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t3oard of Health Memo re Fee System 5 September 11, '19BG <br /> 7MG'+ of the patients are in the lowest income category we know ere are serving the <br /> greatest need (also by dental need standards); because of the low incomes we charge <br /> very small fees; our collection rate is well below 50% our income may not even <br /> meet our budget. <br /> lam as concerned about impact of this recommendation on certain services, i.e.,, <br /> hypertension screening, V.D. and TB, as anyone else. Therefore, if adverse effects <br /> are noted, I would immediately recommend limited/selected fee waivers. The value <br /> of an internally consistept policy for administration of that policy can not be <br /> overstressed. We can not communicate among staff, much Jess the public, a policy <br /> that is overly specific per service. We simply have too many services. This <br /> logic applies to use of one sliding scale also. ► <br /> I am convinced that it's only a matter of time before local health will be <br /> like mental health, with acxross-the•-board fees for all services. <br /> I view this recommendation to you as my obligation. It was difficult to <br /> formulate. I will be happy to discuss the total logic behind it in detail at the <br /> meeting. However, the-Board must formulate its own collective policy. Please <br /> feel free to ask me to individually or collectively furnish you with necessary data_ <br /> JR <br /> 99 <br /> 1 <br /> Attachments: 2 <br /> E <br /> I� <br /> 1 . <br /> I <br /> 1 <br /> 0 <br /> H <br /> F <br /> 3 <br /> yS <br /> L <br /> E <br /> l <br /> i <br /> r <br />