11/07/2007
New Hanover County Health Department
Revenue and Expenditure Summaries for September 2007
Cumulative: 25% Month 3 of 12
Revenues
Cunt Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenw Balance %
Revenue Amounl Earned Remaining Amount Earned Remaining
Federal S State $ 1,908,709 $ 772,368 $ 1,136,343 40.47% S 1,902,273 $ 672,060 $ 1,230,213 35.33%
AC Fees $ 642,661 S 174,784 $ 467,877 27.20% $ 611,161 $ 162,966 $ 448,195 26.66%
Medlract $ 1,569,058 S 154,630 $ 1,414,428 9.85% S 1,546,994 $ 193,202 $ 1,353,792 12.49%
Medicaid Max S 309,128 $ $ 309,128 0.00% $ 310,000 $ . $ 310,000 0.00%
EH Fees $ 310.000 $ 54,533 $ 255,467 17.59% $ 310,000 $ 51,945 $ 258,055 16.76%
Health Fees $ 344,700 $ 94,424 $ 250,276 27.39% $ 250,200 $ 62,259 $ 187,941 24.88%
Health Choice $ 35,125 3 1,291 $ 33,834 3.68% $ 35,125 $ 2,445 $ 32,680 6.96%
tidier $ 3,746,477 $ 696,903 $ 3,049,574 18.60% $ 2,676,206 $ 455,438 $ 2,220,768 17.02%
Tolab $ 8,865,858 $ 1,948,930 $ 6,916,926 21.98% S 7,841,959 $ 1,600,314 f 6,W,645 20.94%
Expenditures
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended seen. %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary S Fringe $ 13,759,049 $ 2,316,738 $ 11,442,311 16.8% $ 12,095,529 $ 2,099,4S 9,996,089 17.36%
Operating $ 2,269,787 $ 496,728 $ 1,773,059 21.88% S 2,198,416 $ 461,577 $ 1,738,839 21.00%
Capital Outlay S 25,900 f 1 25,900 0.00% $ 88,585 $ 30.940 $ 57,645 34.93%
Totals $ 16,054,738 $ 2,813,466 $ 13,241,269 17.52% $ 14,382,530 $ 2,591.957 f 11,780,573 18.02%
Summary
Budgeted Actual %
FY 08-07 FY 011-07
Expenanures:
Salaries B Fringe $ 13,759,049 $ 2,316,738
Operating $ 2,269,787 $ 496,728
Capital OuOay, $ 25.900 $
Total Expenditures $ 16,064,736 $ 2,813.466 17.52%
Revenue; $ 8,865,858 $ 1,948,930 21.98%
Het County f$ $ 7,188,878 $ B6g536 12.03%
Revenue and Expenditure Summary
For the Month of September 2007
7
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07
Grant Re uested Pendin Received Denied
Date (BOH
10/3/2007 Healthy Carolinians - Request for funds from
the North Carolina Division of Public Health,
Office of Healthy Carolinians, for support of $12,048 $12,048
the local task force.
ACHIEVE Grant - Centers for Disease
ControINMCA - Workplace Wellness $40,000 $40,000
Services
91512007 No Activity for September 2007
811/2007 No Activity for August 2007
I'll WIC Mini rant -Request to ratify application
7/11/2007 11
for mini-grant funds for minor renovations to
the WIC registration workstations to improve $18,000 $18,000
customer service.
61612007 Landfall Foundation - Request for funds to
purchase 16 wheelchairs for the NHCHD $2,700 $2,700
School Health Nursing Program.
51212007 Living Well: Received notification from Cape
Fear Memorial Foundation of continuation
funding for the publication of the Living Well $0 $12000
news aper insert.
41412007 Ministering Circle (Colposcopy funding) -
Request for $12,000 start-up funds from
Ministering Circle for purchase of Colposcopy
equipment. Also plan to request additional
funds from other grant sources such as Cape
Fear Memorial Foundation for expansion of
program to include a second colposcopy unit
and additional training, supplies and contract
services. $12,000 $12,000
Cape Fear Memorial Foundation -
Colposcopy Program - Womens Preventative
Health. $25,000 for start up cost for physician
and interpreter contracted services, $25,000
equipment, supplies, and training. $25,000
31712007 Closing The Gap - Request for 225,000
($75,000 per year for 3 years) from North
Carolina Office of Minority Health and Health
Disparities for a Health Educator to focus on
prevention of HIV and other sexually
transmitted disease in the Latino and Afro-
$225,000 $225,000
American opulations.
21712007 CA -MRSA: Funding from UNC-Chapel Hill
School of Medicine to assist with research
related to the prevalence of community
associated methicillin resistant staphylococus $12,600 $12,600
aureus
11312007 Smart Start - New Hanover County
Partnership for Children - Child Care
$178,500 $1709000 $8,500
Nursing Program
8
As of 10/9!2007
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07
Oate BOH Grant Re nested Pendin Received Denied
12/6/2006 E>-k. Endowment Funds, NHRMC - Dental
Unit - Personal Health Services- $25,000 for
indigent dental care and $15,000 for sedation
equipment 540,000 $20,000 $20.000
11/1/2006 No Activi Tor November 2006
1014/2000
March oT Olmea -Maternity Cara
Coord=7 tion expenditures for Baby Love
raBaby Boutique and Learning Center $3,000 $3,000
9/6/2006 No Activi Tor Se tem ber 2006
812/2006 No Activi for Au ust 2006
7/5/2006 erv ce oor gnat on am y
Counseling Program (Cape Fear Memorial
Foundation) - Funding for Licensed Clinical
Social Worker for 3 ears $260,000 $75,000 5185,000
at maR Move More - ommun ty rant
(NC Oa pt oT Public Health Physical Activity
and Nu[rition Branch $16,496 S-22-,,4-16 $4,079
Totals S845.3,43 $52,048 $360016 5445 279
6.16% 42.59% 52.67%
P4ndin Grants 2 15%
Funded Total Re nest 5 38%
Partia ll Funded 4 31%
Denied Total Re nest 2 15%
Numbers oT Grants A lied For 13 100%
9
As or tore/2007
• NEW HANOVER COUNTY BOARD OF COMMISSIONERS
~ Request for Board Actioa
Agenda-- Consent Meeting Date:
Agenda: ® BOH: November 7, 2007
Co Comm_ Consent Agenda
November 19, 2007
De artment- Hcalth Presenter: Kim Roane, Business Mana er
Contact: Kiwi Roane 798-6522
Subject: Grant Funding - Cape Fear Memorial Foundation - "Living Well" Publication -
$650
Brief Summary: Cape Fear Manorial Foundation has notified the New Hanover County
Health Departnzant (NHCHD) of additional continuation grant Funding of $ 650 to cover
the additional cost of producing the "Living Well" publication during 2007_ Tltis
additional award was made as a result of the Foundation's request for NHCHD to
coordinate the publication, the increased costs of producing the issues, and did not
involve an application proccss_ This is a grant fundcd project which will end when grant
fimdin ends-
Recommended Motion and Requested Actions: To approve acceptance of the additional
award of $ 650 in Cape Fear Memorial Foundation grant funds for the Living Well
ro ram and submit to the New Hanover Coup Commissioners for their considerat
Funding Source: Cape Fear Memorial Foundation grant funding- No County match
re uired_
Will above action result in:
F-1114aw Position Number of Position(s)
OPosition(s) Modification or change
®No Chan o in Position s
Ex lanation-
Attachments: Grant award letter from CFMF
30
J
1
(Ca'Qe Fear
I#aw MEMORIAL FOUNDATION
2508 INDEPENDENCE BLVD, STE 200 (910) 452-0611 PHONE
WILMINGTON, NC 28412 (910) 452-5879 FAX
www.ctmfcln.org
October 3, 2,007
Mr. David E. Rice
New Hanover County Health Department
2029 South 17th Street
BOARD of DIRECTORS: Wilmington, NC 28401-4946
Re: Grant #925, 2007 issues of Living Well publication
AcNEs R. BEANE
WILLIAM H. CAMERON Dear David:
J. RKNAR` CORBM. M.D., F.A.C.R. Enclosed please find a check for $650 for the 2007 issues of Living
JAMES D. HVN.^.LET. M.D.. F.A.C.O.S. Well. Rob Nielson has requested that we submit this amount to cover the
W. CARTER MEEANE. III final billings for the last issue due out soon.
~a.T. SINCLAIR, Jr.. M.D.. CHAIRMAN
Thank you for your assistance with these publications. We feel that they
RCNAIC SINCIFIR were informative and helpful to our residents.
Rosen F. WARwCr., CPA
RIcNARa L. Wc•coE.Rr Sinter Y,
GARFT GAPP.'i FFIM-4NT
s
Gang Ga r
President
DEDICATED TO ADVANCING GOD'S DESWE FOR OUR HEALING AND HEALTH 11
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda- Consent Meeting Date:
Agenda: ® BOH: 1 1/07/07
CC- 11/19/07
Department: Health; Health Programs Presenter: Scott Harrelson, Deputy Health
Administration Director
Contact: Scott Harrelson 798-6592
Subject= Grant Application - North Carolina Department o£ Health and Human Services
Division of Public Health Asthma Pro ram - Health Pro rams Administration - $18,000
Brief Suiiirrxury: The North Carolina Asthma Program seeks to reduce the burden of
asthma. Funding will be used to promote the smoke free initiative, NC Smoke Free
Dining Campaign, which will include the NC Restaurant Heart Health Survey, promotion
o£ smoke-free dining decals, certiflcates and other activities designed to raise program
awareness. The Air Quality Flag Program will also be utilized to increase the
community's awareness or the Air Quality Index and air quality forecasts- These
programs will be implemented to enhance the local asthma efforts in New Hanover
Coun
Recommended Motion and Requested Actions: To accept and approve North Carolina
Asthma Program grant application for $18,000 to promote smoke free and air quality
initiatives in New Hanover County and to submit to the New Hanover County
Commissioners for their consideration .
Funding Source: North Carolina Department of Health and Human Services Asthma
Program- No county matching funds are required- Program will be discontinued once
funds are ex ended-
Will above action result in:
New Position Number o£ Position(s~i
QPosition(sDo Modification or change
®No Chan a in Position s
Explanation: A portion of the grant funds will go toward the salary of our Project Assist
Coordinator. This will enable us to transfer current salary funds for the Project Assist
Coordinator into much needed o cratin funds for Project Assist.
Attachments: Asthma Pro ram Bud et Summa Sheet
*ftwl
1 2
North Carolina Asthma Program Budget
Bud et Cate o Amount Requested
A. Salary budget to project $5000.00
.10 FTE From January 1,
2008-August 31, 2008
(A portion of the grant funds will go
toward the salary of our Project Assist
Coordinator. This will enable us to
transfer current salary funds for the
Project Assist Coordinator into much
needed operating funds for Project Assist.)
B. Training $2000.00
Air Quality Flag program
regional training
One training and/or workshop is
planned for the region
C. Educational Materials and $9,000.00
Resources
Media Campaign for smoke free
restaurants, smoke free billboard
at Sharks stadium, restaurant
certificates and decals- air quality
flags and brochures
D. Travel $1,000.00
Project Coordinator's travel
across the region, kick off
workshop, regional meetings and
planned workshops
E. Supplies $1,000.00
General Office Supplies such as
binders, pen and other supplies for
regional training and workshops
F. Total $18,000.00
~W
13
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Consent Meeting
Agenda- ® Agenda: ® BOH: 11/07/07
C'-('-71 1 / 1 9/07
Department: Health Presenter: Janet McCumbee, Personal Health
Services Mara er
Contact: Janet McCumbee 798-6559
Subject: Transfer of a Program Assistant Position to Access III of the Lower Cape Fear,
IRC_
Brief Summary: Access III of the Lower Cape Fear, Inc- has requested we transfer the
Program Assistant Position (working title-Health Check Coordinator) from the Health
Department to their agency. This arrangement would be a good fit for their agency and
mission, and the position would continue with the same job duties- 'I-EZ position would
continue to work with our staff and clients, while being employed by Access III. This
arrangement has been approved by the Division of Medical Assistance (DMA, the
current fundirt source for the
position- and Requested Actions: To accept and approve the transfer of the
` Program Assistant Position (Health Check Coordinators from the Health Department to
\rr Access III, and to approve the budget amendment related to deleting the position
(revenue and expenditures) and to submit to the New Hanover County Commissioners for
their consideration-
Fundin Source: DMA
Will above action result in:
EJ New Position Number of Position(s)l
X Position(s~ Modification or change
No Change in Position(s)
Ex lanation: Delete the Pro am Assistant Position (Bud et # 1 10-61450
Attachments: Letter from Access III o£ the Lower (--ape Fear, Inc.
ADM-001 NHCBOH Aoquest for Board Action 14
1
}
October 17, 2007
David Rice
Health Director
2029 South 17th Street
Wilmington, NC 28401
Dear Mr. Rice,
Access III of the Lower Cape Fear, Inc., would like to request the transfer of the Health
Check Coordinator position from the Health Department to our agency. We realize that
this is a sizable request and only make the suggestion out of our hope to maximize the
effectiveness of the position in serving the needs of the community.
As you know, the North Carolina Department of Health and Human Services has
contracted with Access III of the Lower Cape Fear to manage the care of the Carolina
Access Medicaid and Health Choice populations in our six county region. Our duties
focus on linking patients with a Medical Home, reducing emergency room use, and
managing chronic illnesses such as diabetes, asthma, COPD, and heart failure.
Our Case Mangers currently work very closely with all of the Health Check
Coordinators on reducing the number of children who utilize the Emergency Room for
their primary care needs. Each morning we receive a list of Medicaid patients who have
been in the Emergency Room and work closely with the Health Check Coordinators to
contact those patients and redirect them to their Medical Home. In addition, the Health
Check Coordinators and Access III Case Managers work closely together, and with our
medical providers, to ensure that patients receive the appropriate health check
screenings, follow up appointments, and to counsel patients against missing
appointments.
Access III of the Lower Cape Fear is now also hosting Cape Fear HealthNet, which is an
effort to create a system of care, including case management, for the poor and
uninsured in Brunswick and New Hanover Counties. Our vision is to link as many
uninsured as possible to Medicaid or Health Choice. Those who do not qualify will be
linked to a Medical Home at one of the safety net agencies and will receive case
management services and pharmaceutical assistance.
Our vision is to utilize the Health Check Coordinator position as it is currently utilized at
the Health Department: to help families get their children to well check-ups, keep
patients from utilizing the Emergency Room as their medical home, and link patients
with Medicaid. We would continue to make the Coordinator available for Medicaid
outreach at the Health Department, the school mental health programs, and the dental
van programs. In addition, we hope to better coordinate the position with our case
managers so that families can be prompted about critical health appointments for
15
children with asthma, diabetes, or other chronic or critical health problems- We would
also like to integrate the position with some of our outreach efforts to get uninsured `may
children linked to Medicaid or Health Choice_
In short, we are committed to continuing to utilize the Health Check position for all the
appropriate functions outlined by the Division of Medical Assistance and to continue the
outreach efforts as they have been occurring at the Health ~epartment_ We would
simply like to expand the role to better serve the needs of chronically ill and to make
best use of the synergy that we believe possible between the work of the Health Check
Coordinator and our Case Managers-
Moving the position will also assist the Health E)epartment by eliminating your financial
liability for the unfunded aspects of the program. Access 111 of the Lower Cape Fear
intends to accept nm^ funding for the position and to make up any unfunded expenses,
while continuing to support the Health E3epartment's outreach efforts-
1 hope that you will look favorably upon this request- Please feel free to contact me with
any questions. I am also available to discuss with your Executive Committee on
October aOt- and/or with the Board of Health when it meets on November 7-_
Thank you very much for your consideration of this matter-
rte/
Best regards,
Lydia F. Newman
Executive Director
'Wool
1 45
Y
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
~r Requ¢st for Board Action
Agenda: Consent Meeting Date: 10/30/07
Agenda: Q BOH: 11/07/07
De artment: Health Presenter: David E_ Rice, Hcalt Director
Contact David E_ Rice 798-6501
Subject Board of Health Policy - ]Delegation of Authori to Health Director
Brief Summary: To state general policies that shall guide the New Hanover Ca!unty
Board of I3calth (NHCBH~ and Health Director. The scope of this policy applios to all
members of the New Hanover County Health De artmcnt (NHCHD workforc .
Recommended Motion and Requested Actions: To approve the Board o£ 14<-alt)a Policy -
Delcgation of Authorit to Health Director-
Fundin Source: N/A
Will above action result in:
F-INaw Position Nurnbar of Position(s)
OPosition(s) Modification or change
®No Chan e in Positions
Explanation: Accreditation Standard on Governance, Benchmark 37.6: The locpal board
of health shall approve policies for the recruitment, retention and workforce cl tiVeIopment
for agency staff Based on Benchmark 37.6, the Board of Health Policy - Delegation of
Authority to Health Director would provide documentation of evidence to meet this
re uirerncnt_
Attachments: Board of Health Policy of Authori to Health Director
L
1 7
it
4- New Hanover County Health Department --WAIL
Policies and Procedaares
Y S
rz az ~
- re uneh
Sub-ect-_ [Dele ation of Authority to Health [Director
[Date of Ori in: "11/07/2007 [DRAFT
Policy Number: -S-ADM-076
PURPOSE AND SCOPE=
To state general policies that shall guide the New Hanover County Board of Health (NHCBH) and Health
[Director- The scope of this policy applies to all members of the New Hanover County FA- iIth Department
(NHCH[D) workforca-
POLICY-
This policy can only be changed by a majority vote of the N"4--BF] (refer to NHIQBH Operating
Procedures)- The N"CB" will revise this policy at the same time the job descriptio of the Health
Director is reviewed.
~c. PROCEDURE-
V It is the NHCBH's Policy:
1. To employ a qualified Health [Director and delegate to him/her the authority and~nesponsibility for
the overall management of the Health Department in accordance with written Ipolicies_ In the
absence of written policies, the Health Director is to be guided by an application bf NHCBH intent
as established in other policies and counseled as necessary by the appropriates, members of the
NHCBH-
2- To establish a job description for the position of the Health [Director including appropriate
qualifications of education, experience, personal factors and skills in accordancel, with 130A-
40.
3. To evaluate the Health [Director on an annual basis. Such evaluation will be co'Iordinated by the
Chair through the NHCBH Executive Committee with results reported to the full Board. It is the
responsibility of the NHCBH to hire and terminate, if necessary, the Health [D~rector_ It is the
responsibility of the NHCBH to review and approve a job description for the Health [Diractor-
4_ The responsibilities of the Health [Director include:
Recruitment, selection and advancement procedures that are to ba!. administered in
compliance with state and federal employment laws, rules and regulatioos_
Implementation of program, policies, and fiscal plans.
- Performance of management functions which will assure that program" services will be
available, accessible, acceptable, efficient and coordinated to promote continuity of care
and meet appropriate standards,
- [Delegation of authority and accountability for program functions to H40alth [Department
staff who is assigned responsibilities-
Coordination with other governmental and private groups concerned with the planning
and delivery of health services for community residents.
•
Performance of administrative functions which will provide accountability for funds
received and expended and assure that all regulations and requirements are satisfied.
- Leadership of Health [Department staff addressing such functions as staff development,
job descriptions evaluation, termination, grievance procedures, pension and related
employee benefits.
"Healthy People, Healthy Environment, Healthy Community" 18
Use of statistical and other relevant information for determining needs, planning services, _
monitoring staff and program activity, and evaluating attainment Of objacti1v~a- .
Present t0 the NHCBH issues which may require policy statements and/or action, .~rr?
including issues which may prevent conflict of interest.
Develop the organizational structure for the Health department, Iprapare current
organizational charts, and establish lines of -port/communication-OTHER INFORMATION: (attached)
REFERENCES:
Legal Authority G. S. 130^ NC Public Health Laws
CHANGE HISTORY:
Version Mate .,Comments
A 111/07/2007 Original document (C)raft)
1
1 9
"Healthy People, Healthy Environm¢nt, Healthy Community-
CRAFT
08 Executive Committee ~
Meeting Cates
5:45 p_m. ,
- -
• January 29, 2008
• February 26, 2008
• Marc--" 25, 2008
• April 29, 2008
May 27, 2008
• June 24, 2008
• July 29, 2008
• August 26, 2008
• September 23, 2008
• October 28, 2008
• November 18, 2008
• Cecember 16, 2008
20
O DAFT
New Hanover County Board of Health
2008 Meeting r3ates
• January 2, 2008
• February 6, 2008
• March 5, 2008
• April 2, 2008
April 10, 2008 -Staff Appreciation Luncheon
• May 7, 2008
• June 4, 2008
• July 9, 2008
• August 6, 2008
• September 3, 2008
• October 1, 2008
• November 5, 2008
• December 3, 2008
• pecember 11, 2008 - Holiday Celebration
2 1
Y New Hanover County
z _ Health Department
c 2029 South 17t° Street °
Wilmington, NC 28401-4946
Phone (910)798-6500 FAX (910) 341-4146
Toc New Hanover County Board of Hcalth
From. David E. Rice, Health Director
Janet McCuinbee, Personal Health Services Manager
Date: October 1 1, 2007
R¢. Annual Summary of New Hanover County Health Department Compliance
with Enforcement of Communicable Disease Laws - Fiscal Year 2006-20017
Communicable Control Measures'...
Disease Issued
HEPATITIS B 7 6
Communicable Control Measures Isolation Orders Warrants Successful
Disease Issued Issued Issued''.Prosecutions
HIV 1 2 4 3 3
TUBERCULOSIS ] 5 9 O N/A
Lv.-
"N ¢althy Y¢ople, 9ealthy Environment, 1I¢althy Community"
New Hanover County
Animal Control Services
Advisory Committee
Meeting Minutes 10/18/07
Present: John Boozer, JoE Needham, Joyce Bradley, Bob Weedon. Whitney Doremus, Martha: Raynor,
Dianne Connor. Patrice Kaizar
Absent: Gretchen Colby, Cindy Meyers
Old Business
1. Landscaping.
Please visit when there is light, so everyone can see the completed work.
2. Co-location shelter.
We are ready for an event. Fortunately, we had no need to test it this
year (so far!). Special thanks to Martha and Humane Society group for
helping us get ready.
3. Ashley HS w/ Karen Campbell.
Patrice has been unable to contact the individual either.
4. Additional ordinance changes/updates.
a. Restriction of animals given as prizes at county fairs.
b. Change time frame on DD hearing notification.
All changes have been tabled at present date. They were pulled from the
commissioner agenda, and we were asked to review them again.'
5. CDC - Rabies Awareness Day Sept 8.
This was a huge success. We vaccinated 385 animals in two hours and
gained some great publicity in the process.
6. Compassion Fatigue & Burnout.
Martha commented on the workshop. It was very beneficial for staff and
visitors to all to be on the same page. It was eye-opening for some.
7. Division image concerns.
We continue to work through these. Whitney suggested a fund-raiser,
perhaps in April for public health month.
8. Public Health Forum - July 31, & other SEPHLI items.
This went well, and we will probably continue with much of what we
started through our project in years to come.
9. Advisory committee by-laws.
Some additional revisions need to be made to make sure all concerns are
addressed in the document.
New Business
1- ACS newsletter_ _001
Bob, Whitney, and Patrice will work on this.
2_ Brunswick County rabies clinic-
This is Saturday, 1 0/20 frorn 1 -3 p_rn_ at Brunswick River Park_
3_ Inner City rabics clinic-
Whitncy said We had to change this to 1 1/1 O, because they were booked
on 1 1/3. Bob can still do vaccinations. Ti7Tle is 1 -3 p_m_
4_ Animal law group-
Discussion focused on the revision handout regarding kennel inspections.
The intent is to put an end to puppy mills in our county- The group will
review the changes and discuss next meeting_
5. Member rotations 8e cornurittee make-up.
Time to go through some changes/additions to the committee_
6_ Elcction of next year's officers.
JoE will take over as Chair, and Dianne as Vice-
C--hair-7- Cornmittee meeting dates.
Next meeting is January 16 at 7 p_m_
Respectfully submitted by Jean McNeil
_Oov
Page 1 of 4
i Rice, navid E.
From: Rice, David E.
Sent: Thursday, October 11, 2007 9:02 AM
To: Roane, Kim
Cc: Harrelson, Scott; McCumbea, Janet
Subject: RE: Recommendations from October Meeting
Approved. _
David E_ Rice, MPH, MA
Health Director
New Hanover County Health E)epartment
2029 South 17th street
Vlfilmington, NC 28401
910-798-6691
dricaCo-Onhcoov.com
http://www. n hchd . ore
From: Roane, Kim
Sent: Thursday, October li, 2007 8:57 AM
To: Rice, E>avid E.
Subject: F.A.C.T. Recommendations from October Meeting
The following recommendations for approval were agreed upon at our October meeting (no individual fee
change is expected to generate more than $5,000/year, so Health Director approval is permitted as per policy):
- Increase the fee for N/arivax vaccine from $80.00/dose to $90.00/dose, based on a recent increase in our
cost-
a Establish a fee of $210.00, and a code for Pulpal IDebridement (M3221), a dental service offered
occasionally on the Mobile Mental Unit. Fee is based on the cost of providing the service and the rate
charged in our community. This service is not Medicaid reimbursable-
oue to the high cost of Gardisil ($150/dose x 3 doses = $450), some of our patients who want the vaccine
are unable to pay the cost of this private vaccine at the time of service- While we do not recommend a
general variance from our established fee policy guidelines that require payment for flat rate fees such as
this at the time of service, we would like to have your permission, on a case by case basis, to request
approval from you as the Health Director to allow a payment plan to be set up for patients with
demonstrated need. These requests would flow through the Business Manager (or designee) to you (or
your designee) so that we could monitor the frequency of the extensions of time to pay for the service-
Changes to the NHCHE:> Fee Policy to comply with Blue Cross/ Blue Shield contract requirements:
Page 9, Section H.
Current: Payment, or w-pay for third party billing, is expected at the time of service for all chargeable
services. Partial payment is accepted for all chargeable services, with the exception of flat fee services-
Co-pays are not subject to sliding fee scale. Medicaid patients are exempt for co-pays.
Change: Payment, or app/icab/e deductible, co-Insurance, and co-pay for t//rd party bJ//Jng, is
expected at the time of service for a// chargeab/e services- Partial payment is accepted for a// chargeab/e
services, with the exception of flat fee services. Co-pays are not subject to sliding fee scale. Medicaid
patients are exempt for co-pays. Payment for non-covered services is expected at time of service.
Patients must sJgn the AcKnow/edgment of Non-Covered Services form to accept responslbJ/Jty
for payment of designated sarvicas.
Page 9, Section J
10/11/2007
Page 2 of 4
Current: Payment in full is required at the time of service for vaccines not supplied by the State, with the
exception of flu, pneumonia, and meningococcal vaccines provided to Medicaid, Medicare Part S, and
Health Choice recipients. Insurance companies will not be billed for these vaccines except for Blue Cross
Blue Shield (to include State Health Plan) due to Cost Wise reimbursement. Patients will be provided a
receipt for submission to their insurance company.
Change.- Payment in fu// is required at the time of service for vaccines not supp/isd by ttss Stets, with the
exception of flu, pneumonia, and meningococca/ vaccines provided to Medicaid, Msd/care, and Hsa/M
Choice recipients and vaccines prov/ded to BCBS recipients. /nsurance companies will not be b///ad
for these vaccines except for Blue Cross Blue Shield (to include the State Hsa/th P/an) due to our
contractual agrBSment_ Pat/ants with other /nsurance will be provided a rata/pt for submission to
their insurance company- _
Page 14, *1
Current: The fee policy will be explained to each patient with explanations of purpose and details of
procedure when the patient presents for services. Each patient is given an opportunity to pay and every
effort will be made by staff to collect the total or partial payment on the day of the visits. Payment in full is
required for flat fee services.
Change= The fee Po/icy wi// be explained to Bach patient with explanations of purpose and details of
procedure when the patient presents for services. Each patient /s g/~ an opportunity to pay and every
effort will be made by staff to co//ect the total or partial payment or app/icab/e daduct/b/B, co-/nsurance,
and co-pay for th/rd party bi//ing on the day of the visits. Payment in fu// is requinsd for Nat faa
services with the exception of f/u, pneumonia, and maningococca/ vaccines not prov/dad by the
State for Medicaid Medicare, and Health Choice recipients and vaccines not provided by the States
for BCBS r~cipiwnts-
Page 14, *2
Current: Provided that patient confidentiality is not jeopardized, bills showing total charges <less sliding
scale discount) will be mailed to patients 30 days after their visit- Two additional statements with balance
owed will be mailed if no payment or subsequent visit is made. Note: As previously identified in Section
1, General Guidelines, Item K; for patients who demonstrated no "good faith" effort to pay on their account
with a balance of thirty-five ($35) dollars or more and sixty (60) days or more past due, NHCHO will
submit necessary information to the New Hanover County (NHC) Finance Office for the purpose of
collecting such outstanding debt. Additionally, such patient accounts will be flagged within our patient
care management database as being in a collection status- An administrative penalty of $15.00 may be
applied to delinquent patient accounts that are sent to NH(-- Finance Office for Processing. Patient
statements will inform patient of this fee.
Change: Providsd that patient confidentiality is notjaopardized, b///s showing tote/ charges (/ass sliding
sca/B discount) will be mailed to patients within 45 days after their visit. Two add/t/ona/ statements
w/th ba/ante owed w/// be mailed /f no payment or a partla/ payment is made. Note: As previously
identified in SBCtion Genera/ Guidelines, /tsm for patients who demonstrated no good faith" Effort to
pay on their account with a balance of thirty-five ($35) do//are or mors and sixty (60) days or more past
duo, NHCHC will submit necessary information to the Nsw Hanover County (NHC) F%nancB Ofcs for the
purpose of co//ect/ng such outstanding debt- Additions//y, such patient accounts will bs Nagged with/n our
patient care management database as being in a co//action status. An administrative penalty of $15.00
may be applied to delinquent patient accounts that era sent to NHC Finance Ofce for Processing-
Patisnt statements will inform patient of this fee. Excapt/on to this rule is Fam//y P/ann/ng. Paymenf
arrangements will be made for unpaid 15a/antes To-F=amily Planning services.
Page 14, 4*3
Current: Patients with account balances who have demonstrated no "good faith" effort to pay will be
subject to service restrictions- Service restrictions will be at the discretion of the Health Director or
designee and may include prioritizing or restricting appointments.
Change: Patients with account ba/antes who have demonstrated no "good faith- effort to pay will be
10/11/2007
Page 3 of 4
subject to service restrictions- Service restrictions will be at t/7e discretion of the Health Director or
designee and may include prioritizing or restricting appointments- Exception to t/s/s ru/e is Farms//y
Planning services and those sere/cas prov/ded to patients pBr Sfate laws (sea N_ Paga !O)_
Changes to fees for the following services based on increase in reimbursement rate from BC--BS to
better cover cost of providing services:
NHCHU Recomvnm ncled
CPT Uescri tion Fees Chan es
46900 01estna Anal Lesion 5 190.00 $240.00
56501 I7estro Vulva Lesion s 132.00 $150.00
57170 Oia hra m Fitting 89.00 $110.00
58301 lug Removal 96.89 $120.00
71021 " Chest X-Ra /Lordotic 40.00 $50.00
80061 Li id Panel 20.00 $25.00
82120 Amines- Wet Mount 6.00 $10.00
83036 Hamo lobin Al C 15.00 $20.00
84152 PSA 30.00 $35.00
84439 T4, Free 15.00 $20.00
84443 TSH 25.00 $30.00
90801 Psychiatric pia nostic Interview Exam 142.00 $180.00
90802 INTAC Ps Ox Interview 151.00 $190.00
90804 Pstx, Office 20-30 min 61.00 $75.00
90806 Ps tx, Office 45-50 min 92.00 $115.00
90808 Ps tx, Office 75-80 min 137.00 $175.00
90810 Intac Ps tx, Office 20-30 min 66.00 $90.00
90812 Intac Ps tx, Office 45-50 min 99.00 $125.00
90814 Intac Ps tx, Office 75-80 min 143.00 $180.00
90846 Family Ps tx w/o patient 89.00 $115.00
90847 Family Ps tx w/ patient 109.00 $140.00
90853 Group Ps chothena 31.00 $40.00
92587 OAE Hearin Screening 54.00 $70.00
96152 Intensive Ps chosocial Counselin 25.00 $30.00
Re-Assessment Med Nutrition Therapy (15
97803 min 18.00 $20.00
Re-Assessment Mad Nutrition Therapy (30
97803 min 36.00 $40.00
Re-Assessment Mad Nutrition Therapy (45
97803 min 54.00 $60.00
Re-Assessment Med Nutrition Therapy (60
97803 min 7200 .$80.00
99381 Well Exam c1 113.00 $120.00
99382 1-4 Yr Exam 120.00 $130.00
Thank you for your consideration,
Kim
Kim Roane
Business Manager
N. Hanover County Health department
(91 O) 798-6522
10/11/2007
Page 4 of 4
fax (910) 341-4146
-../00
-.000
10/11/2007
,Department of the Treasury Notice Date: Oct 30, 2007
,Internal Revenue Service Notice Number: CP 5100
!P.O. Box 2508 Employer Identification Number: 65-1317627
Cincinnati, OH 45201 Tax Form: 1023
Document Locator Number:
17053-299-30904-7
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIlIIUI For assistance, call: 1-877-829-5500
PUBLIC HEALTH FOUNDATION OF NEW
HANOVER COUNTY INC
c/o DAVID E RICE
2029 S 17TH ST
WILMINGTON, NC 28401
Acknowledgement Notice
Information about the Application Process
We received your application for exemption from Federal income tax and your user fee payment.
During the initial review process, applications for exemption are separated into three groups:
1. Those that can be processed immediately based on information submitted,
2. Those that need minor additional information to be resolved, and
3. Those that require additional development.
If your application falls in the first group or second group, you will receive your determination letter stating
that you are exempt from Federal income tax or a request for information via phone, fax, or letter. If your
application falls within the third group, you will be contacted when your application has been assigned to
an Exempt Organizations specialist for technical review. You can expect to be contacted within
approximately 60 days from the date of this notice.
IRS does not issue "tax exempt numbers" or "tax exempt certificates" for state or local sales or income
taxes. If you need exemption from these taxes, contact your state or local tax offices.
How to Get Additional Information
General information about the application process and tax-exemption can be found by visiting our
website, www.irs.gov/eo. If you are unable to locate the information needed, you may call our toll free
number shown above Monday through Friday. When communicating with us, please refer to the
employer identification number and document locator number shown above.
Sign up for Exempt Organizations' EO Update, a regular e-mail newsletter that highlights new information
posted on the Charities pages of irs.gov. To subscribe, go to www.irs.gov/eo and click on "EO
Newsletter."
For general infortnotiort, tax forms, and publications, visit www.irs.aov
<TEGE. CP 5100 (02/2007):-
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