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HomeMy WebLinkAboutAgenda - 12-11-2007-4dORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: December 11, 2007 Action Agenda Item No. 4- - G~' SUBJECT: New Dental Fee for Occlusal Guards and Fee Adjustment DEPARTMENT: Health PUBLIC HEARING: (YIN) No ATTACHMENT(S): None INFORMATION CONTACT: Rosemary Summers, 245-2411 PURPOSE: To approve a new fee for occlusal guards and adjustment in one current fee for the Health Department. BACKGROUND: Dental Health Services in the Health Department needs to be able to provide for an occlusal guard, commonly called a nightguard for dental patients. An occlusal guard is designed to minimize the effects of bruxism (grinding) and other occlusal factors and preserves the integrity of teeth. This is a preventive measure that reduces further damage to permanent teeth and more costly future repairs. Currently these patients must be referred to a private practitioner for this service and generally cannot afford to have it provided to them. The proposed full charge Health Department fee for this service is $274, which is comparable to the lowest private practice charge. The fabrication of the appliance would be done by an external lab. The lab cost to fabricate the appliance is $95. The dental patient would be responsible for the full cost of the lab charge in addition to the $274 fee at their per cent payment level on the sliding scale. The Department estimates that approximately 12 patients per year would need this appliance. Approximately 7 patients are estimated to be 20% pay on the sliding scale, paying $54.80 plus the $95.00 lab charge. Four patients are estimated to be 80% pay, paying $219.20 plus the $95 lab charge. One patient is estimated to be 100% pay, paying $274 and the full $95 lab charge. In this scenario, the full charge .for these services would be $3,288 with the cost recovery through patient fees being $1,534.40. No new staff or equipment is being added as a result of this service. The Department is also requesting an increase in the 100% fee to $92 for alveolplasty in conjunction with four or more teeth in one quadrant: This prepares the bone to be able to accept a partial or a denture. This requested increase is due to the increase in the Dental Medicaid rates effective 2007-08. The present rate is $84 and the approved Medicaid rate is $92. FINANCIAL IMPACT: The additional fees will help defray the cost of services provided to dental health patients by the Health Department. The overall cost recovery of the occulsal guard is projected at approximately 48% of the full charge for the service due to the percent pay class of the patients served by the Health Department. This is approximately the same cost recovery as all of the services provided by the dental health service program and should not impact the overall budget of the Department because this service is provided in the same time frame with the same staff as other dental services. RECOMMENDATION(S): The Manager recommends that the Board approve a fee of $274 for occlusal guard, a $95 lab charge for the occlusal guard, and $92 for alveolplasty by quadrant.