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MINUTES <br />ORANGE COUNTY BOARD OF HEALTH <br />March 23, 2011 <br />Board of Health Minutes Transcription completed by Lisa Smith March 23, 2011 <br /> <br /> <br />The spreadsheet shows that in Alternate #2, the county share of support is increased by <br />approximately $34,000. <br /> <br />Total cuts of $102,769 proposed in the Governor’s budget or in the federal pass through funds <br />represented on the budget, Alternate #2 represents nearly an 18% cut in the total allocation of <br />state and federal funds. This does not include those cuts that would be associated with Smart <br />Start program cuts. <br /> <br />Motion to approve Alternate Budget #1 FY 2011/12 as the current budget request to be <br />forwarded to the Financial Service Department for consideration for the health <br />department as was made by Chris Harlan, seconded by Carol Haggerty, and carried <br />without dissent. <br /> <br />B. Pregnancy Medical Home and Care Coordination Plan for Services <br /> <br />Effective February 28, 2011, the Maternal Care Coordination (MCC), and Child Service <br />Coordination (CSC) programs ended and on March 1, 2011, the Pregnancy Care Management <br />(PCM) and Care Coordination for Children (CC4C) programs began. The MCC and CSC <br />programs were fee for service care coordination programs that provided education, referrals, <br />and coordination services to high-risk Medicaid-eligible pregnant women and families with <br />children experiencing or at risk for developmental delays. Services were provided to families <br />who met the eligibility requirements by nurses and social workers in the Health Department’s <br />Family Home Visiting Section (FHV). <br /> <br />With the advent of PCM, the program shifts to providing case management services to all <br />Medicaid-eligible pregnant women who are screened by medical providers (now called <br />Pregnancy Medical Homes) and found to have at least one high risk criteria. Assessments will <br />be made of those referred and the clients will be triaged by intensity level according to <br />intervention needs. Those at highest risk will be seen weekly, those at medium risk at least <br />monthly and those at lower risk contacted less than monthly. This will allow the greatest amount <br />of resources to go to those in greatest need and should result in better outcomes for all levels <br />and cost saving. Payment will no longer be fee for service but will be on a capitated basis (per <br />member/per month) based on the number of Medicaid eligible pregnant women in the county. <br /> <br />The CC4C program will operate much like the current CSC program in that children with <br />developmental delays will be assessed by medical providers and referred for services. Referrals <br />can also come directly from families or other community agencies. The difference will be in the <br />payment method (per member per month instead of fee for service). As of this time, we are <br />uncertain as to the caseloads of FHV staff and as to whether we will be in need of additional <br />personnel to meet the expected outcomes. <br /> <br />Attached is a transition plan developed by the FHV management team to guide staff on their <br />responsibilities as the programs change. Also attached are fact sheets for the PCM and CC4C <br />programs. The programs have not been fully developed and “are a work in progress” as the <br />changes are on a fast track at the State level. We are following developments closely and will <br />be developing a more complete transition plan to submit to the State as more information <br />becomes available. These new care management programs are a joint venture between <br />Division of Medical Assistance (DMA – Medicaid), Community Care of North Carolina (CCNC – <br />regional entities formed to manage the Medicaid population), and Public Health. The goal is to <br />improve health outcomes and reduce costs.