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MINUTES ORANGE COUNTY BOARD OF HEALTH October 22, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 October 22, 2009 for a limited number of pregnant women and children. The rate cuts for the services per unit of services delivered (measured in 15 minute increments) in question are: Maternity Care Coordination: Old rate 29.30 New rate 17.76 Child Service Coordination: Old rate 21.74 New rate 14.43 Maternal Outreach: Old rate 15.25 New rate 14.43 Maternal Outreach services cannot be provided unless the patient is also enrolled in Maternity Care Coordination but you can only bill for one service per month under the new billing requirements, effectively making it impossible to bill for both services. If no changes are made to the current delivery model, the Department will be short of earned Medicaid revenue by $145,347 for FY 09-10 for these programs. This is approximately a 38% reduction in actual revenue for the current fiscal year. FY 10-11 will see a higher deficit because we will not have a first quarter of higher earnings to mitigate the shortfall and we are anticipating further cuts in these reimbursement rates. The re-drafted plan focuses on services to pregnant women, young infants and school age children in order to meet our mandate to ensure that babies are born healthy. The re-drafted plan may require some additional county funding in the 09-10 fiscal year, while staff learn new duties and are able to reach full productivity. The 2010-2011 year, shows a projected decrease in county funding for these services. Staff has met with Human Resources, Financial Services, and the Staff Attorney to review the plan and received positive feedback. Final approval of the County Manager is needed for this plan to move forward. Anissa Vines asked when the decision to unfreeze the vacant positions by the County Manager will take place. Rosemary Summers stated she has put in a request to meet with the County Manager and expected the meeting to occur very soon. Mike Carstens asked for clarification on billing. Dr. Summers stated that billing is done in 15 minutes increments with no difference between telephone contacts and in-person visits as far as billable amounts. There is a maximum realignment plan limit of 6 “units” per month that can be billed. Motion to support the Health Director in efforts for approval of reorganization was made by Steve Yuhasz, seconded by Tony Whitaker, and carried without dissent. E. Informational Items a. Pending and Recurring Items: The monthly listing of upcoming Board agenda items was provided to the Board for informational purposes. b. Healthy Carolinians Recertification: Orange County Healthy Carolinians received its third recertification on October 2 at the annual Statewide Conference.