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MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 30, 2019 S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ January Page 3 • Orange County, Chapel Hill, Carrboro, and Hillsborough have really shown dedication to improving affordable housing by using mechanisms that address affordable housing such as creating Orange County Bonds, dedicated local budget funding, dedicated staff to advance affordable housing, inclusionary housing policy, the creation of housing advisory boards, and the Northside Neighborhood Initiative. The BOH had questions that were addressed by Mr. Dowling and Ms. Bailey. B. 2nd Quarter Financial Reports & Billing Dashboard Reports Rebecca Crawford, Financial & Administrative Services Director, gave a report on the 2nd quarter revenue and billing accuracy. The report is as follows: • Total Health Department Revenue: Average YTD monthly revenue in FY19 after the second quarter is $210k/month or $1.3m YTD, representing 36.4% of our overall budgeted revenue for the year. Multiple factors contribute to the lower than normal revenue: Electronic Medical Record (EMR) change to Epic, provider on maternity leave in Dental, and departmental closures due to hurricane Florence, snow, and overall wet weather negatively impacting onsite well and septic inspections. Allocations of Medicaid Max funds will not be transferred into our budget until the end of the fiscal year. Expenses are higher than revenues, but on trend, at 45.5% of the overall budget. • Total Billing Accuracy: Billing Accuracy is under construction due to the change in medical EMR. The Informatics team and UNC Epic reporting staff are working diligently to have this measure for both medical and dental back by the third quarter financial report. • Dental Earned Revenue by Source: The FY 18-19 average monthly revenue ($41k/month) for the second quarter is below our budget projection ($45k/month) and our FY 17-18 average of $42.6k/month due to having a dentist on maternity leave. We are now able to see our new Hygienist has quickly caught up to our existing Hygienists in terms of seeing patients and meeting monthly revenue goals and anticipate the monthly average will increase along with our total revenue to be closer to the budgeted amount. FY 18-19 dental earned revenue totaled $246k at the end of the second quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently below the budgeted projection for FY 18-19 ($55.6k/month) at $29k/month (although higher than the first quarter average of $16.3k/month) due to provider turnover (2 new providers started seeing patients in late July and August) and as clinic staff continue to work through issues with the new EMR, improved customer service during the EMR transition with longer appointment times (meaning we saw fewer patients), and have dealt with clinic closures due to hurricane Florence and snow. We anticipated these issues as they arise in all new automation projects and have staff dedicated to fixes by increased training for providers, weekly workflow meetings, a Quality Improvement team called the “Epic Optimization Team”, and teams devoted to building algorithms with UNC IT to decrease errors in the billing system build (our state requirements make our billing very different from a typical UNC outpatient clinic and require much more specificity). Medical clinic revenue totals $174k for second quarter FY 18-19.