DATE:

 

12/02/2002

SUBJECT:  FINAL READING ORDINANCE NO. 2002-O-304

Amending Section 1 of ordinance No. 93-O-128, modifying the sliding fee scale and implementing a co-pay for clinic health services provided at the Maternal and Child Health (M&CH) Program of the City of Laredo Health Department; and, exempting persons that are indigent; and, appropriating revenues to the M&CH Program as per Texas Department of Health’s program income guidelines.  Federal and State regulations remain unchanged for services provided by this program.

INITIATED BY:                                                           STAFF SOURCE:               

Cynthia Collazo                                                              Hector F. Gonzalez, M.D., M.P.H.

Asst. City Manager                                                         Health Director

PREVIOUS COUNCIL ACTION:   On November 18, 2002, Council held public hearing introducing ordinance and instructed staff to proceed with final reading.

BACKGROUND:

 

The Maternal and Child Health (M&CH) Program of the City of Laredo Health Department provides comprehensive maternal and child health services which include:  pre-natal care, post-partum care, family planning, and child health services.

 

A sliding fee scale based on the federal poverty income guidelines is to be used to determine the fee to be charged for services for those clients not eligible for Medicaid including Title V, private insurance and self-pay.  A client; however, shall not be denied services due to inability to pay.

 

All revenues collected from the delivery of these services will be identified and reported as program income, and expended in accordance with contract provisions of the Texas Department of Health.

 

SLIDING FEE SCALE

% OF POVERTY INCOME

 

FAMILY SIZE

% OF CHARGES

CO-PAY PRESCRIPTION MEDICATION

CO-PAY OVER THE COUNTER

TO BE PAID BY CLIENT

CO-PAY VISIT

0-185%

1-8

0%

$0

$10

$5

186-199%

1-8

25%

$10

$10

$5

200-249%

1-8

50%

$10

$10

$5

250-299%

1-8

75%

$10

$10

$5

>300%

1-8

100%

$10

$10

$5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FINANCIAL:   Revenues to be collected on an annual basis are approximately $50,000 and are to be allocated as per TDH program income guidelines and appropriated on a quarterly basis to   the M&CH Program, expense account #226-6079 and revenue line item # 226-0000-355-4080.

RECOMMENDATION:

STAFF:  Recommends that Council approve ordinance.

 

 

ORDINANCE 2002-0-304

 

AMENDING SECTION 1 OF ORDINANCE NO. 93-O-128, MODIFYING THE SLIDING FEE SCALE AND IMPLEMENTING A CO-PAY FOR CLINIC HEALTH SERVICES PROVIDED AT THE MATERNAL AND CHILD HEALTH (M&CH) PROGRAM OF THE CITY OF LAREDO HEALTH DEPARTMENT; AND, EXEMPTING PERSONS THAT ARE INDIGENT; AND,  APPROPRIATING REVENUES TO THE M&CH PROGRAM AS PER TEXAS DEPARTMENT OF HEALTH’S PROGRAM INCOME GUIDELINES.  FEDERAL AND STATE REGULATIONS REMAIN UNCHANGED FOR SERVICES PROVIDED BY THIS PROGRAM.

 

                WHEREAS,          the Maternal and Child Health (M&CH) Program of the City of Laredo Health Department provides prenatal care, post partum care, family planning and well child services; and,

 

                WHEREAS, the Health Director of the Health Department recommends that the   fee schedule and sliding fee scale be modified to include a co-pay; and,

 

WHEREAS, a client shall not be denied services due to inability to pay.

 

                NOW THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF LAREDO THAT:

 

Section 1:              The Health Director of the City of Laredo Health Department is hereby authorized to modify the sliding fee scale and implement a co-pay for services provided at the Maternal and Child Health Program:

 

FEE SCHEDULE

CODES

DESCRIPTION OF SERVICES

 

CHARGES

101

Office Visit

10 Min.

$35.00

 

99202

Office Visit Expanded

20 Min

$53.00

 

99203

Office Visit Detailed

30 Min.

$71.00

 

99204

Office Visit Comprehensive

45 Min.

$104.00

 

99205

Office Visit Comprehensive

60 Min.

$130.00

 

84703

Pregnancy Test, qualitative

 

$10.00

 

35415

Routine venipuncture, collection

 

$5.00

 

 

of specimen

 

 

 

 

 

 

 

 

ESTABLISHED PATIENT

99311

Office Visit

5 Min.

$20.00

 

99212

Office Visit Focused

10 Min.

$30.00

 

99213

Office Visit Expanded

15 Min.

$40.00

 

99214

Office Visit Detailed

25 Min.

$61.00

 

99215

Office Visit Comprehensive

40 Min.

$94.00

 

 

 

 

 

 

NEW OR ESTALBLISHED PATIENT

99241

CONSULTATION Focused

15 Min.

$52.00

 

99242

Consultation Expanded

30 Min.

$81.00

 

99243

Consultation Detailed

40 Min.

$105.00

 

99244

Consultation Comprehensive

60 Min.

$148.00

 

99245

Consultation Comprehensive

80 Min.

$196.00

 

 

 

 

 

 

SLIDING FEE SCALE

% OF POVERTY INCOME

FAMILY SIZE

% OF CHARGES TO BE PAID BY CLIENT

0-132%

1-8

0%

133-150%

1-8

25%

151-175%

1-8

50%

176-200%

1-8

75%

>200%

1-8

100%

SLIDING FEE SCALE

 

 

 

% OF CHARGES

 

 

% OF POVERTY INCOME

FAMILIY SIZE

 

TO BE PAID BY CLIENT

 

 

CO-PAY VISIT

CO-PAY

PRESCRIPTION MEDICATION

CO-PAY

OVER THE COUNTER

0-185%

1-8

0%

$0

$10

$5

186-199%

1-8

25%

$10

$10

$5

200-249%

1-8

50%

$10

$10

$5

250-299%

1-8

75%

$10

$10

$5

>300%

1-8

100%

$10

$10

$5

Section 2.        A client shall not be denied services due to inability to pay.

 

Section 3.              The Health Director may adjust the income limits upon which the fees are based to conform with changes in the federal poverty income guidelines.

 

Section 4.              This ordinance does not and is not intended to exempt, change or modify the terms of any governing federal or state regulations which apply to the provision of said services by the Maternal and Child Health Program of the City of Laredo Health Department.

 

PASSED BY THE CITY COUNCIL AND APPROVED BY THE MAYOR

 

ON THIS _________________ DAY OF ________________________,  2002.

 

 

 

 

 

______________________

ELIZABETH G. FLORES

MAYOR

 

 

 

ATTEST:

 

______________________

GUSTAVO GUEVARA, JR.

CITY SECRETARY

 

 

 

APPROVED AS TO FORM:

 

______________________

JAIME FLORES

CITY ATTORNEY