Approved Minutes of October 25, 2023

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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH October 25, 2023 the annual flu vaccines and updated COVID boosters cost per dose, which was confirmed to be around $30 and $120 respectively. Mr. Bagby asked if the BOCC would also discuss this fee update, or if it would be `rubber- stamped' based on the BOH's recommendation. Ms. Stewart explained that the fee schedule amendments typically go onto the BOCC's consent agenda, meaning that they likely would not discuss it at a meeting unless a Board member has questions about the proposal. Ms. Stewart has already answered some questions from the Board of County Commissioners about this vaccine. Motion to approve the fee changes was made by Dr. Lee Pickett, seconded by Dr. Alison Stuebe, and carried without dissent. C. Delinquent Accounts and Debt Set-Off Reports Frederick Perschau, Finance and Administrative Services Director, presented information about delinquent accounts within the health department. He explained that the finance department identifies accounts which have been delinquent for 12+ months with a balance of$50 or greater. These accounts are put into set-off, which means they are sent to a county attorney and then the state for debt collection. The outstanding balance can then be garnished from state tax refunds and lottery winnings. Mr. Perschau clarified that this is different from a write-off, which is done on delinquent accounts with a balance of$49.99 or less, wherein the relevant accounts are made inactive, and the debt is not collected. In response to Dr. Crandell's question as to whether there is a cost for the attorney, Ms. Stewart clarified that as it goes through the County Attorney's Office, there is no charge to the health department. However, there is likely a charge paid by the Attorney's Office for this service. Mr. Perschau said that for the 2022-2023 fiscal year, there is a total outstanding set-off balance of$3,589.17 across 32 accounts, which will move into collections. For the same period, there is an outstanding write-off balance of$4,162 across 59 accounts. Ms. Stewart clarified that this figure does not include any delinquent accounts in the Personal Health Services department (including the medical clinic) due to an ongoing software problem making calculations of these accounts infeasible at this time. These will be submitted in 2024. Dr. Crandell asked whether a person whose account had been made inactive would have to pay off their debt before the account would be reactivated and they would be able to again receive services at the health department. Ms. Stewart explained that this is not required, but we would certainly ask them to pay what they are able. Mr. Whitaker asked if this information is tracked by obtaining the taxpayer ID of patients. Ms. Hudson explained that the debt set-off program requires verification of the identity of the individual, generally using verification questions based on public records, such as previous addresses, middle initial, etc. A service through the County Attorney's Office then obtains the Social Security Number after sending the demand letter warning of the impending submission to debt set-off. She added that for Environmental Health Services, most accounts are written off when the account owner no longer owns the property, has passed away, or is a corporation. Dr. Jonnal expressed that she felt a little uncomfortable with the idea of a public health department sending people to collections for unpaid medical bills, and asked if there is another way to resolve the outstanding debt. Ms. Stewart explained that the department works with S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ October Page 7