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MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2012 Board of Health Minutes Transcription completed by Lisa Smith February 22, 2012 Page 2 V. Reports and Discussion with Possible Action A. FY 12-13 Budget The proposed budget for the Health Department for FY 2012-2013 is essentially a “flat” budget, with minimal increases. When the vehicle capital request, proposed new 0.5 FTE in Environmental Health, and involuntary increases are removed, there is actually a decrease in county appropriations. The proposed operating general fund budget is $7,327,880, with an additional $122,718 allocated for two grants. The grand total is $7,450,598. The fiscal outlook from the state is still unclear, with guidance to budget similar amounts as appropriate in the current fiscal year. The exception is a definitive loss of Health Promotion funds as well as the anticipated loss of state tobacco money. Staff will continue to closely monitor the state budget discussions in the legislature. In the attached FY 2012-13 division budgets, multi-program divisions have allocated expenses and revenues by program. This information will better capture the cost of service delivery while examining its correlation to better health outcomes for our clients. Commissioner Yuhasz asked if we could provide a graph that shows the percentage of county and non-county appropriations. Staff will put together another graph and send out electronically to board members. A motion to approve the general fund budget in the amount of $7,327,880 for 2012-2013 as presented and the grant fund budget in the amount of $122,718 for 2012-2013 as presented and forward to the Board of County Commissioners for action was made by Susan Elmore, seconded by Anissa Vines, and carried without dissent. B. FY 2012-13 Fee Schedule The new Medicaid Cost Settlement methodology required that the Health department examine its existing fees. In doing so, staff used the following methodology: 1. Increased fees to the regional cost average rather than our actual cost if it was significantly higher 2. Decreased fees if our actual cost was less than our current fee 3. Confirmed that all fees are equal to or exceed the Medicaid reimbursement rate This resulted in an increase of 42 fees and decrease of 14 fees for the medical clinic and an increase in 43 fees for the dental clinic. Additional fee adjustments: • Recommend an increase in the minimum fee for medical nutrition therapy from $15 to $20. This will align the minimum fee more closely with Personal Health Services primary care minimum fee of $20. • Establish new fees as a result of a mandatory Medicaid changes in global obstetrician billing packages effective October 1, 2011 instead of billing per visit. • Changed minimum fee for dental service from $30 per visit to $30 per procedure. This brings our fee structure similar to other dental clinics like Alamance County.