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04/06/2005 . Revenues Type of Revenue Federal & State e Fees Medicaid Medicaid Max EHFees Health Fees Other Expenditures . Type of Ex enditure New Hanover County Health Department Revenue and Expenditure Summaries for February 2005 Cumulative: 66.67% Month 8 of 12 " Budgeted Amount Current Year Revenue Balance Earned Remalnln % Prior Year Budgeted Revenue Balance Amount Earned Remalni" $ 1,956,517 $ 1,328,516 $ 628,001 $ 580,161 $ 409,113 $ 171,048 $ 1,138,039 $ 604,141 $ 533,898 $ 151,600 $ $ 300,212 $ 157,645 $ 113,545 $ 128,823 $ 2,526,535 $ 1,543,196 $ 794.421 $ 146,205 $ 390,681 59.98% 74.36% 62.58% Budgeted Amount Current Year Expended Balance Amount Remainl" % Prior Year Expended Balance Amount Remalnl" % Budgeted Amount $4,040.457 59.82% $814.406 52.47% $ 282,393 25.59% Summary Budgeted Actual % FY 04-05 FY 04-05 Expenditures: Salaries & Fringe $10,427,295 $6,177,045 Operating Expenses $1,792,905 $952,498 Capital Outlay $127,784 $17,652 Total Expenditures $12,347,984 $7,147,195 57:88% Revenue: $6,766,609 4,171,434 61.65% Net County $$ $5,581,375 $2,975,761 53.31 % . Revenue and Expenditure Summary For the Month of February 2005 10 NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 04-05 . Date (BOHI Grant Reauested Pendlna Received Denied 3/2/2005 Smart Start- Child Care Nursino Prooram $ 239,Ooo $ 239,000 Smart Start- Health Check Coordination Proaram $ 43,800 $ 43,800 Smart Start- Navioator Prooram $ 155,000 $ 155,000 "f<I. Wi) 2/2/2005 No actlvltv for February 2005. Champion McDowell Davis Charitable 1/5/2005 Foundation - Good SheDherd Clinic .$ 56,400 $ 56,400 , 12/1/2004 No activity for December 2004. March of Dimes- Matemity Care Coordination Program educational supplies and incentives 111712004 for Dreonant women. $ 3,000 $ 3,000 $ - 10/6/2004 No actlvltv to reDOrt for October 2004. 9/112004 No actlvltv to reDOrt for SeDtember 2004. OffIce of the State Fire Marshal- NC Department of Insurance- Risk Watch 8/4/2004 continuation fundino (3vears l $ 25,000 $ 25,000 NC Physical Activity and Nutrition Branch- Eat Smart Move More North Carolina $ 20,000 $ 20,000 NC March of Dimes Community Grant Program- Smoking Cessation- Program did 71712004 not aDDlv for Drant. $ 50,000 $ - $ - $ - Wolfe-NCPHA Prenatal Grant. Diabetic Suoolies for Prenatal Patients $ 5.000 $ 5,000 61212004 No actlvltv to reoort for June 2004. Kate B. Reynolds Foundatlon- 5/5/2004 Transoortable Dental Unit Grant $375,000 $ 311,000 $64,000 Cape Fear Memorial Foundatlon- Dental Grant $185,000 $175,000 $10,000 Cape Fear Memorial Foundation- School 4/7/2004 Health Emeraenev Dental Services Grant $ 15,000 $ 15,000 Safe Kids Coalition- Govemo(s Highway $ 16,000 SafelY Proaram- (Coalition Vehicle Request) $ 16.000 Safe Kids Coalition- Safe Kids Buckle Up 3/312004 Proaram- Child Safetv Seat Grant $3,500 $3.500 2/412004 No actlvltv to reDOrt for February 2004. Cape Fear Memorial Foundatlon- Funds needed to enhance heallh education in 4 areas other than Diabetes (an enhancement 11712004 to Diabetes Todav Grant). "(livino Well) $20,000 $18,500 $1,500 12/3/2003 No actlvltv to reDOrt for December 2003. Cape Fear Memorial Foundation- Funds needed to cover dental services for needy children as identified by School Health 11/5/2003 Nurses. $3,000 $3,000 NC Medical Foundation - Through the Good Shephard Ministries for nursing services to the loooulation freouentino the shelter. $25,000 $25,000 Duke Unlverslty- To provide 10 hours of I $10,388 nursino services for TB Outreach. $10,700 -$312 . . As of 3124/2005 . NOTE: Notification received since last report. . 11 NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 04-05 Date (BOH) Grant ReQuested Pendlno Received Denied NC Tobacco and Control Branch, DHHS- Continuation of Tobacco Prevention Program, $100,000 $64,093 $35,907 10/1/2003 No actlvltv to reDort.for October 2003. New Hanover County Safe Schools- Unlling for Youth "U4Youth"(funding will be received 9/312003 over a 3 vear ~rant oeriodl $49,000 $ 12,702 $36,298 Safe Kids Coalltlon- Fire Prevention (Please note this grant was pulled- coalition not able to meet deadline for reouest) $2,500 $2,500 8/612003 NC DHHS- OPH Preoaredness and Response $82,350 $31,950 $50,400 Smart Start- Partnership for Children 7/312003 Grant Increase for Part Time Nurse Position) $5,523 $5,523 Cape Fear Memorial Foundation - Diabetes Today (two-year request; $42,740 annually) Received $25,00 vear 1 and $20,000 vear 21 $85,480 $45,000 $40,480 Duke University Nicholas School of the Environment-Geographic Infonnation SYStems Grant (Env Health 1 $10,000 $10,000 Safe Kids Coalition- Safe Kids Mobile Car Seat Check up Van $50,000 $50,000 Totals $1,634,941 $437,800 $809,845 $337 296 26.78% Pending Grants 3 12% Funded Total Reouest 9 36% Partiallv Funded 7 28% Denied Total Reouest 6 24% Numbers of Grants Apolied For 25 100% As of 312412005 . NOTE: NotifICation received since last report. 49.53% 20.63% ,. . . . 12 . I' . NEW HANOVER COUNTY BOARD OF COMMISSIONERS , Request for Board Action Agenda:D Consent Meeting Date: 4/18/05 Agenda: ~ Department: Health Presenter Cindy Hewett, Business Manager Contact: Cindy Hewett, Business Manager, ext 6680 Subject: Appropriating unbudgeted revenue ($45,500) eamed in the Epidemiology (Communicable Disease) Program Brief Summary: The New Hanover County Health Department has generated additional revenue in the Communicable Disease Program (5151) through the administration of FLU shots during this fiscal year. We are requesting to appropriate these funds to cover the cost of items needed such as a copier lease, cost of temporary staff, medical records shelving, postage machine and folding machine, along with additional clinic enhancements. Recommended Motion and Requested Actions: To approve the associated budget amendment in the amount of$45,500 for the Communicable Disease Program, . Funding Source: Medicare earnings generated through the administration of FLUs hots given this fiscal year Will above action result in: DNew Position Number ofPosition(s) Dposition(s) Modification or change No Chan e in Position s Explanation: This fiscal year we were allowed to bill Medicare for the full amount of state supplied FLU vaccines administered ($20/shot), In previous years, we have only been allowed to bill Medicare for the administration of state su lied FLU vaccine, '<!"j. I Attachments: Budget Amendment and Financial Screen Printout. . 13 . . . 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'0-8<( c 0.- ~ Cll . ::l <( Z E Ill'- Z Cll 0 . 1: E:s:5j:: [ ~Q.Q)c Cll t.l > 0 15 . ACTION: R SCREEN: RSUM USERID: PUBL REV E N U E BUD GET . BFY= 05 REV SRCE -------- -------- 01- 3142 02- 3153 03- 3224 04- 3279 05- 3327 06- 3339 07- 3528 08- 4118 09- 6063 lO- ll- 0?/22/05 01:38:33 PM SUMMARY I N QUI R Y 510 ORGANIZATION= 5151 ACTIVITY= 2000 FUND= 110 AGENCY= , TOTALS IND: TOTALS: DESCRIPTION FED/CTS FUND FLU/PNEU VAC STATE GRANT lAP-STATE TITLE XIX TITLEXIX MAX NC CTR PHP HLTH FEES GOODSHEPHERD 10-*L009 HEADER CHANGE . I 250,112.00 CURRENT AMT 28,000.00 24,000.00 7,904.00 37,236.00 35,000.00 27,000.00 0.00 69,545.00 21,427.00 295,704.00 -45,592.00 RECOGNIZED AMT .AVAILABLE AMT 28,000.00 114,461. 79 7,904.00 43,139.18 17,511. 00 0.00 0.00 63,261.52 21,426.51 0.00 -90,461.79 0.00 -5,903.18 17,489.00 27,000.00 0.00 6,283.48 0.49 .. 16 . .' \ , . . NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: Consent Meeting Date: 04/18/05 A enda: ~ Department: Health Presenter: Cindy Hewett, Business Manaer Contact: Cind Hewett, Business Mana er, ext 6680 Sub'ect: Chan es in the New Hanover Coun Health D artment Fee Poli Brief Summary: The New Hanover County Health Department is proposing, both, narrative and fee changes to its current fee policy. These changes relate specifically to services rovided throu the Personal Health Services Division. Recommended Motion and Requested Actions: To accept and approve changes to the New Hanover Coun Health D artment Fee Polic as resented. Funding Source: Health Fees, Medicaid, Medicare and other third party reimbursement agencies. . Will above action result in: DNew Position Number ofPosition(s) Dposition(s) Modification or change ~o Chan e in Position s Explanation: The New Hanover County Health Department is requesting to adjust its " current Fee Policy based on changes in services provided within its clinic and outreach ro ams. Fee ad'ustments are based on chan es in Medicaid reimbursement rates. I Attachments: Letter to the Board of Health. . 17 . . , . .. . . NEW HANOVER COUNTY HEALTH DEPARTMENT 7029 SOUTH 17111 STREET . WILMINGTON, NC 28401-4946 TELEPHONE (910) 343-6500 FAX (910) 341-4146 March 28, 2005 To: New Hanover County Board of Commissioners From: Cynthia W. Hewett, MSIS Business Manager Subject: Changes in the New Hanover County Health Department Fee Policy 1. Weare requesting approval for the following changes in CPT codes and fees. Change CPT Code Current Proposed Justification Needed Fee Fee Increase Fee 90801 $140.00 $142.00 Increase in TXIX Reimbursement for Psychiatric Diagnostic Interview Exam Increase Fee 90802 $150.00 $151.00 Increase in TXIX Reimbursement for INT AC Psv Dx Interview Increase Fee 90804 $60.00 $61.00 Increase in TXIX Reimbursement for Psytx, Office 20-30 minutes Increase Fee 90806 $91.00 $92.00 Increase in TXIX Reimbursement for P5ytx, Office 45-50 minutes . . Increase Fee 90808 $135.00 $137.00 Increase in TXIX Reimbursement for Psytx, Office 75-80 minutes Increase Fee 90810 $65.00 $66.00 Increase in TXIX Reimbursement for Intac Psvtx, Office 20-30 minutes Increase Fee 90812 $98.00 $99.00 Increase in TXIX Reimbursement for Intac Psvtx, Office 45-50 minutes Increase Fee 90814 $142.00 $143.00 Increase in TXIX Reimbursement for Intac Psvtx, Office 75-80 minutes Increase Fee 90846 $88.00 $89.00 Increase in TXIX Reimbursement for Family Psvtx, wlo natient Increase Fee 90847 $107.00 $109.00 Increase in TXIX Reimbursement for Family Psvtx, wi natient Increase Fee 90853 $30.00 $31.00 Increase in TXIX Reimbursement for Group Psvchotheranv Increase Fee J1055 $43.29 $54.00 Increase in TXIX Reimbursement for Depo Provera Iniection Add Fee 92587 NIA $54.00 Add fee for OAE Hearing Screening As of 03/28/05 18 . I Increase Fee S9445 $] 1.00 $]6.50 Increase in TXIX Reimbursement for MOW Services Delete Code 90676 $]60.00 NIA We are no longer providing Intradermal Rabies Vaccine Add Code 90675 NIA $]29.00 Add fee for Intramuscular Rabies Vaccine Increase Fee 88]4290 NC $10.69 Increase fee for billing non-medicaid clients for Pap Smear Processing Fee Add Code 90734 Nla $92.00 Add fee for reimbursement of Menactra Vaccine .' .' 2. We are requesting approval of our updated Socio-Economic Form (form attached). 3. We are requesting approval to automatically implement use of the new Federal Poverty Levels (FPL), upon receipt from the state, as they apply to our various programs. Currently, our WIC Program uses 185% ofFPL, Women's Preventive Health Program uses 250% ofFPL and other select clinic services use 350% ofFPL. . . As of 03/28/05 19 . Name: New Hanover County Health Department 2029 South 17'" Street Wilmington, North Carolina 28401 Phone: (910) 343-6500 Fax: (910) 341-4146 Fax Medical Records (910) 772-7805 Socio-Economic Income Statement DaB: .SS# Circle Correct Answers: Resident of North Carolina Medicaid Eligihle Insurance Self-pay No-pay Yes Yes Yes Yes Yes No No No No No Gross annual income of economic unit Total numher in household supported by income above. Sliding Fee Scale Percentage: Family Planning (100-250010 of Poverty Level): % Other Sliding Fee Services (100-350% of Poverty Level): % Gross income is defined as salary, wages, overtime pay, earnings from self-employment, investment income (stocks, bonds, savings account interest, rentals, etc.), public assistance monies, unemployment compensation, alimony, child support, military allotments, Social Security benefits, Veteran's Administration benefits, retirement and pension, Worker's Compensation, regular contributions from individuals not living in the household, Supplementary Security Income (SSI) benefits, and prize winnings. Economic unit includes persons living in the household, related or non-related, who share their production of income and consumption of goods. . erification of income is required as noted in the New Hanover County Health Department (NHCHD) Fee Policy Patients who do not provide proof of income attime of registration will be charged 100% of our current fees for services provided. Patients will have 10 days to return to the NHCHD with proof of income in order for the sliding fee scale to apply If proof of income has not been provided within the 10 day period, charges will remain at the full 100% of our current fees. Patients who do not prefer to provide proof of income will be charged 100% of our current fees. Upon penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief, this income staten'1~nt is true and correct. I understand that the information may be checked by a state reviewer, and I agree to provide financial records required to carry out this review. I also understand that mv emolover mav be asked to verify information concernimr mv income. o I prefer not to provide NHCHD with proof of income; therefore, I understand that I am fully obligated for payment of services provided. o Proof of income has been provided as required. o Proof ofincome will be provided within IO days of signature date below I understand if proof of income is not provided within the 10 day period, charges will remain at 100% of current charges. I, the undersigned, verify the above information is true to the best of my knowledge and I understand payment is expected at the time of service for all services rendered. I Signature ofPatlentlParentlAuthonzed RepresentatlvelDate Relationship of Authorized Representattve Signature ofWllnesslDate I _roof ofIncome Received: ~ross Annual Income of Economic Unit: Received within 10 Days: Yes No Total Number in Economic Unit: FP Sliding Fee Scale % Other Sliding Fee Scale % I Signature of Parent/Guardian/Authorized RepresentatlveIDate I Signature of WltnessIDate Revised 02-09-05 20 I , ~ . . 64,0/-0) SCHOOL HEALTH UPDATE HOW ARE WE GROWING? With the efforts of Dr. Thomas Fanning Wood the NC Board of Health was created in 1877. In 1919 Dr. George Cooper, Director of Preventive Medicine and Hygiene saw the need of a system of "medical inspection of elementary school children." Six nurses were hired through the efforts of Dr. Cooper, and they became the forerunners of School Health Nurses, checking immunizations, following communicable diseases, completing screening for hearing, vision and dental and teaching health and hygiene to students, as well as to mothers across the state. Until 1989 School Nurses in New Hanover County were employed by the Board of Education. In March 1989, Robert Parker, New Hanover County Health Director requested the State Board of Education allow local school districts to contract with local health departments for all nursing positions in local school districts. The request was approved and subsequently New Hanover County Health Department began contracting with the Board of Education to provide school health nursing services to students in New Hanover County. . ----1989 1989-90 1990-93 1994-95 1995-96 t 1996-97 .- 1997-98 1998-99 . 1999-00 Full time nurses employed by Board of Education at the three high schools Public Health Nurses visited Middle and Elementary schools weekly The first two full time nurses were hired by the Health Department and assigned to the six Middle Schools. Public Health Nurses visited Elementary schools weekly No additional nurses added. The first full time High School nurse was hired for New Hanover High School. Public Health Nurses continued to visit Elementary schools weekly No additional nurses added. Three nurses hired, one for a High School and two were assigned to work half/day week in the elementary schools with the greatest need. Public Health Nurses visited the remaining elementary schools weekly. Two nurses, one Elementary and one Middle School nurse was hired. No additional nurses added. The first full time Middle School Nurse was added . . . 2000-01 2001-02 2002-03 2003-04 2004-05 . /176 Jco'f 04/01105 eh . Five nurses were hired making a total of fourteen School nurses employed in the Schools. Public Health Nurses continued visiting elementary schools. Four nurses were added this year Seven nurses were added with the opening of two additional schools Sixteen full time nurses and one halftime nurse was assigned to the Elementary schools according to needs of the school. Middle and High Schools each had a full time nurse. Lakeside High School had a nurse 1Iday week. Pre-K schools were visited by a Public Health Nurse weekly Currently there are twenty one full time nurses and a three fourths time Nurse now serving the twenty two elementary schools. Middle and High Schools have a full time Nurse except Lakeside has a nurse 1Iday week (two half days/week) at Principal request. The three Pre-K Schools have a nurse V. day/week. A total of thirty five nurses which include the two School Health Supervisors who have Lakeside and the three Pre-K Schools along with supervision of the thirty three nurses and managing the School Health Nurse Program. This year five of the nurses were moved into Team Leader positions to assist with mentoring and training of the school nurses. Murrayville Elementary School is scheduled to open in the fall of the School Year 2005-06 which will need a full time nurse. The goal is a nurse for every 750 students by Year 2014. Our four High Schools this year range from 1600-1850 students each. Thirty of the nurses are salaried through the contract with the Board of Education. Funding for these nurses paid by the Board of Education are partially the result of time studies completed quarterly by the School Nurses. Scf ~~ij{~. ~ .. .. . . . New Hanover County Health Department School Health Year 2004 SCHOOL HEALTH 1 st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Year to Date Prior Year Number of Student 18890 17072 35962 Records Assessed Nurse / Student Office 25606 49263 74869 Visits Number Medicated I 7349 15529 22878 Sneclal Procedures Telephone Calis/Consultations With 22871 35185 58056 Teacher or Parent/Home Visits Emergency Action Plans 2056 517 2573 Develoned TOTAL 76772 117566 0 0 194338 0 Page 1 of 1 2/11/05 )- . ::t :> D ::> i- (I) w 2 l- (/) W <..> :::.: 6: w , .::;: I,U :r Q U) rJ1 <( co , ...I o o ::r <..> (Ii , It') C i~' i'~ ~ :;. .~J(~) ;\ .c:>._;;;:_=_ III a: a: w " 0- W- :; " .. rev"",..", !~\~f!1: V'*:.j\;; . "to:,,,,',;-; i";r.;:J<i, '" t?~~.~~ ~ '. ":1" <D r;~~' "?i! m f;'.~'~';':';; ..- ~;.;"~;~,j,,;:' ~ ~ :; ;;; ~ ~ b:: I- > <.) :J =:J w () 0 Ll.J ~ <{ (/) 0 Z 0 '----,----------- I~I CI U m ". zoo Oc ;:u u;~ O. 0.: Z N o ;;: '" 2 Q I/) :r '" I/) z .. 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New Hanover County Animal Control Services 180 Division Drive Wilmington, North Carolina 28401 Animal number and description: Surgery/date: Suture Removal Necessary: 0 Yes Date: DNo General After Care Instructions: Spays 0 Your pet will have a small abdominal incision that may be held together by several skin sutures. Be sure to keep the incision clean and dry Some irritation and swelling is normal after the surgery It is also normal for your pet to lick the incision. If your pet chews on the incision it may become very red or start to have a discharge. Please contact your veterinarian if irritation occurs. Sutures should be removed, if necessary, by your regular veterinarian on the date listed above. Neuters 0 Keep your pets incision clean and dry. The sutures used in this procedure are 0 Internal and will dissolve in time; D External and you should see your veterinarian on the date listed above for suture removal. Some post- surgical irritation and swelling is normal. It is normal for your pet to lick their incision, but chewing can lead to strong irritation or discharge. Please contact your veterinarian if irritation occurs. General Pet Care: . Take your new pet to your veterinarian for regular check-ups. . Talk to your veterinarian about the prevention of diseases by vaccinations and parasite prevention needed for your pet. . Be sure to have a good relationship with your pet by being loyal and patient with them. . Follow local pet registration laws, which protect both animals and people in the community Thank you for adOyting a yet from :New j-{anover County .Jtnima{ Con tro { Services! .' . . New Hanover County Health Department FY04-05 MONTHLY REVENUE REPORT As of February 28. 2005 . Summary for the New Hanover County Health Department Cumulatlva % 66.67% Month Reported Mon8of12 Feb-05 Current Year Prior Vear Type of Budgeted Revenue Balance % Budgeted Revenue Balance % Revenue Amount Earned Remaining Amount Earned Remaining Federal & State 1.956.517 1.328.516 $ 828.001 $ 1.985.125 1.190.704 $ 79<1.421 59.98% ACFees 580.161 409.113 $ 171.048 $ 570.161 423.956 $ 146.205 74.36% Medicaid 1.138.039 604.141 $ 533.898 $ 1.04<1.080 653.399 $ 390.681 62.58% Medicaid Max 151.600 $ 273.333 EHFees 300.212 $ 300.212 Health Fees 113.545 $ 113.850 Other 2.526.535 $ 2.385.203 . Revenue Summary For Month of February 2005 New Hanover County H,ealth Department FY04-05 MONTHLY REVENUE REPORT As of February 28, 2005 '. Cumulative % 66.87% Program: 5111 Environmental Heatth Current Vear Type of Budgeted Revenue Balance % Revenue Amount Earned Remaining 15.973 $ 8,290 $ 7.683 300,212 $ 157.645 $ 142.567 Month Reported Mon 80f 12 FetKl5 . Budgeted Amount Prior Vear Revenue Balanee Earned Ramalnlng % 10.729 185.442 Program: 5112 Vector Control Type of Revenue Budgeted Amount Current Yea' Revenue Balance Earned Remaining % Budgeted Amount Prior Vear Revenue aal.nce Earned Remalnln % . Program: 5114 Animal Control Current Yea, Prior Yea, Type of Budgeted Revenue Balance 'Ie Budgeted Revenue Balance % Revenue Amount Earned Remaining Amount Earned Remalnln 580,161 $ 409,113 171.048 570,161 423,956 74,36% Note: County Appropriation is nol figured on the individual program report. The County appropriation in each program is the difference between the 10tal amounts on the program expenditure report and the 10tals on the program revenue report. . For Month of February 2005 .' New Hanover County Health Oepartment FY04-05 MONTHLY REVENUE REPORT As of February 28, 2005 Cumul81lve % 68.67% Month Reporled Moo 801 12 FetKl5 Program: 5125 Community Health Program: Type of Budgeted Revenue Balance % Budgetad Revenue Balance % Revenue Amount Earned Remaining Amount Earned Remalnln Fed & State $ 29,147 $ $ 29,147 $ 29,147 $ 100.00% TXIX $ 8.000 $ $ 10,000 $ 1,527 $ 8,373 16.27% Health Fees $ 3,500 $ $ 3,500 $ 1,753 $ 1,747 50.09% Other $ 29,408 $ $ 76,551 $ 60,072 $ 18,479 76.48% Totals $ 70,055 $ 74,676 $ (4,521) 106.60% $ 121,196 $ 92.599 $ 28.599 76.40% Note: Comprised 01 Personal Health General (5161), NeuroIogy(5172),and Children's Special Health Services (5178) Budgets Program: 5126 Health Promotions " .0 Type of Revenue Budgeted Amount Current Year Revenue Balance Earned Remaining % Budgeted Amount Prior Veer Revenue 8alance Earned Remalnln % . Program: 5131 Administration .; Type of Revenue Budgeted Amount Current Year Revenue Balance Earned Remaining % Budgeted Amount Prio, Vaa, Revenue Balance Eamed Remainin % 155.833 0.00% Program: 5134 Navigalor.Pannership . Type of Revenue Budgeted Amount Current Year Revenue 8alance Earned Remaining % Budgeted Amount Prior Year Revenue Balance Earned Remaining % For Month of February 2005 New Hanover County Health Oepaltment 1'Y 04-05 MONTHLY REVENUE REPORT As of February 28, 2005 '. Cumulative % 66.67% Month Reponed Mon 80f 12 FetKl5 Program: 5121 Laboratory Current Yea, Revenue Balance Earned Remaining $ 1.000 $ $ $ % 4.600 5.600 4.600 5.600 $ $ $ $ Budgeted Amount 1.500 3,000 4.500 9.000 $ Prior Year Revenue Ba'ance Eamad Remaining $ 43 $ 1,457 % Type of Revenue Health Fees Fed & State Mad Max otals 0.00% 0.00% 2.87% 43 $ 8.957 0.48% Program: 5122 Public Health Bioterrorism Budgeted Amount Current Year Revenue Balance Earned Remaining $ 212.462 $ 149.915 % Prior Year Revenue 8alance Earned Remaining $ 190.362 $ 251.348 % 5123 Cere Coordination Current Year Prior Year Type of Budgeted Revenue Belance % Budgeted Revanue Balance Revenue Amount Earned Remalnln Amount .Earned Remainln Fed & State $ 87.283 $ 89.508 $ 17.775 79.64% $ 106.905 $ 58.660 $ 48.245 TXIX $ 1.039.039 $ 556.319 $ 482.720 53.54% $ 941.762 $ 618.444 $ 323.318 Other $ 3.000 $ $ 3.000 0.00% $ 90.000 $ Totals $ 1.129.322 $ 625.827 $ 503.495 55.42% $1.138.~7 $ 677.104 $ 461.563 59.46% Note: Comprised of Child Service Coordination (5133), Matemily Care Coordination (5159). Maternal Outreach Work... (5157) and Navigator (5154) Budgets Program: % . 54.87% ~5.67% Program: 5124 Women's Preventive Hearth Cunent Year Prior Year Type of Budgeted Revenue Balance % Budgeted Revenue 8alance % Revenue Amount Earned Remaining Amount Eamad Remaining 219.167 $ 208.442 $ 10,725 244.100 $ 213.773 $ 30.327 87:58% 31.000 $ 15.550 $ 15.450 31.000 $ 12.637 $ 18.363 40.76% 22.500 $ 27.963 $ (5.463) 22,500 $ 21.328 $ 1172 94.79% 70.000 $ $ 23.000 $ $ Note:County Appropriation is not figured on the individual program report. The County appropriation in each program is the difference between the total amounts on the program expenditure report and the 10tals on the program revenue report. . for Month of february 2005 .. . . Cumulative % Program: Type of Revenue Budgeted Amount Program: Type of Revenue Budgeted Amount 7,500 Program: Type of Revenue Federal & State Medicaid Health Fees Med Max Other Budgeted Amount $ 73,140 $ 35,000 $ 69,545 $ 27,000 $ 45,427 New Hanover County Health Department FY 04-05 MONTHLY REVENUE REPORT As of February 28, 2005 66_67% Month Reported Mon Sol 12 Feb-05 5141 Women Infants and Children (WIC) Current Year Revenue Balance Earned Remaining Prior Year Revenue 8alance Earned Remaining % % Budgeted Amount 5142 Nutrition Current Year Revenue Balance Earned Remaining Prior Year Revenue Balance Earned Remaining % % Budgeted Amount 8,818 . 5151 Epidemioiogy Current Yeaf Revenue Balance Earned Remaining $ 79,043 $ (5,903) $ 19,982 $ 15,018 $ 76,856 $ (7,311) $ $ 27,000 $ $ 24,000 Prior Yea' Revenue Balance Earned Remaining 59,089 $ 16,505 14,114 $ 20,886 79,212 $ (9,862) 78.17% 40.33% 114.22%1 % % Budgeted Amount $ 75.594 $ $ 35,000 $ $ 69,350 $ Note: County Appropriation is nol figured on the individual program repon. The County appropriation in each program is the difference between the total amounts on the program expenditure report and the totals on the program revenue report. For Month of February 2005 New Hanover County Health Department FY <04-05 MONTHLY REVENUE REPORT As of February 28, 2005 '. Cumulative % 66.67% Program: 5152 TS Type 01 Budgeted Revenue Balance % Revenue Amount Eamed Remaining Federal & State $ 79.249 $ 79.249 $ Medicaid $ 7.500 $ 1.160 $ Health Fees $ 16.000 $ 22.237 $ Month Reponed Mon 801 12 Feb-05 . Budgeted Revenue Balance % Amount Earned Remaining 77.218 $ 54.766 $ 22.452 7.500 $ 2.415 $ 5.085 16.000 $ 16.713' $ (713) Program: 5155 Child Care Health Consultant Current Vea, Revenue Balance % Earned Remaining 34.700 $ 33.781 Prior Year Revenue Balance Earned Remaining $ 16.886 $ 47.609 % Type 01 Revenue Program: 5160 Health Check Current Vea, Revenue Balance Earned Remaining $ 21.157 $ 20.590 ,% Prior Ye.' Revenue Balance Earned Remaining $ 13.610 $ 28.137 % . Program: 5162 Maternal Health Type 01 Revenue Budgeted Amount Current Year Revenue Balance Earned Remaining ,/, Budgeted Amount Prior Year Revenue Balance .earned Remaining % Program: 5166 Partnership for Children Current Yea, Type ot Budgeted Revenue Balance % Revenue Amount Earned Remaining Other $ 172.500 $ 83.565 $ 88.935 iotals $ 172.500 $ 83.565 ! 88.935 Budgeted Amount $ 172.500 Prior Year Revenue Balance Earned Remaining $ 77 .624 $ 94.876 % 45.00% $ 172.500 $ 77.624 $ 94.876 45.00% Note: County Appropriation is nol figured on the individual program repen. The County appropriation in each program is the difference between the total amount~ on the program expenditure repon and the 10tals on the program revenue report. . L For Month of February 2005 .. New Hanover County Health Department FY 04-05 MONTHLY REVENUE REPORT As of February 28, 2005 Cumulative % 66.67% Month Reponed Mon 801 12 FetKl5 Program: 5167 Child Health Type 01 Revenue Budgeted Amount Current Year Revenue Balance Eemed Remaining % Budgeted Amount Prior Year Revenue Balance Earned Remaining % Program 5189 School Health Current Yea' Prior Ye., Revenue Balance % Revenue Balance % Eamed Remaining Earned Remaining $ 1,160,410 $ 505,890 $ 1,273,794 $ 318,448 . Program 5170 NC Wisewoman Current Year Prior Year Type of Budgeted Revenue Balance % Budgeted Revenue Balance . % Revenue Amount Eamed Remaining Amount Eamed Remaining . . For Month of February 2005 New Hanover County Health Department FY 04-05 MONTHLY REVENUE REPORT As of February 28, 2005 ..' Cumulative % 66,67% Month Reported Mon 801 12 F~5 Program: 5181 Projec1 Assist Type 01 Revenue Budgeted Amount Current Year Revenue Balance Earned Remaining % Budgeted Amount Prior Vea, Revenue Balance earned Remaining % Program: 5183 Safe Communities Type 01 Revenue Budgeted Amount Current Year Revenue Balance Earned Remaining % Budgeted Amount Prior Veer Revenue Balance earned Remalni % . Program: 5187 Projec1 Slop Type 01 Revenue Budgeted Amount Current Yea' Revenue Balance Earned Remaining % Budgeted Amount Prior Yea, Revenue Balance .earned Remaining % Note: County Appropriation is n01 figured on the individual program report. The County appropriation in each program is the difference between the total amounts on the program expenditure report and the totals on the program revenue report. . F or Month of February 2005 .' . . New Hanover County Health Department FY04-05 MONTHLY REVENUE REPORT As of February 28, 2005 Cumulative % 66.67% Month Reported Mon 80112 Feb-05 Program: 5166 T8 Outrech Current Yea, Revenue Balance Earned Remaining $ . 2.675 Prior Year Revenue Balance Earned Remaining 7.791 $ 2,597 0;' % Prog.ram: Safe Schools 5189 Current Year Revenue Balance Earned Remaining 21.819 $ 30,081 Prior Year Revenue Balance Earned Remaining $ % Budgeted Amount % Program: 5120 Good Shepherd Current Year Revenue Balance Earned Remaining $ 56.400 Prior Year Revenue Balance Earned Remaining $ Budgeted Amount % % Totals 56,400 $ 56.400 0.00% Note:County Appropriation is not figured on the individual program report. The County appropriation in each program is . the dWference between the total amounts on the program expenditure report and the totals on the program revenue report. For Month of February 2005 . . . Type of Expenditure Salary & Fringe Operating Capital Outlay New Hanover County Health Department FY04-05 MONTHLY EXPENDITURE REPORT As of February 28, 2005 Summary tor the New Hanover County Heellh Oepanment Cumulative % 66.67% Month Reponed Mon8of12 Current Year Prior Veer Budgeted Expended Balance % B~geted Expended Balance Amount Amount Remaining Amount Amount Remelnlng Feb-05 $ 10,427,295 $ 6,177,045 . $ $ 1,792,905 $ 952,498 $ $ 127,784 $ 17,652 $ 4,250,250 840,407 110,132 59.24% $ 53.13% $ 13.81% $ 10,056,016 $ 6,015,559 $4,040.457 1,713,542 $ 899, \36 $ 814,406 379,510 $ 97,117 $ 282,393 % 59.82% 52.47% 25.~9% Expenditure Summary for Month of February 2005 . . Program: Cumulative % Type of Expendilure Budgeted Amount 1.011.926 71.340 Program: Budgeted Amount &w+lanollllr.county Mealth.oepartment 'FY~4-05 MOI<<HL V:EXilENOITURe'ftEf>ORT As of February 28,~5 .', 5111 €nvironmental Health 66.67% lAon8of.12 Feb-05 Month Reported Current Yea, Expended Balance Amount Remaining Prior Vea, Expended Balance Amount Remaining % % Budgeted Amount 561,520 41,963 450,406 29.377 6O~3% '82.18% 5112 Vector Control Current Year Expended Balance Amount Remaining Prior Year Expended ealance Amount Remaining % % Budgeted Amount 213.151 51.137 . Program: 5114 Animal Control Current Yea, Prior Yea, Type 01 Budgeted Expended Balance '/0 Budgeted expended Belance % Expenditure Amount Amount Remaining Amount Amount Remaining Salary & Fringe 766,164 505,545 $ 260.619 756.620 500.678 $ 255.842 '66.18% Operating 189.293 114.798 $ 74.495 181.329 83.492 $ 97.a37 4M4% Capital Outlay 1.817 1.784. $ 23 54.116 21.759 $ 32.357 Program: Type 01 Expenditure Salary & Fringe Operating Capital Outlay Budgeted Amount 291,165 74.483 5121 Labor-nory Current Year Expended Balance Amount Remaining 187.-854 $ 103.311 43.371 $ 31,112 $ Prior Year expended .salance Amount Remaining 178.733 $ 117,798 45,ll85 $ 33,{l98 l,~S5 $ 1.345 % % Budgeted Amount 296.531 78,963 3,000 . for Month of february 2005 . Type 01 Expenditure Type 01 Expenditure . Type 01 Expenditure Type of Expenditure Salary & Fringe Operating Capital OuUay . Program: Cumulative % Budgeted Amount 308,091 53.584 Program: Budgeted Amount Program: Budgeted Amount Program: Budgeted Amount 1,049,095 57,760 New Hanover County Health Department FY 04-05 MONTHLY EXPENDITURE REPORT As of February 28; 2005 5122 Public Health 8ioterrorism Month Reponed FeIHlS % Man 8 01 '2 Prior Year Expended Balance Amount Remaining % Budgeted Amount 177.363 34.994 130.728 18,590 5131 Administration Current Year Expended Balance Amount Remaining Prior Year Expended Balance Amount Remaining % Budgeted Amount % 430,108 174,355 5132 Board Members Current Year Expended Balance Amount Remaining Prior Year Expended Balance Amount Remaining . % Budgeted Amount % 5123 Care Coor<linstion Current Year Expended Balance Amount Remaining 578;26<1 $ 470.831 31,1563 $ 26.097 $ Prior Year Expended Balance Amount Remaining 623,716 $ 453,328 25.602 $ 36.021 $ % Budgeted Amount 1.077.044 61.623 '/,. for Month of february 2005 Type of Expenditure Type of Expenditure Capital Outlay Salary & Fringe Operating Type 01 Expendllure Type 01 Expenditure Salary & Fringe Operating Capital Outlay Program: Cumulative % Budgeted Amount 146.820 8.500 Program: Budgeted Amount 3.222 414,426 46.217 Program: Budgeted Amount Program.: Budgeted Amount 1.095.921 166.350 New Hanover(;ounty Health Oepartment FY 04-05 MONTHLY EXf'ENDITURE 'REPORT As of February 28, 2005 .' 5134. Navigator parinershiP 66.67% Current Year Expended Balance Amount Remaining Month Reponed Feb-05 Man 8 of 12 Prior Vear Expended aalance Amount Remain) % % Budgeted Amount 47,152 3,404 103.817 3.598 99,668 5.096 5141 Women. Infants and Children Current Year Expended Balance % Amoun. Remainin 3.058 184 226.997 187,429 36,900 9,317 Prior Year' Expended Balance Amount Remaining % Budgated Amount 5142 . Nutrition Current Vear Expended Balance Amoun. Remaining Prior Year Expended aai_ Amount Remaining % % Budgeted Amount . 5151 Communicable Disease (Epidemiology) Current Vear -Expended Balance Amount Remaining 666.248 429,673 136.084 30.266 Prior Yea, -Expended' Balance Amount Remaining 1)95.529 I 4048,675 95,378 $ 32,145 I 2.259 % % Budgeted Amount 1,144.20<1 127,523 2,259 . For Month of February 2005 . Program: Cumulative % Type 01 Expenditure Budgeted Amount 276.667 38.888 New Hanover County Health Department FY04-05 MONTHLY EXPENOITUREREPORT As of February 28, 2005 5152 'Tuberculosis 88.67% Month Reported Man 8 01 12 Feb-05 Current Yea' Prior Year Expended Balance % Budgeted Expended Balance % Amount Remaining Amount Amount Remaining 168,797 107.870 240.817 143.233 97.584 21,943 16.943 38.886 18.169 20.717 Program: Type 01 Expenditure Budgeted Amount 5154 Navigator Current Year Expended Balance Amount Remaining Prior Year Expended Balance Amount Remaining % Budgeted Amount % . Program: 5124 Women'!j Prevent;ve Health Current Year Prior Year Type 01 Budgeted Expended Balance % Budgeted Expended Balance % Expenditure Amount Amount Remaining Amount Amount Remalnln 593.44g 339.740 253.709 603.377 370.271 211.771 104.045 107.726 164.600 118.972 Program: Type 01 Expenditure Salary & Fringe perating Capital Budgeted Amount 57.376 10,714 . 5155 Child Care Health Consultanl Current Year Expended Balance Amount Remaining 45,830 $ 11.546 2,945 $ 7,769 $ Prior Year Expended Balance Amount Remaining 24.296 $ 33.003 872 $ 5.024 688 $ 612 % % Budgeted Amount 57.299 5.896 1.300 For Month of february 2005 <New Hanover County Health<oepartment fY 04-05 MONTHLY eXf'IENOIT~ REPORT As of February 28, 2005 .' Program: 5133 Child Service Coordination Cumul811ve % 66.67% Month Reported Mon8 01 12 feb.()5 Type 01 expenditure Salary & Fringe Operating Budgeted Amount Current Yea, Expended Balance Amount Remaining $ 7.964 $ (7.964) $ 746 $ (746) % Budgeted Amount Prior Year -Expended Balance Amount Remaini % Program: . .5125 Community Health Current Year Prior Year Type 01 Budgeted Expended Balance % Sudgeted Expended Balance % Expendhure Amount Amount Remaining Amount Amount Remaining 534.924 302.515 232.409 446.676 322.304 124,572 72.12% 78.786 35.364 43.422 128.943 39.642 89.301 30.74% Program: 5157 Maternal Outreach Wort<e.. . Type 01 Expenditure Budgeted Amount Current Year Expended Balance Amount Remaining % Budgeted Amount .Prior Year Expended Salance Amount Remaining % Program: 5126 Health Promotions Type of Expenditure Salary & Fringe Operating Current Year Expended Balance Amount Remaining $ 62.376 $ 7.969 % Prior- Year Expended Salance Amount Remaining $ .sg.859 $ 6.372 % . For Month of February 2005 Program 5'63 Family Planning Type of ExPenditure _ Salary & Fringe Operabng Capital Oubay Budgeted Amount Current Year Expended- Balance Amount Remaining 10.235 $ ('0.235) $ $ % Budgeted Amount Prior Yea' 'Expended Balance Amount Remaining $ $ $ % 0.00%. 0.00% . For Month of February 2005 -New f.lanover County Health Oepartment fY 04-05 MONTHLY EXf>.ENOITQRE 'RE'PORT As of February 28, ~5 .. Cumulative % 66.67'10 Month Reported Man e of 12 Feb-05 Program: 5161 Personal Health Current Year Prior Year Type 01 Budgeted Expended Balance % Budgeted Expended 8alance % Expenditure Amount Amount , Remaining Amount Amount Remaining Salary & Fringe $ $ 10.623 $ (10.623) Operating $ $ 157 $ (157) Capital $ 12.600 $ 12.800 $ 100.00% Total. $ 12.800 $ 23.560 $ (10.780) 184.22% Program: 5166 Partnership lor Children Current Year Prior Year Type 01 Budgeted Expended' Balance % BUdgeied bpended Balance % Expenditure Amount Amount ' Remaining Amount Amount Remaining Salary & Fringe $ 150.340 $ 89.223 $ 61.117 59.35% $ 164.265 $ 103.337 $ 60.928 52.91% . Operating $ 22.159 $ 1.535 $ 20.624 6.93% $ 5.835 $ 2.407 $ 3.428 41.25% Capital $ $ $ 0:00% 2400 $ $ 2.400 0.00% Total. $ 172.499 $ 90.758 $ 81.741 52.61% $ 172.500 $ 105.744 $ 64.356 61.30% . Program: 5167 Child Health Current Year Prior Year Type 01 Budgeted Expended Balance % Budgeted Expended .Balanee % Expenditure Amount. Amount Remaining Amount Amount Remaining $ 332.107 188.281 143.826 327.069 197.447 129.522 60.37'10 $ 43.252 21.711 21.541 40.588 11 ;500 29.088 28.33% . For Month of February 2005 . . . New Hanover County Health Department FY 04-05 MONTHLY EXf>.ENDITURE REPORT As of February 28, 2005 Program: 5168 Dental Health Cumulative % 68.67% Month Reported Mon6of12 Feb-05 Current Year Prior Year Type of Budgeted Expended Balance % Budgeted Expended Belence % Expenditure Amount Amount Remaining Amount Amount Remelnlng Program: 5169 School Health Type of Expenditure Current Vea, Expended Balance Amount Remaining % Prior Year Expended Belence Amount. Remalni... Budgeted Amount % Budgeted Amount 1.601.861 70.582 1.015.057 37.960 586.804 32.622 866.178 22.137 Program: 5170 Wise Woman . TyPe 01 Expenditure Salary & Fringe Operating Current Year Expended Balance Amount Remaining 9.592 5.632 914 4,190 'Ie Prior Year Expended Belence Amount Remall)in % Budgeted Amount For Month of february 2005 ~ew Wanover County Health Department FY 04-05 MONTHLY EXPENDITURE REPORT As of February 28, 2005 .' Program: 5174 Jail Health Cumul81lve % 66.67% Current Vear Type of Budgeted Expended Balance .", Expenditure Amount Amount Remaining Month Reponed Mon80112 FetKl5 Budgeted Amount Prior Yea, Expended Balance Amount Remaining % 5,562 (5,582) Program: 5176 Children Special Health Services Typo of Expenditure Budgeted Amount Current Yea, Expended Balance Amount Remaining % Budgeted Amount Prior ,Yea, Expended Balance Amount Remaint % (200) . . Program: 5160 Risk Reduction Type of Expenditure Budgeted Amount Current Vear . Expended Balance Amount Remaining % Budgeted Amount Prior Year Ex'pended Balance Amount Remaining % (926) . For Month of February 2005 . New Hanover County Health Department FY04-05 MONTHLY EXPENDITURE ftEPORT As of February 28, 2005 I Program: 5181 Project Assist Cumulative % 66.67% Current Year Type of Budgeted Expended Salance % Expenditure Amount Amount Remaining 45.609 27.208 18.401 23.830 8.572 15.258 Month Reported Ioton 8af 12 FetKl5 Budgeted Amount Prior Yea, Expended Balance Amount Remalnl % 21,210 13.195 Program: 5182 Heallh Education Current Year Prior Year Type of Budgeted Expended Balance % Budgeted Expended Balance % Expendllure Amount Amount Remaining Amount Amount Remalnl 1.979 (1.979) 0.00% 38 (38) 0.00% . Program: 5183 Safe Communities Current Yea, Prior Yea, .. Type of Budgeted Expended Balance % Budgeted Expended Balance . % Expenditure Amount Amount Remaining Amount Amount Remainl" Salary & Fringe $ Operating $ Program: 5186 Smart Start for Asthma Type of Expendllure Salary & fringe Operating Budgeted Amount Current Year Expended Balance Amount Remaining $ $ % . Budgeted Amount Prior Yea, Expended Balance Amount Remaining $ $ % . For Month of February 2005 ~ew Hanov.er County Mealth Department FY 04-05 MONTHLY EXPENDITURE ReflORT As of February i8, 2005 .,. Program: 5187 Project Stop Cumulative % 66.67% Month Reponed Mon8of'2 feb-05 Current Veor Prior Veer Type 01 Budgeted Expended Balance % Budileted Expended Bolance % Expendnure Amount Amount Remaining Amount Amount Remoinlng 26.034 9.476 '6.556 36.814 4.346 32.468 11.81% 4.195 486 3.709 11.466 1.295 10.171 11.29% " Program: 5188 TB Outreacl1 CurrentVeor Prior Year Type 01 Budgeted Expended Balance % Budgeted Expended Bolonce % Expendnure Amount Amount Remaining Amount Amount Remainln 10,700 10.700 5.000 5.388 . Program: 5189 Sate Schools, United 4 Voulh Current Year Prior Yea' Type 01 Budgeted Expended Balance % Budgeted Expended Balance % Expenditure Amount Amount Remaining Amount Amount Remaining 49,124 28.388 20.736 2.776 889 '.887 Program: 5120 Good Shepherd Type 01 Expendnure Budgeted Amount Current Yea, Expended Bolanee Amount Remaining % Budgeted Amount Prior Year Expended Bolance Amount Remaining % 33.100 23.300 30.'00 23.300 . For Month of February 2005 ~,I .., ,. . . NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 SOUTH 17TH STREET WILMINGTON, NC 28401-4946 TELEPHONE (910) 343-6500 FAX (910) 341-4146 April 6, 2005 To: New Hanover County Board of Health From: Cynthia W Hewett, MSIS Business Manager Subject: Changes in the New Hanover County Health Department Fee Policy I We are requesting approval for the following changes in CPT codes and fees, Change CPT Code Current Proposed Justification Needed Fee Fee Increase Fee 90801 $140,00 $142,00 Increase in TXIX Reimbursement for Psychiatric Diagnostic Interview Exam Increase Fee 90802 $150,00 $151.00 Increase in TXIX Reimbursement for INTAC Psy Dx Interview Increase Fee 90804 $60,00 $61.00 Increase in TXIX Reimbursement for Psytx, Office 20-30 minutes Increase Fee 90806 $91.00 $92,00 Increase in TXIX Reimbursement for Psytx, Office 45-50 minutes Increase Fee 90808 $135,00 $137,00 Increase in TXIX Reimbursement for Psytx, Office 75-80 minutes Increase Fee 90810 $65,00 $66,00 Increase in TXIX Reimbursement for Intac Psytx, Office 20-30 minutes Increase Fee 90812 $98,00 $99,00 Increase in TXIX Reimbursement for Intac Psvtx, Office 45-50 minutes Increase Fee 90814 $142,00 $143,00 Increase in TXIX Reimbursement for Intac Psytx, Office 75-80 minutes Increase Fee 90846 $88,00 $89,00 Increase in TXIX Reimbursement for Family PSylx, wlo patient Increase Fee 90847 $107,00 $109,00 Increase in TXIX Reimbursement for Family Psytx, wi patient Increase Fee 90853 $30,00 $31.00 Increase in TXIX Reimbursement for Group Psychotherapy Increase Fee 11055 $43,29 $54,00 Increase in TXIX Reimbursement for Depo Provera Iniection Add Fee 92587 NIA $54,00 Add fee for OAE Hearing Screening As of 04/05/05 . . . .. . Increase Fee S9445 $11.00 $16.50 Increase in TXIX Reimbursement for MOW Services Delete Code 90676 $160.00 NIA We are no longer providing Intradermal Rabies Vaccine Add Code 90675 NIA $129.00 Add fee for Intramuscular Rabies Vaccine Increase Fee 8814290 NC $10.69 Increase fee for billing non-medicaid clients for PaD Smear Processing Fee Add Code 90734 Nla $92.00 Add fee for reimbursement of Menactra Vaccine 2. We are requesting approval of our updated Socio-Economic Form (form attached). 3 We are requesting approval to automatically implement use of the new Federal Poverty Levels (FPL), upon receipt from the state, as they apply to our various programs. Currently, our WIC Program uses 185% of FPL, Women's Preventive Health Program uses 250% ofFPL and other select clinic services use 350% ofFPL. 4. Currently, we offer Childbirth Classes to Medicaid recipients only. We are requesting approval to expand this service and also offer Childbirth Classes to non-Medicaid clients. Charges for non-medicaid clients would be set at the Medicaid reimbursement rate (currently $21.50 per class) and placed on a sliding fee scale. Clients would be required to provide proof of income to determine fee eligibility. For non-medicaid clients, payment would be required at the time of service. As of 04/05/05 ., . . . . ~ MENOMUNE versus MENACTRA The Battle of the Meningococcal Vaccines Menactra vaccine (Meningococcal Groups A, C, Y and W-135 Polysaccharide Diphtheria Toxoid Conjugate) and Menomune vaccine (Meningococcal Polysaccharide Groups A, C, Y and W -135 Combined) are both used for active immunization for the prevention of invasive meningococcal disease caused by N meningitides serogroups A, C, Y and W-135 Menomune is currently the only vaccine the health department supplies. Menomune is used for children and adults from ages 2 years and up. Most college age adolescents receive the vaccine and many universities now require it. Unfortunately, revaccination may be indicated for those individuals at high-risk of infection, especially children who were first vaccinated when they were less than four years old. Why revaccination? Antibody levels decline rapidly over two to three years and a subsequent dose may be considered within 3 to 5 years. Menomune is a polysaccharide vaccine which is made from a long chain of polysaccharides that come from the outer coat of the meningococcus bacterium, providing a limited duration of immunity. Menactra is also used for active immunization of meningococcal disease, but with its own perks. It is licensed for ages eleven to fifty-five years and may not require a booster dose. Menactra is targeted for adolescents that come in for their booster dose of Td at eleven to twelve years ofage (peak meningitis risk category ages 15-24). Though diphtheria is listed in the Menactra description, it does not protect against diphtheria. An adolescent receiving Menactra should be well protected through adolescence and into the college years. Menactra is a conjugate vaccine created by attaching the meningococcal polysaccharides to a carrier protein. Conjugate vaccines have been shown to induce boostable memory responses and thus, longer immunity Menactra will÷ eventually replace Menomune. A single-dose vial ofMenactra, price per unit, is $82.00 In February 2005, the Centers for Disease Control and Prevention recommended a vaccine for adolescents. The vaccine will prevent meningococcal disease, an uncommon but serious infection. , ,," "_, ~ ~ < ~~ ~,{y'<. ~'';<'"~.f!,:''''>~''-''''' * - ,Q. What is melliiigococcuS? ';', . ,:;' -::ii '::' ';: ~ ~.~~: .~, ~ ^ ~ 'r""~';..o."';:~.~,,,,,,,:.,,~,~;;~'.,~,, A. Meningocoa:us is a bacteriwn. Meningococc:ll bacteria live on the lining of the nose and throar and are spread from one person to another by close personal conract. Occasionally, the virus enters the bloodstream and causes severe disease. Five different types of meningococcal bactetia, classified on the basis of a complex sugar that coats the bacteria (called polysaccharide), cause vinually all meningococc:ll disease in the world. These five different types of meningococc:ll bacteria are called types A, B, C, Y .d W-135. fJ.., ~at are. tke ~l1m~Omf [ibiUf;;i'li~r:~~f4l;(.I"i,':; tntechOIl? '. \ .. r,>~_ '- -~' s. :",,'; '1~;;;~:t'lt~s:s"-~:'!.~7.~,,,,,wJt~.,fX~' 'J~ , t ~ ..," " ~ f " """ ~ , '" ,,..~ 4.' ~ 'i';c~' ,~~,:.<{k;:~'("~":.N -... '~"-:'~\;"" ~ ::J;~ A. Meningococcus infects the bloodstream. the lining of the brain and spinal cord (causing meningitis). Symptoms of bloodstream infection include fever, chills, rash. low blood pressure and dark purple spots on the arms and legs. Symptoms of meningitis include fever, headache, confusion and stiff neck, A. Yes. Every year in the United Srates approximately 2.500 people are infected with meningococcus and 300 die from the disease. Also, about 400 people every year who swvive infection have permanent disabilities, such as seizures, loss of limbs, kidney disease, deafness and mental retardation. The highest incidence of meningococc:ll disease occurs in infants less than I year of age, In children between 2 and 10 years of age, the incidence of .~ingoco~ infect~ons is very low, but starting in adolescence the ,dence of disease rIses. Although adolescents are less likely to be infecled than infimts, they are more likely to die when infected. Meningococcal bacteria are particularly dangerous because they rapidly make large quantities of a poison called endotoxin. Endotoxin damages small blood vesse1s and causes low blood ptessure and shock. For this reason, meningococcal bacteria can kill people soon after they enter the bloodstream. Children can be perfecrly healthy one minute and dead four to six hours laler; disease can be so rapid and overwhelming that even apptopriate, early medical care may be too late. ' Because outbreaks occur in colleges, schools and child-<:are centers. :md other areas where people have close conract, meningococcal mfecnons often cause p~ic in the community. A. Yes. In February 2005. the CDC recommended a new vaccine for use in the United Srates to prevent meningococcus. A previous version of the meningococcal vaccine was first available (" the United States in 1982. This older vaccine was effective in older children and teenagers against four of the five different types of meningococcus (A, C, Y and W-135), but booster doses were required every three to five years. The new vaccine, which protects against the same types of meningococc:ll bacteria as the previous vaccine. probably will nO! require booster doses. Neither the previous meningococcal vaccine nor the new vaccine protects against meningococcus type B, which accounts for two-thirds of all meningococc:ll disease in infimts and one-third of cases in adolescents. Unfortunately, researchers have not yel figured out how ro make an effecdve vaccine using the !)'pe B memngococcal polysaccharide coating. more I. E~:':' ,~,' .: ~'..',\,~: .~:::.; ,/i""' " r1f;)~r;;;'i~~;;'tie:'?G~" ,,,,?''i:1cr~ . "~' --:;5~,;}:';(,r'u:: ~;'"'-~:;,f'~~,:: 't:''';~'~ '''.<; .':W#:~' . ~~.l",..~"..,ratm:l'~,..' .~.,.',.':ri'.ll1\.."~'.l.;r;;;.I'>.~..'~-~,.'.!J,j..':::'/~.'.i~y:,~-T".'.""~"; ~.';'.."."~";'; ,."tL "~~<.'.. '*"'_4'.'~"",,'.''i..'" ';', ~,'_'~~"~c"'~t,\':;:""'<' -,;;;~~;",,::?:t':':':"r;~r":"'" ~ .'~'( ~', r li~~1t,1'(l c. " ,(I :;. ;\~t., }~~J11~k~-Dl;~~:~~~~~~ ~.~~~~~L1i~/~{r~.~~$!ti;_~~~,~~~~~~~G1f"~t:t:''3. .-J~~;~'~: ''i'? > : - '_ ,', ''':'' t'i~' ,/ ; " ,"'-. ~..., ',.t","~ ~,.~j,~" ;,,,; ,';;~~~:"~~~_-:~'~',;.~",~~,~," -1:", Q. >Ho.ir.is. th(1~1~~,,:i'!f!!f!fl(lJllFr:iI1!',:~t'.C~0';; {.,;;,: A. The meningococcal vaccine is made using the complex sugar (called polysaccharide) that resides on the surface of the bacteria. Polysaceharides are stripped from the surface of four of the five different types of meningococc:ll bacteria that cause disease (types A, C, Y and W-135) and each is linked (conjugated) to a harmless ptotein. The four conjugated polysaccharides are combined into a single shot and protect against four different types of meningococc:ll bacteria. ." '." '<.:", ,<"'~ :d_ tli<-l'''''''' ~ ;"~k. ~-,." ',~, ;""")/" -:' _""I: -C'~~ q. (Is. th~ :!'~l!fli~lgoc~'i:C,!~t'!it~c.~ne,ts4ffil Y~';;;}\j;'-:: ~f~F'l;~~ A! Yes. The meningococcal vaccine can cause pain or redness at the site of injection, bur-because it is not made from whole bacteria, it cannot possibly cause bloodstream infections or meningitis. The technology used to make the new meningococc:ll vaccine is the same as that used to make the pneumococc:ll and Haemophilus influenzae type B (Hib) vaccines, both of which have been given safely to millions of infants. A. Yes. The new meningococc:ll vaccine protects adolescents from most of the meningococcal disease caused by types A, C, Y and W-135 (which accounts for about two-thirds of all meningococc:ll disease in adolescents). Because the meningococcal vaccine does not include type B, which accounts for about one-third of cases in adolescents, it does not prevent all cases of meningococcal disease. Unfortunately, researchers have not been able to make an effective vaccine using the meningococc:ll type B polysaccharide coating. The new vaccine can be given once and, unlike the previous meningococcal vaccine. is not likely to require repeated doses. Children or adults who received the previous meningococcal vaccine can receive the new vaccine. Thj~ in!urm:lli()n !~ pr()\"idcLl L'J''- lhe \;ll(]liC l:LiuL,:tion (.[:Ilt('] H T:,L Chijtl"':il dr"piLi! c.J Phibdei~'dli;,. Tht "t.:lll',::' t, JI, t',,-il'~,Hi,\]ja] rt.~(i,lr~: fC1J' ;,;:.... '''', ;:~;Ii.~~ i:~,~'lr~(~~~I(~_~.~~~~l~\i~d ;;;~l; i~:~ ~:~"li:~!,l'~~'I~:~ ;:,il,/,(~~:I;i(\~';~; ~~~1i'I~~::~ 1:'~~;, ~i~:'l~;\':~~:" '; I:"~~ (<'lliU i~ iundt'd lw d',~, \\-',,';':1L',' 'l1d l,(,i'!;'ud,,' Hen!,; E:"ll~n\\'el' Cluii' ii', i\diil(II'_ ]'~"d:jUll\liofiL ;,l1d inkL:iou: DI~G:~l';:, d,,- !\I;ib,..! h(....n."", Elld(}\\.tt; " .,t Ii i:;k~,!OL'~ :',i~~';,s::- ,<..:~ ,C.j:-H'~ T!:.. ~ ,j,dc>.:"", :~(J":". ,;,; iiC ,-.'~,. ]",I+i' I)...n;I:'il"'l<:ili ~ln..c' i:1t:"r 1::1111" 'WI"" 'L,1';l, IS: j,' "",,,.., ::ll"t;"~(d, ,:',d ](l'.":;i!"+_ ]'j-,.. ,;,<,,:11,[: ;liC,::!,!: l ,_,il," ~ "':~ ,n: !'[:U.I\'~ I'll::", ("(:1 ,',' :;~. \nnte 0: ,hi.' l11;lle1'i::;1 \\';;~ ehe:'PlC:G fl'CH" .ii(' ("'',;OJ.;, ,__m, ';!'S: '\:' .. 'C !(iii S/'('!!h~ ,. ihll:Tii 1-" rw: ~ 1- 'j'::. ",;:' ,I', ;:.C:' i1i, ;In;j....lI \':;,' J~:"lf~!,..r'.'" ~nl~;ll~'J!;:i::\" :~jL d,,:; "cr'" -, ,\',edl' ,"(<1; - 1":-:"''''''',: \-,-,-,-.}.-:r'~ii\:;'-1-,-: '--.""';-,~ ,'t:,' '.',' 'f ",'-_~ ~ ~~l ~.f:Wkf!;slt!!ii{#,g?i,Jf1e,ineningo,c~ccal VaCci!let" : ,,;,' A. The meningococcal vaceine is recommended for all adolescents entering middle school (II - 12 years old) and high school (15 years old). However, the vaccine will benefit all teenagers and young adults in the United States. -',*,"'l~~$~J~ ~'l ",wt~y",,~<~~'-'i~~,:;'-,'~- ,;;., '- ~ . ~,,', y> ~, '(j}1Sh~1iIdfo1JjleViishi!fen il!t^ the 1IlCmillgococcdl;o': ~__':>;;.<','~~-~"f;:~V' "':1<\ "'_~.. '\ -', vacCtne.",'??t,t,.1;;4't;i.~!l~iff~~J;(i ~"~~'':: ~. ,t. -_' :; <' " ""-;"";:".,.,~~2:l.;<<l<>;'l;1,;{';',~b(*~I',,"J-~~,,,,'~ 'A, ,>"" ,\/~ ~ "~, ~< < "c, '.." ~ .~~"', . ", A. Yes, all college freshmen, especially students living in donnitories, should receive the meningococcal vaccine. College freshmen living in dormitories are five times more likely to get meningococcal disease than people of the same age who do not attend college. -"I> ,"';:-.... ;t.-'-....'i,;" '-' .c-"j.V"''!r,.c;:, ~ ' !i/'lfi~mli/itetin'1#!Y/{NIil'/sChool gets mt!llillgococcal :; . ifi ,'.^' ~'7/ "fly 'if./il'Lil '. . ~?;,r:::~'1!~'tt~~~~~'&'Jt~~'^~", pl{:" " " ~" ~ . :~~",.' ;<,~,,~\!><-)"~ A. Children in close contact with someone with meningococcaA infection should receive an antibiotic to prevent the disease. ci. contact with someone with meningococcal disease is defined as 1) living in the same house, 2) attending the same child-care center or nursery school, or 3) kissing or sharing utensils Ot toothbrushes. Antibiotics used to prevent meningococcal infection include rifampin. .. ceftriaxone, azithromycin and ciprofloxacin. ~~~~';:~'o/t.'ke't\i''''''::':1~~~~~''kI'f!ii{l1'*"<'' ~'~, "U t,'~ '/ . <,' ~~ ...,'i J f-"-;' .Q.';'Does'"'.'iheimtiitillgoioccal vacCine prevent izll caSes' .;~~~/~'" '1"1> .,-<,--,~<~ .:'.,;P)&~~;t-'::c,J_ ~ ;;,' ~' ~ ~ ;; oJji"llte1lt,zp:ttsr;)j<"-~"!J?::i:'[H:?~:: o-:~ ~ ~ ;',,;:"' ~",' {" '- ,.l , ~'if,,;-:-?e}~~~_, ,1t~~~~~;;~,;A;':~ ~'::0;.~~' ; : 4t. :, " ", ~,t, : A. The meningococcal vaceine will prevent many, but not all, cases of meningococcal meningitis. Other bacteria, such as pneumococcus and Haemophilus influenzae type B (Hib), also cause meningitis. Fortunately. vaccines' to prevent pneumococcus and Hib are routindy given to all children before 2 years of age. Some viruses also cause meningi.tis, but meningitis caused by most viruses is not as severe as meningitis caused by bacteria. f':Y , " ! Ir. APR- 5-05 TUE 12:23 PM CAPE FEAR MEM FOUNDATION FAX N~ 910 452 5879 P. 2 . 80ard Q' Trv,t",,: Agnes R, l3eane ,^"Ilam H, Cameron J. RIchard Ccfb9rt, 111.0. W. COI't'u MebOno.1lI _.110 A. Rhyne. M. D. ItT.Sinclair.Jr"M.D, Robert F Warwick. CPA ~ichord l. WoodbUy ~'ry A. Ga"i~ p,.,Jd.n' . . Cape Fear Memorial Foundation 2508 Independence Boulevard, SUite 200 IMlmlnglO<\ North Corolina 28412 (910) 482.0611 FAX; (910)452-6819 April S. 2005 Mr. David E, Rice, M.P,H" M,A. Health Director New Hanover County Health Department 2029 South 17th Street Wilmington, NC 28401-4946 Dear David, As we have discussed, Cape Fear Memorial Foundation is interested in continuing work with the Health Department in providing health education to the community with the quarterly "Living Well" newspaper inserts. 2005's first subject is asthma. Once you notify us that the County Commissioners have once again agreed to our collaboration in this coromunity service, the Foundation will issue a check for $20,000, This is our best estimate of the costs related to these newspaper inserts, It is once again our intention to fully fund this project through the Health Department. Thank you for your consideration and assistance with this project. Dedicated to Advancing God'. Desire for our Healing and Health