Minutes 12-14-2010 - Laserfiche WebLink

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Commissioner Jacobs thanked Rosemary Summers for the thorough presentation, because the last presentation was not thorough. He thinks that the County Commissioners said that they wanted to develop a dental clinic at southern Orange and this is not the Manager's recollection. He said that whatever was resolved should have been in the agenda packet. Commissioner Jacobs asked about the Medicaid maximization cost settlement funds and if they were for capital purposes primarily, partially, or optionally. Rosemary Summers said that in the action the County Commissioners took in 1998 establishing the fund, the funds were designated for capital. This is for capital furnishings and equipment. Often that is where the funding does not get placed, so that was the argument. Deputy Director of Financial Services Michael Talbert said that the Medicaid maximization funds are one project within the Capital Projects Fund. It is not a separate fund in itself, but it is one capital project. The funding for that project is the Medicaid maximization money that comes in each year as a supplement. He said that the financial impact of this project is that there will be a budget amendment for$576,000 to recognize official Medicaid maximization money that has come in the last two years. This increases the budget from $1.8 million to $2,392,000. The County has spent a little over$300,000 of that money over the past ten years. When the project was established in 1998, the County banked the money for future capital needs. After the budget amendment, the County will have a little over$2 million to go towards this project. Commissioner Jacobs asked about "this project." Michael Talbert clarified that there is a project for Medicaid maximization and the recommendation for tonight is to use this funding for this renovation of the Whitted Building. When this is done, there will be $600,000 remaining in the fund that can be used for future health and dental clinic needs. Discussion ensued about the details of this fund. Commissioner Hemminger said that she did not even know these funds existed. She asked if the funds could be spent for planning and Rosemary Summers said yes, as long as the programs that earn those funds are what will be going to go into that facility. Commissioner Foushee said that she is in favor of the Manager's recommendations, but she thinks that the time has passed that the County Commissioners talk strategically about how to provide dental clinic services, particularly in southern Orange County. The needs are going to be greater in the future. She still thinks that transportation is going to be problematic. She said that if the Towns of Chapel Hill and Carrboro have information about where to site a dental clinic in southern Orange County, she would like to have this information and assistance from the Towns. Rosemary Summers made reference to the list of dental Medicaid providers and pointed out that anything that says Brower Hall is part of the UNC School of Dentistry. The majority of the providers that are general dentistry providers are in the School of Dentistry. She said that she has been in discussion with Piedmont Health for the short-term and arrangements have been made for patients that cannot get transportation to Hillsborough. Piedmont Health will accept a referral from Orange County at the County's cost to charge for the patient for an initial visit for eligible patients. Commissioner McKee said that he does not doubt that there will be increases in the use of health and dental clinics. He said that the County may need to address a dual system again. He said that it is his understanding that Orange County is not required to provide dental services at any particular level other than common decency. He asked Rosemary Summers if she anticipates hiring additional staff to handle the additional inflow. Rosemary Summers said that one of the options that the Board of Health discussed was the eight-chair clinic that this renovation would take care of is with no additional staff now.