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ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 5 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/14, 9/22/15 F. Fees may be charged for education, community-based limited clinical services (such as influenza shots) and screening services provided to individuals or groups. The following applies to these services: 1. They include orientation, field training, dental screening and education, and/or other health promotion activities such as infant and toddler car seats, bike helmets, or equipment rental. 2. The Health Director will negotiate fees for services where fees have not been previously determined. 3. Income eligibility requirements do not apply to these services. G. Per NC General Statute Chapter 7B, Subchapter 4, Article 35, and confidentiality regulations, emancipated minors and other individuals requesting confidential services will be considered a family of one for determination of charges. Private insurance will also not be billed for minors receiving services for which they can consent unless permission is received from the minor. H. Persons requesting any program services may be encouraged to apply for Medicaid, as applicable. I. The Personal Health Services Division clinical and nutrition services will use the appropriate sliding fee schedule for services when adjustable fees are allowed; all other fees will be charged at 100%. 1. Clients, who require services provided on the sliding fee schedule, are expected to pay the appropriate fee in full based on sliding fee guidelines. 2. This schedule will require assessment of the client’s financial status on an annual basis or when a financial status change occurs, as specified in section III. J. Dental Health Services, Primary Care Services, and Nutrition Services will use a sliding fee schedule for all services, with a minimum charge to be established at the annual fee review during the budget preparation process. 1. The minimum charge for dental, primary care, and nutrition services will apply regardless of the determination of the client’s financial status. 2. If a client is determined to fall at the 0% pay level, the minimum charge will be the only charge levied and collected. 3. Minimum charge is due at time of service. K. Fee schedules will be reviewed annually during the budget process and adjusted as appropriate; a complete cost analysis for purposes of fee adjustments will be performed every five years. The process for this cost analysis includes a review of the following elements: a. Most recent vaccine and drug purchase costs b. Most recent lab pricing lists c. Most recent Medicaid Cost Settlement data for procedure costs d. Environmental Health equipment, labor, and staff costs e. Review of fee schedules of surrounding jurisdictions