Human Services
Charity Care Program
Dallas County Health and Human Services - 2377 N. Stemmons Freeway, Dallas, TX 75207
Telephone: 214-819-2000
The DCHHS Charity Care Program (CCP) is designed to allow qualified providers to receive reimbursement for the cost of delivering healthcare services, such as, immunizations, public health services, and other preventative services, when those costs are not reimbursed by another source.
Eligibility Policy
Eligibility of patients for Charity Care is based on the financial information supplied by the patient or someone acting on the patient’s behalf. The patient is required to provide annual household income and documentation to support such income.
Eligibility for Charity Care will be considered for those individuals who are:
- Uninsured or underinsured* individuals
- Current residents of the State of Texas
- Have a household income at or below 400% of the Federal Poverty Guidelines
Persons in family/household | Poverty Guideline | 400% of the FPL |
1 | $15,060 | $60,240 |
2 | $20,440 | $81,760 |
3 | $25,820 | $103,280 |
4 | $31,200 | $124,800 |
5 | $36,580 | $146,320 |
6 | $41,960 | $167,840 |
7 | $47,340 | $189,360 |
8 | $52,720 | $210,880 |
For families/household with more than 8 persons, add $5,140 for each additional person. |
Below are some examples of supporting documentation to determine income eligibility:
- State benefit letter (SNAP/TANF)
- IRS Form W-2
- Unemployment Benefits Letter
- SSI/SSDI Benefits Letter
*Underinsured - a person has insurance coverage, but the limits may not be high enough to cover the full expenses of a claim.
How to Apply
You can pick up an application from the DCHHS main building on the first floor.Return the completed application with supporting documents using one of the following options:
Via Mail: | Dallas County Department of HHS ATTN: Financial Administration 2377 N. Stemmons Freeway Suite 876 Dallas, TX 75207-2710 |
Via Email: | ccp_dchhsfa@dallascounty.org |
If you have any questions, please contact the Financial Administration office at (214) 819-2109.
Frequently Asked Question's
What is the Public Health Charity Care Program?
The DCHHS Charity Care Program is a program designed to provide public health services to individuals and families who are uninsured, underinsured, or unable to afford medical care.
Who is eligible for the Charity Care Program?
Individuals or households with annual income that fall at 400% or below of the Federal Poverty Level may qualify. The household income is based on cumulative income of household members and family size. Please refer to the following link to determine if household qualifies for the Charity Care Program: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines. Proof of income and will be required to determine eligibility.
What services does the Charity Care Program cover?
The services covered by the Charity Care Program may include children and adult immunizations, diagnosis and treatment of Sexually Transmitted Diseases or Infections, Tuberculosis Prevention and Control and associated laboratory tests, prescription medications, and other public health services administered by DCHHS.
How do I apply for the Charity Care Program?
To apply for the Charity Care Program, you will need to complete the Charity Care Application Form (Link) and provide proof or income or attestation of low income. The application process typically involves providing information about your income, household size, and medical needs. You will also need to submit required income documentation to verify your eligibility.
Is the Charity Care Program free of charge?
The Charity Care Program is designed to provide public health services at a reduced cost or at no cost to eligible individuals.
Can undocumented immigrants apply for the Charity Care Program?
Yes. The eligibility criteria for the Charity Care Program does not consider immigration status and no proof of citizenship is required.
Will my personal information be kept confidential?
Yes, the personal information provided during the application process is kept confidential and used solely for determining eligibility and providing appropriate assistance. DCHHS is required to adhere to strict privacy HIPAA laws and regulations.
How long does the application process take?
The application form is typically completed and processed the day of services are rendered at the respective clinic. DCHHS will follow-up with the individual applicant for any outstanding income documentation.
Can I appeal if my application is denied?
There is no appeal process. However, application for services are typically not denied for eligible participants. Applications may be denied if required documentation is not provided.
Flyers
The CCP is authorized under Section 1115 of the Social Security Act, also known as the 1115 waiver. The regulations for the CCP is provided for in Title 1 Texas Administrative Code, Section 355.8217.
Click on an image to view a larger version of the flyer.
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