Myself ........
Maybe this is a silly question - but would the therapist consider some kind of a negotiation on the sliding fee?
OR .......... I imagine you may be self-employed - or could you become self-employed if you're not?
This may sound ludicrous - but if you could become a corporation, there are a ton of legal write-offs you can take. I did that for 16-years of my 22-years in business as a one person C-Corporation with myself as the only employee.
One of the very biggest write-offs is 100% of your medical insurance. And if even a one-person corp, you can legally write-off all of your medical bills and prescription meds - not to mention much of a life insurance policy and some of your car expenses.
The beauty of all that is that you reduce your net business income - in other words, your gross salary to yourself. So then, your gross salary becomes a lot less than it shows now on a 1040 - thereby likely reducing the costs of the sliding scale of your therapist.
It's all perfectly legal IF you're a corporation (which is not costly to do) and much of it can be a write-off IF you're self-employed.
Actually, when I was seeing my sliding scale psychologist, I was self-employed and most of my expensive medical insurance (80% I think) was a write-off in addition to close to 60% of my car expenses including depreciation + small business misc. expenses.
As a result, in a bad business year, my gross income was something like $8k and my sliding scale fee for a PHD Psychologist was around $30. per session. My insurance did not cover it (typical) - but if I had been a corp. at the time, The $30. sessions could have been written off too.
It's too bad most government regulations have to be so complex - and at times, so unfair! A meeting with a good CPA can help even the playing field!
LOL Myself
Rob & Gizmo