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Commissioner Jacobs asked about Dr. Sheaffer and wondered why he gave his <br />house as a foster home facility. DSS staff member Denise Schaeffer said that originally <br />this was a home for young mothers and small children and then in the 1970's, there was <br />a need for a home for these types of children. She said that Dr. Schaeffer remained <br />somewhat involved over the years and continued to make donations. <br />Commissioner Jacobs said it would be a nice gesture to continue to use the <br />name of Sheaffer House to honor Dr. Sheaffer. <br />3. Medicaid Spending Trends <br />Nancy Colton said that there are a couple of documents in the packet showing <br />where the Medicaid dollars go. There are two different ways to look at spending of <br />Medicaid dollars. The Medicaid reports come to them showing the spending of Orange <br />County -what we spend an our residents no matter where they are served. Then <br />Orange County's provider report shows everybody who bills and receives Medicaid who <br />happens to bill from Orange County. The provider's report is much bigger than the <br />paying report particularly because of UNC Hospitals. These are pretty significant <br />numbers. <br />John Link said that this money is coming in from other counties as well. <br />Nancy Colton said that if you subtract the $73 million from the $192 million, what <br />is left shows what had to come from somewhere else. Also some of theirs went to <br />another county, although nowhere near as much. The $26 million for physicians is <br />mostly UNC. The UNC situation certainly drives what is in their figures. Intermediate <br />nursing homes are also fairly significant casts. This will give you a feel far who gets the <br />Medicaid dollars. <br />Assistant County Manager Gwen Harvey asked about others not shown on the <br />report who receives Medicaid dollars. <br />Nancy Coston said the report is very long and she only listed the ones who <br />receive the largest amount of dollars. They actually get the report for everyone who <br />receives these funds but it would be very cumbersome to chart all of the smaller <br />recipients. <br />Commissioner Jacobs asked about the regulations regarding evacuating nursing <br />home residents. <br />Nancy Coston said that she is not involved in licensing nursing homes but the <br />rest homes are expected to have a plan in advance. Whether they have a realistic plan <br />is probably questionable. A lot of times their plan is to stay in place with a generator. <br />This is one of the issues on their list to fallow up with adult home care. Nancy Coston <br />said that in the east, corporations have plans to move residents inland. <br />John Link asked if the prescription line was mostly the hospital and Nancy <br />Coston said that the local pharmacies, particularly the chains get a lot of this money <br />also. <br />John Link asked about the spending patterns of DSS budget. <br />Nancy Coston said Medicaid spending for the first two months is higher and <br />normally it is lower in these two months. She said that they do have more Medicaid <br />clients and she is not sure why the budget is higher. She said that this does not include <br />children that have switched from Health Choice to Medicaid. <br />Gwen Price said they anticipate that about 300 children will switch in October. <br />