Helping Hand Community Counseling is proud to offer free or discounted counseling for individual, couple, or family services for those who might not otherwise have access to the services. Our reduced fee program is available for people who are experiencing financial hardship and in need of a short-term cost reduction for services. Due to the high demand of this service, it is vital that those applying consider the commitment and dedication to attendance and out of session tasks.

Each recipient is paired with one of our practitioners who will best suit your needs. These services are reviewed by our Chief Operating Officer or his/her designee to ensure quality of care. Client’s information is protected by privacy and confidentiality regulations, which can be found in the intake packet.

Helping Hand Community Counseling Sliding Fee Program

POLICY: To make available discount services to those in need.

PURPOSE: This program is designed to provide free or discounted care to those who have no or limited means to pay for their medical services (Uninsured or Underinsured). In addition to quality healthcare, service recipients are entitled to financial counseling by someone who can understand and offer possible solutions for those who cannot pay in full.

Helping Hand Community Counseling (HHCC) will offer a Sliding Fee Discount (SFD) Program to all who are unable to pay for their services within the context of HHCC’s financial ability. HHCC will base program eligibility on a person’s ability to pay and will not discriminate based on age, gender, race, creed, disability, or national origin. The Federal Poverty Guidelines are used in creating and annually updating the sliding fee schedule to determine eligibility. (This will apply to all groups provided for substance abuse issues. For each group of 8 service recipients who are fully funded, one additional person may be allowed to participate in the group at the sliding fee scale rate).

PROCEDURE: The following guidelines are to be followed in providing the SFD Program.

1. Notification: HHCC will notify service recipients of the SFD Program by:
          ☐ Notification of the SFD Program will be offered to each service recipient upon admission.
          ☐ SFD Program application will be included with collection notices sent out by HHCC.
          ☐ HHCC places notification of SFD Program in the clinic waiting area.

2. All service recipients seeking healthcare services at HHCC are assured that they will be served regardless of ability to pay. No one is refused service because of lack of financial means to pay.

3. Request for discount: Requests for discounted services may be made by service recipients, family members, social services staff or others who are aware of existing financial hardship. The SFD Program is available to all service recipients in all programs. Information and forms can be obtained via in-person at the front desk or email.

4. Administration: The SFD procedure will be administered through the Chief Operating Officer or his/her designee. Information about the SFD Program policy and procedure will be provided, and assistance offered, for completion of the application. Dignity and confidentiality will be respected for all who seek and/or are provided charitable services.

5. Alternative payment sources: All alternative payment resources must be exhausted, including all third-party payment from insurance(s), Federal and State programs.

6. Completion of Application: The service recipient/responsible party must complete the SFD Program application in its entirety. By signing the SFD Program application, persons authorize HHCC access in confirming income as disclosed on the application form. Providing false information on a SFD Program application will result in all SFD Program discounts being revoked and the full balance of the account(s) restored and payable immediately. If an application is unable to be processed due to the need for additional information, the applicant has two weeks from the date of notification to supply the necessary information without having the date on their application adjusted. If a service recipient does not provide the requested information within the two-week period, their application will be re-dated to the date on which they supply the requested information. Any accounts turned over for collection because of the service recipient’s delay in providing information will not be considered for the SFD Program.

7. Eligibility: Discounts will be based on income and family size only. HHCC uses the Census Bureau definitions of each.
          a) Family is defined as: a group of two people or more (one of whom is the householder)related by birth, marriage, or               adoption and residing together; all such people (including related subfamily members) are considered as members of               one family.
          b) Income includes earnings, unemployment compensation, workers’ compensation, Social Security, Supplemental               Security Income, public assistance, veterans’ payments, survivor benefits, pension or retirement income, interest,               dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance               from outside the household, and other miscellaneous sources. Noncash benefits (such as food stamps and housing               subsidies) do not count.

8. Income verification: Applicants must provide one of the following: prior year W-2, two most recent pay stubs, letter from employer, or Form 4506-T (if W-2 not filed). Self- employed individuals will be required to submit detail of the most recent three months of income and expenses for the business. Adequate information must be made available to determine eligibility for the program. Self-declaration of Income may only be used in special circumstances. Specific examples include participants who are homeless. Service recipients who are unable to provide written verification must provide a signed statement of income, and why (s)he is unable to provide independent verification. This statement will be presented to the HHCC Program Director or his/her designee for review and final determination as to the sliding fee percentage. Self-declared service recipients will be responsible for 100% of their charges until management determines the appropriate category.

9. Discounts: Those with incomes at or below 100% of poverty will receive a full 100%discount. Those with incomes above 100% of poverty, but at or below 200% of poverty, will be charged according to the attached sliding fee schedule. The sliding fee schedule will be updated during the first quarter of every calendar year with the latest federal poverty guidelines,http://aspe.hhs.gov/poverty.

10. Nominal Fee: Service recipients receiving a full discount will be assessed a $25 nominal charge per visit. However, service recipients will not be denied services due to an inability to pay. The nominal fee is not a threshold for receiving care and thus, is not a minimum fee or co-payment.

11. Waiving of Charges: In certain situations, service recipients may not be able to pay the nominal or discount fee. Waiving of charges may only be used in special circumstances and must be submitted HHCC’s COO, or their designee, for final approval. Any waiving of charges should be documented in the service recipient’s file along with an explanation (i.e., ability to pay).

12. Applicant notification: The SFD Program determination will be provided to the applicant(s)in writing and will include the percentage of SFD Program write-off, or, if applicable, the reason for denial. If the application is approved for less than a 100% discount or denied, the service recipient and/or responsible party must immediately establish payment arrangements with HHCC. Sliding Fee Discount Program applications cover outstanding service recipient balances for six months prior to application date and any balances incurred within 12 months after the approved date unless their financial situation changes significantly. The applicant has the option to reapply after the 12 months have expired or anytime there has been a significant change in family income. When the applicant reapplies, the look back period will be the lesser of six months or the expiration of their last SFD Program application.

13. Refusal to Pay: If a service recipient verbally expresses an unwillingness to pay or vacates the premises without paying for services, the service recipient will be contacted in writing regarding their payment obligations. If the service recipient is not on the sliding fee schedule, a copy of the sliding fee discount program application will be sent with the notice. If the service recipient does not make effort to pay or fails to respond within 30 days, this constitutes refusal to pay. At this point in time, HHCC can explore options not limited to, but including offering the service recipient a payment plan, waiving of charges, or referring the service recipient to collections efforts.

14. Record keeping: Information related to SFD Program decisions will be maintained and preserved in a centralized confidential file located in a secure location within the primary location or within our EHR system companywide, to preserve the dignity of those receiving free or discounted care:
          a) Applicants that have been approved for the SFD Program will be logged in a binder maintained in the primary               location, making notes of names of applicants, dates of coverage and percentage of coverage provided through our               sliding fee program.
          b) Each month, the office manager will update the log by entering the dollar amount covered by the agency through               this policy for each service recipient for that month.
          c) The office manager will also document all denials of applications by applicant name and date of application, and               reason for denial (i.e., not eligible, service recipient withdrew application, service recipient refused amount of sliding               fee assistance offered, Service recipient did not produce documentation required with application, or service               recipient has not responded to communication attempts/discharged from program, etc.).

15. Policy and procedure review: Annually, the amount of SFD Program provided will be reviewed by the CEO and COO, or their designee. The sliding fee schedule will be updated based on the current Federal Poverty Guidelines. Pertinent information comparing amount budgeted and actual community care provided shall serve as a guideline for future planning. This will also serve as a discussion base for reviewing possible changes in our policy and procedures and for examining institutional practices which may serve as barriers preventing eligible service recipients from having access to our community care provisions.

16. Budget: During the annual budget process, an estimated amount of SFD Program service will be placed into the budget as a deduction from revenue. CEO and COO approval for SFD Program will be sought as an integral part of the annual budget.