Should you be interested in seeing if you qualify for reduced or free services, you will be responsible for providing specific information when filling out a “Fee Determination Form” prior to the delivery of services with one of our case managers to determine assistance eligibility.
Only the earned and unearned income of the individual applying for services and the earned and unearned income of the individual’s spouse is considered.
Deductibles and amounts not paid by other insurances are the responsibility of the client or family.
Income from SSI, SSDI, and adoption subsidy is not considered in calculating family income. The individual receiving SSI or SSDI is not counted in calculating the size of the household.
Financial responsibility is based on income, family size, and allowable deductions including the following: court ordered obligations, childcare necessary for employment, medical expenses, transportation necessary for travel to work and other specific destinations, extraordinary rehabilitative expenses, and state and federal tax payments.
The assets of the adult applying for services are not used in calculating household income.
Patients are responsible for the percentage that is determined through the sliding fee scale. For example, if a family of 4 earns $32,000 gross income annually and they have $5,000 in allowable deductions annually; the family’s adjusted annual income would be $27,000. Using the adjusted annual income on “Fee Determination Scale”, the family would be responsible for 10% of the hourly fee for services. If the individual received individual psychosocial rehabilitation services, the financial responsibility would be $7.40 per hour.