annual income determination - CHC sliding fee scale

[Guest guest]

Good points.

The issue is one that has been brought up before and concerns the use of

historical as opposed to prospective data to determine annual income. In the

case where a prospective annual income is derived on current income, the result

can often be a high annual income because it assumes full employment during the

year at the current rate of income. A more accurate reflection may be the

historical annual income.

To some extent the determination of the MSFW annual income for sliding fee scale

purposes is up to the respective CHC policy set for determining income. This

policy is set by the C/MHC board and they have the discretion of how they will

determine the annual income. (note: this is not the case when it comes to annual

income determination for Medicaid and SCHIP purposes, that is set by the

respective State Medicaid agency.) Indeed, I have spoken to some migrant health

centers that are keen to the issue and have adopted a more MSFW patient

equitable policy.

On the second issue, that of relatives outside of the US. I would venture to say

that again this is a policy that would be determined by the individual health

center and borders on the documentation and verification of the patient

assertions. I would be interested in hearing on how other migrant health centers

handle this issue.

Both of these issue illustrate the importance of having migrant and seasonal

representatives on the governance board as well as having staff that is

sensitive to MSFW issues especially when it comes to access for health care

services.

Ruiz

Assistant Director Systems Development and Policy Administration

Migrant Health Coordinator

National Association of Community Health Centers, Inc.

7200 Wisconsin Avenue Suite 210

Bethesda, MD 20814

(301) 347-0442

(301) 347-0459 FAX

(202) 365-0154 Cell Phone

jruiz@...

www.nachc.com

[Guest guest]

I would very much like to see a BPHC policy or guidance document on this

issue. Many centers fear repercussions during their PCER if they adopt

" MSFW equitable " policies, and ask for something in writing from the Bureau.

Deb Norton

Ruiz wrote:

>Good points.

>

>The issue is one that has been brought up before and concerns the use of

historical as opposed to prospective data to determine annual income. In the

case where a prospective annual income is derived on current income, the result

can often be a high annual income because it assumes full employment during the

year at the current rate of income. A more accurate reflection may be the

historical annual income.

>

>To some extent the determination of the MSFW annual income for sliding fee

scale purposes is up to the respective CHC policy set for determining income.

This policy is set by the C/MHC board and they have the discretion of how they

will determine the annual income. (note: this is not the case when it comes to

annual income determination for Medicaid and SCHIP purposes, that is set by the

respective State Medicaid agency.) Indeed, I have spoken to some migrant health

centers that are keen to the issue and have adopted a more MSFW patient

equitable policy.

>

>On the second issue, that of relatives outside of the US. I would venture to

say that again this is a policy that would be determined by the individual

health center and borders on the documentation and verification of the patient

assertions. I would be interested in hearing on how other migrant health centers

handle this issue.

>

>Both of these issue illustrate the importance of having migrant and seasonal

representatives on the governance board as well as having staff that is

sensitive to MSFW issues especially when it comes to access for health care

services.

>

>

> Ruiz

>Assistant Director Systems Development and Policy Administration

>Migrant Health Coordinator

>National Association of Community Health Centers, Inc.

>7200 Wisconsin Avenue Suite 210

>Bethesda, MD 20814

>(301) 347-0442

>(301) 347-0459 FAX

>(202) 365-0154 Cell Phone

>jruiz@...

>www.nachc.com

>

>

>

>

>

>

>

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