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MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 4 Motion was made by Susan Elmore to approve charging for I 693 visits on the sliding fee scale, if the individual does not slide to zero and they think it is a hardship for them, they will be made aware and can avail themselves of the fee waiver, seconded by Liska Lackey and carried without dissent. C. 2014-2015 Budget Budget Presentation/Discussion- Dr. Colleen Bridger See attached Budget Packet The proposed FY 2014-2015 budget for the Health Department is essentially a “flat” budget, with minimal increases. Dr. Bridger pointed out the increases in the recommended budget that are county controlled: such as Health Savings Account, the 2% COLA for employees, employee equity adjustments, medical insurance costs, retirement match and county wide 3% bilingual retention program. Motor pool increased 3 cents per mile resulting in a $3000.00 increase. Staffing: New position request focused on childhood poverty whose primary focus will be to assess current programs and resources, partner with critical community stakeholders, and identify pilot communities within the county for the purpose of implementing a Harlem Children’s Zone-like program. We will maintain a partially grant- funded Foreign Language Interpreter position beyond the state funding period which expires at the end of the current fiscal year. We also included a Nurse Retention career ladder payment.  Fee Schedule In reviewing the clinic fee schedules the staff used the following methodology: • Utilized a Clinical Fee Schedule Cost per Service Calculation provided by the NC Division of Public Health to compare charges for services to cost of services. • Compared charges for services with Medicaid’s reimbursement rates and confirmed that all charges for service were equal to or exceeded the Medicaid reimbursement rate. This resulted in an increase of 9 charges in Personal Health for services that were raised to the Medicaid reimbursement rate. Dr. Bridger mentioned that by keeping fees for clinical services below our actual costs, we would be losing some Medicaid cost settlement funds. The challenge is that uninsured patients who pay a percentage of their visit will pay more if we increase our fees. There was some discussion regarding Environmental Health fees. Dr. Bridger committed to completing a cost study for Environmental Health prior to the next fiscal year’s Budget presentation. The BOH members had several questions that were addressed by Dr. Bridger.