Sponsor: Public Health
Title
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Proposed Changes and Additions to Public Health Fees
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Recommendation
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Approve proposed changes and additions to Public Health fees for client services, vaccines, medications and individual and group education.
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Background and Rationale
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Saint Paul - Ramsey County Public Health provides client services related to Tuberculosis Control, Sexual Health and Immunizations, in addition to family home visiting services in Family Health. Fees for services are established based on the cost of the services provided and standard reimbursement rates. Billing is conducted to collect fees from health insurance companies for clients who are insured and from clients who are responsible for payment, often based on a sliding fee scale in accordance with the federal poverty guidelines. Approved fees are adjusted when the cost of drugs, vaccines, medications or lab equipment and supplies are changed by the manufacturer or supplier. New fees are added as vaccines or medications change and as new services are made available. Fee changes and the need for new fees may occur at any time throughout the year.
The County Manager has authority to provisionally approve Public Health fees with county board approval to be obtained within 120 days. On February 13, 2025, the County Manager provisionally approved updates to the Public Health fee schedule for client care, laboratory services, vaccines, medications and individual and group education. Public Health is requesting approval of these changed and additional fees. The proposed fee changes and additions reflect the cost of services and allow the county to obtain reimbursement for services provided.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☒ Accountability
Racial Equity Impact
Approximately 80% of the client visits to Public Health clinical programs are from racially and ethnically diverse communities. Of the total clinical services population, approximately 11% of clients are self-pay status, meaning they are uninsured and pay out of pocket for the services received. Clients are on a sliding fee scale and are charged based on their ability to pay. Pricing of services, testing and medications are set at an appropriate level to ensure that clients are not overcharged for services received.
Community Participation Level and Impact
The proposed fee changes reflect Public Health’s commitment to treat clients fairly and accurately charge for the services provided to the community. Public Health presents suggested fee changes to the Community Health Services Advisory Committee (CHSAC). The CHSAC is a joint committee, which consists of county and city residents that advises the department and elected officials on issues related to public health.
☒ Inform ☐ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
Based on the magnitude and frequency of the charges, the proposed changes in fee structure are expected to be relatively revenue neutral with limited budget impact. If Public Health has an overall excess in revenue, additional funds go back to the General Fund. If there is a decrease in revenue, Public Health will reduce expenses in other areas to cover the expenses.
Last Previous Action
On December 12, 2023, the Ramsey County Board of Commissioners authorized the County Manager to provisionally approve Public Health fees until County Board approval is obtained within 120 days (B2023-239).
Attachments
1. Fee Schedule