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MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2013 Page 5 • Dr. Bridger stated they were working to figure out utilizing staff and compensation for use of them. How it will work is still being discussed. The Health department will continue with GPR using UNC dental students. • Tony W hitaker stated he liked expanding services without increasing the budget much. • Susan Elmore stated it was good in helping to fill in the gaps, and she supported it. She asked what other risks had been identified and what milestones were needed to evaluate how it’s working. In response Mr. Toomey stated we have to follow many rules. Dr. Bridger stated the biggest challenge was integrating two separate cultures. Federally qualified health centers (FQHCs) are more flexible and the two agencies have different ways of working. Have to refocus on the mission. Communication is key. VII. Reports and Discussion with Possible Action A. Informational Items a. Budget Year to Date Report-Christy Bradsher gave a summary of budgeted to actual revenue and expenses where the department will be overall. Year to date we a have received 79% of estimated revenue and expended 78% of projected expenses. Overall, although total revenue is down, total expenditures are down to offset revenue. b. I-693 report/update: Pam McCall gave the follow up report on the process of completing and I-693 (Included in packet) in response to Ms. Flicka Bateman’s request to review how the fee was assessed for that services. As background, Ms. McCall stated cost of completing the form was looked at including registration by the Medical Office Assistant, utilization of the language line, and cost of the Nurse performing the assessment and administering vaccines if needed. She went over how other Health Departments Civil Surgeons charge for the service. A provider must be designated as a civil surgeon to complete the I-693 assessment. Ms. McCall reported the number of refugees coming to Orange County has decreased over the past several years. Last year we completed (31) I-693 assessments and this year we have completed (25). In terms of additional free services provides to refugees we provide the Communicable Disease and TB screenings free to further assist those needing this service. Due to the amount of staff time and costs associated with completing the I-693 assessments, Ms. McCall recommended keeping the fee at $25, but stated staff would do a better job of educating clients on a 1 time waiver for financial hardship. The current fee for the I-693 service is $25.