For those who offer free or reduced rates how do you determine who can pay your fee and who can't? Do you have something officially written up or is it based upon your life, instincts, number of reduced clients you currently have?
I offer a discounts this way:
Set dollar discount on my full fee to anyone who can prove current eligibility for WIC, medicaid, or who is an active duty military member or spouse of an active duty military member ranked e5 or below. This takes any responsibility for income analysis off of my shoulders.
Anyone who has the balls to ask for a cash pay discount and agrees to pay in one lump sum gets a little bit off. I guess the Dave Ramsey fan in me just has to reward the asking..
Since I have an apprentice in primaries, I will reduce my fee (pretty significantly) for clients willing to let her be their primary ie all prenatals, all postpartums and me sitting on my hands at their birth. This is offered only at my discretion. There are some women who I don't get the feeling are good candidates for this situation, for whatever reason (ie complicated OB history, young unsure primi, etc) and they don't get this offer.
I sponsor a local natural birth forum and offer $200.00 off of my regular fee for members of that forum who mention my sponsorship.
For the most part, I use common sense, a social justice ethic, and my own life experience as a guide. I have an advertised discount for military and student families, and anybody else, I'd work out a reduced fee on a case-by-case basis.
I know enlisted military/Natl Guard are getting paid a pittance for doing a lot of really tough work. And I was a student on a limited income, so I know that a few hundred bucks can be make-or-break. I only offer the student discount to families where both partners are students, as I think that if one partner is a student and the other works full-time and makes more $ than I do at my own day job, they don't NEED a discount. If people balk at the fee or tell me they aren't sure they can afford the full fee, I would instantly offer to work with them at a reduced rate, but nobody has done that yet.
If I get a client who is referred to me through her care provider and is a single mom making a cruddy income (like, she works as a housecleaner at a motel -- I don't need to ask her income to know she's barely keeping her nose above water), I tell her that if she can swing paying for my gas/parking, that would be great, but that I budget for a certain number of births per year that I do with women who want a doula but can't pay the full fee. I think women will feel better about having you work with them and will take your services for granted less if they pay something, even if it's just $10 for gas or crocheting 5 potholders and a table doily for you. and anytime I talk about doula services to an audience, I always tell them, "If you want to have a doula, don't ever let cost be a barrier. JUST ASK. Among all the doulas in town, we can ALWAYS find somebody to work with you, regardless of your ability to pay for services." I do take to heart the DONA vision that there should be a doula for every woman who wants one.
Thanks for the info ladies. Right now for our teen and low income referral service we had set the guidelines at WIC qualification. Just trying to figure out if that is a good basis for them receiving free assistance. I know some will say never give it away, but we are a nonprofit and we were set up to give it away - well somewhat because they do have to invest themselves in this. I have set it up so they have to attend childbirth classes to get services free, and there are a few other requirements.