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E-43 FAMILY PLANNING PATIENT FEES The North Carolina Statewide Family Planning Program has received approval from the Regional Health Administrator of a phase-in schedule for the self-pay patient coll.ection system in local family ~lanning programs (Exhibit 23). This effort will 'culminate July l, 1979 with statewide patient fees implementation and bring'~e project into, full compliance with the Health Services Funding Regulations. A pilot project has begun in five ~ounties which will .provide the opp.ortunity to test various patient fee procedures and their ~mpact on the scope of family plahning services. Technical assistance is being offered to other local providers during this phase-in period in preparation for full implementation of the system. It is important to note that there, are additional local programs charging family planning patient fees other than those partici- pating in the pilot project. An educational effort has begun to inform and gain support from locally elected officials and members of local Boards'of Health. It is necessary that these groups provide approval of the fee schedule enabling local health departments to charge for services offered. At the same time, local Health Oirectors are working with county government personnel,to establish mechanisms -for depositing fees in a revenue line item for the fam!ly planning budgets. This process will ensure that fee collections will be programmed back into family'planning programs enabling an expansion of necessary services, A sliding Fee scale has been developed and approval has been granted by the Regional Office. (Exhibit 24) Those patients falling below the ~itle XX income eligibi.lity requirements who are not certified for services will be assessed a nominal fee '(15%) of full charges. Free service is provided to those individuals who are below the 80% state median income figures based on family.size and eligible or certified for ~iedicaid and Title XX. A waiver of all family planning fees ~s appl'ied to teenagers, Fees are based on a cost analysis study and are similar to the reimbursement rates negotiated with third 'party payors for each I