Ariz. Admin. Code R6-6 app A - Cost of Care Portion Table

DEPARTMENT OF ECONOMIC SECURITY DIVISION OF DEVELOPMENTAL DISABILITIES COST OF CARE PORTION TABLE

Income based on 200% of federal poverty guidelines issued January 23, 2009

PERCENT TO PAY OF SERVICES RECEIVED FAMILY SIZE
1 2 3 4 5 6 7 8 9 10
M O N T H L Y F A M I L Y I N C O M E
0.0% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
to $1,805 to $2,428 to $3,052 to $3,675 to $4,298 to $4,922 to $5,545 to $6,168 to $6,792 to $7,415
15.0% $1,806 $2,429 $3,053 $3,676 $4,299 $4,923 $5,546 $6,169 $6,793 $7,416
to $2,058 to $2,768 to $3,479 to $4,190 to $4,900 to $5,611 to $6,321 to $7,032 to $7,743 to $8,453
20.0% $2,059 $2,769 $3,480 $4,191 $4,901 $5,612 $6,322 $7,033 $7,744 $8,454
to $2,310 to $3,108 to $3,906 to $4,704 to $5,502 to $6,300 to $7,098 to $7,895 to $8,693 to $9,491
25.0% $2,311 $3,109 $3,907 $4,705 $5,503 $6,301 $7,099 $7,896 $8,694 $9,492
to $2,563 to $3,448 to $4,333 to $5,219 to $6,104 to $6,989 to $7,874 to $8,759 to $9,644 to $10,529
30.0% $2,564 $3,449 $4,334 $5,220 $6,105 $6,990 $7,875 $8,760 $9,645 $10,530
to $2,816 to $3,788 to $4,761 to $5,733 to $6,705 to $7,678 to $8,650 to $9,623 to $10,595 to $11,567
35.0% $2,817 $3,789 $4,762 $5,734 $6,706 $7,679 $8,651 $9,624 $10,596 $11,568
to $3,069 to $4,128 to $5,188 to $6,248 to $7,307 to $8,367 to $9,427 to $10,486 to $11,546 to $12,606
40.0% $3,070 $4,129 $5,189 $6,249 $7,308 $8,368 $9,428 $10,487 $11,547 $12,607
to $3,321 to $4,468 to $5,615 to $6,762 to $7,909 to $9,056 to $10,203 to $11,350 to $12,497 to $13,644
45.0% $3,322 $4,469 $5,616 $6,763 $7,910 $9,057 $10,204 $11,351 $12,498 $13,645
to $3,574 to $4,808 to $6,042 to $7,277 to $8,511 to $9,745 to $10,979 to $12,213 to $13,448 to $14,682
50.0% $3,575 $4,809 $6,043 $7,278 $8,512 $9,746 $10,980 $12,214 $13,449 $14,683
to $3,827 to $5,148 to $6,470 to $7,791 to $9,112 to $10,434 to $11,755 to $13,077 to $14,398 to $15,720
55.0% $3,828 $5,149 $6,471 $7,792 $9,113 $10,435 $11,756 $13,078 $14,399 $15,721
to $4,079 to $5,488 to $6,897 to $8,306 to $9,714 to $11,123 to $12,532 to $13,940 to $15,349 to $16,758
60.0% $4,080 $5,489 $6,898 $8,307 $9,715 $11,124 $12,533 $13,941 $15,350 $16,759
to $4,332 to $5,828 to $7,324 to $8,820 to $10,316 to $11,812 to $13,308 to $14,804 to $16,300 to $17,796
65.0% $4,333 $5,829 $7,325 $8,821 $10,317 $11,813 $13,309 $14,805 $16,301 $17,797
to $4,585 to $6,168 to $7,751 to $9,335 to $10,918 to $12,501 to $14,084 to $15,668 to $17,251 to $18,834
70.0% $4,586 $6,169 $7,752 $9,336 $10,919 $12,502 $14,085 $15,669 $17,252 $18,835
to $4,837 to $6,508 to $8,178 to $9,849 to $11,520 to $13,190 to $14,861 to $16,531 to $18,202 to $19,872
75.0% $4,838 $6,509 $8,179 $9,850 $11,521 $13,191 $14,862 $16,532 $18,203 $19,873
to $5,090 to $6,848 to $8,606 to $10,364 to $12,121 to $13,879 to $15,637 to $17,395 to $19,153 to $20,910
80.0% $5,091 $6,849 $8,607 $10,365 $12,122 $13,880 $15,638 $17,396 $19,154 $20,911
to $5,343 to $7,188 to $9,033 to $10,878 to $12,723 to $14,568 to $16,413 to $18,258 to $20,103 to $21,948
85.0% $5,344 $7,189 $9,034 $10,879 $12,724 $14,569 $16,414 $18,259 $20,104 $21,949
to $5,596 to $7,528 to $9,460 to $11,393 to $13,325 to $15,257 to $17,190 to $19,122 to $21,054 to $22,987
90.0% $5,597 $7,529 $9,461 $11,394 $13,326 $15,258 $17,191 $19,123 $21,055 $22,988
to $5,848 to $7,868 to $9,887 to $11,907 to $13,927 to $15,946 to $17,966 to $19,985 to $22,005 to $24,025
95.0% $5,849 $7,869 $9,888 $11,908 $13,928 $15,947 $17,967 $19,986 $22,006 $24,026
to $6,101 to $8,208 to $10,315 to $12,422 to $14,528 to $16,635 to $18,742 to $20,849 to $22,956 to $25,063
100.0% $6,102 $8,209 $10,316 $12,423 $14,529 $16,636 $18,743 $20,850 $22,957 $25,064
Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater

PERCENT TO PAY OF SERVICES RECEIVED FAMILY SIZE
11 12 13 14 15 16 17 18 19 20
M O N T H L Y F A M I L Y I N C O M E
0.0% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
to $8,038 to $8,662 to $9,285 to $9,908 to $10,532 to $11,155 to $11,778 to $12,402 to $13,025 to $13,648
15.0% $8,039 $8,663 $9,286 $9,909 $10,533 $11,156 $11,779 $12,403 $13,026 $13,649
to $9,164 to $9,874 to $10,585 to $11,296 to $12,006 to $12,717 to $13,427 to $14,138 to $14,849 to $15,559
20.0% $9,165 $9,875 $10,586 $11,297 $12,007 $12,718 $13,428 $14,139 $14,850 $15,560
to $10,289 to $11,087 to $11,885 to $12,683 to $13,481 to $14,278 to $15,076 to $15,874 to $16,672 to $17,470
25.0% $10,290 $11,088 $11,886 $12,684 $13,482 $14,279 $15,077 $15,875 $16,673 $17,471
to $11,414 to $12,300 to $13,185 to $14,070 to $14,955 to $15,840 to $16,725 to $17,610 to $18,496 to $19,381
30.0% $11,415 $12,301 $13,186 $14,071 $14,956 $15,841 $16,726 $17,611 $18,497 $19,382
to $12,540 to $13,512 to $14,485 to $15,457 to $16,429 to $17,402 to $18,374 to $19,347 to $20,319 to $21,291
35.0% $12,541 $13,513 $14,486 $15,458 $16,430 $17,403 $18,375 $19,348 $20,320 $21,292
to $13,665 to $14,725 to $15,785 to $16,844 to $17,904 to $18,964 to $20,023 to $21,083 to $22,143 to $23,202
40.0% $13,666 $14,726 $15,786 $16,845 $17,905 $18,965 $20,024 $21,084 $22,144 $23,203
to $14,791 to $15,937 to $17,084 to $18,231 to $19,378 to $20,525 to $21,672 to $22,819 to $23,966 to $25,113
45.0% $14,792 $15,938 $17,085 $18,232 $19,379 $20,526 $21,673 $22,820 $23,967 $25,114
to $15,916 to $17,150 to $18,384 to $19,619 to $20,853 to $22,087 to $23,321 to $24,555 to $25,790 to $27,024
50.0% $15,917 $17,151 $18,385 $19,620 $20,854 $22,088 $23,322 $24,556 $25,791 $27,025
to $17,041 to $18,363 to $19,684 to $21,006 to $22,327 to $23,649 to $24,970 to $26,292 to $27,613 to $28,934
55.0% $17,042 $18,364 $19,685 $21,007 $22,328 $23,650 $24,971 $26,293 $27,614 $28,935
to $18,167 to $19,575 to $20,984 to $22,393 to $23,802 to $25,210 to $26,619 to $28,028 to $29,437 to $30,845
60.0% $18,168 $19,576 $20,985 $22,394 $23,803 $25,211 $26,620 $28,029 $29,438 $30,846
to $19,292 to $20,788 to $22,284 to $23,780 to $25,276 to $26,772 to $28,268 to $29,764 to $31,260 to $32,756
65.0% $19,293 $20,789 $22,285 $23,781 $25,277 $26,773 $28,269 $29,765 $31,261 $32,757
to $20,417 to $22,001 to $23,584 to $25,167 to $26,750 to $28,334 to $29,917 to $31,500 to $33,084 to $34,667
70.0% $20,418 $22,002 $23,585 $25,168 $26,751 $28,335 $29,918 $31,501 $33,085 $34,668
to $21,543 to $23,213 to $24,884 to $26,554 to $28,225 to $29,895 to $31,566 to $33,236 to $34,907 to $36,578
75.0% $21,544 $23,214 $24,885 $26,555 $28,226 $29,896 $31,567 $33,237 $34,908 $36,579
to $22,668 to $24,426 to $26,184 to $27,942 to $29,699 to $31,457 to $33,215 to $34,973 to $36,731 to $38,488
80.0% $22,669 $24,427 $26,185 $27,943 $29,700 $31,458 $33,216 $34,974 $36,732 $38,489
to $23,793 to $25,639 to $27,484 to $29,329 to $31,174 to $33,019 to $34,864 to $36,709 to $38,554 to $40,399
85.0% $23,794 $25,640 $27,485 $29,330 $31,175 $33,020 $34,865 $36,710 $38,555 $40,400
to $24,919 to $26,851 to $28,784 to $30,716 to $32,648 to $34,581 to $36,513 to $38,445 to $40,378 to $42,310
90.0% $24,920 $26,852 $28,785 $30,717 $32,649 $34,582 $36,514 $38,446 $40,379 $42,311
to $26,044 to $28,064 to $30,083 to $32,103 to $34,123 to $36,142 to $38,162 to $40,181 to $42,201 to $44,221
95.0% $26,045 $28,065 $30,084 $32,104 $34,124 $36,143 $38,163 $40,182 $42,202 $44,222
to $27,170 to $29,276 to $31,383 to $33,490 to $35,597 to $37,704 to $39,811 to $41,918 to $44,025 to $46,131
100.0% $27,171 $29,277 $31,384 $33,491 $35,598 $37,705 $39,812 $41,919 $44,026 $46,132
Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater Or greater

To determine amount to pay:

1. Find family size, include any children out of the home that are receiving Division services.
2. Find Monthly Family Income (round to the nearest whole dollar).
3. Move down the correct family size column to the cell that contains the range corresponding to the monthly family income.
4. From that cell move to the far left to the percent pay column.
5. The percent is the percent you are required to pay monthly for the services your family / child received.
6. The payment amount is not to exceed the cost of services provided.

Notes

Ariz. Admin. Code R6-6 app A
Adopted effective February 17, 1982 (Supp. 82-1). Former Appendix A repealed, new Appendix A adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Former Appendix A repealed, new Appendix A adopted effective December 1, 1996, under an exemption from A.R.S. Title 41, Chapter 6; filed in the Office of the Secretary of State, November 22, 1996 (96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4). Former Appendix A repealed; new Appendix A made by exempt rulemaking at 16 A.A.R. 314, effective January 25, 2010 (Supp. 10-1).

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.


No prior version found.