable collateral contact information may include the following:
(1) Public records, such as domestic relations or other courthouse records.
(2) A school teacher or principal.
(3) A regulated child care provider.
(4) A health care professional.
(5) A social service worker or counselor.
(6) A religious professional.
(7) An attorney.
(8) Any other third party with knowledge about a fact or circumstance bearing on eligibility.
(e) The eligibility agency may not contact an alleged abuser or former abuser in a domestic violence situation.
Cross References This section cited in 55 Pa. Code § 3042.65 (relating to verification of income); 55 Pa. Code § 3042.66 (relating to verification of residence); 55 Pa. Code § 3042.67 (relating to verification of work, education or training); 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.69 (relating to verification of identity); 55 Pa. Code § 3042.71 (relating to verification of family size); 55 Pa. Code § 3042.73 (relating to verification of care and control); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.63. Self-certification.
(a) The eligibility agency shall inform the parent or caretaker in writing that self-certification is made subject to 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities).
(b) The eligibility agency shall accept the statement of the parent or caretaker as sufficient proof of the following eligibility factors:
(1) Age of the child.
(2) Inclusion in the family composition of a child who is 18 years of age or older but under 22 years of age and meets the definition of family set forth in § 3042.3 (relating to definitions).
(3) Citizenship or immigration status.
(4) Immunization status or exemption from the immunization requirement.
(5) Days and hours for which the child needs care.
(6) Status of an individual who formerly received TANF as specified in § 3042.115(1) (relating to reporting requirements for former TANF families).
(7) Personal interview time frame extension or telephone contact based on hardship as specified in § 3042.56(d) and (e) (relating to personal interview).
Cross References This section cited in 55 Pa. Code § 3042.64 (relating to self-declaration); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.64. Self-declaration.
(a) If attempts to verify eligibility by documentary evidence or collateral contact are unsuccessful, the eligibility agency shall proceed without delay to determine the family’s eligibility based upon a self-certification as specified in § 3042.63 (relating to self-certification) or by written self-declaration by the parent or caretaker.
(b) The eligibility agency shall instruct the parent or caretaker that a written self-declaration is made subject to 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities).
(c) The eligibility agency shall accept a parent’s or caretaker’s self-declaration statement, unless evidence contradicts the statement.
(d) If a parent or caretaker uses self-declaration to establish eligibility as described in subsection (a), the eligibility agency shall require the parent or caretaker to provide another form of acceptable verification no later than 30 calendar days following the date the written self-declaration is accepted by the eligibility agency, unless otherwise specified in this chapter.
(e) For a parent or caretaker using self-declaration, eligibility is pending verification until another form of acceptable verification is returned to the eligibility agency as required under this section.
(f) If the eligibility agency does not receive the verifications as required under this section, or if the family is determined ineligible, the eligibility agency shall take the necessary steps to terminate the eligibility pending verification with proper notification to the family as specified in § 3042.155 (relating to notice of adverse action).
Cross References This section cited in 55 Pa. Code § 3042.3 (relating to definitions); 55 Pa. Code § 3042.65 (relating to verification of income); 55 Pa. Code § 3042.66 (relating to verification of residence); 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.69 (relating to verification of identity); 55 Pa. Code § 3042.71 (relating to verification of family size); 55 Pa. Code § 3042.73 (relating to verification of care and control); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.65. Verification of income.
(a) Acceptable verification of earned income from employment includes one of the following:
(1) Pay stubs reflecting earnings for 4 weeks in the most recent 6-week period, the Department’s employment verification form reflecting actual or anticipated earnings, the Internal Revenue Service form used for reporting tips, an employer statement of anticipated earnings and hours, or other document that establishes the parent’s or caretaker’s earnings or anticipated earnings from employment.
(2) Another document that establishes income from work.
(3) The Department’s cash verification form.
(4) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(5) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
(b) Acceptable verification of income from self-employment includes:
(1) Tax returns, including schedules related to self-employment, filed for the preceding Federal tax year and which document profit for that year.
(2) The Department’s self-employment verification form that includes a statement of gross earnings, minus allowable cost of doing business, and that shows a profit.
(c) Acceptable verification of unearned income includes one of the following:
(1) A copy of a current benefit check, an award letter that designates the amount of a grant or benefit, such as a letter from the Social Security Administration stating the amount of the Social Security benefit, a bank statement, a court order, or other document or database report that establishes the amount of unearned income.
(2) A collateral contact as specified in § 3042.62.
(3) A written self-declaration by the parent or caretaker as specified in § 3042.64.
(d) Acceptable verification of the amount of support received or paid by the family includes one of the following:
(1) Information from the Pennsylvania Child Support Enforcement System.
(2) Information from a domestic relations office.
(3) Court order.
(4) Pay stub.
(5) Written statement by the noncustodial parent or the noncustodial parent’s legal representative.
(6) A copy of a current benefit check that designates the amount of support.
(7) Collateral contact as specified in § 3042.62.
(8) A written self-declaration by the parent or caretaker as specified in § 3042.64.
Cross References This section cited in 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.66. Verification of residence.
(a) The parent or caretaker shall submit verification of residence at the time of application.
(b) Acceptable verification of residence includes any of the following:
(1) Mail received by the parent or caretaker or a copy of a lease, utility bill, deed, driver’s license, rental agreement or other document establishing residence.
(2) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(3) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
(c) The parent or caretaker shall submit verification of residence at the time of redetermination if the parent or caretaker reported a change of address.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.67. Verification of work, education or training.
Acceptable verification of the number of hours of work, education, training or enrollment in education or training includes one of the following:
(1) A document provided by the parent or caretaker as verification of earned or anticipated earned income, if this verification indicates or can be used to compute the number of hours the parent or caretaker worked, is normally scheduled to work or, in cases when hours vary, the average number of hours worked.
(2) A copy of a work schedule signed by the employer.
(3) A copy of the class or training schedule from an education or training representative.
(4) Another document that establishes the number of hours of work or anticipated hours of work, education or training.
(5) A collateral contact as specified in § 3042.62 (relating to collateral contact).
Cross References This section cited in 55 Pa. Code § 3042.34 (relating to prospective work, education and training); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.68. Verification of circumstances relating to a decrease in copayment.
Acceptable verification of circumstances relating to a decrease in copayment includes any of the following:
(1) Verification of a decrease in income as specified in § 3042.65 (relating to verification of income).
(2) Verification of a change in family size and composition as specified in § 3042.71 (relating to verification of family size).
(3) Verification of maternity and family leave as indicated by one of the following:
(i) A birth certificate.
(ii) The Department’s medical assessment form.
(iii) A medical record or a written statement from a licensed physician, physician’s assistant, CRNP or psychologist.
(iv) A written statement or other documentation completed by a licensed physician, physician’s assistant, CRNP or psychologist that describes the inability to work or participate in education or training and includes a date of anticipated return to work.
(v) A written statement from the employer or an education or training representative.
(vi) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(vii) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
(4) Verification relating to inability to work due to a disability as specified in § 3042.70 (relating to verification of inability to work due to a disability).
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.69. Verification of identity.
(a) The parent or caretaker shall submit verification of identity at the time of application.
(b) Acceptable verification of identity includes any of the following:
(1) Employer identification card.
(2) Military photo-identification card.
(3) Passport.
(4) Other verifiable photo-identification.
(5) Driver’s license with or without a photograph.
(6) State-issued birth certificate.
(7) Certificate of naturalization.
(8) Certificate of United States citizenship.
(9) Alien registration receipt card or permanent resident card.
(10) Valid or expired State driver’s learner’s permit.
(11) Social Security card.
(12) Marriage license, divorce decree or court order for a name change.
(13) Marriage record that contains the date of birth.
(14) Voter registration card.
(15) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(16) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
(c) The parent or caretaker shall submit verification of identity at the time of redetermination if the eligibility agency becomes aware of an additional parent or caretaker residing in the household.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.70. Verification of inability to work due to a disability.
Acceptable verification of inability to work due to a disability at the time of application or redetermination includes:
(1) An assessment by a licensed physician, physician’s assistant, CRNP or psychologist that states the following:
(i) The condition causing the inability to work or to participate in education or training.
(ii) The manner in which the condition causing the disability prevents the parent or caretaker from providing care for the child.
(iii) The date the parent or caretaker is expected to return to work or resume participation in education or training or the date the parent or caretaker will be able to care for the child.
(2) If the parent or caretaker with a disability submits written verification of disability payments from Social Security, Supplemental Security Income, Worker’s Compensation, 100% of Veterans Disability or 100% of another type of work-related disability, that verification shall serve as permanent verification of the parent’s or caretaker’s inability to work.
Cross References This section cited in 55 Pa. Code § 3042.37 (relating to eligibility of households including a parent or caretaker with a disability); 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.71. Verification of family size.
Acceptable verification of family size includes one of the following:
(1) A birth certificate.
(2) A custody order.
(3) A medical record or a written statement from a licensed physician, physician’s assistant, CRNP or psychologist.
(4) A written statement from the parent indicating that the caretaker has care and control of the child for whom subsidized child care is requested.
(5) A school record.
(6) A government or social service agency record.
(7) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(8) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
Cross References This section cited in 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.72. Verification of child’s incapability of caring for himself.
Acceptable verification of a child’s incapability of caring for himself as specified in § 3042.11(d) (relating to provision of subsidized child care) is documentation by a licensed physician, physician’s assistant, CRNP or psychologist.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.73. Verification of care and control.
Acceptable verification of care and control includes one of the following:
(1) A school record.
(2) A medical record or a written statement from a licensed physician, physician’s assistant, CRNP or psychologist.
(3) A social service record.
(4) A religious record.
(5) A domestic relations office support order.
(6) A court order.
(7) A rental or lease agreement.
(8) A written statement from the parent or caretaker verifying that a relative has care and control of the child.
(9) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(10) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.74. Verification of foster child status.
(a) Acceptable verification of foster child status includes one of the following:
(1) A statement from a children and youth agency.
(2) A record from a government or social service agency.
(b) Verification of foster child status must be verified at application, redetermination or upon adding the child to the family composition.
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
ELIGIBILITY AGENCY RESPONSIBILITIES
§ 3042.81. Eligibility agency.
(a) The eligibility agency shall manage the subsidized child care program in part of a county, a single county or several counties.
(b) The eligibility agency may be either a prime contractor or a subcontractor designated in a prime contract.
§ 3042.82. Eligibility determination.
(a) The eligibility agency shall determine eligibility for subsidized child care as specified in this chapter.
(b) The eligibility agency may not impose eligibility conditions other than the conditions listed in this chapter.
(c) The eligibility agency may not require the parent or caretaker to select a particular provider or combination of providers as a condition of eligibility.
§ 3042.83. Confidentiality.
(a) The eligibility agency and its employees shall keep confidential the information in the family file and use that information only for purposes directly connected to the administration of their duties.
(b) Agents of the United States, the Commonwealth and the Department who are responsible for eligibility review, evaluation or audit functions shall have access to, and the right to the use and disclosure of, information on applicants or recipients of subsidized child care. This use and disclosure is confined to the agent’s responsibility to carry out review, evaluation or audit functions.
(c) Disclosure of information beyond the scope of review, evaluation or audit functions performed by the agents requires the parent’s or caretaker’s informed and written consent.
(d) Information in the family file may be disclosed to the local CAO when necessary to ensure that funds are authorized appropriately.
(e) The eligibility agency shall ensure the confidentiality of an individual who files an appeal or complaint about a family’s receipt of subsidized child care for a child.
§ 3042.84. Family file.
(a) An eligibility agency shall establish and maintain a separate file for the family of each parent or caretaker who applies for subsidized child care.
(b) The family file shall contain documents pertaining to eligibility determination, redetermination, subsidized child care authorization, copayment agreements and copies of written notices required by this chapter.
(c) A parent or caretaker or an authorized representative has a right to examine the family file.
Cross References This section cited in 55 Pa. Code § 3042.151 (relating to general notification requirements).
§ 3042.85. Record retention.
(a) An eligibility agency shall retain paper or electronic family files, completed application forms, written notices, books, records and other fiscal and administrative documents pertaining to subsidized child care.
(b) An eligibility agency shall maintain records for at least 6 years from the end of the fiscal year in which subsidized child care has been provided or until an audit or litigation is resolved.
(c) The fiscal year is a period of time beginning July 1 of any calendar year and ending June 30 of the following calendar year.
§ 3042.86. Change reporting and processing.
(a) A parent or caretaker shall report income in excess of 85% of the SMI no later than the 10th day of the month following the month of the change in income.
(b) If the parent or caretaker reports a change that results in the family or a child in the family becoming ineligible for subsidy, the eligibility agency shall evaluate the reported change as follows:
(1) First, the eligibility agency shall assess whether the reported change in income is an irregular fluctuation or a temporary increase. Irregular fluctuations and temporary increases will not impact eligibility.
(2) Second, for a change in income that is not an irregular fluctuation or a temporary increase in income, the eligibility agency shall take the necessary steps to terminate the subsidy with proper notification to the family as specified in § 3042.155 (relating to notice of adverse action).
(c) Parents and caretakers may voluntarily report changes on an ongoing basis.
(1) The eligibility agency shall act on information reported by the parent or caretaker if it would reduce the family copayment or increase the family subsidy. The eligibility agency shall review the change and reduce the copayment as specified in § 3042.94 (relating to parent or caretaker copayment requirements).
(2) The eligibility agency is prohibited from acting on information reported by the family that would reduce the family’s subsidy unless the information provided indicates the family’s income exceeds 85% of the SMI for a family of the same size.
(d) If the parent or caretaker fails to report a change in the child’s provider, the child remains eligible. The eligibility agency may not make retroactive payment more than 30 calendar days prior to the date the parent or caretaker reported the change, except for a former TANF family as specified in § 3042.119 (relating to retroactive payment for former TANF families).
Cross References This section cited in 55 Pa. Code § 3042.19 (relating to subsidy continuation); and 55 Pa. Code § 3042.153 (relating to notice of eligibility).
§ 3042.87. Voluntary request to terminate subsidized child care.
(a) A parent or caretaker may request the eligibility agency to terminate subsidy.
(b) Upon receipt of a request to terminate subsidy, the eligibility agency shall take steps to terminate the family’s eligibility.
(c) The eligibility agency shall notify the parent or caretaker as specified in § 3042.156 (relating to notice confirming voluntary withdrawal).
§ 3042.88. Child abuse reporting.
The eligibility agency shall immediately report suspected child abuse in accordance with the 23 Pa.C.S. Chapter 63 (relating to Child Protective Services Law) and Chapter 3490 (relating to protective services).
COPAYMENT AND PAYMENT BY THE DEPARTMENT
§ 3042.91. General copayment requirements.
(a) The eligibility agency shall determine the amount of the parent’s or caretaker’s copayment during the eligibility process based on the parent’s or caretaker’s actual or verified anticipated income and family size.
(b) The eligibility agency will set the copayment at an initial determination of eligibility for subsidized child care and reestablish it at each successive redetermination of eligibility.
(c) The copayment covers each child in the family who is receiving subsidized child care.
(d) The copayment includes each day of the week for which the family establishes a need for child care.
(e) The copayment is due on the first day of the service week and each week thereafter, regardless of the day the parent or caretaker enrolls the child.
(f) The eligibility agency may not increase the amount of the copayment during the eligibility period, unless the provisions specified in § 3042.176 (relating to collection) apply.
Cross References This section cited in 55 Pa. Code § 3042.112 (relating to general requirements for former TANF families); 55 Pa. Code § 3042.132 (relating to eligibility determination for Head Start); 55 Pa. Code § 3042.153 (relating to notice of eligibility); 55 Pa. Code § 3042.163 (relating to subsidy continuation during the appeal process); and 55 Pa. Code § 3042.164 (relating to parent or caretaker rights and responsibilities regarding appeal).
§ 3042.92. Department’s payment.
(a) The payment rate is the daily amount paid to a child care provider for services delivered to a child who is eligible for subsidized child care.
(b) If the copayment does not exceed the payment rate for care, the difference between the payment rate and the weekly copayment is the Department’s payment for subsidized child care.
(c) If the Department’s weekly payment to the provider is less than $5, the family is not eligible for subsidized child care with that provider.
§ 3042.93. Adjusted copayment for prospective work.
(a) Upon notification by the parent or caretaker of receipt of payment for employment, the eligibility agency shall:
(1) Adjust the family copayment, if applicable, no later than 20 calendar days following the date the parent or caretaker reports the receipt of payment from employment.
(2) Provide notice to the parent or caretaker of the planned change in the copayment.
(b) The parent or caretaker shall begin paying the adjusted copayment starting the first day of the service week following the date the written notice is postmarked or hand-delivered to the parent or caretaker by the eligibility agency.
(c) A single parent or caretaker who applies for subsidized child care and who reports prospective work is not required to pay a copayment until the parent or caretaker receives income from work.
§ 3042.94. Parent or caretaker copayment requirements.
(a) If the copayment is decreased as the result of a parent or caretaker voluntarily reporting a change or as the result of a redetermination, the parent or caretaker shall begin paying the reduced copayment on the first day of the service week following the date the parent or caretaker reported a change or the date the redetermination was completed.
(b) If the copayment is increased as the result of a redetermination, the parent or caretaker shall begin paying the increased copayment on the first service day of the week following the expiration of the notification period specified in § 3042.151(a) (relating to general notification requirements) advising the parent or caretaker of the copayment increase.
(c) The copayment is due on the first day of the service week and each week thereafter, regardless of the day the parent or caretaker enrolls the child.
Cross References This section cited in 55 Pa. Code § 3042.86 (relating to change reporting and processing).
§ 3042.95. Delinquent copayment.
(a) A copayment is delinquent if it is not paid by the last day of the service week.
(b) On the day the provider reports the copayment is delinquent, the eligibility agency shall notify the parent or caretaker in writing that action will be taken to terminate subsidy for the child.
(c) If a copayment is delinquent, the eligibility agency will apply the first payment paid during a week to the current week’s copayment. The eligibility agency will apply subsequent payments during a week to the delinquent copayment.
(d) To maintain eligibility for subsidized child care when a parent or caretaker incurs a copayment delinquency, the parent or caretaker shall pay all of the following prior to the expiration of the notification period:
(1) The current weekly copayment.
(2) The delinquent copayment.
(3) The amount of any additional delinquencies accumulated during the notification period.
Cross References This section cited in 55 Pa. Code § 3042.96 (relating to eligibility agency responsibilities regarding copayment).
§ 3042.96. Eligibility agency responsibilities regarding copayment.
(a) The eligibility agency shall generate notices based on delinquent copayments.
(b) The eligibility agency shall send the provider a copy of each notice issued to a parent or caretaker whose child is enrolled with the provider.
(c) When a copayment is reported to the eligibility agency as delinquent, the eligibility agency shall mail a notice to the parent or caretaker. The notice must state that service will be terminated on a date set forth on the notice, which is the first day after 10 calendar days following the date of the written notice, unless the delinquent copayment is paid by that date.
(d) A family whose subsidy is terminated for failure to make required copayments may not be reauthorized for subsidy until all outstanding copayments have been paid in full as specified in § 3042.95(d) (relating to delinquent copayment).
(e) The eligibility agency shall retain a copy of the termination notice.
(f) The eligibility agency shall distribute, to each parent or caretaker who applies for subsidized child care, a handbook of parent’s rights and responsibilities in the subsidized child care program provided by the Department.
§ 3042.97. Use of the Federal Poverty Income Guidelines and State Median Income.
(a) The FPIG are used to determine the income limits and copayments for subsidized child care.
(b) Following annual publication of the FPIG, the Department will publish an updated copayment chart in Appendix B (relating to copayment chart) through a notice in the Pennsylvania Bulletin.
(c) The eligibility agency shall inform each parent or caretaker of the dollar amount that is equivalent to 235% of FPIG or 85% of the SMI.
(d) The eligibility agency shall inform each parent or caretaker that 235% of FPIG and its specific dollar figure are the highest annual income amounts permitted at the time of redetermination.
(e) The eligibility agency shall inform each parent or caretaker that 85% of the SMI and its specific dollar figure are the highest annual income amounts permitted between redeterminations.
(f) A family is ineligible at any time its annual income exceeds 85% of the SMI.
§ 3042.98. Copayment determination.
(a) The eligibility agency shall determine the family copayment based on the following:
(1) The family size and family income as specified in § § 3042.41—3042.44 (relating to determining family size and income).
(2) A copayment shall be at least $5, unless waived as specified in § § 3042.145(d)(2) and 3042.146(c)(2) (relating to domestic and other violence; and homelessness).
(3) Except as provided under paragraph (2), the family’s annual copayment may not exceed 7% of the family’s annual income.
(4) If the family’s annual income is 100% of FPIG or less, the annual copayment may not exceed 5% of the family’s annual income.
(b) The eligibility agency shall determine the copayment by using the copayment chart in Appendix B (relating to copayment chart).
Cross References This section cited in 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
§ 3042.99. Copayment exceeding monthly payment for care.
(a) If the copayments for 1 month are equal to or exceed the monthly payment for care, the family is not eligible for subsidized child care with that provider. The family must enroll the child or children with another eligible provider as specified in § 3042.12 (relating to parent choice).
(b) If the copayments for 1 month are equal to or exceed the monthly payment for care because other children in the family are currently on the waiting list, the family may choose to suspend the child’s care with that provider until funding becomes available to enroll other children in the family in care.
ELIGIBILITY REDETERMINATION
§ 3042.101. Eligibility redetermination.
(a) The eligibility agency shall complete a redetermination of eligibility no less than every 12 months and establish the family’s next redetermination date.
(b) Prior to the redetermination, the eligibility agency shall do the following:
(1) Provide the parent or caretaker with the Department’s form listing the following information last reported for each parent or caretaker or child in the family:
(i) Earned income.
(ii) Unearned income.
(iii) Hours of work, education or training.
(iv) Family composition.
(v) Address.
(2) Request that the parent or caretaker verify the family’s current income.
(3) Verify the following factors only if the parent or caretaker reports a change:
(i) Work, education or training.
(ii) The number of hours of work, education or training.
(iii) Family composition.
(iv) Address.
(c) The parent’s or caretaker’s annual income must meet the requirements set forth in § 3042.31(c) (relating to financial eligibility).
Cross References This section cited in 55 Pa. Code § 3042.112 (relating to general requirements for former TANF families); and 55 Pa. Code § 3042.133 (relating to eligibility redetermination for Head Start).
§ 3042.102. Procedures for redetermination.
(a) No earlier than 6 weeks prior to redetermination, the eligibility agency shall send the family a form that lists the factors that will be reviewed for the redetermination of eligibility and explain the verification that will be needed to complete the redetermination.
(b) If the parent or caretaker submits only some of the required verification elements prior to the redetermination, the eligibility agency shall request in writing that the parent or caretaker submit the additional verification no later than the family’s redetermination date.
(c) The eligibility agency shall retain a copy of the notification in the family file.
(d) The eligibility agency shall send a written notice to the parent or caretaker regarding failure to provide required verification only after the family’s redetermination date.
(e) The eligibility agency shall require the parent or caretaker to complete, sign, and either mail, hand-deliver, fax or electronically submit the applicable form at each redetermination.
FORMER TANF FAMILIES
§ 3042.111. General provisions for former TANF families.
(a) A family that is no longer eligible for TANF cash assistance benefits or a family that voluntarily left the TANF program and meets the eligibility requirements specified in this chapter may qualify for subsidized child care.
(b) The eligibility agency shall review the information received from the CAO about a parent or caretaker who formerly received TANF benefits.
(c) The eligibility agency shall determine the date TANF benefits ended and establish the 183-day period after eligibility for TANF benefits ends, within which the parent or caretaker may receive child care benefits.
(d) Eligibility for former TANF child care benefits shall begin the day following the date TANF benefits ended and shall continue for 183 consecutive days.
(e) The parent or caretaker may request child care benefits at any time during the 183-day period after eligibility for TANF ended.
(f) The eligibility agency may not place a child on a waiting list if a former TANF parent or caretaker requests subsidized child care for that child any time prior to 184 calendar days after TANF benefits ended.
(g) A family is not eligible for former TANF benefits if a parent or caretaker is currently disqualified from receiving TANF benefits as specified in § § 255.1(c) and 275.51 (relating to restitution and disqualification policy; and imposing the disqualification).
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); 55 Pa. Code § 3042.120 (relating to transfer from other states); and 55 Pa. Code § 3042.121 (relating to expiration of TANF benefits).
§ 3042.112. General requirements for former TANF families.
(a) During the 183-day period after eligibility for TANF benefits ended or after a family voluntarily left the TANF program, a parent or caretaker shall meet the following conditions:
(1) A former TANF parent or caretaker who is not transferred to the eligibility agency by the CAO or who applies for subsidized child care during the 183-day period after eligibility for TANF ended shall meet the work requirement as specified in § 3042.33 (relating to work, education and training).
(2) The family’s annual income may not exceed 85% of the SMI.
(3) The parent or caretaker shall select an eligible child care provider as specified in § 3042.12 (relating to parent choice).
(4) The parent or caretaker shall make timely payment of the copayment as specified in § 3042.91 (relating to general copayment requirements).
(b) A former TANF parent or caretaker who is transferred to the eligibility agency by the CAO or who applies for subsidized child care during the 183-day period after eligibility for TANF ended as specified in subsection (a) shall not be placed on a waiting list.
(c) The eligibility agency shall complete a redetermination of eligibility and establish the family’s next redetermination date as specified in § 3042.101(a) (relating to eligibility redetermination).
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); 55 Pa. Code § 3042.113 (relating to notification requirements for former TANF families); 55 Pa. Code § 3042.115 (relating to reporting requirements for former TANF families); and 55 Pa. Code § 3042.120 (relating to transfer from other states).
§ 3042.113. Notification requirements for former TANF families.
(a) If the eligibility agency determines that a parent or caretaker met the requirements in § 3042.112 (relating to general requirements for former TANF families) and was receiving child care on the date TANF benefits ended, the eligibility agency shall notify the parent or caretaker of the family’s eligibility status and the date the 183-day former TANF period will expire.
(b) If the eligibility agency determines that a parent or caretaker was not receiving child care or cannot determine whether the parent or caretaker was receiving child care on the date TANF benefits ended, the eligibility agency shall notify the parent or caretaker by letter of the following:
(1) The parent or caretaker may be eligible for child care benefits.
(2) The parent or caretaker may contact the eligibility agency if child care is needed during the 183-day period after TANF benefits ended.
(3) Eligibility for subsidized child care is assured if the minimum requirements specified in § 3042.112(a) are met.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); 55 Pa. Code § 3042.114 (relating to personal interview requirements for former TANF families); and 55 Pa. Code § 3042.117 (relating to failure to contact the eligibility agency following the transfer).
§ 3042.114. Personal interview requirements for former TANF families.
(a) When the parent or caretaker contacts the eligibility agency within 183 days after TANF benefits end, the eligibility agency shall inform the parent or caretaker of the requirement to attend a personal interview with the eligibility agency. The personal interview shall occur no later than 30 calendar days following the date of the letter.
(b) When the parent or caretaker contacts the eligibility agency in response to the letter specified in § 3042.113(b) (relating to notification requirements for former TANF families), the eligibility agency shall schedule a personal interview with the parent or caretaker.
(c) To maintain continuous child care payment from the day following the date TANF benefits ended, the parent or caretaker shall attend a personal interview with the eligibility agency as specified in § 3042.115 (relating to reporting requirements for former TANF families).
(d) The eligibility agency may waive the requirement for the personal interview if the parent or caretaker has completed a personal interview with the eligibility agency within the previous 12 months.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); and 55 Pa. Code § 3042.117 (relating to failure to contact the eligibility agency following the transfer).
§ 3042.115. Reporting requirements for former TANF families.
At the time of the parent’s or caretaker’s personal interview with the eligibility agency and within the 183-day period after TANF benefits ended, the eligibility agency shall:
(1) Require the parent or caretaker who contacts the eligibility agency within 60 calendar days following the date TANF benefits ended to self-certify the following information that was electronically transferred by the CAO:
(i) The need for child care to work or attend education or training and the days and hours for which the child needs care.
(ii) The name of the employer, education or training.
(iii) The hours the parent or caretaker works or attends education or training.
(iv) The accuracy of the facts in the TANF transfer information regarding family address, size and income.
(v) Financial eligibility as specified in § 3042.112(a) (relating to general requirements for former TANF families).
(2) Require the parent or caretaker whose information was unavailable or has changed since the time of the electronic transfer to self-declare the information that was unavailable or has changed.
(3) Require the parent or caretaker who does not contact the eligibility agency within 60 calendar days following the date TANF benefits ended to self-declare the following:
(i) The need for child care to work or attend education or training and the days and hours for which the child needs care.
(ii) The name of the employer, education or training.
(iii) The hours the parent or caretaker works or attends education or training.
(iv) The accuracy of the facts in the TANF transfer information regarding family address, size and income.
(v) Financial eligibility as specified in § 3042.112(a).
(4) Advise the parent or caretaker to report income in excess of 85% of the SMI.
(5) The eligibility agency shall require a parent or caretaker to complete a subsidized child care application under the following circumstances:
(i) The parent or caretaker received TANF benefits in another state.
(ii) The CAO did not have sufficient information to electronically transfer to establish a case file.
(6) Advise the parent or caretaker that the eligibility agency shall complete an eligibility determination or redetermination.
(7) Collect information regarding the parent’s or caretaker’s choice of provider or help the parent or caretaker to locate an eligible provider.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); 55 Pa. Code § 3042.63 (relating to self-certification); and 55 Pa. Code § 3042.114 (relating to personal interview requirements for former TANF families).
§ 3042.116. Verification of transfer of TANF benefits.
Documentation by the eligibility agency that indicates the date TANF benefits ended within the State or in another state, as specified in § 3042.120(b) (relating to transfer from other states), is acceptable verification of transfer of TANF benefits within the State or from another state.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care).
§ 3042.117. Failure to contact the eligibility agency following the transfer.
(a) If a parent or caretaker who was receiving child care on the date TANF benefits ended fails to contact the eligibility agency in response to the letter specified in § 3042.113(a) (relating to notification requirements for former TANF families), the eligibility agency shall contact the parent or caretaker by telephone no later than 31 calendar days following the date of the letter.
(b) When the eligibility agency contacts the parent or caretaker as specified in subsection (a), the eligibility agency shall determine the following:
(1) The parent’s or caretaker’s choice to participate in the personal interview.
(2) The parent’s or caretaker’s continuing need for child care.
(c) If the eligibility agency determines that the parent or caretaker was not receiving child care or cannot determine whether the parent or caretaker was receiving child care on the date TANF benefits ended, the eligibility agency may not authorize payment for child care benefits until the date the parent or caretaker contacts the eligibility agency and requests benefits.
(d) If a parent or caretaker who was receiving child care on the date TANF benefits ended does not attend a personal interview as specified in § 3042.114(a) (relating to personal interview requirements for former TANF families), the eligibility agency shall contact the parent or caretaker by telephone no later than the day following the date the parent or caretaker failed to attend the personal interview to determine the information specified in subsection (b).
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care).
§ 3042.118. Payment authorization for former TANF families.
(a) The eligibility agency shall review a request from a parent or caretaker to authorize child care payment at any time during the 183-day period after eligibility for TANF benefits ended.
(b) The eligibility agency shall authorize child care payment at any time during the 183-day period after eligibility for TANF ended.
(c) The eligibility agency may not pay child care costs that exceed the maximum child care allowance minus the family copayment for the type of care the child received from the provider.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care).
§ 3042.119. Retroactive payment for former TANF families.
(a) If the eligibility agency authorizes payment to an eligible provider that is currently participating in the subsidized child care program for a parent or caretaker who was receiving child care on the date TANF benefits ended, the authorization is retroactive to the day following the date TANF benefits ended.
(b) If the eligibility agency determines that the parent or caretaker was not receiving child care or cannot determine whether the parent or caretaker was receiving child care on the date TANF benefits ended, the eligibility agency shall require the parent or caretaker to submit verification of child care costs incurred during the 183-day period after eligibility for TANF ended.
(c) The eligibility agency shall authorize payment to an eligible provider that is currently participating in the subsidized child care program for the parent or caretaker specified in subsection (b) retroactive to the date the parent or caretaker first incurred child care expenses.
(d) If the eligibility agency determines that the parent or caretaker has selected an ineligible provider, it shall inform the parent or caretaker that the parent or caretaker shall contact the eligibility agency to discuss child care arrangements within 30 calendar days as specified in § 3042.12 (relating to parent choice).
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); 55 Pa. Code § 3042.14 (relating to payment of provider charges); and 55 Pa. Code § 3042.86 (relating to change reporting and processing).
§ 3042.120. Transfer from other states.
(a) A parent or caretaker who received TANF program benefits in another state and applies for subsidized child care is eligible if the parent or caretaker meets the following conditions:
(1) The parent or caretaker applies within 183 days after TANF benefits ended.
(2) The parent or caretaker meets the requirements specified in § 3042.112 (relating to general requirements for former TANF families).
(b) The eligibility agency shall determine the date TANF benefits ended in the other state and establish eligibility for the 183-day period after eligibility for TANF ended as specified in § 3042.111 (relating to general provisions for former TANF families).
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); and 55 Pa. Code § 3042.116 (relating to verification of transfer of TANF benefits).
§ 3042.121. Expiration of TANF benefits.
(a) A parent or caretaker who was receiving child care on the date TANF benefits ended and who has exhausted the 5-year limit on TANF benefits is eligible for up to 92 calendar days of subsidized child care to seek work.
(b) The eligibility agency shall determine the date TANF benefits ended and establish the period of former TANF eligibility as specified in § 3042.111 (relating to general provisions for former TANF families).
(c) The parent or caretaker may apply at any time during the 183-day period after eligibility for TANF ended.
(d) The maximum period of potential eligibility for former TANF child care benefits under this section is 183 days.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care); and 55 Pa. Code § 3042.122 (relating to verification of expiration of TANF benefits).
§ 3042.122. Verification of expiration of TANF benefits.
Documentation by the eligibility agency that indicates the date TANF benefits expired within the State or in another state, as specified in § 3042.121(b) (relating to expiration of TANF benefits), is acceptable verification of expiration of TANF benefits.
Cross References This section cited in 55 Pa. Code § 3042.11 (relating to provision of subsidized child care).
HEAD START
§ 3042.131. General provisions for Head Start.
(a) A child who is enrolled in a Head Start program, whose parent or caretaker needs extended hours or days of child care beyond the hours or days provided by the Head Start program to work, is eligible for subsidized child care under this section if the parent or caretaker meets the eligibility requirements for subsidized child care as specified in § 3042.132 (relating to eligibility determination for Head Start) each time a child in the family applies for Head Start special eligibility.
(b) The eligibility agency shall verify with the Head Start program that the child is enrolled in a Head Start program that meets Federal and State Head Start standards.
(c) If a child in the family as specified in § 3042.41 (relating to family size) is enrolled in the Head Start program, the family copayment is based on family size and income. If additional children in the family are enrolled in subsidized child care, the family copayment is based on family size and income.
(d) If extended hours or days of care are provided beyond the Head Start program hours or days, a facility that has a certificate of compliance by the Department as a child care facility shall provide the extended hours and days of care.
Cross References This section cited in 55 Pa. Code § 3042.132 (relating to eligibility determination for Head Start).
§ 3042.132. Eligibility determination for Head Start.
Upon program entry and continuation in the Head Start special eligibility program, a parent or caretaker shall meet the following conditions:
(1) Verification of a minimum of 20 hours of work per week as specified in § 3042.33 (relating to work, education and training) each time a parent or caretaker applies for a child in the family for the Head Start special eligibility program.
(2) Verification that extended hours and days of child care are needed to work as specified in § 3042.131(a) (relating to general provisions for Head Start).
(3) Verification of income eligibility for subsidized child care as specified in § 3042.31 (relating to financial eligibility) each time a parent or caretaker applies for a child in the family for the Head Start program.
(4) Compliance with the waiting list conditions specified in § 3042.57 (relating to waiting list).
(5) Payment of the copayment as specified in § 3042.91 (relating to general copayment requirements).
(6) Report when a child is no longer enrolled in Head Start within 10 calendar days following the date the Head Start enrollment ended.
Cross References This section cited in 55 Pa. Code § 3042.131 (relating to general provisions for Head Start).
§ 3042.133. Eligibility redetermination for Head Start.
(a) The eligibility agency may not complete a redetermination prior to the expiration of the 12-month eligibility period as specified in § 3042.101(a) (relating to eligibility redetermination) upon receiving notification that a child is no longer enrolled in a Head Start program.
(b) The eligibility agency shall conduct a redetermination when the child is no longer enrolled in the Head Start program, if the 12-month redetermination period has expired as specified in § 3042.101(a).
(c) The eligibility agency shall conduct a redetermination as specified in § 3042.101 if the family has additional children who are not enrolled in Head Start but receive subsidized child care. A family that includes a child enrolled in a Head Start program and a child who is not enrolled in a Head Start program is subject to redetermination requirements as specified in § 3042.101(a).
(d) Eligibility for a child enrolled in a Head Start program is unrelated to the eligibility of other children in the family who are not enrolled in a Head Start program and receive subsidized child care. Eligibility for a child enrolled in a Head Start program shall continue as specified in this section.
(e) The eligibility agency shall conduct a redetermination between the time a child is no longer enrolled in Early Head Start and the time the child enters Head Start, with the exception of the requirement set forth in subsection (a).
WAIVERS AND PERIODS OF PRESUMPTIVE ELIGIBILITY
§ 3042.141. General waiver requirements.
The eligibility agency may grant a waiver to a family experiencing domestic violence or homelessness upon the request of the parent or caretaker as specified in § § 3042.145 and 3042.146 (relating to domestic and other violence; and homelessness).
§ 3042.142. Time frame for waiver determinations.
The eligibility agency shall act on a parent’s or caretaker’s waiver request no later than 15 calendar days following the date the parent or caretaker requests the waiver.
§ 3042.143. General verification requirements for waivers.
The Department’s form that provides for verification by documentary evidence, third party statement or self-certification is acceptable verification of domestic violence or homelessness.
§ 3042.144. General notification requirements for waivers.
(a) The eligibility agency shall provide written notice to the parent or caretaker regarding the eligibility agency’s determination to grant or deny a waiver request. At the request of the parent or caretaker, the eligibility agency shall mail the notice to an alternate address or hand-deliver it to the parent or caretaker.
(b) If the eligibility agency grants the waiver, the notice must include the basis for granting the waiver.
(c) If the eligibility agency denies the waiver, the notice must include all of the following:
(1) The basis for the denial.
(2) The right to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
(3) The verification the parent or caretaker shall submit for the eligibility agency to grant the waiver and the time frames in which the parent or caretaker shall submit the verification.
(4) The evidence or information needed to substantiate the waiver request and the time frames in which the parent or caretaker shall provide the information.
§ 3042.145. Domestic and other violence.
(a) The eligibility agency may grant a waiver to a parent or caretaker for any of the following reasons:
(1) A family member is the victim of past or present domestic or other violence.
(2) A family member is the victim of a threat of past or present domestic or other violence.
(b) Except as otherwise provided under this chapter, the eligibility agency may grant a waiver if compliance with a requirement of this chapter would either make it more difficult for a family or household member to escape domestic violence or place a family or household member at risk of domestic violence.
(c) The following requirements of this chapter may not be waived:
(1) Age of the child as specified in § 3042.11(b) and (c) (relating to provision of subsidized child care).
(2) Income limits as specified in § 3042.31 (relating to financial eligibility).
(3) State residency as specified in § 3042.32 (relating to residence).
(4) The minimum number of hours of work, education or training as specified in § 3042.33 (relating to work, education and training).
(5) Citizenship as specified in § 3042.36 (relating to citizenship).
(6) The number of paid absences as specified in § 3042.18 (relating to absence).
(d) The following may be waived for a temporary period not to exceed 92 calendar days:
(1) Verification requirements as specified in § § 3042.61—3042.74 (relating to self-certification and verification).
(2) The amount of copayment as specified in § 3042.98 (relating to copayment determination).
(e) Except as specified in subsections (c) and (d), the eligibility agency will grant a domestic violence waiver for the balance of the 12-month eligibility period following verification being provided to the eligibility agency.
(f) The eligibility agency shall utilize and accept the Department’s form providing for verification by documentary evidence, third party statement or self-certification as acceptable verification of domestic violence. The following apply:
(1) If the eligibility agency does not receive the required verifications before expiration of the 92-day period specified in subsection (d), or if the family is otherwise determined to be ineligible, the eligibility agency shall take the necessary steps to terminate the temporary eligibility with proper notification to the family as specified in § 3042.155 (relating to notice of adverse action).
(2) If a family is determined ineligible or fails to provide the required verifications, services received during the 92-day period are not considered an error or improper payment. The eligibility agency will pay the amount owed to a child care provider for services provided.
Cross References This section cited in 55 Pa. Code § 3042.98 (relating to copayment determination); 55 Pa. Code § 3042.141 (relating to general waiver requirements); and 55 Pa. Code § 3042.161 (relating to appealable actions).
§ 3042.146. Homelessness.
(a) At the time of application, the eligibility agency may grant a period of presumptive eligibility to a parent or caretaker who is experiencing homelessness as defined in § 3042.3 (relating to definitions) for a temporary period not to exceed 92 calendar days.
(b) A parent or caretaker who is experiencing homelessness may be permitted to substitute job search activities to meet the work requirement specified in § 3042.33 (relating to work, education and training) for the duration of the period of presumptive eligibility for a temporary period not to exceed 92 calendar days.
(c) A parent or caretaker may be permitted to self-certify their status as experiencing homelessness as specified in § 3042.63 (relating to self-certification) to qualify for and be granted a period of presumptive eligibility for a temporary period not to exceed 92 calendar days.
(d) Except as specified in subsections (e) and (f), the eligibility agency will grant a waiver to families who are experiencing homelessness the balance of the 12-month eligibility period following verification being provided to the eligibility agency.
(e) The following requirements of this chapter may not be waived:
(1) Age of the child as specified in § 3042.11(b) and (c) (relating to provision of subsidized child care).
(2) Income limits as specified in § 3042.31 (relating to financial eligibility).
(3) State residency as specified in § 3042.32 (relating to residence).
(4) The minimum number of hours of work, education or training as specified in § 3042.33 (relating to work, education and training), subject to the provisions in subsection (b).
(5) Citizenship as specified in § 3042.36 (relating to citizenship).
(6) The number of paid absences as specified in § 3042.18 (relating to absence).
(f) The following requirements of this chapter may be waived for a temporary period not to exceed 92 calendar days:
(1) Verification requirements as specified in § § 3042.61—3042.74 (relating to self-certification and verification).
(2) The amount of the copayment as specified in § 3042.98 (relating to copayment determination).
(g) The eligibility agency shall utilize and accept the Department’s form providing for verification by documentary evidence, third party statement or self-certification as acceptable verification of homelessness. The following apply:
(1) If the eligibility agency does not receive the required verifications before expiration of the 92-day period specified in subsection (f), or if the family is determined ineligible, the eligibility agency shall take the necessary steps to terminate the temporary eligibility with proper notification to the family as specified in § 3042.155 (relating to notice of adverse action).
(2) If a family is determined ineligible at any time during a temporary period of presumptive eligibility, services received during the 92-day period are not considered an error or improper payment. The eligibility agency will pay the amount owed to a child care provider for services provided during the temporary period of presumptive eligibility.
(h) At the end of a 92-day temporary period of presumptive eligibility, the eligibility agency may establish a new 12-month eligibility period and reset the redetermination due date.
Cross References This section cited in 55 Pa. Code § 3042.3 (relating to definitions); 55 Pa. Code § 3042.98 (relating to copayment determination); 55 Pa. Code § 3042.141 (relating to general waiver requirements); 55 Pa. Code § 3042.147 (relating to presumptive continued eligibility at redetermination); and 55 Pa. Code § 3042.161 (relating to appealable actions).
§ 3042.147. Presumptive continued eligibility at redetermination.
(a) The eligibility agency may grant a temporary period of presumptive continued eligibility to a parent or caretaker at redetermination for a period not to exceed 92 calendar days from the date of the redetermination.
(b) For a parent or caretaker to be granted a period of presumptive continued eligibility at redetermination, the parent or caretaker shall submit verification of work, education or training that satisfies the work-hour requirement as specified in § 3042.33 (relating to work, education and training) that is set to begin prior to the expiration of the temporary 92-day period specified in subsection (a), unless the provisions in § 3042.146 (relating to homelessness) apply.
(c) Prior to the expiration of the temporary 92-day period of presumptive continued eligibility, the eligibility agency will verify the parent or caretaker has begun work, education or training and is in compliance with the work-hour requirement specified in § 3042.33.
(d) If the parent or caretaker has not begun work, education or training as specified in subsection (b), or is otherwise determined ineligible prior to the expiration of the 92-day period, the eligibility agency shall take the necessary steps to terminate the temporary eligibility with proper notification to the family as specified in § 3042.155 (relating to notice of adverse action).
(e) If a family is determined ineligible at any time during a temporary period of presumptive continued eligibility, services received during the 92-day period are not considered an error or improper payment. The eligibility agency will pay the amount owed to a child care provider for services provided during the temporary period of presumptive continued eligibility.
(f) At the end of a 92-day temporary period of presumptive continued eligibility, the eligibility agency will complete a redetermination to establish the 12-month eligibility period and reset the redetermination due date.
Cross References This section cited in 55 Pa. Code § 3042.3 (relating to definitions); and 55 Pa. Code § 3042.161 (relating to appealable actions).
NOTIFICATION AND RIGHT TO APPEAL
§ 3042.151. General notification requirements.
(a) The eligibility agency shall issue written notification to the parent or caretaker no later than 13 calendar days prior to taking an action that affects the family’s eligibility status for subsidized child care or a change in the amount of the family’s subsidized child care benefit.
(b) Following the preparation of a written notice, the eligibility agency shall:
(1) Mail or hand-deliver, within 1 working day of preparation, the original and one copy of the notice to the parent or caretaker.
(2) Notify the family’s child care provider as soon as the family is determined eligible or ineligible for subsidized child care.
(3) Retain a copy of the notice in the family file as specified in § 3042.84 (relating to family file).
Cross References This section cited in 55 Pa. Code § 3042.94 (relating to parent or caretaker copayment requirements).
§ 3042.152. Notice of right to appeal.
The following information must be included in the notice of the right to appeal:
(1) The statement regarding the parent’s or caretaker’s right to appeal.
(2) The time frame associated with filing a timely appeal as specified in § § 3042.164(d) and 3042.166(b) (relating to parent or caretaker rights and responsibilities regarding appeal; and hearing procedures).
(3) The time frame associated with subsidy continuation as specified in § 3042.163 (relating to subsidy continuation during the appeal process).
(4) The consequence of filing an untimely appeal.
(5) The responsibility to repay if subsidy continues and the parent or caretaker does not win the appeal.
(6) Instructions regarding how to appeal.
Cross References This section cited in 55 Pa. Code § 3042.144 (relating to general notification requirements for waivers); 55 Pa. Code § 3042.153 (relating to notice of eligibility); 55 Pa. Code § 3042.154 (relating to notice of ineligibility); 55 Pa. Code § 3042.155 (relating to notice of adverse action); 55 Pa. Code § 3042.156 (relating to notice confirming voluntary withdrawal); 55 Pa. Code § 3042.157 (relating to notice confirming a change in benefits); 55 Pa. Code § 3042.158 (relating to notice confirming a change in copayment); and 55 Pa. Code § 3042.159 (relating to notice of overpayment).
§ 3042.153. Notice of eligibility.
(a) The notice of eligibility must be on a form provided by the Department.
(b) If the eligibility agency determines a family eligible for subsidy upon initial application, at the time of redetermination or at a review of a reported change, the written notification must include all of the following:
(1) The amount of the copayment.
(2) The parent’s or caretaker’s responsibility to pay the copayment as specified in § 3042.91(e) (relating to general copayment requirements).
(3) The parent’s or caretaker’s responsibility to report changes as specified in § 3042.86 (relating to change reporting and processing).
(4) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(5) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
§ 3042.154. Notice of ineligibility.
(a) The notice of ineligibility must be on a form provided by the Department.
(b) If the eligibility agency determines a family ineligible for subsidy, the written notification must include all of the following:
(1) The decision.
(2) The reason for the decision.
(3) A citation, and brief explanation in simple, nontechnical language, of the applicable section of this chapter or other applicable law that was the basis for the decision.
(4) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(5) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
§ 3042.155. Notice of adverse action.
(a) The eligibility agency shall send a notice to a parent or caretaker currently receiving subsidy when the eligibility agency proposes to terminate subsidy payment.
(b) The eligibility agency shall prepare a notice of adverse action on a form provided by the Department.
(c) The notice of adverse action must include all of the following:
(1) The decision or proposed action.
(2) The date the action will occur.
(3) The reason for the decision or proposed action and information about how to become eligible.
(4) A citation, and brief explanation in simple, nontechnical language, of the applicable section of this chapter or other applicable law that is the basis for the decision or proposed action.
(5) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(6) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
Cross References This section cited in 55 Pa. Code § 3042.22 (relating to subsidy termination); 55 Pa. Code § 3042.64 (relating to self-declaration); 55 Pa. Code § 3042.86 (relating to change reporting and processing); 55 Pa. Code § 3042.145 (relating to domestic and other violence); 55 Pa. Code § 3042.146 (relating to homelessness); and 55 Pa. Code § 3042.147 (relating to presumptive continued eligibility at redetermination).
§ 3042.156. Notice confirming voluntary withdrawal.
(a) The eligibility agency shall, by written notice to the parent or caretaker, confirm the parent’s or caretaker’s voluntary withdrawal of a child from subsidized child care.
(b) The notice confirming voluntary withdrawal must be on a form provided by the Department.
(c) The written notice confirming voluntary withdrawal must include all of the following:
(1) The decision.
(2) The reason for the decision.
(3) A citation, and brief explanation in simple, nontechnical language, of the applicable section of this chapter or other applicable law that was the basis for the decision.
(4) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(5) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
Cross References This section cited in 55 Pa. Code § 3042.87 (relating to voluntary request to terminate subsidized child care).
§ 3042.157. Notice confirming a change in benefits.
(a) The eligibility agency shall, by written notice to the parent or caretaker, confirm a change in the parent’s or caretaker’s subsidized child care benefits when the change does not affect the family’s eligibility. Changes in benefits include a change in the number of days or hours during which the child is enrolled, subsidy suspension and subsidy disruption.
(b) The notice confirming a change in benefits must be on a form provided by the Department.
(c) The written notice confirming a change in benefits must include all of the following:
(1) The decision.
(2) The reason for the decision.
(3) A citation, and brief explanation in simple, nontechnical language, of the applicable section of this chapter or other applicable law that was the basis for the decision.
(4) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(5) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
§ 3042.158. Notice confirming a change in copayment.
(a) The eligibility agency shall, by written notice to the parent or caretaker, confirm a change in the family copayment amount.
(b) The notice confirming a change in copayment must be on a form provided by the Department.
(c) The written notice confirming a change in copayment must include all of the following:
(1) The decision.
(2) The reason for the decision.
(3) A citation, and brief explanation in simple, nontechnical language, of the applicable section of this chapter or other applicable law that was the basis for the decision.
(4) The amount of the copayment and the date the change in copayment will become effective.
(5) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(6) The right of the parent or caretaker to appeal the decision and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
§ 3042.159. Notice of overpayment.
(a) The eligibility agency shall notify the parent or caretaker in writing of an overpayment.
(b) The notice of overpayment must include all of the following:
(1) The reason for the overpayment as specified in § 3042.171 (relating to overpayment).
(2) The period of the overpayment.
(3) The amount of the overpayment.
(4) An explanation of how the overpayment was calculated.
(5) The repayment methods as specified in § 3042.176 (relating to collection), except in cases of suspected fraud.
(6) The name, address and telephone number of the local legal services office where the parent or caretaker may obtain free legal representation.
(7) The right of the parent or caretaker to appeal the decision on the overpayment and how to appeal as specified in § § 3042.152 and 3042.161 (relating to notice of right to appeal; and appealable actions).
Cross References This section cited in 55 Pa. Code § 3042.172 (relating to eligibility agency responsibilities regarding overpayment).
APPEAL AND HEARING PROCEDURES
§ 3042.161. Appealable actions.
A parent or caretaker has the right to appeal a Departmental or eligibility agency action or failure to act, including the following:
(1) Denial of subsidy, including a period of presumptive eligibility as specified in § § 3042.146 and 3042.147 (relating to homelessness; and presumptive continued eligibility at redetermination).
(2) Termination of subsidy.
(3) Computation of the copayment.
(4) Denial of a request for waiver of a requirement of this chapter based on domestic violence or homelessness as specified in § 3042.145 (relating to domestic and other violence) and § 3042.146.
(5) Failure of the eligibility agency to act upon a request for subsidy within the time limits specified in this chapter.
(6) Subsidy suspension as specified in § § 3042.18 and 3042.20 (relating to absence; and subsidy suspension).
(7) Subsidy disruption as specified in § 3042.21 (relating to subsidy disruption).
(8) Subsidy termination as specified in § 3042.22 (relating to subsidy termination).
Cross References This section cited in 55 Pa. Code § 3042.144 (relating to general notification requirements for waivers); 55 Pa. Code § 3042.153 (relating to notice of eligibility); 55 Pa. Code § 3042.154 (relating to notice of ineligibility); 55 Pa. Code § 3042.155 (relating to notice of adverse action); 55 Pa. Code § 3042.156 (relating to notice confirming voluntary withdrawal); 55 Pa. Code § 3042.157 (relating to notice confirming a change in benefits); 55 Pa. Code § 3042.158 (relating to notice confirming a change in copayment); and 55 Pa. Code § 3042.159 (relating to notice of overpayment).
§ 3042.162. Discontinuation of subsidy during the appeal process.
(a) Subsidy is not continued pending a hearing decision if the parent or caretaker appeals the disruption of subsidy when the eligibility agency lacks funding to continue subsidy to a child as specified in § 3042.21 (relating to subsidy disruption).
(b) Subsidy is suspended pending a hearing decision if the parent or caretaker fails to make timely payment of the copayment.
(c) Following a suspension under subsection (b), a subsidy will be reinstated pending the hearing decision if all copayments are brought up to date.
§ 3042.163. Subsidy continuation during the appeal process.
(a) Subsidy continues at the prior level until the Department hears the appeal and makes a final decision, if the parent or caretaker does any of the following:
(1) Files an appeal that is postmarked or delivered no later than 10 calendar days after the date of the written notice.
(2) Appeals for a reason other than disruption of subsidy or a lack of funding.
(b) If subsidy continues as specified in subsection (a), the parent or caretaker shall continue to make timely payment of the copayment that was in effect prior to issuance of the written notice until the Department makes a final decision as specified in § 3042.91 (relating to general copayment requirements).
(c) If subsidy continues during the appeal process and the hearing officer finds in favor of the eligibility agency or the Department, the parent or caretaker shall reimburse the Department for the amount of the subsidy or increase in subsidy paid for child care from the proposed effective date of the written notice until the date subsidy is terminated or decreased, based on the final administrative action order.
Cross References This section cited in 55 Pa. Code § 3042.152 (relating to notice of right to appeal); 55 Pa. Code § 3042.164 (relating to parent or caretaker rights and responsibilities regarding appeal); and 55 Pa. Code § 3042.165 (relating to eligibility agency responsibilities regarding appeal).
§ 3042.164. Parent or caretaker rights and responsibilities regarding appeal.
(a) A parent or caretaker appealing a written notice shall submit a written request to the eligibility agency in accordance with Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings) within 30 calendar days following notification. The parent or caretaker shall specify the reason for the appeal and the current address and a telephone number, if possible, where the parent or caretaker can be reached during the day.
(b) A parent or caretaker may orally appeal. The eligibility agency shall document the date of the oral appeal in the case file. The parent or caretaker shall confirm the oral appeal in writing to the eligibility agency no later than 7 calendar days following the date the parent or caretaker orally requested an appeal.
(c) A parent or caretaker may authorize an adult to represent the parent or caretaker at the hearing.
(d) If the parent or caretaker wants subsidy to continue pending a hearing decision, subject to § 3042.163 (relating to subsidy continuation during the appeal process), the parent or caretaker shall submit a written appeal no later than 10 calendar days following the date the written notice is postmarked or hand-delivered to the parent or caretaker by the eligibility agency.
(e) If the parent or caretaker requests that subsidy continue pending a hearing decision, the parent or caretaker shall make timely payment of the copayment that was in effect prior to issuance of the written notice until the Department makes a final decision as specified in § 3042.91 (relating to general copayment requirements).
Cross References This section cited in 55 Pa. Code § 3042.152 (relating to notice of right to appeal).
§ 3042.165. Eligibility agency responsibilities regarding appeal.
(a) If the parent or caretaker is unable to prepare a written appeal, the eligibility agency shall assist the parent or caretaker in preparing a written appeal. The parent or caretaker shall sign the appeal request.
(b) When the eligibility agency receives an appeal that is timely postmarked or delivered, the eligibility agency shall date-stamp the appeal, the envelope and the attachments with the date of receipt and retain copies of all original appeal information.
(c) The eligibility agency shall keep a copy and forward the original appeal along with the postmarked envelope to the Department’s Bureau of Hearings and Appeals no later than 3 working days following the date the appeal is received by the eligibility agency.
(d) The eligibility agency may not take the proposed adverse action until 13 calendar days following the date the written notice is postmarked or hand-delivered to the parent or caretaker and then only if the parent or caretaker has not filed an appeal. Subsidy may be continued at the prior level only if the parent or caretaker meets the requirements in § 3042.163 (relating to subsidy continuation during the appeal process).
(e) The eligibility agency may take the proposed adverse action before 13 calendar days following the date a provider closes for financial difficulties or loss of certification or if funding is not available to continue subsidized care to the child.
§ 3042.166. Hearing procedures.
(a) Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings) applies to hearings that are held under this chapter, except as specifically superseded by this chapter.
(b) The Department will dismiss an appeal postmarked or delivered after 30 calendar days from the date the written notice is postmarked or hand-delivered to the parent or caretaker unless one of the provisions allowing for appeals after 30 calendar days applies as specified in § 275.3(b)(2) and (3) (relating to requirements).
(c) The hearing may be conducted by a telephone conference call with the parties to the appeal, including the parent or caretaker, the authorized representative of the parent or caretaker, the eligibility agency, the Department and the hearing officer.
(d) The parent or caretaker has the right to request a face-to-face hearing instead of a telephone hearing. Face-to-face hearings will be held in locations specified by the Department.
(e) If a parent or caretaker does not withdraw an appeal, the eligibility agency, or the Department, if appropriate, will take part in the scheduled hearing to justify the action to which the parent or caretaker objects.
(f) If the eligibility agency or the Department fails to appear at the hearing and the parent or caretaker appears, the parent’s or caretaker’s appeal will be sustained.
(g) If the parent or caretaker fails to appear for the hearing, regardless of whether the eligibility agency or the Department appears, the appeal is considered abandoned and the decision of the eligibility agency or the Department will be sustained.
(h) The Department will notify the eligibility agency and the parent or caretaker, in writing, when disposition of the appeal is made.
(i) The eligibility agency shall implement the final administrative action within the time limit ordered by the Department or on the first day child care is needed in the week following receipt of the final administrative action order.
Cross References This section cited in 55 Pa. Code § 3042.152 (relating to notice of right to appeal).
OVERPAYMENT AND DISQUALIFICATION
§ 3042.171. Overpayment.
The parent or caretaker may not be required to repay an overpayment except for an overpayment resulting from one of the following:
(1) Fraud.
(2) Failure to comply with this chapter.
(3) Subsidy continuation pending an appeal when the parent or caretaker did not win the appeal.
Cross References This section cited in 55 Pa. Code § 3042.159 (relating to notice of overpayment); 55 Pa. Code § 3042.172 (relating to eligibility agency responsibilities regarding overpayment); and 55 Pa. Code § 3042.176 (relating to collection).
§ 3042.172. Eligibility agency responsibilities regarding overpayment.
(a) The eligibility agency shall inform a parent or caretaker who files an appeal and requests subsidy continuation pending appeal that, if the hearing decision is in favor of the eligibility agency or the Department, the parent or caretaker shall reimburse the amount of the overpayment unless the hearing officer determines a hardship.
(b) The eligibility agency shall pursue possible overpayments in active and closed cases, including those that were voluntarily closed.
(c) The following are the responsibilities of the eligibility agency when exploring possible overpayments:
(1) Determination of whether the overpayment is the result of one of the conditions specified in § 3042.171 (relating to overpayment).
(2) Written assurance that the methods of exploring overpayments are appropriate to the particular situation and to the different eligibility factors.
(3) Assurance that the methods of exploring overpayments do not infringe on the civil liberties of individuals or interfere with the due process of law.
(4) Investigation of a credible complaint that a parent or caretaker is erroneously receiving subsidized child care.
(5) Identification and documentation of the causes of the overpayment.
(6) Computation of the amount of the overpayment.
(7) Referral of suspected fraud cases to the Office of Inspector General.
(8) Submission of an overpayment notice to the parent or caretaker as specified in § 3042.159 (relating to notice of overpayment).
(d) The eligibility agency shall refer all cases of suspected provider fraud to the Office of Inspector General.
Cross References This section cited in 55 Pa. Code § 3042.176 (relating to collection); and 55 Pa. Code § 3042.178 (relating to collection for a family whose child is no longer in care).
§ 3042.173. Delaying recoupment.
(a) Recoupment shall be delayed until after a hearing decision if the family files an appeal of the overpayment decision no later than 10 calendar days after the date the written notice is postmarked or hand-delivered to the parent or caretaker by the eligibility agency.
(b) Recoupment shall be delayed for cases referred to the Office of Inspector General for suspected fraud until the investigation is complete.
(c) The method of recoupment in cases of suspected fraud will be determined in conjunction with the Office of Inspector General.
§ 3042.174. Notifying the Department.
The eligibility agency shall notify the Department when recoupment stops before the overpayment is fully recouped.
§ 3042.175. Repayment.
The parent or caretaker shall repay the eligibility agency or Department the full amount of the overpayment.
§ 3042.176. Collection.
(a) The eligibility agency shall collect the total amount of the overpayment from a family whose child continues to receive subsidized child care when the eligibility agency identifies an overpayment as specified in § 3042.172 (relating to eligibility agency responsibilities regarding overpayment).
(b) If the Department, eligibility agency or other entity identifies an overpayment unrelated to fraud, subject to repayment as specified in § 3042.171 (relating to overpayment), related to a family whose child continues to receive subsidized child care, the eligibility agency shall do all of the following:
(1) Notify the parent or caretaker by a letter that a repayment is required, the amount of the repayment and the following repayment options:
(i) A one-time payment of the full amount owed.
(ii) A one-time partial payment and an increase in the copayment to be paid until repayment is complete.
(iii) An increase in the copayment until the repayment is complete.
(2) Automatically implement an increase to the copayment until the repayment is complete when the parent or caretaker does not select an option as specified in paragraph (1) no later than 10 calendar days following the date of the letter.
(3) Notify the parent or caretaker by a second letter of failure to choose a repayment option as specified in paragraph (1), the amount of the increased copayment and the number of weeks the increased copayment will continue.
(c) When the Office of Inspector General has determined fraud in an active case, the eligibility agency shall determine collection methods in conjunction with the Office of Inspector General.
Cross References This section cited in 55 Pa. Code § 3042.91 (relating to general copayment requirements); and 55 Pa. Code § 3042.159 (relating to notice of overpayment).
§ 3042.177. Copayment increase related to overpayment.
(a) A copayment increase for the purpose of collecting an overpayment may not exceed an amount greater than 5% of the family’s gross monthly income. If the parent or caretaker indicates to the eligibility agency that an increase to 5% would cause hardship to the family, the family and the eligibility agency may agree to a lesser amount.
(b) A parent or caretaker may choose to increase the copayment beyond the amount specified in subsection (a) to repay an overpayment in a shorter period of time.
(c) The eligibility agency shall issue a written notice before implementation of an increase in the copayment.
§ 3042.178. Collection for a family whose child is no longer in care.
(a) The eligibility agency shall collect the total amount of the overpayment as specified in § 3042.172 (relating to eligibility agency responsibilities regarding overpayment) from a family whose child is no longer receiving subsidized child care if the eligibility agency identifies an overpayment.
(b) If the Department, eligibility agency or other entity identifies an overpayment unrelated to fraud, for a family whose child is no longer receiving subsidized child care, the eligibility agency shall do all of the following:
(1) Notify the Department of the subsidy termination date, the amount of the overpayment recouped and the amount outstanding. The Department will notify the parent or caretaker by letter of the overpayment, the amount of the outstanding overpayment and that repayment is required in either a single payment or under a payment plan agreeable to the parent or caretaker and the eligibility agency. The letter must state that the parent or caretaker has 10 calendar days to respond to the Department indicating agreement or disagreement and indicating the choice of a repayment method.
(2) Send a second letter that repeats the information contained in the letter specified in paragraph (1) when the Department notifies the eligibility agency that the parent or caretaker failed to respond. The second letter must also request a response from the parent or caretaker no later than 10 calendar days following the date of the letter.
(c) When the Office of Inspector General has determined fraud in a case when the child is no longer in care, the eligibility agency shall determine the collection methods in conjunction with the Office of Inspector General.
(d) The Department may institute civil legal proceedings when the parent or caretaker fails to respond to the second letter.
§ 3042.179. Disqualification.
(a) The parent or caretaker is disqualified from participating in the subsidized child care program if one of the following applies:
(1) A Federal or State court finds the parent or caretaker guilty of fraud in applying for or receiving subsidized child care.
(2) A hearing officer determines that the parent or caretaker committed fraud under the procedures and standards in Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings).
(3) The parent or caretaker signs a disqualification consent agreement as part of a court’s deferred adjudication process.
(4) The parent or caretaker agrees to be disqualified by signing an administrative disqualification hearing waiver.
(b) Upon disqualification under subsection (a), a parent or caretaker and eligible children in the parent’s or caretaker’s family is prohibited from participation in the subsidized child care program:
(1) For 6 months from the date of the first conviction, hearing decision or determination.
(2) For 12 months from the second conviction, hearing decision or determination.
(3) Permanently from the date of the third conviction, hearing decision or determination.
(c) A parent or caretaker may not be granted a hearing on a court conviction or administrative disqualification hearing decision that led to the disqualification.
APPENDIX A
Income to be Included, Deducted and Excluded in Determining Gross Monthly Income PART I. Income inclusions.
Income from the following sources is included when determining total gross monthly income:
A. Money, wages or salary earned by a parent or caretaker before deductions for taxes, Social Security, savings bonds, pensions, union dues, health insurance and similar purposes, for work performed as an employee. This includes commissions, tips, piece-rate payments and cash bonuses. Income earned by an unemancipated minor is not included.
B. Armed forces pay, which includes base pay plus cash, but does not include housing subsistence, allowances or the value of rent-free quarters.
C. Voluntary and court-ordered support received for any person in the family.
D. Net income from nonresident and real property, defined as gross receipts minus the expenses for continuing the income, such as depreciation charges, business taxes (not personal income taxes), interest on mortgages, repairs and similar expenses.
E. Social Security benefits, Supplemental Security Income, survivors’ benefits and permanent disability insurance payments made by the Social Security Administration before deductions of health insurance premiums.
F. Railroad retirement, disability or survivors’ benefit payments made by the United States Government under the Railroad Retirement Act of 1974 (45 U.S.C. § § 231—231v) before deductions of health insurance premiums.
G. State blind pension payments made by the Department.
H. Public assistance benefits or retirement benefits.
I. Private pensions and annuities, including retirement benefits paid to a retired person or their survivors by a former employer or a union, either directly or through an insurance company.
J. Government employee pensions paid by Federal, State, county or other governmental agencies to former employees, including members of the armed forces, or their survivors.
K. Unemployment compensation received from government unemployment insurance agencies or private companies during periods of unemployment and strike benefits received from union funds.
L. Workers’ compensation received from private or public insurance companies.
M. Veterans’ payments, defined as money paid periodically by the Veterans Administration to disabled members of the armed forces or to the survivors or dependents of deceased or disabled veterans, subsistence allowances paid to the survivors of deceased veterans and subsistence allowances paid to veterans for education and on-the-job training, as well as so-called ‘‘refunds’’ paid to ex-service persons as GI insurance premiums. For a disabled veteran in the Vocational Rehabilitation Program, the subsistence allowance and the veteran’s disability allowance are counted as income.
N. Capital gains, profit from S-corporations and dividends, including dividends from stocks, bonds, mutual funds or from membership in an association.
O. Interest on savings and bonds.
P. Income from estates and trust funds.
Q. Net income from royalties.
R. Lump sum cash of more than $100; inheritances, life insurance benefits; personal injury and other damage awards and settlements; retroactive benefits such as retirement, survivor’s or disability insurance and delayed unemployment: divorce settlements; gifts; or workers’ compensation.
S. Lump-sum cash lottery winnings or cash prizes of more than $100.
T. Profit from self-employment, calculated as total gross receipts minus costs of doing business. The costs of doing business shall only include the following:
(1) Costs of maintaining a place of business, such as rent, utilities, insurance on the business and its property, and property taxes. If a business is operated in a home, the costs of maintaining a place of business are only those costs identified for the part of the home used exclusively for the business.
(2) Interest on the purchase of income-producing equipment and property.
(3) Employee labor costs, such as wage, salaries, taxes, benefits, unemployment compensation or workers’ compensation.
(4) Cost of goods sold, supplies and materials.
(5) Advertising costs.
(6) Accounting and legal fees.
(7) Transportation costs necessary to produce income.
U. Net income from room rent or room and board, calculated as follows: Gross income received minus $10 per month for each room rented. Divide the remainder by 2. That number is the income inclusion.
Conversion Table Convert weekly, biweekly, semimonthly and other pay periods to gross monthly amounts using the following conversion table:
Frequency of income Conversion method Daily Multiply the daily income by the number of workdays in a week, then multiply by 4.3. Weekly Multiply by 4.3. Biweekly (every 2 weeks) Divide by 2, then multiply by 4.3. Semimonthly (twice per month) Multiply by 2 for monthly gross income. Monthly Use the figure given. Quarterly Divide by 3. Annually Divide by 12. Lump sum income Divide by 12.
Cross References This appendix cited in 55 Pa. Code § 3042.43 (relating to income adjustment); and 55 Pa. Code § 3042.44 (relating to estimating income).
PART II. Income deductions.
The following are deducted when determining adjusted monthly income:
A. Voluntary or court-ordered support paid by the parent or caretaker or a family member to a present or former spouse not residing in the same household.
B. Voluntary or court-ordered child support paid by the parent or caretaker or family member to a person not residing in the same household.
C. A medical expense not reimbursed through medical insurance that exceeds 10% of the family gross monthly income. The medical expense must have been incurred within the 90-day period prior to the date the parent or caretaker notifies the eligibility agency of that expense and there must be an expectation that the expense will continue to be incurred for the 6 months following the outset of the expense. Medical expenses are based on the monthly expenses or monthly payment plan, or both. Medical expenses include bills for doctors, hospital costs, dental services, health care premiums, institutional care, medications, prosthetic devices, durable medical equipment or mental health services.
D. The stepparent deduction as shown in Appendix C (relating to stepparent deduction chart).
Cross References This appendix cited in 55 Pa. Code § 3042.43 (relating to income adjustment).
PART III. Income exclusions.
Income from the following sources is excluded in determining gross monthly income:
A. Employment earnings of an individual who is an unemancipated minor.
B. Tax refunds, including earned income tax credits.
C. Withdrawals of bank, credit union or brokerage deposits.
D. Money borrowed.
E. Nonrecurring money in amounts under $100 per person per year, given as a gift, from any source.
F. The value of benefits under the Food Stamp Act of 1977 (7 U.S.C. § § 2011—2036d).
G. The value of foods donated from the United States Department of Agriculture.
H. The value of supplemental foods assistance under the Child Nutrition Act of 1966 (42 U.S.C. § § 1771—1793) and the special food service programs for children under that act.
I. Loans and grants, such as scholarships, obtained and used for conditions that preclude their use for living costs.
J. A grant or loan to an undergraduate student for educational purposes, made or insured under any program administered under the Higher Education Act of 1965 (20 U.S.C. § § 1001—1161aa-1).
K. A payment received under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (42 U.S.C. § § 4601—4655).
L. A home produce used for household consumption.
M. A payment made on behalf of an individual for household expenses, such as rent, food and utilities.
N. Payments to Volunteers in Service to America under the Domestic Volunteer Service Act of 1973 (42 U.S.C. § § 4950—5085), which include AmeriCorps income.
O. Earnings received by any youth under the Workforce Investment Act of 1998, as amended (Pub.L. No. 105-220) or the Youth Build Program (29 U.S.C. § 3226).
P. Foster care payments by a foster care placement agency, including payments to permanent legal custodians.
Q. Stipends derived from the Foster Grandparent Program under section 211 of the Domestic Violence Service Act of 1973 (42 U.S.C. § 5011).
R. Low Income Home Energy Assistance Program (LIHEAP) benefits and cash in-kind energy assistance provided by private agencies and utility companies.
S. Adoption assistance payments by a county children and youth agency.
T. Income received from Federal student aid or participation in a Federal work-study program.
U. Payments made by the Veterans Administration to children of Vietnam veterans under The Benefits for Children of Vietnam Veterans Act (38 U.S.C. § § 1802—1838).
APPENDIX B
Copayment Chart
Family Copayment Scale Effective May 6, 2024
(Based on the 2024 Federal Poverty Income Guidelines)
Weekly Family Size: 1 Weekly Family Size: 2 Weekly Family Size: 3 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $7,963 $5 Less than: $8,406 $5 Less than: $9,102 $6 $7,963.01 $8,848 $6 $8,406.01 $9,607 $6 $9,102.01 $10,618 $7 $8,848.01 $9,733 $7 $9,607.01 $10,808 $8 $10,618.01 $12,135 $8 $9,733.01 $10,617 $8 $10,808.01 $12,009 $9 $12,135.01 $13,652 $9 $10,617.01 $11,502 $10 $12,009.01 $13,209 $11 $13,652.01 $15,169 $10 $11,502.01 $12,387 $11 $13,209.01 $14,410 $12 $15,169.01 $16,686 $11 $12,387.01 $13,272 $12 $14,410.01 $15,611 $14 $16,686.01 $18,203 $12 $13,272.01 $14,156 $14 $15,611.01 $16,812 $15 $18,203.01 $19,720 $13 $14,156.01 $15,041 $15 $16,812.01 $18,013 $17 $19,720.01 $21,237 $14 $15,041.01 $15,926 $17 $18,013.01 $19,214 $19 $21,237.01 $22,754 $16 $15,926.01 $16,811 $18 $19,214.01 $20,414 $21 $22,754.01 $24,271 $17 $16,811.01 $17,696 $20 $20,414.01 $21,615 $23 $24,271.01 $25,788 $18 $17,696.01 $18,580 $21 $21,615.01 $22,816 $25 $25,788.01 $27,305 $19 $18,580.01 $19,465 $23 $22,816.01 $24,017 $27 $27,305.01 $28,822 $20 $19,465.01 $20,350 $24 $24,017.01 $25,218 $29 $28,822.01 $30,339 $22 $20,350.01 $21,235 $26 $25,218.01 $26,419 $31 $30,339.01 $31,855 $23 $21,235.01 $22,119 $28 $26,419.01 $27,620 $33 $31,855.01 $33,372 $24 $22,119.01 $23,004 $29 $27,620.01 $28,820 $35 $33,372.01 $34,889 $26 $23,004.01 $23,889 $31 $28,820.01 $30,021 $37 $34,889.01 $36,406 $27 $23,889.01 $24,774 $33 $30,021.01 $31,222 $39 $36,406.01 $37,923 $29 $24,774.01 $25,658 $35 $31,222.01 $32,423 $42 $37,923.01 $39,440 $30 $25,658.01 $26,543 $37 $32,423.01 $33,624 $44 $39,440.01 $40,957 $32 $26,543.01 $27,428 $39 $33,624.01 $34,825 $47 $40,957.01 $42,474 $33 $27,428.01 $28,313 $41 $34,825.01 $36,026 $49 $42,474.01 $43,991 $35 $28,313.01 $29,198 $43 $36,026.01 $37,226 $52 $43,991.01 $45,508 $36 $29,198.01 $30,082 $45 $37,226.01 $38,427 $54 $45,508.01 $47,025 $38 $30,082.01 $30,967 $47 $38,427.01 $39,628 $57 $47,025.01 $48,542 $40 $30,967.01 $31,852 $49 $39,628.01 $40,829 $59 $48,542.01 $50,059 $41 $31,852.01 $32,737 $51 $40,829.01 $42,030 $62 $50,059.01 $51,575 $43 $32,737.01 $33,621 $54 $42,030.01 $43,231 $65 $51,575.01 $53,092 $45 $33,621.01 $34,506 $56 $43,231.01 $44,431 $68 $53,092.01 $54,609 $46 $34,506.01 $35,391 $58 $44,431.01 $45,632 $71 $54,609.01 $56,126 $48 $35,391.01 $35,880 $61 $45,632.01 $46,833 $74 $56,126.01 $57,643 $51 $35,880.01 $36,370 $63 $46,833.01 $48,034 $77 $57,643.01 $59,160 $53 $36,370.01 $36,859 $66 $48,034.01 $48,698 $80 $59,160.01 $60,677 $56 $36,859.01 $37,349 $69 $48,698.01 $49,363 $83 $60,677.01 $61,516 $58 $37,349.01 $37,838 $72 $49,363.01 $50,027 $87 $61,516.01 $62,355 $61 $37,838.01 $38,328 $76 $50,027.01 $50,691 $91 $62,355.01 $63,194 $64 $38,328.01 $38,817 $79 $50,691.01 $51,355 $96 $63,194.01 $64,034 $66 $38,817.01 $39,307 $83 $51,355.01 $52,020 $100 $64,034.01 $64,873 $69 $39,307.01 $39,796 $87 $52,020.01 $52,684 $105 $64,873.01 $65,712 $72 $39,796.01 $40,285 $90 $52,684.01 $53,348 $109 $65,712.01 $66,551 $75 $40,285.01 $40,775 $94 $53,348.01 $54,013 $114 $66,551.01 $67,390 $78 $40,775.01 $41,264 $98 $54,013.01 $54,677 $119 $67,390.01 $68,229 $81 $41,264.01 $41,754 $102 $54,677.01 $55,341 $124 $68,229.01 $69,068 $84 $41,754.01 $42,243 $106 $55,341.01 $56,006 $129 $69,068.01 $69,908 $87 $42,243.01 $42,733 $110 $56,006.01 $56,670 $134 $69,908.01 $70,747 $90 $42,733.01 $43,222 $114 $56,670.01 $57,334 $139 $70,747.01 $71,586 $93 $43,222.01 $43,712 $118 $57,334.01 $57,998 $144 $71,586.01 $72,425 $97 $43,712.01 $44,201 $122 $57,998.01 $58,663 $149 $72,425.01 $73,264 $100 $44,201.01 $44,690 $127 $58,663.01 $59,327 $155 $73,264.01 $74,103 $103 $44,690.01 $45,180 $131 $59,327.01 $59,991 $160 $74,103.01 $74,942 200% FPIG $30,120 $135 $59,991.01 $60,656 $166 $74,942.01 $75,782 $140 $60,656.01 $61,320 $171 $75,782.01 $76,621 200% FPIG $40,880 $177 $76,621.01 $77,460 200% FPIG $51,640
Weekly Family Size: 4 Weekly Family Size: 5 Weekly Family Size: 6 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $9,165 $5 Less than: $8,596 $5 Less than: $9,861 $6 $9,165.01 $10,998 $6 $8,596.01 $10,745 $7 $9,861.01 $12,326 $8 $10,998.01 $12,831 $7 $10,745.01 $12,894 $9 $12,326.01 $14,791 $9 $12,831.01 $14,664 $9 $12,894.01 $15,044 $11 $14,791.01 $17,256 $11 $14,664.01 $16,497 $11 $15,044.01 $17,193 $13 $17,256.01 $19,721 $13 $16,497.01 $18,330 $13 $17,193.01 $19,342 $15 $19,721.01 $22,186 $15 $18,330.01 $20,163 $15 $19,342.01 $21,491 $17 $22,186.01 $24,652 $17 $20,163.01 $21,996 $17 $21,491.01 $23,640 $20 $24,652.01 $27,117 $19 $21,996.01 $23,829 $20 $23,640.01 $25,789 $22 $27,117.01 $29,582 $21 $23,829.01 $25,662 $22 $25,789.01 $27,938 $25 $29,582.01 $32,047 $23 $25,662.01 $27,495 $24 $27,938.01 $30,087 $28 $32,047.01 $34,512 $25 $27,495.01 $29,328 $27 $30,087.01 $32,236 $31 $34,512.01 $36,977 $28 $29,328.01 $31,161 $30 $32,236.01 $34,385 $34 $36,977.01 $39,442 $30 $31,161.01 $32,994 $32 $34,385.01 $36,534 $37 $39,442.01 $41,908 $32 $32,994.01 $34,827 $35 $36,534.01 $38,683 $40 $41,908.01 $44,373 $35 $34,827.01 $36,660 $38 $38,683.01 $40,832 $43 $44,373.01 $46,838 $37 $36,660.01 $38,493 $41 $40,832.01 $42,982 $47 $46,838.01 $49,303 $40 $38,493.01 $40,326 $44 $42,982.01 $45,131 $50 $49,303.01 $51,768 $42 $40,326.01 $42,159 $47 $45,131.01 $47,280 $53 $51,768.01 $54,233 $45 $42,159.01 $43,992 $50 $47,280.01 $49,429 $57 $54,233.01 $56,698 $48 $43,992.01 $45,825 $53 $49,429.01 $51,578 $60 $56,698.01 $59,164 $50 $45,825.01 $47,658 $56 $51,578.01 $53,727 $64 $59,164.01 $61,629 $53 $47,658.01 $49,491 $59 $53,727.01 $55,876 $68 $61,629.01 $64,094 $56 $49,491.01 $51,324 $63 $55,876.01 $58,025 $72 $64,094.01 $66,559 $59 $51,324.01 $53,157 $66 $58,025.01 $60,174 $76 $66,559.01 $69,024 $62 $53,157.01 $54,990 $69 $60,174.01 $62,323 $80 $69,024.01 $71,489 $65 $54,990.01 $56,823 $73 $62,323.01 $64,472 $84 $71,489.01 $73,955 $69 $56,823.01 $58,656 $77 $64,472.01 $66,621 $88 $73,955.01 $76,420 $72 $58,656.01 $60,489 $80 $66,621.01 $68,770 $92 $76,420.01 $78,885 $75 $60,489.01 $62,322 $84 $68,770.01 $70,919 $97 $78,885.01 $81,350 $78 $62,322.01 $64,155 $88 $70,919.01 $73,069 $101 $81,350.01 $83,815 $82 $64,155.01 $65,988 $92 $73,069.01 $75,218 $106 $83,815.01 $86,280 $85 $65,988.01 $67,821 $96 $75,218.01 $77,367 $110 $86,280.01 $88,745 $89 $67,821.01 $69,654 $100 $77,367.01 $79,516 $115 $88,745.01 $91,211 $93 $69,654.01 $71,487 $104 $79,516.01 $81,665 $120 $91,211.01 $93,676 $96 $71,487.01 $73,320 $109 $81,665.01 $83,814 $124 $93,676.01 $96,141 $100 $73,320.01 $74,334 $113 $83,814.01 $85,963 $129 $96,141.01 $98,606 $105 $74,334.01 $75,348 $117 $85,963.01 $87,152 $135 $98,606.01 $99,970 $110 $75,348.01 $76,362 $123 $87,152.01 $88,341 $141 $99,970.01 $101,333 $116 $76,362.01 $77,376 $129 $88,341.01 $89,529 $148 $101,333.01 $102,697 $121 $77,376.01 $78,390 $136 $89,529.01 $90,718 $156 $102,697.01 $104,061 $126 $78,390.01 $79,404 $142 $90,718.01 $91,907 $163 $104,061.01 $105,424 $132 $79,404.01 $80,418 $148 $91,907.01 $93,096 $170 $105,424.01 $106,788 $138 $80,418.01 $81,432 $155 $93,096.01 $94,285 $178 $106,788.01 $108,152 $143 $81,432.01 $82,446 $161 $94,285.01 $95,474 $185 $108,152.01 $109,515 $149 $82,446.01 $83,460 $168 $95,474.01 $96,662 $193 $109,515.01 $110,879 $155 $83,460.01 $84,474 $175 $96,662.01 $97,851 $201 $110,879.01 $112,243 $161 $84,474.01 $85,488 $182 $97,851.01 $99,040 $209 $112,243.01 $113,606 $168 $85,488.01 $86,502 $189 $99,040.01 $100,229 $217 $113,606.01 $114,970 $174 $86,502.01 $87,516 $197 $100,229.01 $101,418 $225 $114,970.01 $116,334 $180 $87,516.01 $88,530 $204 $101,418.01 $102,607 $234 $116,334.01 $117,698 $187 $88,530.01 $89,544 $211 $102,607.01 $103,795 $242 $117,698.01 $119,061 $193 $89,544.01 $90,558 $219 $103,795.01 $104,984 $251 $119,061.01 $120,425 $200 $90,558.01 $91,572 $227 $104,984.01 $106,173 $260 $120,425.01 $121,789 $207 $91,572.01 $92,586 $234 $106,173.01 $107,362 $269 $121,789.01 $123,152 $214 $92,586.01 $93,600 $242 $107,362.01 $108,551 $278 $123,152.01 $124,516 200% FPIG $62,400 $251 $108,551.01 $109,740 $287 $124,516.01 $125,880 200% FPIG $73,160 200% FPIG $83,920
Weekly Family Size: 7 Weekly Family Size: 8 Weekly Family Size: 9 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $11,125 $5 Less than: $9,292 $5 Less than: $10,240 $7 $11,125.01 $13,906 $6 $9,292.01 $12,389 $7 $10,240.01 $13,654 $10 $13,906.01 $16,687 $8 $12,389.01 $15,487 $9 $13,654.01 $17,067 $12 $16,687.01 $19,469 $11 $15,487.01 $18,584 $12 $17,067.01 $20,480 $14 $19,469.01 $22,250 $13 $18,584.01 $21,681 $15 $20,480.01 $23,894 $17 $22,250.01 $25,031 $16 $21,681.01 $24,778 $18 $23,894.01 $27,307 $20 $25,031.01 $27,812 $19 $24,778.01 $27,876 $21 $27,307.01 $30,720 $22 $27,812.01 $30,593 $22 $27,876.01 $30,973 $24 $30,720.01 $34,134 $25 $30,593.01 $33,375 $25 $30,973.01 $34,070 $27 $34,134.01 $37,547 $28 $33,375.01 $36,156 $28 $34,070.01 $37,168 $31 $37,547.01 $40,961 $31 $36,156.01 $38,937 $32 $37,168.01 $40,265 $35 $40,961.01 $44,374 $35 $38,937.01 $41,718 $35 $40,265.01 $43,362 $39 $44,374.01 $47,787 $38 $41,718.01 $44,500 $39 $43,362.01 $46,460 $43 $47,787.01 $51,201 $42 $44,500.01 $47,281 $43 $46,460.01 $49,557 $47 $51,201.01 $54,614 $45 $47,281.01 $50,062 $47 $49,557.01 $52,654 $51 $54,614.01 $58,027 $49 $50,062.01 $52,843 $51 $52,654.01 $55,751 $56 $58,027.01 $61,441 $53 $52,843.01 $55,625 $55 $55,751.01 $58,849 $60 $61,441.01 $64,854 $56 $55,625.01 $58,406 $59 $58,849.01 $61,946 $65 $64,854.01 $68,268 $60 $58,406.01 $61,187 $63 $61,946.01 $65,043 $69 $68,268.01 $71,681 $64 $61,187.01 $63,968 $67 $65,043.01 $68,141 $74 $71,681.01 $75,094 $68 $63,968.01 $66,749 $71 $68,141.01 $71,238 $79 $75,094.01 $78,508 $72 $66,749.01 $69,531 $76 $71,238.01 $74,335 $84 $78,508.01 $81,921 $77 $69,531.01 $72,312 $81 $74,335.01 $77,433 $89 $81,921.01 $85,334 $81 $72,312.01 $75,093 $85 $77,433.01 $80,530 $94 $85,334.01 $88,748 $85 $75,093.01 $77,874 $90 $80,530.01 $83,627 $99 $88,748.01 $92,161 $90 $77,874.01 $80,656 $95 $83,627.01 $86,724 $105 $92,161.01 $95,575 $94 $80,656.01 $83,437 $100 $86,724.01 $89,822 $110 $95,575.01 $98,988 $99 $83,437.01 $86,218 $105 $89,822.01 $92,919 $116 $98,988.01 $102,401 $104 $86,218.01 $88,999 $110 $92,919.01 $96,016 $122 $102,401.01 $105,815 $109 $88,999.01 $91,780 $116 $96,016.01 $99,114 $128 $105,815.01 $109,228 $114 $91,780.01 $94,562 $121 $99,114.01 $102,211 $134 $109,228.01 $112,641 $119 $94,562.01 $97,343 $127 $102,211.01 $105,308 $140 $112,641.01 $116,055 $124 $97,343.01 $100,124 $133 $105,308.01 $108,406 $146 $116,055.01 $119,468 $130 $100,124.01 $102,905 $138 $108,406.01 $111,503 $152 $119,468.01 $122,882 $135 $102,905.01 $105,687 $144 $111,503.01 $114,600 $159 $122,882.01 $126,295 $140 $105,687.01 $108,468 $150 $114,600.01 $117,697 $166 $126,295.01 $129,708 $146 $108,468.01 $111,249 $156 $117,697.01 $120,795 $172 $129,708.01 $133,122 $152 $111,249.01 $112,788 $163 $120,795.01 $123,892 $179 $133,122.01 $136,535 $160 $112,788.01 $114,326 $169 $123,892.01 $125,605 $186 $136,535.01 $138,423 $167 $114,326.01 $115,865 $178 $125,605.01 $127,319 $196 $138,423.01 $140,311 $175 $115,865.01 $117,403 $186 $127,319.01 $129,032 $205 $140,311.01 $142,200 $184 $117,403.01 $118,942 $195 $129,032.01 $130,745 $215 $142,200.01 $144,088 $192 $118,942.01 $120,481 $204 $130,745.01 $132,459 $225 $144,088.01 $145,976 $200 $120,481.01 $122,019 $214 $132,459.01 $134,172 $236 $145,976.01 $147,864 $209 $122,019.01 $123,558 $223 $134,172.01 $135,886 $246 $147,864.01 $149,753 $218 $123,558.01 $125,096 $233 $135,886.01 $137,599 $256 $149,753.01 $151,641 $227 $125,096.01 $126,635 $242 $137,599.01 $139,312 $267 $151,641.01 $153,529 $236 $126,635.01 $128,173 $252 $139,312.01 $141,026 $278 $153,529.01 $155,417 $245 $128,173.01 $129,712 $262 $141,026.01 $142,739 $289 $155,417.01 $157,305 $254 $129,712.01 $131,251 $273 $142,739.01 $144,452 $301 $157,305.01 $159,194 $264 $131,251.01 $132,789 $283 $144,452.01 $146,166 $312 $159,194.01 $161,082 $274 $132,789.01 $134,328 $294 $146,166.01 $147,879 $324 $161,082.01 $162,970 $283 $134,328.01 $135,866 $305 $147,879.01 $149,593 $336 $162,970.01 $164,858 $293 $135,866.01 $137,405 $316 $149,593.01 $151,306 $348 $164,858.01 $166,746 $303 $137,405.01 $138,944 $327 $151,306.01 $153,019 $360 $166,746.01 $168,635 $314 $138,944.01 $140,482 $338 $153,019.01 $154,733 $372 $168,635.01 $170,523 $324 $140,482.01 $142,021 $349 $154,733.01 $156,446 $385 $170,523.01 $172,411 200% FPIG $94,680 $361 $156,446.01 $158,159 $398 $172,411.01 $174,299 200% FPIG $105,440 200% FPIG $116,200
Weekly Family Size: 10 Weekly Family Size: 11 Weekly Family Size: 12 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $11,188 $5 Less than: $12,137 $5 Less than: $13,085 $7 $11,188.01 $14,918 $8 $12,137.01 $16,182 $8 $13,085.01 $17,446 $10 $14,918.01 $18,647 $11 $16,182.01 $20,228 $12 $17,446.01 $21,808 $13 $18,647.01 $22,377 $14 $20,228.01 $24,273 $15 $21,808.01 $26,170 $16 $22,377.01 $26,106 $17 $24,273.01 $28,319 $19 $26,170.01 $30,531 $19 $26,106.01 $29,836 $21 $28,319.01 $32,364 $22 $30,531.01 $34,893 $23 $29,836.01 $33,565 $25 $32,364.01 $36,410 $26 $34,893.01 $39,254 $26 $33,565.01 $37,295 $28 $36,410.01 $40,455 $31 $39,254.01 $43,616 $30 $37,295.01 $41,024 $32 $40,455.01 $44,501 $35 $43,616.01 $47,978 $34 $41,024.01 $44,753 $37 $44,501.01 $48,546 $40 $47,978.01 $52,339 $38 $44,753.01 $48,483 $41 $48,546.01 $52,592 $44 $52,339.01 $56,701 $42 $48,483.01 $52,212 $46 $52,592.01 $56,637 $49 $56,701.01 $61,062 $47 $52,212.01 $55,942 $51 $56,637.01 $60,683 $55 $61,062.01 $65,424 $51 $55,942.01 $59,671 $56 $60,683.01 $64,728 $60 $65,424.01 $69,786 $56 $59,671.01 $63,401 $61 $64,728.01 $68,774 $66 $69,786.01 $74,147 $61 $63,401.01 $67,130 $66 $68,774.01 $72,819 $71 $74,147.01 $78,509 $66 $67,130.01 $70,860 $71 $72,819.01 $76,865 $77 $78,509.01 $82,870 $71 $70,860.01 $74,589 $77 $76,865.01 $80,911 $83 $82,870.01 $87,232 $76 $74,589.01 $78,318 $82 $80,911.01 $84,956 $88 $87,232.01 $91,594 $81 $78,318.01 $82,048 $88 $84,956.01 $89,002 $94 $91,594.01 $95,955 $86 $82,048.01 $85,777 $93 $89,002.01 $93,047 $101 $95,955.01 $100,317 $91 $85,777.01 $89,507 $99 $93,047.01 $97,093 $107 $100,317.01 $104,678 $97 $89,507.01 $93,236 $105 $97,093.01 $101,138 $113 $104,678.01 $109,040 $103 $93,236.01 $96,966 $111 $101,138.01 $105,184 $120 $109,040.01 $113,402 $108 $96,966.01 $100,695 $118 $105,184.01 $109,229 $127 $113,402.01 $117,763 $114 $100,695.01 $104,425 $124 $109,229.01 $113,275 $134 $117,763.01 $122,125 $120 $104,425.01 $108,154 $131 $113,275.01 $117,320 $141 $122,125.01 $126,486 $127 $108,154.01 $111,884 $137 $117,320.01 $121,366 $148 $126,486.01 $130,848 $133 $111,884.01 $115,613 $144 $121,366.01 $125,411 $156 $130,848.01 $135,210 $139 $115,613.01 $119,342 $151 $125,411.01 $129,457 $163 $135,210.01 $139,571 $146 $119,342.01 $123,072 $158 $129,457.01 $133,502 $171 $139,571.01 $143,933 $153 $123,072.01 $126,801 $166 $133,502.01 $137,548 $179 $143,933.01 $148,294 $160 $126,801.01 $130,531 $173 $137,548.01 $141,593 $187 $148,294.01 $152,656 $167 $130,531.01 $134,260 $181 $141,593.01 $145,639 $195 $152,656.01 $157,018 $174 $134,260.01 $137,990 $188 $145,639.01 $149,684 $203 $157,018.01 $161,379 $181 $137,990.01 $141,719 $196 $149,684.01 $153,730 $212 $161,379.01 $165,741 $188 $141,719.01 $145,449 $204 $153,730.01 $157,775 $220 $165,741.01 $170,102 $196 $145,449.01 $149,178 $212 $157,775.01 $161,821 $229 $170,102.01 $174,464 $204 $149,178.01 $151,241 $221 $161,821.01 $164,059 $238 $174,464.01 $176,877 $214 $151,241.01 $153,304 $232 $164,059.01 $166,297 $250 $176,877.01 $179,290 $225 $153,304.01 $155,367 $244 $166,297.01 $168,535 $263 $179,290.01 $181,702 $235 $155,367.01 $157,430 $255 $168,535.01 $170,773 $275 $181,702.01 $184,115 $246 $157,430.01 $159,493 $267 $170,773.01 $173,011 $288 $184,115.01 $186,528 $257 $159,493.01 $161,556 $279 $173,011.01 $175,248 $301 $186,528.01 $188,941 $269 $161,556.01 $163,619 $291 $175,248.01 $177,486 $314 $188,941.01 $191,353 $280 $163,619.01 $165,683 $304 $177,486.01 $179,724 $328 $191,353.01 $193,766 $292 $165,683.01 $167,746 $317 $179,724.01 $181,962 $341 $193,766.01 $196,179 $304 $167,746.01 $169,809 $330 $181,962.01 $184,200 $355 $196,179.01 $198,592 $316 $169,809.01 $171,872 $343 $184,200.01 $186,438 $370 $198,592.01 $201,004 $328 $171,872.01 $173,935 $356 $186,438.01 $188,676 $384 $201,004.01 $203,417 $341 $173,935.01 $175,998 $370 $188,676.01 $190,914 $399 $203,417.01 $205,830 $354 $175,998.01 $178,061 $384 $190,914.01 $193,152 $414 $205,830.01 $208,243 $367 $178,061.01 $180,124 $398 $193,152.01 $195,390 $429 $208,243.01 $210,655 $380 $180,124.01 $182,187 $412 $195,390.01 $197,628 $444 $210,655.01 $213,068 $393 $182,187.01 $184,250 $427 $197,628.01 $199,865 $460 $213,068.01 $215,481 $407 $184,250.01 $186,313 $441 $199,865.01 $202,103 $476 $215,481.01 $217,894 $421 $186,313.01 $188,376 $456 $202,103.01 $204,341 $492 $217,894.01 $220,306 $435 $188,376.01 $190,439 $472 $204,341.01 $206,579 $508 $220,306.01 $222,719 200% FPIG $126,960 200% FPIG $137,720 200% FPIG $148,480
Weekly Family Size: 13 Weekly Family Size: 14 Weekly Family Size: 15 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $9,355 $5 Less than: $9,988 $5 Less than: $10,620 $6 $9,355.01 $14,033 $6 $9,988.01 $14,981 $7 $10,620.01 $15,929 $9 $14,033.01 $18,711 $10 $14,981.01 $19,975 $10 $15,929.01 $21,239 $12 $18,711.01 $23,388 $13 $19,975.01 $24,969 $14 $21,239.01 $26,549 $16 $23,388.01 $28,066 $17 $24,969.01 $29,963 $18 $26,549.01 $31,859 $20 $28,066.01 $32,744 $21 $29,963.01 $34,956 $23 $31,859.01 $37,169 $24 $32,744.01 $37,421 $26 $34,956.01 $39,950 $27 $37,169.01 $42,479 $28 $37,421.01 $42,099 $30 $39,950.01 $44,944 $32 $42,479.01 $47,788 $33 $42,099.01 $46,777 $35 $44,944.01 $49,938 $37 $47,788.01 $53,098 $38 $46,777.01 $51,454 $40 $49,938.01 $54,931 $43 $53,098.01 $58,408 $42 $51,454.01 $56,132 $45 $54,931.01 $59,925 $48 $58,408.01 $63,718 $48 $56,132.01 $60,810 $51 $59,925.01 $64,919 $54 $63,718.01 $69,028 $53 $60,810.01 $65,487 $57 $64,919.01 $69,913 $60 $69,028.01 $74,338 $59 $65,487.01 $70,165 $62 $69,913.01 $74,906 $66 $74,338.01 $79,647 $64 $70,165.01 $74,843 $69 $74,906.01 $79,900 $73 $79,647.01 $84,957 $70 $74,843.01 $79,520 $75 $79,900.01 $84,894 $80 $84,957.01 $90,267 $76 $79,520.01 $84,198 $82 $84,894.01 $89,888 $87 $90,267.01 $95,577 $82 $84,198.01 $88,876 $88 $89,888.01 $94,881 $94 $95,577.01 $100,887 $89 $88,876.01 $93,554 $95 $94,881.01 $99,875 $101 $100,887.01 $106,197 $95 $93,554.01 $98,231 $101 $99,875.01 $104,869 $108 $106,197.01 $111,506 $101 $98,231.01 $102,909 $108 $104,869.01 $109,863 $115 $111,506.01 $116,816 $108 $102,909.01 $107,587 $115 $109,863.01 $114,856 $123 $116,816.01 $122,126 $115 $107,587.01 $112,264 $122 $114,856.01 $119,850 $130 $122,126.01 $127,436 $122 $112,264.01 $116,942 $130 $119,850.01 $124,844 $138 $127,436.01 $132,746 $129 $116,942.01 $121,620 $138 $124,844.01 $129,838 $146 $132,746.01 $138,055 $136 $121,620.01 $126,297 $145 $129,838.01 $134,831 $154 $138,055.01 $143,365 $144 $126,297.01 $130,975 $153 $134,831.01 $139,825 $163 $143,365.01 $148,675 $151 $130,975.01 $135,653 $161 $139,825.01 $144,819 $172 $148,675.01 $153,985 $159 $135,653.01 $140,330 $170 $144,819.01 $149,813 $180 $153,985.01 $159,295 $167 $140,330.01 $145,008 $178 $149,813.01 $154,806 $189 $159,295.01 $164,605 $175 $145,008.01 $149,686 $187 $154,806.01 $159,800 $199 $164,605.01 $169,914 $183 $149,686.01 $154,363 $196 $159,800.01 $164,794 $208 $169,914.01 $175,224 $192 $154,363.01 $159,041 $205 $164,794.01 $169,788 $217 $175,224.01 $180,534 $200 $159,041.01 $163,719 $214 $169,788.01 $174,781 $227 $180,534.01 $185,844 $209 $163,719.01 $168,396 $223 $174,781.01 $179,775 $237 $185,844.01 $191,154 $218 $168,396.01 $173,074 $233 $179,775.01 $184,769 $247 $191,154.01 $196,464 $227 $173,074.01 $177,752 $242 $184,769.01 $189,763 $258 $196,464.01 $201,773 $236 $177,752.01 $182,429 $252 $189,763.01 $194,756 $268 $201,773.01 $207,083 $246 $182,429.01 $187,107 $262 $194,756.01 $199,750 $279 $207,083.01 $212,393 $255 $187,107.01 $189,695 $273 $199,750.01 $202,512 $290 $212,393.01 $215,330 $268 $189,695.01 $192,282 $287 $202,512.01 $205,275 $305 $215,330.01 $218,268 $282 $192,282.01 $194,870 $301 $205,275.01 $208,037 $320 $218,268.01 $221,205 $295 $194,870.01 $197,457 $315 $208,037.01 $210,800 $335 $221,205.01 $224,142 $309 $197,457.01 $200,045 $330 $210,800.01 $213,562 $351 $224,142.01 $227,079 $323 $200,045.01 $202,633 $345 $213,562.01 $216,325 $366 $227,079.01 $230,017 $337 $202,633.01 $205,220 $360 $216,325.01 $219,087 $383 $230,017.01 $232,954 $351 $205,220.01 $207,808 $375 $219,087.01 $221,850 $399 $232,954.01 $235,891 $366 $207,808.01 $210,395 $391 $221,850.01 $224,612 $416 $235,891.01 $238,829 $381 $210,395.01 $212,983 $407 $224,612.01 $227,374 $433 $238,829.01 $241,766 $396 $212,983.01 $215,571 $423 $227,374.01 $230,137 $450 $241,766.01 $244,703 $412 $215,571.01 $218,158 $440 $230,137.01 $232,899 $468 $244,703.01 $247,641 $428 $218,158.01 $220,746 $457 $232,899.01 $235,662 $486 $247,641.01 $250,578 $444 $220,746.01 $223,333 $474 $235,662.01 $238,424 $504 $250,578.01 $253,515 $460 $223,333.01 $225,921 $491 $238,424.01 $241,187 $522 $253,515.01 $256,452 $477 $225,921.01 $228,509 $509 $241,187.01 $243,949 $541 $256,452.01 $259,390 $493 $228,509.01 $231,096 $527 $243,949.01 $246,712 $560 $259,390.01 $262,327 $510 $231,096.01 $233,684 $545 $246,712.01 $249,474 $579 $262,327.01 $265,264 $528 $233,684.01 $236,271 $563 $249,474.01 $252,236 $599 $265,264.01 $268,202 $545 $236,271.01 $238,859 $582 $252,236.01 $254,999 $619 $268,202.01 $271,139 200% FPIG $159,240 200% FPIG $170,000 200% FPIG $180,760
Weekly Family Size: 16 Weekly Family Size: 17 Weekly Family Size: 18 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $11,252 $5 Less than: $11,884 $5 Less than: $12,516 $7 $11,252.01 $16,878 $7 $11,884.01 $17,826 $8 $12,516.01 $18,774 $11 $16,878.01 $22,504 $11 $17,826.01 $23,768 $12 $18,774.01 $25,032 $15 $22,504.01 $28,130 $16 $23,768.01 $29,710 $17 $25,032.01 $31,290 $19 $28,130.01 $33,755 $21 $29,710.01 $35,652 $22 $31,290.01 $37,548 $24 $33,755.01 $39,381 $25 $35,652.01 $41,594 $27 $37,548.01 $43,806 $29 $39,381.01 $45,007 $31 $41,594.01 $47,536 $32 $43,806.01 $50,064 $34 $45,007.01 $50,633 $36 $47,536.01 $53,478 $38 $50,064.01 $56,322 $40 $50,633.01 $56,259 $42 $53,478.01 $59,420 $44 $56,322.01 $62,581 $45 $56,259.01 $61,885 $48 $59,420.01 $65,362 $50 $62,581.01 $68,839 $51 $61,885.01 $67,511 $54 $65,362.01 $71,304 $57 $68,839.01 $75,097 $57 $67,511.01 $73,137 $60 $71,304.01 $77,246 $64 $75,097.01 $81,355 $64 $73,137.01 $78,763 $67 $77,246.01 $83,188 $71 $81,355.01 $87,613 $70 $78,763.01 $84,389 $74 $83,188.01 $89,130 $78 $87,613.01 $93,871 $77 $84,389.01 $90,014 $82 $89,130.01 $95,072 $86 $93,871.01 $100,129 $85 $90,014.01 $95,640 $89 $95,072.01 $101,014 $94 $100,129.01 $106,387 $92 $95,640.01 $101,266 $97 $101,014.01 $106,956 $102 $106,387.01 $112,645 $99 $101,266.01 $106,892 $105 $106,956.01 $112,898 $110 $112,645.01 $118,903 $107 $106,892.01 $112,518 $113 $112,898.01 $118,840 $118 $118,903.01 $125,161 $114 $112,518.01 $118,144 $121 $118,840.01 $124,781 $127 $125,161.01 $131,419 $122 $118,144.01 $123,770 $129 $124,781.01 $130,723 $136 $131,419.01 $137,677 $130 $123,770.01 $129,396 $137 $130,723.01 $136,665 $144 $137,677.01 $143,935 $138 $129,396.01 $135,022 $146 $136,665.01 $142,607 $153 $143,935.01 $150,193 $146 $135,022.01 $140,648 $155 $142,607.01 $148,549 $163 $150,193.01 $156,451 $155 $140,648.01 $146,273 $164 $148,549.01 $154,491 $172 $156,451.01 $162,709 $164 $146,273.01 $151,899 $173 $154,491.01 $160,433 $182 $162,709.01 $168,967 $173 $151,899.01 $157,525 $182 $160,433.01 $166,375 $192 $168,967.01 $175,225 $182 $157,525.01 $163,151 $192 $166,375.01 $172,317 $202 $175,225.01 $181,483 $191 $163,151.01 $168,777 $202 $172,317.01 $178,259 $213 $181,483.01 $187,742 $201 $168,777.01 $174,403 $212 $178,259.01 $184,201 $223 $187,742.01 $194,000 $210 $174,403.01 $180,029 $222 $184,201.01 $190,143 $234 $194,000.01 $200,258 $220 $180,029.01 $185,655 $233 $190,143.01 $196,085 $245 $200,258.01 $206,516 $230 $185,655.01 $191,281 $243 $196,085.01 $202,027 $256 $206,516.01 $212,774 $241 $191,281.01 $196,907 $254 $202,027.01 $207,969 $268 $212,774.01 $219,032 $251 $196,907.01 $202,532 $265 $207,969.01 $213,911 $280 $219,032.01 $225,290 $262 $202,532.01 $208,158 $277 $213,911.01 $219,853 $291 $225,290.01 $231,548 $273 $208,158.01 $213,784 $288 $219,853.01 $225,795 $304 $231,548.01 $237,806 $284 $213,784.01 $219,410 $300 $225,795.01 $231,737 $316 $237,806.01 $244,064 $295 $219,410.01 $225,036 $312 $231,737.01 $237,679 $329 $244,064.01 $250,322 $307 $225,036.01 $228,148 $325 $237,679.01 $240,966 $342 $250,322.01 $253,784 $323 $228,148.01 $231,260 $341 $240,966.01 $244,253 $359 $253,784.01 $257,246 $339 $231,260.01 $234,372 $358 $244,253.01 $247,540 $377 $257,246.01 $260,708 $355 $234,372.01 $237,485 $375 $247,540.01 $250,827 $395 $260,708.01 $264,170 $371 $237,485.01 $240,597 $392 $250,827.01 $254,114 $413 $264,170.01 $267,632 $388 $240,597.01 $243,709 $410 $254,114.01 $257,401 $432 $267,632.01 $271,093 $405 $243,709.01 $246,821 $428 $257,401.01 $260,688 $451 $271,093.01 $274,555 $423 $246,821.01 $249,933 $446 $260,688.01 $263,975 $470 $274,555.01 $278,017 $440 $249,933.01 $253,045 $465 $263,975.01 $267,262 $490 $278,017.01 $281,479 $458 $253,045.01 $256,157 $484 $267,262.01 $270,549 $510 $281,479.01 $284,941 $477 $256,157.01 $259,270 $504 $270,549.01 $273,836 $530 $284,941.01 $288,403 $495 $259,270.01 $262,382 $523 $273,836.01 $277,123 $551 $288,403.01 $291,865 $514 $262,382.01 $265,494 $543 $277,123.01 $280,410 $572 $291,865.01 $295,327 $534 $265,494.01 $268,606 $564 $280,410.01 $283,697 $594 $295,327.01 $298,789 $553 $268,606.01 $271,718 $584 $283,697.01 $286,984 $615 $298,789.01 $302,251 $573 $271,718.01 $274,830 $605 $286,984.01 $290,271 $638 $302,251.01 $305,712 $593 $274,830.01 $277,942 $627 $290,271.01 $293,558 $660 $305,712.01 $309,174 $614 $277,942.01 $281,055 $648 $293,558.01 $296,845 $683 $309,174.01 $312,636 $635 $281,055.01 $284,167 $670 $296,845.01 $300,132 $706 $312,636.01 $316,098 $656 $284,167.01 $287,279 $693 $300,132.01 $303,419 $729 $316,098.01 $319,560 200% FPIG $191,520 200% FPIG $202,280 200% FPIG $213,040
Weekly Family Size: 19 Weekly Family Size: 20 Weekly Family Size: 21 Co-pay Annual Income Co-pay Annual Income Co-pay Annual Income $5 Less than: $13,148 $5 Less than: $13,780 $5 Less than: $14,413 $8 $13,148.01 $19,722 $9 $13,780.01 $20,671 $9 $14,413.01 $21,619 $13 $19,722.01 $26,297 $13 $20,671.01 $27,561 $14 $21,619.01 $28,825 $18 $26,297.01 $32,871 $18 $27,561.01 $34,451 $19 $28,825.01 $36,031 $23 $32,871.01 $39,445 $24 $34,451.01 $41,341 $25 $36,031.01 $43,238 $28 $39,445.01 $46,019 $29 $41,341.01 $48,231 $31 $43,238.01 $50,444 $34 $46,019.01 $52,593 $35 $48,231.01 $55,122 $37 $50,444.01 $57,650 $40 $52,593.01 $59,167 $42 $55,122.01 $62,012 $44 $57,650.01 $64,856 $46 $59,167.01 $65,741 $48 $62,012.01 $68,902 $51 $64,856.01 $72,063 $53 $65,741.01 $72,315 $55 $68,902.01 $75,792 $58 $72,063.01 $79,269 $60 $72,315.01 $78,890 $63 $75,792.01 $82,682 $65 $79,269.01 $86,475 $67 $78,890.01 $85,464 $70 $82,682.01 $89,573 $73 $86,475.01 $93,682 $74 $85,464.01 $92,038 $78 $89,573.01 $96,463 $82 $93,682.01 $100,888 $82 $92,038.01 $98,612 $86 $96,463.01 $103,353 $90 $100,888.01 $108,094 $90 $98,612.01 $105,186 $95 $103,353.01 $110,243 $99 $108,094.01 $115,300 $99 $105,186.01 $111,760 $104 $110,243.01 $117,133 $108 $115,300.01 $122,507 $107 $111,760.01 $118,334 $113 $117,133.01 $124,024 $118 $122,507.01 $129,713 $116 $118,334.01 $124,908 $121 $124,024.01 $130,914 $127 $129,713.01 $136,919 $124 $124,908.01 $131,483 $130 $130,914.01 $137,804 $136 $136,919.01 $144,126 $133 $131,483.01 $138,057 $140 $137,804.01 $144,694 $146 $144,126.01 $151,332 $142 $138,057.01 $144,631 $149 $144,694.01 $151,584 $156 $151,332.01 $158,538 $152 $144,631.01 $151,205 $159 $151,584.01 $158,475 $166 $158,538.01 $165,744 $161 $151,205.01 $157,779 $169 $158,475.01 $165,365 $177 $165,744.01 $172,951 $171 $157,779.01 $164,353 $179 $165,365.01 $172,255 $187 $172,951.01 $180,157 $181 $164,353.01 $170,927 $190 $172,255.01 $179,145 $198 $180,157.01 $187,363 $191 $170,927.01 $177,501 $200 $179,145.01 $186,035 $210 $187,363.01 $194,569 $202 $177,501.01 $184,076 $211 $186,035.01 $192,926 $221 $194,569.01 $201,776 $212 $184,076.01 $190,650 $223 $192,926.01 $199,816 $233 $201,776.01 $208,982 $223 $190,650.01 $197,224 $234 $199,816.01 $206,706 $245 $208,982.01 $216,188 $234 $197,224.01 $203,798 $246 $206,706.01 $213,596 $257 $216,188.01 $223,395 $246 $203,798.01 $210,372 $258 $213,596.01 $220,486 $269 $223,395.01 $230,601 $257 $210,372.01 $216,946 $270 $220,486.01 $227,377 $282 $230,601.01 $237,807 $269 $216,946.01 $223,520 $282 $227,377.01 $234,267 $295 $237,807.01 $245,013 $281 $223,520.01 $230,094 $295 $234,267.01 $241,157 $308 $245,013.01 $252,220 $294 $230,094.01 $236,669 $308 $241,157.01 $248,047 $322 $252,220.01 $259,426 $306 $236,669.01 $243,243 $321 $248,047.01 $254,937 $336 $259,426.01 $266,632 $319 $243,243.01 $249,817 $334 $254,937.01 $261,828 $350 $266,632.01 $273,838 $332 $249,817.01 $256,391 $348 $261,828.01 $268,718 $364 $273,838.01 $281,045 $345 $256,391.01 $262,965 $362 $268,718.01 $275,608 $378 $281,045.01 $288,251 $359 $262,965.01 $266,602 $376 $275,608.01 $279,420 $394 $288,251.01 $292,237 $377 $266,602.01 $270,238 $395 $279,420.01 $283,231 $414 $292,237.01 $296,224 $396 $270,238.01 $273,875 $415 $283,231.01 $287,043 $434 $296,224.01 $300,210 $415 $273,875.01 $277,512 $435 $287,043.01 $290,854 $455 $300,210.01 $304,197 $434 $277,512.01 $281,148 $455 $290,854.01 $294,666 $476 $304,197.01 $308,183 $454 $281,148.01 $284,785 $475 $294,666.01 $298,477 $497 $308,183.01 $312,169 $474 $284,785.01 $288,422 $496 $298,477.01 $302,289 $519 $312,169.01 $316,156 $494 $288,422.01 $292,059 $518 $302,289.01 $306,101 $541 $316,156.01 $320,142 $515 $292,059.01 $295,695 $539 $306,101.01 $309,912 $564 $320,142.01 $324,129 $536 $295,695.01 $299,332 $561 $309,912.01 $313,724 $587 $324,129.01 $328,115 $557 $299,332.01 $302,969 $584 $313,724.01 $317,535 $611 $328,115.01 $332,102 $579 $302,969.01 $306,605 $607 $317,535.01 $321,347 $635 $332,102.01 $336,088 $601 $306,605.01 $310,242 $630 $321,347.01 $325,158 $659 $336,088.01 $340,074 $624 $310,242.01 $313,879 $654 $325,158.01 $328,970 $684 $340,074.01 $344,061 $647 $313,879.01 $317,515 $678 $328,970.01 $332,781 $709 $344,061.01 $348,047 $670 $317,515.01 $321,152 $702 $332,781.01 $336,593 $734 $348,047.01 $352,034 $693 $321,152.01 $324,789 $727 $336,593.01 $340,405 $760 $352,034.01 $356,020 $717 $324,789.01 $328,426 $752 $340,405.01 $344,216 $786 $356,020.01 $360,006 $742 $328,426.01 $332,062 $777 $344,216.01 $348,028 $813 $360,006.01 $363,993 $766 $332,062.01 $335,699 $803 $348,028.01 $351,839 $840 $363,993.01 $367,979 200% FPIG $223,800 200% FPIG $234,560 200% FPIG $245,320
Source The provisions of this Appendix B amended May 10, 2024, effective May 6, 2024, 54 Pa.B. 2594. Immediately preceding text appears at serial pages (417467) to (417474).
Cross References This appendix cited in 55 Pa. Code § 3042.97 (relating to use of the Federal Poverty Income Guidelines and State Median Income); and 55 Pa. Code § 3042.98 (relating to copayment determination).
APPENDIX C
Stepparent Deduction Chart
County of residence Family composition/size 2 3 4 5 6 Each
additional personAdams, Allegheny, Berks, Blair, Bradford, Butler, Centre, Columbia, Crawford, Cumberland, Dauphin, Delaware, Erie, Lackawanna, Lebanon, Lehigh, Luzerne, Lycoming, Monroe, Montour, Northampton, Philadelphia, Sullivan, Susquehanna, Union, Warren, Wayne, Westmoreland, Wyoming and York $461 $587 $724 $859 $976 $121 Armstrong, Bedford, Cambria, Clarion, Clearfield, Fayette, Forest, Fulton, Greene, Huntingdon, Jefferson, Juniata, Northumberland, Schuylkill and Somerset $406 $532 $662 $791 $894 $121 Beaver, Cameron, Carbon, Clinton, Elk, Franklin, Indiana, Lawrence, McKean, Mercer, Mifflin, Perry, Potter, Snyder, Tioga, Venango and Washington $444 $573 $698 $829 $943 $121 Bucks, Chester, Lancaster, Montgomery and Pike $481 $614 $749 $885 $1,001 $121
Cross References This appendix cited in 55 Pa. Code § 3042.43 (relating to income adjustment); and 55 Pa. Code Appendix A Part II (relating to income deductions).
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