HomeMy WebLinkAboutAgenda - 11-16-2010 - 4dORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: November 16, 2010
Action Agenda I
Item No. ~-- ' Q
SUBJECT• Adjustment of Minimum Charge for Health Department Dental Services to $30
DEPARTMENT: Health PUBLIC HEARING: (YIN) No
ATTACHMENT(S): INFORMATION CONTACT:
Rosemary Summers, 245-2411
PURPOSE: To approve an adjustment to the minimum charge for Health Department dental
services from $25 to 30 to minimize the revenue impact from adjusting the sliding fee scale
downward.
BACKGROUND: All Health Department clinical services have relied on software that was
custom developed by Anne Presnell, an Orange County programmer using mainframe
technology that allowed data collection and batch transfer to the state data system -Health
Statistics Information System (RBIs). That program has served the Health Department well for
over 20 years. The Information Technologies Department informed Health Department staff
last fiscal year that the mainframe was to be decommissioned in 2010-2011. With the
anticipated State transition last year from HSIS to a new software program -Health Information
System (HIS), the Health Department had been able to project compliance with the mainframe
decommissioning. The promise of the new HIS program has not been fulfilled.
Orange County first started using the system in mid-June and has identified multiple serious
problems that are affecting both service delivery as well as the billing and collections functions.
One of the problems identified that does not have a technological solution at this time is that the
Health Department can only have one sliding scale identified for the entire department.
Currently, Orange County medical services slide services to 0% pay in accordance with Title X
requirements for family planning services. The dental clinics have used a sliding fee scale that
slides to 20% pay rather than 0% pay. Dental services currently require a $25 minimum fee.
The new software will not allow two sliding fee scales.
Staff has continued to use the mainframe for self-pay clients until the issue could be resolved
by HIS programmers. County staff has been notified that this is a very low priority and will not
be addressed this year.
2
In addition to minimizing the loss in revenue from changing the sliding fee scale to 0%, this also
places all reimbursable services provided by the Health Department on the same sliding fee
scale. From the administrative perspective, this allows for greater efficiencies in sharing staff
resources at the front desk by simplifying the financial intake assessment process.
The Board of Health took action on this recommendation at its October 27, 2010 meeting by
changing the sliding fee scale to 0% to 100% based on 250% of the federal poverty level for all
dental clinical services. In addition the Board of Health is recommending that the minimum fee
for dental services be increased to $30.
FINANCIAL IMPACT: Staff has analyzed the fiscal impacts of two options:
1) Changing the sliding fee scale to 0% pay without changing the minimum charge; and
2) Changing the sliding fee scale to 0% pay and increasing the minimum charge by $5.
Analysis of Options
1) The total number of dental encounters from July 1, 2009 through June 30, 2010 billed at
20% pay was 2,002 encounters. The total amount billed for those services was $49,379.
This includes the $25 minimum fee plus 20% of any amount owed over that $25. Of
those encounters, 1,415 would have qualified for 0% pay, and if only charged $25 as the
minimum charge, would have yielded $35,375, a loss of $14,004 from the current
budgeted amount.
2) If the minimum charge is increased by $5 to $30, it is estimated that the loss falls to
$4,279 from the collection of the additional $5 charged to both the 0% and 20% pay
encounters. At the 20% pay level, only the balance left after the $30 minimum fee would
be charged to the patient. At levels above 20% pay, charges would likely exceed the $30
minimum and would be charged at the appropriate percentage.
RECOMMENDATION(S): The Manager recommends that the Board accept the Board of
Health's recommendation that the minimum charge for dental services be increased to $30 and
that the County fee schedule be revised accordingly.