Sliding Fee Scale (SFS) Policy –

1. Frequency of client eligibility re-evaluation

   1. Client eligibility for the Sliding Fee Scale (SFS) will be re-evaluated annually or sooner if there is a significant change in the client's financial or family status that may affect eligibility as determined by provider.

2. Income definition

   1. Income will be defined as the client's total household income before taxes, including wages, salaries, self-employment earnings, social security, disability, pensions, TANF, Military VA, Food Stamps and any other sources of income.

3. Family size definition

   1. Family size will be defined as the number of individuals supported by the client's household financially, including the client, their spouse/domestic partner, and dependent children as defined by IRS guidelines.

4. Documentation and verification requirements to determine client eligibility

   1. Clients applying for the SFS must provide documentation of income and family size. Acceptable documentation is determined by the clinician and can include tax returns, pay stubs, employer verification, or social security benefits statements. The clinician can determine if other relevant documentation is needed or acceptable.

5. How your site advertises the Sliding Fee Discount Program to the client population to increase access to care.

   1. The SFS will be prominently advertised through various channels to ensure awareness and accessibility among the client population. This includes:

      1. Posting information on the facility's website.

      2. Providing information to all clients at the site’s physical location via posted printouts.

      3. Ensuring all staff are trained to inform clients during the intake process about the SFS and its benefits.

Nominal Charges

1. Nominal charges may apply to SFS clients depending on their income level. Nominal charges are defined as minimal fees for services provided under the SFS. The establishment and collection of nominal charges will adhere to the following policies:

   1. Nominal charges will be calculated based on a percentage of the standard fee schedule or a flat fee, determined by the clinician.

   2. Clients will be informed of nominal charges prior to receiving services.

   3. Policies for establishing nominal charges will be transparent and consistent for all SFS clients.

   4. Refusal to pay nominal charges may result in a review of eligibility status and may impact continued participation in the SFS as determined by the clinician.

Description of collection policies for outstanding debt

1. SFS clients with outstanding debt will be subject to the facility's standard collection policies. All escalation of attempts to collect a debt is determined by the clinician. Regardless, these policies will:

   1. Ensure fair and respectful treatment of clients.

   2. Include efforts to establish payment plans based on the client's ability to pay.

   3. Clearly define steps for escalating collection efforts, if necessary, while considering the client's financial circumstances.

   4. Provide opportunities for clients to discuss their financial situation and seek assistance, including referrals to financial counseling services.