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Charging for Services

Case Study

Caregiver Support Service Part II:  Establishing a sliding fee scale for respite service

After the unit cost for each of the two caregiver support services described in the previous case study was determined, a sliding fee scale was chosen based on state guidelines for sliding fee scales using the poverty level for the current year as the basis for the scale.  See the example, Respite Sliding Fee Scale, to view how the agency established a range of fees to fit the guidelines provided by the state at various percentages above the poverty income level.   Review the detail of the income ranges and suggested sliding fees on the Caregiver Respite Contribution scale.   Note that the top fee of $18.00 matches the full cost of the service listed in the cost summary worksheet noted in the Establishing true costs section of this module.

The new policy and scale was introduced carefully with both staff and volunteers to explain why this change was being implemented – including noting that the volunteer program still had costs to run it, and other funding sources were not covering the full costs.   The fee scale is discussed at intake, and agreed upon.  Monthly statements are sent out, though unpaid balances do not accumulate.   A few volunteers and participants left the program, but overall, the transition was a success, and the income from the sliding fees has gradually risen each year.       

To see a summary of the sliding fee scale, click here: “Respite Sliding Fee Scale”