Delinquent account forms: working with clients who are reticent to pay for treatment

As resources within governmental funding bodies have diminished, the collection of client fees has taken on increased importance for most community mental health centers. The Lake County Health Department, Mental Health Division, has responded to this need by standardizing the fee setting and collection process. For example, clients must provide income verification prior to receiving a sliding-scale fee. Further adjustments in fees must be presented in writing to an administrator. The current study looks at the efficacy of using a delinquent account monitoring system to target persons who fall behind in payments. Clinical staff members are asked in this process to develop a plan with their clients to reduce the balance owed for counseling and to present this plan to their supervisors. The study found that this method was successful in increasing collections both during and after the intervention for mental health clients. Substance abuse clients, however, increased payments only when confronted but returned to former habits in the ensuing months. The standardization of the fee setting and collection process has also led to an overall improvement in fee collection.