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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH September 20, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ August Page 5 • Effective January 1, 2018, there is a limit on first-time prescriptions for acute pain to no more than 5 days. Surgical procedures are limited to 7 days. Subsequent consultations for same pain, can renew, refill, or issue new prescription of a controlled substance. • Effective January 1, 2020, there will be electronic prescribing of targeted controlled substances. They will be integrated with the NCCSRS database. • OCHD Dental Clinic procedures include: o Checking the NCCSRS before prescribing any opioid prescription. o The baseline drug given is ibuprofen 800mg o Opioid prescription is prescribed only if 1) the patient cannot take ibuprofen for medical reasons; 2) multiple teeth were extracted; and 3) surgical extraction of teeth with bone removal, requiring extensive healing. o No more than 15 tabs per procedure. o No refills within 30 days. o Flag/monitor patients who may be drug seekers. The BOH had questions that were addressed by Dr. George. D. Men’s Primary Care Update Pam McCall, Personal Health Services Director, began by stating that the program which began as a pilot program in February 2016 to refer male Orange County residents to Family Centered Healthcare. The program was designed to provide low-income males, specifically those from northern Orange County, with access to low-cost primary care. Ms. McCall gave a brief update on its progress. Highlights include: • There were 53 men referred between 7/1/16 and 7/30/17. There were 55% that kept their appointments. • There were 42 unique patient (unique patient is equivalent to 1 patient) visits in FY 16-17 in which 30% were referred in FY 15-16. • Most of the patients hear about the program by calling when looking for healthcare needs. The 2nd most popular method of contact was when a family member called on their behalf. • The total amount expended by OCHD is $13,347. The OCHD doesn’t pay for specialist care. Patients needing these services can apply for charity care through UNC. The average amount expended by OCHD per patient is $318. The amount was $253 in FY 15-16. The average amount expended by the patient is $28. In FY 15-16, it was $47. More than half (64%) of patients paid nothing as they slid to 0% on the sliding scale. • The months with the largest number of visits to Family Centered Healthcare were July, September, October and March. • The most frequent diagnoses were primary hypertension, major depressive disorder, obesity and type 2 diabetes without complications. • Transportation has been an issue; however, the HCOC, as well as other agencies, is working on this issue. • There isn’t enough information as of yet to spot trends; although, the OCHD feels that this is a successful program and an effective way to treat this population. The BOH had questions that were addressed by Ms. McCall.