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ORANGE COUNTY <br />BOARD OF COMMISSIONERS <br />ACTION AGENDA ITEM ABSTRACT <br />Meeting Date: March 7, 2013 <br />Action Agenda <br />Item No. 5 -d <br />SUBJECT: Request to Add Colposcopy Fees to Health Department Fee Schedule <br />DEPARTMENT: Health PUBLIC HEARING: (Y /N) No <br />ATTACHMENT(S): <br />INFORMATION CONTACT: <br />Dr. Colleen Bridger, Health Director, <br />919- 245 -2400 <br />1 <br />PURPOSE: To consider a Health Department request that the Board of County Commissioners <br />adopt fees for Colposcopy services approved by the Board of Health at its January 16, 2013 <br />meeting. <br />BACKGROUND: The Orange County Health Department (OCHD) clinics provide cervical <br />cancer screening services for clients in Family Planning, Maternal Health and Primary Care <br />Programs. In fiscal year 2011 -2012, 721 Pap tests were performed and 103 required <br />colposcopy follow -up. <br />Colposcopy is a diagnostic procedure to examine the cervix when the Pap screening test <br />reveals abnormal changes in the cells of the cervix. The health care provider uses a special <br />magnifying device called a colposcope to find problems that cannot be seen by the eye alone. If <br />needed, abnormal tissue may be collected for pathology during the colposcopy procedure. <br />Currently the department practice is to refer clients requiring colposcopy to UNC's Dysplasia <br />clinic in Chapel Hill. In many cases barriers such as transportation and difficulty in navigating <br />the UNC Healthcare System deter women from getting the needed follow -up. In FY 2011 -12 <br />approximately 47% of total Health Department clients referred for colposcopy kept the <br />appointment. Thirty -six percent (36 %) of Hillsborough clinic patients kept the referral <br />appointment, and 55% of Chapel Hill clinic patients kept the referral appointment. <br />In order to reduce the rate of missed Colposcopy appointments for referred patients, the <br />department requested and received approval from the Board of Health to provide the <br />Colposcopy services in -house for clients. The fee to provide the service must be approved by <br />the Board of Commissioners. <br />