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Agenda - 03-05-2009 - Attachment 2
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Agenda - 03-05-2009 - Attachment 2
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3/22/2016 1:55:34 PM
Creation date
3/19/2009 3:31:26 PM
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BOCC
Date
3/5/2009
Meeting Type
Work Session
Document Type
Agenda
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Attachment 2
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Minutes - 20090305
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\Board of County Commissioners\Minutes - Approved\2000's\2009
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S-25 * PHS -- Description — Describe, in detail, the service delivery impact of the <br /> proposed reduction/change. <br /> The Department will continue to provide the mandatory Communicable Disease screening <br /> and provision of needed immunizations. Following this screening, refugees will be <br /> referred to community medical providers to establish a medical home and receive ongoing <br /> care. Because of their poor health status, they often require specialty services. <br /> Approximately 240 Refugees (children and adults) will be impacted by this change in <br /> service. <br /> Communicable Disease screening on all arriving refugees is a mandatory service, but <br /> refugee health assessments (comprehensive physical exams) are not. Nonetheless, a <br /> comprehensive physical exam is highly recommended. Many refugees arriving with <br /> complex health conditions that the Health Department staff is not trained to handle, are <br /> already being referred to medical providers who provide more comprehensive services for <br /> assessment, treatment and ongoing care. As we discontinue the health assessment <br /> service, we will need to work with our community partners to assure.a clear delineation of <br /> roles (Communicable Disease screening by Health Department, Refugee Health <br /> Assessments by community medical providers). Since the Refugee Health Assessment is <br /> a Medicaid-reimbursable service and refugees are eligible for Medicaid in the first 8 <br /> months after arrival, there is a funding stream available for community medical providers <br /> to be paid for this service. This will likely impact other community providers such as <br /> Carrboro Community Health Center who already provide services to a large number of <br /> refugees. <br /> The .5 Family Nurse Practitioner, currently assigned to refugee health assessments will be <br /> reassigned to provide an additional 720+ services in our traditional mandatory <br /> prevention/treatment programs. This includes mandatory clinical services such as <br /> Sexually transmitted diseases, Family Planning, Maternal, and Child Health care. As a <br /> safety net provider during difficult economic times, there is a greater request for these <br /> services. We anticipate that the Medicaid-revenue earned for Refugee Health <br /> Assessments ($15,608) will be replaced by Medicaid and fees generated providing the <br /> above traditional services. In addition, since Refugee Health Assessments (including the <br /> use of interpreters) take on average 1.5 hours to complete, we will be able to increase <br /> Family Nurse Practitioner productivity 3-fold with other services (averaging 20-30 minutes <br /> to provide). <br /> S-26 * PHS -- Proposal (Provide a brief description of the service change) <br /> Discontinue HIV Community Testing Program <br /> S-26 * PHS -- Fiscal Impact (This number should correspond to the amount included <br /> on the department's budget request excel spreadsheet) <br /> $5,652 Reduction in medical supplies <br /> S-26 * PHS -- Description — Describe, in detail, the service delivery impact of the <br /> proposed reduction/change. <br /> This reduction will result in the loss of opportunity for higher-risk individuals to receive <br /> rapid HIV (Human Immunodeficiency Virus) testing results in a discreet community setting. <br /> 48 <br />
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