Item L1
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 2/21/2007 - KL
Division: Monroe County Health Department
Bulk Item: Yes No ~
Staff Contact Person: Dr. Susana May, M.D.. M.P.H.
AGENDA ITEM WORDING:
Approval of a Resolution authorizing the Monroe County Health Department to establish clinical fees
for primary care services offered as set forth in Exhibit A attached to and made a part of the resolution.
ITEM BACKGROUND:
F.S. 154.01(2) requires Counties to establish and maintain full-time county health departments to
provide environmental health, communicable disease control and primary care services through contract
with the Florida Department of Health. The Board recently approved such a contract for the Monroe
County Health Department on 1/17/07. F. S. 154.06(1) authorizes each county to collect fees for
primary care services provided that a schedule of such fees is established by resolution of the Board or
by rule of the Department. The MCHD is requesting authorization to establish clinical fees for primary
care services offered at the MCHD An increase in fees was previously authorized by Resolution of the
Board on 9/21/05 authorizing an increase in fees charged for birth and death certificates.
PRE~OUSRELEVANTBOCCACTION: ,
9/21/2005 Board approved Resolution 358-2005 authorizing an increase in fees charged for birth and
death certificates.
1/17/2007 Board approved core contract between Monroe County and the Florida Department of
Health for public health services provided by the Monroe County Health Department.
CONTRACT/AGREEMENT CHANGES:
N/A
,-
,h ,"
STAFF RECOMMENDATIONS:
Approval.
TOTAL COST:
BUDGETED: Yes
No
COST TO COUNTY:
SOURCE OF FUNDS:
REVENUE PRODUCING: Yes ---1L No AMOUNT PER MONTH_ Year
APPROVED BY: County A~ OMBlPurchasing _ Risk Managemenl_
DOCUMENTATION: Included x NotRequired ~
DISPOSITION:
AGENDA ITEM #
Revised 2/05
RESOLUTION NO.
- 2007
A RESOLUTION OF THE BOARD OF COUNTY
CUMM1SSIONERS OF MONROE COUNTY, FLORIDA
AUTHORIZING THE MONROE COUNTY HEALTH
DEPARTMENT TO ESTABLISH CLINICAL FEES FOR
PRIMARY CARE SERVICES OFFERED AT THE
MONROE COUNTY HEALTH DEPARTMENT AS SET
FORTH IN EXHIBIT "A" ATTACHED HERETO AND
MADE A PART OF TillS RESOLUTION.
WHEREAS, F. S. 154.01(2) requires counties to establish and maintain full-time county
health departments to provide environmental health, communicable disease control and primary
care services; and
WHEREAS, F.S. 154.01(3) requires the Department of Health to enter into contracts
with counties for this purpose; and
WHEREAS, on January 17,2007, the Board apprpved the annual core contract between
the Monroe County and the Florida Department of Health for public health services; and
WHEREAS, F. S. 154.06(1) authorizes each county and each county health department
to collect fees for primary care services rendered through the county health departments provided
that a schedule of such fees is established by resolution of the Board of County Commissioners
or by rule of the department; and
WHEREAS, F.S. 154.06(2) requires all funds collected under this section to be
expended solely for the purpose of providing health services and facilities within the county
served by the county health department and pursuant to the rules and regulations cited therein
and pursuant to all other applicable rules and regulations; and
WHEREAS, on September 21, 2005, the Board previously approved a resolution
authorizing the Monroe County Health Department to increase the fees charged for birth and
death certificates (Resolution No. 358-2005), which will remain in effect; and
WHEREAS, the Monroe County Health Department has indicated the need to establish
clinical fees for primary care services offered at the Monroe County Health Departmentas set
forth in Exhibit irA" attached hereto and made a part of this Resolution; and
WHEREAS, the Board is satisfied with the justification provided by the Monroe County
Health Department;
NOW THEREFORE; BE IT RESOLVED BY THE BOARD OF COUNTY
COM.MISSIONERS OF MONROE COUNTY, FLORIDA;
1. That the Monroe County Health Department shall collect fees for primary care
services as specified in Exhibit "A If attached hereto and made a part of this
Resolution.
2. The Monroe County Health Department is solely responsible for ensuring
effective notice is provided to the general public and other impacted agencies and
organizations of the specific service fee increases.
3. The Monroe County Health Department is solely responsible for ensuring the
County's compliance with all financial and transitional rules and regulations, and
any other factors that may be impacted by the service fee increases at all levels;
local, state and federal.
4. Any prior resolution, ordinance or contract inconsistent herewith is hereby
repealed.
5. This resolution shall become effective on M~ch 1, 2007.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida at a regular meeting held on the _ day of February, A.D., 2007.
Mayor Mario DiGennaro
Mayor Pro Tern Dixie M. Spehar
Commissioner Charles II Sonny" McCoy
Commissioner George Neugent
Commissioner Sylvia Murphy
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY:
Mayor Mario DiGennaro
(Seal)
ATTEST:
DANNY KOHL AGE, CLERK
Deputy Clerk
Date
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FEE RESOLUTIONS
A. PURPOSE. To establish public. health service fees in order to expand existing
public health services to the community at large.
B. PRIMARY CARE SERVICES.
(1) Acute Episodic 'Illness - Primary care services will be charged on a fee-for-
service basis not less than the prevailing Medicaid rate, nor more than the
. prevailing Medicare rate. The fee will be derived by considering the type of visit,
the client sliding fee group based on Federal OM8 Guidelines, and the State
Medicaid rate. Medicaid identification will be accepted as full payment in lieu of
charges.
(2) Family Planning - The fee will be derived by considering the type of visit, the
client sliding fee group based on Federal OMS Guidelines, and the State
Medicaid rate. Medicaid identification will be accepted as full payment in lieu of
charges. .
(3) Well Child Services - The fee will be derived by considering the client sliding
fee group, which is calculated at eligibility c;Jetermination based on Federal OMS
Guidelines. The fee group will be applied to the rate not less than the prevailing
Medicaid rate, nor more than the prevailing Medicaid rate. Medicaid
identification will be accepted as full payment in lieu of the fee.
(4) School/Day Care Physicals - A one-time service, $30.00 per physicaL (A
limited visit which fulfills the basic requirement of the School System or a Day
Care Center. Lab tests andlor services performed beyond the basic .
requirement will be charged for separately.)
(5) Pharmacy - Fees are assessed per cost of prescription plus dispensing fee.
The fee will be derived by adding $5 dispensing fee plus the cost of prescription.
Cost of prescription is the cost of medication plus 0% to 20% to be determined
on a sliding fee scale category. The payment will be assessed by considering
the client sliding fee group, which is calculated at eligibility determination, based
on Federal OMS Guidelines. Medicaid identification will be accepted as full
payment in lieu of charges.
(6) Women's Health Care - Non Federally funded program for
lininsured/underinsured women, A one time fee of $125 to cover complete
woman's physical, PAP smear, Gonorrhea, Syphilis, HIV, Chlamydia and
Human Papilloma Virus, if indicated. A complimentary follow up visit if required,
Lab services andlor other services charged separately. No income verification
needed.
EXHIBIT
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(7) Lead Screening - The fee will be derived by considering the client sliding fee
group which is calculated at eligibility determination, based on Federal OMS
Guidelines. The fee group will be applied to the rate established by the State
Medicaid program. Medicaid identification will be accepted as full payment in
lieu of charges.
(8) Blood Chemistries Only - Actual Cost plus per visit
specimen drawing and handling fee of
$20.00
$30.00
(9) Herpes Culture Test
(10) Pregnancy Test - Nurse Consultation
Official documentation of positive test
No Charge
$10.00
(11) Pregnancy Test- Teenage Clients
No Charge
Medicaid Rate
(12) Chest X-Ray
(13) Hypertension, series of up to five tests
paid at first visit
$10.00
(14) Thin-Prep PAP laboratory test
$25.00
$25.00
(15) HPV Test
C. COMMUNITY PUBLIC HEALTH SERVICES
(1) Tuberculosis X-ray for suspected, confirmed or
Symptomatic contact or case
No Charge
(2) Tuberculosis Skin Test for suspected, confirmed or
Symptomatic contact or case
No Charge
(3) Tuberculosis (TB) Sputum Culture for suspected,
confirmed, or symptomatic contact of case
No Charge
(4) Chest X-ray for health care employees or for
vocational or college student program requirements, with
Physician interpretation
(5) Tuberculin (TB) Skin Test, with reading
$50.00
$35.00
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(5) Sexually Transmitted Diseases - The fee will be derived by considering the
client sliding fee group which is calculated at eligibility determination, based on
Federal OMS Guidelines. The fee group will be applied to the rate established
by the State Medicaid Program. Medicaid identification will be accepted as full
payment in lieu of charges. Patients referred by the Disease Intervention
Specialist for initial testing may be charged.
(6) Testing for HIV I Antibodies
(a) For Health Department Clients with eligibility card:
. For test results within the normal time period
(State Lab per sliding fee scale) No Charge to $20.00.
.
For Faster test results (within 48 hours)
Private Lab
$40.00
(b) For people who are not already Health
Department Clients:
For test results within the normal time
Period (State Lab)
For faster test results (within 48 hours)
Private Lab
$20.00
$40.00
(7) Immunizations for adults (such as international travel vaccinations, hepatitis
prevention, etc.):
Flat Fee: Prevailing vaccine costs plus dispensing fee.
Dispensing Fee:
(8) Required Immunizations for children up to age 18
$35.00
No Charge
(9) laboratory SelVices
Blood Drawing Fee:
Prevailing lab cost plus blood drawing
$15.00
(10) Class/Seminar attendance registration
Per person charge for health care, social work
and counseling employees, per BCe resolution
AIDS 101
AIDS 500
AIDS 501
$ 5.00
$10.00
$50.00
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VITAL STATISTICS:
(1) Birth Certificates:
Fee Pursuant to BCe Resolution
State Fee Pursuant to Section 382.025,
FS (Surcharge for Certificates Issued by
Local Registrars)
State Surcharge, Child Welfare Training
Trust Fund
Total Fee for Birth Certificates
$ 12.00
(2) Additional Copies
$ 2.50
$ 1.50
$16.00
$ 7.00
$ 4.00
$ 13.00
$ 10.00
(3) Protective Covers
(4) Death Certificates - Certified Copy
(5) Express Fee
E. MEDICAL RECORDS:
(1) Copying Medical Record (per page for first ,25 pages)
Per page thereafter
$1.00
25 cents
F. PUBLIC RECORDS:
(1) Copying of Public Record (per page)
25 cents