Title
Adopt a Resolution Amending Article I.B - Public Health Bureau of the Monterey County Master Fee Resolution effective October 10, 2019, to adjust fees pursuant to the attached Fee Schedule relating to services provided by the Health Department’s Administration and Public Health Bureau.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Adopt a Resolution Amending Article I.B - Public Health Bureau of the Monterey County Master Fee Resolution effective October 10, 2019, to adjust fees pursuant to the attached Fee Schedule relating to services provided by the Health Department’s Administration and Public Health Bureau.
SUMMARY:
The Monterey County Health Department’s Public Health Bureau (Public Health) is requesting approval of proposed fee adjustments to the Public Health Bureau’s Master Fee schedule, Article I.B., to more closely reflect, while still not exceeding, the actual and reasonable costs of services and benefits provided to the public by Health Department’s Administration and Public Health Bureau.
DISCUSSION:
The fee adjustments are recommended in the following categories:
• Public Health Nursing. The Public Health Nursing Home Visitation -Targeted Case Management (TCM) program provides case management for Medi-Cal beneficiaries, including coordination and referral for resources for client medical, social, educational and other support issues. The proposed fees are adjusted based on Interim Medi-Cal TCM reimbursement rate submitted to the California Department of Public Health for individual case management by a Public Health Nurse.
• Children’s Medical Services. The Medical Therapy Program (MTP) is a special program within Children's Medical Services <http://www.dhcs.ca.gov/services/ccs> that provides physical therapy (PT), occupational therapy (OT) and medical therapy conference (MTC) services for children who have disabling conditions, generally due to neurological or musculoskeletal disorders. The proposed fees are adjusted to reflect costs for providing evaluation, treatment, and case conference/consultation and report services.
• The Public Health and Environmental Health Laboratories were established under the authority of section 101150 of the Health and Safety Code. The laboratory is certified by the California State Department of Health (DHS #0904) and the Federal Centers for Medicare and Medicaid Services (CLIA #050643583). It also operates a co-located State Certified Environmental Laboratory for testing environmental samples and food for disease causing organisms and toxic chemicals. The proposed fees are adjusted in the public health, environmental lab categories. The adjustments include fee setting methodology, fee increases based on fee setting methodology, adding of new tests, removing of tests, and reviewing the shipping and handling language.
• Health Promotion/Wellness. The Monterey County Employee Health Promotion/Wellness Program was developed in 1985 as a partnership between management, unions, and employees to address the health and safety needs of Monterey County employees. The Health Promotion Partnership provides prevention initiatives (e.g., flu vaccine clinics, biometric screenings), health risk reduction and condition management programs, and health education programs. The proposed fees are for program staff to provide group classes and materials needed to provide a minimum of one (1) hour classes.
• Sexual Assault Response Team (SART) Fee Schedule. The Monterey County Health Department (County) has operated the Sexual Assault Response Team (SART) Program since July 1, 2007. A revision to the Fee Schedule was approved and became effective on July 1, 2011. Since 2011, no adjustments have been made to the SART fee schedule. Pursuant to Penal Code Section 13823.95, the County is allowed to charge local law enforcement agencies in order to recover a portion of the cost associated with performing forensic examinations and testifying in court at their request. The County requests that existing fees be amended as follows; Victim Examinations remain at $925, Suspect Examinations reduced from $925 to $675, Annual Retainer Fee of $2,000 becomes an annual contribution which will no longer be credited towards examinations.
• Epidemiology Research/Evaluation. The Research/Evaluation provides epidemiological consulting services to local agencies. Services include health outcomes study design, coordination, and management; bio statistical analysis; spatial analysis; grant development; and program evaluation. The proposed fees are for services provided by subject matter experts who work with agencies to build local capacity and foster collaborative relationships.
The Board of Supervisors approved a Fee Schedule request relating to services provided by the Health Department’s Administration and Public Health Bureau on July 16, 2019 (effective August 16, 2019), but, unfortunately, the proposed Fee Article attachments to that Board Report and circulated in Legistar at that time were incorrect earlier versions of the fee adjustments and did not actually reflect the fees that were intended to be requested at that time. To facilitate full transparency, the matter is being resubmitted at this time and it is requested that your Board approve these superseding and correct fees, effective October 10, 2019.
The calculations and documents in support of the fee adjustments recommended herein are attached hereto. By definition, the changes to these charges are not a “tax” and are exempt from voter approval pursuant to Article XIII C section 1(e)(1)-(3) and (5) of the California Constitution (Prop. 26; charges imposed for specific benefit conferred/privilege/service or product, reasonable regulatory costs provided or granted to the payor, and/or fines and/or penalties). As such, they reflect no more than the actual cost of the service/benefit received by the payor.
This work supports the MCHD 2018-2022 Strategic Plan Goal: 1. Empower the community to improve health; Goal 2. Enhance public health and safety through prevention; and Goal 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. Additionally, this work supports three of the ten essential public health services: inform, educate, and empower people about health issues; link people to needed personal health services and assure the provision of health care when otherwise unavailable; and assure competent public and personal health care workforce.
OTHER AGENCY INVOLVEMENT:
A copy of the Proposed Resolution and the Proposed fee schedule (in two formats: comparison to current and prior year amounts if applicable (changes in italics/strikeouts at the base of page one, and clean version) are attached to this report and on file with the Clerk of the Board, along with additional calculations documenting the recommended fees.
FINANCING:
The recommended fee adjustments are intended to improve on the recapture of costs associated with the provision of the indicated services, and do not exceed actual costs for providing these services. As such, the fees represent a charge imposed for the specific service provided directly to the payor that is not provided to those not charged, and which does not exceed the reasonable costs to the County for providing the service. Anticipated revenues resulting from the proposed fee adjustments are included in the Fiscal Year (FY) 2019-20 Adopted Budget. The proposed fees will offset actual and reasonable costs of services and benefits provided to the public by the
Health Department’s Administration and Public Health Bureau.
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: Patricia McFadden, Management Analyst II, ext. 4726
Approved by: Elsa M. Jimenez, Director of Health, 4526
Attachments:
Proposed Resolution on file with the Clerk of the Board
Proposed Article I.b fee schedule (clean; effective October 10, 2019) on file with the Clerk of the Board
Proposed Article I.b. fee schedule (strikethrough, current and proposed fees shown for comparison) on file with the Clerk of the Board
Public Health Bureau fee schedule calculations justification on file with the Clerk of the Board