Policy Advisory: Nominal Fees for Consumers

The National HCH Council provides this Policy Advisory in response to HRSA Policy Information Notice 2014-02, encouraging Heath Center Boards of Directors not to impose “nominal” fees on consumers living below the Federal Poverty Guidelines, as we believe these constitute a significant barrier to care for people living in poverty.

Like all health centers, HCH projects exist to ensure access to quality health care. The vast majority of homeless users of health centers have income well below 100% of FPG. Foremost among the well-documented barriers to care for people experiencing homelessness is an inability to pay. To address this barrier, many HCH projects, consistent with HRSA policy, include the full 100% discount in their sliding fee scales and do not impose nominal fees. We believe this is a best practice. Read the Policy Advisory.