ORDINANCE NO. 746.3

AN ORDINANCE OF THE COUNTY OF RIVERSIDE

AMENDING ORDINANCE NO. 746 ESTABLISHING ABILITY

TO PAY (ATP) PLAN TABLES FOR THE DETERMINATION OF

COST TO BE CHARGED FOR CLINIC SERVICES BY

THE DEPARTMENT OF PUBLIC HEALTH

The Board of Supervisors of the County of Riverside, State of California, Ordains as follows:

Section 1. That the Board of Supervisors established that the Board of Supervisors establishes that the minimum obligation to pay for clinic services shall be by annual income based on Table I (Exhibit A), or monthly income based on Table II (Exhibit B).

Section 2. Supersession. This Ordinance and the Ability to Pay (ATP) Plan Tables established herein supersede any prior Ordinance, Resolution or Ability to Pay (ATP) Plan Tables as established by this Ordinance.

Section 3. This Ordinance shall take effect thirty days after the date of adoption.

ADOPTED: 9-27-94 (Eff.: 10-27-94)

AMENDED: 8.1 (Eff.: 08-24-95)

7.2 (Eff.: 09-19-96)

7.3 11/03/98 (Eff.: 12-04-98)

(Ordinance includes Attachments: AExhibit A@ and AExhibit B@)

County of Riverside (EXHIBIT A)

Department of Health

ABILITY TO PAY PLAN (ATP) 1998 TABLE 1

(Based on Annual Income)

Payment Obligation *$20 or 10% 20% 40% 60% 80% 100%

Family Income as a From 0% 151% 175% 200% 225% 250%

% of Poverty Level to 150% 174% 199% 224% 249% or greater

No,. Of Persons in Family

Household Unit Income

1 From 0 12,076 14,008 16,021 18,033 20,046 To 12,075 14,007 16,020 18,032 20,045

2 From 0 16,276 18,880 21,593 24,305 27,018

To 16,275 18,879 21,592 24,304 27,017

3 From 0 20,476 23,752 27,165 30,577 33,990

To 20,475 23,751 27,164 30,576 33,989

4 From 0 24,676 28,624 32,737 36,849 40,962

To 24,675 28,623 32,736 36,848 40,961

5 From 0 28,876 33,498 38,309 43,121 47,934

To 28,875 33,495 38,308 43,120 47,933

6 From 0 33,076 38,368 43,881 49,393 54,906

To 33,075 38,367 43,880 49,392 54,905

7 From 0 37,276 43,240 49,453 55,665 61,878 To 37,275 43,239 49,452 55,664 61,877

8 From 0 41,476 48,112 55,025 61,937 68,850 To 41,475 48,111 55,024 61,936 68,849

9 From 0 45,676 52,984 60,597 68,209 75,822

To 45,675 52,983 60,596 68,208 75,821

10 From 0 49,876 57,856 66,169 74,481 82,794 To 49,875 57,855 66,168 74,480 82,793

*$20 OR 10%, WHICHEVER IS GREATER, IF THE TOTAL CHARGES ARE LESS THAN $20.00, THEN THE PATIENT IS OBLIGATED FOR THE ACTUAL AMOUNT CHARGED.

Revised: 8/18/98

County of Riverside (EXHIBIT B)

Department of Health

ABILITY TO PAY PLAN (ATP) 1998 TABLE II

(Based on Annual Income)

Payment Obligation *$20 or 10% 20% 40% 60% 80% 100%

Family Income as a From 0% 151% 175% 200% 225% 250%

% of Poverty Level to 150% 174% 199% 224% 249% or greater

No,. Of Persons in Family

Household Unit Income

1 From 0 1,007 1,168 1,336 1,504 1,671

To 1,006 1,167 1,335 1,503 1,670

2 From 0 1,357 1,574 1,800 2,026 2,252

To 1,356 1,573 1,799 2,025 2,251

3 From 0 1,707 1,980 2,265 2,549 2,833

To 1,706 1,979 2,264 2,548 2,832

4 From 0 2,057 2,386 2,729 3,072 3,414

To 2,056 2,385 2,728 3,071 3,413

5 From 0 2,405 2,792 3,193 3,594 3,995

To 2,406 2,791 3,192 3,593 3,994

6 From 0 2,757 3,198 3,658 4,117 4,576

To 2,756 3,197 3,657 4,116 4,575

7 From 0 3,107 3,604 4,122 4,640 5,157

To 3,106 3,603 4,121 4,639 5,156

8 From 0 3,457 4,010 4,586 5,162 5,738

To 3,456 4,009 4,585 5,161 5,737

9 From 0 3,807 4,416 5,051 5,685 6,319

To 3,806 4,415 5,050 5,684 6,318

10 From 0 4,157 4,822 5,515 6,208 6,900

To 4,156 4,821 5,514 6,207 6,899

*$20 OR 10%, WHICHEVER IS GREATER. IF THE TOTAL CHARGES ARE LESS THAN $20.00, THEN THE PATIENT IS OBLIGATED FOR THE ACTUAL AMOUNT CHARGED.

Revised: 8/18/98