HomeMy WebLinkAboutAgenda - 04-17-2008-3ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: April 17, 2008
Action Agenda
Item No. 3
SUBJECT: Proposed Fiscal Year 2008-09 County Fee and Occupancy Tax Chan es
DEPARTMENT: Budget
PUBLIC HEARING: (YIN) No
ATTACHMENT(S):
Proposed Fee Changes for Fiscal Year
2008-09
INFORMATION CONTACT:
Laura Blackmon, (919) 245-2300
Donna Coffey, (919) 245-2151
PURPOSE: To review and discuss proposed County fee and occupancy tax changes for fiscal
year 2008-09.
BACKGROUND: Counties in North Carolina have authority to recoup, through user fees, costs
associated with a number of programs. Each year, staff reviews currently charged fees to
determine if the current fees are appropriate, or if they need to be updated to reflect actual
costs to deliver the associated service. State statutes and other legislative mandates govern
fees associated with departments such as the Health Department, Department of Social
Services, Register of Deeds and Sheriff.
The attached spreadsheet, Proposed Fee Changes for Fiscal Year 2008-09, provides a list of
proposed fee changes for the upcoming fiscal year. The effective date of the new fees and
occupancy tax is July 1, 2008. In summary, the proposed fees include:
/ Animal Services -the Board approved the fees included on the spreadsheet on
December 3, 2007 with an effective date of July 1, 2008.
/ Health Department -The Board of Health updates its fee schedule annually to reflect
the most recent Medicaid reimbursement rates. In addition, lab fees charged reflect
direct lab fee costs incurred by the Department for services performed by UNC and State
labs.
/ Social Services -Effective January 1, 2008, state adoption laws (NCGS 48-9-101, 48-9-
104 and 48-9-109) were amended to allow licensed child placing agencies including,
departments of social services, to voluntarily act as confidential intermediaries between
adult adoptees, adult lineal descendants of a deceased adult adoptee, parents of
adoptees under the age of 21, and birth parents. The department will charge a prepaid
non-refundable fee of $300. The department will reduce or waive fees for those
applicants who have verified income at 200 % of the poverty level or below.
2
/ Solid Waste Enterprise Fund -Effective July 1, 2008, the State of North Carolina will
require a $2 per ton excise tax on every ton received at the landfill (NCGS 48-9-101, 48-
9-104 and 48-9-109). This will result in a $2 increase to Mixed Use and Construction and
Demolition fees that will go directly to the state each month.
/ Visitors Bureau Fund -Senate Bill 622 of the 1991 session of General Assembly gave
Orange County the authority to levy up to a 3% room occupancy tax on the gross
receipts derived from the rental of accommodations in the County. The Board of County
Commissioners adopted resolution, on February 19, 2007, to consider a 1 % increase in
the tax. The increase would take the tax from its current rate of 2% to the maximum rate
of 3%.
Should the Board wish to move forward with updating the County's current fee schedule and
occupancy tax, staff will bring an agenda item to the May 1 regular meeting for approval of the
proposed fees and occupancy tax rate. This will allow departments to begin outreach
campaigns to notify the public during May and June.
FINANCIAL IMPACT: Staff projects that the proposed fee increases will have the following
impacts on individual departments:
/ Animal Services -Additional revenue from civil penalties/fees increases estimated at
$1,500 for fiscal year 2008-09
/ Health Department - A majority of Health Department patients fall in the zero to 20
percent pay scale; therefore, staff projects revenue generated by the fee increases will
be minimal.
/ Social Services -Based on the projected cases, staff projects little, if any, additional
revenues.
/ Solid Waste Enterprise Fund -This tax is a State imposed revenue and the County
plans to pass the monies on to the State. Staff anticipates no additional County revenue
from the tax.
/ Visitors Bureau -Staff anticipates that. the 1 % increase in Occupancy Tax will generate
approximately $250,000 in fiscal year 2008-09. The Bureau plans to use the additional
funds to meet the demands of increased competition for tourism.
RECOMMENDATION(S): The Manager recommends that the Board of County Commissioners
discuss the proposed 2008-09 fee changes and direct staff to include the fee updates on the
Board's May 1, 2008 regular meeting agenda for Board approval.
04/17/2008
Proposed Fee Changes for FY 2008-09
Description Current Fee Proposed Fee FY
2008-09
Animal Contro/~
Failure to Vaccinate against Rabies $100 $200
Failure to License $50 $200
Mistreatment $50 $200
Public Nuisance Violations $25, $50, $100, $150,
$200 $50, $100, $200, $300,
$400
Health Denfal Services z
Comprehensive Oral Evaluation $48 $50
Periodic Oral Evaluation $40 $42
Limited Oral Evaluation $40 $42
Re-evaluation-limited, problem $27 $28
Consultation $50 $52
Panoramic Film $64 $67
BWX 1 Film $26 $27
BWX 2 Films $27 $28
Bitewings- lhre films $30 $31
BWX 4 Films $37 $38
1st Intraoral PA Film $25 $26
Additional PA Film $23 $24
Intraoral Occulusal Film $26 $27
Full Mouth Series w BWX $81 $84
Prophy/Child under age 13 $41 $43
Prophy/Adult age 13 and up $60 $62
Fluoride Varnish (age 13&under) $29 $30
Fluoride Varnish (age 13-20) $29 $30
Topical Fluoride varnish;therapeutic application for moderate to high
caries risk patients $28 $29
SealantlNEWLY ERUPTED TEETH $34 $35
Scale/Root Planing 1-3 teeth p/q $95 $99
Scale Root Planing 4> teeth p/q $101 $105
Full mouth Debridement $87 $90
Periodontal Maintenance $75 $78
Amal One Surtace Prim/ Perm $75 $78
Amal Two Surface Prim/ Perm $86 $89
Amal Three Surface PrimlPerm $109 $113
Amal Four Surface Prim/Perm $122 $127
Resin One Surface Anterior $69 $72
Resin Two Surface Anterior $88 $92
Resin Three Surface Anterior $109 $113
Resin Four Surface Anterior $125 $130
Resin Comp. Crown Ant. Prim $156 $164
Resin Comp. isur.Post-Prim/Perm $85 $88
Resin Comp. 2sur.Post-Prim/Perm $124 $129
Resin Comp. 3sur.Posterior Perm $159 $165
Resin Comp.4+sur.Posterior Perm $195 $203
Application of Desensitizing Medicament $25 $26
Application of Desensitizing Resin for cervical and/or root surface per
tooth $25 $26
Pulpotomy $97 $101
SSC Primary Tooth $154 $160
SSC Permanent Tooth $183 $190
Prebacricated Resin Crown $193 $201
Prefab.est.coat SSC prim. Tooth $177 $184
Sedative Filling $68 $71
Palliative Treatment $56 $58
Ext. Erupted Tooth Prim/Perm $69 $72
Extraction Surgical -100+ $107 $111
Ext. cornal remnants deciduous $50 $52
Alveoplasty extractions p/quad $92 $108
Alveloplasty in conjunction with extraction 1-3 teeth per quadrant $100 $104
Alveloplasty not in conjunction with extraction 4 or more tooth spaces
per quadrant $175 $182
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04/17/2008
Alveloplasty not in conjunction with extraction 1-3 tooth spaces per
quadrant $150 $156
Recement Crown NOT cov, by MA $53 $55
Study Models $48 $50
I & D Minor Surgery $162 $168
Occulsal Adjustment Limited $80 $83
Fractured Tooth Txt. $64 $67
Pulp Cap-direct exp. Pulp MED $42 $44
Pulp Cap-indirect nearly exposed $42 $44
Biopsy OralTissue $138 $144
Pin Retention/tooth $28 $29
Band & Loop/Quadrant Impress $0 $0
Band & Loop/Quadrant Deliver 209125 $221 $230
Fixed Bilateral Impress $0 $0
Fixed Bilateral Deliver 419/30 $445 $463
Occlusal guard, by report minimize bruxism $274/95 lab $274 $265
Fabrication of Athletic Mouthguard $100 $104
Root Canal Therapy Anterior $400 $416
Root Canal Therapy Bicuspid $475 $494
Root Canal Therapy Molar $600 $624
Flat Fee Fabrication of Allelic Moutguard Projects $15 $16
Boll and Bite Mouthguards (students with braces) $5 $5
Health Personal Health Fees s
Drainage of Skin Abscess $112 $116
Drainage of Skin Abscess $191 $198
Drainage of Pilonidal Cyst $186 $193
Remove Foreign Body $127 $132
Drainage of Hematoma/Fluid $138 $144
Puncture Drainage of Lesion $90 $94
Debride Infected Skin $53 $55
Paring of corn/callus (1 lesion) $44 $46
Remove Skin Tags $85 $88
Shave Skin Lesion $69 $71
Remove Skin Lesion Excision 0.5cm or Less $127 $132
Remove Skin Lesion Excision 0.6 -1.OCm $149 $155
Remove Skin Lesion Excision 1.1-2.OCm $164 $171
Remove Skin Lesion Excision 2.1-3.OCm $186 $193
Remove Skin Lesion Excision 0.5cm or Less $127 $132
Remove Skin Lesion Excision 0.6 -1.OCm $154 $160
Remove Skin Lesion Excision 1.1-2.OCm $175 $182
Remove Skin lesion Excision 2,1-3.Ocm $207 $215
Trim Nail(s) $22 $22
Debride Nai11-5 $32 $33
Drain Blood from Under Nail $53 $55
Norplant (Remove) $212 $221
Repair Superficial Wound(s) 2.5cm or less $164 $171
Repair Superficial Wound(s) 2.6-7.5cm $175 $162
Initial Burn(s) Treatment $80 $83
Dsg and/or debridement, small $92 $96
Destroy Benign/Premal Lesion $69 $71
Destroy Lesions, 2-14 $17 $18
Destruct Lesion(s), 1-14 $104 $108
Chem. Caul of granulation tissue $75 $78
Inject Single Tendon-Ligament-Cyst $69 $71
Inject Single Tendon Orgin ?Insertion $64 $66
Inject Single-Multi Trigger Pts, 1-2 Muscles $64 $66
Inject Single-Multi Trigger Pts, 3+ Muscles $74 $77
Drain/Inject, Small Joint or Bursa $64 $66
Drain/Inject, Intermediate Joint or Bursa $69 $71
Drain/Inject, Major Joint or Bursa $80 $83
Drain Finger Abscess, Simple $313 $325
Apply Finger Spl(nt, Static $42 $44
Remove foreign body intranasal $232 $241
Control Nosebleed $117 $122
Lab: Venlpuncture $17 $18
Capillary Puncture $11 $11
Incise External Hemmorrhofds $175 $182
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04/17/2008
Dlagnoslic Anoscopy $95 $99
Anoscopy with Tumor-Polyp-Lesion Removal $229 $238
Insertion of non-dwelling bladder cath $89 $93
Destroy Lesion (Male) $144 $149
Incision/Drainage of Vulva or Perineum $132 $138
Incision/Drainage of Gland Abscess $164 $147
Destroy Lesions (Female) $140 $146
Diaphragm Fit $90 $94
Insert Intrauterine Device {IUD) $95 $99
IUD Removal $107 $111
Insert IUD $90 $94
Fetal Non Stress $48 $50
Paracervical Block $167 $174
Remove Foreign Body from External Eye $64 $66
Remove Foreign Body from Outer Ear Canal $132 $138
Remove Ear Wax $64 $66
Lipid Panei (Fasting) - (UNC Lab) $18 $18
Lipid Panel $24 $25
Livor Function (UNC Lab) $11 $11
U/A (W/Micro) $27 $28
U/A (Dipstick Only) $17 $18
Pregnancy Test $11 $11
Albumin Serum (UNC Lab) $6 $6
Amylase (UNC Lab) $9 $9
Total Bll(ruhln (UNC lab) $7 $7
Direct Billrubin (UNC Lab) $7 $7
Neonatal Bilirubin (UNC Lah) $9 $9
Hemoccult $11 $11
Fecal occult blood, single spec. $10 $10
Ca (UNC Lab) $7 $7
CO2 (UNC Lab) $6 $6
CL (UNC Lab) $6 $6
Total Cholesterol (UNC Lab) $6 $6
CREAT {UNC Lab) $7 $7
812 (UNC Lab) $21 $21
Ferrltin (UNC Lab) $19 $19
Folato (UNC Lab) $20 $20
GLU (UNC Lab) $5 $5
Glucose $11 $11
O'Sullivan $27 $28
OGTT (3 HR) $48 $50
Glucose (Random) $17 $18
GGT $11 $11
FSH (UNC Lab) $25 $25
Luteinizing Hormone (UNC Lab) $25 $25
Hemoglobin Al C $21 $21
IBC (UNC Lab) $12 $12
Iron Profile (FE): IBC (UNC Lab] $9 $9
LDH (UNC Lab) $8 $8
Lipase (UNC lab) $9 $9
Lipid Panel {Non-Fasting) HDL (UNC Lab) $11 $11
LDL (UNC Lab] $13 $13
ALK PHOS (UNC Lab) $7 $7
K (UNC Lab) $6 $6
TP-Serum (UNC Lab] $5 $5
TP-Urino (UNC Lab) $5 $5
NA (UNC Lah) $6 $6
Thyroxine (T4) - (UNC Lab) $8 $8
Free T4 (UNC Lab) $12 $12
TSH (UNC Lab} $22 $22
T4 (UNC Lab) $19 $19
SGOT, AST (UNC Lab) $7 $7
SGPT, ALT (UNC Lab) $7 $7
Iron Profile/Tranfarrin: % Saturation (UNC Lad) $17 $17
TRIG (UNC Lab) $8 $8
T3U (UNC Lab) $B $8
BUN (UNC Lab) $5 $5
Ur(c Acld (UNC Lab) $6 $6
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04/17/2008
QUANT HCG/Serum (UNC Lab) $12 $12
Hemoglobin $11 $11
CBC wlo Diff (UNC Lab) $9 $9
CBC with Diff (UNC Lab) $10 $10
CBC w/o Diff (UNC Lab) $9 $9
SED Rate {UNC Lab) $4 $4
RMSF (Acute) (UNC Lab) $9 $9
ANA (anti-nuclear antibody) titer {UNC Lab) $16 $16
Confirmation, if ANA+ (UNC Lab) $15 $15
MONO Spot (UNC Lah) $7 $7
RA Factors - Quai (UNC Lab) $7 $7
RA Factors - Quan (UNC Lab) $7 $7
PPD $13 $14
RMSF (Convalescent) (UNC Lab} $27 $27
Rubella (UNC Lab) $20 $20
Varicella Immune Status Test (UNC Lab) $17 $17
Hepatitis C RIBA (UNC Lab) $16 $16
Antibody Identification (UNC Lab} $21 $21
ABO Group (UNC Lab) $4 $4
RH Type (UNC Lab) $7 $7
GC Culture $17 $18
Throat Culture (UNC Lab) $8 $8
Lrlne Culture (UNC Lab) $11 $11
ID & Sensitivity (UNC Lab) $9 ., $9
STAT Male Smear $22 $22
Fungal Direct Test (FDIR} (UNC Lab) $7 $7
Wet Mount $17 $18
Parasitology Tast #9807-Glardia (UNC Lab) $16 $16
Parasitology Test #9807-Cryptosporfdlum (UNC Lab) $16 $i6
HBsAG (UNC Lab) $13 $13
Streptococcus Group A Assay W/Optic (UNC Lah} $20 $20
Pap Smear (State Lab) $12 $12
Rhogam Injection $122 $127
Admin Fee (1 vaccine) $11 $11
Admin Fee (2+ vaccines) $11 $11
Hep A -Adult $70 $73
Hep A (Ped/Adol) $32 $33
Gardasil $130 $135
Preservative free Influenza vaccine $30 $31
Influenza Split 6-35 mo. $13 $14
Influenza Split Syr and Above $25 $26
Influenza Virus Vaccine Live for Intranasal $26 $27
Rabies (IM) $225 $234
Rabies (ID) $202 $210
Varicella vaccine $BS $86
Immunization: Pneumococcal -State $35 $36
Meningococcal Vaccine, Subcutaneous/Jet $95 $99
Menactra Meningococcal Vaccine $95 $99
Zostavax vaccine $170 $177
Immunization: Hep B (20+ yrs) $74 $40
IV fluid/infusion therapy, up to 1 hr $69 $72
IV infusion, each additional hour $22 $23
IV Infusion Up to One Hour $132 $138
Psychiatric Diagnostic interview Exam $144 $149
Psychiatric Diag Interview Exam, Interactive $153 $159
Psychother, Indiv, Insight, 20-30 min. $62 $64
Psychother, Indiv, Insight, 45-50 min. $92 $96
Psychother, Indiv, Insight, 75-80 min. $138 $144
Psychother, Indiv, interac, 20-30 min. $67 $69
Psychother, Indiv, Interac, 45-50 min. $98 $102
Psychother, Indiv, interac, 75-80 min. $145 $150
Psychotherapy, Family, w/o Patient $90 $94
Psychotherapy, Family, (Conjoint) W/Pt Present $110 $114
Psychotherapy, Group $31 $32
Inlnfusion Each Additional Hour up to Eight $38 $39
Audiometry $17 $18
Pure Tone Audiometry, Air $22 $22
OAE (Limited) $0 $0
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04/17/2008
Electrocardiogram, Complete $32 $33
Electrocardiogram, Tracing Only $22 $22
Airway Inhalation Treatment $22 $22
AerosolNapor Inhalation Treatment $22 $22
Pulse Oxygen $8 $e
Denverll $107 $111
Health & Behavior Intervention $27 $28
Medical Nutrition Therapy/Initial 15 min. Unit $20 $21
Medical Nutrition Therapy/Re-Assess 15 min. Unit $20 $21
lab: Handling Fee $11 $11
Special Supplies $17 $18
Vision $11 $11
Induction of Vomiting $64 $66
New Office/Outpt Tx Brief E&M $80 $83
New Office/Outpt Tx Expanded Prob Focused E8M $122 $127
New Offce/Outpt Tx Detailed E&M $164 $171
New Office/Outpt Tx Moderate Complex E&M $239 $248
New Office/Oufpt Tx High Complex E8M $302 $314
Estab Offic/Outpt Tx Brief E&M $42 $44
Estab Office/Outpt Tx Prob Focused E&M $74 $77
Estab Office/Outpt Tx Expanded Focused E&M $100 $104
Estab Office/Outpt Tx Detailed E&M $149 $155
Estab Office/Outpt Tx Comprehensive E8M $222 $231
Initial Office Consultation Minor Problem $132 $138
Telephone Coord Brief $17 $18
Telephone Coord Moderate $22 $22
Telephone Coord Lengthy $27 $28
Preventive/New Pt < 1 yr. $100 $104
Preventive/New Pt 1-4 yrs. $100 $104
Preventive/New Pt 5-11 yrs. $196 $204
Preventive/New Pt 12-17 yrs. $217 $226
Preventive/New Pt 18-39 yrs. $212 $221
Preventive/New Pt 40-64 yrs. $254 $264
Preventive/New Pt 65+yrs. $230 $239
Preventive/Estab Pt < 1 yr. $95 $99
Preventive/Estab Pt 1-4 yrs. $95 $99
PreventivelEstab Pt 5-11 yrs. $159 $165
Preventive/Estab Pt 12-17 yrs. $186 $193
PreventivelEStab Pt 18-39 yrs. $180 $188
Preventive/EStab Pt 40-64 yrs. $202 $210
Preventive/Estab Pt 65+yrs. $202 $210
Home Visit for Postnatal Assmt & F/U Care $80 $63
Home Visit for Newborn Care & Assessment $80 $63
Newborn EPSDT Screen Nome Visit $85 $50
Periodic Oral Eval $33 $21
Oral eval <3 yrs with counseling $48 $50
Topical fluoride varnish $20 $21
Adm of Influenza Vaccine $5 $5
Adm of Pneumococcal Vaccine $5 $5
CBRS Individual Professional $20 $21
Ampicillin (OMNIP-POLYN-TOTAN) Up to 500mg $6 $6
Azithromycin SOOmg $27 $28
Penicillin GBenzathine/Procaine 1,200,000 Units $22 $22
Penicillin G Benzathine up to 600,000 Units $17 $18
Penicillin G Benzathine up to 1,200,000 Units $27 $28
Penicillin G Benzathine up to 2,400,000 Units $53 $55
Ceftriaxone Sodium/Rocephin per 250mg $22 $22
Ciprofloxacin, 200mg $22 $22
Depo Provers Injection $58 $61
Dlphenhydramine HCUBenadryl up to 50mg $6 $6
Promelhazine_mg $8 $8
B-12 Injection $6 $6
Normal Saline Solution infusion 1000cc $17 $18
Mirena IUD $504 $524
Sports Physical $42 $44
Camp Physical $42 $44
College Physical $42 $44
Childbirth Education $27 $28
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04/17/2008
RN Serv(ces up to 15 min. $21 $21
New Personal Health Fees
Nuvaring n/a $56
Tissue Biopsy -Level III Tech {UNC Lab) n/a $41
Tissue Biopsy -Level III Prof (UNC Lab) n/a $6
Tissue Biopsy -Level IV Tech {UNC Lab) n!a $54
Tissue Biopsy -Level IV Prof (UNC Lab) n/a $30
Tissue Biopsy -Special Siain/Microorg Tecli (UNC Lab) n/a $54
Tissue Biopsy -Special Stain/Microorg Prof (UNC Lab) n/a $21
Tissue Biopsy -Special Stain Tech (UNC Lab) n/a $48
Tissue Biopsy -Special Stain Prof (UNC Lab) n/a $9
Tissue Biopsy -IHC 5tainTech (UNC Lab) n/a $45
Tissue Biopsy -IHC StainProf (UNC Lab) n/a $34
PSA Screen (UNC Lab) n/a $25
PSA Diagnostic (UNC Lab) n/a $25
Culture, Fungal Dermatology Screen (UNC Lab) n/a $10
RSV (Respiratory Syncylial virus) Antigen Screen (UNC Lab) n/a $i6
Biopsy of Skin (Single Lesion) n/a $93
Biopsy of Skin (Each additional lesion) n/a $31
Lesion Diameter 0.6-1.0 cm n/a $85
Lesion Diameter 1.1-2.0 cm n/a $103
Lesion Diameter>2.OCm n/a $123
Shaving of Skin lesion -scalp, neck, hands, feet, genitalia n/a $66
Lesion Diameter 0.6-1.0 cm n/a $91
Lesion Diameter 1.1-2.0 cm n/a $10G
Lesion Diameter >2.0 cm n/a $124
Shaving of Skin lesion -face, ears, nose, lips, mucous membrane n/a $BO
Lesion Diameter 0.6-1.0 cm n/a $99
lesion Diameter 1.1-2.0 cm n/a $115
lesion Diameter >2.0 cm n/a $142
Inactivated Polio Vaccine (IPV) n/a $31
Glucose Tolerance Test (beyond 3 specimons) nta $10
"'Lab Fees charged by the Orange County Healih Department reflect direct lab (ee costs incurred by the Department for
services performed by UNC and State labs.
SOC%a/ SerVlCES
Adoption Intermedia Fee' n/a $300
Solid Waste Enterprise Fund
Mixed Use° $47/ton $49/ton
Construction and Demo° $41/ton $43/ton
Visitors Bureau
Occupancy Tax Rates 2 % of gross receipts
derived from rental o
accommodations in the
Coun 3 % of gross receipts
derived from rental o
accommodations in the
Coun
Footnotes:
' Board of County Commissioners approved these fees on December 3, 2007 with an effective date of July 1, 2008.
z Board of Healih is scheduled to approve these fees at their April meeting.
' Effective January 1, 2008, the state adoption laws (NCGS 48-9-101, 48-9-104 and 48-9-109) were amended to allow
licensed child placing agencies including, departments of social services, to voluntarily act as confidential intermediaries
between adult adoptees, adult lineal descendants of a deceased adult adoptee, parents of adoptees under the age of 21,
and birth parents. The department will charge anon-refundable fee of $300 to be paid in advance. Fees will be reduced
or waived for those applicants who have verified income at 200 % of the poverty level or below.
Effective July 1, 2008, the State of North Carolina will require a $2 per ton tax on every ton of waste received at the
landfill (NCGS 48-9-101, 48-9-104 and 48-9-109). This will result in a $2 increase to Mixed Use and Construction and
Demolition fees which the County plans to pass directly to the state each month.
s Senate Bill 622 of the 1991 session of the General Assembly gave Orange County the authority to levy up to a 3 % room
occupancy tax on the gross receipts derived from the rental of accommodations in the County. The Board of County
Commissioners adopted resolution, on February 19, 2007, to consider a 1 % increase in the tax taking it from the current
rate of 2 % to the maximum rate of 3 % .
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