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MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 August 24, 2006 Orange County Healthy Carolinians breakfast this spring, this grant application is focused specifically on engaging African American churches in increased education and programming in this area. This will also aid in addressing the overwhelming need to reduce health disparities. If approved, the grant will provide $15,000 for project expenses. No permanent staff will be added through the grant, however a small amount is designated for a part time project assistant. The Health Promotion Coordinator will manage the project. We anticipate that the grant award announcements may be made in early September with an October 1 start date. If the Department is the recipient of the grant award, we will need to request a budget amendment by the County Commissioners before these funds can be spent. C. Acceptance of Additional Family Planning Funds Ortho-McNeil Pharmaceutical, Inc. dramatically increased the price of most of their oral contraceptive products beginning in July. They began at that point charging the maximum price allowed by law for its Public Health Service (340B) prices for all of its multi-source contraceptive pills. For some of the most widely used oral contraceptive pills this was a 6 or 7 fold increase in price. Ortho representatives relate the price increase for these oral contraceptives to the recent availability of generics of these products. With the increased competition for these products, Ortho decided to raise prices from the lowest to the maximum allowed and reduce production of these products. Alternate oral contraceptive supplies have been difficult to identify, as other manufacturers did not increase their supplies. Health departments are restricted from writing separate prescriptions for these pharmaceuticals because they are considered to be part of the “bundled” service provided. As budgets were fixed as of July 1, 2006, it leaves health departments in a particularly difficult situation, faced with providing services to fewer patients than in previous years. This could also result in higher pregnancies and increased overall costs to the health care system. In FY 05-06, 1191 clients total were seen in the OCHD family planning program. 704 (59%) were on oral contraceptives. The Health Department staff has diligently searched for alternatives to the current medicines provided, seeking out the lowest prices possible. The clinicians have met and considered all of the possible options for patients. Finally, the numbers of packets of pills provided to patients at a single visit have been limited to three months to ration our supply. This will present an additional barrier for some women who will need to return every three months for additional supplies. In addition, there is some preliminary indication that other providers in the community will be referring women to the health department rather than bearing the burden of this increase themselves. The state has been providing some assistance to local departments in finding suitable generics and making sure that the state contract price is the lowest available. They are still negotiating with Medicaid to see if the reimbursement rate could be raised or to remove the contraceptive method from the bundled service so that a separate prescription could be written. The State also has received performance increases from the federal government as a result of higher numbers of women being seen in family planning last fiscal year. Those performance dollars are being distributed to local health departments based on the percentage of total family planning