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HomeMy WebLinkAboutBOH agenda 092618 ORANGE COUNTY BOARD OF HEALTH MEETING AGENDA DATE: September 26, 2018 TIME: 7:00 P.M. PLACE: Whitted Building, 3rd Floor Meeting Room 300 West Tryon Street Hillsborough, NC 27278 TIME ITEM 7:00 p.m. I. Welcome New Employees 7:00 – 7:05 II. Public Comment for Items NOT on Printed Agenda public Comment for Items ON Printed Agenda will be handled during that agenda item (Please sign up for both on sheet near the entrance to room.) Please limit your comments to 3 minutes. 7:05 – 7:10 III. Approval of September 26, 2018 Agenda 7:10 – 7:15 IV. Actions Items (Consent) A. Minutes of August 22, 2018 Susan Elmore 7:15 – 7:50 V. Educational Sessions A. Nutrition Update/Employee Health and Wellness Renee Kemske (20 minutes) (relative to BOH Strategic Plan Priority: Physical Activity and Nutrition) B. Medicaid Transformation Update (15 minutes) Quintana Stewart 7:50 – 8:10 VI. Action Items (Non Consent) A. BOH Policy (20 minutes) Rebecca Crawford/ Quintana Stewart 8:10 – 8:35 VII. Reports and Discussion with Possible Action A. Health Director Annual Evaluation Susan Elmore B. Committee for 2019 Vice-Chair Selection Susan Elmore C. Health Director Report Quintana Stewart D. Media Items Kristin Prelipp 8:35 – 8:40 VIII. Board Comments 8:40 IX. Adjournment BOARD MEMBERS: To ensure a quorum, SEND E-MAIL to lstrange@orangecountync.gov advising her of your attendance at this meeting OR CALL 919-245-2411. Compliance with the “Americans with Disabilities Act” and Title VI - Interpreter services and/or special sound equipment are available on request. Call the Immigrant and Refugee Health Program Manager at 919.245.2387 to request an interpreter or other accommodation. Conforme a la “Ley sobre Estadounidenses con Discapacidades” (ADA) y el Título VI – los servicios de intérprete y/o equipo de sonido especial están disponibles a solicitud. Llame a la Administradora del Programa de Salud para Inmigrantes y Refugiados al 919-245-2387 para solicitar un intérprete u otros arreglos o adaptaciones. MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 1 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality of life, promote the health, and preserve the environment for all people in the Orange County community. THE ORANGE COUNTY BOARD OF HEALTH MET ON August 22, 2018 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Susan Elmore – Chair, Timothy Smith –Vice- Chair, Keith Bagby, Bruce Baldwin, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski, Jessica Frega and Liska Lackey. BOARD OF HEALTH MEMBERS ABSENT: Jennifer Deyo and Sam Lasris. STAFF PRESENT: Quintana Stewart, Health Director; Coby Jansen Austin, Director of Programs and Policy; Hannah Baldwin, Dental Hygienist; Lakaya Craig, Temporary FSA Zone Navigator; Rebecca Crawford, Financial and Administrative Services Director; Dominika Gazdzinska, Community Outreach Specialist; Victoria Hudson, Interim Environmental Health Director; Donna King, Health Promotion & Education Services Director; Kimberly Powell, Advance Practice Practitioner; Kristin Prelipp, Communications Manager; Juliet Sheridan, Health Informatics Manager; Beverly Scurry, BOH Strategic Plan Manager;and La Toya Strange, Administrative Assistant II. GUESTS PRESENT: None. I. Welcome New Employees Susan Elmore, Chair, called the meeting to order. She began by introducing new BOH member, Keith Bagby. Mr. Bagby gave a brief introduction of himself including that he recently became the chair of the ABC Board and is recently retired. The rest of the BOH members introduced themselves to Mr. Bagby. Quintana Stewart, Health Director, welcomed new employees Hannah Baldwin, Lakaya Craig, Dominika Gazdzinska, Kimberly Powell and Juliet Sheridan. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the August 22, 2018 Agenda Motion was made by Barbara Chavious to approve the agenda, seconded by Liska Lackey and carried without dissent. IV. Action Items (Consent) A. Minutes of June 27, 2018 Meeting Motion was made by Jessica Frega to approve the minutes of June 2018, seconded by Bruce Baldwin and carried without dissent. MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 2 V. Educational Sessions A. Cybersecurity Jim Northrup, Chief Information Officer, shared information on how Orange County tackles cybersecurity and vulnerabilities. The presentation was a general overview as to not disclose any confidential security information. Below is a summary: • Data must be protected. The OC servers are backed up at 2 different locations and the tapes are moved offsite at least 25 miles away which is the recommended minimum distance. • The number 1 reason that hacking occurs is due to people clicking on links. • OC has a fairly sophisticated filtering system. Currently 30% of email gets delivered to a mailbox; it used to be 2-3%. • Multiple audits are completed throughout the year. • OC IT is big on user-education. OC IT conducts phish testing, provides video training on key cybersecurity access for all staff and minimizes known vulnerabilities such as poor passwords. Eventually, OC IT will not allow the individual to log in if they don’t complete the cybersecurity training. • OC IT is working on a continuity operation plan. A restoration process/plan is also in place. After the County’s 4th cyberattack, restoration was completed in 12 hours which is a big improvement from the 2 ½ weeks (24 hours/day) it took for restoration during the 1st attack thanks to the OC IT restoration plan. • Six years ago, OC didn’t pay the ransomware when it was attacked and 99.98% of data was restored. Restoration takes the most time as there are millions and millions of files. To restore 1 serve driver takes 1 day. • OC IT has a web tracking system that can track what an individual clicks. Trying to identify people that are already on our network is an issue, not necessarily those that are trying to get in. OC IT needs to protect from the inside. Penetration testing is conducted and the reports are analyzed. • In response to the question of protecting healthcare data, it was shared that OCHD is one of the earliest partners of IT in terms of being proactive. • These measures have been critical in preventing a Mecklenburg County government situation. The BOH had questions that were addressed by Mr. Northrup. B. 4th Quarter Financial and Billing Dashboard Reports Rebecca Crawford, Financial & Administrative Services Director, gave a report on the 4th quarter revenue and billing accuracy. The report is as follows: • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY18 after the fourth quarter is $276/month or $3.5 million for the entire fiscal year, representing 98.5% of our overall budgeted revenue for the year. This is an increase of ~$600k over FY 16-17. Expenses were lower than revenues at 94% of the total overall budget due to multiple contracts that crossed into the beginning of FY 18-19 and will be spent out by August 2018, which was $9.8 million compared to year end FY 16-17, which was $9.2 million. MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 3 • Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14- 15, the average billing accuracy rate for medical for FY 17-18 was 91% as compared to the year-end average of 96% in FY 16-17. The average billing accuracy rate for dental for FY 17-18 was 101% as compared to 100% in FY 16-17. • Dental Earned Revenue by Source: The FY 17-18 average monthly revenue ($42.5/month) for the fourth quarter is below our budget projection ($43.4k/month) but above our FY 16-17 average of $39.8/month. FY 17-18 dental earned revenue totaled $511k at the end of the fiscal year, compared to $478k at the end of FY 16-17. • Medical Earned Revenue by Source: Medical earned revenue for the fiscal year was below the budgeted projection for FY 17-18 ($686k) at $609k since we had a provider on maternity leave until the end of December, provider turnover at the end of the fiscal year, and reduced appointments available to allow for Epic preparation. • Grants Fund Revenue: FSA received a multi-year grant for $100k per fiscal year for 3 years at the end of FY 17-18. These funds will carry through FY 18-19 and FY 19-20. We’ll track these and any other multi-year grants through this section of the financial report on an ongoing basis. • Note for FY 18-19 Revenue: FAS (Finance and Administrative Services Division) anticipates medical revenue will be delayed for the first 3 months of FY 18-19 as we close out billing in the Patagonia Electronic Medical Record System (EMR) and begin billing in the new Epic EMR. UNC has built an incredible billing system for the Health Department, however it is the first system like it they have ever built and we continue to work through anticipated system issues, which will delay billing to commercial insurance and Medicaid. Patients are still being seen so revenue will catch up in the latter part of the Fiscal Year. FAS also anticipates a potential delay in Environmental Health revenue as the division transitions to a new Central permitting system in October. Staff are training frequently now to reduce the impact on county residents and prepare for the upcoming Go Live. The BOH members had questions that were addressed by Ms. Crawford. C. Fluoride Ad Hoc Committee Update Liska Lackey, BOH member, began by reminding the Board that the role they have in reviewing a policy in which they have no authority is due to their duty to protect the public’s health while recognizing that OWASA has that authority. Ms. Lackey then reviewed the proposed plan for addressing key components in the November 3, 2017 letter in which OWASA requested a review of fluoridation. Ms. Lackey acknowledged and praised the fluoride committee members that provided input into this proposed plan. Board suggestions included making sure there is focus on the at-risk population and having local experts (e.g. those in the triangle area) participate. The Board came to a general consensus and all agreed on the proposed plan. Ms. Lackey will generate a letter for the Board chair’s signature to be sent to OWASA. The BOH members had questions that were addressed by Ms. Lackey. MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 4 D. Family Success Alliance Update Coby Jansen Austin provided an update on the Family Success Alliance and its strategic planning process. Below are highlights: • Currently, navigators are still assisting families in zone 4 and 6. They are actively working to recruit their 4th cohort of students and their families into the navigator program. • Recruiting for two more part-time navigators (with benefits) has occurred. The Social Worker Supervisor II position was reposted. Full-time navigators work with 20 families. There are 596 participants and 147 families that the navigators are assisting. • There are still 10 non-profits agencies that are working with the Family Success Alliance. • Parent Council was launched and has been meeting since February. They’re also going to give input on the strategic plan. • An external evaluation will be developed to determine if the families were satisfied with their services. • The strategic planning process has involved 2 full day retreats where discussion regarding the mission, vision, values and primary strategies (family empowerment, systems change and foundational support) occurred. Ms. Austin asked the Board for their feedback. • Goals of the primary strategies are to have parents be change leaders, expansion which may possibly take a year and to start building relationships as it’s harder to engage with other partners not already involved with the Family Success Alliance. An invitation for new partners has been extended. The BOH members had questions that were addressed by Ms. Austin. VI. Action Items (Non-Consent) A. FY 17/18 Delinquent Accounts Per the department’s Delinquent and Uncollectable Accounts policy (15.0), uncollectible accounts must be administratively written off of the general ledger. The purpose of this accounting function is to precisely account for funds which are truly unrecoverable. The last administrative write-offs were performed by the Board of Health in August 2017 (Personal Health, Dental Health, and Environmental Health) for FY 2016-2017. Personal Health, Dental Health, and Environmental Health continue to participate in the NC Debt Set-Off Program, which allows the county to collect debts on delinquent accounts with a balance between $50 and $4,000 through the customer’s tax refund. The Health Department anticipates collecting payments on delinquent accounts being pursued through the NC Debt Set-Off program; therefore, those accounts are not included in this write-off request. Based on the definitions of uncollectible accounts in the department’s policy, the following table represents all uncollectible debt from clients for FY 2017-2018. MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 5 Division Number of Uncollectable Accounts Write-Off Amount Personal Health 98 $1,750.60 Dental Health 76 $1,843.21 Environmental Health 2 $300.00 Total $3,893.81 We request to administratively move a total of $3,893.81 in uncollectible debt from ‘active’ to ‘inactive’ status for the reasons indicted in the table above. The customer will never be informed that a debt has been written off. If a customer whose account had been determined uncollectible returns to clinic within three years, the delinquent write-off amount will be reactivated and the billing process resumed. Likewise, if a customer requests a non-required service from Environmental Health, the delinquent write -off amount will be reactivated and the billing process resumed. The BOH members had questions that were addressed by Ms. Crawford. Motion to administratively move a total of $3,893.81 in uncollectable debt from “active” to “inactive” status was made by Mia Burroughs, seconded by Jessica Frega and carried without dissent. B. BOH Policy Review Quintana Stewart began by informing the BOH members that she has reviewed the Operating Procedures to ensure that all Accreditation requirements were met. Suggested edits/revisions discussed regarding the Operating Procedures were: • In section “C. Committees”, the current subcommittees that are in the Strategic Plan need to be listed. • Language needs to reflect diversity and the benefits of including such language into the Board’s Operating Procedures. A draft will be formed and will be voted on at the next BOH meeting. VII. Reports and Discussion with Possible Action A. Health Director Report In addition to her report, some of the highlights Ms. Stewart gave are below: • There are multiple strategic plans in process. The Racial Equity Commission will have staff and community focus groups to assist with their process. The Family Success Alliance had 2 days of strategic planning that discussed the program and its future direction. The Leadership Team is working on individual department plans. • Fulfilling a request by the Board, Ms. Stewart was accepted into the Municipal and County Administration Program at UNC SOG. She also expressed excitement about MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 6 being accepted into the NC Public Health Leadership Institute and has already started coursework. • The NCALHD presented the OCHD the Challenge Award for its 2013 work on tobacco policy. • Ashley Rawlinson and Healthy Carolinians will host its 2nd Suicide Prevention Walk on Friday, September 21st in Hillsborough at Gold Park. • The NCPHA will take place in Charlotte. Several of our staff are on the agenda including Victoria Hudson (a poster presentation), Nicholas Cordeiro (oral health) and Iulia Vann and Tommy Green (F.I.T. Program). Susan Elmore added that the ANCBH also has awards. She encouraged staff to go to their website and complete an application next year as it’s a great opportunity to reward for a job well done. B. Media Items Kristin Prelipp, Communications Manager, briefly mentioned the article topics of the F.I.T. Program, a radio interview hosted by Frank Stasio in which Dr. Evan Ashkin and Tommy Green participated, rabies and the Safe Syringe Program that were included in the Media Items packet. Media items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Board Comments None. IX. Adjournment Jessica Frega moved to adjourn the meeting at 9:05pm and Commissioner Mia Burroughs seconded. The next Board of Health Meeting will be held September 26, 2018 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Community Health Grant- Nutrition Services Attachment(s): Staff or Board Member Reporting: Renée Kemske, Nutrition Program Manager Purpose: ____ Action _X _ Information only ____ Information with possible action Summary Information: OCHD was initially awarded funding ($122,065) for a Community Health Grant from the Office of Rural Health from September 2017 to June 30, 2018 with the goal of increasing access to primary care and self-management support services for adults with chronic conditions. OCHD used the funding to pilot a voucher program covering the costs of the fee for nutrition services, to provide diabetes testing supplies for primary care patients and to offer diabetes classes in Spanish. UNC Family Medicine is a partner on this grant and used funds to increase the number of chronic disease management classes offered. The partners also initiated a Community Health Collaborative to increase awareness of local resources and to formalize referral systems. OCHD was awarded additional funding for FY18-19 ($145,917) to expand the pilot program by developing a transportation assistance program, replicating the nutrition services voucher program at the Chatham County Public Health Department and by providing funding and support for the Department on Aging cholesterol screenings and wellness events. UNC Family Medicine also plans to offer the chronic disease management classes in Spanish. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ___________________________ _X_Accept as information ___Revise & schedule for future action ___Other (detail): Community Health Grant Nutrition Update ORANGE COUNTY HEALTH DEPARTMENT NUTRITION SERVICES Renée Kemske, MPH, RD, LDN, Nutrition Program Manager OBJECTIVES Provide an overview of Nutrition Services Discuss goals/progress of Community Health Grant Present upcoming plans for FY18-19 OVERVIEW OF SERVICES Medical Nutrition Therapy Diabetes Self-Management Education Services Employee Wellness Services CDC Minority Diabetes Prevention Program NUTRITION COUNSELING NUTRITION COUNSELING Medical Nutrition Therapy (MNT) Provided by an RD who works with the referring medical provider to improve conditions such as diabetes, heart disease, and obesity Conducts thorough review of medical history, medications, labs, diet, and lifestyle patterns Develops a personalized nutrition treatment plan/goals to improve health outcomes MEDICAL NUTRITION THERAPY (MNT) MNT Data Total Encounters for FY 2017-2018: 782 Health Department 415 53% Non-Health Department 367 47% Types of clients Count % Maternal Health 163 21% Child Health 148 19% PC 87 11% FP 17 2% Adult Non Health-Dept Referrals 250 32% Child Non Health-Dept Referrals 117 15% MEDICAL NUTRITION THERAPY (MNT) Clients by Payment Type (782 Total) Payer Count % Medicaid 328 42% Insurance 240 31% Self-Pay 214 27% DIABETES SELF-MANAGEMENT EDUCATION SERVICES (DSME) DIABETES SELF-MANAGEMENT EDUCATION SERVICES (DSME) Participants will receive 10-hours of education: Initial health assessment Two 4-hours group education classes on the basics of diabetes care Follow-up appointment 3 months after the group class (1-hour group) COMMUNITY HEALTH GRANT Background Submitted Application-March 2017 Community Health Grant through the Office of Rural Health Awarded $122,065 Ten -month period (September 2017-June 2018) To increase access to primary care and self- management support services for residents with chronic disease. COMMUNITY HEALTH GRANT Target Population: Adults who are uninsured or who have Medicaid or Medicare Adults with any of the following conditions: Obesity Pre-diabetes or diabetes Abnormal lipids Hypertension GRANT SPECIFIC AIMS Supplement staff funding and operational costs Medical Nutrition Therapy Diabetes Self-Management Education Services Create a voucher program covering the costs of the minimum fee for nutrition services ($20) Cover the cost of A1C tests and SMBG supplies for people with diabetes Increase accessibility of interpretation services for LEP patients (MNT and DSME Interpreters) GRANT SPECIFIC AIMS Funds to supplement costs for UNC Family Medicine to offer at least two Living Healthy classes Stanford Curriculum chronic disease classes Hire Community Health Worker Establish relationships with people in the community offering support to better manage chronic conditions Increase awareness of services/link people to services (outreach and marketing) Teach Living Healthy classes Conduct focus groups GRANT SPECIFIC AIMS Convene Community Partnership/Collaborative Medical providers and community agencies Partnership Goal To increase community awareness of services and linking residents to care through formal referral systems COMMUNITY PARTNERSHIP AIMS Conduct a needs assessment/gap analysis of current services in Orange County (chronic disease focus) Increase outreach and awareness of services available to residents (medical providers, organizations, residents) Develop coordinated programing and referrals systems Conduct focus groups to gather input on resident needs and barriers to care CHG FY17-18 YEAR IN REVIEW Voucher Program Provided 134 appointments 105 Medical Nutrition Therapy 29 Diabetes Self-Management Education Tripled the # of primary care clients seen (31 v. 87) Diabetes Testing Supplies Developed and implemented protocol to offer A1C tests and diabetes testing supplies at no cost for uninsured clients CHG FY17-18 YEAR IN REVIEW DSME Spanish Classes Held 2 classes (4 sessions) Purchased simultaneous interpretation devices to aid in interpretation MNT Behavior Change Incentives Purchased water bottles, calorie tracking book, step tracker in May 2018 for MNT clients CHG FY17-18 YEAR IN REVIEW Success Stories One Spanish LEP client has lost 20# since starting MNT appts (October 2017). Client reported she would not have been able to afford the service without the voucher and reported it was the support of the service that helped her lose weight. DSME Class Evaluation Data 100% of participants had improved knowledge of diabetes self- care behaviors Spanish LEP clients rated the class as excellent and liked the simultaneous interpretation devices used CHG FY17-18 YEAR IN REVIEW Living Healthy Classes Offered 5 Classes (54 people) Rogers Road Community Center, UNC Family Medicine, Passmore Senior Center Standardized Evaluation tool (Patient Activation Measure) Scores increased by five points pre/post the classes Participants ranked their satisfaction at 4.9 out of 5 CHG FY17-18 YEAR IN REVIEW Living Healthy Classes Offered 5 Classes (54 people) Rogers Road Community Center, UNC Family Medicine, Passmore Senior Center Standardized Evaluation tool (Patient Activation Measure) Scores increased by five points pre/post the classes Participants ranked their satisfaction at 4.9 out of 5 CHG FY17-18 YEAR IN REVIEW Community Health Worker/Outreach Progress Regularly updated provider/community contact sheet for disseminating information (478 contacts) Provided two mass mailings/emails to contacts regarding services (44 practices and 159 medical providers) Provided 29 on-site visits to medical practices and 69 email/phone call follow-ups Conducted 58 additional outreach efforts CHG FY17-18 YEAR IN REVIEW Community Health Collaborative Held 4 meetings: 11/2/17, 1/11/18, 4/26/18, 6/21/18 Partners: PHS, OCHD, UNCFM, YMCA, OCDOA, CCPHD, CCNC, Carolina Health Net Started resource guide of community partners to increase awareness of local services CHG FY17-18 YEAR IN REVIEW Older Adult Focus Group May 2018,10 Participants Passmore Senior Center Barriers to Care Key Points Decreased awareness of chronic disease programs Transportation and cost Communication Preferred methods: mail, senior times and email CHG FY17-18 YEAR IN REVIEW Latino Community Focus Group May 2018, 7 Participants St. Thomas More Church Barriers to Care Key Points Decreased awareness of chronic disease programs Cost, time and language Communication Preferred methods: text messaging, email, church FY18-19 GRANT OVERVIEW Awarded $145,914 (July 2018 - June 30, 2019) OCHD to continue voucher program covering the minimum fee costs CCPHD to replicate voucher program ($15) Cover the cost of A1C tests and SMBG supplies for people with diabetes Supplement staff funding and operational costs FY18-19 CHG SPECIFIC AIMS Transportation Assistance Program Pilot program for high risk individuals to increase access to care Convened committee (9/7/18) Assessment criteria Vendors Safety and legal factors Initial implementation plan FY18-19 CHG SPECIFIC AIMS Expand Collaboration with OC Department on Aging Provide financial support for quarterly cholesterol screenings Provide targeted outreach to older adults through existing wellness programming FY18-19 CHG SPECIFIC AIMS Train Community Health Worker in Spanish Living Healthy Curriculum - provide at least 1 class in Spanish Increase accessibility of interpretation services for LEP patients MNT interpreters Offer at least 2 diabetes classes in Spanish GRANT SPECIFIC AIMS Continue Quarterly Community Collaborative Meetings Medical providers, community organizations and residents Formalize a referral and feedback system between services and increase community awareness of services Conduct Final Focus Group Review data analysis and develop action plans based on analysis SUMMARY/QUESTIONS Provided an overview of Nutrition Services Discussed goals/progress of Community Health Grant Presented plans for FY18-19 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Medicaid Transformation Update Attachment(s): Medicaid Transformation Presentation 2018 Staff or Board Member Reporting: Quintana Stewart Purpose: ____ Action _X Information only ____ Information with possible action Summary Information: In September 2015, the NC General Assembly enacted Session Law 2015-245, which directed the transition of Medicaid from a fee-for-service structure to a managed care structure. On August 10, 2018 NC DHHS released a Request for Proposal for PrePaid Health Plans (PHPs) in Medicaid Managed Care. This update will outline the requirements for PHPs and the impact of this for the Local Health Departments in NC. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ___________________________ __X_Accept as information ___Revise & schedule for future action ___Other (detail): Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Board of Health Policy Review Attachment(s): Staff or Board Member Reporting: Purpose: ____ Action _ Information only __X__ Information with possible action Summary Information: The Board will review and discuss the Board of Health Operating Procedures to ensure processes are efficient and in compliance with NC General Statue 130A. The Board will review the requested revisions to detail Board Composition and updated Committee listings. Additional revisions will be made as needed and the Board will be asked to approve the policy. Proposed revisions include: III. Composition A. The composition of the Board of Health is governed by NCGS 130A-35(b)-(d) which states the composition of the board shall reasonably reflect the population and makeup of the county. B. For purposes of Board composition, diversity includes, but is not limited to, professional experience, cultural and educational background, geography, age, gender, race and ethnicity. When assessing Board composition or identifying suitable candidates for appointment/re-appointment, the Board will consider candidates on merit and statutory requirement with consideration to the benefits of diversity. C. The Orange County Board of Health is committed to ensuring diversity among members and values the benefits that diversity brings. Diversity promotes the inclusion of different perspectives and ideas, mitigates against group think and ensures that the Board has the opportunity to benefit from a variety of skills, backgrounds and experiences. D. The Board’s commitment to diversity shows internal and external stakeholders that the organization emphasizes diverse constituencies and does not discriminate against minorities, thereby enhancing the Board’s reputation with county government and citizens. C. Committees 3. Physical Activity & Nutrition to replace Access to Care 5. Social Determinants of Health to replace Childhood and Family Obesity Prevention Recommended Action: _X_Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ___________________________ ___Accept as information ___Revise & schedule for future action ___Other (detail): ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 1 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx Purpose To outline operating procedures for the Board of Health in accordance with pertinent state, local and federal requirements for the operation of the Board. I. Name and Office The name of this organization is the Orange County Board of Health (hereinafter “Board”). The principal office of the Board is located at 300 West Tryon Street, Hillsborough, NC 27278. II. Charge to the Board The Board is the primary policy-making and adjudicatory body (NCGS 135A-25(a)) for the health department and is charged to protect and promote the public health of Orange County (NCGS 130A-39). III. Composition A. The composition of the Board of Health is governed by NCGS 130A-35(b)- (d) which states the composition of the board shall reasonably reflect the population and makeup of the county. B. For purposes of Board composition, diversity includes, but is not limited to, professional experience, cultural and educational background, geography, age, gender, race and ethnicity. When assessing Board composition or identifying suitable candidates for appointment/ re-appointment, the Board will consider candidates on merit and statutory requirements with consideration to the benefits of diversity. C. The Orange County Board of Health is committed to ensuring diversity among members and values the benefits that diversity brings. Diversity promotes the inclusion of different perspectives and ideas, mitigates against group think and ensures that the Board has the opportunity to benefit from a variety of skills, backgrounds and experiences. Increasing diversity at the board level is an essential element in supporting the attainment and sustainability of its strategic objectives. Diversity allows the board to make more effective decisions for the department and community residents as well as enhances its reputation among county government and citizens. D. The Board’s commitment to diversity shows internal and external stakeholders that the organization emphasizes diverse constituencies and does not discriminate against minorities, thereby enhancing the Board’s reputation with county government and citizens. A. Diversity will include and make good use of the differences in the skills, knowledge, professional experience, cultural and educational background ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 2 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx gender, age, race, ethnicity, geography, and other qualities of the individual members as a whole. IV. Terms of Office A. By NCGS 130A-35 (c), members shall serve three year terms and no member may serve more than three consecutive three-year terms unless the member is the only person residing in the county who represents one of the professions designated in subsection (b) of NCGS 130A-35. B. It is the policy of the Orange County Board of Health that members may serve three, three-year consecutive terms. Members appointed to fill unexpired terms are eligible to subsequently be appointed to three additional terms. V. Officers and Committees A. Chair and Vice-Chair The Board members shall select a Chair and Vice-Chair by majority vote each year at the last meeting of the calendar year. B. Secretary The Orange County Health Director shall serve as Secretary to the Board, but the Director is not a member of the Board. The Health Director may delegate the duties of the secretary that are set forth in these operating procedures to an appropriate local health department employee. C. Committees The Board shall review the existing committee structure annually and make decisions regarding the number and types of standing committees. Board members are appointed to committees in January of each year. Only Board members may serve as committee members of standing Board committees and the number of Board members on any single committee must be at least two members and may not exceed five members. The Board shall have the following standing committees: 1. Executive Committee To provide the structure for the work of the Board of Health and act as an advisor to the health director and senior management staff as needed. Chair and Vice-Chair are committee members. 2. Nominating and Bylaws Committee To develop and present an annual slate of officers for Board consideration, to oversee the board recruitment process, and to recommend operating procedure changes as needed. Members are appointed by the Chair on an ad hoc basis. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 3 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx 3. Access to CarePhysical Activity and Nutrition To oversee the action steps and deliverables outlined in the Access to Care Physical Activity and Nutrition section of the Board of Health Strategic Plan 4. Mental Health and Substance Abuse To oversee the action steps and deliverables outlined in the Mental Health and Substance Abuse section of the Board of Health Strategic Plan 5. Childhood and Family Obesity Prevention Social Determinants of Health To oversee the action steps and deliverables outlined in the Childhood and Family Obesity Prevention Social Determinants of Health section of the Board of Health Strategic Plan All standing committees are subject to the North Carolina open meetings laws and shall comply with the provisions of those laws. 6. Temporary Committees The Board may establish and appoint members for temporary committees as needed to carry out the Board’s work. Temporary committees must limit their work to the specific charge outlined by Board motion and may include members that are not serving on the Board of Health. All temporary committees are subject to the North Carolina open meetings laws and shall comply with the provisions of those laws. VI. Meetings A. Regular Meetings The Board shall hold regular meetings no less than quarterly. As a general rule, the Board will meet monthly. A calendar of regular meetings and location of each meeting will be established at the last regular meeting of the calendar year for the next calendar year. The dates may be adjusted annually based on Commissioner meeting dates for the year to enable the Commissioner member of the Board to attend. The requirements of the open meetings law shall apply to all regular board, regular or ad hoc committee or task for meetings. Notification of the public will be in compliance with open meeting law notification. B. Agenda The Secretary to the Board shall prepare an agenda for each meeting. Any board member who wishes to place an item of business on the agenda shall submit a request to the Secretary at least five working days before the ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 4 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx meeting. For regular meetings, the Board may add items to the agenda or subtract items from the agenda by a majority vote. The agenda for a special or emergency meeting may be altered only if permitted by and in accordance with the North Carolina open meetings laws. C. Presiding Officer The Chair of the Board shall preside at Board meetings if he or she is present. If the Chair is absent, the Vice-Chair shall preside. If the Chair and Vice- Chair are both absent, another member designated by a majority vote of members present at the meeting shall preside. D. Quorum A majority of the actual membership of the Board, excluding vacant seats, shall constitute a quorum. A member who has withdrawn from a meeting without being excused by a majority vote of the remaining members shall be counted as present for purposes of determining whether or not a quorum is present. E. Voting Each Board member shall be permitted to abstain from voting, by so indicating when the vote is taken. A member must abstain from voting in cases involving conflicts of interest as defined by North Carolina law. If a member has withdrawn from a meeting without being excused by a majority vote of the remaining members, the member’s vote shall be recorded as an abstention. F. Minutes The Secretary shall prepare minutes of each Board meeting. Copies of the minutes shall be made available to each Board member before the next regular Board meeting. At each regular meeting, the Board shall review the minutes of the previous regular meeting as well as any special or emergency meetings that have occurred since the previous regular meeting, make any necessary revisions, and approve the minutes as originally drafted or as revised. The public may obtain copies of Board meeting minutes at the Board of Health website (http://www.orangecountync.gov/departments/health/agendas_and_minutes.p hp). VII. Contract Negotiations The Health Director is authorized to enter into a contract with any governmental or private agency or with any person, for the provision or receipt of public health ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 5 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx services. The Board of Commissioners or its designee must approve contracts requiring payment for services rendered to the Health Department. The Health Director will discuss with the Board contracts that represent significant deviation from current Board of Health policy prior to authorizing that contract. VIII. Amendments to Operating Procedures These operating procedures may be amended at any regular meeting or at any properly called special meeting that includes amendment of the operating procedures as one of the stated purposes of the meeting. A quorum must be present at the meeting at which amendments are discussed and approved, and any amendments must be approved by a majority of the members present at the meeting. IX. Other Procedural Matters The Board shall refer to Bell, II, A. Fleming. Suggested Rules of Procedure for Small Local Government Boards, Second Edition, Institute of Government, The University of North Carolina at Chapel Hill, 1998 to answer procedural questions not addressed in this document, so long as the procedures prescribed in Suggested Rules of Procedure for Small Local Government Boards do not conflict with North Carolina law. X. Rules Development Procedure The board shall evaluate the need for adoption of rules to protect and promote the public health. In addition, existing rules should be evaluated periodically for the need for revisions to respond to new risks, advances in technology, or changes in statutes or state regulations. A. The Board will follow the procedures outlined in NCGS 130A-39. 1. Not less than 10 days before the adoption, amendment or repeal of any local board of health rule, the proposed rule shall be made available at the office of the county clerk, and a notice shall be published in a newspaper having general circulation within Orange County. The notice shall contain: a. A statement of the substance of the proposed rule or a description of the subjects and issues involved. b. The proposed effective date of the rule, and c. A statement that copies of the proposed rule are available at the local health department. A local board of health rule shall become effective upon adoption unless a later effective date is specified in the rule. 2. Copies of all rules shall be filed with the secretary of the local board of health and will be made available to all Board of Health members. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 6 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx 3. A local board of health may, in its rules, adopt by reference any code, standard, rule or regulation, which has been adopted by any agency of this State, another state, any agency of the United States or by a generally recognized association. Copies of any material adopted by reference shall be filed with the rules. XI. Adjudication Procedures A. The Board will follow all procedures as specified in NCGS 130A-24. In the case where a member of the public is appealing a decision on the application of an Orange County Board of Health adopted rule or concerning the imposition of administrative penalties by a local health director, the process will include the following steps: 1. The aggrieved party shall provide written notice of appeal to the Health Director within 30 days of the challenged action. The notice shall contain the name and address of the aggrieved person, a description of the challenged action and a statement of the reasons why the challenged action is incorrect. 2. The Health Director shall notify the Board within five working days of receipt of the appeal and transmit all documents upon which the challenged action was taken. 3. The Board of Health shall hold a hearing within 15 days of the receipt of the notice of appeal from the health director to the Board. The Board will give the person not less than 10 days notice of the date, time and place of the hearing. The local board of health shall issue a written decision based on the evidence presented at the hearing. The decision shall contain a concise statement of the reasons for the decision.The hearing must meet the requirements of procedural due process. a. No contact outside the hearing with parties involved or between board members. b. Board members with any bias must not participate. c. Board must allow the appellant’s attorney to attend and advise his/her client. d. Board must take sworn and relevant testimony. e. Board must provide for cross-examination of witnesses. f. Board must keep detailed or verbatim minutes. 4. The proceedings shall be recorded and a transcript of the hearing shall be prepared and be available to the appellant and/or the Board upon request. 5. At the next regularly scheduled Board meeting following the hearing, the Board must issue a written decision based on the evidence presented at the hearing. The decision shall contain a concise statement of the ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process A: Operating Procedures Reviewed by: Health Director Approved by: Health Director, Board of Health Review Annually (July) Page 7 of 7 Original Effective Date: February 8, 1979 Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12, 11/5/13, 11/14, 8/15 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VI. A. BOH 2018 Review of Operating Procedures.docx reasons for the decision and the Secretary will transmit the final written decision of the Board to the person appealing via certified US mail. 6. A person who wishes to contest a decision of the Board of Health shall have a right of appeal to the district court having jurisdiction within 30 days after the date of the decision. XII. Annual Review of the Health Director The Board will annually review the performance of the Orange County Health Director using the process detailed in the Board of Health Policy and Procedure Manual, Section III, B.d. Annual Performance Review Process for Health Director. XIII. Compliance with North Carolina Law In conducting its business, the Board shall comply with all applicable North Carolina laws, including but not limited to open meetings laws, public records laws, and the laws setting forth the responsibilities and duties of local boards of health. To assist the Board in compliance, the local health director shall maintain a current copy of relevant North Carolina General Statutes and make them available to Board members on request. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Fee and Eligibility Policy Review Attachment(s): Draft Fee and Eligibility Policy Staff or Board Member Reporting: Rebecca Crawford Purpose: ____ Action _X__ Information only ____ Information with possible action Summary Information: The Board of Health reviews its policy manual annually. Updates to two sections of the Fee and Eligibility section of the policy are recommended below: I.E. Fee and Eligibility Policy Staff recommends making the following revisions to the Fee and Eligibility Policy for the purposes of clarification, to be in compliance with state requirements, and to update according to system changes: - Service Limitation/Denial (Section V.C.): Expanded the section stating that Family Planning patients will never be refused service due to an outstanding balance or inability to provide proof of income to include Maternal Health and Child Health patients at the recommendation of the DHHS Administrative Consultant. - Fees Collection (Section VII.E.): Clarified that clients are given a statement showing the cost of services after charges are processed upon request rather than at the time services are received since the Epic Electronic Medical Record (EMR) system is unable to produce a statement until after charges are processed, which may not occur until after the patient has left the clinic. - Fees Collection (Section VII.I.): Updated the Billing Cycle section to specify the billing statement process for the Epic Electronic Medical Record (EMR) system since it differs from both the Patagonia EMR and Eaglesoft EMR that was detailed in the previous version. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to _______________ _X__Accept as information ___Revise & schedule for future action ___Other (detail): ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 1 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 I. Purpose A. Public health services are increasingly costly to provide. The Health Department serves the public’s interest best by assuring that all legally required public health services are furnished to all citizens. The department provides recommended and requested public health services based upon the priorities established by the Board of Health. B. Fees are a means to help provide services to the residents of Orange County. Fees help finance and extend public health services when government funding is not sufficient to support the full cost of providing all required and requested services. C. Fees for Orange County Health Department services are authorized under North Carolina G.S. 130A-39, provided that: 1. They are in accordance with a plan recommended by the Health Director and approved by the Board of Health and the Orange County Board of Commissioners. 2. They are not otherwise prohibited by law. 3. They are deposited to the account of the local Health Department for public health purposes in accordance with the provisions of the Local Government Budget and Fiscal Control Act. D. Fees for services must also be in compliance with N.C. Administrative Code, Title X Regulations, and Women’s and Children’s Health Program Rules. E. There will be no charge for Title X Services provided for individuals with income less than 100% of the Federal Poverty Level (FPL.) II. Policy Implementation The implementation of this policy is delegated to appropriate financial or support staff in each division of the health department. III. Income Eligibility A. Definitions 1. Definition: A family is defined as a group of individuals who are living together as one economic unit. Individuals are considered members of a single family or economic unit when their production of income and consumption of goods are related. A pregnant woman is counted as a family of two in determining family size. 2. Income eligibility requirements apply to: Dental Health, Family Planning, Child Health, Maternal Health, Adult Health, Nutrition Services, Family Home Visiting, and Primary Care Services. 3. The Health Department utilizes a sliding fee scale based on Federal Poverty Guidelines in accordance with the Fee Schedule approved annually during the County Budget process. NC DPH updates and issues the scale yearly. Specifically, ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 2 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 the health department uses the 101% - 250% Federal Poverty Level sliding scale. Determination of Sliding Fee percentage is based on gross income and family size. 4. Verification of income is required at time of enrollment for services, at the annual financial interview, or if there is a change in the work status in the family unit for clients to be eligible for the sliding fee scale. a. An annual gross income statement is preferred for evaluation. i. Gross income is defined as the total of all cash income before deductions for income taxes, employee social security taxes, insurance premiums, bonds, etc. For self-employed applicants, net income after business expenses. Gross income does NOT include money earned by children for babysitting, lawn mowing and other tasks. ii. In general gross income includes: salary, wages, commissions, fees, tips, overtime pay, unemployment compensation, public assistance money, alimony and child support payments, Social Security benefits, VA benefits, Supplemental Security Income (SSI) benefits, retirement & pension payments, worker’s compensation, bonuses, prize winnings and other sources of cash income except those specifically excluded. B. Sources 1. Sources of income verification may include, but are not limited to: a. Current pay stub b. Self-employment accounting records c. Letter documenting current employment and wages from employer d. Recent income tax return e. Unemployment or workers compensation receipt f. Public assistance letter g. Prior income verification through enrollment in other Health Department programs 2. If an individual claims “no income” (except for minors consenting to specific services under G.S. 90-21.5), a signed “Verification of Income and/or Residency” form (Attachment A) indicating financial support from another party must be submitted. 3. Failure to provide verification within 30 days or less of date of service will result in charges being assessed at 100% of sliding fee scale. The client will receive notification of required income verification at the time the initial appointment is made. 4. The client must read, sign and understand the “Determination of Eligibility Payment Plan for Clinical Services” and “Statement of Financial Responsibility Payment Plan” form (Attachment B) at their initial visit and annual financial reviews. C. Environmental Health Persons seeking Environmental Health services must obtain and properly complete an application for service and pay the corresponding fee for service (all applicants pay at the 100% pay status) before an appointment for a field visit will be scheduled. Sometimes ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 3 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 additional fees may be necessary if during service delivery it is determined that the correct fees were not initially paid, or services requested are more than applied for. Wastewater Treatment Management Program (WTMP) and Mobile Home Park fees are the only Environmental Health services invoiced after the inspection. These inspections are not application based but occur on a regulated, recurring schedule. IV. Residency Requirements A. Any individual, Orange County resident or non-resident, may be eligible for services provided by the Health Department. Exceptions include non-STD Communicable Disease cases, designated Family Home Visiting programs (Orange County residents only), and when prohibited by law or regulation. B. Proof of Residency may be determined by using the US Postal and/or Orange County GIS website and one of the following: Driver’s License, Government-issued identification, Pay Stub (Within the last 30 days), Utility bill (Within the last 45 days); Current rental or lease agreement; Personal or property tax bill; Student identification, and Matrícula Consular (Mexican ID Card 1). Clients without one of the above identifying information sources but reportedly living within the county will be required to produce a written statement or letter from the head of household, verifying that the person resides in their home. Special cases will be referred to the Clinic Manager or Supervisor. Failure to provide proof of residency may result in referral to another resource. C. Proof of Residency in Orange County is required for self-pay patients to be eligible for the sliding fee scale when requesting Maternal Health, Child Health, Primary Care, Nutrition Services, and Dental Health Services. Out-of-county residents will be assessed at 100% of charges not covered by a third party payer source. V. Service Limitation/Denial A. Services will not be denied based solely on the inability to pay, with the exception of those services that require a flat or minimum fee. Emergency dental services and urgent primary care services will be provided to clients regardless of any outstanding balance due. B. Otherwise, services may be denied if the department does not have the resources needed to provide a quality non-mandated service or the individual does not meet the residency or financial requirement. 1 The Matrícula Consular de Alta Seguridad (MCAS) (Consular Identification Card) is an identification card issued by the Government of Mexico through its consulate offices to Mexican nationals residing outside of Mexico. Retrieved from http://en.wikipedia.org/wiki/Matr%C3%ADcula_Consular on October 14, 2012. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 4 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 C. Family Planning, Maternal Health, and Child Health clients will never be refused service due to an outstanding balance or inability to provide proof of income. Health Department clients are eligible to receive Family Planningthese services regardless of their participation in other programs. Family Planning, Maternal Health, and Child Health services are voluntary to all clients. D. Maternal and Child Health clients who are at 60% to 100% pay status may have services limited or denied for failure to make payments based on designated Payment Plans (“good faith” effort). E.D. Falsification of eligibility by the client may result in denial or limitation of services. F.E. The Health Department shall not deny a service due to religion, race, national origin, creed, sex, marital status, familial status, sexual orientation, veteran status or age. G.F. The Health Department shall assure that no otherwise qualified handicapped individual, solely by reason of his/her handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity covered by this agreement. H.G. The Health Director can override any decision to deny or limit services to a client in accordance with the existing fee waiver process. VI. Fees for Services A. In order to facilitate early entry into prenatal care or family planning services, pregnancy tests will be provided free of charge unless they are required as part of another service. B. In order to facilitate early identification of and referral for hypertension, two blood pressure screenings will be provided in the clinic free of charge. Borderline readings will be checked free until determined to be normal or the client is referred for further evaluation. Follow-up of clients with a diagnosis of hypertension will be charged according to the fee policy. C. Fees are not charged for diagnosis and treatment of sexually transmitted diseases, or investigation and control of communicable diseases. There is also no charge to clients for any State-provided vaccine. D. Fees are charged for health and dental services provided to individuals unless prohibited by law or regulation. Fees are established based upon cost analysis, Medicaid and Medicare rates, comparable provider rates and/or state or contractual agreements. The Health Director shall inform the Board of Health and the Orange County Board of Commissioners of these adjustments in a timely manner. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 5 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 E. Fees may be charged to clients for “non-program” specific services without being adjusted on a sliding fee scale (flat fees). F. Fees may be charged for education, community-based limited clinical services (such as influenza shots) and screening services provided to individuals or groups. The following applies to these services: 1. They include orientation, field training, dental screening and education, and/or other health promotion activities such as infant and toddler car seats, bike helmets, or equipment rental. 2. The Health Director will negotiate fees for services where fees have not been previously determined. 3. Income eligibility requirements do not apply to these services. G. Per NC General Statute Chapter 7B, Subchapter 4, Article 35, and confidentiality regulations, emancipated minors and other individuals requesting confidential services will be considered a family of one for determination of charges. Private insurance will also not be billed for minors receiving services for which they can consent unless permission is received from the minor. H. Persons requesting any program services may be encouraged to apply for Medicaid, as applicable. I. The Personal Health Services Division clinical and nutrition services will use the appropriate sliding fee schedule for services when adjustable fees are allowed; all other fees will be charged at 100%. 1. Clients, who require services provided on the sliding fee schedule, are expected to pay the appropriate fee in full based on sliding fee guidelines. 2. This schedule will require assessment of the client’s financial status on an annual basis or when a financial status change occurs, as specified in section III. J. Dental Health Services, Primary Care Services, and Nutrition Services will use a sliding fee schedule for all services, with a minimum charge to be established at the annual fee review during the budget preparation process. 1. The minimum charge for dental, primary care, and nutrition services will apply regardless of the determination of the client’s financial status. 2. If a client is determined to fall at the 0% pay level, the minimum charge will be the only charge levied and collected unless the client is deemed homeless. 3. Minimum charge is due at time of service. K. Fee schedules will be reviewed annually during the budget process and adjusted as appropriate; a complete cost analysis for purposes of fee adjustments will be performed every five years. The process for this cost analysis includes a review of the following elements: a. Most recent vaccine and drug purchase costs b. Most recent lab pricing lists ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 6 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 c. Most recent Medicaid Cost Settlement data for procedure costs d. Environmental Health equipment, labor, and staff costs e. Review of fee schedules of surrounding jurisdictions f. Analysis of existing self-pay client base and how increased costs would affect their ability to get necessary care L. Based on G.S. 130A-41, the Health Director is authorized to enter into contracts, which may include negotiated reimbursement rates. M. The Health Director may not make exceptions to the Fee Policy except to accommodate specific situations through the fee waiver process (Attachment C). N. Any minimum administrative fee or flat fees shall be applied without discrimination to all patients. O. There will be no “schedule of donations”, bills for donations, or any other implied coercion for donations from clients as a condition for being seen at the Health Department. Donations to the health department can be made through the Orange County Community Giving Fund. Fees for services will not be waived because of client donations. P. Fees for 340b drugs dispensed to Medicaid patients will be reviewed and set annually based on the average, annual cost to the County to purchase the drugs. VII. Fee Collection A. Environmental Health service fees are paid before an appointment is scheduled. Field staff cannot accept fees in the field. B. Fees collected from Medicaid and Medicare and other third party insurance for a covered service, combined with payment of any applicable co-pays and co-insurance, constitutes full payment for that service. C. A co-payment, deductible, or balance of charge can be collected at the time of service from individuals covered by other third party insurance plans when OCHD is a member of their provider panel (exception family planning). For Family Planning clients, family income should be assessed before determining whether co-payments or additional fees are charged; if their family income is verified to be at or below 250% FPL, they should not pay more (in copayments or additional fees) than what they would otherwise pay when the schedule of discounts is applied. With regard to other insured clients, payments towards a deductible for clients whose family income is verified to be at or below 250% FPL should have the appropriate sliding fee schedule applied. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 7 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 D. If OCHD is not on the insurance provider panel, the client will be charged for the service(s) based on the Health Department’s fee schedule. The client will be provided with documentation of services for submission of a claim to their insurance company. E. At the time services are receivedAfter charges are processed, the client will be given a statement showing the cost of services for that visit as well as their total account balance upon request. F. Payment is due at the time services are rendered. G. When the client is unable to pay in full at the time services are rendered, a payment plan is established, and the client must sign a “Payment Agreement Form” (Attachment D) except for minimum-fee or flat-fee charges. Client must then make a payment in any amount in order to activate the payment plan. H. When a client requests “no mail”, discussion of payment of outstanding debt shall occur at the time the service is rendered. A remark regarding “no mail” is entered into the medical data system. No letters or other correspondence concerning insurance or past due accounts will be sent to any client that requests “no mail”. Reasonable efforts will be made to collect charges without jeopardizing client confidentiality. I. The Billing Cycle for the Health Department (by Division) is as follows: 1. Personal Health Division a. Billing statements will be sent no more than three days after charges post to client ledger. Statements will be sent to clients for the next two consecutive months for balances due. After three consecutive months with a past due balance, accounts will be forwarded to the County Attorney Office and pursued through debt set-off in accordance with the county policy. Accounts with a balance of less than $50 will remain delinquent until paid or written-off. 1.2. & Dental Health Divisions a. Bill statementss will be sent monthly by the tenth of the month for two months after services have been rendered indicating a statement of balance due. Every quarter, all accounts with a balance $50 or more that are more than 60 days past due will be forwarded to the County Attorney Office and pursued through debt set-off in accordance with the county policy. Accounts with a balance of less than $50 will remain delinquent until paid or written-off. b. If a debt is not paid, when the client attempts to make another appointment, the client will be told they have a previous balance, and they must have an active payment plan or make a payment at time of next service except for Family Planning clients. 2.3. Environmental Health Division a. An initial invoice for additional or miscellaneous Wastewater Treatment Management Program (WTMP) charges is mailed with the inspection form. b. If no payment is received within 90 days, a second notice is mailed. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy E: Fee and Eligibility Policy Reviewed by: Financial Review Committee, Health Director Approved by: Board of Health, Health Director Page 8 of 8 Original Effective Date: January 25, 2001 Revision Dates:, 2/4/13, 8/12/13, 10/22/2014, 9/22/2015, 4/26/2016, 9/2018 c. If no payment is received after an additional 30 days and the debt is $50 or greater, the account is forwarded to the County Attorney’s Office, which will pursue it through the county’s debt set-off procedure. d. Debt owed by a corporation or non-individual is dissolved upon sale of property. e. The county attorney’s office has deemed debt that becomes part of an estate will become dissolved. f. If the client presents and voluntarily wishes to pay on the account, any amount the client offers will be accepted, documented in the client file, and a receipt will be provided. g. Mobile Home Parks are billed annually on the calendar year. The procedure is the same as noted above. J. Insurance and Third Party Billing 1. Where a third party is responsible, bills are to be submitted to that party; 2. Third parties authorized or legally obligated to pay for clients at or below 100% FPL are properly billed. 3. Third party bills (including Medicaid) show total charges without any discounts unless there is a contracted reimbursement rate that must be billed per the third party agreement. 4. The health department will bill insurance and managed care organizations for which provider approval has been established. The patient will be responsible for all deductibles, coinsurance and non-covered charges. 5. Patient or parent/guardian signature is required to give authorization to file claims and provide necessary information to the insurance company (Attachment E). 6. Patients, or the accompanying parent/guardian of an un-emancipated minor with appropriate insurance benefits, who receive public health services will be given the opportunity to choose whether to have insurance filed in order to avoid breach of confidentiality or pay the associated fee according to where the patient falls on the sliding fee scale. VIII. Review and Approval A. This Policy shall be reviewed annually by members of the Financial Review Committee. The committee shall have representatives from each division, and must also include the Health Department’s Finance and Administrative Services Director B. Any policy revisions must be approved by the Health Director and the Board of Health. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Health Director Annual Review Attachment(s): Board of Health Policy III.B.d Staff or Board Member Reporting: Susan Elmore Purpose: ____ Action ____ Information only _X__ Information with possible action Summary Information: Per Board of Health Policies and Procedures (Policy III.B.d), the Board completes a required annual review of the health director’s performance in accordance with the Statutory Requirement in GS130A-41. The purpose of this discussion is to determine this year’s process for the annual review, with guidance available in the attached policy for the information flow and input into the performance evaluation. The annual review will occur during closed session at the November 2018 meeting. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ___________________________ ___Accept as information ___Revise & schedule for future action _X_Other (detail): Determine annual review process and solicit board members to carry out tasks as needed. ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process B: Supplemental Processes d. Annual Performance Review Process for Health Director Reviewed by: Board of Health Approved by: Board of Health, Health Director Review Annually (July) Page 1 of 2 Original Effective Date: January 2000 Revision Dates: 4/23/09, 1/2014, 11/2014 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VII.A. Attachment III.B.d.Evaluation of Health Director.doc Annual Performance Review Process for Health Director Purpose To provide the Board with a process for accomplishing the required annual review of the health director’s performance in accordance with the statutory requirement GS 130A-41. Guidelines: 1) Orange County Personnel Policies are followed in conducting this review. Steps in the standard process are: • Preparation of an annual work plan by the employee and supervisor. • Preparation of performance notes at the end of the plan year that relate to the objectives contained in the work plan. • A conference between the employee and the supervisor regarding the employee’s performance for the year. • Supervisor prepares a Work Planning and Performance Summary after the conference which outlines the findings of the discussion and makes the final recommendation as to performance. • Supervisor forwards all paperwork to Human Resource Director. 2) In the case of the Health Director, the “supervisor” of the Director is the entire Board. The Chair assumes the responsibility of managing the information flow and input into the performance evaluation. This may include the formation of an ad-hoc committee to assist in the completion of the performance evaluation. 1. The Health Director prepares performance notes relevant to the year and emails them to all Board members. 2. The Chair schedules a meeting with the County Manager to obtain input on the Health Director’s performance. 3. The Chair may or may not solicit additional feedback, including from senior management staff and direct reports at the Health Department through electronic or in-person methods each year. A 360⁰ evaluation should be conducted at least every 5 years. 4. The Chair presents these findings to the full Board at a closed session of the Board and a general discussion of performance is then held. The Board reaches agreement on a recommendation and then the health director is called into the room and the Chair guides the discussion by Board members. 5. The Board is required to keep minutes during the closed session, including any motions made and actions resulting from such motions and transmit them to the Secretary (Health Director) for the permanent record. 6. Board members indicate changes they would like to see included in the following year’s work plan and those areas are discussed with the Health Director in the meeting. Following the meeting, the Chair writes the performance summary, finalizes the paperwork, obtains the Health Director’s signature and sends it to the Human Resources Director for the County. The ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section III: Board Processes Process B: Supplemental Processes d. Annual Performance Review Process for Health Director Reviewed by: Board of Health Approved by: Board of Health, Health Director Review Annually (July) Page 2 of 2 Original Effective Date: January 2000 Revision Dates: 4/23/09, 1/2014, 11/2014 S:\MANAGERS WORKING FILES\BOH\AGENDAS & ABSTRACTS \2018 Agenda & Abstracts\September 2018\VII.A. Attachment III.B.d.Evaluation of Health Director.doc Human Resources Director processes the remaining paperwork. The goal should be to have the performance review complete within 30 days of the hiring date anniversary. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 26, 2018 Agenda Item Subject: Committee for 2019 Vice-Chair Selection Attachment(s): Staff or Board Member Reporting: Susan Elmore Purpose: ____ Action ____ Information only _X__ Information with possible action Summary Information: Per the Board of Health Policies and Procedures, the Board shall elect a Chair and Vice-Chair by majority vote each year at the last meeting of the calendar year. This discussion’s purpose will include asking for volunteers to serve on the Committee for Vice-Chair Selection. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ___________________________ _X_Accept as information ___Revise & schedule for future action ___Other (detail): Health Director’s Report September 2018 • September 6, 2018 - Meeting with Dr. Mike Steiner, UNC Pediatrics & Adolescent Medicine, Dr. Robert Murphy, Executive Director for Center for Child & Family Health in Durham, NC and Dr. Alison Steube, Medical Director of Lactation and Associate Professor of OB/GYN at UNC to discuss the efforts to implement a Postnatal Nurse Home Visiting program here in Orange County. Durham, Guilford and Forsyth Counties have established programs and there is interest in replicating such a program in Orange. We currently do some postnatal home visiting via our CCN programs, so we’re brainstorming ways to expand the program to a universal program. Follow-up meeting scheduled. • September 7, 2018 - NC DHHS Administrative Site Visit completed by Administrative Consultant Kathy Brooks. OCHD received feedback that policies and processes meet or exceed expectations with regard to fiscal management and reporting. This includes the department’s practice with regard to billing and re-billing. Rebecca and her team are to be commended for their great work. • The Racial Equity Commission completed their community focus group with approximately 12 community members present to give feedback on health department services and programs. An online survey has also been sent to all department staff. • As of Tuesday, September 11, 2018 the health department began to plan and focus heavily on response activities for Hurricane Florence. The Emergency Operation Center (EOC) was activated on Wednesday, September 12th. Health Department staffed the Health & Medical Station 24/7 thru Sunday, September 16th. I appreciate all the Division Directors for their willingness to work throughout the response period. Kudos to staff for stepping up to assist our sister department, DSS, with Shelter Operations. In addition to the nurses and environmental health staff that traditionally assist with shelter operations, various staff from the department also worked in other roles in the Shelter, specifically the Smith Middle School Shelter on Saturday night. Our colleagues across the County have expressed their gratitude for our help. • As a result of Hurricane Florence, the first week of Municipal and County Administration course was cancelled and rescheduled for December 4th – 7th. The Annual NCPHA Conference in Charlotte, NC has been postponed until December 12th -14th in Charlotte. Upcoming Events • Departmental Strategic Plan Sessions scheduled for September 25, 2018 and October 1, 2018. Working with Consultant, Deitre Epps, Race for Equity, LLC. • September 28, 2018 - Annual UNC PHield Trip – a way of introducing incoming public health students from UNC to local governmental public health; approximately 40-50 students will come to Hillsborough to learn from staff what local public health looks like in practice. Donna King serves as lead on this and has an afternoon of fun and engaging activities planned. Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] HEALTH 08/30/2018 05:45 am ET | Updated 2 hours ago Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. Kamala Harris and Kirsten Gillibrand’s newly proposed legislation focuses on social problems and medical interventions. By Anna Almendrala  EDITION Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] MICHAEL KOVAC VIA GETTY IMAGES Sens. Kirsten Gillibrand (D-N.Y.) and Kamala Harris (D-Calif.) have proposed complementary bills to improve maternal health and pregnancy outcomes. Efforts to drive down the rates of maternal mortality in the U.S. tend to focus on how doctors and hospitals can change the way they administer medical care. Yet research shows that things like loving relationships, safe homes and being part of a fair and equitable community also play an important role in whether a woman has a positive experience with pregnancy and giving birth. So experts were heartened by a pair of complementary bills, announced over the past week, that tackle this problem from both sides. The most recent national proposal, a bill from Sen. Kirsten Gillibrand (D-N.Y.) announced Tuesday, would give money to states and hospitals who need help standardizing their childbirth and postpartum treatment plans to evidence- based best practices, and would help maternal mortality review committees investigate deaths to figure out how they can be avoided in the future. These kinds of quality improvements dominate the national debate about how to improve Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] maternal care. California, for example, has managed to cut maternal deaths by more than half since 2006, while the rest of the country’s maternal mortality rate continues to rise. Experts attribute this to the state’s maternal quality care collaborative, a network of hospitals and public health agencies that share real-time data in the hopes of improving performance on preterm births, cesarean sections and other factors that can complicate a woman’s care. But focusing solely on the medical care delivered at a hospital doesn’t address the nine months of prenatal care a woman typically receives during her pregnancy, as well as the postpartum period in which she is at a high risk of medical complications related to birth. A different bill, proposed by Sen. Kamala Harris (D-Calif.) last week, takes an unusual approach by focusing on the community and social stressors that might make pregnancy more dangerous for women, especially women of color. It suggests that investing more money to improve the quality of these mothers’ lives may also help avoid birth-related complications and deaths. Given their late introduction in the legislative session and the lack of support from Republican senators, both bills have a slim chance of passing the Senate. But they could be poised to move quickly if the Democrats win a majority in Congress. If that happens, would Harris’ plan to focus on the social factors affecting pregnancy and childbirth work? One modest state program could give us a preview. A portion of Harris’ bill relies heavily on the architecture of an innovative social program in North Carolina called a pregnancy medical home. It incentivizes doctors to screen every woman on Medicaid at their first prenatal appointment and assign them a pregnancy care manager if they’re deemed to be at high risk for a dangerous birth, whether for medical issues like a history of stillbirths, or for social issues like intimate partner violence or homelessness. “Things like loving relationships, safe homesand being part of a fair and equitablecommunity also play an important role inwhether a woman has a positive experiencewith pregnancy and giving birth. Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] Harris’ bill would replicate this by awarding $25 million to up to 10 states to create their own version of the pregnancy medical home. When North Carolina’s Medicaid agency launched this initiative in 2011, it wasn’t even thinking about maternal mortality, said Dr. M. Kathryn Menard, one of the co-founders of the North Carolina program and the director of Maternal-Fetal Medicine at the University of North Carolina School of Medicine. Instead, the goal was to keep Medicaid costs down by preventing preterm births and cesarean sections. But one fascinating side effect of the effort may be that it helped to narrow the gap between black and white women in terms of maternal mortality. Harris’ bill notes that in 2004, pregnancy-related deaths of black women in North Carolina were five times higher than those of white women. But by 2013, the latest year for which statistics are available, the gap disappeared. Black women’s maternal mortality rate declined to a rate of 24.3 deaths per 100,000 live births, while the maternal mortality rate for white women saw a slight uptick, to 24.2 deaths per 100,000. Meanwhile, in the rest of the U.S., black women die from pregnancy-related causes at a rate that’s three times higher than that of white women. These results caught the attention of Harris’ office, which confirmed to HuffPost that it mentioned North Carolina’s program because it’s the only statewide approach connecting the social issues affecting the health of mothers and babies to the prenatal care the mother receives. How The Program Works Every woman who is on North Carolina’s Medicaid plan, a safety net health insurance program, is supposed to answer a short two-page questionnaire during her first prenatal visit about factors in her life that have been linked to riskier births. These could be medical, like a history of stillbirth, hypertension or substance abuse, or social, like questions about homelessness, domestic violence or recent sexual trauma. These social issues connect directly to maternal and infant survival. Going hungry could lead to intrauterine growth restriction, which is when the fetus doesn’t grow and thrive in the womb. Domestic violence endangers the lives of both mother and child. High levels of the stress Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] hormone cortisol have been linked to premature birth and low birthweight. And studies suggest that a lifetime of racism could account for African-Americans’ poorer birth outcomes compared to those of recent African immigrants. Doctors are reimbursed $50 for going through the questionnaire with patients at their first prenatal appointment ― an incentive that results in about an 80 percent screening rate, said Menard. Then women who score high on this risk assessment are paired up with pregnancy case managers, who meet with them monthly or weekly throughout their pregnancies to check up on them and try to help them surmount any barriers standing in the way of their prenatal appointments. Care managers help connect women to counseling, sign up for food stamps or put them in touch with charities that give away cribs and car seats. They can also help them work on longer-term goals, like finding a new job, housing or going back to school before the baby arrives. Finally, once a woman gives birth, the same care manager helps the woman make a postpartum appointment with her doctor, acquire any contraception she may need while adjusting to parenthood, and then transitions the woman to a primary care provider. Nationwide, only about 40 percent of women see their OB/GYN within three months of giving birth. In all, more than 25,000 women ― almost 50 percent of all pregnant women on Medicaid in North Carolina ― were part of the pregnancy medical home program in 2017. —Dr. M. Kathryn Menard, one of the co-founders of the North Carolina program The program appears to have achieved some modest results. Unintended pregnancies among women on Medicaid have gone down slightly since 2012, from 52 percent to 45 “I hope they’ll learn from our experience andcall on us so that they don’t make the samemistakes along the way. Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] percent, said Kate Berrien, a director at Community Care of North Carolina, the nonprofit that operates the state’s pregnancy medical home program. Preterm births were also down 7 percent from 2011 to 2014. In other states that have run pilot programs, the results are similarly encouraging. A small, year-long experiment conducted with pregnant Medicaid patients in Texas found that hospitals were able to cut down on visits to the emergency room and inpatient hospital days for pregnant women, saving about $330,000 in ER services and almost $500,000 in inpatient care. A final analysis of this experiment also found that these Texas mothers were also significantly less likely to deliver by C-section and that their newborns were significantly less likely to be admitted to neonatal intensive care. Michael Lu, senior associate dean at the George Washington University School of Public Health and former director of the federal Maternal and Child Health Bureau in the Obama administration, praised North Carolina’s program but also said it would be prudent to wait for a more comprehensive evaluation before scaling it nationwide as Harris has outlined in her bill. Still, he did agree that social issues can be a major stressor on bodies ― especially ones that are already experiencing the physical stress of a normal pregnancy. Lu compared the pressure of homelessness, unemployment and violence to the gunning of a car engine ― sooner or later, the engine is going to wear out. “Unemployment, poor housing, family and neighborhood violence, the lack of partner and social support, and the experience of racism can affect pregnancy outcomes by causing chronic stress, which in turn can cause wear and tear on the body’s organs and systems,” Lu said. “That’s how these social determinants not only get under the skin but also get inside the womb to affect pregnancy outcomes.” Harris’ office hopes that this moment in history, when the American public is galvanized around the issue of maternal mortality, will help pave the way for the senator’s bill and others like it. Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] —Dr. M. Kathryn Menard Menard cautions that North Carolina’s declining racial disparity in maternal deaths can’t be attributed solely to the program she helped create. “The trend of narrowing the gap started before this program launched, and it continued in a positive direction,” she said. “It’s also really important to not overstate what one can see in statistics from uncommon events.” For the past 15 years, an average of about 22 women have died annually in North Carolina because of pregnancy-related causes. This means that a change of even just a handful of women in either direction could change the rates of maternal mortality and racial disparity wildly from one year to the next. “It turns out that in 2013, the ratio of white to black was one,” Menard said of the racial disparity statistics cited in Harris’ bill. “But the next year it could be three again, just because these numbers are not that big.” But she does allow that rates of maternal deaths among black women are going down. And pregnancy medical homes could be playing a role. When there’s no one else to count on, pregnancy caremanagers are there. Public health experts may be waiting for more data before recommending that this program go nationwide. But LaTosha Scott, one of North Carolina’s 400 pregnancy care managers tasked with attending to women with the riskiest pregnancies, feels from the bottom of her heart that this program needs to be in “every state, every county and every area.” It’s on social workers like Scott, 32, to help pregnant women surmount serious social issues “It’s also really important to not overstate whatone can see in statistics from uncommonevents. Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] so they can focus on the pregnancy at hand. Scott’s part social worker, life coach, fixer and friend for the approximately 50 women she’s responsible for at any given time as a pregnancy care manager in Orange County, North Carolina. Scott remembers a recent patient who had become homeless and had all four children taken into the child welfare system until she could find a new home. Meanwhile, the woman was pregnant again and struggling to get everything ready for the birth. Soon before her due date, she came to Scott with a problem: She had the car seat and newborn supplies, but couldn’t see herself being able to lug it all on the bus to the hospital once she was ready to give birth. Scott took it all and stored it in her own office at the University of North Carolina Medical Center in Chapel Hill. And when the woman gave birth, she carried the supplies up to the postpartum wing of the hospital. For more well-connected women, Scott’s role might be filled by a sister, best friend or auntie, while wealthier women might be able to employ a doula, nanny or concierge to help them get ready for the baby. But for the women Scott sees, who may be struggling with homelessness or addiction, she is one of the few emotional supports they can count on throughout their whole pregnancy. “She’s able to focus more on the pregnancy because she knows now she has support,” Scott said about her work. “It’s like, ‘I have Latosha to call on, and she can at least tell me where to go.’” Menard says she was surprised to see that North Carolina’s pregnancy medical home program had caught the attention of a senator from California, as the initiative is still relatively young and still considered novel. But she says that whether or not Harris’ bill passes, she hopes it sparks an overdue discussion about the social causes of maternal mortality in addition to the medical delivery component of maternal care. Menard also thinks states should not wait for a federal law to pass before starting their own programs, and she invites anyone to contact her agency for insight into how to get something Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] off the ground. “I hope they’ll learn from our experience and call on us so that they don’t make the same mistakes along the way,” she said. “We can get them there a lot faster than we got there.” Unable to play video. HTML5 is not supported! Content loading... BEFORE YOU GO PHOTO GALLERY 6 Unexpected Ways Your Body Changes AfterPregnancy See Gallery