Department of Health

Community health fees policy

Community health services (CHSs) use a schedule of fees and income ranges when assessing people seeking services. This fee schedule applies to the Community Health Program and the Home and Community Care program, which are funded by the Department of Health.

Note:

  • Even if a consumer has declared that they are in a particular income level, mitigating circumstances may affect the consumer’s ability to pay a fee. In these cases, consumers have the right to have the fee reduced or waived.
  • No one can be denied a service because they are not able to pay fees.

Fees Policy Principles

The following principles provide a consistent framework within which community health services providers are to operate.

  • Inability to pay cannot be used as a basis for refusing a service to people who are assessed as requiring a service:
  • Where fees are to be charged, it should be done in accordance with a scale of fees appropriate to the consumer’s level of income, amount of service used, and any changes in circumstances and ability to pay.
  • All agencies should charge the full cost of the service where consumers are receiving, or have received, compensation payments intended to cover the cost of care.
  • Consumers with similar levels of income (after considering levels of expenditure) and service usage patterns should be charged equivalent fees for equivalent services.
  • Fees charged should not exceed the actual cost of service provision. Generally, the fee charged should be all-inclusive and covers all materials used in delivery of the service. Where there is a significant additional cost for material utilised in the provision of a service, a separate fee can be charged.
  • Fee collection should be administered efficiently and attempts should be made to minimise the cost of administration.
  • The revenue from fees is to be used to enhance and/or expand services.
  • Procedures for the determination of fees, including assessment criteria, should be clearly documented and publicly available. The onus is on the service provider to ensure all consumers are aware that this information is available.
  • Procedures for determination and collection of fees should take into account the situation of special needs groups.
  • Assessment of a person’s capacity to pay fees should be as simple and unobtrusive as possible, with due regard for individual’s privacy. Any information obtained should be treated as confidential.
  • Consumers and their advocates have the right of appeal against a given fee determination.
  • For the purposes of this policy, solicited donations for services are equivalent to fees and are subject to all provisions of this policy. The implementation of this policy cannot be avoided by using the terms payments or donations instead of fees.

Reviewed 04 November 2022

Health.vic

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