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•..�raj;� <br /> 2 September' 11, '198cY, <br /> Board of Health E4emo re Fee System ., <br /> By separate contracts and regulations we shall continue to charge family <br /> forfeit our $72,000/year in family planning grants. BY agree_ <br /> planning fees or forf with the Robert eit J ohnson Foundation and all local parties, we shall. <br /> pent <br /> continue dental fees. Therefore, technically the compliance problem lies with <br /> EPSDT and other clinical services. One quick and simple solution would be to <br /> provide EPSDT services to anyone free and not bill EPSDT and to not start any <br /> other clinical service fees. This could lead to our budget expenditures exceed- <br /> ing our income by $-13,000. The only way I know to balance such a projected defi- <br /> cit involves staff and program reductions. I Via received on August 13, a Department of Human Resources (DHR) p ublica- <br /> tion from its Division of Plans and Operations (OPO). This publication is entitled <br /> 'Minimum Administrative Standards for Local Human Service Programs, and applies <br /> equally to local DSS, Health and Mental Health. Apparently, there is a trio, year <br /> grace period to get into compliance with a large number of operational, standards. <br /> Regards (Board) policy development for our department, relevant to our immediate <br /> problem, the 'Standards' state: "Client services services--eligibility dequirementsDfor <br /> Depart- <br /> each service.....fee-for-service plan"; "• <br /> ment [DHR1 for reimbursement purposes (by us) shall be net of all applicable <br /> credits, refunds, and fees/income generated as a result of program activities/ <br /> services.."; and, "Each local human service agency....that provide first and <br /> third party reimbursable services should: <br /> (�) establish for each patient/client at the time of initial. visit, an <br /> accounts receivable ledger card....which shall indicate:... <br /> (a) The ability to pay for services, <br /> (b) The amounts billed for services, and <br /> .-(c) All money received on behalf of the patient/client from <br /> first or third party sources; <br /> E4y^personal interpretation of this is that DHR intends to push for fee <br /> systems in local health departments during the next several years, wherever <br /> possible. <br /> I have called staff together (two meetings on September 5) arid discussed <br /> this significant issue and solicited their ideas and suggestions.. The following <br /> outline as modified was used for the staff discussions-- <br /> PROPOSED EXPANSION OF FEES-FOR-5ERVICE SYSTEM AT THE HEALTH DEPARTMENT <br /> GOAL: SERVICES AT THROUGH SCOPE ASYPRESEN E Tg PROVIDE <br /> CONSTRAINTS: LA . (PASTJDHSOGUIDANDCEEREGARDSTIIOT CHARGINGFFOR OTB,SVD, - <br /> ETC., WAS SAID TO BE INCORRECT.) <br /> OBJECTIVE: 1. CHARGE 14EDICAID AND OTHER THIRD-PARTY PAYORS VHEE1 POSSIBLE. <br /> CONSTRAINTS: 1) CANNOT CHARGE THIRD--PARTY PAYORS FOR A SERVICE WITHOUT <br /> CHARGING EVERYONE. <br /> ?) EXCEPT CHARGE E THAN ANYONE ELSE <br /> ADJUSTMENTS. <br /> EI <br /> 3) E-JUST MAKE REASONABLE EFFORT TO COLLECT FROM PATIENTS <br /> WITHOUT THIRD-PARTY COVERAGE. <br /> OBJECTIVE: 2. CHARGE SERVICES RECEIVED, IF THIRD-PARTY <br />