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MINUTES ORANGE COUNTY BOARD OF HEALTH May 26, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 May 26, 2010 the past and clarified that the veterinarian representative would also serve on the Animal Services Committee as liaison. Physician representative Paul Chelminski will complete the partial term left by Dr. Tim Carey on June 30, 2010. Dr. Chelminski will be eligible for reappointment to his first full term and has agreed to serve. Motion to recommend Dr. Paul Chelminski for re-appointment to his first full term as Physician Representative; recommend appointment of Matthew Helm as Pharmacist Representative, and Dr. Carol Haggerty as Dentist Representative and forward recommendations to the Board of County Commissioners for consideration was made by Christopher Cooke, seconded by Mike Carstens, and carried without dissent. D. Budget Updates The County Manager’s recommended budget was presented to Commissioners on May 18, 2010. The budget situation has evolved over the last few months and several recommendations contained in the budget are causing concern for the department. Rosemary Summers reported that the Governor’s budget has a recommendation from the State Division of Medical Assistance (DMA) to discontinue Medicaid reimbursement for maternal outreach services as of July 1, 2010. This is a continuation by DMA to downsize or eliminate all case management programs. OCHD has one remaining maternal outreach worker providing services to support pregnant women in receiving services to ensure a healthy birth outcome for both mother and child. With little support for fighting this recommendation, the department has chosen to eliminate the program as of June 1, 2010. Dr. Summers said that the remaining maternal outreach worker will be transferring to a medical office assistant position as of June 1, 2010. The medical office assistant vacancy was created through the retirement of an individual that has been with the county for 30 years. This transfer was agreed to by the County Manager. It should be pointed out that this is a reduction in services to pregnant women and it will remain to be seen whether birth outcomes will be affected in future years. This is the second downsizing of this program during this fiscal year. Other possible effects as a result of the Governor’s budget include a recommendation to limit adult dental Medicaid reimbursement to only emergency care. The OCHD dental clinic sees 300 adult Medicaid visits per year, with an average charge of $100 per visit. This would be a loss of $30,000 in production and revenue due to the cut. If that passes the dental clinic would have some adult Medicaid revenue for emergency treatment, but that would be limited only to medications, x-rays, and tooth extraction. The likely scenario is that these patients would still be coming to us but now they would be 0% pay and instead of $100 per visit and the clinic would be receiving $25 per visit. Smart Start funds are proposed to be cut 4%. The cuts cannot come from day care subsidy so it is likely the cuts to the programs will be in the 6% range. We