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MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 23, 2019 S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ October Page 4 Rebecca Crawford, Financial and Administrative Services Director, began by informing the Board of the purpose behind presenting quarterly reports. She stated that, although it’s an Accreditation requirement, it also assists in maintaining public trust and transparency. Next, Ms. Crawford thoroughly described each section of the dashboard. Lastly, she presented on the 1st quarter revenue and billing accuracy while providing an in-depth explanation on the revenues and expenditures on the financial report. Her report is as follows: • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY19-20 after the first quarter is $216k/month or $647k YTD, representing 20% of our overall budgeted revenue for the year. As usual though, the total first quarter revenue is skewed down due to the majority of state funds not eligible to be drawn in July (this is typical) and allocations of Medicaid Max funds will not be transferred into our budget until the end of the fiscal year. Expenses are in line with revenues, at 19% of the overall budget. • Total Billing Accuracy: The medical and dental billing accuracy measure continues to be a challenge as we work with UNC and the Dental EHR, Eaglesoft, to improve the accuracy of the reporting system for Health Department revenue and is not included in this quarter’s dashboard. • Dental Earned Revenue by Source: The FY 19-20 average monthly revenue ($53.4k/month) for the first quarter is above our budget projection ($45k/month) and our FY 18-19 average of $47k/month. We are seeing the direct impact of adding the additional Dental Hygienist in FY 18-19 and will potentially exceed our projected annual revenue related to this position ($72,157) since the dental clinic is fully staffed. FY 19-20 dental earned revenue totaled $160k at the end of the first quarter compared $118k at the end of the FY 18-19 first quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently below the budgeted projection for FY 19-20 ($57k/month) at $43k/month due to provider turnover and as clinic staff continue to work through issues with the billing in the Epic EMR. Our EMR Quality Improvement team called the “Epic Optimization Team” along with clinic staff have made a large amount of progress in improving our revenue from medical clinic services from the Epic system and the monthly average revenue of $43k/month is already higher than it was in FY 18-19 at $41k/month. We anticipate this trend toward increased revenue will continue to improve. Medical clinic revenue totals $130k for first quarter FY 19-20. • Environmental Health Earned Revenue by Source: Environmental Health earned revenue is currently below the budgeted projection for FY 19-20 ($54k/month) at $41k/month. It is a seasonal trend to see lower revenue in the first quarter of the year than in later quarters due to spring pool inspections; however, the decreased revenue is directly related to the limited number of temporary staff available to complete WTMP inspections. EH had 7 temporary Environmental Health Specialists (EHS) working regularly to complete the inspections at this time last year and now have only 2 temporary EHS working irregularly. We found it difficult to recruit and retain the temporary EHS this summer given the heat. As a result, permanent staff in EH are adding WTMP inspections to their current workloads in order to complete them as required by the end of the fiscal year. • Grants Fund Revenue: