ComplaintsforHamilton Family Health Team

• Initial Complaint

  11/03/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I am required to get a 2 step TB test to do the Personal Support Worker course. I was told to call the Hamilton Family Health Team to book an appointment but there shouldn't be a charge because it is required for an educational program. I looked up this information online afterwards which I came across the exact same thing, published by Health Services Branch stating "the patient cannot be charged when it is required as evidence of immunization for admission in a school, college, university or other educational program, including a work placement that the program may require" but Hamilton Family Health is charging a $40 "service fee" for a 2 step TB even though they technically cannot charge a patient when it is required for school. When I made my appointment on the phone yesterday, the receptionist told me "it is a service fee and cannot be waived".

  Business response

  22/03/2022

  Business Response /* (1000, 5, 2022/03/18) */ I am happy to respond to the concern raised and further would welcome direct communication with the complainant if so desired. By way of explanation and historical context Tuberculosis Skin Testing is undertaken in Primary Care for several reasons, some of those include: a condition of employment or volunteering, entrance to educational programs, entrance to LTC, or for medically necessary reasons. Some of these reasons for testing result in OHIP insured Testing and some are not OHIP insured as the complainant alluded to. Prior to 2016 all TB testing was OHIP insured, Public Health provided all of the serum for this testing free of charge, and the testing was predominantly completed in family physicians offices as a routine component of care. In 2016 Public Health stopped providing TB serum free of charge for all reasons for testing except medically necessary and entrance to LTC. Family practices were then required to purchase costly vials of serum for this purpose but because the vials are 10 dose vials it resulted in significant waste. Most family physicians fully stopped doing TB testing at that point in time. In 2017 the rules changed again and family physicians can request the serum from Public health for those entering school and LTC. But they need to fill out an individual request per person, submit the request, wait for delivery and then arrange the testing with the patient. For other reasons for testing they are still required to purchase the serum independently. This again results in considerable waste and inefficiency. For OHIP eligible testing physicians can bill OHIP for this service and the fee covers their time and supplies. Given the initial change in 2016 the HFHT, working with partners, established the community clinic to service all of Hamilton and provide access to TB Screening, filling the gap in family practice. We however cannot Bill OHIP for the service and have no way of covering the cost of staff time, supplies, disposal fees, and overhead. It is for this reason that we have a service charge. As a non-profit organization we do our best to keep this fee minimal and on a cost recovery basis. The fee does not cover the serum itself or the reporting. We continue to encourage family physicians to follow the Public Health process and access TB serum for screening that is OHIP covered but as you can appreciate, small, single physician practices would frequently result in waste of 8 doses which is not palatable from a system and cost perspective. We also advocate for changes in entrance requirements etc to remove the requirement for TB testing as more recent research points to its limited value. In the meantime we are committed to continuing to offer this service to our community ensuring that testing is accessible to all. Consumer Response /* (2000, 7, 2022/03/21) */ (The consumer indicated he/she ACCEPTED the response from the business.)

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