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iMINUTES-Draft <br />ORANGE COUNTY BOARD OF HEALTH <br /> April 25, 2018 <br />S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 2 <br />excellent presentation of an overview of the national and local opioid crisis titled “Opioid <br />Epidemic: Collisions at the Crossroads”. Below are some of the highlights. <br /> <br /> Opioids are prescribed for moderate to severe pain, particularly chronic pain. <br /> Chronic pain is recognized as another important public health problem that is often <br />undertreated. <br /> Key factors that led to the rise in the prescribing and consuming of opioids <br />o The intent to cure pain <br />o Wide acceptance that opioid painkillers were low-risk and non-addictive <br />o Lack of experience in opioid addiction science <br /> It was learned, early on, that you can’t identify a drug misuser. It’s difficult to determine <br />who is a straight shooter vs a misuser without defining unacceptable behaviors that <br />misusers exhibit such as cocaine in urine and doctor shopping. <br /> The Joint Commission required physicians to ask patients to rate the amount of pain <br />they’re experiencing. This leads to the option of patient function vs pain score to <br />determine the patient’s pain level. <br /> The decision of whether and how providers should use opioids in a primary care setting <br />falls largely on expert opinion and clinical judgment. <br /> Chronic pain has been found to be interconnected to mental illness and substance <br />misuse of which 60-80% of people experience depression or anxiety. There is limited <br />literature available that addresses this issue and most of it is incredibly flawed. <br /> Admissions for prescription opioid abuse treatment escalated more than 5 fold from <br />35,648 in 2001 to 180,708 in 2011. <br /> In 2016, the prescribing rate for opioids was 61 prescriptions per 100 persons. During <br />this time, there was also a huge increase in opioid misuse in urban areas. <br /> In 2016, around 64,000 people died from drug overdoses in the U.S. <br /> The opioid crisis is not a Caucasian epidemic; it just started there, primarily in the <br />Appalachian area. It then, eventually, spread to the African-American and Native <br />American communities. <br /> Every 25 minutes a baby is born with opioids in their system and suffers opioid <br />withdrawal. <br /> The prescribing of opioids has decreased; however, fentanyl prescription has increased. <br />Fentanyl is 100 times more potent than opioids. <br /> Although opioid deaths and the prescribing beg an to decrease in 2010, they’re starting <br />to spike again. <br /> Besides public health, there are clinical and mental health dimensions to the opioid <br />crisis. <br /> Some remedies to address the epidemic include naloxone, CDC guidelines, mental <br />health reform and prescription monitor programs (PMPs). <br /> <br />The BOH had questions that were addressed by Dr. Chelminski. <br /> <br /> B.&C. 3rd Quarter Billing Dashboard and Financial Reports <br /> <br />Rebecca Crawford, Financial & Administrative Services Director, gave a report on the 3rd <br />quarter revenue and billing accuracy. The report is as follows: <br /> <br />• Total Health Department Revenue: Average YTD monthly revenue in FY18 after the <br />third quarter is $211/month and totals $2.1M YTD, representing 61.2% of our overall <br />budgeted revenue for the year. The total third quarter revenue is slightly skewed down <br />due to the majority of state funds not eligible to be drawn in July (this is typical) but we