Item C27 C27
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE �� i Mayor Holly Merrill Raschein,District 5
The Florida Keys Mayor Pro Tern James K.Scholl,District 3
Craig Cates,District 1
Michelle Lincoln,District 2
' David Rice,District 4
Board of County Commissioners Meeting
December 13, 2023
Agenda Item Number: C27
2023-1915
BULK ITEM: Yes DEPARTMENT: Administration
TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard
n/a
AGENDA ITEM WORDING:
Approval of resolution approving fee schedule for primary care services, community public health
services, vital statistics, medical records, and related administrative charges offered by Monroe County
Health Department.
ITEM BACKGROUND:
F.S. 154.6(1)5 authorizes each county and county health department to collect fees for public health
services rendered by the county health department provided the schedule of fees is established by
resolution by the Board of County Commissioners. All funds collected must be expended solely for the
purpose of providing health services and facilities within the county served by the county health
department. The fees listed in this schedule are comparable with fees charged in neighboring counties.
Revenue collected provides support for department functions and provision of services. The fee
schedule for clinical services fees was last amended in 2010.
PREVIOUS RELEVANT BOCC ACTION:
9-15-2010: BOCC adopts Resolution No. 294-2010, setting fee reschedule for clinical services.
INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
Increases for certain fees are shown in the attached chart.
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
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Res 294-2010.pdf
Resolution FDOH Fee Schedule clinical fees 2023.pdf
FINANCIAL IMPACT:
TBD, depending on usage.
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RESOLUTION NO. 294 — 2010
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
RETURNED/DISHONORED 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-define
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
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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
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.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida at a regular meeting held on the 15t'day of September, A.D., 2010. _
Mayor Sylvia Murphy Yes o
Mayor Pro Tem Heather Carruthers Yes -n
Commissioner George Neu gent Yes Q
Commissioner Kim Wigington Yes
Commissioner Mario Di Gennaro Yes
. : o
Cn o
BOARD OF COUNTY COMMISSIONERS
(Seal) OF MONROE COUNTY,FLORIDA
ATTEST: DANN(YL.KOLHAGE, CLERK
By:.,a 1.1- uoo� BY•
Deputy Clerk Mayor
!1 iel1 iV•VED AJ 7 0
SUZ NNE -
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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) 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 3`d 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 OMB 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, 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 $35.00
1 11/12/2009
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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 OMB 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 $ 5.00
AIDS 500 $10.00
AIDS 501 $50.00
VITAL STATISTICS:
(1) Birth Certificates: $ 16.00
Additional Copies $ 16.00
(2) Protective Covers $ 4.00
(3) Death Certificates—Certified Copy $ 13.00
Additional Copies $ 13.00
(4) Express Fee $ 10.00
E. MEDICAL RECORDS:
(1) Copying of Medical Record (per page) $ 1.00
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 11/12/2009
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RESOLUTION NO. - 2023
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY,
FLORIDA AUTHORIZING THE MONROE
COUNTY HEALTH DEPARTMENT TO
ESTABLISH FEES SPECIFICALLY FOR VITAL
STATISTICS AND THE HEALTH CLINIC 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 July 19, 2022, the Board approved the annual core contract
between 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 Vital Statistics and Health Clinic 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, the Monroe County Health Department has indicated the need
to re-define and re-establish fees for Vital Statistics and certain aspects of Health
Clinic 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, the Board is satisfied with the justification provided by the Monroe
County Health Department;
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NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF
COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA that;
I. The Monroe County Health Department shall collect fees for Vital
Statistics and Health Clinic services 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 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.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe
County, Florida, at a regular meeting of the Board held on the 13th day of December 2023.
Mayor Holly Merrill Raschein
Mayor Pro Tern Michelle Lincoln
Commissioner Craig Cates
Commissioner James K. Scholl
Commissioner David Rice
Attest: KEVIN MADOK, CLERK BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By: By:
As Deputy Clerk Mayor
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 12-5-2023
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EXHIBIT A
MONROE COUNTY HEALTH DEPARTMENT
VITAL STATISTICS & CLINIC SERVICES COUNTY FEE
SCHEDULE
The Fee Schedules for Vital Statistics and Health Clinic Services in Monroe County have not been
updated in many years. As such, the Monroe County Health Department conferred with neighboring
counties and senior leadership in Tallahassee to prepare a Fee Schedule aligned and comparable to
those with more recent updates. Revenue generated from Vital Statistics and Health Clinic services,
once approved, will provide additional support for departmental functions and provision of services.
Thank you for your consideration.
Program Service Current Fee Proposed Details r/t service and fee
Fee
Vital Statistics Birth $16.00 $16.00 + Certification of a registered
Certificate $6.25 birth.
administrative
fee Adjusted fee aligned with
Monroe County Tax Collector.
Vital Statistics Death $13.00 $16.00 + Official certification of death
Certificate $6.25 with or without cause.
administrative
fee Adjusted fee aligned with
neighboring counties.
Clinic Medicare Unchanged All clinical visits with provider
General Clinical Services Rates are adjusted based on a sliding
Non- Unchanged scale established by the Federal
Medicare Poverty Guidelines.
Rates 160%
of Medicaid
Rate
($163.27)
Clinic Medicare Unchanged All laboratory services are
General Lab Services Rates adjusted based on a sliding
160% of Unchanged scale established by the Federal
Medicaid Poverty Guidelines.
Rate
$163.27
Clinic School Health New Svc. $75.00 Comprehensive physical exam
Physicals for school completed by
(ages 5-18) physician or APRN,
completion of required forms,
and evaluation of immunization
status.
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Clinic Occupational New Svc. $95.00 Comprehensive physical exam
Health for work placement completed
Physicals by physician or APRN,
completion of required forms,
and evaluation of immunization
status.
Clinic Consultation New Svc. $50.00 Medical staff review of
for Travel immunizations for travel and
Immunizations completion of required forms.
Clinic Civil Surgeon New Svc. $300 Comprehensive physical exam
Refugee for adjustment of status
Health completed by physician or
Physical APRN, completion of required
forms, and evaluation of
immunization status.
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