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2 <br />In addition to minimizing the loss in revenue from changing the sliding fee scale to 0%, this also <br />places all reimbursable services provided by the Health Department on the same sliding fee <br />scale. From the administrative perspective, this allows for greater efficiencies in sharing staff <br />resources at the front desk by simplifying the financial intake assessment process. <br />The Board of Health took action on this recommendation at its October 27, 2010 meeting by <br />changing the sliding fee scale to 0% to 100% based on 250% of the federal poverty level for all <br />dental clinical services. In addition the Board of Health is recommending that the minimum fee <br />for dental services be increased to $30. <br />FINANCIAL IMPACT: Staff has analyzed the fiscal impacts of two options: <br />1) Changing the sliding fee scale to 0% pay without changing the minimum charge; and <br />2) Changing the sliding fee scale to 0% pay and increasing the minimum charge by $5. <br />Analysis of Options <br />1) The total number of dental encounters from July 1, 2009 through June 30, 2010 billed at <br />20% pay was 2,002 encounters. The total amount billed for those services was $49,379. <br />This includes the $25 minimum fee plus 20% of any amount owed over that $25. Of <br />those encounters, 1,415 would have qualified for 0% pay, and if only charged $25 as the <br />minimum charge, would have yielded $35,375, a loss of $14,004 from the current <br />budgeted amount. <br />2) If the minimum charge is increased by $5 to $30, it is estimated that the loss falls to <br />$4,279 from the collection of the additional $5 charged to both the 0% and 20% pay <br />encounters. At the 20% pay level, only the balance left after the $30 minimum fee would <br />be charged to the patient. At levels above 20% pay, charges would likely exceed the $30 <br />minimum and would be charged at the appropriate percentage. <br />RECOMMENDATION(S): The Manager recommends that the Board accept the Board of <br />Health's recommendation that the minimum charge for dental services be increased to $30 and <br />that the County fee schedule be revised accordingly. <br />