HomeMy WebLinkAboutAgenda - 02-02-2010 - 6bORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 2, 2010
Action Age~da
Item No. ~_
SUBJECT: New and Updated Clinical Services Fees for Health Department
DEPARTMENT: Health PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): INFORMATION CONTACT:
Rosemary Summers, 245-2411
PURPOSE: To approve new and updated clinical services fees for the Health Department.
BACKGROUND: Occasionally the Health Department must add or adjust fees in the clinical
services area to reflect requirements, program changes, or best practices as recommended by
the state or other national bodies. The table below contains the fee requests.
Service Fee
Urine Micro-Albumin $ 4.18 New
Free T3 th roid $ 42.00 New
I a $ 13.58 New
Tt $ 16.85 New
Urine Toxicolo Screen $160.88 New
Tda Vaccine $ 45.00 New
DSME Individual
Assessment $ 22.00 New
DSME Grou Class $ 12.00 New
Pediatric He atitis A $ 25.00 Ad'ustment
There are five new laboratory fees requested that represent the cost of the laboratory service at
UNC McLendon Labs. The Health Department has a standing agreement with UNC Labs for
reference tests such as these based on the Medicare reimbursement rate. Iga and Ttg are
laboratory tests that are recommended practice for screening for celiac disease. Urine micro-
albumin and Free T3 are used in the provision of primary care. The urine toxicology screen will
be used in the prenatal program. The fees would apply to patients on a sliding fee scale. It is
expected that there will be no more than 10 of these tests in any given year.
There is one new vaccine fee - Tdap (tetanus, diphtheria and pertussis). Because of State
budget cuts to the universal vaccine program, this vaccine that can only be given to 6th graders
2
and up and will no longer be free to adolescents and adults, with a few exceptions. It will
continue to be free for rising 6th graders as they are required to have it, and to post partum
women who are Health Department patients. Children under the age of 7 require a different
vaccine that will continue to be available free through the state. The proposed fee of $45 covers
the cost of the vaccine ($35) and a $10 administration fee. The Health Department encourages
all adolescents and adults to receive this vaccine because it contains protection against
pertussis that is resurging in the community.
Health Department staff believe the cuts implemented in the immunization program will increase
the demand for immunization services by the Health Department. Certain combination vaccines
will no longer be available free to private providers or the Health Department for all children who
require them. Instead, state supplied free vaccine will only be single vaccine dose. This will
require an injection for each type of vaccine rather than the combined vaccine. Any provider
may choose to purchase these combination vaccines and administer them but they will be able
to charge patients to recover the costs.
Health Department staff believe some private providers will refer patients who cannot pay for
the combination vaccines to the Health Department for immunization services. If the Health
Department chooses to purchase combination vaccines, the Department must provide it free to
a child who is unable to pay. Combination vaccines are very expensive and the County would
not be able to recoup the cost given the high number of uninsured, low income patients.
The Department will continue to provide all state supplied vaccines for the vaccine for children's
program to any child who meets the qualifying criteria.
There are two new fees for the Diabetes Self-Management Program (DSME). This is a new
program that provides nutrition assessment, consultation and education for adults with Type II
diabetes. The Department is seeking to become American Dietetic Association certified to be a
provider of these services. Certification will allow the Department to recover costs from
insurance companies for the services provided. Start-up costs for this program are grant
funded for two years (July 2009-June 2011) by the Kate B. Reynolds Foundation. Establishing
these fees now will allow the Department to begin cost recovery. Both the individual
assessment fee and the group class fee are for each 30 minutes of service.
There is one updated fee for Hepatitis A vaccine. This is actually a fee reduction. At the time
the fee was initially approved, the vaccine was new and more expensive. The fee previously
was $33 and now will be $25. For the past two years, the state has supplied the vaccine free
since it was a recommended but not required vaccine. The cost of the vaccine has been
reduced since the vaccine has become more commonly manufactured and provided. The new
fee will still cover the cost of the vaccine ($15) and provide for an administration fee of $10.
FINANCIAL IMPACT: The ability to charge fees for the services above will enable the Health
Department to recover partial to full costs of the charges for services provided. Without these
fees, the Department would not be able to recover costs but would still need to provide the
services. For the Diabetes Self Management Program, it will provide the basis for that program
becoming self-sufficient by the end of the grant year.
RECOMMENDATION(S): The Manager recommends that the Board approve these fees and
amend the County fee schedule to include these fees.