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RESOLUTION 2007-136 <br />Z T <br />W n e <br />O <br />C <br />I— N c <br />d' w <br />d c <br />0 U-1 CD a <br />F=- i c <br />Q O a <br />=r U <br />v m <br />r, <br />H% <br />c <br />a <br />co <br />O �- <br />0 <br />rn <br />rn <br />a <br />9/26/2007CLFEE2007-08 FINAL <br />For the purpose of family planning, sexually transmitted disease, or HIV/AIDS services only, minors seeking those services shall be <br />considered a separate family for income eligibility determination purposes and shall be assessed fees for those services based upon their <br />own personal gross income. <br />Any client who elects to waive the eligibility determination process shall be assigned to the full fee category. If there is no fee for a service, <br />income eligibility does not need to be determined, except for WIC. <br />The self -declaration statement shall include a signed acknowledgment that the statement is true at the time it is made, and that the person <br />making the statement understands that the provider shall attempt to verify the statement. Verification can be secured by telephone, in <br />written form, or by face-to-face contact, verification does not require a written document to confirm an applicant's or client's statement. <br />If th d I 1 <br />e prove er is unable to verify wages pato or an employer will not verify wages paid, the self -declaratory statement provided by the <br />I nnnGn aria .......a <br />I <br />.G.,.� y ..y %.nu aria mew suocontractors shall not be denied services for tuberculosis, sexually transmitted disease. or HIWAInS <br />coin bl <br />I <br />JChentsInterviewedexaminedortestedat , , IRCHD's initiative because they are a contact to a case of communicable disease or hem' <br />IL.e <br />y are a member of a group at risk mat is being investigated by the IRCHD shall not be charged a fee for the interview examination nr <br />to f • th <br />s mg, ese clients may be charged on a sliding tee scale for any treatment indicated, but they cannot be denied services based <br />Inn in�Lili{.. ►........ _ <br />I <br />I <br />„J V VU Uy irc..nu dna mew suocontractors shall not be denied family planning services for failure or inability to pay a prescribed fee <br />• ardl fh" <br />d female sterilization, shall be limited <br />ien s may request d review of their fee charge on the basis that they have severe, unusual, and unavoidable expenses or obliaatinns that <br />subt f II <br />I <br />P <br />1 <br />munica dlsedsC control because of tenure or inability to pay a prescribed fee, regardless of their income. <br />eg ess o t eir income, however, the family planning services of inserting Norplant, and male an <br />depending on the availability of funds to pay for these services. <br />CI' t � I <br />s an is y reduce their ability to pay and which warrant special consideration. <br />Ili <br />m <br />CES <br />C <br />D <br />3 <br />A <br />o <br />Z <br />c <br />a <br />C <br />a. <br />1 <br />= <br />> <br />- <br />I <br />C. <br />• <br />Z <br />c <br />a <br />C <br />1 <br />1 <br />c <br />a <br />C <br />Z T <br />W n e <br />O <br />C <br />I— N c <br />d' w <br />d c <br />0 U-1 CD a <br />F=- i c <br />Q O a <br />=r U <br />v m <br />r, <br />H% <br />c <br />a <br />co <br />O �- <br />0 <br />rn <br />rn <br />a <br />9/26/2007CLFEE2007-08 FINAL <br />