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HomeMy WebLinkAboutOrdinance 10593'~! k - 6~ Z _ -_ _ -___ ~..: . ~~ . .` ~ ~ ~~f ~r ~ . !`; • vRI~INa~eE No 1®~ aN ORDINANCE INCRr=ASING APPi~opRlATJcaNS tN 7HZe GEf~SERAL t=UntD oi, F1EAL~"H Df;PARTMENT, WEALTH SERVICES, ACCOUNT 50-15.02, OF THE CITY dF FORT WORTH FOR FISCAL YEAR i9&9-90 pY THE SUM OF 530,215 AND DECREASING THE UNRESERVED, UNDESfGNATED FUND BALANCE OF ?'ME GENERAL FUNp 01 SY TWE SAME AMOUNT FOR THE f~URPOSF OF PARTICIPATING tN TIaE TEXAS MEDICA{p ASSISTANCE PROGRAM; PROVIDING FOR A SEVERAEfL1TY CLAUSE; MAKING TH15 gRDINANCE CUMULATIVE OF F~RiOR ORDINANCES AND REPEALINCa ALL PRIOR ORbINANCES IN CONFLICT HEREWITH, Pi~C3VIDING FOR ENGROSSMENT ANb ENROLLMENT, AND PROVIDING AN EFFECTIVE C}ATt=. i3E t7' ORDAiN1~® 19Y THE CITY COU~ICtL OF THE CITY OF F®I~"f' °a~ORTH, TEXAS: SECTtC9N 9. That in addition to those amounts allocated to the various City departrne~nts for the Fiscal Year ~ 989-90 and in the Budget of the City Manager, there shall also be increased appropriations In the General Fund 01, Health bepartment, Meaith Services, Account 50-15-Q2, In the amount of $30,2 5, thereby decreasing the unreserved, and®signated fund balance by the same amount for the purpose of participating in the Texas Medicaid Assistance Pragran't SECT9C~P! ~ Should any portion, section or part of a section°~ of Phis ordinance be declared invalid, inoperative or void far any reason by a court of Competent jurfs;;iction, such d®cisian, opinion or judg©ment shall in n4 way impair th® remaining portions, sections, ~r parts of sections of this ordinance, which said remaining provisions sha91 be and remain in fuN fc~rc~ and effect. ~Fls i~Vll~a d. That this ordinance shaft be cumulative of Qrdinance No 1f}363 and aff Other ordinances and appropriations amending th® same except ~n those instances where the provisions of this ordinance era Ira direct conflict with such other ordinances and appropriations, in which instance said conflicting provisions of said prior ordinances and appropriations are hereby expressly repeated. 5 ZmCTIC>~d~ 4. T'he City Secretary of the City of Fort Worth is hereby directed to engross and enroll this ordinance by Copying th® caption and affeCtivQ date into the minutes of the Gity Council Gild by filing this ordinanc® in the ordinance records of the Gity of Fort Worth SECTIC?iu S. This ordinance shelf take effect and be in full force and effect from and after the date of its passage, and it i$ sa ordained Apl~R®VEI~ AS 'TO t°dRPJI ANI~ l~EGt~LITY: /~Z~~ty Attarne ` Date _ Adopted ~^ /~ ~~.~ Effeclive ~ ~~ ~ _ _~ ~ ~~,Y` ~i mayor and ~~~a r,n~il ~~~a.m.~a a,n.a.~a~i~~a, DATE REFERENCE SUBJECT IMPLEMENTATION OF PAGE NUMBER MEDICAID PROGRAM 4 5-29-90 G-8641 ' °f --- -- RECOMMENDATION• It is recommended that the City Council authorize the City Manager to• 1) Participate in the Texas Medicaid Assistance Program (Medicaid) by implementing the Maternity Clinic Services Program and the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program in the Maternal/Child Health Clinics in the Public Health Department; 2) Approve the fee schedule proposed for the Maternity/Child Health Services, 3) Deposit revenue collected from the Maternal/Child Health Clinics in one of the following revenue accounts (1) Medicaid-Maternity Services, (2) Medicaid-EPSDT, (3) Maternity Services, and (4) Well Child Services. These designations would separate Medicaid reimbursements from fees collected from clients, 4) Approve the monthly transfer of program related revenue from General Fund O1 to Special Revenue Fund 03, based on a rate proportionate to the total state support for the City's maternal child health clinics (currently at 28%), to be reserved for reinvestment in the Maternal/Child Health Program; and 5) Adopt the attached supplemental appropriations ordinance increasing appropriations by $30,215 in General Fund 01, Health Department Services Account No. 50-15-02 and decreasing the General Fund 01 unreserved, undesignated fund balance by the same amount. Background Last year, the presentation of the proposed budget for the Department of Public Health included a description of plans that were being made to initiate Medicaid activities in the Maternal/Child Health Clinics. These activities focused on initiating the Medicaid Maternity Clinic Services program, which offers antepartum and postpartum care to eligible clients and the Medicaid (EPSDT) program which offers medical screening for children. Progress made in program implementation is outlined below 1. Medicaid provider numbers have been issued to the Maternity/Child Health Clinics for both the EPSDT and Maternity Service program. 2. North Tri-Ethnic Clinic was selected for the Medicaid pilot program and staff in the clinic have been trained in procedures to follow in the rviedicaid program. sue~ECr IMPLEMENTATION OF MEDICAID PROGRAM 3. A fee schedule which is listed below has been proposed for use in the clinics. Included as a part of the fee schedule is the recommendation that the classification guidelines followed by Tarrant County Hospital District for Medicaid activities be adopted by the Public Health Department. No client will be denied services due to inability to pay. Maternal/Child Health Proposed Fee Schedule Adult routine clinic visit $20.00 Child routine clinic visit $30.00 Sickledex $ 2.00 Lead blood levels $ 4.00 Urine C&S $ 3.00 VDRL (other than maternity) $ 5.00 Rubella (other than maternity) $ 4.00 Non-Stress Test $20.00 Sonogram $25.00 RHPGAM $ 4.00 3 hr. Postprandial $20.00 50 gram Glucola $10.00 HCT $ 2.00 Pregnancy test $ 2.00 MSAFP Referral Prenatal Vitamins $ 5.00 Immunizations (per person) $ 4.00 Day Care Physicals $30.00 Birth Control $ 4.00 Maternal/Child Health Proposed Fee Schedule Cont'd Condoms (36) $ 4.00 Condoms (refill of 12) $ 2.00 Foam Kit $ 4.00 Foam Refill $ 1.00 Diaphragm $ 4.00 Diaphragm jelly $ 1.00 Introducer for Diaphragm $ 1.00 Ampicillin $ 5.00 Enrollment in the Medicaid Program will enhance access to other health care services. For example, Medicaid EPSDT Program benefits now require Medicaid Programs to pay for health care services that are needed to treat illness or conditions discovered during routine screening visits, even if those services are not generally covered by the Medicaid Program. In addition, participation in Medicaid can now be used as proof of financial eligibility for the Womens, Infants and Children food supplement program. ,~ ,-.~ . ;, ~, ;,y , A supplemental appropriation of $30,215 is required to cover the start up cost of implementing thw Medicaid Program in the 6 clinics in the final five months of the current fiscal year. ~...,~ >~-~ -SUBJECT IMPLEMENTATION OF MEDICAID PROGRAM Funds requested will be allocated as shown below. Personnel $12,475 Fringe Benefits 2,037 Insurance 4,436 Contractual 8,245 Equipment 2,537 Supplies 485 $30,215 Projected annual costs for program operation in FY 90-91 are shown below Personnel $ 42,552 Fringe Benefits 6,952 Insurance 8,592 Contractual 73.790 $131,886 The funding proposed assumes existing staff will assist in initial screening of clients. If existing staff did not participate in the screening and referral process, an additional Clerk II would be required in each clinic. The cost of that additional clerical position for one clinic is $17,536; for six clinics the cost would be $105,216. Increased costs cover time-sharing staff from the Texas Department of support to handle the paperwork. costs for processing claims, increased Human Services and additional clerical Annual revenue from Medicaid visits is projected to be $354,750. This projection is based on estimated client visits and the assumption that 50% of the client visits will qualify as Medicaid visits. Attendance/Womens Clinic 21,000 visitssx;;50%~~Medicaid = Attendance/Pedia'trics 18,500 x 50% Medicaid = 9,250 x 10,500 x $10 visit = $105,000 $27 visit = $249,750 * *' ra :. The program related income policy will be followed for revenue collected at the clinics, 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 government approves, or c) deducted from the federal/state contribution. To determine the state share of program related income, the percentage of state contribution to the total program funding for maternal child health clinics for each fiscal year is calculated. For FY 1989-90, the Texas Department of Health's contribution is $643,876; the City of Fort Worth's contribution is $1,657,361. Therefore, the state share of program related income generated by Medicaid reimbursements and client fees is 28°~. DAVE REFERENCE suB~ECr IMPLEMENTATION OF NUMBER MEDICAID PROGRAM 5-29-90 G-8641 PAGE 4 ~f 4- Recommendation 4) will establish a separate account in Special Revenue Fund 03 to record the proportionate state share of program related revenue wh,ch w,ll be reserved for reinvestment into the Medicaid Program as outlined in the Texas Department of Health Local Health Services Contract. To remain consistent with City financ,al policy, all transfers from SPec,al Revenue Fund 03 to General Fund 01 will require C,ty 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, a M&C will be submitted for City Council approval. All expenses w,ll be charged to the General Fund. FINANCING: Upon adoption of recommendation 4), a project account will be established in Special Revenue Fund 03 to record the proportionate state share of program-related revenue reserved for reinvestment ,nto the Med,ca,d Program. Upon adoption of the attached supplemental appropriations ordinance, sufficient funds will Abe available in General Fund 01, Health Department, Health Services Account No. 50-15-02 for partici;pat,on in the programs outlined above. Expenditures will be in various index codes. The unreserved, undesignated fund balance ~in General Fund 01 will be $26,318,921 after this supplemental appropriation. RG.~k/6 APPROVED BY CITY COUNCIL MAY ~y 1990 ~~ City Se+c[+RcuY of the Cite of Fort Womb. Texan SUBMITTED FOR THE CITY MANAGER'S OFFICE BV Ramon G ORIGINATING DEPARTMENT HEAD NICK CU/'r FOR ADDITIONAL INFORMATION CONTACT Letha A DISPOSITION BY COUNCIL. 6191 [] APPROVED OTHER (DESCRIBE) 7204 7202 PROCESSED BY CITY SECRETARY DATE ' ~~ ,.. ., r':;~ ~', r