Agenda - 02-02-2010 - 6b - Laserfiche WebLink

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2 and up and will no longer be free to adolescents and adults, with a few exceptions. It will continue to be free for rising 6th graders as they are required to have it, and to post partum women who are Health Department patients. Children under the age of 7 require a different vaccine that will continue to be available free through the state. The proposed fee of $45 covers the cost of the vaccine ($35) and a $10 administration fee. The Health Department encourages all adolescents and adults to receive this vaccine because it contains protection against pertussis that is resurging in the community. Health Department staff believe the cuts implemented in the immunization program will increase the demand for immunization services by the Health Department. Certain combination vaccines will no longer be available free to private providers or the Health Department for all children who require them. Instead, state supplied free vaccine will only be single vaccine dose. This will require an injection for each type of vaccine rather than the combined vaccine. Any provider may choose to purchase these combination vaccines and administer them but they will be able to charge patients to recover the costs. Health Department staff believe some private providers will refer patients who cannot pay for the combination vaccines to the Health Department for immunization services. If the Health Department chooses to purchase combination vaccines, the Department must provide it free to a child who is unable to pay. Combination vaccines are very expensive and the County would not be able to recoup the cost given the high number of uninsured, low income patients. The Department will continue to provide all state supplied vaccines for the vaccine for children's program to any child who meets the qualifying criteria. There are two new fees for the Diabetes Self-Management Program (DSME). This is a new program that provides nutrition assessment, consultation and education for adults with Type II diabetes. The Department is seeking to become American Dietetic Association certified to be a provider of these services. Certification will allow the Department to recover costs from insurance companies for the services provided. Start-up costs for this program are grant funded for two years (July 2009-June 2011) by the Kate B. Reynolds Foundation. Establishing these fees now will allow the Department to begin cost recovery. Both the individual assessment fee and the group class fee are for each 30 minutes of service. There is one updated fee for Hepatitis A vaccine. This is actually a fee reduction. At the time the fee was initially approved, the vaccine was new and more expensive. The fee previously was $33 and now will be $25. For the past two years, the state has supplied the vaccine free since it was a recommended but not required vaccine. The cost of the vaccine has been reduced since the vaccine has become more commonly manufactured and provided. The new fee will still cover the cost of the vaccine ($15) and provide for an administration fee of $10. FINANCIAL IMPACT: The ability to charge fees for the services above will enable the Health Department to recover partial to full costs of the charges for services provided. Without these fees, the Department would not be able to recover costs but would still need to provide the services. For the Diabetes Self Management Program, it will provide the basis for that program becoming self-sufficient by the end of the grant year. RECOMMENDATION(S): The Manager recommends that the Board approve these fees and amend the County fee schedule to include these fees.