Title
Adopt a further Resolution amending Article I.d. of the Monterey County Master Fee Resolution effective July 1, 2022, to add certain fees related to the Health Department’s Clinic Services Bureau (Clinic Services) pursuant to the attached Fee Schedule.
Report
RECOMMENDATION:
Adopt a further Resolution amending Article I.d. of the Monterey County Master Fee Resolution effective July 1, 2022, to add certain fees related to the Health Department’s Clinic Services Bureau (Clinic Services) pursuant to the attached Fee Schedule.
SUMMARY/DISCUSSION:
The Health Department’s Clinic Services Bureau (Clinic Services) operates Federally Qualified Health Center Look (FQHC) clinics that are required, by the Health Resources and Services Administration (HRSA), to periodically review its fee schedule to ensure that it accurately reflects costs of services rendered and that fees are consistent with local prevailing rates or charges. In compliance with the requirements, Clinic Services has been reviewing and adjusting its fee schedules annually.
On May 24, 2022, the Board of Supervisors approved Resolution No. 22-181, amending Article I.d. of the Monterey County Master Fee Resolution effective July 1, 2022, to adjust certain fees related to the Health Department’s Clinic Services Bureau (Clinic Services) pursuant to the attached Fee Schedule. Clinic Services has returned with this item for issuance of a Board resolution that includes fees associated with Adverse Childhood Experiences (ACEs) and Community Health Worker (CHW) Services. California recently enacted the ACEs Equity Act in 2022 to expand health insurance coverage for ACEs, which includes screening patients for potential traumatic events that occur during childhood. Effective July 1, 2022, Medi-Cal announced coverage for CHW services. CHW services are preventive health services to prevent disease, disability, and other health conditions or their progression to prolong life and promote physical and mental health.
The attached FY 2022-23 Fee Schedule has been amended to include the fees associated with ACEs and CHW Services.
This work supports the Monterey County Health Department’s 2018-2022 Strategic Plan Goals: 1. Empower the community to improve health; and 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports the following of the ten essential public health services, specifically: 5. Develop policies and plans that support individual and community health efforts; and 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
The office of the County Counsel and Auditor-Controller have reviewed and approved this Agreement as to legal form and fiscal provisions, respectively.
FINANCING:
The recommended fee additions are intended to recapture service costs with considerations of operation cost, payor reimbursements and prevailing local charges, without generating additional revenue. It is to assure that the programs remain revenue neutral with no additional impact on the County’s General Fund Contribution to the Department. The fee increase is also intended to stay compliant with HRSA’s requirements. FQHCs reimbursements by Medi-Cal and Medicare is Perspective Payment System (PPS), which will not be affected by the proposed fee schedules. Similarly, Clinic Services does not expect significant increase in revenue from patients resulted from the fee increases.
Currently, all patients visiting Clinic Services clinics are screened for eligibility into State and Federal programs to ensure that all patients eligible for a third-party payor source are enrolled in appropriate programs. All patients can apply for the Sliding Fee Discount Program (SFDP) and eligible for the discounts if they are under the 200% Federal Poverty Level, as approved by FQHC regulations.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Stacey Fiess, Management Analyst, 796-1329
Approved by:
______________________________ Date:_________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Resolution Amendment
Board Resolution No. 22-181, approved May 24, 2022
Proposed Article I.d. Fee Schedule, effective July 1, 2022