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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
MICHIGAN: Jackson County Health Department Proposes STD Walk-In Clinic Fee, $100,000 Over Budget
Lisa Satayut
March 11, 2013
MLIve Michigan (03.10.13)

The Jackson County Health Department in Jackson, Mich., may begin charging a fee for walk-in services at its STD clinic. The Jackson County Board of Commissioners’ Human Services Committee was expected to discuss this issue at its March 11 meeting. Director for Personal and Preventative Health Services Mary Ricciardello noted that Jackson County has not charged clinic users since 2003, when the Family Planning Clinic closed. The board is proposing fees of $10 for county residents and $20 for non-county residents. For the past four years, the clinic has averaged 1,805 clients per year, with a budgeted program revenue of $76,994; however, the cost of running the clinic is $178,638. Jackson County is one of a few Michigan counties providing these services for free. Thus, the county has seen an increase in out-of-state and non-county residents using their services, averaging approximately 10 clients a month from surrounding counties and three per month from out-of-state clients. The county averages $56 for females and $36 for males for STD testing—for laboratory costs only. These costs do not include nursing care costs. Ricciardello pointed out that nurses test, counsel, and treat clients; prepare specimens; complete all necessary paperwork; perform data entry for electronic medical records; inform clients of test results; and notify partners of positive clients. Ricciardello explained that, since the nursing services are not provided by physicians or nurse practitioners, the county can only bill Medicaid for laboratory testing, and not bill for the many other nurse-provided services. She noted that the clinic asks patients for monetary donations, but rarely receives any. The Jackson County Health Department offers chlamydia, syphilis, gonorrhea, bacterial vaginosis, and pregnancy and HIV testing. The fee proposal would help balance a small part of the costs and act as a deterrent to out-of state/county residents. The full board of commissioners would need to vote on this proposal for it to take effect. If approved at the April board meeting, the fees would begin on May 1.