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ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director additional fees may be necessary if during service delivery it is determined that the correct fees were not initially paid, or services requested are more than applied for. Wastewater Treatment Management Program(WTMP)and Mobile Home Park fees are the only Environmental Health services invoiced after the inspection. These inspections are not application based but occur on a regulated,recurring schedule. IV. Residency Requirements A. Any individual,Orange County resident or non-resident,may be eligible for services provided by the Health Department. Exceptions include non-STD Communicable Disease cases, designated Family Home Visiting programs (Orange County residents only), and when prohibited by law or regulation. B. Proof of Residency may be determined b, u�the US Postal and/or Orange County GIS website and one of the following: Driver's License, Government-issued identification,Pay Stub (Within the last 30 days),Utility bill(Within the last 45 days); Current rental or lease agreement; Personal or property tax bill; Student identification, and Matricula Consular(Mexican ID Card'). Clients without one of the above identifying information sources but reportedly living within the county will be required to produce a written statement or letter from the head of household,verifying that the person resides in their home. Special cases will be referred to the Clinic Manager or Supervisor. Failure to provide proof of residency may result in referral to another resource. C. Proof of Residency in Orange County is required for self-pay patients to be eligible for the sliding fee scale when requesting Maternal Health,Child Health,Primary Care, Nutrition Services,and Dental Health Services. Out-of-county residents will be assessed at 100%of charges not covered by a third party payer source. V. Service Limitation/Denial A. Services will not be denied based solely on the inability to pay,with the exception of those services that require a flat or minimum fee. Emergency dental services and urgent primary care services will be provided to clients regardless of any outstanding balance due. B. Otherwise, services may be denied if the department does not have the resources needed to provide a quality non-mandated service or the individual does not meet the residency or financial requirement. 1 The Matricula Consular de Alta Seguridad(MCAS)(Consular Identification Card)is an identification card issued by the Government of Mexico through its consulate offices to Mexican nationals residing outside of Mexico.Retrieved from hiip:Hen.wikipedia.org/wiki/Matr%C3%ADcula_Consular on October 14,2012. Page 3 of 8 Original Effective Date:January 25,2001 Revision Dates:, 4/2016,9/2018,10/2019,10/2020