Approved Minutes of August 23 2023

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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 23,2023 VII. Action Items (Non-Consent) A. Semi-Annual Financial Review Frederick Perschau, the new Finance and Administrative Services Director, presented a review of the Health Department finances for the 2023 (July 2022-June 2023)fiscal year. Key points included: • Total health revenue (including all service revenue, state allocations, donations, and grants) was under budget (-64% of expected total) due to various operational issues (e.g., seeing fewer patients, understaffing, Southern Human Services being closed for HVAC repairs). o The greatest gap in revenue was in the Dental department due to personnel/staffing issues. Because the Health Department has recently hired a new dental assistant and three new half-time hygienists, it is anticipated that this issue will resolve. • Overall budget was $5M, of which $3.2M was spent. Most of the expenses were personnel costs and cost of supplies, which increased due to inflation. • COVID funding was allocated at $1.4M, of which $505K has been spent down (on vaccines, school portions, enhanced detection, Regional Infection Prevention Services). Approximately $200K will roll over and need to be spent down by the end of 2024. Dr. Stuebe asked whether the financial review accounted for reimbursement from Medicaid. Mr. Perschau replied that delays in reporting are common with reimbursement and that the figures may need to be adjusted in a later period. Ms. Stewart added that the Medicaid reimbursement period has returned to 365 days (having been shortened to 90 days at the onset of the transformation) which will also cause these figures to improve. Furthermore, two new positions in the billing unit have been added to the health department, which will also help address these gaps. B. New Fee Proposals Mr. Perschau provided an overview of the updated fee proposals, stating that most of the proposed changes are recommended because of updates to UNC lab fees, with the changes to post-partum care being adjusted to be in line with the Medicaid reimbursement rate. Dr. Jonnal asked how these fees are being charged (i.e., private insurance, Medicaid, self- payment), as she was concerned that some seemed expensive and might negatively affect access to care for self-pay patients. Ms. Stewart replied that for most patients these fees would be billed to insurance or Medicaid, which would increase Health Department revenue, and that for self-pay patients a sliding fee scale, which can slide as low as $0 if needed, would be available. Motion to approve the new fee proposals was made by Dr. Shielda Rodgers, seconded by Dr. Alison Stuebe, and carried without dissent. C. Board of Health Policy Review Ms. Stewart reviewed the proposed policy changes with the board members. The proposed changes were as follows: S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ August Page 6