Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, Health System
Cassius Lockett, Director, Public Health, Policy and Planning
Subject: Public Health, Policy and Planning Fee Schedule Update
RECOMMENDATION:
title
Adopt a resolution updating the Public Health, Policy and Planning Fee Schedule effective July 1, 2018.
body
BACKGROUND:
The San Mateo County Public Health, Policy and Planning Fee Schedule (Fee Schedule) includes fees charged by the Public Health Laboratory (PHL), the Public Health Clinics, and Vital Statistics. Fee-based services include: clinical and environmental testing, vaccines, medical services, birth and death certificates, and Medical Marijuana identification cards.
On June 27, 2017, your Board approved the Public Health, Policy and Planning’s (PHPP) request to adopt the updated Fee Schedule effective July 1, 2017.
The fees charged are determined by considering the cost of providing services and the need to prevent fees from becoming a barrier to testing for communicable diseases. Some fees may be waived for persons determined to be at risk for transmitting a communicable disease to others.
DISCUSSION:
The Fee Schedule is updated annually to add fees for new services, eliminate fees that are no longer necessary, and align fees with changing costs. A cost-based methodology is used for transparency and to help PHPP determine the financial viability of services. The fees do not exceed the cost of providing the product or the service of enforcing the regulation for which the fees are levied. The methods used to determine the fees for each program are as follows.
The Health Clinic fees are determined by historical benchmarking. Some immunization fees are based on materials provided by external agencies. Fees for lab tests provided by PHL are matched to the PHL fee schedule.
The PHL fees are calculated by allocating annual lab expenditures based on staff time to complete each test, the price of test kits, the category of test for which supplies are used, and the volumes for each test. Individual tests of public health importance may be discounted by the Health Officer or lab director.
The Vital Statistics fees are mandated by the California Department of Public Health, with some portion going to the State Registrar and the remainder to the Vital Statistics program.
Based on historical client volumes, the total fees projected to go to the PHPP programs mentioned above for the 2018-2019 fiscal year are at or below total expenditures.
PHPP requests your Board to authorize the Chief of the Health System or designee to make changes to the Fee Schedule to replace tests for diseases already included on the approved Fee Schedule with an equivalent test, as long as the new test fee is no more than 10% greater the current test fee; and to add tests that provide a greater level of clinical information than current tests, as long as these fees are not more than 10% greater than the highest fee in that category (e.g. Laboratory Fees, Respiratory Disease Tests, etc.).
The resolution has been reviewed and approved by County Counsel as to form.
Approval of this Resolution contributes to the Shared Vision 2025 outcome of a Healthy Community by ensuring that critical public health testing, clinical services, and Vital Statistics’ records are provided to residents of San Mateo County. It is anticipated that 54,500 clinical and environmental PHL test orders will be completed on behalf of the public.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Estimated |
FY 2018-19 Projected |
|
Number clinical and environmental PHL test orders completed on behalf of the public |
54,500 test orders |
53,000 test orders* |
* This performance measure is expected to decline due to a reduction in orders from the San Mateo Medical Center in FY2018-19.
FISCAL IMPACT:
The changes to the PHPP fees are expected to generate an additional $15,880 in revenue in FY 2018-19 to offset cost increases. These funds have been included in the PHPP FY 2018-2019 Recommended Budget. There is no Net County Cost associated with the approval of this fee schedule.