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04/06/1988 BOH Minutes _1 r--."",,,\ The New Hanover County Board of Health met on Wednesday, April 6, 1988, at the Health Department. Members Present: Jean Credle, Chairman Donald Blake Pascal Camak, DDS Albert Corbett Michael Goins, OD Julius Howard John Leonard, DVM Amaryllis Rehder Sheram Robinson Catherine Vangellow Members Absent: Peter Pappas, M. D. Others Present: Robert S. Parker, Secretary to the Board Frances F. De Vane, Recording Secretary Ms. Credle called the meeting to order at 8:00 A. M. Mr. Howard presented the invocation. Ms. Credle called for corrections to the minutes of the meeting of March 2, 1988. Mr. Howard moved the minutes be approved. Upon vote, the MOTION CARRIED. Department Focal: Ms. Dianne Harvell, Environmental Health Director, presented to the Board members a Sewage Program Update on alternate type sewage systems at Figure Eight Island and Oyster Point. She distributed handouts on the Maintenance of Sewage Systems. Budget Committee Dr. Leonard, Chairman, reported that the Budget Committee will meet after the recommended budget is received from the County Manager. He reported that the Office of Management and Budget had notified the Health Department that they had submitted an excellent budget and that a hearing would not be necessary. The Budget Committee will present the FY 1988-89 Budget at the May Board of Health meeting. Personnel Committee Mr. Howard, Chairman, reported that the Personnel Committee met on April 1, 1988, and reviewed the Board of Health's performance appraisals of Mr. Parker, Health Director. The Committee recommended a 2.5% merit increase. He commended Mr. Parker for outstanding performance. Mr. Howard moved that the Board approve the 2.5% salary increase. Upon vote, the MOTION CARRIED. L (\ Community Relations Committee: -- Mr. Robinson, Chairman, presented a list of activities recognizing Public Health Week (April 10 - 16, 1988). These activities include Public service Announcements by Board of Health members, public Health bulletin boards, health department history for seventh graders in New Hanover County, and news releases. - Unfinished Business: New Business: Request New position - Community Health Technician - Home Health Mr. Parker presented a request for a Community Health Technician, Home Health, due to program expansion and increase of Home Health services and visits. Mr. Howard moved that the request for the new position of community Health Technician be approved. Upon vote, the MOTION CARRIED. Request New Position Nutrition I - Wic 1/2 Time Nutritionist I to Full-time Mr. Parker presented to the Board a request for the part-time Nutritionist in wic to be increased to a full-time Nutritionist I position. He stated this was necessary to meet the demands of the present patient caseload. Ms. Vangellow moved that the Wic Nutritionist I position be increased to a full-time Nutritionist I position. upon vote, the MOTION CARRIED. -- - Revision of Bad Debt Write Off Policy New Hanover County Health Department Fee policy Mr. Parker presented a proposed Revision of the Bad Debt Write Off Policy of the New Hanover County Fee pOlicy. He explained that this new policy expands the present Family Planning Bad Debt policy to include Personal Health Fees and expands the period of time for bad debt write offs from one year to two years. Mr. Corbett moved that the proposed Bad Debt Write Off Policy be adopted as a revision to the New Hanover County Fee policy. Upon vote, MOTION CARRIED. (Bad Debt Write Off Policy Attached) Mr. Parker informed the Board that he plans to request that the Board review the Fee Policy for all programs at the May Board of Health meeting. Fee Policy Clarification - Swimming Pool Plan Review Mr. Parker stated that in the listing of Environmental Health fees there is a charge for Swimming Pool Plan Review and that the .. policy needs clarification for Swimming Pool Renovation Plan Review. Ms. Harvell, Environmental Health Director, stated that -- .- 141 this charge would be difficult to apply and she recommended that there be no charge for Swimming Pool Renovation Plan Review. It was the consensus of the Board that swimming pool renovation plan review should be excluded from Environmental Health fees. Katie Beckett Proqram Changes Mr. Parker recommended to the Board that Home Health continue as case manager for the Katie Beckett Medicaid patient but that Medical Personnel Pool should provide nursing care for this patient. This recommendation is based upon modifications of rulings from State Personnel and IRS which would require the County to hire nursing personnel for Katie Beckett as employees rather than independent contractors. Annual costs for this service are in excess of $100,000. Mr. Blake moved that Home Health continue as case manager for the Katie Beckett Medicaid patient and that nursing care services be transferred to Medical Personnel Pool. Upon vote, MOTION CARRIED. Board Member Comments: Ms. Credle congratulated Ms. Rehder for her participation on the State Cancer Committee. Health Director Comments: Mr. Parker recognized the Board of Health as the most progressive, enthusiastic Health Board in the State of North Carolina. He congratulated them on their interest in health promotions. Mr. Parker reminded the Board of the Continuing Education Program for Boards of Health which is scheduled on Thursday, April 21, 1988, from 6:30 P.M. - 9:30 P. M. at the Hilton in Wilmington, North Carolina. This is an inservice on Health Department Fees and Public Health Funding in North Carolina. Board members were encouraged to attend this program. Mr. Parker stated that Public Health Week is to be April 10 - 16, 1988. Mr. Parker introduced the following new staff members: Susan Stanton, Clerk Typist, Laboratory Clay Feltman, Sanitarian Technician, Vector Control Angela Evans, Clerk Typist, Community Health Mr. Parker displayed the color scheme and building materials for the addition to the health department building both interior and exterior. He stated he felt they were architecturally compatible. The total cost of this expansion is $1. 4 million. Construction is to begin June 26, 1988. 142 Mr. Parker reported that the momentum for the passage of the Pepper/Roybal Bill (H.R. 3436) is tremendous. He stated that this is one of the biggest happenings in Home Care since the Medicaid Act. This Bill has been co-sponsored by Congressmen Rose, Lancaster and Jones and is due voted upon in early May. It will provide home care for disabled children, adults and senior citizens. .... - There being no further business, Mr. Blake moved the meeting be adj ourned. Upon vote, the MOTION CARRIED. The meeting was adjourned at 9:40 A. M. R spectful~ed' ean Credle Chairman, Board of Health ~ 2-(J~ Robert S. Parker Secretary to the Board Approved: .... - .... - NEW HANOVER COUNTY HEALTH DEPARTMENT - BAD DEBT WRITE OFF POLICY After all procedures have been followed as previously described in the fee policy, the bad debt write offs will be handled as follows: The patient I s ledger card will be coded with a red "R" each time the patient is reminded of the outstanding balance. Bad debts will be written off as uncollectible, two years following the date of the last visit except when: 1. There has been no intervening visit within two years and the patient still wishes to remain an active patient. Future services may be denied if effort for payment is not made. 2. Small amounts are being paid toward the bill. List of patients and amounts owed will be submitted to the Health Director when the date list is submitted. Health Director must approve with signature and date before proceeding further. Write offs will be done by adjusting patients balance to "0" and ledger card placed as inactive. Any future visits would reactivate the ledger card and charges begin again. Patients with a previous bad debt write off whose income is in the pay category will not be allowed to charqe services. Patients returning who wish to pay on previous balance ( even though it may have been written off) will be allowed to do so. Clerk will make an adjustment in the Accounts Receivable Column to reflect the amount of write offs and submit this in the Quarterly Fees Report. 5-:25-g~ Date t4QA JL OJ Health Director ~ ~. NHCHD 4/88 - 23 -