1. A.

   1. 1. The Department of Health and Human Resources, Women's Advocacy Bureau, has adopted a fee schedule for the Teen Parent Center program, as mandated by federal regulations, as published in the Federal Register, Vol. 47, Number 40, Monday March 1,1982, pg. 8682.
   2. 2. In accordance with Title XX of the Public Health Services Act (42 U.S.C. 3002) administered through United States Government, Department of Health and Human Services, Office of Adolescent Pregnancy Programs, all Teen Parent Center clients must be charged a fee for services provided. In accordance with the act, the following policy is being adopted. The policy and fee schedule are as follows.
2. B. Fee Policy. All persons receiving services from the Teen Parent Center shall be assessed a fee for each service received. The intake and initial assessment are not considered services. The fee for each service is based on the actual cost to the program incurred in the provision of that service.

3. C. Fee Adjustment Schedule

   1. 1. The fee adjustment schedule is designed to provide for proportional payment for each service based on the family's ability to pay. Three variable figures are utilized in figuring the schedule:

      1. a, state median income as promulgated annually by the Secretary of the United States Department of Health and Human Services;
      2. b. family size;
      3. c. cost of service provided.

   2. 2. Persons whose gross family income is less than one-half the current state median income adjusted for family size will not be responsible for payment of services. Persons whose gross family income is more than 150 percent of the current state median income adjusted for family size will be charged the full cost of services provided. Between these two levels, fees will be adjusted in accordance with the following formula.

      Gross Family Income as a Percent of Median Income Adjusted for Family Size	Fees as a Percent of Cost
      50-55 percent	4 percent
      55-60 percent	5 percent
      60-65 percent	6 percent
      65	8 percent
      70	10 percent
      75	12 percent
      80	14 percent
      85	17 percent
      90	20 percent
      95	23 percent
      100	26 percent
      105	30 percent
      110	35 percent
      115	40 percent
      120	45 percent
      125	52 percent
      130	60 percent
      135	70 percent
      140	80 percent
      145	90 percent
      150	100 percent

4. D. Program Services

   1. 1. Program services are divided into two general categories: (a) Basic Services, and (b) Employment Services. Each of the two large groups are subdivided into the individual services that may be provided to clients. The following is a listing of the groupings and the codes assigned to each service for recording purposes.

      Basic Services	Codes
      Individual Counseling/referrals	100
      Group Counseling/referrals	1002
      Family Counseling/referrals	1003
      Educational Workshop Sessions	1004

      Employment Services	Codes
      Job Preparation Workshop Sessions	2001
      Employment Counseling	2002
      Employment Referrals (beyond first five)	2003
      Job Placement	2004

5. E. Determination of Fees/Income Verification

   1. 1. All clients whose gross family income is above the minimum indicated on the fee adjustment schedule shall pay a fee for each service provided. The determination of fees will be made during the intake procedures or as soon as verification of income information is obtained. In the case of clients who are unemancipated minors, the income information is to be obtained (or verified if provided by minor) from the parents or legal guardian. This can be done by telephone; however, the record should reflect the name of the person providing the information. If income information cannot be obtained by telephone, the Income Verification Form is given to the applicant, completed by the parents or legal guardian, and returned to the center. The intake worker will use the fee adjustment schedule to determine the fee once this information is received. The parents will then be informed of the fee by the intake worker. The completed intake form and/or the income verification form will become a part of the permanent record, and a ledger card will be given to the secretary/fee clerk, noting the fee rate.

6. F. Collection of Fees

   1. 1. During the intake procedure the client and the parent or guardian of the client will be informed that fees will be paid upon delivery of service. In the case of an emancipated minor who is responsible for his own debts, only the client will be informed of the fee collection. The clients will be instructed to see the secretary/fee clerk prior to leaving the center. The secretary/fee clerk will note payment on the client's ledger card or bill the client in the event that payment is not received. Billing will occur on a monthly basis.
   2. 2. All fees collected will be held by the secretary/fee clerk in a locked box until delivery to the Women's Advocacy Bureau accountant. This shall be the first working day of the month or when $50 is accumulated, whichever comes first.

7. G. Waiver of Fees

   1. 1.

      1. a. It is imperative that clients understand that no services will be refused due to inability to pay. The following circumstances warrant fee waiver:

         1. i. lack of income over last three months;
         2. ii. payment of unusually high medical bills; or
         3. iii. death of income provider.

      2. b. This information will be obtained during the intake and noted on the Fee Determination Form and on the client's ledger card.

         Teen Parent Center Fee Adjustment Schedule
         Percent Median Income	Annual Gross Family Income By Number In Family	% of Cost Paid	Basic Service	Employment Counseling and Job Placement
         	2	3	4	5	6	7	8	9+
         50	5,614	6,935	8,256	9,576	10,897	12,218	13,718	15,218	4	2.00	2.00
         55	6,175	7,628	9,081	10,534	11,987	13,440	14,940	16,440	5	2.00	2.00
         60	6,736	8,322	9,907	11,492	13,077	14,662	16,162	17,662	6	3.00	3.00
         65	7,298	9,015	10,732	12,449	14,166	15,884	17,384	18,884	8	3.00	4.00
         70	7,859	9,708	11,558	13,407	15,256	17,105	18,605	20,105	10	5.00	5.00
         75	8,421	10,402	12,383	14,365	16,346	18,327	19,827	21,327	12	5.00	6.00
         80	8,982	11,095	13,209	15,322	17,436	19,549	21,049	22,549	14	6.00	6.00
         85	9,543	11,789	14,034	16,280	18,525	20,771	22,271	23,771	17	7.00	8.00
         90	10,105	12,482	14,860	17,237	19,615	21,993	23,493	24,993	20	9.00	9.00
         100	11,227	13,869	16,511	19,153	21,795	24,436	25,936	27,436	26	11.00	12.00
         105	11,789	14,563	17,337	20,110	22,884	25,658	27,158	28,658	30	13.00	14.00
         110	12,350	15,256	18,162	21,068	23,974	26,880	28,380	29,880	35	15.00	16.00
         115	12,912	15,950	18,988	22,026	25,064	28,102	29,602	31,102	40	17.00	18.00
         120	13,473	16,643	19,813	22,983	26,153	29,324	30,824	32,324	45	19.00	21.00
         125	12,034	17,337	20,639	23,941	27,243	30,545	32,045	33,545	52	22.00	24.00
         130	14,596	18,030	21,464	24,899	28,333	31,767	33,267	34,767	60	26.00	28.00
         135	15,157	18,723	22,290	25,886	29,423	32,980	34,489	35,989	70	30.00	32.00
         140	15,718	19,417	23,115	26,814	30,512	34,211	35,711	37,211	80	34.00	37.00
         145	16,280	20,110	23,941	27,772	31,602	35,433	36,933	38,433	90	39.00	41.00
         150	16,841	20,804	24,767	28,729	32,692	36,054	38,154	39,654	100	43.00	46.00

   2. 2. In the event that the client refused to pay or is unable to pay, the Payment Agreement Form is completed. The ledger card will reflect the client's ability or willingness to pay. If no payment can be collected, no billing will be necessary. For clients whose circumstances provided for them to pay less than the required amount, they will be billed for the full amount with all payments received recorded on the ledger card.
8. H. Changes in Fees. The client is to be informed that the secretary should be notified of any change which may later occur in income, employment, or family composition which might result in a change in the adjusted fee. The secretary shall also conduct a periodic check every 90 days with each client to determine any change in factors, including cost changes, which would cause change in the fee and adjusted fee. The counselor assigned to the case is also responsible for notifying the secretary of such changes as they occur. The secretary is to adjust the fee appropriately in accordance with the fee adjustment schedule. The adjusted fee must be approved by the center director and is indicated by her initial on the ledger card.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 46:2127(B), R.S. 36:251 et seq. and R.S. 46:1751-1767.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Human Resources, Women's Advocacy Bureau, LR 9:618 (September 1983).