Agenda - 03-09-1999 - III-B - Laserfiche WebLink

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ORANGE COUNTY Board of Commissioners Action Agenda Item No._IIL B._ Action Agenda Item Abstract Meeting Date: March 9,1999 Subject: Orange County Health Department as the Safety Net Provider Department: HEALTH Public Hearing Yes X No Budget Amendment Needed Yes X No Attachments(s): Core Public Health Functions, NACHO 1993 Information Contact: Excerpt from New Partnerships for the Future of Public Health Health Director's Office X2411 "Future Trends Affecting Public Health Challenges & Opportunities" Telephone Number "Prevention, Public Health, and Managed Care" Hillsborough - 732 -8181 Excerpts from Access to Health Care in North Carolina 1996 Chapel Hill - 968 -4501 Orange County Data from 1998 NC Data Guide to Child Well -Being Mebane - 227 -2031 Durham - 688 -7331 Purpose: To discuss jointly the philosophy, need, and implications for the Health Department to be the "Safety Net Provider" of health services. Background: The rapid change in the health care system has brought a plethora of new forms of financing and delivering health services. Even with the increased focus of managed care organizations on the need for community prevention programs, there is still a large number of citizens that remain without a regular source of health care. While those in poverty qualify for Medicaid, in some communities private providers are reluctant to accept Medicaid patients. One example in Orange County is the reluctance and often outright refusal of private dentists to accept Medicaid clients. The most consistent providers of those services are the UNC Dental School, Piedmont Health Services with its new dental program, and the Orange County Health Department. Dental health is only one example offered. Physicians are more likely to accept Medicaid clients into their practices because the reimbursement is at least at a more competitive level than dental reimbursement, however many physician practices "limit" their Medicaid enrollment. In addition to the Medicaid population, there is a significant portion of the population that is uninsured, either because they cannot afford private insurance rates or because they are small business owners who cannot afford health care coverage. A third population is the growing Latino population that often do not qualify for state or federal funds because they are undocumented aliens. A typical situation might be that the father is employed and has a work permit, but either the wife or the children or both are not "registered. As the health department considers future plans for delivering services to clients, it would be good to have some direction from both boards regarding this issue. Recommendation: To receive the information and to discuss the issues. • 61