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HomeMy WebLinkAboutOrdinance 10840~t ORDINANCE NO. ,~=~a-= AN ORDINANCE AMENDING CHAPTER 16, "HEALTH AND SANITATION," OF THE CODE OF THE CITY OF FORT WORTH, TEXAS (1986), AS AMENDED, BY AMENDING ARTICLE I, SECTION 16-9; ARTICLE I, SECTION 16-13; AND DELETING ARTICLE XVI, SECTION 16-408, THEREOF, TO PROVIDE THAT FEES FOR PERMITS AND SERVICES AUTHORIZED PURSUANT TO THESE SECTIONS SHALL BE IN AN AMOUNT ESTABLISHED BY CITY COUNCIL; PROVIDING THAT THIS ORDINANCE SHALL BE CUMULATIVE; PROVIDING A SEVERABILITY CLAUSE; PROVIDING FOR ENGROSSMENT AND ENROLLMENT; PROVIDING FOR PUBLICA- TION IN THE OFFICIAL NEWSPAPER; AND PROVIDING AN EFFEC- TIVE DATE. BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF FORT WORTH, TEXAS: SECTION 1. That Article I of Chapter 16, "Health and Sanitation," of the Code of the City of Fort Worth, Texas ( 1986) , as amended, be and is hereby amended by deleting existing Section 16-9 and replacing it with a new Section 16-9, to read as follows: "Section 16-9. Cross-connections - Annual permit fees. "Before the Director of Public Health will issue a per- mit for a cross-connection control device to the person required in Section 16-8 to have a permit, said person shall pay the permit fee in the amount established by City Council." That Article I of Chapter 16, "Health and Sanitation," of the Code of the City of Fort Worth, Texas ( 1986) , as amended, be and is hereby amended by deleting existing Section 16-13 and replacing it with a new Section 16-13, to read as follows: "Section 16-13. Public health service fees. "The Department of Public Health shall be entitled to collect fees from those individuals using the facil- ities and/or services of the department provided by the public health laboratory, sexually-transmitted disease clinic, human immunodeficiency virus services, personal health services program, dental clinic, health promo- tion program, and any other program. The fee for the facilities and/or services. shall be in an amount estab- lished by City Council." That Article XVI of Chapter 16, "Health and Sanitation," of the Code of the City of Fort Worth, Texas (1986), as amended, be and is hereby amended by deleting Section 16-408. SECTION 2. This ordinance shall be cumulative of all provisions of ordi- nances and of the Code of the City of Fort Worth, Texas (1986), as amended, except where the provisions of the ordinance are in direct conflict with the provisions of such ordinances and such Code, in which event conflicting provisions of such ordinances and such Code are hereby repealed. SECTION 3. It is hereby declared to be the intention of the City Council that the sections, paragraphs, sentences, clauses and phrases of this ordinance are severable, and, if any phrase, clause, sentence, paragraph or section of this ordinance shall be declared unconstitutional by the valid judgment or decree of any court of competent jurisdiction, such unconstitutionality shall not affect any of the remaining phrases, clauses, sentences, para- graphs and sections of this ordinance, since the same would have been enacted by the City Council without the incorporation in this ordinance of any such unconstitutional phrase, clause, sen- tence, paragraph or section. SECTION 4. The City Secretary of the City of Fort Worth is hereby directed to engross and enroll this ordinance by copying the 2 caption and effective date in the minutes of the City Council and by filing the ordinance in the ordinance records of the City. SECTION 5. The City Secretary of the City of Fort Worth, Texas, is hereby directed to publish the caption and effective date of this ordinance for two (2) days in the official newspaper of the City of Fort Worth, Texas, as authorized by Section 53.013, Texas Local Government Code. SECTION 6. This ordinance shall be in full force and effect from and after the date of its passage and publication, and it is so ordained. APPROVED AS TO FORM AND LEGALITY: ~~yc~.Eity ttorney Iye, .~. Date : '`~ 30 ~ 9 1 ADOPTED • ~ ~'' " /' `" / EFFECTIVE: 3 i' SCHEDULE OF FEES FOR PERMITS AND SERVICES OF THE FORT WORTH PUBLIC HEALTH DEPARTMENT ESTABLISHED BY CITY COUNCIL CROSS CONNECTION CONTROL DEVICES PERMIT FEES (1) For reduced pressure (RP) principle devices• (a) First RP device at a location (b) Each additional RP device at same establishment location (c) Each double-gate, double-check valve device at the same location (2) For double-gate, double-check valve (DGDCV) devices without RP devices: (a) First DGDCV device at a location (b) Each additional DGDCV device at same establishment location PUBLIC HEALTH SERVICE FEES (1) Public Health Laboratory (a) Bacteriological analysis of standard water sample (b) Chemical analysis of standard water sample Regulatory or complaint water samples that are submitted to the laboratory from the environmental health divisions of either the City or Tarrant County health departments or the state health department, Region V, shall be exempt from imposition of these fees. (2) Sexually-transmitted disease clinic *(a) Clinic fee, includes initial and return visits within 30 days *(b) Clinic fee, return visits after initial 30 days (c) Herpes culture (d) Condoms, four (4) (e) HIV test (f) PAP smear (g( Trichomoniasis treatment for 1-day dose (4 SOO,mg. tablets) (h) Venereal warts treatment (i) Scabies/lice treatment $100.00 $ 50.00 $ 25.00 $ 50.00 $ 25.00 $ 8.00 $ 50.00 Standard Fee $ 48.00 $ 40.00 $ 52.00 $ 1.00 $ 10.00 $ 20.00 $ 5.00 $ 2.00 $ 9.00 Y. ~ (~ ) Chlamydia slide $ 10.00 (k) Chancroid culture $ 25.00 *(1) Urinalysis $ 11.00 *(m) Pregnancy test $ 5.00 (n) Tineacruris treatment $ 11.00 Individuals using the facilities and/or services of the sexually- transmitted disease clinic shall pay for such services according to a sliding scale based on the individual's personal income and family size as a percent of the federal poverty income guidelines which are established for Medicaid, as mandated under the Omnibus Budget Reconciliation Act of 1989, Public Law 101-239, regardless if Medicaid reimbursement is used for that individual. An individual whose personal income and family size is 0-133% of the federal poverty income guidelines shall pay 10% of the standard fee for sexually-transmitted disease clinic services. An individual whose personal income and family size is 134-200% of the federal poverty income guidelines shall pay 50% of the standard fee for sexually transmitted disease clinic services. An individual whose personal income and family size is 201% or more of the federal poverty income guidelines shall pay 100% of the standard fee for sexually-transmitted disease clinic services. No client will be denied services marked by an asterisk (*) due to inability to pay. (3) Personal Health Services Clinic (a) Copy of immunization record: Computer generated $ 1.00 Manual retrieval $ 4.00 *(b) Pregnancy Test $ 5.00 *(c) Each immunization $ 15.00 Individuals receiving immunizations from the personal health services clinics shall be charged an administrative fee for each immunization received according to a sliding scale based on the individual's personal income and family size as a percent of the federal poverty income guidelines which are established for Medicaid, as mandated under the Omnibus Budget Reconciliation Act of 1989, Public Law 101-239, regardless if Medicaid reimbursement is used for that individual. An individual whose personal income and family size is 0-133% of the federal poverty income guidelines shall pay 10% of the standard fee for each immunization received from the personal health services clinic. An individual whose personal income and family size is 134-200% of the federal poverty income guidelines shall pay 50% of the standard fee for each immunization received from the personal health services clinic. An individual whose personal income and family size is ZOOy or more of the federal poverty income guidelines shall pay 100y of the standard fee for each immunization received from the personal health services clinic. No client will be denied services marked by an asterisk (*) due to inability to pay. (4) Dental Clinic (a) Clinic appointment fee $ 10.00 (b) Denture program Full denture $315.00 Single denture $165.00 (5) Health Promotion Program (a1 Pregnancy Test $ 5.00 (b) Cholesterol screen $ 5.00 (c) Lipids screening test $ 15.00 (d) Lipids screening test plus serum glucose test $ 17.00 (e) Hemoglobin or hematocrit $ 5.00 (f) Serum glucose test $ 5.00 MASrer~~:b_ ss ACCOUNTING 2 TRANSPGRTATION~PUELfG :VO'7KS•O y~A TF'R ADMiN(S'f RATiu^I d J~,// ~~®D" HEALTH 6LPSP.TMCNT 1 LA .,~-d' pity of .fort Worth, ~'exas aid (~®aac~~ca~ c~®~,~~+c~a~~~~®~ DATE REFERENCE. SUBJECT ADOPTION OF ORDINANCE AMENDMENT PAGE NUMBER ESTABLISHING PUBLIC HEALTH FEES FOR 4 5-7-91 **G-9136 PERMITS AND SERVICES AUTHORIZED BY 1°r AP ER F HE Y , IMPLEMENTATION OF MEDICAID PROGRAM FOR THE SEXUALLY TRANSMITTED DISEASE PROGRAM, AND INCREASE OF PERSONAL HEALTH SERVICES' FEES RECOMMENDATION: It is recommended that the City Council: 1. Adopt the attached ordinance amendment which would remove references to specific amounts of permits and fees for services charged by the Department of Health from the Code of the City of Fort Worth, Texas in Chapter 16 and provide that amounts of such permits and fees will be established by City Council in an M&C. 2. Adopt the attached schedule of fees for permits and public health services for Chapter 16 of the City Code. Authorize the City Manager to: 3. Participate in the Texas Medicaid Assistance Program (Medicaid) by implementing the Physician Services: Group Practice (PSGP) for Sexually Transmitted Disease (STD) Specialty at the Public Health Department; Approve the proposed fee schedule for the STD program; Deposit revenue collected from the STD program in the following revenue accounts of the PSGP for STD specialty: A. Medicaid/STD-General Fund GGO1, Account No. 464065, Center 0501603 for Medicaid patients, B. STD/Clinic-General Fund GGO1, Account No. 464894, Center 0501603 for fee for service patients These designations would separate Medicaid reimbursement from self pay clients. Approve the monthly transfer of program related revenue from General Fund GGO1 account-center 464065 0501603, 464894 0501603 Medicaid program related income to Grant Fund GR 76 account-center to be established upon approval of Medicaid program-related income, based on a rate proportionate to the total state support of the City's Sexually Transmitted Disease Program (currently at 34%) to be reserved for reinvestment in the STD program; 4. Implement revised fees for immunization services and pregnancy tests provided by the personal health services program; ~'v :.h DATE REFERENCE SUBJECIF.1UVr 1 1VI\ Vf VRU11\MI\l.C nPlGiwr~u~ ~ PAGE NUMBER ESTABLISHING PUBLIC HEALTH FEES FOR 2 4 -5-7-91 **G=9136 PERMITS AND SERVICES AUTHORIZED BY °f IMPLEMENTATION OF MEDICAID PROGRAM FOR THE SEXUALLY TRANSMITTED DISEASE PROGRAM, AND INCREASE OF PERSONAL HEALTH SERVICES' FEES 5. Implement the.. attached fee schedule for other public health permits and services. BACKGROUND STD PROGRAM The Medicaid program will initiate the PSGP Program for STD Specialty. This program provides treatment and early detection of sexually transmitted diseases. These services are currently being provided in the STD clinic. The implementation of the PSGP program will enable the collection of fees from Medicaid. The fee schedule proposed for the City of Fort Worth STD Clinic is attached. Based on a survey by the Public Health Department of health care professionals and other health care agencies in the community of the current average charges for STD services, it is recommended that fees be adjusted and increased to the prevailing rate in the community. For people who do not qualify for Medicaid fees will be charged on a sliding fee scale based on the client's personal income and family size. No client will be denied services which are marked by an asterisk (*) on the fee schedule. Implementation of this program in the STD Clinic will have the following financial impact: The annual revenue from Medicaid visits is projected to be $97,280.00. This projection is based on estimated client visits and the assumption that 20% of the client visits will qualify for Medicaid. Attendance/STD Clinic: 5,800 new visits/yr. x 20% Medicaid = 1,160 X $48.00/visit = $55,680.00, 5,200 return visits X 20% Medicaid = 1,040 X $40.00/visit = $41,600.00 The program related income policy will be followed for the revenue collected at the clinics and for Medicaid payments, as outlined in the Texas Department of Health Local Health Services Contract, and the Federal/State Uniform Grant and Contract Management Standards. The essence of these standards is that program related income must be: a) Used to expand or enhance the program, b) Used to finance the non-Federal/State share of the project if the State/Federal Governments approve, c) Deducted from the federal/state contribution. To remain consistent with City financial policy, all transfers from Grant Fund 76 to General Fund GGO1 will require City Council approval. When the Health Department requests use of these funds to expand the program., or to finance the non-Federal/State share of the program, an M&C will be submitted for City Council approval. All expenses will be charged to the General Fund. ~1~, .I!"!~ "L'~. - ; ~niE REFEREtt~E~~ ~' suaiECrAD(~!P I.©N"~0~~- RD-INANCE AME DMEN.T PacE_: NUIriBER ! , ;^.ESTABUISH,I:NG~~~PUB1x-IG':~HEALTH FEES FOR"` 3 4 5-~-91 **G=9136 ~ PERMITS:. AND~.SER~VIGES AUTHORISED RY °f CHAP 16 OF T CIT C DE, E:~_ IMPLEMENTATION OF MEDICAID PROGRAM FOR ^~T~iE SEXUALLY TRANSMITTED DISEASE PROGRAMS AND INCREASE OF PERSONAL HEALTH" SERVICES'' FEES BACKGROUND PERSONAL HEALTH SERVICES ~,T.1 _}- a) Fee for Immunization - The City ofr,Fort Worth currently. charges clients for immunizations at x4.00 a client, regardless of their ability to pay. This fee•was~set as an administrative.fee at.a time°when immunizations at the Public Health clinics were- 1-i'mited ~.to .only cl.i.ents who met federal poverty income. guidelines., Agencies providing immunization services to these groups of cl ients~;coul.d .not. charge for the cast. o€ vaccine.; but~yarere allowed tc set a fee to .cover the vaccine .administrative castsa. If clients could not afford the administrative fee, they (the clients) were not denied service. The Federal Government funding heavily subsidizes the cost of the immunization program through direct funding to the local health department, or more commonly through the state health department to the local health department. A memorandum from the Texas Department of Health recently pointed out the discrepancy between the Federal and State rules as to which clients are eligible. for Public Health immunization programs. The Texas Department of Health (TDH) clinical fee rules stated that "patients or clients whose incomes are above the 200% poverty level will be referred. to the private sector for care .unless extenuating circumstances exist". The 1991 .Federal immunization grant. states "~no children may be denied vaccine at any vaccine site assisted by Federal grant funds". The Texas Department of Health has since revised its pol~i~cy to reflect the Federal requirement (since TDH receives Federal grant funds), and effective immediately all children are to receive vaccine at all public health clinics provided by the public health regions and local health department contractors regardless of poverty level. The fees charged shall be on the current schedule of fees used by either the local. health department or the region. The City of Fort Worth Public Health Department in 1990 instituted its own fee-for-service schedule, but did not address clients for the vaccine program whose incomes were 200%+ of Federal poverty guidelines. Under the proposed fee schedule, most of the clients currently served by the Health Department clinics and whose incomes normally fall between 0-133% of. Federal poverty guidelines will actually pay less with the proposed schedule than they are paying currently; this should ensure continued accessibility to the immunization program for this group of the population. The cost of immunizations in the private sector is quite high, even for those above the poverty level and many individuals are referred to the Health Department. The proposed sliding scale attempts to bring immunizations in line with the 1990 fee-for-service schedule without making the costs prohibitive. The proposed fee schedule is attached. 1 R" 1 ~~ ¢>. DATE REFERENCE' sue~ECTADOPTI N OF ORDINANCE AMENDMENT PACE NUMBER- ESTABLISHING PUBLIC HEALTH FEES FOR 4 4 5-7-91 **G-9136 PERNFITS AND SERVICES~AUTHORIZEO BY °` TY DE, IMPLEMENTATION OF MEDICAID PROGRAM FOR THE SEXUALLY TRANSMITTED DISEASE PROGRAM, AND INCREASE OF PERSONAL HEALTH SERVICES' FEES b) Fee for Pregnancy Testing - Pregnancy testing is the first step taken by many women in deciding to seek prenatal care; the test should therefore be readily available and affordable. The City of Fort Worth Public Health Department has offered pregnancy testing to its clients at $2.00 per test for many years. The current cost (including quality control runs and administrative costs) is about $17.00 per test, of which $3.25 is for the cost of supplies and reagents. The Health Department now proposes the fee be increased to $5.00 per test. Please note that the cost for providing pregnancy tests at four other major area agencies ranges from $10.00 - $28.00 per test. Again, the proposed fee of $5.00 per pregnancy test will help recover some of the costs associated with providing the service while maintaining the service at a financially accessible level. No clients will be denied immunizations or pregnancy testing due to inability to pay. BACKGROUND OTHER INCLUDED FEES No change is requested in the amount of the other fees included in this communication. They are included for the purpose of removal of references to specific fees from the ordinance and adoption of these fees under the terms of this communication.. FINANCING Upon approval and completion of recommendation No. 3, a project account will be established in Grant Fund GR 76 to record the proportionate state share of program-related revenue reserved for reinvestment into the Medicaid program. The expenditures will be in various accounts in the Grant Fund GR 76, the center to be designated at the time of Grant approval. Upon approval of recommendation No. 4, monies will be deposited in General Fund GGO1, Account No. 464714, Center 0501502, Support Services. LW:z 50CHA16 RPPROVED BY CITY COUNCIL MAY '7 1991 C TYMMANACER'S THE Libby Watson 6140 DISPOSITION BY COUNCIL: b$aF~$Ep BY OFFICE BY ~ APPROVED ORIGINATING Dr. Nick Curr 7204 y ^ OTHER (DESCRIBE) Citq o DEPARTMENT HEAD: o 6BhR~O1F1~ FS~T~ FOR ADDITIONAL INFORMATION Dr. Nick Curry 7204 ~- CONTACT • DATE Adopted Ordinance Noa/ _~ ~: