Item Q1
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 11/18/09 - KL
Division: Monroe County Health Department
Bulk Item: Yes X
No
Staff Contact: Robert Eadie. 809-5610
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 10/21/09. P.8. 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 of
County Commissioners or by rule of the Department. The MCHD is requesting authorization to
establish clinical fees for primary care services offered at the MCHD.
PREVIOUS RELEVANT BOCC ACTION:
10/21/2009 Board approved core contract between Monroe County and the Florida Department of
Health for public health services provided by the Monroe County Health Department
2/17/2008 Board approved Resolution No. 502-2008 establishing fees specifically for primary care
services, vital statistics, medical records, public records and returned/dishonored checked provided by
the Monroe County Health Department
CONTRACT/AGREEMENT CHANGES:
No increase in fees from Resolution No. 502-2008.
STAFF RECOMMENDATIONS:
Approval.
TOTAL COST:
N/A
BUDGETED: Yes
No
COST TO COUNTY:
N/A
SOURCE OF FUNDS: N/A
REVENUE PRODUCING: Yes x No AMOUNT PER MONTH_ Year
APPROVED BY: County Atty V OMB/Purchasing _ Risk Management_
DOCUMENTATION:
Included x
Not Required _
DISPOSITION:
AGENDA ITEM #
Revised 2/05
RESOLUTION NO.
- 2009
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA
AUTHORIZING THE MONROE COUNTY HEALTH
DEPARTMENT TO ESTABLISH FEES SPECIFICALLY
FOR PRIMARY CARE SERVICES, COMMUNITY PUBLIC
HEALTH SERVICES, VITAL STATISTICS, MEDICAL
RECORDS, PUBLIC RECORDS AND
RETURNEDIDISHONORED CHECKS OFFERED AT THE
MONROE COUNTY HEALTH DEPARTMENT AS SET
FORTH IN EXHIBIT "A" ATTACHED HERETO AND
MADE A PART OF THIS 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 October 21, 2009, the Board approved 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 December 17, 2008, the Board approved a resolution authorizing the
Monroe County Health Department to increase the fees charged for primary care services offered
at the Monroe County Health Department (Resolution No. 502-2008); and
WHEREAS, the Monroe County Health Department has indicated the need to re-defme
and re-establish fees for public health services offered at the Monroe County Health Department
as set forth in Exhibit ''A'' attached hereto and made a part of this Resolution; and
WHEREAS, pursuant to F. S. 154.01(a) and 154.06(1), this fee resolution does not
include fees for environmental health services offered at the Monroe County Health Department
which are regulated by a uniform statewide fee schedule and are specifically outside of the
jurisdiction ofthe Board of County Commissioners of Monroe County, Florida; 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
COMMISSIONERS OF MONROE COUNTY, FLORIDA that;
1. The Monroe County Health Department shall collect fees for primary care
services, community public health services, vital statistics, medical records,
public records, returned/dishonored checks as specified in Exhibit "A" 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
County1s 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.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida at a regular meeting held on the _ day of November, A.D., 2009.
Mayor George Neugent
Mayor Pro Tem Sylvia Murphy
Commissioner Kim Wigington
Commissioner Heather Carruthers
Commissioner Mario Di Gennaro
(Seal)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By:
BY:
Deputy Clerk
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) Primary care services include well and sick adult and child health services
and family planning services. These services will be charged at not more than
150% of the prevailing Medicare rate. Where there is no Medicare fee, the fee
will be the Medicaid rate. Service levels will be determined utilizing current
Medicare guidelines for coding and billing services provided. Discounting
adjustments will be made to client fees based upon the current contract for
services with Medicare and other 3rd party payers. In addition, sliding scale
adjustments to fees for primary care services will be based upon Federal OMB
guidelines and in accordance with State of Florida Department of Health Policy
56-66-08. Medicaid is billed at the current Medicaid Cost-based rate and
reimbursement for these services is considered payment in full.
(2) Pharmacy - Medications issued will be provided at the most recent cost.
Medicaid is accepted as payment in full. '
(3) Injection fee for parenteral medications per injection
$35.00
(4) Lab fees - All laboratory and pathology fees are subject to sliding scale fee
adjustment based upon OMS Federal Guidelines.
a. Bloods Specimens sent to outside laboratory- cost plus a $25.00
venipuncture fee per visit.
b. Specimens tested in c1inic- $10.00
(hemoglobin, urine, blood sugar, mono, wet mount, strep)
c. Pregnancy test
No charge
d. Non-blood specimens sent to outside laboratory, processing fee $10.00
per visit.
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) Tuberculin (TB) Skin Test, with reading, any other than
I
EXHIBIT
A
$35.00
11/2/2009
]
.D
.D
2
listed above in C. (1).
(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. Medicaid identification will be accepted as full
payment in lieu of charges. $70.00
(6) Adult Immunizations: Per vaccine- cost + $35.00 injection fee per vaccine.
(7) Required Immunizations for children up to age 18 and eligible for
the Vaccine for Children program No Charge
(8) Class/Seminar attendance registration
Per person charge for health care, social work
and counseling employees.
AIDS 101
AI DS 500
AIDS 501
$ 5.00
$10.00
$50.00
VITAL STATISTICS:
(1) Birth Certificates:
Additional Copies
$ 16.00
$ 16.00
(2) Protective Covers
$ 4.00
(4) Express Fee
$ 13.00
$ 13.00
$ 10.00
(3) Death Certificates - Certified Copy
Additional Copies
E. MEDICAL RECORDS:
(1) Copying of Medical Record (per page)
50 cents
F. PUBLIC RECORDS:
(1) Copying of Public Record (per page)
25 cents
G. RETURNED/DISHONORED CHECKS: (S. 215.34(2), F.S.)
A service fee of $15.00 or 5% of the face amount of the check, draft, or money
order whichever is greater, not to exceed $150.00
2
11/2/2009
RESOLUTION NO. 502 - 2008
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA
AUTHORIZING THE MONROE COUNTY BEALm
DEPARTMENT TO ESTABLISH FEES SPECIFICALLY
FOR PRIMARY CARE SERVICES, COM:MUNITY PUBLIC
HEALTH SERVICES, VITAL STATISTICS, MEDICAL
RECORDS, PUBLIC RECORDS AND
RETURNEDJDISHONORED CHECKS OFFERED AT THE
MONROE COUNTY HEALTH DEPARTMENT AS SET
FORTH IN EXHIBIT "A" ATTACHED HERETO AND
MADE A PART OF THIS 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 approved 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 role 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 approved a resolution authorizing the
Monroe County Health Department to increase the fees charged for birth and death certificates
(Resolution No. 358-2005); and
WHEREAS, on February 21, 2007, the Board approved a resolution authorizing the
Monroe County Health Department to increase the fees charged for primary care services offered
at the Monroe County Health Department (Resolution No. 093-2007); and
WHEREAS, the Monroe County Health Department has indicated the need to fe-define
and re-establish fees for public health services offered at the Monroe County Health Department
as set forth in Exhibit "A /t attached hereto and made a part of this Resolution; and
WHEREAS, pursuant to F, S. 154.01(a) and 154.06(1), tbis fee resolution does not
include fees for environmental health services offered at the Monroe County Health Department
which are regulated by a uniform statewide fee schedule and are specifically outside of the
_ jurisdiction of the Board of County Commissioners of Monroe County, Florida; and
WHEREAS, the Board is satisfied with the justification provided by the Monroe County
Health Department;
NOW THEREFORE; BE IT RESOL YED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA;
1. That the Monroe County Health Department shall coHect fees for primary care
services, community public health services, vital statistics, medical records,
public records, returned/dishonored checks as specified in Exhibit ''A II attached
hereto and made a part oftms 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 alllevels~
local, state and federal.
4. Any prior resolution, ordinance or contract inconsistent herewith is hereby
repealed.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida at a regular meeting held on the 17thday of December, AD., 2008. S c t;f 3!
% C"))> :I r-
::Q r- Z ~ r"l
Mayor Neugent Yes ~g~ CiI '='
Mayor Pro TemMurphy Yes nxr I d
Commissioner DiGennaro Yes g5:?S PI;) ::0
_~.~ Commissioner Wigington Yes .~?::1r- ~ ~
//~r~cO~~~C.ommissionerCarruthers Yes :<~$2 ~ g
l O~ ;}\. ...., a>
/~' _ ,,'). _, r- m t\) :::0
,':;> l~ - ...... en t::l
10" . 'I'
f ~ .. ':
: ~ ,r. :'J'
, /l-~!
" ,6~NNY L. KOLHAGE, CLERK
;,,:......~,'."=- ~"rJ L
. .', 'Y'
B ","';'-.
eputy Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONaOE COUNTY, FLORIDA
~".. J!.. n~,~
BY:
Mayor
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) Primary care services include well and sick adult and child health serv~ces
and family planning services. These services will be charged at not more than
150% of the prevailing Medicare rate. Where there is no Medicare fee, the fee
will be the Medicaid rate. Service levels will be determined utilizing current
Medicare guidelines for coding and billlng services provided. Discounting
adjustments will be made to client fees based upon the current contract for
services with Medicare and other 3rd party payers. In addition, sliding scale
adjustments to fees for primary care services will be based upon Federal OMS
guidelines and in accordance with State of Florida Department of Health Policy
56-66-08. Medicaid is billed at the current Medicaid Cost-based rate and
reimbursement for these services is considered payment in full.
(2) Pharmacy - Medications issued will be provided at the most recent cost.
Medicaid is accepted as payment in full.
(3) Injection fee for parenteral medications per injection
$35.00
(4) Lab fees - All laboratory and pathology fees are subject to sliding scale fee
adjustment based upon OMS Federal Guidelines.
a. Bloods Specimens sent to outside laboratory- cost plus a $25.00
venipuncture fee per visit.
b. Specimens tested in clinic- $10.00
(hemoglobin, urine, blood sugar, mono, wet mount, strep)
c. Pregnancy test
No charge
d. Non-blood specimens sent to outside laboratory, processing fee $10.00
per visit.
C. COMMUNITY PUBLIC HEALTH SERVICES
(1) Tuberculosis X-ray for suspected, confinned 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) Tuberculin (TB) Skin Test, with reading, any other than
EXHIBIT
-A-
$35.00
10/30/2008
listed above in C. (1),
(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. Medicaid identification will be accepted as full
payment in lieu of charges. $70.00
(6) Adult Immunizations: Per vaccine- cost + $35.00 injection fee per vaccine.
(7) Required Immunizations for children up to age 18 and eligible for
the Vaccine for Children program No Charge
(8) Class/Seminar attendance registration
Per person charge for health care, social work
and counseling employees.
AIDS 101
AIDS 500
AIDS 501
$ 5.00
$10.00
$50.00
VITAL STATISTICS:
(1) Birth Certificates:
Additional Copies
(2) Protective Covers
(4) Express Fee
$ 16.00
$ 16.00
$ 4.00
$ 13.00
$ 13.00
$ 10.00
(3) Death Certificates - Certified Copy
Additional Copies
E. MEDICAL RECORDS:
(1) Copying of Medical Record (per page)
50 cents
F. PUBLIC RECORDS:
(1) Copying of Public Record (per page)
25 cents
G. RETURNED/DISHONORED CHECKS: (S. 215.34(2), F.S.)
A s(~rvice fee of $15.00 or 5% of the face amount of the check, draft, or money
order whichever is greater, not to exceed $150.00
2
10/30/2008
Statutlj.s & Cunstitution :View Statutes :->2009->ChOI54->Section 06: flsenate.gov
Page 1 of 1
Go
The 2009 Florida Statutes
Title XI
COUNTY ORGANIZATION AND
INTERGOVERNMENTAL RELATIONS
154. 06 Fees and services ren dered ; authority...
Chapter 154
PUBLIC HEALTH
FACILITIES
View Entire
Chapter
(1) The Department of Health may establish by rule fee schedules for public health services
rendered through the county health departments. Such rules may include provisions for fee
assessments, copayments, sliding fee scales, fee waivers, and fee exemptions. In addition, the
department shall adopt by rule a uniform statewide fee schedule for all regulatory activities
performed through the environmental health program. Each county may establish, and each county
health department may collect, fees for primary care services, provided that a schedule of such
fees is established by resolution of the board of county commissioners or by rule of the
department, respectively. Fees for primary care services and communicable disease control
services may not be less than Medicaid reimbursement rates unless otherwise required by federal
or state law or regulation.
(2) All funds collected under this section shall be expended solely for the purpose of providing
health services and facilities within the county served by the county health department. Fees
collected by county health departments pursuant to department rules shall be deposited with the
Chief Financial Officer and credited to the County Health Department Trust Fund. Fees collected
by the county health department for public health services or personal health services shall be
allocated to the state and the county based upon the pro rata share of funding for each such
service. The board of county commissioners, if it has so contracted, shall provide for the
transmittal of funds collected for its pro rata share of personal health services or primary care
services rendered under the provisions of this section to the State Treasury for credit to the County
Health Department Trust Fund, but in any event the proceeds from such fees may only be used to
fund county health department services.
(3) The foregoing provisions notwithstanding, any county which charges fees for any services
delivered through county health departments prior to July 1, 1983, and which has pledged or
committed the fees yet to be collected toward the retirement of outstanding obligations relating
to county health department facilities may be exempted from the provisions of subsection (1) until
such commitment or obligation has been satisfied or discharged.
History.--ss. 1,2, ch. 69-80; ss. 19,35, ch. 69-106; s. 3, ch. 72-323; s. 34, ch. 77-147; s. 9, ch. 83-
177; s. 3, ch. 89-311; s. 22, ch. 97-101; s. 11, ch. 97-237; s. 2, ch. 2000-242; s. 153, ch. 2003-261.
Disclaimer: The information on this system is unverified. The journals or printed bills of the respective chambers should be
consulted for official purposes. Copyright <<:>2000-2006 State of Florida.
http://www.flsenate.gov/Statutes/index.cfm?p=2&App_mode=Display_Statute&Search_String=&UR...ll/2/2009