AGENDA INFORMATION FORM.DOC

Maricopa County — Formal (2011-06-22)

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Agenda Item Id:
Item Title
INCREASE TO ARIZONA VITAL RECORDS FEE SCHEDULE
C Number: C-86-11-081-M-00
Action Requested:
Pursuant to ARS §11-251.08, set a public hearing for 9:00 a.m., Wednesday, June 8, 2011 to authorize
and approve Department of Public Health to increase the existing fee schedule for Maricopa County
through its Department of Public Health’s (MCDPH) Vital Records product/fee list. The fee increases will
affect the fees charged for Arizona vital records. The proposed fee increases are attributed to an
anticipated fee increase to be adopted by Arizona Department of Health Services (ADHS).
Use of the fee schedule will be based on the following Board of Health recommendation. According to
A.R.S. 36-341 (A), a Local Registrar (County Health Officer) may establish their own fees to be charged
for services provided by Vital Records. The fee schedule is as follows:
State Approved Surcharges to County Vital Records Offices as of July 01, 2011:
Record Type Approved Additional Approved Total
Surcharge Per Copy Surcharge Per Copy
Certified Copy $4.00 $5.00
Non-certified Copy $1.00 $1.00
The proposed MCDPH Office of Vital Registration Fee Schedule will be consistent with the new State and
County fees as of July 1, 2011.
Certified Copies: *Current County Fee **Proposed County Fee
Birth Certificate $15.00 $20.00
Establishing Paternity $25.00 $30.00
Delayed Birth Application n/a $20.00
BC Correction/Amendment $25.00 $30.00
Foreign Born Application n/a $20.00
Putative Father Registryn/a $5.00
Death Certificate $15.00 $20.00
DC Correction/Amendment $25.00 $30.00
Presumptive Death $15.00 $20.00
Fetal Death Certificate $15.00 $20.00

Certificate of Birth
Resulting in Stillbirth $15.00 $20.00
Record Search n/a $5.00
*(Includes $1.00 surcharge)
**(Includes $1.00 surcharge plus $4.00 additional State Charge)
Non Certified Copies: Current Fee Proposed Fee
Birth Non-Certified $5.00 $5.00
Death Non-Certified $5.00 $5.00
Board Required Information:
These fees were heard by the Board of Health on April 25, 2011.
Additional Information:
Pima County’s Fee Schedule has already been approved and all other Arizona Counties are anticipated
to follow and make effective.
The Office of Vital Registration issues certified and non-certified copies Arizona vital records. Arizona
vital records include birth certificates from 1950 to the present and certified copies death, fetal death,
and certificates of birth resulting in stillbirth and fetal death.
Expenditure Impact By FY:
No Impact
Item Notes:
(5/4/2011 2:42:22 PM) - Step: ClrkOfBrd
User: Juanita Garza - COBX
Response: APPROVE
(5/4/2011 11:02:30 AM) - Step: CountyAtty
User: David Benton - CAOX
Response: APPROVE
Comments:
Approved as to form
(5/3/2011 2:28:07 PM) - Step: OMB
User: LeeAnn Bohn - OMBX
Response: APPROVE
Comments:

Recommend approval.
(4/29/2011 8:18:34 AM) - Step: OMB_C1
User: Jacqueline Edwards - OMBX
Response: APPROVE
Comments:
Recommend approval.
(4/28/2011 1:41:54 PM) - Step: DepartmentChief
User: Daren K. Frank - PLANDEVX
Response: APPROVE
Comments:
ok
(4/28/2011 10:22:15 AM) - Step: DeptHead
User: Max Porter - PHSX
Response: APPROVE
(4/28/2011 9:26:00 AM) - Step: DeptCoor
User: Frances Delgado
Response: APPROVE
Comments:
All edits are complete and item is ready for approval.
(4/25/2011 8:21:11 AM) - Step: DepartmentChief
User: Suzanne Gray - PLANDEVX
Response: APPROVE
(4/22/2011 12:07:36 PM) - Step: DeptHead
User: Frances Delgado
Response: APPROVE
(4/22/2011 11:33:06 AM) - Step: DeptCoor
User: Frances Delgado
Response: APPROVE
Comments:
Please move item forward.

(4/22/2011 11:11:44 AM) - Step: Originator
User: Matt Juan - PHSX
Response: APPROVE
Is there a Financial Impact?
no
Is there related Managing for Results information?
yes
Program Activity Performance/Demand Anticipated Results
Measure
Vital Registration Birth & Death Certificate Number certificate copies 275,000 certificate copies
of birth/death certificates of birth/death certificates
requested requested
General Item Information
Department: Department of Public Health
Constellation:
Contact Name: Michele Casteneda-Martinez
Phone Number: 602 506-6345
Return To: Matt Juan
Phone Number: 602 372-0675
Location: Supervisors' Auditorium
Board:
Meeting Date: 5/11/2011
Item Tracking
Step Action User Date
Originator APPROVE Matt Juan - PHSX 4/22/2011 11:11:40 AM
DeptCoor APPROVE Frances Delgado 4/22/2011 11:33:04 AM
DeptHead APPROVE Frances Delgado 4/22/2011 12:07:35 PM
DepartmentChief APPROVE Suzanne Gray - PLANDEVX 4/25/2011 8:21:08 AM
OriginatorMonitor RECALL Frances Delgado 4/25/2011 8:49:22 AM
DeptCoor APPROVE Frances Delgado 4/28/2011 9:25:59 AM
DeptHead APPROVE Max Porter - PHSX 4/28/2011 10:22:13 AM
DepartmentChief APPROVE Daren K. Frank - 4/28/2011 1:41:53 PM

PLANDEVX
OMB APPROVE LeeAnn Bohn - OMBX 5/3/2011 2:28:05 PM
Legal APPROVE David Benton - CAOX 5/4/2011 11:02:29 AM
ClrkOfBrd APPROVE Juanita Garza - COBX 5/4/2011 2:42:20 PM
CountyManager APPROVE Chris Pinuelas - CAOX 5/4/2011 3:14:04 PM
Board of Supervisors / Directors Approved on 5/11/2011.