Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
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, 2020.
body
BACKGROUND:
The San Mateo County Public Health, Policy, and Planning (PHPP) Fee Schedule (Fee Schedule) includes fees charged by the Public Health Laboratory (PHL), 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 25, 2019 the Board approved a request made by Public Health, Policy, and Planning to adopt the updated Fee Schedule, effective July 1, 2020.
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 on 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:
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 the PHL are matched to the PHL fee schedule.
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 PHL director.
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 FY 2020-21 are at or below total expenditures.
Here, there are no increases in fees, but PHPP is updating the fees to include HIV Insti Test under Blood Draws and Laboratory at $14, and for SARS-CoV-2 PCR to $148.
PHPP further requests the Board to authorize the Chief of San Mateo County Health or designee to make changes to the Fee Schedule to replace tests for diseases that are 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 no 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.
It is anticipated that 54,650 clinical and environmental PHL test orders will be completed on behalf of the public.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Estimated |
|
Number of clinical and environmental PHL test orders completed on behalf of the public |
52,536 PHL test orders |
52,536 PHL test orders |
*New measure
FISCAL IMPACT:
The changes to the PHPP fees are minimal and are expected to generate no additional revenue in FY 2020-21. These funds have been included in the PHPP FY 2020-21 Recommended Budget. There is no Net County Cost associated with the approval of this fee schedule.