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.