Tuesday, March 20, 2018

City Stumbles Over Increasing Nursing Fees

Staff stated the clear need for the city to recover the full cost of lab testing in proposing increased fees to City Council.  Finance Director Tina Diershke implied federal grant funds could not be used to subsidize lab testing for patients needing affordable access to healthcare with her statement.

“1115 Waiver grant is for costs associated with operating and maintaining the clinic”
City Council heard in its application for Section 1115 Waiver grant funding in December 2012:

Council must have been confused after learning the City did not need to charge every patient a price to cover city costs.  Health Department Director Sandra Villareal said the city needed to offer free testing to meet goals under the Section 1115 Waiver grant.

Tina and Sandra gave two very different descriptions of how the new testing fee would work.  It took Council time to discern who was correct.  Staff's explanation of testing charges went as poorly as the city's need to charge/not charge presentation.

There was no crisis for City Council to approve new nursing fees which likely will result in a miniscule incremental revenue for the city.  City Council could have sent staff back to rework the item.  Instead they voted unanimously to approve new testing fees for an area accounting documents show had nearly $700,000 in excess revenue over expenses for the last five years.

There appears to be a low bar for staff to hurdle for Council approval for price increases in an area where the state and federal government provide grants for citizens to obtain affordable access to care.

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