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HomeMy WebLinkAbout09/08/1982 !I I I , 0091 4 The New Hanover County Board of Health met on Wednesday, September 8, 1982 at the New Hanover County Health Department. Members Present: Carl Durham, Chairman Roma Lee Hall, Vice Chairman J. William Eakins, M.D. William Grathwol Larry Neal, D.D.S. James Strickland Hobart Whaley Members Absent: Donald Blake One Vacant Membership Others Present: James M. Brown, Health Director Robert Pope, Attorney Mabel Price, Recording Secretary Mr. Durham, Chairman, called the meeting to order at 8:00 A. M. and called for corrections to the August 11, 1982 minutes. Mrs. Hall moved the minutes be approved. Mr. Whaley seconded the motion and it carried unanimously. Consultants Report: Jim McMahan and Nancy Lane of Planning and Design Associates were present for the meeting and gave their final report for the August 16 - Sep- tember 10, 1982 contract. Mr. McMahan gave an update on recommended fee schedule and policy, the revised position description for the Administrative Officer, the Cost Report and the Home Health Bookkeeping System. Ms. Lane gave recommendations for a Long Range Planning Policy. Both consultants expressed their thanks to the Board and Staff for the opportunity of working with them and their appreciation for all the cooperation they had received. Fee Policy Committee Report: Dr. Neal presented a proposed Fee Policy and Schedule which had been prepared by his Committee and Nancy Lane of Planning and Design Associates. Dr. Neal moved the policy and schedule be adopted by the Board. Mrs. Hall seconded the motion. After some discussion and clarification the motion was unanimously approved. The policy and schedule will be presented to the County Commissioners for their approval on September 20, 1982. Copy of the policy and schedule is attached as a part of these minutes. Septic Tank Committee: Dr. Eakins gave a report on the meeting with the Drainage Committee and the Sub-Division Committee. Both committees have proposals that are being considered by the County Commissioners. Shellfish and Seafood Ordinance: Dr. Neal reported that he is working to bring the proposed ordinance more in line with the wording in the State ordinance before presenting it for adoption. He will also have one more public hearing. Water Sampling: There was no report from this committee. I Priorities Progress: Mr. Strickland reported that number one on the priorities list - the hiring of an Environmental Health Chief - had been given much thought and that there is a possibility of reclassification of this position from Environ- mental Health Supervisor to Environmental Health Director, upgrading the position r~r 9 , 5 . ¡ ~ r " ....,u \. ..., ~. - ~ - from Grade 72 to Grade 76. He also reported that Mr. Brown had been to Raleigh to talk with Dr. Ronald Levine, State Health Director and Stacey Covil, Chief of Environmental Health bget recommendations of qualified applicants. Mr. Strickland suggested that a committee be set up to screen applicants for the position - possibly someone from the Board, County Personnel, someone from State and Mr. Brown. Mr. Grathwol moved that Mr. Brown proceed with having this position reclassified according to State and County Policies. Mrs. Hall seconded the motion and it carried unanimously. Mr. Dur- ham asked that a letter accompany the request explaining the reasons the reclassifica- tion is being requested. Mr. Strickland reported briefly on the other priority list items: Cost Report, Fee Collection Policy, Renovation of Building, Study of telephone system, Long Range Planning, Internal Monthly Report for Home Health. I Mr. Brown presented his plan for reorganizing the Administrative'Di~ision of the Health Department. Under this plan the Administrative Officer II would work at the same level of other Division Chiefs. The Personnel Technician and Finance Technician would work independently but the Administrative Officer would work with policy and procedure in relationship to these two positions. Mr. Brown also proposed hiring an Administrative Secretary to take over the secretarial duties of his office and for the Board of Health. Mrs. Hall moved that the Board of Health approve the position for Administrative Officer and approve the plan as presented. Mr. Strickland seconded the motion and it carried unanimously. Resignation from Board: Mr. Durham announced that Dr. Franklin had resigned from the Board of Health. Dr. Franklin is moving out of the State. Long Range Planning Policy: Mr. Durham presented the following Long Range Planning Policy for consideration of the Board: "The New Hanover County Board of Health affirms that long range planning should be an intergral part of the operation of the New Hanover County Health Department. A ten year plan shall be established which will define the growth needs and directions of the Health Department such that the Health Department can best serve the public health requirements of New Hanover County. There shall be a yearly review and update of the plan submitted to the Board of Health. The Board of Health instructs the Health Department administration to establish such a long range plan at the earliest possible time." Mr. Whaley moved the above policy be adopted. Mr. Grathwol seconded the motion and it carried unanimously. I PDA Consultants: Mr. Durham expressed thanks on behalf of the Board to Jim McMahan and Nancy Lane of Planning and Design Associates for all the help and assistance they have given to the Board of Health and the Department. The Board was in agreement that a letter of thanks be given to them from the Board. Grievance Review: Mr. Durham told the Board that a Health Department Staff Member had filed a grievance through the employee's attorney and asked that the grievance be heard by the Board, bypassing the regular route of the grievance procedure. Mr. Durham appointed a committee to work with the persons involved in the grievance. The committee will be as follows: Bill Grathwol, Chairman, Mrs. Hall and Mr. strickland. The committee will bring their recommendations to the entire Board for action. Mr. Pope advised that these meetings will be an exception to the established grievance policy, may set a precedence and must be accomplished through executive sessions. Mr. Gillespie, Attorney for the employee, was present for the meeting. Health Director's Report: 1. Tom Stich, Sanitarian, reported that the Environmental Health Section had participated in Environmental Health week and showed the Board snapshots of the display the Environmental Health Section had made and placed at Independence Mall during that week. I · " 009 J 6 II 2. Hilda White, Personnel, gave a brief report on the status of vacancies, new hires and resignations for the month of August. She also gave goals and objectives of the personnel position. 3. Marian Duggins, Nursing Director, reported on the reorganizational plans for the Personal Health Division and gave a follow-up report on the Perinatal Program. Executive Session: Mr. Brown requested that the Board adjourn to Executive Session. Dr. Eakins moved that the Board go to executive session. Mr. Grathwol seconded the motion and it carried unanimously. Mr. Durham moved the Board return to regular session. Dr. Eakins seconded the motion and it carried unanimously and the Board returned to regular session at 10:20 A. M. There being no further business Mr. Grathwol moved the meeting be adjourned. Dr. Eakins seconded the motion and it carried unanimously and the meeting was adjourned at 10:21 A. M. Respectfully submitted, ~ÞI2. Chairman, Board of Health I ecretary to the~~ Approved: October 6, 1982 I STA TE OF NORTH CAROLINA, COUNTY OF NEW HANOVER. AFFIDAVIT OF PUBLICATION I Befort! m~, a Notary Public in and fOE afore~aid State and County, came this -.~;!..day of.___.~~g_~____..uI9_Jt?_ I __:____..J.:.ª-Q.Q1LBrJ.,ns_0lL_____________m_u_' who being duly sworn, deposes and says that he isÇlª§§_·_A<J.Y..!__Mgr the STAR-NEWS NEWSPAPERS, Inc. and that the advertising of N9t,tÇ_E?__9X.J?YÞJj-_Ç__JJßfu'Jng appeared in said publication on the date (or dates) and in the space as specified below: DATE _'?dZJL__:1Qiß_2_______________ ("- A 'P'I'Tn'tJ n'li' A 1'\ Notice of Public Hearing Shellfish Seafood Ordinance SIZE ----...--------1 ------...-.----- _______ m.h_ cols. x____n___m___Jines ... - ---- -------------...------------------------ The New Hanover County Board of Health will hold a public heanng re proposed ordinance at ----------- 730 P-.M, Tuesday, August 31, 1982 In the County CommiSSion- er's Meeting room, County Ad- ------------ ::::;"~F'on building, 320 Chast- Copies of the ordinance can be seen at the office of the clerk ------------ to the Board of County Commls- ~~r;:rswa;:e~t :m~:: ~~ab'; Sub3cribed and sworn to before ~ at the Health Depart- me this_____~_~___day oÍ-___~.!!~_~________~____n____19__ª~ _2.~____.~~_L!J_~^_:_____________ Notary Public. My commission expires__!~_~_:.__~_?.__________, 19___~§ - - ---- -------------..----------------- ------- -------------- n_____________ cols. x__u___________lines -------------------...-------------------- -----------~-- u_uu________ cols. x_______________Jines ------------- ___m_________ cols. x___m_________Jines STAR-NEWS NEWSPAPERS, Inc. By Upon reading the foregoing affidavit with the advertisement thereto annexed it is adjudged by the Court ìa '"hat the said publication was duly and properly made, and that the summons has been duly and legally eerved ,n the defendant(s). ( This_________________day of _________________,19--------. \ / -------------------------------------------- Clerk of Superior Court J &6 L -9784 · . I I I NEW HANOVER COUNTY HEALTH DEPARTMENT FEE PLAN Wilmington, N.C. I. Rationale In response to continued inflation and reductions in federal and state subsidies, New Hanover County Health Dep~rtment has been forced to seek ways to assure that its limited resources are focussed on those activities that provide the maximum public benefit. Public interest is best served by assuring that all legally mandated services are available to all County residents. Some non-voluntary services , such as communicable disease control, must be available without any barriers such as charges that would deter use of the service. Other voluntary services, such as animal licenses , benefit a limited number of people, who should share in the cost to provide the service. In recent years, the health department has been requested to provide additional personal and environmental health services for public benefit. The Department can best serve the community by continuing to mãke these services available to citizens with the greatest need and the least access to alternatives. User fees provide a means to distribute services to County citizens on the basis of demand. Combined with a sliding fee scale, these fees can also distribute the burden of payment on the basis of ability to pay. Selectively applied, they distribute the cost of services to those who gain unique and particular benefits for themselves. Fees for public health department services are authorized under North Carolina General Statute 130-17, provided that: 1) the fees are in accordance with a plan recommended by the Health Director and approved by the Board of Health and the County Commissioners; and 2) the fees are not otherwise prohibited by law. Fees have been charged and collected by New Hanover County Health Department for several years. This revision of those formal and informal fee plans superceeds all preceding plans. II. Goals and Philosophy It is the intent of the New Hanov~r County Board of Health and the County Commissioners to insure that the New Hanover County Health Department : 1. Provides its medical care services free of charge to indigent people. 2. Charges people and their third-party payors, who can afford to pay, competitive private rates for comparable medical services. 3. Charges uniform fees for voluntarily procured non-medical services, such as animal control and environmental services, where permitted by state law. 9/82 · . I I I Fees p.2 4. Sets fees that will insure that certain services in the health department can become as nearly financially self-sufficient as possible. III. Affected Services Fees will be charged for specified services provided by the New Hanover County Health Department, in the Personal Health, Environmental Health, Animal Control, Family Planning, Home Health, Nutrition, Laboratory, and Pharmacy Division. Mandated public health services, community health, epidemiologic investigation and control, health education, tuberculosis control, venereal disease control, and immunization and sanitation inspections may be excluded, Vaccines provided to the health department ðt no cost will be provided without charge. Fees pro- hibited by law will not be imposed. Separate fees may be charged for la~oratory, x-ray, and other technological services when these are not included as part of another comprehensive service. Fees may be charged for educational services provided to individuals or groups, such as orientation, preceptorship, or field training. IV. Fee Schedule Insofar as possible, fees for certain medical añd laboratory services may be based upon reasonable prevailing rates. Fees for other services will be based upon budgetary costs to the health department, plus a county overhead fee. Where budgetary costs cannot be allocated with preC1S1on, nominal fees may be established in amounts related to known costs. Where Medicaid, other third party or program contract fee amounts are established on the basis of statewide average or other costs, the health department fee may be set equal to that amount. Fees will be adjusted at least annually by the Board of Health upon recommendation from the Health Director, to reflect budgetary and third party constraints. V. Medically Indigent Sliding Fee Scale Individuals will be charged for clinical services on the basis of ability to pay. Families with annual incomes that exceed current federal Poverty Income guidelines or other income guidelines which must be employed for other federal or state funded programs will be charged full rates. Others will be offered reduced rates based upon family income. The reduced rate, sliding fee scale, will be maintained as uniformly as possible among health department programs. Eligibility for reduced rates will be determined by clerical personnel prior to service. Verbal statements of patients, their parents or guardians, may be ac- cepted. Signed statements may also be required for certain programs. Enrollment 9/82 '. ,. I I I Fees p.3 under Social Security Titles XVIII. XIX. XX. or other third party coverage will be determined where applicable. Individuals who are identified as possibly eli- gible will be referred to appropriate agencies for eligibility determination. Once eligibility for reduced rates is determined. it will be continued for a period of one year. unless ·otherwise requested by a patient. Third party coverage will be verified on each visit. Fees for environmental health and animal control services will not be adjusted by the sliding scale. VI. Collection Fees will be collected at the time service is rendered. by trained clerical per- sonnel at central bookkeeping stations. In certain cases. fees will be collected at the point of service by the professional rendering services. Responsible audit trails will be maintained for all fee collections. Individuals who pay at the time of service will be provided with itemized receipts. Itemized bills will be sent to others,monthly. Enrollment in a third party pay- ment plan may be presumed to constitute full payment for that service. Failure to pay a proper charge for services rendered will constitute a debt for reasonable collection. Unpaid accounts will be billed monthly. Balance due of less than five dollars ($5.00) will be billed again. Balances of $5.00 to $25.00 will be billed three times. Balances in excess of $25.00 will be billed four times. Third and fourth bills will be stamped "Account Past Due. Service May be Withheld Pending Payment." Balances less than $2.00 will not be billed. Arrangements may be made for deferred or extended payment, when necessary for good causes. Once a year. the Health Director. or his designated representative. will review bad debts outstanding six months after the last bill has been rendered as described. At that time he or she will authorize write off of such amounts for accounting pur- poses. Payments received later for bad debts will be accepted and credited to appropriate accounts. However, no further collection efforts will be applied to these accounts. VII. Delinquent Accounts No individual will be denied services at the New Hanover County Health Department because of inability to pay, as determined by the Sliding Fee Scale. With the exception of Family Planning. patients. individuals with unpaid balances may be denied subsequent optional services. pending demonstration of a good faith effort to make payment. Attachments: Eligibility Scale Fee Schedule 9/82 ~ 0 0 0 0 0 0 0 0 0 0 ~ 0 0 0 ~ 0 Ln 0 \0 ~ N 0 CO \0 ~ N 0 CO \0 ~ CO ...... M Ln CO M ~ Ln \0 \0 ...... CO 0\ 0 0 - N 0 . - .. .. .. .. .. .. .. .. .. .. .. .. 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" , .' ~"~ .... .. ...... ./' NEW HANOVER COUNTY HEALTH DEPARTMENT FEE SCHEDULE FISCAL YEAR 1983 I SERVICE FULL CHARGE Animal Control 3.00 per year 17.00/ 25 dogs 25.00 (1st two times/yr.) +3.00/day lodging Pending will include Spay Neuter Charges '$25.00 for each law violated up to County maximum (subject to County ceiling) 3.00 per animal per day County Dog Tag Impounded Dog Redemption Adoption Citations Shelter Fee Adult Health Screening CPT-4 Initial & Annual Visit, consists of: 54.00 Chest X-Ray Visual acuity exam Glaucoma exam Height, Weight, Blood pressure check Cancer screen - oral exam, neck and axillary nodes, thyroid nodule palpation, breast exam, teaching self breast examination, vagina and cervix visual exam, nutritional assessment, pap smear Diptheria - Tetanus shot Follow-up personal record review and call-back Laboratory tests: Hemocult Routine blood sugar Coulter hematology (WBC, RBC, Hgb. Hct., MCV) Routine Urinalysis 71010 98592 98600 98609 98588 I 88150 90720 90000 82270 82947 85021 81000 following: 5.00 9.00 8.00 4.00 5.00 3.75 4.00 20.00 17.75 10.00 5.00 Follow up Visit may consist of one or more of 98609 Weigþt and blood pressure Nutritional Counseling Nursing Counseling, intermediate visit (15.30 min.) Hemocult Routine blood sugar monitoring Wet Smear for Trichinosis and Yeast Nurse Counseling, brief, [15 min. 71010 Chest X-Ray 98588 Cancer Screen 98592 Visual Acuity Exam 88150 Pap Smear EPSDT 1 Child Health Screen 82270 82947 87205 , 21.96 9/82 . . I I , . ,. ~.....'" ." ~.... 4.10 '" ~:'!..... ... . . 4 ~ , ~ ...;... . \' ..J ._.t. ,'i N. H. Fee Schedule Environmental Health Septic Tank Permit Soil Evaluation Unrestricted Septic Tank Installer License Fee Restricted Septic Tank Installer Licnese Fee Well Permit, including sample analysis Rat Bait Ship Inspections - Wilmington Ship Inspections - Sunny Point Water Samples: Coliform bacteria analysis Sample Collection and filing fee Repeat Water Samples (includes analysis) Non-Community Water Samples Environmental Health ;2 I' '\. ~.., Page 2 5.00 20.00 100.00 per calendar year 50.00 per last 6 mos. 10.00 per job 15.00 1. 50 per lb. 35.00 70.00 (overtime) 42.50 ,85.00 (overtime) 10.00 5.00 8.00 Pending charge; Proposed changes pending approval of septic tank ~rdinance Septic tank permit Septic tank approval Soil evaluation - Residential soil evaluation - Non-Residential 15.00 35.00 to 3 bedrooms 5.00 per additional bedroom 35.00 first 1,000 gallons per day 5.00 each additional 500 gallons per day 1. Charge may be determined by established program policy, medicaid or other program policy, e.g. State family planning grant, EPSDT. 2. Pending approval of County Septic Tank Ordinance. 9/82 , . I 99000 '9072 82947 85021 82270 87177 85031 82996 88150 87060 87086 181002 1000 6592 87205 87086 9/82 ._i ,'.............: ,,~ '.- Fee Policy NH page 3 SERVICE Epidemiology Supplies 1 Family Planning Limited Service / Pregnancy Test Intermediate Service wo pelvic Extended Service w pelvic Comprehensive Service, Initial or Annual Visual Exam, speculum evaluation Condeloma painting Collect Specimen in Office 1 Home Health Agency Public Health Nu~se Visit Physical Therapy Service Home Health Aide Visit Speech Therapy Service Immunization 1 Innoculation Ingredients Flu Yellow Fever Pneumonia Laboratory Acid fast culture and smear, Blood glucose Cholesterol test Choliform bact. in water Coulter hematology (WBC,RBC,Hgb,Hct,MCV) Feces for occult blood ( hemocult) M~lk Analysis - routine Milk analysis- buttermilk, sr. cream, yougurt Ova and parasite test Pinworm prep Platelet count Pregnancy test Pap Smear Sedimentation rate Throat culture Urine culture and sensitivity Urinalysis, complete Urinalysis, routine VDRL for employment physical Wet smear for trich and yeast Wound culture Mail-off fee Differential count FULL CHARGE cost + 10% 5.00 12.55 23.30 62.74 4.00 5.00 3.00 Self pay 7.00 8.00/hr 6.00 NA 3.00 cost 3.00 7.50 6.00 10.00 5.00 5.00 10.00 7.00 4.00 5.00 4.00 7.00 4.00 5.00 5.00 5~00 3.75 10.00 10.00 4.00 3.00 5.00 3.75 10.00 5.00 3.50 Medicare 19.60 22.40 16.80 Medicaid 19.11 21.84 16.38 "j:¡ ,J; '~ ~ :2 ,:~ ~~ , (; . {~ if ! ~ :2 i~ ~. ~r. ", '~ ~" .i ,~ ,,~ ',;Ii $; ~~ l' I~ ':1 , ~~ ,~ :.~~ ::)f ~ . ~' J '1 'J, ;-li' ,~' .,,> '~ ~ ~. ¡ ~ i¡ ·r J¡, ~~ ~, )~ , ;~ ,,: " 'f ft. ,1 ',~f !~ r¡;~ J~ ,~ ¥.' ~:~ Ii? '11: .' :' ~ i ,ii', 1 J, : . ~ , '¡¡';' í ;1-1 k Vo:ì.l-" ~'{.! , . '( j , " ,~%~ "a?, t, ~ I · . Fee Policy NH page 4 I SERVICE FULL CHARGE Laboratory cont. Stool culture 7.00 Nutrition Nutritional Counseling ( includes materials ) 8.00 per session Pharmacy Dispensing Ingredients Unc1assified1 2.00 cost Authorized record copies Education/ training per student day Group education per staff hour 2.00 10.00 10.00 X-ray I With physician interpretation Without physician interpretation 20 .00 9.00 , 1. Charge may be determined by established program policy, e.g. Medicaid or other state grant such as family planning. Vaccines received by the department without cost will be provided without charge 9/82