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MINUTES ORANGE COUNTY BOARD OF HEALTH February 25, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 February 25, 2009 of the fee. The Board is required by statute to recommend a fee schedule to Commissioners for approval. Commissioner Yuhasz asked what counties were used for comparisons. Wayne Sherman stated that similar counties, Chatham, Durham, Wake, New Hanover, and were compared for personal health fees and Alamance, Durham, Guilford, and Wake counties were used for dental health fees. Steve Yuhasz inquired if an increase in fees would affect patient load. Dr. Summers replied that it would not because the majority of our patients are below 100% and will not generate significant revenue. Motion to approve the methodology was made by Anissa Vines, seconded by Tim Carey and carried without dissent. Motion to approve the fee schedule was made by Jim Stefanadis, seconded by Matt Vizithum and carried without dissent. C. Budget for FY 09-10 Rosemary Summers explained that a number of items reflect direction by the County Manager and the budget staff. The direction provided was to cut 10% of the overall departmental operating budgets including temporary personnel and overtime. This also applied to all grant funded projects regardless of whether they were 100% grant funded. In addition, in order to be bottom line neutral with county funding we had to propose additional cuts in expenditures beyond the required 10% operating reduction. The Health Department is funded approximately 40% by external revenue sources (fees, third party reimbursements, contracts, state and federal funding, and grants). Changes in our patient pay mix, reductions in reimbursement rates, and the downturn in the building trades are projected to negatively affect our bottom line revenues. The Department was not able to achieve a revenue and expenditure balance without delaying positions for the 09-10 budget year. These were included in the Service Reduction report provided to the Board. The Department was also directed to include the action plan items from the BOCC priorities adopted at their retreat earlier this year. These action plan items were to be “exchanged” or “substituted” for current programs or activities and were directed to be bottom-line cost neutral. We were unable to achieve this in total, although the Department was able to shift resources to partially meet this need. In addition, the department submitted critical capital requests that were approved and funded, but then frozen, for the current budget year. Several of these items have been requested in previous years and unfunded. Some items are rising to critical levels for replacement. The BOCC will receive the Service Reduction Proposals from the “Community Services Team” on March 5 for discussion at a work session. Advice from the Board of Health regarding critical health priorities to the Commissioners would be useful for them to factor in as they begin to make funding decisions later in the spring. NCGS 130A requires the Board of Health to act upon a health department budget and