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MINUTES ORANGE COUNTY BOARD OF HEALTH April 21, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 12 April 21, 2010 economic downturn, Social Services and the Health Department, from the standpoint of health and dental services is in greater demand. Chris Harlan stated she felt the Board should take the stand that we have done enough and this is as far as we can go and it is a political decision for the Commissioners to make. She also pointed out that some non-mandated services are revenue producers and questioned the wisdom of cutting revenue producing programs simply because they are not mandated. Motion to draft a letter to the Board of County Commissioners from the Board of Health expressing the Board of Health’s position and objections to proposed budget cuts that would adversely affect delivery of mandated public health services was made by Jim Stefanadis, seconded by Chris Harlan, and carried without dissent. F. Medicaid Audit Findings for Statewide Public Health Each year staff at the NC Division of Public Health gathers information from each local health department and prepares a cost report for all Medicaid services offered by each health department for a fiscal year. These cost reports are averaged across the state to determine a total settlement amount for all of the local health departments. The Division of Public Health uses a formula based on costs and service numbers identified for each department to distribute the funds to each health department. The settlement is based only on the federal share of the Medicaid earnings (approximately 65%), not the state share. Orange County has earned approximately $250,000 each year since the inception of the program in the late 1990’s. These funds have been placed in a capital account and allowed to accrue over the years and are used for renovations, equipment, and furnishings. Earnings must be spent in the program that earned the revenue. In 2006 the NC Division of Medical Assistance Audit Division began conducting desk audits of this process. Orange County Health Department along with 12-14 other departments was audited in 2007 for the FY04-05. The audit letter received in 2008 stated that there were disallowances identified that would affect the calculation of the reimbursement amount. The health director sent a letter to the Audit Division requesting an exit conference to dispute the findings and has received no reply to date. In addition, papers were just submitted for a desk audit for FY08-09. Wayne Sherman reported that last month, 10 health departments across the state received letters from the Audit Division for FY04-05 audits that identified major disallowances in calculating the total costs for each department. Orange County was not one of these. At the March 18th meeting of the North Carolina Association of Local Health Directors (NCALHD), the Association approved a motion from the Reimbursement and Finance Committee to authorize the Association’s President to utilize $25,000 of Association funds to begin the process of appealing Medicaid’s decision to disallow costs for 10 health departments as the result of desk audit reviews for FY04-05. On March 8, 2009 eight health departments