DHS-6413J-ENG 10-21
Minnesota Child Care Assistance Program
Copayment schedules
Effective October 4, 2021
The Child Care Assistance Program requires that all families pay a copayment fee. The copayment amount is based on family size and gross annual income after allowable deductions. Families pay copayments to their child care provider biweekly.
The Child Care Assistance Program’s copayment schedules have been updated to reflect the state median income guidelines for federal fiscal year 2022. The new copayment schedules are effective October 4, 2021 and remain in effect until new copayment schedules are published.
To be income eligible to receive child care assistance, families currently receiving benefits from the Minnesota Family Investment Program must have a gross annual income that is at or below the 67
percent exit level for their household size. All other Child Care Assistance Program applicants must have a gross annual income that is at or below the 47 percent entrance level for their household size.
Once a family is determined eligible, their gross annual income must be at or below the 85 percent exit level for their household size during their 12-month eligibility period to continue receiving child care assistance.
At redetermination, a family’s gross annual income cannot exceed the 67 percent exit limit. If their income exceeds 67 percent for their household size at redetermination, the family is no longer eligible for child care assistance.
Child Care Assistance Program P.O. Box 64962
St. Paul, MN 55164-0962
(Page 1) DHS-6413J-ENG 10-21
Attention. If you need free help interpreting this document, ask your worker or call the number below for your language.
ያስተውሉ፡ ይህንን ዶኩመንት ለመተርጎም እርዳታ የሚፈልጉ ከሆነ፡ የጉዳዮን ሰራተኛ ይጠይቁ ወይም በሰልክ ቁጥር 1-844-217-3547 ይደውሉ።
.1-800-358-0377 مقرلا ىلع لصتا وأ كفرشم نم كلذ بلطا ،ةقيثولا هذه ةمجرتل ةيناجم ةدعاسم تدرأ اذإ :ةظحلام
သတိ။ ဤစာရြက္စာတမ္းအားအခမဲ့ဘာသာျပန္ေပးျခင္း အကူအညီလုုိအပ္ပါက၊ သင့္လူမွဳေရးအလုုပ္သမား အားေမးျမန္း ျခင္းသုုိ ့မဟုုတ္
1-844-217-3563 ကုုိေခၚဆုုိပါ။
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1-888-468-3787 .
請注意，如果您需要免費協助傳譯這份文件，請告訴您的工作人員或撥打1-844-217-3564。
Attention. Si vous avez besoin d’une aide gratuite pour interpréter le présent document, demandez à votre agent chargé du traitement de cas ou appelez le 1-844-217-3548.
Thov ua twb zoo nyeem. Yog hais tias koj xav tau kev pab txhais lus rau tsab ntaub ntawv no pub dawb, ces nug koj tus neeg lis dej num los sis hu rau 1-888-486-8377.
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1-844-217-3549wuh>I
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LB1 (8-16)
(Page 3) DHS-6413J-ENG 10-21
Income limits at-a-glance
Below is the income entrance level at application, exit level at redetermination, and exit level during the 12-month eligibility period for household sizes two through thirteen. See page 1 of this document for details about the individual income limits.
Two person household
47% entrance level $36,096
67% exit level (at redetermination) $51,457 85% exit level (during eligibility period) $65,281
Four person household
47% entrance level $53,083
67% exit level (at redetermination) $75,671 85% exit level (during eligibility period) $96,001
Six person household
47% entrance level $70,069
67% exit level (at redetermination) $99,886 85% exit level (during eligibility period) $126,721
Eight person household
47% entrance level $73,254
67% exit level (at redetermination) $104,426 85% exit level (during eligibility period) $132,481
Ten person household
47% entrance level $76,439
67% exit level (at redetermination) $108,966 85% exit level (during eligibility period) $138,241
Twelve person household
47% entrance level $79,624
67% exit level (at redetermination) $113,507 85% exit level (during eligibility period) $144,001
Three person household
47% entrance level $44,589
67% exit level (at redetermination) $63,564 85% exit level (during eligibility period) $80,640
Five person household
47% entrance level $61,576
67% exit level (at redetermination) $87,779 85% exit level (during eligibility period) $111,361
Seven person household
47% entrance level $71,662
67% exit level (at redetermination) $102,156 85% exit level (during eligibility period) $129,601
Nine person household
47% entrance level $74,847
67% exit level (at redetermination) $106,696 85% exit level (during eligibility period) $135,361
Eleven person household
47% entrance level $78,032
67% exit level (at redetermination) $111,237 85% exit level (during eligibility period) $141,121
Thirteen person household
47% entrance level $81,216
67% exit level (at redetermination) $115,777 85% exit level (during eligibility period) $146,881
Two person household
47% entrance level $36,096
67% exit level (at redetermination) $51,457 85% exit level (during eligibility period) $65,281
Gross income range Biweekly
From To copayment
$0 $13,064 $0
$13,065 $17,419 $2
$17,420 $21,296 $21
$21,297 $22,310 $23
$22,311 $23,323 $24
$23,324 $24,337 $24
$24,338 $25,351 $28
$25,352 $26,365 $30
$26,366 $27,386 $30
$27,387 $28,392 $32
$28,393 $29,414 $36
$29,415 $30,428 $37
$30,429 $31,441 $39
$31,442 $32,455 $48
$32,456 $33,469 $49
$33,470 $34,483 $59
$34,484 $35,496 $65
$35,497 $36,510 $71
$36,511 $37,524 $82
$37,525 $38,538 $88
$38,539 $39,552 $95
$39,553 $40,565 $107
$40,566 $41,579 $121
$41,580 $42,593 $137
$42,594 $43,607 $154
$43,608 $44,620 $173
$44,621 $45,634 $192
$45,635 $46,648 $207
$46,649 $47,669 $223
$47,670 $48,683 $239
$48,684 $49,697 $256
$49,698 $51,457 $277
$51,458 $65,281 $277
Three person household
47% entrance level $44,589
67% exit level (at redetermination) $63,564 85% exit level (during eligibility period) $80,640
Gross income range Biweekly
From To copayment
$0 $16,469 $0
$16,470 $21,959 $2
$21,960 $26,307 $26
$26,308 $27,559 $28
$27,560 $28,811 $29
$28,812 $30,064 $30
$30,065 $31,316 $35
$31,317 $32,568 $36
$32,569 $33,830 $38
$33,831 $35,073 $39
$35,074 $36,335 $45
$36,336 $37,587 $47
$37,588 $38,839 $48
$38,840 $40,091 $59
$40,092 $41,344 $61
$41,345 $42,596 $73
$42,597 $43,848 $80
$43,849 $45,101 $88
$45,102 $46,353 $101
$46,354 $47,605 $109
$47,606 $48,858 $117
$48,859 $50,110 $132
$50,111 $51,362 $150
$51,363 $52,614 $168
$52,615 $53,867 $191
$53,868 $55,119 $214
$55,120 $56,371 $237
$56,372 $57,624 $256
$57,625 $58,885 $276
$58,886 $60,138 $295
$60,139 $61,390 $316
$61,391 $63,564 $342
$63,565 $80,640 $342
(Page 5) DHS-6413J-ENG 10-21
Four person household
47% entrance level $53,083
67% exit level (at redetermination) $75,671 85% exit level (during eligibility period) $96,001
Gross income range Biweekly
From To copayment
$0 $19,874 $0
$19,875 $26,499 $2
$26,500 $31,318 $31
$31,319 $32,809 $33
$32,810 $34,299 $35
$34,300 $35,790 $36
$35,791 $37,281 $42
$37,282 $38,772 $43
$38,773 $40,274 $45
$40,275 $41,754 $47
$41,755 $43,256 $54
$43,257 $44,747 $55
$44,748 $46,237 $57
$46,238 $47,728 $71
$47,729 $49,219 $73
$49,220 $50,710 $87
$50,711 $52,201 $96
$52,202 $53,692 $104
$53,693 $55,182 $120
$55,183 $56,673 $130
$56,674 $58,164 $139
$58,165 $59,655 $157
$59,656 $61,146 $178
$61,147 $62,637 $201
$62,638 $64,127 $227
$64,128 $65,618 $254
$65,619 $67,109 $282
$67,110 $68,600 $305
$68,601 $70,102 $328
$70,103 $71,593 $352
$71,594 $73,084 $376
$73,085 $75,671 $408
$75,672 $96,001 $408
Five person household
47% entrance level $61,576
67% exit level (at redetermination) $87,779 85% exit level (during eligibility period) $111,361
Gross income range Biweekly
From To copayment
$0 $23,279 $0
$23,280 $31,039 $2
$31,040 $36,329 $36
$36,330 $38,058 $38
$38,059 $39,788 $40
$39,789 $41,517 $42
$41,518 $43,246 $48
$43,247 $44,976 $50
$44,977 $46,718 $52
$46,719 $48,435 $54
$48,436 $50,177 $62
$50,178 $51,906 $64
$51,907 $53,636 $66
$53,637 $55,365 $82
$55,366 $57,094 $84
$57,095 $58,824 $101
$58,825 $60,553 $111
$60,554 $62,283 $121
$62,284 $64,012 $139
$64,013 $65,741 $150
$65,742 $67,471 $162
$67,472 $69,200 $182
$69,201 $70,929 $207
$70,930 $72,659 $233
$72,660 $74,388 $263
$74,389 $76,118 $295
$76,119 $77,847 $328
$77,848 $79,576 $354
$79,577 $81,319 $380
$81,320 $83,048 $408
$83,049 $84,778 $436
$84,779 $87,779 $473
$87,780 $111,361 $473
Six person household
47% entrance level $70,069
67% exit level (at redetermination) $99,886 85% exit level (during eligibility period) $126,721
Gross income range Biweekly
From To copayment
$0 $26,684 $0
$26,685 $35,579 $2
$35,580 $41,340 $42
$41,341 $43,308 $43
$43,309 $45,276 $45
$45,277 $47,243 $48
$47,244 $49,211 $55
$49,212 $51,179 $57
$51,180 $53,162 $60
$53,163 $55,115 $62
$55,116 $57,098 $71
$57,099 $59,066 $73
$59,067 $61,034 $75
$61,035 $63,001 $93
$63,002 $64,969 $96
$64,970 $66,937 $115
$66,938 $68,905 $126
$68,906 $70,873 $138
$70,874 $72,841 $158
$72,842 $74,809 $171
$74,810 $76,777 $184
$76,778 $78,745 $207
$78,746 $80,713 $235
$80,714 $82,680 $265
$82,681 $84,648 $300
$84,649 $86,616 $336
$86,617 $88,584 $373
$88,585 $90,552 $402
$90,553 $92,535 $433
$92,536 $94,503 $464
$94,504 $96,471 $497
$96,472 $99,886 $538
$99,887 $126,721 $538
Seven person household
47% entrance level $71,662
67% exit level (at redetermination) $102,156 85% exit level (during eligibility period) $129,601
Gross income range Biweekly
From To copayment
$0 $30,089 $0
$30,090 $40,119 $2
$40,120 $42,279 $42
$42,280 $44,292 $44
$44,293 $46,305 $47
$46,306 $48,317 $48
$48,318 $50,330 $56
$50,331 $52,343 $59
$52,344 $54,371 $61
$54,372 $56,368 $63
$56,369 $58,396 $72
$58,397 $60,408 $75
$60,409 $62,421 $77
$62,422 $64,434 $95
$64,435 $66,446 $98
$66,447 $68,459 $117
$68,460 $70,472 $129
$70,473 $72,484 $141
$72,485 $74,497 $162
$74,498 $76,509 $175
$76,510 $78,522 $188
$78,523 $80,535 $212
$80,536 $82,547 $240
$82,548 $84,560 $271
$84,561 $86,573 $306
$86,574 $88,585 $343
$88,586 $90,598 $381
$90,599 $92,610 $411
$92,611 $94,638 $443
$94,639 $96,651 $475
$96,652 $98,664 $508
$98,665 $102,156 $550
$102,157 $129,601 $550
(Page 7) DHS-6413J-ENG 10-21
Eight person household
47% entrance level $73,254
67% exit level (at redetermination) $104,426 85% exit level (during eligibility period) $132,481
Gross income range Biweekly
From To copayment
$0 $33,494 $0
$33,495 $44,659 $2
$44,660 $45,276 $45
$45,277 $47,334 $48
$47,335 $49,391 $49
$49,392 $51,448 $58
$51,449 $53,506 $60
$53,507 $55,579 $62
$55,580 $57,620 $65
$57,621 $59,693 $74
$59,694 $61,751 $76
$61,752 $63,808 $79
$63,809 $65,865 $97
$65,866 $67,923 $100
$67,924 $69,980 $120
$69,981 $72,037 $132
$72,038 $74,095 $144
$74,096 $76,152 $166
$76,153 $78,210 $179
$78,211 $80,267 $192
$80,268 $82,324 $216
$82,325 $84,382 $246
$84,383 $86,439 $277
$86,440 $88,496 $313
$88,497 $90,554 $351
$90,555 $92,611 $390
$92,612 $94,668 $420
$94,669 $96,741 $452
$96,742 $98,799 $485
$98,800 $100,856 $519
$100,857 $104,426 $562
$104,427 $132,481 $562
Nine person household
47% entrance level $74,847
67% exit level (at redetermination) $106,696 85% exit level (during eligibility period) $135,361
Gross income range Biweekly
From To copayment
$0 $36,899 $0
$36,900 $49,199 $2
$49,200 $50,465 $51
$50,466 $52,567 $59
$52,568 $54,669 $61
$54,670 $56,787 $64
$56,788 $58,873 $66
$58,874 $60,991 $75
$60,992 $63,093 $78
$63,094 $65,195 $80
$65,196 $67,297 $99
$67,298 $69,399 $102
$69,400 $71,501 $123
$71,502 $73,603 $135
$73,604 $75,705 $147
$75,706 $77,808 $169
$77,809 $79,910 $183
$79,911 $82,012 $197
$82,013 $84,114 $221
$84,115 $86,216 $252
$86,217 $88,318 $283
$88,319 $90,420 $320
$90,421 $92,522 $358
$92,523 $94,624 $398
$94,625 $96,726 $430
$96,727 $98,844 $462
$98,845 $100,946 $496
$100,947 $103,048 $530
$103,049 $106,696 $575
$106,697 $135,361 $575
Ten person household
47% entrance level $76,439
67% exit level (at redetermination) $108,966 85% exit level (during eligibility period) $138,241
Gross income range Biweekly
From To copayment
$0 $40,304 $0
$40,305 $53,739 $2
$53,740 $55,832 $62
$55,833 $57,995 $65
$57,996 $60,126 $67
$60,127 $62,289 $77
$62,290 $64,435 $79
$64,436 $66,582 $82
$66,583 $68,729 $102
$68,730 $70,876 $105
$70,877 $73,023 $125
$73,024 $75,169 $138
$75,170 $77,316 $150
$77,317 $79,463 $173
$79,464 $81,610 $187
$81,611 $83,757 $201
$83,758 $85,903 $226
$85,904 $88,050 $257
$88,051 $90,197 $289
$90,198 $92,344 $327
$92,345 $94,491 $366
$94,492 $96,637 $407
$96,638 $98,784 $439
$98,785 $100,947 $472
$100,948 $103,094 $506
$103,095 $105,241 $541
$105,242 $108,966 $587
$108,967 $138,241 $587
Eleven person household
47% entrance level $78,032
67% exit level (at redetermination) $111,237 85% exit level (during eligibility period) $141,121
Gross income range Biweekly
From To copayment
$0 $43,709 $0
$43,710 $58,279 $2
$58,280 $59,204 $66
$59,205 $61,378 $69
$61,379 $63,587 $78
$63,588 $65,778 $81
$65,779 $67,970 $84
$67,971 $70,161 $104
$70,162 $72,353 $107
$72,354 $74,544 $128
$74,545 $76,736 $140
$76,737 $78,927 $153
$78,928 $81,119 $176
$81,120 $83,310 $191
$83,311 $85,502 $205
$85,503 $87,693 $231
$87,694 $89,885 $262
$89,886 $92,076 $295
$92,077 $94,268 $334
$94,269 $96,460 $373
$96,461 $98,651 $415
$98,652 $100,843 $448
$100,844 $103,051 $482
$103,052 $105,242 $517
$105,243 $107,434 $553
$107,435 $111,237 $599
$111,238 $141,121 $599
(Page 9) DHS-6413J-ENG 10-21
Twelve person household
47% entrance level $79,624
67% exit level (at redetermination) $113,507 85% exit level (during eligibility period) $144,001
Gross income range Biweekly
From To copayment
$0 $47,114 $0
$47,115 $62,819 $2
$62,820 $64,884 $80
$64,885 $67,120 $83
$67,121 $69,357 $86
$69,358 $71,593 $106
$71,594 $73,829 $109
$73,830 $76,065 $131
$76,066 $78,302 $144
$78,303 $80,538 $156
$80,539 $82,774 $180
$82,775 $85,010 $195
$85,011 $87,247 $210
$87,248 $89,483 $235
$89,484 $91,719 $267
$91,720 $93,955 $301
$93,956 $96,192 $340
$96,193 $98,428 $381
$98,429 $100,664 $424
$100,665 $102,900 $457
$102,901 $105,154 $492
$105,155 $107,390 $528
$107,391 $109,626 $564
$109,627 $113,507 $611
$113,508 $144,001 $611
Thirteen person household
47% entrance level $81,216
67% exit level (at redetermination) $115,777 85% exit level (during eligibility period) $146,881
Gross income range Biweekly
From To copayment
$0 $50,519 $0
$50,520 $67,359 $2
$67,360 $68,463 $84
$68,464 $70,744 $87
$70,745 $73,025 $108
$73,026 $75,306 $111
$75,307 $77,587 $133
$77,588 $79,868 $146
$79,869 $82,149 $160
$82,150 $84,430 $184
$84,431 $86,711 $198
$86,712 $88,992 $214
$88,993 $91,272 $240
$91,273 $93,553 $273
$93,554 $95,834 $307
$95,835 $98,115 $347
$98,116 $100,396 $389
$100,397 $102,677 $432
$102,678 $104,958 $466
$104,959 $107,257 $502
$107,258 $109,538 $538
$109,539 $111,819 $576
$111,820 $115,777 $624
$115,778 $146,881 $624
