Agenda 01/22/2013 Item #16D6 1/22/2013 Item 16.D.6.
EXECUTIVE SUMMARY
Recommendation to approve a resolution superseding Resolution No. 2004-66 and all prior rate
resolutions and schedules for the Collier County Health Department allowing the Collier County
Health Department to establish the proposed Fee Schedule.
OBJECTIVE: To establish an updated Collier County Health Department Fee Schedule
CONSIDERATIONS: On March 9, 2004, agenda item 16.D.1, the Board of County Commissioners
established resolution 2004-66, which under Section 154.06 of the Florida Statutes allows County Health
Departments to establish fee schedules for services rendered through its department.
The current fee schedule was last updated and approved by the BCC on May 26, 2006 as item 16.D.1.
The proposed fee schedule is being submitted for approval to reflect new services and fee adjustments.
The proposed fee schedule is incorporated into the proposed resolution and shows the current fee,
proposed fee and the change, if any. The proposed fee schedule incorporates 55 new fees primarily for
additional dental procedures, decreases fees for four vaccines, and increases nine fees for vaccines, dental
procedures, and phlebotomy.
Additionally, the proposed fee schedule adds fee flexibility in setting vaccine fees as the cost of some
vaccines vary widely and is often dependent on supply.
The fee schedule is used for self-pay patients and for those patients who qualify for use of a sliding fee
scale based on their income level. No patient is denied essential public health services due to their
inability to pay.
Funds collected under this section shall be expended solely for the purpose of providing public health
services within Collier County.
FISCAL IMPACT: Service fees comprise approximately 27% of the Collier County Health Department
budget and are an essential component of program sustainability.
LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board
action—JBW
GROWTH MANAGEMENT IMPACT: There is no Growth Management Plan impact associated with
this item.
RECOMMENDATION: That the Board approves the attached proposed Resolution and Fee Schedule
for the Collier County Department of Health.
Prepared By: Alan Portis, Collier County Health Department
Packet Page -1336-
1/22/2013 Item 16.D.6.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.6.
Item Summary: Recommendation to approve a resolution superseding Resolution No.
2004-66 and all prior rate resolutions and schedules for the Collier County Health Department
allowing the Collier County Health Department to establish the proposed Fee Schedule.
Meeting Date: 1/22/2013
Prepared By
Name: AlonsoHailey
Title: Operations Analyst,Public Service Division
1/8/2013 2:25:02 PM
Approved By
Name: AlonsoHailey
Title: Operations Analyst,Public Service Division
Date: 1/8/2013 2:59:26 PM
Name: CarnellSteve
Title: Director-Purchasing/General Services,Purchasing
Date: 1/8/2013 3:22:34 PM
Name: WhiteJennifer
Title: Assistant County Attorney,County Attorney
Date: 1/9/2013 10:20:48 AM
Name: FinnEd
Title: Senior Budget Analyst, OMB
Date: 1/10/2013 4:11:17 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 1/11/2013 11:36:25 AM
Name: OchsLeo
Title: County Manager
Date: 1/11/2013 3:07:23 PM
Packet Page-1337-
1/22/2013 Item 16.D.6.
Packet Page -1338-
1/22/2013 Item 16.D.6.
RESOLUTION NO. 2013-
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, SUPERSEDING RESOLUTION NO.
2004-66 AND ALL PRIOR RATE RESOLUTIONS AND SCHEDULES
FOR THE DEPARTMENT OF HEALTH AND ESTABLISHING THE
FEES, RATES AND CHARGES FOR SERVICES RENDERED BY THE
COUNTY HEALTH DEPARTMENT.
WHEREAS, under the Florida
h
Department of Health may establ>. fee schedul s for public health servic srendered through the
Health Department.
WHEREAS, said statutory authority grants the Department of Health the power to
assess fees,co-payments, sliding fee scales, fee waivers and fee exemptions.
WHEREAS, the funds collected under Section 154.06 of the Florida Statutes shall be
expended solely for the purpose of providing health services and facilities within the county
served by the county health department. Fees collected by the county health department pursuant
to department rules shall be deposited with the Chief Financial Officer and credited to the
County Health Department Trust Fund.
WHEREAS, the fees collected by the county health department for public health
services or personal health services shall be allocated to the state and the county based upon the
pro rata share of funding for each service.
WHEREAS, the Board of County Commissioners, shall provide for the transmittal of
funds collected for its pro rate share of personal health services or primary care services rendered
under the provisions of this section to the State Treasury for credit to the County Health
Department Trust Fund, but in any events the proceeds from such fees may only be used to fund
county health department services.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY,FLORIDA,that:
Section 1. Resolution No. 2004-66 and all prior rate resolutions and fee schedules for the
Department of Health are hereby superseded in their entirety.
Section 2. The schedule of rates, changes and fees set forth are attached and made an
• integral component of this Resolution.
Section 3. The effective date of this Resolution shall be January 22,2013.
This Resolution adopted after motion, second and majority vote favoring same this 22nd day of
January, 2013.
2013 Resolution—Rates and Charges for Department of Health
Packet Page -1339-
1/22/2013 Item 16.D.6.
AOC
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
By By
,DEPUTY CLERK GEORGIA A. HILLER ESQ.
CHAIRWOMAN
Approved as to form
and legal sufficiency:
Jennifer B. White
Assistant County Attorney
2013 Resolution—Rates and Charges for Department of Health
Packet Page-1340-
1/22/2013 Item 16.D.6.
COLLIER COUNTY HEALTH DEPARTMENT - FEE SCHEDULE
This fee schedule is established as authorized by Florida Statutes Section 154.06. All funds collected shall be
expended soley for the purpose of providing public health services within Collier County.
Financial Eligibility: Shall be determined for all clients receiving personal health services for which a sliding fee
is to be charged, and shall be re-determined a minimum of once a year or shorter if income or family size
changes. Clients that waive the financial eligibility determination shall be assigned to the full fee category and
attest to their decision by signing the HMS generated fact sheet.
Clients will not be charged in the following circumstances:
(1) Clients enrolled in Medicaid, however charges may apply for non-covered services. (2) Childhood
immunizations required for school (pre-K- 12th). Third party payers shall be billed an administration (injection)
fee. (3) Anonymous HIV testing if there is an inability to pay. (4) No charge to a minor's parent(s) if the minor is
without parental consent, has no income and is receiving STD or HIV services. (5) Clients that are part of a
contact or at-risk group related to the investigation of a communicable disease. Charges may apply for any
subsequent clinical examination and treatment.
Note: Patients may not be denied the following services due to their failure or inability to pay: communicable
disease services, TB, STD, H1V/AIDS communicable disease control services. •
MEDICAL VISITS
Fees are based on 150%of the current Medicare fee schedule.
Diaq Code Description of Service Current Fee Proposed Fee Change
99201 New Prob Focused 50.00 50.00 0.00
99202 New Expanded Prob Focused 75.00 NEW
99203 New Detailed Low 120.00 NEW
99204 New Comp Moderate 175.00 NEW
99205 New Comp High 200.00 NEW
99211 Min Visit MD 40.00 40.00 0.00
99212 Est Prob Focused 50.00 50.00 0.00
99212-STD Est Prob Focused-STD 50.00 50.00 0.00
99213 Est Expanded Prob Focused 75.00 NEW
99214 Est Detailed Visit 120.00 NEW
99215 Est Comp Visit 160.00 NEW
99499 Physical Exam Alone, no other tests(Employment, College) 50.00 50.00 0.00
IMMPE Immigration PE(Adult)with CXR, PPD, RPR, HIV 175.00 175.00 0.00
IMMPE Immigration PE(Child) 115.00 115.00 0.00
ANCILLARY MEDICAL SERVICES
*X-Ray fees are contracted services and may increase or decrease without notice.
Diaq Code Description of Service Current Fee Proposed Fee
36415 Venous Blood Draw 5.00 10.00 5.00
46924 TCA Anal (per treatment) 50.00 50.00 0.00
54065 TCA Male (per treatment) 50.00 50.00 0.00,
56501 TCA Female(per treatment) 50.00 50.00 0.00
710XX Chest X-Rays' -Single(1)View 30.00 0.00
-Two(2)View 40.00 0.00
86580 PPD Placement and reading 20.00 20.00 0.00
86703 HIV Testing 20.00 20.00 0.00
1693 MD Completion of 1-693 INS Immigration Form 30.00 30.00 0.00
Packet Page -1341-
1/22/2013 Item 16.D.6.
VACCINATIONS
Vaccine fees are based on the current cost of the vaccine and may increase or decrease without notice. An
administration (injection)fee is applied to all vaccines given.
Diaq Code Description of Service Current Fee Proposed Fee
90471 Immunization Administration 20.00 `'NEW'
90472 Immunization Administration Each Additional Vaccine 5.00 !'NEW;
90632 IM HEP A,Adult Intramuscular 50.00 30.00 (21100)
90636 IM HEPA-HEPB Vaccine 50.00 55.00 5.00,
90649 HPV Vaccine 130.00 NEW
90658 IM Influenza Vaccine 25.00 15.00 4410.00}`
90675 Rabies Vaccine, Intramuscular Pre/Intramuscular Post 150.00 205 00 55.00 a
90707 IM MMR Vaccine 60.00 55.00' -1 00)'
90716 Varicella Vaccine 75.00 90.00 15.00
90718 TDAP Vaccine 35.00 =-NEW.
90718 IM TD or Tetnus Vaccine 25.00 25.00 0.00
90736 IM Zostavax Vaccine 160.00 NEW
90732 IM Pneumonia Vaccine 35.00 60.00 25.00
90744 IM HEP B Vaccine 75.00 35.00 140.00)
DENTAL SERVICES
Dental fees are based on the 2007 Survey of Fees conducted by the American Dental Association (ADA) for the
South Atlantic Region.
Diaq Code Description of Service Current Fee Proposed Fee
D0120 Periodic oral evaluation-established patient 33.00 35.00 2.00
D0140 Limited oral evaluation-problem focused 50.00 50.00 0.00
D0145 Oral evaluation for a patient under three years of age and counseling 40.00 NEW
D0150 Comprehensive oral evaluation-new or established patient 58.00 58.00 0.00
D0210 Intraoral-complete series(including bitewings) 93.00 93.00 0.00
D0220 Intraoral-periapical first film 20.00 20.00 -` 0.00
D0230 Intraoral-periapical each additional film 16.00 16.00 0.00
D0240 Intraoral-occlusal film 29.00 29.00 0.00
D0270 Bitewing-single film 16.00 16.00 _y- 0.00
D0272 Bitewings-two films 32.00 32.00 0.00
D0273 Bitewings-three films 40.00 NEW
D0274 Bitewings-four films 45.00 45.00 0.00
D0277 Vertical bitewings-7 to 8 films 74.00 NEW
D0330 Panoramic film 82.00 82.00 0.00
D0350 Oral/facial photographic images 35.00 NEW
D0460 Pulp vitality tests 20.00 NEW
D0470 Diagnostic casts 75.00 75.00 0.00
PREVENTIVE
D1110 Prophylaxis-adult 64.00 64.00 0.00
D1120 Prophylaxis-child 48.00 48.00 0.00
D1203 Topical application of fluoride-child 27.00 27.00 0.00
D1204 Topical application of fluoride-adult 27.00 27.00 0.00
D1206 Topical fluoride varnish;therapeutic application for moderate to high 30.00 30.00 0.00
D1330 Oral Hygiene Instructions 37.00 37.00 0.00
D1351 Sealant-per tooth 39.00 39.00 0.00
D1510 Space maintainer-fixed-unilateral 233.00 233.00 0.00
D1515 Space maintainer-fixed-bilateral 335.00 335.00 0.00
Packet Page -1342-
1/22/2013 Item 16.D.6.
01550 Re cementation of space maintainer 59.00 59.00 . fl 00
D1555 Removal of fixed space maintainer 74 00 ,� NEW
RESTORATIVE
D2140 Amalgam-one surface, primary or permanent 91.00 91.00' } 0,00
D2150 Amalgam-two surfaces,primary or permanent 117.00 117.00 €r'- 0.00
D2160 Amalgam-three surfaces, primary or permanent 140.00 140.00.T^'"; O.00
D2161 Amalgam-four or more surfaces, primary or permanent
171.00 171.00 Nr e#O0s`.
D2330 Resin-based composite-one surface, anterior 85.00 90-00 ii**9.0g
m
D2331 Resin-based composite-two surfaces, anterior 139.00 139.00 f-:: O'90 l
4
D2332 Resin-based composite-three surfaces,anterior 171.00 171.00��:, .0
D2335 Resin-based composite-four or more surfaces or involving incisal 211.00 211.00 400.0,09#
,1
D2390 Resin-based composite crown,anterior 227.00 227.00 M . ,D0.
D2391 Resin-based composite-one surface, posterior 123.00 123.00 044.0t4
D2392 Resin-based composite-two surfaces, posterior 164.00 164.00 a0 PD i
D2393 Resin-based composite-three surfaces,posterior 204.00 204.00 OitI
02394 Resin-based composite-four or more surfaces, posterior 232.00 232.00 :{r 00
D2740 Crown-porcelain/ceramic substrate 800.00 050410A6
D2750 Crown-porcelain fused to high noble metal 886.00 a�a ;n1EU11
D2752 Crown-porcelain fused to noble metal 854.00 ,# JEW
D2790 Crown full cast high noble metal • 900 00 NEW;
D2792 Crown-full cast noble metal 890.00 ._� 11ZIE,YV
D2799 Provisional crown
250.00 250.00 i�`+`+0 40; .
02915 Recement cast or prefabricated post and core 99.00 :` uNEW
D2920 Recement crown 77.00 77 00 0yt00
D2930 Prefabricated stainless steel crown-primary tooth 197.00 197.00 g ll- 100;~
246.00 246 00 '- 0f00?
D2931 Prefabricated stainless steel crown permanent tooth :
D2932 Prefabricated resin crown 246.00 :: NEW
D2940 Protective restoration 80.00 80.00 E 101130;
D2950 Core buildup,including any pins 180.00 180.00 ti, -0.00
D2952 Post and core in addition to crown, indirectly fabricated 290.00 irotop ,
D2954 Prefabricated post and core in addition to crown 230.00 230.00 tft.i.4017.103.
D2962 Labial veneer(porcelain laminate)-laboratory 887.00 NEW
D2970 Temporary crown(fractured tooth) 250.00 250.00 to 00
ENDODONTICS
D3110 Pulp cap direct(excluding final restoration) 56.00 56 00A(F40 00
D3120 Pulp cap-indirect(excluding final restoration) 54.00 54.00 1 0j00
03220 Therapeutic pulpotomy(excluding final restoration)-removal of pulp 138.00 138.00 00.101DA
lipowom
application of medicament I
D3221 Pulpal debridement, primary and permanent teeth 146.00 146.00 r 000
03230 Pulpal therapy(resorbable filling)-anterior,primary tooth (Excluding 185.00 185.00 0 00
D3240 Pulpal therapy(resorbable filling)-posterior, primary tooth(excluding 209.00 209.00 ,0`00
D3310 Endodontic therapy, anterior tooth (excluding final restoration) 571.00 571.00 , 0 00
03320 Endodontic therapy, bicuspid tooth(excluding final restoration) 665.00 665.00 0 00
D3330 Endodontic therapy, molar(excluding final restoration) 807.00 807.00 Gligni51061
D3346 Retreatment of previous root canal therapy-anterior 625.00 625.00 03)0
PERIODONTICS
D4211 Gingivectomy or gingivoplasty-one to three contiguous teeth or tooth 160.00 160.00 � 0 00-
D4249 Clinical crown lengthening hard tissue 570.00 NEW
D4321 Provisional splinting-extracoronal 350.00 NEW
D4341 Periodontal scaling and root planing-four or more teeth per quadrant 187.00 187.00 0 00
D4342 Periodontal scaling and root planing-one to three teeth per quadrant 130.00 130.00 0 00
D4355 Full mouth debridement to enable comprehensive evaluation and 132.00 132.00 0 00
D4381 Localized delivery of antimicrobial agents via a controlled release 40.00 40.00 0 00
D4910 Periodontal maintenance 100.00 100.00 0 00
PROSTHODONTICS, REMOVABLE
Packet Page-1343-
1/22/2013 Item 16.D.6.
D5110 Complete denture-maxillary 1,200.00 1,200 00 0.-00 :
05120 Complete denture mandibular 1,200.00 1,200 00 . o `OD
05130 Immediate denture maxillary 1,200.00 1,200 00 -:030 '
05140 Immediate denture mandibular 1,200.00 1,200.00 024$00()
D5211 Maxillary partial denture-resin base(including any conventional 880.00 880.00 "00
D5212 Mandibular partial denture-resin base(including any conventional 880.00 880.00:3,,.T.0030
D5213 Maxillary partial denture-cast metal framework with resin denture 1,300.00 1,300 00 "Q 00j
D5214 Mandibular partial denture-cast metal framework with resin denture 1,300.00 1,30000 t 9'004
teeth)
D5225 Maxillary partial denture flexible base(including any clasps,rests 1,100.00 1,100 00}hi.01D0
D5226 Mandibular partial denture flexible base(including any clasps, rests 1,100.00 1,100 00 j 'oo
05410 Adjust complete denture-maxillary 72.00 72.00 l .go
05411 Adjust complete denture mandibular 72.00 72.00 og l0;
05421 Adjust partial denture maxillary 72.00 72.00 0O
72.00 72 00` X30
D5422 Adjust partial denture-mandibular + ,
05510 Repair broken complete denture base 167.00 167.00 IQ,00
D5520 Replace missing or broken teeth-complete denture(each tooth) 150.00 150.00 kilig011C0
D5610 Repair resin denture base 150.00 150.00 p .;Y 000
05620 Repair cast framework 238.00 238.00 r .000
05630 Repair or replace broken clasp 194.00 194.00 6,00
05640 Replace broken teeth-per tooth 125.00 125.00 00
PROSTHODONTICS,REMOVABLE
D5650 Add tooth to existing partial denture 182.00 182.00 ,k0'O
05660 Add clasp to existing partial denture 105.00 175.00 :70' 00
05730 Reline complete maxillary denture(chairside) 250.00 250.00 4'^Lµb 00
05731 Reline complete mandibular denture(chairside) 250.00 250.00 "00'
D5740 Reline maxillary partial denture(chairside) 250.00 250.00 -13°04
05741 Reline mandibular partial denture(chairside) 250.00 250.00 ''0400~;
05750 Reline complete maxillary denture(laboratory) 339.00 339.00€,. a�0 D0!
D5751 Reline complete mandibular denture(laboratory) 339.00 339.00 gtt03).0
D5760 Reline maxillary partial denture (laboratory) 339.00 339.00 0 OON
05761 Reline mandibular partial denture (laboratory) 339.00 339.00 } 130:-;
D5850 Tissue conditioning,maxillary 145.00 E41f4.
^L1 3
D5851 Tissue conditioning, mandibular 145.00 EW?
- `
PROSTHODONTICS, FIXED ss6 00 -L�EW`
06210 Pontic-cast high noble metal 860.00 s� ; [Eli'V_
06212 Pontic-cast noble metal 874 00 Y NEW
D6240 Pontic-porcelain fused to high noble metal
D6242 Pontic- porcelain fused to noble metal 870.00 VIEW:.
D6245 Pontic-porcelain/ceramic 907.00 ' NEW,
06740 Crown porcelain/ceramic 907.00 N
D6750 Crown-porcelain fused to high noble metal 886.00 NEW;
D6752 Crown-porcelain fused to noble metal 850.00 _NEW;
06790 Crown-full cast high noble metal 890.00 N NEW.
D6792 Crown-full cast noble metal 850.00 NEW:
D6930 Recement fixed partial denture 107 00 NEW;
n ;
D6970 Post and core in addition to fixed partial denture retainer, indirectly 274.00 . -NEW,
D6972 Prefabricated post and core in addition to fixed partial denture 217.00 NEW
D6973 Core build up for retainer, including any pins 180.00 1EW
D6980 Fixed partial denture repair, by report
239.00 NEW':
ORAL AND MAXILLOFACIAL SURGERY
D7111 Extraction, coronal remnants-deciduous tooth 90.00 90.00 0 00
D7140 Extraction, erupted tooth or exposed root(elevation and/or forcepts 112.00 112.00 0 04
D7210 Surgical removal of erupted tooth requiring removal of bone and/or 197.00 197.00 0 00
mucoperiosteal flap if indicated 03):0
Packet Page-1344-
1/22/2013 Item 16.D.6.
D7220 Removal of impacted tooth-soft tissue 229.00 229.00 0.00
D7230 Removal of impacted tooth-partially bony 293.00 293.00 0.00
D7250 Surgical removal of residual tooth roots(cutting procedure) 208.00 208.00 0.00
D7270 Tooth reimplantation and/or stabilization of accidentally evulsed or 374.00 374.00 0.00
D7310 Alveoloplasty in conjunction with extractions-four or more teeth or 293.00 293.00 0.00
D7311 Alveoloplasty in conjunction with extractions-one to three teeth or 229.00 229.00 0.00
D7410 Excision of benign lesion up to 1.25 cm 315.00 NEW
D7411 Excision of benign lesion greater than 1.25 cm 535.00 . NEW
D7510 Incision and drainage of abscess-intraoral soft tissue 159.00 159.00 0.00
D7530 Removal of foreign body from mucosa, skin,or subcutaneous 246.00 NEW
D7880 Occlusal orthotic device, by report 860.00 NEW
D7960 Frenulectomy-Also known as frenectomy or frenotomy-separate 253.00 253.00 0.00
ADJUNCTIVE GENERAL SERVICES
D9110 Palliative(emergency)treatment of dental pain- minor procedure 85.00 85.00 0.00'
D9120 Fixed partial denture sectioning 75.00 NEW
D9210 Local anesthesia not in conjunction with operative or surgical 12.00 NEW
D9630 Other Drugs and Medicaments 20.00 20.00 0.00
D9910 Application of desensitizing medicament 27.00 27.00. .0.00
D9920 Behavior management, by report 85.00 85.00 0.00
D99.40 Occlusal guard, by report 420.00 NEW
D9974 Internal bleaching-per tooth 190.00 200.00 10.00
D9999 Unspecified adjunctive procedure,by Report 20.00 20.00 0.00
ENVIRONMENTAL HEALTH SERVICES
Fees for environmental health services are based on the usual and customary fee for that service.
Description of Service Current Fee Proposed Fee
FOOD
Plan Review(per hour) 50.00 50.00 0.00
GROUP
Plan Review(per hour) 50.00 50.00 0.00
Reinspection (one-time fee) 50.00 50.00 0.00
Construction Inspection (one-time fee) 50.00 50.00 0.00
Adult Family Care(annual fee) 150.00 150.00 0.00
Assisted Living Facilities(annual fee) 250.00 250.00 0.00
Residential Facilities(annual fee) 250.00 250.00 0.00
Schools>200 persons(annual fee) 500.00 500.00 0.00
Schools<200 persons(annual fee) 150.00 150.00 0.00
Other Group Facilities(annual fee) 150.00 150.00 0.00
MHP
Plan Review(per hour) 50.00 50.00 0.00
Reinspection (one-time fee) 50.00 50.00 0.00
TANNING
Plan Review(per hour) 50.00 50.00 0.00
Reinspection (one-time fee) 50.00 50.00 0.00
SWP
Reinspection routine inspections(one-time fee) 75.00 75.00 0.00
Construction Inspection (one-time fee) 100.00 100.00 0.00
Bacteriological Fee (annual fee) 250.00 250.00 0.00
Rough Plumb Inspection (one-time fee) 50.00 50.00 0.00
Renovation Inspection (one-time fee) 50.00 50.00 0.00
Exempt Pool (one-time fee) 100.00 100.00 0.00
Operator Certificate(one-time fee) 20.00 20.00 0.00
Operator Course(one-time fee) 75.00 75.00 0.00
Packet Page -1345-
1/22/2013 Item 16.D.6.
WATER
Water Letter(one-time fee) 30.00 30.00 0.00
Bacteriological Sample Non-Regulated (one-time fee) 25.00 25.00 0.00
Sample Collection Non-Regulated (one-time fee) 60.00 60.00" 0:00
Nitrate Sample Non-Regulated (one-time fee) 60.00 60.00 0.00
Bacteriological Sample Regulated (one-time fee) 15.00 15.00 0.00
Sample Collection Regulated (one-time fee) 40.00 40.00 0.00
Nitrate Sample Regulated(one-time fee) 60.00 60.00 0.00
Lead Sample(one-time fee) 30.00 30.00 0.00
Sodium Sample (one-time fee) 25.00 25.00 0.00
Chloride Sample(one-time fee) 20.00 20.00 0.00
OSTDS
Development Plan Review(one-time fee) 20.00 20.00, '.0.00
Incidental Plan Review(one-time fee) 10.00 10.00 0.00
Construction Permit Application (one-time fee) 160.00 160.00 0.00
Final Cover Inspection (one-time fee) 75.00 75.00 0.00
ATU Permit(annual fee) 150.00 150.00 0.00
PBT Permit(annual fee) 200.00 200.00 0.00
Reinspection (one-time fee) 75.00 75.00 0.00
•
Repair Permit(one-time fee) 200.00 200.00 0.00
Septic Letter(one-time fee) 30.00 30.00 0.00
ADMINISTRATIVE SERVICES
Description of Service Current Fee Proposed Fee
VITAL STATISTICS
Birth Certificate(1st Copy) 10.00 10.00 0.00
Birth Certificate(each additional copy) 6.00 6.00 0.00
Death Certificate 8.00 8.00 0.00
MISC FEES
Emergency Management Plan Review(CEMP)- Initial 48.00 NEW
Emergency Management Plan Review(CEMP)-Update/Renewal 24.00 NEW
Duplication (.25 per page for first 25 copies) 0.25 0.25 0.00
Duplication ($1.00 per page after the first 25 copies) 1.00 1.00 0.00
Returned Check 25.00 25.00 0.00
omok-
Packet Page -1346-