Fees return to Health Clinic

Submitted by San Juan County.

On June 1, San Juan County Health & Community Services will begin collecting fees for some public health services again. HCS will also be rolling out their new sliding fee scale. This sliding fee scale has been adopted to ensure that HCS public health clinics remain as accessible as possible to everyone, no matter their income level.

The updated fee schedule and the new sliding fee scale was adopted on March 15, 2023, after the Board of Health held a public comment session. The approved fee schedule reduced fees associated with HCS public health clinic services and eliminated some fees altogether. Maternal child health home visits and WIC appointments do not have a fee. The following services will cost $10.00 before applying the sliding fee scale (explained below):

Immunization Office Visit Fee ($10 per visit, per patient)

Immunization Administration Fee ($10 per vaccine administered)

Pregnancy Test Fee ($10 per test)

Tuberculosis Test and Test Read Fee ($10 for test and read)

Immunization fees currently do not apply to COVID-19 vaccines. COVID-19 vaccines are provided free of charge to all persons, regardless of insurance and income status.

A sliding fee scale means that the total amount due will be adjusted based on a family’s annual income. The poverty guidelines, which are issued every year in the Federal Register by the Department of Health and Human Services, are a simplified version of the federal poverty thresholds used for administrative purposes. HCS has based their sliding fee scale on these guidelines.

Here is a breakdown of HCS’s sliding fee scale:

Patient Status A: Families making less than the federal poverty guideline will be charged 0% of the total fees.

Patient Status B: Families making between 101% and 125% of the federal poverty guideline will be charged 20% of the total fees.

Patient Status C: Families making between 126% and 150% of the federal poverty guideline will be charged 40% of the total fees.

Patient Status D: Families making between 151% and 175% of the federal poverty guideline will be charged 60% of the total fees.

Patient Status E: Families making between 176% and 200% of the federal poverty guideline will be charged 80% of the total fees.

Patient Status F: Families making over 200% of the federal poverty guideline will pay the full amount.

To see the full sliding fee scale with 2023 annual income amounts, please go to our website. Patients may self-attest or notify HCS front office staff of their annual income amount so that their total clinic fees can be adjusted to match our sliding fee scale. No proof of income will be required, and all fees are due at the time of service. Patients with Medicaid will be assessed at Patient Status A with valid proof of Medicaid enrollment.

So, what does the fee schedule and sliding fee scale look like in real life? Let’s look at an example… A child is brought into a HCS clinic and receives two vaccines. The fees incurred by this visit would be one Immunization Office Fee ($10) and two Immunization Administration Fees ($10 per vaccine, or $20 total). The vaccines are free because the VFC program covers the cost of vaccines for all children in Washington under 18 years old. So, the total fees would be $30.00. However, this child is part of family that makes 160% of the federal poverty guideline (Patient Status D). This means that the adjusted total fee would be 60% of $30, which is $18.00. Now, if this child was part of a family who was enrolled in Medicaid (Patient Status A), then the adjusted total fees would be 0% of $30 which is $0.00.

HCS’s sliding fee scale applies to children through the age of 18 years who receive vaccines through the Vaccines For Children program and uninsured/underinsured adults. Insured adults are asked to get their immunizations and medical services through their medical home and/or primary care provider. Local pharmacies also offer some vaccines for insured adults.

No one will be denied services because of an inability to pay. Fees may be paid in cash or check (made out to “SJC Health”) only. Currently, we are not able to accept payment via credit or debit card. We are currently not able to bill insurance (private or public). For any questions or to schedule an appointment, please call our office at 360-378-4474.