Item N5 N5
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
February 21, 2024
Agenda Item Number: N5
2023-2107
BULK ITEM: Yes DEPARTMENT: Administration
TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard
n/a
AGENDA ITEM WORDING:
Approval of resolution approving an amended and revised 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 current fee schedule for clinical services fees was approved in December 2023. However,
subsequent to adoption, the Health Department realized that the computer system used by the Health
Department for fees for two vital statistics documents (birth certificate, death certificate) cannot be set
up to charge a fee for the document plus an administrative fee. Therefore, these vital statistics fees have
been amended to show one lump sum fee(birth certificate - $20, death certificate- $16).
In addition, the amended and revised fee schedule adds nominal fees for notary services ($10),
expediting ($10), and a plastic sleeve for the cards ($5) to cover administrative costs.
This agenda item therefore asks for approval to the amended and revised fee schedule shown in Exhibit
A to the Resolution.
PREVIOUS RELEVANT BOCC ACTION:
12/13/2023: BOCC adopted Resolution No. 634-2023, setting fee schedule for clinical services.
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INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
Changes to certain fees are shown in Exhibit A to the Resolution.
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
C27 Resolution 634-2023.pdf
FDOH-Monroe Resolution with Amended and Revised Fee Schedule-2023-24-Updated
02.6.2024.docx
FINANCIAL IMPACT:
TBD, depending on usage.
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RESOLUTION NO. 634 - 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 1"he Monroe County Health Department shall collect fees for Vital
Statistics and Health Clinic set-vices as specified in Exhibit 'A" attached
hereto and made a part ofthis 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. 'rhe 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 I day of December 2023.
Mayor Holly Merrill Raschein Yes
Mayor Pro Tem James K. Scholl Yes
"'75 (7omajissioner Craig Cates Yes
Commissioner Michelle Lincoln Yes
Commissioner David Rice Yes
EVIN MADOK., CLERK BOARD OF COUN'FY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
B By:
.....................
As Deputy Clerk Mayor
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 12-5-2023
C)
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2709
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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2710
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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RESOLUTION NO. -2024
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
("AMENDED AND REVISED FEE SCHEDULE").
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 documents and other Health Clinic
services offered at the Monroe County Health Department; and
WHEREAS, on December 13, 2023, the Monroe County Board of County
Commissioners passed and adopted Resolution No. 634-2023, establishing a fee schedule
for vital statistics and other Health Department services; and
WHEREAS, subsequent to adoption,the Health Department was advised that the
computer system used by the Health Department for fees for two vital statistics
documents (birth certificate and death certificate) was unable to process the fee as it was
set up in Resolution No. 634-2023; and
WHEREAS, the Health Department wishes to amend the fee in order to show a
single lump sum fee for birth certificates and death certificates; and
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2712
WHEREAS, the Health Department also wishes to add nominal fees for notary
services($10),expediting($10),and aplastic sleeve for the cards($5)to cover administrative
costs; and
WHEREAS, the Board is satisfied with the justification provided by the Monroe
County Health Department and wishes to approve the fee schedule.
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 Vital
Statistics and Health Clinic services as specified in the Amended and
Revised Fee Schedule attached hereto as Exhibit A 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 February 21, 2024.
Mayor Holly Merrill Raschein
Mayor Pro Tem James K. Scholl
Commissioner Craig Cates
Commissioner Michelle Lincoln
Commissioner David Rice
BOARD OF COUNTY COMMISSIONERS
Attest: KEVIN MADOK, CLERK OF MONROE COUNTY, FLORIDA
By: By:
As Deputy Clerk Mayor
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EXHIBIT A
MONROE COUNTY HEALTH DEPARTMENT
VITAL STATISTICS & CLINIC SERVICES
AMENDED AND REVISED 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.
(Revisions shown with underlines.)
Program Service Current Fee Proposed Fee Details r/t service and fee
Vital Statistics Birth Certificate $16.00 $200 00 Certification of a registered birth.
Adjusted fee aligned with Monroe
County Tax Collector.
Vital Statistics Death Certificate $13.00 air 16 00 Official certification of death with or
without cause.
Adjusted fee aligned with neighboring
counties.
P'4gi_ts - 0.00 10 Qi_)0
a a v i a"e
Clinic Medicare Rates Unchanged All clinical visits with provider are
General Clinical Services Non-Medicare Unchanged adjusted based on a sliding scale
Rates 160%of established by the Federal Poverty
Medicaid Rate Guidelines.
($163.27)
Clinic Medicare Rates Unchanged All laboratory services are adjusted
General Lab Services 160%of Unchanged based on a sliding scale established by
Medicaid Rate the Federal Poverty Guidelines.
($163.27)
Clinic School Health New Svc. $75.00 Comprehensive physical exam for
Physicals(ages school completed by physician or
5-18) APRN,completion of required forms,
and evaluation of immunization status.
Clinic Occupational New Svc. $95.00 Comprehensive physical exam for
Health Physicals work placement completed by
physician or APRN,completion of
required forms,and evaluation of
immunization status.
Clinic Consultation for New Svc. $50.00 Medical staff review of immunizations
Travel for travel and completion of required
Immunizations forms.
Clinic Civil Surgeon New Svc. $300 Comprehensive physical exam for
Refugee Health adjustment of status completed by
Physical physician or APRN,completion of
required forms,and evaluation of
immunization status.
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