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ORANGE COUNTY HEALTH DEPARTMENT <br />Board of Health Policy and Procedures Manual <br />Section I: Board Adopted Policies <br />Policy E: Fee and Eligibility Policy <br />Reviewed by: Financial Review Committee, Health Director <br />Approved by: Board of Health, Health Director <br /> <br /> <br /> Page 3 of 8 <br />Original Effective Date: January 25, 2001 <br />Revision Dates:, 2/4/13, 8/12/13, 10/22/14, 9/22/15 <br /> <br />additional fees may be necessary if during service delivery it is determined that the <br />correct fees were not initially paid, or services requested are more than applied for. <br />Wastewater Treatment Management Program (WTMP) and Mobile Home Park fees are <br />the only Environmental Health services invoiced after the inspection. These inspections <br />are not application based but occur on a regulated, recurring schedule. <br /> <br /> <br />IV. Residency Requirements <br />A. Any individual, Orange County resident or non-resident, is may be eligible for services <br />provided by the Health Department. Exceptions include non-STD Communicable Disease <br />cases, designated Family Home Visiting programs (Orange County residents only), and <br />when prohibited by law or regulation. <br /> <br />B. Proof of Residency may be determined by using the US Postal and/or Orange County <br />GIS website and one of the following: Driver’s License, Government-issued <br />identification, Pay Stub (Within the last 30 days), Utility bill (Within the last 45 days); <br />Current rental or lease agreement; Personal or property tax bill; Student identification, <br />and Matrícula Consular (Mexican ID Card1). Clients without one of the above <br />identifying information sources but reportedly living within the county will be required to <br />produce a written statement or letter from the head of household, verifying that the <br />person resides in their home. Special cases will be referred to the Clinic Manager or <br />Supervisor. Failure to provide proof of residency may result in referral to another <br />resource. <br /> <br /> <br />C. Proof of Residency in Orange County is required for self-pay patients to be eligible for <br />the sliding fee scale when requesting Maternal Health, Child Health, Primary Care, <br />Nutrition Services, and Dental Health Services. Out-of-county residents will be assessed <br />at 100% of charges not covered by a third party payer source. <br /> <br /> <br />V. Service Limitation/Denial <br />A. Services will not be denied based solely on the inability to pay, with the exception of <br />those services that require a flat or minimum fee. Emergency dental services and urgent <br />primary care services will be provided to clients regardless of any outstanding balance <br />due. <br /> <br />B. Otherwise, services may be denied if the department does not have the resources needed <br />to provide a quality non-mandated service or the individual does not meet the residency <br />or financial requirement. <br /> <br />1 The Matrícula Consular de Alta Seguridad (MCAS) (Consular Identification Card) is an identification card issued by <br />the Government of Mexico through its consulate offices to Mexican nationals residing outside of Mexico. Retrieved from <br />http://en.wikipedia.org/wiki/Matr%C3%ADcula_Consular on October 14, 2012.