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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH November 29, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ November Page 6 • Health departments have exceptional expertise in managing these high risk populations at a local level with our medical community. • Reduces our capacity and staffing, which supports other critical community needs like preparedness and communicable disease outbreaks. o Clinical Services and Cost Settlement • Higher costs per service for health departments since we are also complying with federal and state program requirements. • Cost settlement could end; the role with clinical services would be compromised • Unclear if all health departments will qualify for that designation (Primary Care). o Medicaid revenue streams have become critical funding for local health departments. o Local health departments rely on Medicaid funding in part to provide essential and mandated services required in the NC General Statutes (for all populations). Timeline for Medicaid Transformation o February 2018 – Estimated CMS Approval of Amended 1115 waiver application o June 2018 – Requests for proposals released by state o March 2019 – Contracts awarded and executed o July 2019 – Prepaid Health Plans (PHP) go live o July 2020 – Statewide rollout complete Challenges for Public Health o Uncertain about qualifying as an Advanced Medical Home – Primary care role. o Questions about Medicaid dollar being able to follow the patient for services. o Questions regarding how health departments would get paid for social determinants of health initiatives and chronic disease prevention. o Won’t be a level playing field. Our Steps Forward/What’s Next o Electronic Health Record (HER) implementation. o Large scale focus on improvement with clinical quality measures. o Strong role with community and social determinants of health. o NC Association of Local Health Directors is advocating for Local Health Departments. o Consultant hired by NCALHD to provide capacity and expertise. o Ongoing responses to additional legislation, 1115 waiver application amendments and changes to managed care plan. o There’s a monthly Medicaid Transformation digest that will assist in the understanding of this process. The BOH had questions that were addressed by Ms. Crawford and Dr. Cilenti. VI. Action Items (Non Consent) A. Elections (Chair and Vice-Chair) The Board members shall elect a Chair and Vice-Chair by majority vote each year at the last meeting of the calendar year. Motion to elect Susan Elmore to Chair for the 2018 calendar year was made by Jennifer Deyo, seconded by Sam Lasris and carried without dissent.