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ORANGE COUNTY <br /> BOARD OF COMMISSIONERS <br /> ACTION AGENDA ITEM ABSTRACT <br /> Meeting Date: January 22, 2009 <br /> Action Agenda <br /> Item No. <br /> SUBJECT: New Health Department Fees for Personal Health Services <br /> DEPARTMENT: Health PUBLIC HEARING: (Y/N) No <br /> ATTACHMENT(S): INFORMATION CONTACT: <br /> New Fees Proposal Rosemary Summers, 245-2411 <br /> PURPOSE: To establish Health Department fees for certain personal health services to assist <br /> in cost recovery. <br /> BACKGROUND: According to NCGS 130A, the Board of Health is responsible for reviewing <br /> and recommending fees to the Board of County Commissioners in order to recover costs for <br /> those services for which fees may be charged by the Health Department. Establishment of fees <br /> also allows the Health Department to recover costs from third parties such as Medicaid, <br /> Medicare, and private insurance. A standard fee must be established that is charged to a <br /> patient or client regardless of insurance status. The Health Department also has established a <br /> sliding fee scale to charge patients/clients based on income. At the November 2008 meeting, <br /> the Board of Health reviewed and approved this proposal, recommending that it move forward to <br /> Commissioners for action. <br /> While the charge for the service is always the same, the amount collected by the Health <br /> Department varies according to the payor source. Twice a year, Medicaid reviews and makes <br /> rate adjustments based on the experience with various providers throughout the state. The <br /> Health Department reviews and adjusts its fees based on this review to ensure that the <br /> maximum income allowed by Medicaid for a certain procedure can be recovered to defray the <br /> costs for providing a particular service. The Department reviews fees annually as part of budget <br /> process, however, sometimes changes in policy at the state level means a change in the fee <br /> structure or a change in best practice for medical care dictates changes that fall outside of the <br /> budget cycle. <br /> The first four fees noted on the attachment are related to a birth control method that provides 3 <br /> years of protection for a woman wishing to prevent pregnancy. The Department has received <br /> additional family planning funds to be able to purchase this method and offer it to clients. The <br /> next fee is related to a change in state policy that allows the Department to begin charging for <br /> oral contraceptives. The proposed fee for oral contraceptive pills will cover the direct costs of <br />