Approved Minutes of February 22, 2023

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MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2023 A. Proposed Fee Schedule In reviewing Health Department fee schedules, which are done on an annual basis, the Department would like to make multiple fee changes in Environmental Health and Personal Health. The proposed changes are summarized below with a detailed list of the fees in the attached fee schedule: Environmental Health Environmental Health requests to adjust fees in multiple programs including Pools, On-Site Well & Septic and Food & Lodging. The Division proposes to reduce the New Well Construction Permit fee by an additional $50 to more closely align with neighboring Counties/State fees. They also would like to dispose of the Installer Renewal Fee. Installers are required to be certified by their own Board. Our local registration now serves as an "approved installer" list rather than credentialing. Additionally, four requested fee changes are to cover increased programmatic costs; these fees have not changed since 2017-2019. An additional $50 increase to the Mobile Food Unit Plan Review is requested. This was a planned three-year increase, this being year two. Lastly, the Health Department is requesting to add a credit card service fee to offset banking charges for using credit cards to pay for permits. This will mostly impact commercial and construction companies that pay for a great number of fees using a credit card. The total financial impact from Environmental Health fee changes is projected to be an increase of$16,405. Personal Health Personal Health requests to add 31 new fees to the fee schedule. About half of these are UNC Labs fees that are needed infrequently by patients. A few are new vaccines and the remainder are 340B oral contraceptives. They would also like to discontinue 8 fees that are no longer used. Finally, the Department requests to continue scheduled adjustments to the fees for 340B drugs to equal the County's cost to purchase them, as required by the state and federal government, and to reflect Medicaid, vendor, and Medicare rate changes. The total financial impact from Personal Health fee changes is projected to be a maximum increase of$20,004. Tony Whitaker commented that he appreciated that the credit card fees request as he didn't feel that this fee should come from a budget item. In response to Rachel Royce's question regarding 340B fees, Carla Julian replied that the states sets the fees. Ms. Julian also defined the three types of family planning according to NC statute. In response to Dr. Brian Crandell's question about the 340B drugs, Kimberlee Quatrone explained what the 340B drugs were for the OCHD. Dr. Aparna Jonnal commented on having to hire additional staff just to process claims due to Medicaid Transformation. Ms. Stewart informed the Board that many local health departments across the state are being affected financially and administratively due to the time it takes to resubmitting denied claims, reconciliation, etc. The PHPs are based on payment date vs the visit date. Some PHPs aren't honoring their agreement to pay claims within 6 months. Ms. S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda &Abstracts/ February Page 2