06/06/1984 BOH Minutes
a098b
The New Hanover County Board of Health met on Wednesday, June 6,
1984 at the New Hanover County Health Department.
Members Present:
---
Larry Neal, D.D.S., Chairman
Jean Credle, vice Chairman
Ted Bagley
Donald Blake
Carl Durham
William Grathwol
Charles Hicks, M. D.
Arnold Sobol, O.D.
James Strickland
Members Absent:
Harley Phillips, D.M.V.
Hobart Whaley
Others Present:
Robert S. Parker, Secretary to the Board
Mabel Price, Recording Secretary
Dr. Neal, Chairman, called the
called for corrections to the
moved the mi nu tes be approved.
it carried unanimously.
meeting to order at 8:00 A. M. and
May 2, 1984 minutes. Mr. Grathwol
Mr. Durham seconded the motion and
.. -
Department Focal
Linda Wicks, Supervisor of the Jail Health Program, introduced
Penny Wright, Family Nurse practitioner and Dr. Steven Collins.
Ms. Wright is the FNP for the Jail Clinic; Dr. Collins is her
back-up physician. Ms. wright shared some of her experiences
while working in the Jail Clinic and explained the type of things
she does there.
Environmental Ordinances Committee: This committee had met to
consider the request made by Dexter Hayes, Director of the New
Hanover County Planning Department, concerning individual lot
evaluations in sub-divisions. Mr. Grathwol reported that the
Committee does not have a recommendation at this time.
Budget Committee: Mr. Durham told
Hearing with the County Commissioners
that there were no further cuts in the
the Board
was a very
budge t.
that the Budget
good meeting and
Fee Policy Committee: A
Scale had been mailed to
Dr. Sobol moved the' Fee
presented. Mr. Grathwol
unanimously. A copy of the
as a part of these minutes.
final draft of the Fee Policy and Fee
members of the Board. After discussion
Policy and Fee Scale be approved as
seconded the motion and it carried
Fee Policy and Fee Scale is attached
..... .<;i
Spring picnic: Mr. Parker reminded the Board of the Spring picnic
for the Board and employees of the Health Department to be held on
June 14 at 5:00 P. M. He told the Board that participation was
expected to be very good and that the committee was planning
barbecued pork and chicken with all the trimmings.
DagBr
New Position Needed, Home Health Clerk Typist III: Mr. Parker
told the Board that due to growth in the Home Health Program and
considering their move to new quarters on July 1, 1984, an
additional Clerk Typist III position is needed for the program.
Motion was made by Mr. Durham that the position be approved and
forwarded to the County Commissioners. Mr. Grathwol seconded the
motion and it carried unanimously. During the discussion period,
Mr. Durham asked that Mr. Parker give the Board a projection of
the growth expected in the Home Health Program for the next
several years. Mr. Parker stated that he will prepare a report
and mail it to Board members.
.-.-
-
Employee Recognition Program: Susan 0 I Brien, Laboratory Director,
had prepared guidelines for an Employee Recognition Program for
the employees of the department. After discussion of the
guidelines, Mr. Durham moved they be approved. Mr. Grathwol
seconded the motion and it carried unanimously. A copy of the
guidelines are attached as a part of these minutes.
Change in Date of July Meeting: Due to the fact that the
regularly schedule meeting time falls on the 4th of July, the July
meeting will be held on July 11, 1984. The July meeting will be
held at the Animal Control Center in their new quarters.
Speech and Hearing Proposal: A Speech and Hearing grant has been
approved to serve a five County area in Southeastern North
Carolina. The clinic will be held at the New Hanover County
Health Department. A budget in the amount of $17,379 has been .,
approved for administration of this clinic. This budget will pay
for a half-time clerk, clinicians, aUdiologists, speech/hearing __
pathologist, x-rays and general clinic expenses. Mr. Grathwol
moved that we accept the grant and the position and forward to the
County Commissioners for approval. Mr. Durham seconded the motion
and it carried unanimously.
Contract Approvals for Dr. J. Calvin MacKay and Medicare Rental:
Copies of contracts for Dr. J. Calvin MacKay and Medicare Rental
had been mailed to the Board for study. Dr. Sobol moved the
contract with Dr. MacKay be approved. Mrs. Credle seconded the
motion and it carried unanimously. Mrs. Credle moved the contract
with Medicare Rental be approved. Mr. Grathwol seconded the
motion and it carried unaimously.
Comments
Mr. Parker told the Board that consideration is being
North Carolina General Assembly to terminate Boards
North Carolina. He reported that several
organizations are planning to fight this action.
gi ven by the
of Health in
professional
There being
adjourned.
adjourned at
no further business Mr. Grathwol moved
Mr. Durham seconded the motion and
9:25 A. M.
the meeting be
the Board was
--..
--
-
.~
~ ~
Respectfully submitted,
~ k~
Chai~oard of Health
~A-P~
Secretary to the Board
Approved:
00980
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FEE POLICY
ENVIRONMENTAL HEALTH
NEW HANOVER COUNTY HEALTH DEPARTMENT
All fees charged in the Environmental Health Section of the New
Hanover County Health Department are due prior to the provision of
services.
All fees should be collected by either of the two clerk typists in
the section. A receipt will be written for all fees collected.
In cases when the clerks are out of the office, a designated
sanitarian will collect fees and will issue the necessary receipt.
The daily deposit will be done by the Clerk Typist IV before 3:30
P. M.. In cases when the Environmental Health Clerk Typist IV is
out the Environmental Health Clerk Typist III will make the daily
deposit.
The fee schedule is attached.
Fees for water samples will be collected in the office by either
of the Environmental Health clerk typists. If parties wish to
mail fees for water samples this will be appropriate. Analysis
will not be mailed or given to customer until fee is received.
July 1, 1984
FEE POLICY
LABORATORY DIVISION
NEW HANOVER COUNTY HEALTH DEPARTMENT
I. General Gu ide lines
A. The fee system implemented by this Division has been
approved by the Board of Health (Attachment #1).
Implementation date is July 1, 1984.
B.
The fee
services
County.
po li cy
for the
establishes a mechanism
indigent population of
to
New
provide
Hanover
C. All clients are expected to pay for laboratory services.
D.
Partial payment is
reaches $50.00 on
the Health Director
accepted. When the client's balance
the ledger for partial pay patients,
shall be notified.
E.
The laboratory fee
laboratory services
patients.
scale will
requested
only
on
apply
private
to medical
providers
F. All Health Department employees will be charged for
laboratory services requested by private providers and
Health Department FNPs. Laboratory services required for
employment at the New Hanover County Health Department
are exempted.
G. All laboratory environmental services fees will be
collected by the laboratory or environmental health.
II. Indigency Policy
A. Upon admission for laboratory services, the patient's
ability to pay shall be determined by the receptionist.
B. Medically indigent patients will be required to sign a
statement of inability to pay each time they come in for
laboratory services. (Attachment #4)
C. The statement of inabili ty to pay is to be signed by the
patient, parent or legal guardian.
III. Program Application
A. Medical Testing
1. The laboratory will initiate the Laboratory Services
Check List. This list will have all services checked
that are to be done on the patient. There is a $2.00
charge for each service rendered. (Attachment #10)
7-1-84
2. The patient will be directed to the receptionist at
the general reception window.
3. The receptionist will charge and receipt all private
providers patients.
4. The receptionist will attach the Laboratory Services
Check List to the charge-receipt form.
5. The receptionist will direct the patient with the
receipt and attached check list to the laboratory.
6. Laboratory services will be rendered.
7.
Patient
filed at
File #l
File #2
File #3
receipt with attached check list will
the end of each day in one of three files.
Full pay
Medically indigent
Partial or no pay
be
8. Monthly tallies will be made of all three files and
checked against records in the reception area.
9. A monthly tally will be reported to the Health
Director along with other monthly reports.
B. Environmental Charges
1.
Milk Analysis
a. Monthly statements are
Director and mailed
being charged.
prepared by the Laboratory
to the Health Departments
b. Checks are received by the
Division and deposited to account.
Admini'Stration
2. Water Bacteriology
a. Samples collected by the Environmental Health
Division will be charged and the fee collected in
the Environmental Health section.
b.
The water cards will note
wa ter samples submi tted to
fee policy is applicable.
fee
the
charged
laboratory
on all
where
c.
The Environmental
monthly report to
total water sample
Health clerk will submit a
the Laboratory Director listing
revenues for the month.
d.
Water samples not COllected by
Health Division will be billed
Laboratory Director.
the Environmental
monthly by the
-2-
7-1-84
e. Checks will be received by the Administration
Division and deposited to account.
VI. Reporting
A. A monthly report on fees collected will be prepared by
the Laboratory Director. A copy will be attached to the
regular monthly report and sent to the Health Director.
B. A yearly report will be prepared at the end of the fiscal
year.
I'
7-1-84
-3-
I.
FEE POLICY
PERSONAL HEALTH DIVISION
NEW HANOVER COUNTY HEALTH DEPARTMENT
General Guidelines
A.
The fee system implemented by this Division has
approved by the Board of Health (Attachment
Implementation date is July 1, 1984.
been
U)
B.
This fee
services
County.
provide
Hanover
po li cy
fo r the
establishes a mechanism to
indigent population of New
C.
Partial payment is accepted.
reaches amount of $50.00 on
patients, then Health Director
When patient's balance
ledger for partial-pay
shall be notified.
D.
The
will
#2) .
Poverty
programs
Guidelines)
(Attachment
slidi ng fee
be applied
scale (Federal
in specified
E. There are specified charges which are prohibited by
North Carolina State law (Attachment #3).
F. The Jail Medical Program and Juvenile Services shall
not be charged for services.
i i
II. Indigency Policy
7-1-84
A.
Upon admission for specified program
patient's ability to pay shall be
signed statement (Attachment #4 & #5).
the
by
services
determined
B.
All patients referred for lab services
Luther King and Rankin Terrace are
indigent by signerl statement which is a
patient medical record (Attachment #5).
from Martin
designated
part of the
C. See attached forms
1. Statement of inability to pay (Attachment #4 &
#5)
a. To be signed by patient, parent or guardian
b. To be initiated in Adult Health Clinic,
Martin Luther King or Rankin Terrace Clinic
D.
Eligibili ty
issue date)
Clinics.
laboratory
Eligibility
to pay shall be determined annually (from
for Martin Luther King and Rankin Terrace
Adult Health Screening and private
patients shall be required to sign
statement each visit.
III. Program Application
A. General Clinic
It is the policy of the General Clinic to charge a
flat rate fee for the services listed (See Attachment
#l) .
1.
The clerk at the General Clinic
window will collect personal data
record and collect fees for charges.
receptionist
for medical
The clerk:
(a) Determines service requested
(b) Determines charge for service
(c) Collects fee
(d) Receipts patient
(e) Applies Indigency Policy if applicable (See
Section II)
(f) Directs patient to Laboratory, or General
Clinic area
2. Accounts Receivable Bookkeeping System includes:
a.
Day Sheet is used for
and payments collected
needed by the Health
#8) .
rece ipts to show cost
and other transactions
Department (Attachment
b.
Charge slip/receipt including
services is issued to the
receptionist (Attachment #8).
laboratory
patient by
c.
Ledger cards are issued
balance (Attachment #8).
for patients with a
-
d. Indigency Policy Forms (See Indigency Policy
- Section II, Attachment #4).
B. Laboratory will initiate Laboratory Service and
Check List to private provider's patients
(Attachment #10).
1. Receptionist will charge
provider's patient.
and
receipt private
2. Receptionist will attach Laboratory Service Check
List to charge-receipt form (Attachment #8).
3.
Receptionist directs
attached check list
#8) .
patient with
to Labora tory
receipt with
(Attachment
-2-
7-1-84
7-1-84
4. Indigency Policy Forms See Indigency Policy
(Section II Attachment #4).
C. Adult Health Services
It is the policy of the Adult Health Screening Clinic
to charge for initial, annual and follow-up services.
1. Flow
a. Screenin~ visit - initial or annual
(1) Patlent registers at the Adult Health
registration desk.
(2) Adult Health Registration Clerk does
eligibility and determines percentage
pay. If pa t ient is unable to pay,
follow medically indigent guidelines.
Federal Poverty Sliding Fee Scale will
be used. (See Clerical Accounts
Receivable System Section IIIA,
Attachment #9).
b. Follow-up visit refer to specific test to
be performed (Attachment #1)
(1) Patient registers at the Adult Health
registration desk.
(2) Adult Health Registration Clerk assesses
flat rate charge for test. If patient
is unable to pay, follow medically
indigent guidelines. (Section II)
D. Family Planning
The Fee System for the New Hanover County Health
Department Family Planning Program has been approved
by the New Hanover County Board of Health in October,
1983. This policy meets local, State and Federal
Family Planning requirements. (See Attachment #6,
Family Planning Fee Policy).
1. Flow
a. Patient registers
Registration desk.
Family
Planning
at
b. Family Planning Eligibility Clerk determines
eligibility status.
c. Patient receives
Services.
Family
Planning
Cli nic
-3-
d.
Patient returns
Registration Clerk
status and services
to Family Planning
with bill which shows pay
received during visit.
e. Family Planning Registration Clerk collects
fee, if applicable.
E. Satellite Clinic
1. Martin Luther King - Rankin Terrace
Martin Luther King and Rankin Terrace Satellite
Clinics provide comprehensive care including
diagnosis and treatment for any individual who does
not have medical provider, third party payment or who
feels they cannot afford private medical care. By
definition of the program, patients receiving
services are considered to be medically indigent.
a.
Procedure
(1) The majority of
appointment except
patients will be
in an emergency.
seen
by
(2) The medical needs
met accordingly
appoi ntments.
wi 11 be assessed by FNP and
of those people without
b. Clinic Process
(I) Patient registers at receptionist desk.
(2) A record is initiated.
(3) Eligibility is assessed by signed statement
(Attachment #5).
(4) Laboratory specimens collected at the Clinic
site shall denote clinic identification~
F. Home Health
The Home Heal t h
healthcare to
orders.
Program provides skilled and nonskilled
home bound patients with physician's
1.
Flat
and
cost
rate fees are established by the
subject to adjustment according
for services.
Board of Health
to determined
2. Third party payors are billed according to each
payor's guidelines.
3.
Patients who
monthly bi lIs
to the Billing
have no third party payor receive
at the established rate and according
Policy - Home Health (Attachment #7).
7-1-84
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#1 - Fee Scale - Personal Health Division
#2 - Federal Poverty Guidelines Fee Scale
#3 - Charges Prohibited by Law
#4 - Statement of Inability to Pay
#5 - Indigent Statement - Martin Luther King and Rankin
Terrace
#6 - Family Planning Fee
#7 - Home Health Billing
#8 - Accounts Receivable
Day Sheet
Charge Slip/Receipt
Ledger Card
Attachment #9 - Accounts Receivable - Adult Health
Day Sheet
Charge Slip/Receipt
Ledger Card
Attachment #10- Laboratory Service Checklist
Attachment
Attachment
Attachment
Attachment
Attachment
At tachment
Attachment
Attachment
Policy
Policy
- General
Clinic
.
-5-
7-1-84
Attachment #1
ANIMAL CONTROL
,
Service
Charge
*County Dog Tag
5.00 per year, all
dogs over 4 mos.
*Kennel Tag
25.00 per year for
5 to 25 dogs
2.00 per year for each
dog over 25 dogs
Redemption:
All Animals
15.00 - 1st two times/
year
25.00 - 3rd time or
more/year
Shelter Fee
3.00 per day
Adoption: (No Refund)
Adult Dog
Puppy
Adult Cat
Kitten
Other - Large
Small
10.00 - 4 mos. or older
7.00 - under 4 mos.
5.00 - 4 mos. or older
3.00 - under 4 mos.
15.00 - Horses, Cows,
etc.
3.00 - Rabbit,
Chicken, ~tc.
Animals Surrendered to Shelter:
New Hanover County Residence - No Charge
Non-County Residence - $3.00 per Animal
*Effective date for dog tags and kennel tags, January 1, 1985.
July 1, 1984
At tachment #l
ENVIRONMENTAL HEALTH
Service
Septic Tank Permit
Soil Evaluation - Residential
Soil Evaluation - Non-residential
Unrestricted Septic Tank Installer
License Fee
Restricted Septic Tank Installer
License Fee
Well Driller License
Well Worker License
Combination Well Driller and
Well Worker License
Well Permit (including sample analysis)
Rat Bai t
Ship Inspections - Wilmington
Ship Inspections - Sunny Point
Water Samples
Coliform Bacteria Analysis (Lab Fee)
Sample Collection and Filing Fee
Repeat Water Samples (including
analysis)
July I, 1984
Charge
15.00
35.00 to 4 bedrooms
5.00 per additional
bedroom
35.00 first 1,000 gal.
per day
5.00 each additional
500 gal. per day Ii
i
100.00 per calendar yr.
50.00 last 6 months
10.00 per job
25.00
25.00
5U.OU
15.00
1. 50 per lb.
35.00
52.50 (overtime)
42.50
63.75 (overtime)
10.00
5.00
10.00
Attachment #1
LABORATORY
Service
Acid Fast Culture and Smear
Blood Glucose
Cholesterol Test
Coliform Bacteria in Water
Coulter Hematology (WBC,RBC,HGB,HCT,MCV)
Feces for Occult Blood (hemocult)
Ova and Parasite Test
Pinworm Prep
Platelet Count
Sedimentation Rate
Throat Culture
Urinalysis, complete
Urinalysis, routine (Dipstick)
VDRL for Employment Physical
Mail Off Fee
Differential Count
Stool Culture
Pregnancy Test
Services Available Only to Health Department Clients
Pap Smear
Urine Culture and Sensitivity
Wet Smear for Trich and Yeast
Wound Culture
Services Available Under Contract
Milk Analysis - routine
Milk Analysis - buttermilk, sr. cream, yogurt
7-1-84
-4-
Charge
$ 2.00
2.00
2.00
10.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
5.00
2.00
2.00
2.00
2.00
5.00
4.00
At tachment #l
PERSONAL HEALTH
Service
Adult Health Screening
Initial and Annual Visit, Consists of:
Chest X-ray
Visual Acuity Exam
Glaucoma Exam
Height, Weight, Blood Pressure Check
Cancer Screen - oral, neck, axillary nodes,
thyroid nodule palpation, breast, teaching
self breast exam, vagina and cervix visual
exam, nutritional assessment
Pap Smear
Diptheria - Tetanus Shot
Follow-up Personal Record Review and Call Back
Lab Tests:
Hemocult
Routine Blood Sugar
Coulter Hematology (WBC, RBC, HGB, HCT, MCV)
Routine Urinalysis
Charges
$ 48.00
10.00
12.53
12.83
5.32
7.00
5.40
3.00
5.00
8.00
4.00
$121. 08
Cha rges by use of Eligibili ty Scale:
20% 40% 60% 80% 100%
Initial or Annual: 24.00 48.00 73.00 97.00 121.00
FOllow-up Visit - may consist of one or more
of the followi ng:
Weight and Blood Pressure
Nutrition Counselling
Hemocult
Routine Blood Sugar Monitoring
Wet Smear for Trichinosis and Yeast
Nurse Counselling, brief (15 minutes)
Cancer Screen
Visual Acuity Exam
Pap Smear
7-1-84
5.32
14.10
3.00
5.00
5.00
16.40
19.40
12.53
7.00
Attachment U
Service
Charges
Family Planning
Limited Service/Pregnancy Test
Intermediate Service w/o Pelvic
Extended Service w/pelvic
Comprehensive Service, Initial or Annual
Visual Exam, Speculum Evaluation
Condeloma Painting
Collect Specimen in Office
21. 90
16.37
28.68
78.11
11. 40
16.40
3.00
Immunization
Innoculation
Flu
Yellow Fever
Pneumonia
4.00
4.00
8.00
6.00
Nutrition
Nutrition Counselling (including materials)
(Title XX)
10.25
Unclassified
Authorized Record Copies
2.00
t
7-1-84
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