|
|
|
|
|
|
|
COUNTY OF SAN MATEO
Inter-Departmental Correspondence
Health System
|
|
|
|
DATE:
|
July 2, 2010
|
BOARD MEETING DATE:
|
July 27, 2010
|
SPECIAL NOTICE/HEARING:
|
None
|
VOTE REQUIRED:
|
Majority
|
|
|
TO:
|
Honorable Board of Supervisors
|
FROM:
|
Jean S. Fraser, Chief, Health System
|
|
|
Brian J. Zamora, Director, Community Health Division
|
|
|
|
SUBJECT:
|
Public Health Clinic Fees
|
|
|
|
RECOMMENDATION:
|
Adopt a Resolution establishing Public Health Clinic fees effective August 1, 2010.
|
|
|
BACKGROUND:
|
Public Health Clinics are comprised of the Mobile Clinic and Edison Clinic. The Mobile Clinic provides health services to underserved populations in San Mateo County and assists clients in accessing primary care. The Edison Clinic provides clinical services for individuals with HIV infection and Sexually Transmitted Diseases (STD).
|
|
|
The Public Health Clinics have a long history of providing free medical services to homeless, uninsured, and low-income clients throughout the County. Although these clinical services are no longer marketed as “free,” the majority of services do not generate insurance revenue. In FY 2009-10 the Mobile Clinic provided services to 4,108 clients of which 2,948 were uninsured, and 1,623 clients were seen in the Edison Clinic for STD testing and treatment. The STD Clinic does not charge the $25 clinic visit fee, but requests a donation.
|
|
|
In August 2009 your Board approved Public Health Clinic fees effective September 1, 2009. Those fees were calculated based upon the actual cost to the County for the immunizations and the total cost of administration of the programs divided by the number of patients seen annually. The fees do not cover the Clinics’ actual costs but rather only serve to defray the direct cost of the program to the County. The fees are in line with those charged by the other California counties surveyed.
|
|
|
Fees may be waived for any person who meets the eligibility criteria under the Federal Health Care for the Homeless Program (HCH) and/or for persons clinically determined to be at risk for transmitting an STD to others.
|
|
|
|
|
DISCUSSION:
|
This fee schedule adds a provision that in the event free vaccine is received by the County from the State, that only the $35 administration fee will apply. In addition, this fee schedule rounds up or down fees to the nearest dollar so that all the fees are even amounts. Given that Public Health Clinics primarily serve the homeless, uninsured, and low-income clients throughout the County, the decision was made to not increase fees at this time even though County costs, mainly associated with employee expenses, have increased.
|
|
|
The Resolution has been reviewed and approved by County Counsel.
|
|
|
Approval of this Resolution contributes to the Shared Vision 2025 outcome of a Healthy Community by ensuring that vital public health clinical services are provided to residents of San Mateo County. It is anticipated that 45% of the referrals generated by the Mobile Clinic will result in follow-up appointments scheduled at the Mobile Clinic. This measure is used to determine how many clients, and in particular, homeless clients, return for follow-up appointments. This is one of the required Uniform Data System Report (UDS) measures for the Healthcare for the Homeless grant.
|
|
|
Performance Measure:
|
Measure
|
FY 2009-10
Estimate
|
FY 2010-11
Projected
|
Percentage of referrals generated by the Mobile Clinic, which resulted in follow-up appointments scheduled at the Mobile Clinic.
|
34%
|
45%
|
|
|
FISCAL IMPACT:
|
The proposed Public Health Clinic fees are not expected to generate new revenue. The Mobile Clinic’s tentatively Adopted FY 2010-11 Budget is $1,609,080, of which $1,148,239 is covered by Realignment from sales tax, $398,585 is covered by the Health Care for the Homeless grant and service reimbursements. Net County Cost is $62,256. The Edison STD Clinic’s tentatively Adopted FY 2010-11 Budget is $420,523, of which $55,923 is covered by service reimbursements. Net County Cost is $364,600.
|