Department of Assistive and Rehabilitative Services Early Childhood Intervention Services Monthly Maximum Charge Sliding Scale Effective May 1, 2014 Family Size = 3 Family Size = 2 Adjusted Family Income $15,730 $15,731 $23,596 $31,461 $39,326 $55,056 $70,786 $86,516 $102,246 $117,976 or or under $23,595 $31,460 $39,325 $55,055 $70,785 $86,515 $102,245 $117,975 over Monthly Maximum Charge $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 Relation to FPL ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% Family Size = 4 Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% under $35,775 $47,700 $59,625 $83,475 $107,325 $131,175 $155,025 $178,875 over Family Size = 6 Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% under $47,955 $63,940 $79,925 $111,895 $143,865 $175,835 $207,805 $239,775 over Family Size = 8 Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% under $60,135 $80,180 $100,225 $140,315 $180,405 $220,495 $260,585 $300,675 over under $29,685 $39,580 $49,475 $69,265 $89,055 $108,845 $128,635 $148,425 over ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% Adjusted Family Income Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% Adjusted Family Income Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% Adjusted Family Income Monthly Maximum Charge Relation to FPL or or $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 ≤ 100% > 100% to ≤ 150% > 150% to ≤ 200% > 200% to ≤ 250% > 250% to ≤ 350% > 350% to ≤ 450% > 450% to ≤ 550% > 550% to ≤ 650% > 650% to ≤ 750% > 750% $27,910 $27,911 $41,866 $55,821 $69,776 $97,686 $125,596 $153,506 $181,416 $209,326 under $41,865 $55,820 $69,775 $97,685 $125,595 $153,505 $181,415 $209,325 over $36,030 $36,031 $54,046 $72,061 $90,076 $126,106 $162,136 $198,166 $234,196 $270,226 under $54,045 $72,060 $90,075 $126,105 $162,135 $198,165 $234,195 $270,225 over Family Size = 9 Adjusted Family Income $40,090 $40,091 $60,136 $80,181 $100,226 $140,316 $180,406 $220,496 $260,586 $300,676 or or Relation to FPL Family Size = 7 Adjusted Family Income $31,970 $31,971 $47,956 $63,941 $79,926 $111,896 $143,866 $175,836 $207,806 $239,776 $19,790 $19,791 $29,686 $39,581 $49,476 $69,266 $89,056 $108,846 $128,636 $148,426 Monthly Maximum Charge $0 $3 $5 $10 $20 $55 $85 $115 $145 $175 Family Size = 5 Adjusted Family Income $23,850 $23,851 $35,776 $47,701 $59,626 $83,476 $107,326 $131,176 $155,026 $178,876 Adjusted Family Income $44,150 $44,151 $66,226 $88,301 $110,376 $154,526 $198,676 $242,826 $286,976 $331,126 under $66,225 $88,300 $110,375 $154,525 $198,675 $242,825 $286,975 $331,125 over To calculate the adjusted family income range for each monthly maximum charge amount for family size more than 9, add $4,060 for each additional person for each 100% of federal poverty level (FPL).
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