Macon Counly  ON COUN  CAR JULY 13, 2021 6P.M. AGENDA  MACON COUNTY BOARD OF COMMISSIONERS  1. Call to order and welcome by Chairman Tate  2. Announcements (CGCIO) 3. Moment of Silence 4. Pledge of Allegiance 5. Public Hearing(s) - None 6. Public Comment Period 7. Additions to agenda  (A). Amanda Fuller - Certified Government Chief Information Officer  8. Adjustments to and approval of the agenda  9., eports/Presentations  (A) Medicaid Transformation - Shelly Foreman, Community  Relations Regional Director for Vaya Health  10.Old Business 11.New Business  (A) Clay/Macon Regional Hazard Mitigation Plan 2021 Update Emergency Management Director Warren Cabe (B) Request for permission to apply for broadband grant Economic Development Director Tommy Jenkins (C) Request for release of surety bond for Highlands Falls Country Club - Planning, Permitting and Development Director Jack (D)Resolution Exempting Architectural Services for former National Guard Armory renovation and improvements - Mr. Morgan  Morgan  MACON COUNTYCOURTHOUSE: ANNEX PHONE 828-349-2000  5WESTI MAIN: STREET  FRANKLIN, NORTH CAROLI INA: 28734  FAX: 828-349-2400    (E)Satisfaction of Security Instrument regarding Franklin Tubular Products - County Attorney Eric Ridenour (F) Request for funding from KIDS Place - Commissioner Beale and/or Alisa Ashe, Executive Director, KIDS Place  12.Consent Agenda - Attachment #12  All items below are considered routine and will be enacted by one motion. No separate discussion will be held except on request of a member of the Board of (A) Minutes of the April 13, 2021 regular meeting, the May 11, 2021 regular meeting, the May 25, 2021 continued session, the June 3, 2021 continued session and the June 8, 2021 regular  Commissioners.  meeting  (B) Budget Amendments #1-11 (C)Tax releases in the amount of $2,692.47 Macon County Public Health Mountain Historical Society  (D)Billing guide, fee schedule and vaccine fee update summary for (E) Agreement to Provide Recreation Opportunities with the Scaly (F) Service Contract with the Franklin Area Chamber of Commerce (G)Service Contract with the Highlands Area Chamber of (H)Resolution Accepting American Rescue Plan Act (ARPA) funds (I) Grant Project Ordinance Amendment for Weatherization (J) Grant Project Ordinance Amendment for Weatherization (K) Macon Middle School Locker Room Project - Reject bids received on June 21, 2021 as only one bid was received. (L) Monthly ad valorem tax collection report - no action necessary  Commerce  Assistance Program FY 2021 (#8217) Assistance Program FY 2022  Authorize staff to readvertise the project.  13.Appointments  (A)Library Board (2 seats)  14.Closed session as allowed under NCGS 143-318.11(a/5) = Mr.  Ridenour 15.Adjourn/Recess    FOR IMMEDIATE RELEASE  Contact:  Shannon Howle Tufts, PhD UNC School of Government  CGCIO Program  Amanda Fuller Graduates from CGCIOTM Certification Program  the University of North Carolina at Chapel Hill's  Chapel Hill, NC, June 22, 2021. Amanda Fuller, Assistant Information Technology Director, for Macon County has successfully graduated from the 2020-2021 Certified Government ChiefInformation Officers Program' TM at the University ofNorth Carolina at The CGCIOTM program is the first local government specific program for CIOs in the nation and began in 2005. The program is designed for local government Information Technology Directors and ChiefInformation Officers whose challenging responsibilities require a broad understanding ofmanagement, leadership, legal, regulatory, and enterprise topics. The course is approximately 240 hours in length and course instruction covers strategic technology planning, communication, emerging technology trends, risk assessment and management, acquisition management, change management, leadership, cybersecurity, and legal issues related to The program's director, Dr. Shannon Tufts, has been recognized by Government Technology magazine as one ofthe 2010 Top 25 Doers, Dreamers, and Drivers for the creation and expansion ofthis nationally acclaimed program. The program seeks to elevate the position ofti the dedicated and talented cadre of public sector technology leaders who work tirelessly to Amanda Fuller is one oft the 45 local government, state agency, community college, and K-12 education IT leaders in the state ofNorth Carolina who successfully completed the course this year. Over the course ofits existence, the CGCIOTM program has graduated over 2000 public  Chapel Hill's School ofGovernment.  technology.  serve the public good through strategic investments in technology.  sector technology leaders across the nation.    MACON COUNTY BOARD OF LOMMISSIONERS  AGENDA ITEM  CATEGORY - KEPORIS/PRESENTATIONS  MEETING DATE: JULY 13, 2021  9A.  Shelly Foreman, the Community Relations Regional Director for  Vaya Health, will make a presentation on Medicaid Transformation and other topics. The following items from Ms. Foreman are included in the agenda packet: (1) her PowerPoint presentation on "Medicaid Transformation Overview," (2) another PowerPoint entitled "Vaya Health Budget and COVID-19 Funding Information,' (3). a dashboard" report of statistics for Macon County for the first three months of 2021, and (4)aJune 1 press release regarding the consolidation of Vaya Health and Cardinal  Innovations.    7/8/2021  VA VA VAYAHEALTH  Medicaid  Transformation Overview Shelly Foreman Director Vaya Health  Spring 2021  Regional Community Relations  Who & What is Vaya Health  VAYAHEALTH  Local government agency that manages publicly-funded. services and supports for individuals facing a2 23-county catchment area" of  challenges with MHSUIDD needs in We are al local political  subdivision oft the state of North Carolina originally known as an "area authority" and now referred to as a "local management entity/ managed care organization" (LME/MCO).  WNC.  AEET MS DEPAREMENTIZ on HEALE INDTHUMVENT SERVICES    1    7/8/2021  We offer three distinct  health plans: 1. AMH, SU and IDD! health plan for individuals whol have a qualifying type of Medicaid basedi in one of our 22 counties. Human Services pursuantt to the NC 1915(b) Medicaid Waiver.  VAYAHEALTH  AMH,SUand IDDhealth plan foreligible individuals whoare uninsured or underinsured. Because this plani iss supportedy with entitlementt tot these servicesand fundingislimited  We manage this plan under a contract state, localand federal block grant with the NC Department of Health and funds (not Medicaid), therei isno  3. Ahome and community based services and supports health plan for individuals with /DD. This plani is pursuant tot the NC1915(c) "Innovations" Waiver  House Bill 403-Medicaid  Managed Care  VAYAHEALTH  Added Secretary's concept of BH/IDD Tailored Plans that will cover integrated physical health, pharmacy, BH and IDD services for complex, high- risk population Added mild tor moderate BHp population to scope of Standard Plans -list ofs services includes inpatient, OPT, crisis ands some SUD -overlap with enhanced services Established assessment and transition process for members moving between plans Excluded Some Medicaid Benefits from Standard & Tailored Plans Established: a Tribal Option for Enrolled Members of the EBCI/ Federally Recognized Tribes  2    7/8/2021  Goals of Medicaid Transformation  VAYAHEALTH  Deliver whole-person care cost-effective solutions  Unite communities to address member needs and deploy Transition to provider-based care management at site of  care  Improve member experience Reduce provider administrative burden Support a healthier North Carolina Address unique needs of historicalymarginalized  populations  NC-PHPS  VAYAHEALTH  Prepaid Health Plans  Managed care plans-which are called Prepaid Health Plans (PHPs) in North Carolina-will be paid capitated payments by DHHS to manage the care of eligible Medicaid and NC Health Choice beneficiaries. There will be three types of PHPS  Standard Plans Tailored Plans Tribal Option  3    7/8/2021  Standard Plan Enrollment  VAYAHEALTH  State-Wide Standard Plans AmeriHealth Caritas North Carolina, Inc. Blue Cross and Blue Shield of North Carolina UnitedHealthcare of North Carolina, Inc. WellCare of North Carolina, Inc. Open Enrollment: March 15-May 14, 2021 Grace period for Plan changes by members  May 15: NC will auto enroll members who have not chosen a Plan The NC Medicaid Enrollment Call Center number is 833-870-5500/TPA 833- Free NC Managed Care mobile app on Google Play or the App Store  870-5588,  Medicaid Transformation by the Numbers: Macon  County  VAYAHEALTH  Current Medicaid-eligible Estimated Medicaid Standard Plans inJ July Estimated Medicaid Vaya after July Standard Planl launch  8,242 residents  7,451 members moving to  791 members staying with  4    7/8/2021  Standard Plans and Tailored Plans:  What are they?  VAV VAYAHEALTH  Standard Plans willa address the majority oft thel Medicaid population usinga a "whole person care" approach, toi include! both the physical healtha and behaviorall health needs for those individuals with mild tor moderate challenges 4Standard! Plans (commercial) statewide: servingt the 6health regions and: 1Provider Led Entity (PLES)s serving region3,5 July 2021  Tailored Plans "wholey person care" approach fort thosei individuals who have more complex behavioral health orl IDD needs Tailored Plans will manage both the physicalhealthi needs oft the person with behavioral health and orl IDD andt their specialty care needs Thel legislation: statest thatt there willl be nof fewer thans 5a andr no more than 71 Tailored Plans July 2022  Standard Plan Populations  VAYAHEALTH  Medicaid beneficiaries note eligible for Tailored Plan Medicaid beneficiaries note excluded from Managed Care EXCLUDED: Beneficiaries dually eligible for Medicaid and Medicare PACE beneficiaries Medicallyr needy beneficiaries Beneficiaries onlye eligible fore emergency: services Presumptively eligiblee enrollees, duringt the period ofp presumptive eligibility Healthl Insurance Premium Payment (HIPP)E beneficiaries Medicaid beneficiaries note exempt EXEMPT: Members off federally recognized tribes-Tribal Option  5    7/8/2021  Tailored Plan Populations  Individuals with SED orac diagnosis of "severe" SUD or TBI SUDI Diagnosis + Enhanced BH: Service Individuals witha developmental disability Individuals receiving Innovations Wavier Services Individuals ont the Registry of Unmet Needs Individuals with mental illness who: Meet TCLIcriteria Had2 or more psychiatric hospitalizations or readmissions within prior: 18r months Known to have had one or more IVC within prior 18r months Had2orr more. visits tot the EDf fora psychiatric problem within prior: 18 months 0 2orr more episodes using BH crisis services within prior 18r months  Individuals receiving any oft the services currently covered by LME/MCOs that are NOT covered by Children with Complex Needs Children aged 0-3 with or atr risk of developmental delay or disability Children involved with DIJ/ DDP "who meet criteria established by DHHS" Uninsured Individuals utilizing Electroconvulsive Therapy Individuals utilizing clozapine orl long- acting injectable antipsychotics  SPs  Safeguarding Beneficiary Services Through Crossover CrossoVerActVIes Customized AllTransitioningl Members:  Based on Service History, Vulnerability AIIT Transitioning Members  Data Transfer: Claims Prior Authorization Pharmacy Lock In Data Care Plans or Assessments, ifrelevant "High Need" Members: High Need Members aret transitioning Members whoses servicel history indicates vulnerability to service disruption Thiss groupi is identified ont DHHS High Need Member List" "Warm Handoff" Members (52000 Members): High Need Members who! have beeni identified by Medicaid Direct "transition entities" (CCNC/LME- MCOS) orb byt the! Health Plana as warranting ay verbal briefing! between transition entity and Health Plan This groupi is identified ont theD DHHS High! Need Member list" andt through specific warm handoff/summary sheet process.  "High Need" Members  "Warm Handoff" Members    7/8/2021  Tailored Plan RFA Metrics  Total response was 2,645 pages including RFA documents, responses, supporting documentation, and  attachments 18 hard copies submitted loriginal, 2 copies of the entire response including all state released documents 15 copies of only the response, supporting documentation, and Attachment Q 2USB electronic copies  4 4L Large moving boxes, an approximate total weight of And roughly a dozen printers overheated..  254.1 Lbs.  Tailored Plan Rollout  VAYAHEALTH 2022 *  2020  2021  Project 1115 Waiver Readiness TPRFAResponse Sapinnto.sankegeMa Potential ElectronicV Visit Verification 70% Complete CMSI Interoperability MCISC Current Business MCISF PhysicalHealth CareN Management Platform Contracting NCQA SOC2E Examination &F Report InProcess Pharmacy BenefitN Mgmt Contracting  Status 25%C Complete 100% Complete 35%0 Complete 32% Complete NotStarted Delayed  Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 TargetDate  9/30/2022 2/2/2021 Unknown 1/1/2021 6/30/2021 8/2/2021 7/1/2022 10/2/2021 11/30/2023 7/1/2022 7/1/2022  * TaloredPlanGolive- July1,2022 * TalboadPinCatathwnd  7    7/8/2021  Vaya RFA Win Themes"  A"Win Theme" is the reason why Vaya should be Should convince potential customer (DHHS) that you will Includes proof points that differentiate Vaya from C Overall Theme: Proven Results & Visionary Leadership Improving Member Experience & Outcomes Embracing & Promoting Integrated, Whole-person Care Building & Sustaining Cost-effective, Community-based System of  awarded the RFA meet the RFA deliverables competitors Themes:  Care  8      N 0 2  e  I  e - - P  C0 b0 @ M  8    D D  -  D  L  3  V    - E D0 E  C a   n  8 @ e   - O @ C Z J)  8  @ N    - 2 0    Dn Nu  E  a  la - - - a a  9? 0  4:   16 5  - 135 3  C  3 E 00 DE DE E  S  5 8 DE E 00 E  5 E 3  E E -  a 3 3 a    Macon County  Vaya Health Member Dashboard for January- March 2021 Member count by service category (Medicaid) - PSR,3 a Community Support,1 11 Partial Hosp/DayTxt,4  a IH,1 16  - MST, PRFE.2 "Crisisservices, 14 a BHLTF Residential, 16  uI ICF/MR,17 MACTT,19 a Inpatient, 21  - Innovations, 40  - Outpatient,! 503  Member count by service category (State-funded)  Other,6 "Inpatient,9 Other DD,2 2  BHLTF Residential, 12 Community Support,22  Crisis Services, 31  Outpatient, 242  Chartsenisereietenses ACTT: Assertivec CommunityT TreatmentTeam DD:C BHLT -aawg-masa ICF/MR: CrNaN withintellectuald disabilities  IH: Intensivein home Innovations: Homea andCommunity- basedservicesfori p/Day Tx: Prtaagpuveyuener ation  withi intellectuala and/or developmentald (/DD)    Macon County  Vaya Health Member Dashboard for January- March 2021 Top 10 providers by member count (Medicaid)  MeridianE Behavioral Healths Services, Inc. NCGA Acquisition, LLCd dbaA Appalachian Community Services THEL LONG CENTERF FORF PSYCHOLOGY, PLLC  276  139  41 25  Healthcare PLLC Emergency Coverage Corporation Mission Health Community Multispecialty! Providers, LC MHA Angel Medicalc Center, LLLP MHN Mission Hospital, LLLP MountainAreal HealthE Education Center, Inc. Macon Citizens Habilities, Inc.  22 20  100.  150  200  250  Top 10 providers by member count (State-funded)  Meridian BehavioralH Health Services, Inc. NCGA Acquisition, LLCC dbaA Appalachian Community Services Hazelwood Healthcare PLLC RHAH Health Services, Inc. October Road, Inc. MHMission! Hospital, LLLP Davidson Homes, Incd dba Davidson Family. Services Family Preservation Community Services, Inc. Crossroads Treatment Center ofA Asheville, PC BHGX XXXVI, LLCd dba BHG Clyde Treatment Center  143  89  39  20 40 60 30 100 120 140 160    Macon County  Vaya Health Member Dashboard: for January- March 2021 Member count by age and disability type (Medicaid)  350 300 250 200 150 100 50  288  204  16 MH  IDD  #18-20 wAdult MChild  Member count by age and disability type (State-funded)  180 160 140 120 100 80. 60 40 20  162  IDD  MH a18-20 wAdult. uChild  SA  Charts servicereferences IDD: Intellectualand/ord MHN Mentalhealth SA:S Substancea abuse    Macon County  Vaya Health Member Dashboard for January- March 2021 Where members receive services, top 10 Medicaid locations  Macon Haywood Buncombe Jackson Burke Henderson Cherokee Catawba Iredell McDowell  453  98 89 42  50 100 150 200 250 300 350 400 450 500  Member count  Where members receive services, top: 10 State-funded locations  Macon Haywood Buncombe Jackson Caldwell Iredell Catawba Mecklenburg Avery Cherokee  201  82  27 16  50  100  150 Member count  200  250    Count of members receiving Complex Care Management  (Medicaid and State Funded  MH/SUARCM,19  IDD,43  MH/SU,24  Notes:  -Duetodaimslag. claimse correctionsar andn Medicaide eligibilityt thesen aawaeasine -Bydefinition,t thesed datag groupingsp produces some duplicationw withinthec charts. Fore example,a aconsumerr receivingservices -Other Category: Servicest MewPtw:PiwN: grouping. Theset tendtobea ancilaryservicestee ED-related)  fromm moret thanonep providerw willbec countedo oncep pere eachp provider.    CONTACT: Vaya Health: Allison Innman 828-225-2785, ext. 5364 llson.nman@vayahealth.com FOR IMMEDIATE RELEASE June 1, 2021  Cardinal Innovations: Ashley Conger (704)467-3808  shevconger@ardinalinnovationsors  VAYA HEALTH AND CARDINAL INNOVATIONS. ANNOUNCE CONSOLIDATION  Managed care organizations join under Vaya Health leadership to bring strength and stability to public Ashevile/Charlotte, N.C. - Two of North Carolina's largest managed care organizations announced today that they will consolidate in preparation for the state's transformation to Medicaid managed care.. Vaya Health and Cardinal Innovations have already begun transition efforts, with Vaya assuming responsibility for coordinating services and supports for Cardinal Innovations members once consolidated. Together, the organizations will work toward a seamless transition focused oni integrated, compassionate care fori individuals with mental illness, substance use disorders and/ori intellectual and Vaya Health currently manages services for individuals in 22 counties in western North Carolina. If approved by the NCI Department of Health and Human Services (DHHS) and county representatives, the consolidation wille expand Vaya's operations to encompass benefits for the individuals and counties served by Cardinal Innovations. The proposed consolidation marks the fourth such endeavor for Vaya, having successfully led previous mergers with New River Behavioral Healthcare in 2007, Foothills Area Vaya'se experience with transitioning members through consolidation efforts will be especially beneficial as the state's public health care system is undergoing a significant shift. The first phase of NC Medicaid Transformation will launch on. July 1, 2021, with five commercial health plans poised to manage. integrated health benefits for thei majority of Medicaid enrollees. As part of the second phase of transformation to BHa and 1/DD Tailored Plans, which are expected tol launch in July 2022, Vaya and Cardinal Innovations have been preparing to evolve their operations to offer fully integrated care for people with a serious mental illness, a serious emotional disturbance, a severe substance use disorder, The consolidation oft the two organizations will enable a stronger health plan to serve individuals who receive care through North Carolina's public health care: system. It will also bring needed stability to members in counties served by Cardinal Innovations. The organizations are committed to bringing the  behavioral health care in North Carolina  developmental disabilities.  MH/DD/SA Authority in 2008 and Western Highlands Network in 2013.  ani ntelectua/developments disability, or at traumatic brain injury.    best of both together to ensure the widest range of services, highest quality care, and unparalleled "We believe that when we work together to meet the needs of our communities; we all benefit," said Brian Ingraham, Vaya Health President & CEO, "Our number one priority throughout this transition will be tos support members, providers and counties and avoid any disruption in care. We remain committed to offering a successful public service option as a Tailored Plan. Iti isap privilege to have the opportunity to strengthen the public model, support our county partners and serve even more North Carolinians on "The passion and commitment of Vaya staffi in serving our members and communities is beyond compare," said Rick French, Vaya Health Board Chair. "The Board of Directors is pleased to expand that work to ensure Cardinal Innovations health plan members continue to receive quality services and "We believe in our mission to improve the health and wellness of our members and their families," said Trey Sutten, Cardinal Innovations CEO. "It has become increasingly clear that in order to deliver on that mission, we need to consolidate with a strong organization that has al history of meeting member and community needs and can: stabilize the disruption caused by Medicaid Transformation and county realignments. Thave known Brian and the Vaya team for years, and know that our members, providers "The Board and I unequivocally support the entire team at Cardinal Innovations," said Bryan Thompson, Cardinal Innovations Board Chair. "While we. are saddened to reach this forki int the road, we are confident that' Vaya shares our values and is wholly committed to our members, providers and Leadership for the two organizations will be working closely with DHHS as well as local and state government representatives to ensure as successful: transition. The Boards for each organization will establish aj joint steering committee to guide the development ofa a transition plan that puts member, provider and county needs at the forefront of planning efforts. Vaya leadership will be visiting with each county to hear their concerns and learn about the unique needs of each community. Consolidation: of the two entities under Vaya Health leadership is expected to be completed by June 30, 2022. About Vaya Health: Vaya Health is a public managed care organization that oversees Medicaid, federal, state and local funding for prevention, treatment and crisis services delivered by practitioners and providers in Vaya's contracted network. Vaya manages services and coordinates care for individuals in 22 western North Carolina counties, home to more than 1 million residents. Vaya's local model ensures that each county receives individualized attention and: support to meet the unique needs of each community. Every day, Vaya works with providers, local stakeholders andi members to develop needed services, supports and educational programming for a healthier North Carolina. The organization has a proven track record of meeting or exceeding the state's clinical benchmarks and maximizing public funds  commitment: to local communities.  their journey toward health and wellness."  supports."  and communities are in the best possible hands."  communities."    to reach more citizens per capita than any other LME/MCO. Access to care and crisis assistance are  available 24/7at1-800.8496127.  About Cardinal Innovations Healthcare: Cardinal Innovations Healthcare is a specialized health plan and care coordinator for Medicaid recipients and the under- and uninsured in North Carolina with complex behavioral and special needs. Cardinal Innovations connects people with treatment and: support for mental health, intellectual and developmental disabilities, and substance use disorders througha a network of providers in their communities. In 2020, Cardinal Innovations administered nearly $850 million for the care of 825,000 people int the region and invested more than $501 million to improve support systems and to respond to the pandemic. Cardinal Innovations also works with local governments to address public health concerns such as homelessness, suicide prevention, child welfare  and domestic violence through education, engagement and outreach.    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  CATEGORY - NEW BUSINESS  MEETING DATE: July 13, 2021  11A. Emergency Management Director Warren Cabe will update the board on the renewal ofthe Clay/Macon Regional Hazard Mitigation Plan - 2021 Update. Mr. Cabe will be requesting approval ofthe plan, which requires an update and approval every five (5). years. The plan is required for the counties to be eligible for Federal disaster funding. Included in the packet will be a copy ofa a letter acknowledging the plan's compliance with FEMA requirements. The plan document itselfis 338 pages in length, and a copy has been posted to the county's website under the "Public Announcements" tab and may be viewed there. A copy will not be included in the agenda packet. Mr. Cabe has also asked Mr. Ridenour to prepare an "approval" resolution regarding this matter, and can provide the board with additional  details and/or answer questions at the meeting.  11B.  Economic Development Director Tommy Jenkins will inform the  board regarding the National Telecommunications and Information Administration (NTIA) Broadband Infrastructure Program and will be 11C. Planning, Permitting and Development Director Jack Morgan. will present a request from Highlands Falls Country Club to have a surety bond in the amount of $12,500 released. Documentation regarding this matter will be contained in the packet, and Mr. Morgan will be available to provide 11D. Mr. Morgan will also be requesting approval of a resolution that would exempt the architectural services for the proposed renovation and improvements to the former National Guard Armory from the appropriate state statute, as the fee for these services will be less than $50,000. A copy  requesting the commission's permission to apply fora grant.  additional details or answer questions.    of the resolution is attached, and Mr. Morgan can provide additional details 11E. County Attorney Eric Ridenour has prepared a Satisfaction of Security Instrument in regard to Franklin Tubular Products. Mr. Ridenour provided some background information on this matter, as follows: "This stems from an inçentive plan through the EDC that was done in 2013. The original Note and Deed ofTrust were drafted by Ernest Pearson, an attorney in Raleigh. Itis my understanding that the terms ofthe agreement were met several years ago, and Franklin Tubular has requested that the outstanding Deed ofTrust be marked as satisfied. Tommy Jenkins has confirmed that the Deed of' Trust needs to be marked as Satisfied. Attached is the Notice of Satisfaction for the County's approval. John Henning is presenting the same to the Town at their July 5 meeting." A copy oft the document is  at the meeting.  included in the agenda packet.  11F. Please see the information below that is an excerpt from an email from Alisa Ashe to Commissioner Beale regarding a financial request from KIDS  Place. Ronnie,  Per our telephone conversation, here is information about thei financial shortfall KIDS Place is facing this fiscal year (2021-2022). Sorry this is delayed getting to you. My father became suddenly illt this week (pneumonia) and I've been out of the office. Readi this over and let me know ifl need to make edits. Icany work to shorten or whatever you think is needed to best  answer questions that might be asked.  Thank you for all you do for the families of Macon County.  Request: $75,000 What is KIDS Place:  KIDS Place is a private, nonprofit, nationally accredited children's advocacy center that services for childlyouth/teen victims of sexual abuse, physical abuse, neglect, or witness provides to violence or other trauma (such as witness to homicide), in Macon County. KIDS Place and the children of Macon County need your help! 20% cutt tof funding over the previous year's budget.  Funding Cut Explained:  KIDS Place has been notified that its base funding through the Victim's of Crime. Act been cut 67%. Additionally, a competitive VOCA grant was not funded thus adding an (VOCA) additional has    KIDS Place has cuti its budget to bare bones, which means no travel, no training, no new equipment, limited funds for supplies, etc.. ..  but still needs to raise $110,000 to meet this reduced budget and maintain current levels of service provision. KIDS Place will be making greatly a public appeal for community supportdonations and asking for grant funding through local During the 30 years that KIDS Place has been providing services in Macon County this agency has never asked for any county dollars above and beyond those granted through the Community Funding Pool KIDS Place is' VERY appreciative of funds awarded through the Community Funding Pool as this has always been used to leverage additional grant funds and show local support. But this is an unusual circumstance to have VOCA grant funds cut to such a devastating  foundations.  level.  Whati is VOCA Funding:  KIDS Place and other children's advocacy centers in the state are eligible for grant funding through the Victim's Of Crime Act (VOCA) fund. These are not tax dollars. VOCA is funded through restitution payments madei in federal, mostly white-collar crimes. These dollars must be spent to provide services for victims of crime. During the last few years, fewi federal crimes were tried in court with some settled out of court and any fines paid went into the congressional general fund. This has created al huge funding gap of national proportions for children's advocacy centers. In North Carolina, VOCA grant dollars are disbursed through Governor's Crime Commission. Accredited children's advocacy centers, including KIDS Place, are eligiblet for this base funding. KIDS Place had a 67% cut to its base' VOCA grant funding for the two-year granti it wasj just awarded. KIDS Place applied for additional competitive' VOCA grant funding tol help pay for mental health and medical services for child victims of abuse. This competitive grant was not funded. The grant scored well there just wasn't enough funding to go around. This created an additional 20% cut tot funding over the previous fiscal year on top oft the 67% cut.  What is Being Done Nationally and in N.C.  KIDS Place is working with its national parent agency, the National Children's Alliance, and other national victim service organizations asking congress to pass VOCA fix legislation. There has been support on both sides of the aisle. But this fix will take time tot trickle down to the local level. KIDS Place is also working closely with its statewide agency, Children's Advocacy Centers of North Carolina, inc., to ask state legislators to provide VOCA Gap funding for children's  centers.  advocacy  How Does KIDS Place Benefit Macon County?  KIDS Placei is a unique public/private partnership. We operate as ar multidisciplinary Core Team thati is made up of professionals, many of whom are county employees. Team members include representatives from Child Protective Services, the Sheriff's Office, the Franklin Police Department, the Highlands Police Department, the District Attorney's Office, mental health professionals, medical professionals, the KIDS Place child forensici interviewer, the KIDS Place victim assistant, the KIDS Place executive director, Juvenile Justice and sometimes others. The team meets monthly and is coordinated by KIDS Place. The team reviews child maltreatment cases sO that all agencies can share information and work together to ensure the needs oft the child as well as those of each agency are met. Without KIDS Place, there would be no agency to coordinate this team. The multidisciplinary team approach is seen nationally as the gold standard KIDS Place provides evidence-based mental health treatment for childyouth/teen victims, at no cost to thet family. We must provide trauma focused treatment for these little ones so that they do not turn to drugs or other self-destructive forms of" self-medication" because of the trauma they  forv working child maltreatment cases.  have experienced.    KIDS Place provides specialized medical evaluations at no cost. Without KIDS Place, most of these exams would have to be conducted in Asheville requiring child protective services workers and often a detective to travel with the family to Asheville and spend hours out of the county. KIDS Place is currently working with Children's Advocacy Centers in neighboring counties to form aChild Medical Collaborative nonprofit to better be able to meet the increased need for these specialized medical evaluations. Exams will still be done at the children's advocacy in the where the child lives through this new collaborative. This is a very important part of the healing county process for victims and their caregivers. Iti is also crucial for thei investigation of each case. KIDS Place maintains state-of-the-art medical equipment for use by specially trained medical providers. In fact, the equipment used at KIDS Place is more up-to-date than what is used in KIDS Place provides specialized forensic interviews for child protective services and law enforcement. KIDS Place provides a neutral setting for these interviews and highly specialized equipment to capture thei interviews. It typically costs about $5,000 tot train a forensic interviewer. Without KIDS Place, the county would have to train law enforcement and child protective services KIDS Place has often been able to find grant funding to send law enforcement officers and child protective services workers to specialized training to help them be! better trained fort the vital work Iti is an understatement to say that the last year was a hard year for children and families. Just at at time when we are experiencing an increased demand for the services we provide, we have been hit with this huge funding cut. These are our children! We must take care oft them! Some that the children are our future. I always counter that by saying that the children are our we must take care of them today so that we can have a brighter future! Thank you so much for your consideration of this proposal.  Asheville!  workers to dot these interviews and add to their already full workload. they do and to stay current on the latest research in the field.  and say today  Alisa Alisa W. Ashe Executive Director KIDS Place P.O. Box 693 Franklin, NC 28744 828-524-3199 www.kdsplacecacorg    U.S. Departmento ofHomeland: Security Region] IV 3005 Chamblee Tucker Road Atlanta, GA 30341 FEMA  May 28, 2021  Mr. Steve McGugan State Hazard Mitigation Officer Assistant Director/Mitigation Section. Chief Division ofEmergency Management NCI Department of Public Safety 200 Park Offices Drive Durham, NC 27713 Reference: Dear Mr. McGugan:  Mult-jurisdictional Hazard Mitigation Plan: Clay-Macon Regional Hazard Mitigation Plan  -2021 Update  This is to confirm that we have completed al Federal review oft the draft Clay-Macon Regional Multi- jurisdictional Hazard Mitigation Plani for compliance with the Federal hazard mitigation planning requirements contained in 44 CFR 201.6(b)-(d). Wel have determined that the Clay-Macon Regional Hazard Mitigation Plan is Approvable Pending Adoption effective May 28, 2021. For our office to issue formal approval oft the plan, at least one plan participant must submit adoption documentation. Upon submittal ofa copy of documentation oft the adoption resolution(s) to our office, we will issue formal approval oft the plan. Please have Clay-Macon Regional submit a final copy oft their Ifyou or the participants int the Clay-Macon Regional Mult-jurisdictional Hazard Mitigation Plan have further questions or need any additional information please do not hesitate to contact Celicia Davis, of the any Hazard Mitigation Assistance Branch, at (202)997-7490, Carol Maldonado, oft the Hazard Mitigation Assistance Branch, at (470)307-6294 or Edwardine S. Marrone, ofmys staff, at (404)433-3968.  Plan, without draft notations and track changes.  Sincerely,  Kristen M. Martinenza, P.E., FM Kmaz Branch Chief Risk Analysis FEMA Region IV  www.fema.goy    Falls  COUNTRY CLUB  Hgius  June2 21, 2021 Joe Allen NC Code Enforcement Official Macon County 1834 Lakeside Drive Franklin, NC 28734 Dear. Joe:  lam in receipt oft the final inspection report for our renovation project: Project #LD-19-001531. With the project now completed and the final inspection having been done and approved, lam hereby requesting that the Surety bond of $12,500 be released and returned tol Highlands Falls  Country Club. Please send the check to: Highlands Falls Country Club One Club Drive Highlands, NC 28741 Att: Jason Macaulay, GM/COO  Thank you and your staff for your oversight of our project and for your valuable input.  Sincerely,  General Manager/COO  2  One Club Drive, Highlands, North Carolina 28741- 828-526-4118 - www.clubhfcc.com    2 OF 3  Macon County Erosion Control Program Macon County Human Services Building, 1834 LakesldeDrive  Franklin, N.C.28734 Phone: 828-349-2560  LANDI DISTURBING SURETY BOND  Consult inslructions ford completion. AINCIPALINPORMATIONK  Name: HiHlves FAlls Louwry lwb,Tas D.B.A. HicuLaaps falls Gexty Club  Sited orP Project Namet HHIrDSNE Histlaaps Fa-lls CL Rewoidion Land Owner(s) ofRecords_ HiCHAwnSFAlk Gshy Clb, Twc.  Address: CLR DRIVE City/Statelzipt HIEHANDS_AE 28741  Phones and Fax: 828-536-48 $28526-4742FAK E-Mail Address: jmacaulay Dclubhfz.com State! License or Registration #'s: 56-1194946 FTAXID Name: HicHANDS Falls Durtry ylubTue  SURETY INFORMATION:  Address: / CLuB DRIVE City/State/Zipu HEHANPSNE 28741 Phones and Fax: 828-526-418 E-MailAddregg: nsaledKR.en Check S SLr7 Burd# State ofNorth Carolina County ofMacon  828-536-4792 FAV  $63491  ANOPALLAENBFTHESE PRESENTS THAT WE, HICHANDS FAlls Lwhy Cab/RNAAGANay  (Principal Name)  asPrincipals and HFLC/ARN MACAiLy, ,as Surely, are! heldandf firmly boundi unto the County ofMacon, int the sum of(S ,500 ,00)_ Lleck Sor banel amount to the payment where wel bond ourselves our heirs, executors, administrators, ande assigns, firmly by these present. WHBREAS, the abovel bounden Prineipal has applied fora an) EROSION CONTROLPAMAPAOVALAND  (Surely Name)  LAND-DISTURBINGI PERMIT, inl Macon County, North Carolina,  Thec condition oft this obligationi iss such that:  WHEREAS, thes said) Principali is or desires tol bc engaged ina ALAMDDSTURINCACIVITA within Macon County on aj parçel ort tract ofl land whichi isk knowni int the offiçial registry ofthe Macon County Land Records Office byt thei PROPERTY IDENTIFICATION) NUMBER of_ 75408665  ands said  parcel ort tract may also be foundi inl DEEDI BOOK: IA County Register ofDeeds Oftice, and such! land-disturbing activities as proposed! by thel Priucipal, and  mm4PAOBR53C2mt thel Macon  WHEREAS, therc havet been promulgated by Macon County, çertain rules and regulations fort the conduct of POMOCAVIARPIAPPONAALAPARAAXONN    WHEREAS, specific to the conditions creating ther requirement oft this Surety Bond, thes said land- disturbing activityi is subject to $153,22( (C) ofChapter 153 ofthe Macon County Code ofOrdinances: NOWTHEREPORE, ifthe said] Principal shally well and truly perform the land-disturbing from thet time ofunderlaking to çompletion within the guidelines set forthi int thes approved crosion activity aud sediment control plan fort thej project and Chapter 153 ofMacon County'sCodec of Ordinances and Sediment Contro!), Macon County will make no demand fo redeem theb bond. However, the (Erosion said Principal and the said Sutety shall welle and truly pay tol Macon County all applicable stated herein ifthel land-disturbing activityi in isi non-compliance with said Ordinance surety for 90 Itis expressly understood that this bondi may be canccled byt the Surely only at the expiration of thirly (30) calendar days fromt the date upon which the Surelys shalll have filedy with thel Macon Erosion Controll Program andt thel Macon Counly Finance) Director written notice tos SO cancel, This County provision. however, shall noto opcrate to relieve, release or discharge the Surely from any liability,ciyil penalties or criminal penalties already accrued or whichs shall açcrue beforet the expiration ofthet thirty (30) day period. ftis expressly understood that ifthe bond lapses or expires prematurely, the Permit will ber revoked, ande ans application foranew) Land-Disturbing! Permit must then be Land-Disturbing submitted. Itis expressly understood that mpon forfeiture ofapplicable surcty, the Principal does herebys grant tol Macon County the right to enters saidy property at reasonable times andj perform work upon: said value extent oft the bond ando only for the purpose ofi installation ofs sufficieut erosion ands property sediment control measures: and devices on the: site in accordance with Chapter 153 oft the Macon County Code of Ordinançes: Erosion and Sediment Control, Itis expressly understood thati forfeited surety shall be also used to establish erosion control structures or ground covers ine accordancey with an approved sediment  Erosion and Sediment Control, and  bond: funds working days  after a Notice of Violation is received by the Principal,  to the  control! plan,  Thisi ist the_ 10 dayot Nouemlyer dor9  PRINÇIPAL: VINESSTOPRINCIPAL, SURETYSEALL WITNESSTOSURETY, ATTORNEY-IN.FACT (SURETY): Details of Application:  HA  Supeft Chec  1. Ther number ofa acres tol be disturbed, including all borrow and waste areas and all access and hault roads willb bo stated asf followst toi the nearest tenth ofans acre 25 ACRES 2. Dollara amount (U.S.A.) per acre tol be posted (fractions ofa acres willl bep prorated): $ 500 3. Thet totala amount oft the bond wili now be stated as follows: $ 4. And original copy ofall bond forms must be received by Macon County in order for the bond tol be considered valide and beforet thel Land-Distarbing/ Pennitz mayl bei issued.  17.500  PAG620P2,MACONG COUNTYA ROND FORMA FOR LANDDSTURINGACTITO  AC    ZoF 2  FINANCIAL SPONSINLETYOMAURSIT FORM OMINTATONTOLAUTION CONTROL ACT Noj person shall initiate al land-disturbing activity ofko or more acres until an acceptable erosion control plan has been submitted and approved thel Macon Codes and Regulations Department, as covered by the Macon Sedimentation byt Control Ordinance. (Please type or print and, if question is not applicable, placel N/A in 1.) Project Name: Hietawbs Falls lowwfpy Cub  and) County Erosion  thel blank) Part A.  2.) Location oflaud-disturbinge Activity:  Township: HiCHANDSNE Location: L Cu8 DRiE HieHhvps NC 2874!  3.) Approximate date that land-disturbing activity willl be commonced: 1e/e/2019 4.) Purpose of development (residential, commercial, industrial,e etc.). 6olflourse Rewovatjow 5.) Total acreage disturbed or uncovered (including off-site borowe andy waste areas): RSARES 6.) Amount off feet to bes submitted upon approval ofBrosion Control) Plan: $ 2,5004 7.) Has an erosion ands sedimentation plau been filed? Yes_ NO Enclosed_ 8.) Person to contacts shoulds sediment control issues arise duringl laml-distutbingactiviy:  Name: JASNMAcAwAY  Telephone: T-SL4B-PR2Y-ye  9.) Landowner(s) ofRecord (Use blank page tol list additional owners): HicHlaNDs FalkLnfy Clb,Ine  Name(s)  LCLuR DRIVE Current? Mailing Address Herla-ss,AE7H City  Current Mailing Address City  State  Zip  State  Zip  10.) PareeD#(7-digis) 7540366530  PartB.  1.) Person(s) or fitm(s) who are financially responsible for this landisturbingactiviy  (Useb blank sheet to list additional persons ort firms): HIGHANDS FAlls Coastryllas Name(s) LCb Daiye Current Mailing Address City State 328-526-418 Telephone  JASew 10 Club DRIVE Current Mailing Address City Telephone  MACAHAY frergftco  HiGHANS ML 25744 HIGHMOSAE 3874/  Zip  State  Zip  829326418 0929-24-4146    2. (a) Ifthel Financial Responsibility Parly is nots ar resident ofl North Carolina giver name and  street address ofal North Carolina Agent.  Name(s)  Current) Mailing. Address City Telephone  Current Mailing Address City  State  Zip  State  Zip  (b) Ifthe Financial Responsiblel Party is al Partnership or other person engaging inl business undera an Assymed. name, attach a copy oft the certificate off assumed uame, Ifthe Financially Responsiblel Party isa Corporation give name ands street address ofthe  Registered Agent. Name(s)  Current Mailing Address City  Current Mailing Address City  State  Zip  State  Zip  The above information is trues and correct to the best oft my knowledge and beliefs andy was providedb by ne under oath, (This form must bes signed by the financially ifani individual orl his attoney-in-factori ifnot ani individual bya an officer, responsible director, partner, person or registered agent with authority to execute instruments for the finançially responsible Iagreet to provide çorrectedi infonnation should there be any changei in the information person).  provided herein, TAsMAcAWAy, CCM,DG Typeorprint ame ure Signg Jewsifer formy was executed by! him.  GMHRAREE/coo  Title or Authority DeTOBER Date  Zo19 9  oly  ARat Notary) Publio ofthe  Macon  State ofNorth Carolina, hereby cerlifyt AN Jasen. Macrulan Couatyof_ appeared personally before met tbis daye and being dulys sworna acknowledged that the above Witness my! hand andi nofarial scal, this_ 9 dayof OcTober 20_12  Seal  ha A Peu My Commission expires 0n/os/2021  Notary    SACO  Macon County Erosion Control Program  Macon County Human Services Building 1834) Lakesidel Drive Franklin, NC 28734 Phone: 828-349-2560 orl Fax: 828-524-2653  NSTRUCTIONS. FOR CNTZTASIANASTGENCABARACIATASUNITAONNT In compliance with thel Macon County Erosion and Sediment Control Ordinance, application fors a disturbf fivec or more acress shall require thep posting ofas surety bond with the account guaranteed by an established. surety company or otheri instruments satisfactory Countyi to the ofan FAXEDor PHOTOCOPIED bonds will be accepted as evidence that theb bond! has been issued iftho form isc completed, signed ands sealed. However the original must! be received by the County before the) Land-  INFORMATION  to  ini the form permit County  Attoney.  Disturbing) Permit can be issued.  INSTRUCTIONS  THEI BONDMUST: BEI NKCUIBGMAONCAINIYY BOND FORM and completed as Surely company or Cash. Principal, Bonds may only be cancelied byas written 30 day notice to the by County by thel Principal ort the Surety. However, ifthel bondi is cançeledb before the site isi issueda Certificate ofCompliance by the Counly; thel Land-Disturbing! Permit may berevoked, 2. IETHE PRINCIPALIS Al PARTNERSHIP or other person engaging inl business under ans assumed name, a copy of the "Certificate of Assumed Name" must! be: attachedt tot the bond form, Atloast one partner or person must: sign their full legali name as thel legal Partuership or Business Representativoas 3. IETHEI AINCALBACOAPORATOS al Registered Agentr must alsos sign their fulll 4. MAILING ADDRESSES including zip codes, office phone. numbers, fax numbers and cell numbers 5. LSTAILSTATELICENSE: NUMBERS or professional registration numbers heldb by the 6, BONDI NUMBER is to be assigned by the Surety company. Ifthe bondr number has not been assigned, please send rider ore endorsement listing the assigned numberi immediately. 7. BOND AMOUNT willl be determined byt the County by multiplying ther number ofacres to be dislurbed by an amount within the limits specified in the Ordinance. The requiredl bond amount acres willl be fairly determined by The Erosion Control Office and willg generally beb based on diffieulty per  Principle, name as Principal.  legal  must bei included for Principal and Surety,  Principal.  ofsites stabilization upon forfeiture ofa applicable surety,  8. SIGNATURES ofPrincipal and Attorney In Fact (Surety) ARE REQUIRED,  9. INSURANCE COMPANY'S CORPORATESEAL must! be affixed oh bond, Al Notarysealor  Principal's corporate seal are not aeceptable,    3     RESOLUTION EXEMPTING ARCHITECTURALSERVICES FOR THE PROPOSED RENOVATION AND IMPROVEMENTS OF NATIONAL GUARD ARMORY BUILDING, ACCESSORY STRUCTURES AND GROUNDS IN MACONCOUNTY, NORTH CAROLINA, FROM THE PROVISIONS OF ARTICLE 3D OF CHAPTER 143 OFTHE NORTH CAROLINA  GENERAL STATUTES  WHEREAS, Article 3D ofChapter 143of the North Carolina General Statutes establishes  ageneral public policy regarding procurement of architectural services; and  WHEREAS, North Carolina General Statutes Section 143-64.32 provides:  "Units of local government or the North Carolina Department of Transportation may in writing exempt particular projects from the provisions ofthis Article in the case of proposed projects where an estimated professional fee is in an amount less than fifty thousand dollars  ($50,000)"; and  WHEREAS, Macon County is nowi in need of architectural services for the Proposed Renovation and Improvements ofthel National Guard Armory Building, Accessory Structures and Grounds project  in Macon County, North Carolina; and  WHEREAS, the estimated professional architectural fee for the required architectural work on thel Proposed Renovation and Improvements of the National Guard Armory Building, Accessory Structures and Grounds Project in Macon County, North Carolina is in an amount less than fifty thousand  ($50,000) dollars.  NOW, THEREFORE BE IT RESOLVED BY THE BOARD OF COMMISSIONERS OF THE COUNTY OF MACON that the proposed architectural services for the Proposed Renovation and Improvements of the National Guard Armory Building, Accessory Structures and Grounds project in Macon County, North Carolina, ishereby exempted in writing from the provisions of Article 3D of Chapter 143 of North Carolina General Statutes pursuant to the provisions of N.C. Gen. Stat. $143-64.32.  Adopted this 13th day of July, 2021.  James Tate, Chairman  Macon County Board of Commissioners  ATTEST: Clerk to the Board (COUNTY SEAL)    Prepared by and return to: Eric Ridenour, Ridenour & Goss, PA Post Office Box 965, Sylva, NC28779 NORTHCAROLINA MACONCOUNTY  SATISFACTION OF SECURITY INSTRUMENT (G.S. $4 45-36.10; ;G.S.S4 45-37(a)(7))  The undersigned is now the secured creditor in the security instrument identified as follows:  Type of Security Instrument: Deed ofTrust Original Grantor(s): Franklin Tubular Products, Inc. Original Secured Party(ies): County of Macon, Town ofFranklin oft thel Register of Deeds for Macon County, North Carolina. This satisfaction terminates the effectiveness of the security instrument.  Recording Data: The security instrument is recorded in Book M-35 at Page 811-817 in the office  [signatures and Notary appear on the following pages]    Date:  Macon County Board of County Cominissioners  By:  (seal)  James Tate, Chairman  STATE OF NORTHCAROLINA COUNTY OF  aNotary Public, do hereby certify that. James Tate, as  Chairman of the Macon County Board ofCounty Commissioners, personally appeared before me this day and acknowledged the due execution oft the foregoing instrument for the purposes therein expressed.  Witness my hand and notarial seal on this the  day of April, 2021.  Notary Public My Commission Expires: Date:  (Notarial Seal)  By:  (seal)  Derek Roland, Macon County Manager and  Clerk tot thel Board  STATE OF NORTHCAROLINA COUNTY OF  al Notary Public, dol hereby certify that Derek Roland,  as Macon County Manager and Clerk to the Board, personally appeared before me this day and acknowledged the due execution ofthe foregoing instrument for the purposes therein expressed.  Witness my hand and notarial seal on this the  day of April, 2021.  Notary Public My Commission Expires:  (Notarial Seal)  2    Date:  Town of Franklin By:  (seal)  Bob Scott, Mayor  STATE OF NORTHO CAROLINA COUNTY OF I,  al Notary Public, do hereby certify that Bob Scott, as  Mayor of the Town of Franklin, personally appeared before me this day and acknowledged the due  execution oft the foregoing instrument for the purposes therein expressed.  Witness my hand and notarial seal on this the  day of April, 2021.  Notary Public My Commission Expires:  (Notarial Seal)  Date:  Town of Franklin By:  (seal)  Travis' Tallant, Town Clerk  STATE OFNORTHCAROLINA COUNTY OF  a Notary Public, dol hereby certify that Travis' Tallant,  as the Town Clerk for the Town of Franklin, personally appeared before mei this day and acknowledged the  due execution oft the foregoing instrument: for the purposes therein expressed.  Witness my hand and notarial seal on this the  day of April, 2021.  Notary Public My Commission Expires:  (Notarial Seal)  3    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  CATEGORY - CONSENT AGENDA  MEETING DATE: July 13, 2021  Item 12A. Minutes from the April 13, 2021 regular meeting, the May 11, 2021 regular meeting, the May 25, 2021 continued session, the June 3, 2021 continued session and the June 8, 2021 regular meeting will be forwarded to Item 12B. Budget Amendments #1-11 are attached for your review and Item 12C. Approval of tax releases (copy attached) in the amount of Item 12D. Approval of the Macon County Public Health FY 2021-22 Billing and Collection Policies and Fee Schedules, as well as a summary of updated vaccine fees (copies attached). Per Carrie Pazcoguin, the Finance Section Administrator for Public Health, the Macon County Board ofHealth Item 12E. Approval of the annual Agreement to Provide Recreation Opportunities with the Scaly Mountain Historical Society (copy attached) Item 12F. Approval of the service contract with the Franklin Area Chamber Item 12G. Approval of the service contract with the Highlands Area Item 12H. Approval of a resolution accepting American Rescue Plan Act  you in a separate email. (Mike Decker/Tammy Keezer)  approval. (Lori Carpenter)  $2,692.47. (Teresa McDowell)  approved all of these documents on June 22, 2021.  (Lori Carpenter).  ofCommerce (copy attached) (Lori Carpenter).  Chamber ofCommerce (copy attached) (Lori Carpenter).  (ARPA) funds (copy attached) (Lori Carpenter).    Item 121. Approval of a Grant Project Ordinance Amendment for the Weatherization Assistance Program FY 2021 (#8217) in the amount of Item 12J. Approval of a Grant Project Ordinance Amendment for the Weatherization Assistance Program FY 2022 in the amount of $132,289 Item 12K. Reject the sole bid received for the Macon Middle School Locker Room Project on June 21,2021 and give authorization for county staff to re- 12L. A copy of the ad valorem tax collection report, which shows an overall 98.44 percent collection rate as of June 30, 2021. No action is  $261,296 (copy attached) (Lori Carpenter).  (copy attached) (Lori Carpenter).  advertise the project, as only one bid was received.  necessary. (Teresa McDowell)    MACON COUNTY BUDGET  AMENDMENT: #1  FROM: DEPARTMENT: EXPLANATION: ACCOUNT 514091 ORG ITEM 513831 447251 514091 550001 SALARY 514091 550201 MEDICAREFICA 514091 550203 HOSPITALIZATION 514091 550206 LIFEINSURANCE 514091 550207 RETIREMENTGENERAL 514091 550701 COUNTY 401K 514091 556034 SFR PROGRAM OPERATIONS  JOHNLFAY HOUSING  receive increased funding  DESCRIPTION ESFRLP-17 REHABILITION FUNDING INCREASE  LINE ITEM  INCREASE 16,647 8,974 686 2,863 19 918 179 3,008  DECREASE  Total Budget Increase!  16,647  REQUESTED BY DEPARTMENT HEAD LhFng RECOMMENDED BY FINANCE OFFICER Kuulas  APPROVED BY COUNTY MANAGER  ACTION BY BOARD OF COMMISSIONERS 73/2621  APPROVED AND ENTERED ON MINUTES DATED]  CLERKI    MACON COUNTY BUDGET AMENDMENT AMENDMENTE & FROM: Abby Braswell DEPARTMENT: Taxoffice  EXPLANATION: Move fundsa allotted for vehicle thisy year to next budgetyear.  ACCOUNT 113840-417900 114142-569601  DESCRIPTION Fund Balance Appropriated Equipment- Vehicles  INCREASE $21,365 $21,365  DECREASE  REQUESTED. BY DEPARIMENTHEAD. sbbyt Bugwlet BECOMMENDED! BYFINANCEOFFICER: hdiys  APPROVEDI BY COUNTY MANAGEB  ACTION BY BOARDOF COMMISSIONEBS aisfpoal APPROVEDAND ENTERED ONMINUTESDATED.  CLERK    MACON OUMYEPCTAMEOMENT AMENDMENTE_ FROM: LindsayLeopard DEPARTMENT: Maintenance  EXPLANATION: Appropriate funds for backflow! preventers,' truck bed, and pump replacement at  Enloel Farmi not received by 6/30/2021. DESCRIPTION Fund Balance Appropriated Contracted: Services Vehicle Repairs & Maintenance Property/Buldingl Improvements  ACCOUNT 113840 - 417900 114260-5 556607 114260-5 556503 114260-556603  INCREASE $28,800.00 $6,500.00 $7,300.00 $15,000.00  DECREASE  QLSTIDELDEADARCHA, Mikal B loyn  RECOMMENDED BYF FINANCE OFFICER_ APPROVEDI BY COUNTYMANAGER  -  lm Cara  ACTION BY BOARD OF COMMISSIONERS 7/13/2021 APPROVED, AND ENTERED ON MINUTESDATED  CLERK    MACON COUNTY BYPGETAMENDMENT AMENDMENT # 4 FROM: Lindsay Leopard  DEPARTMENT: Emergency. Management  EXPLANATION: Appropriate funds for Prime Mover Vehicles, Dodge Durango (Including tag, tax,  and title), and equipment not received by 6/30/2021.  ACCOUNT 113840 -417900 114370-569601 113850-435526 114375-560906 114375: - 569502  DESCRIPTION Fund Balance Appropriated Equipment -V Vehicles Homeland Security Grant Homeland Security Grant Capital Equipment  INCREASE $34,643.00 $34,643.00 $130,172.00 $65,086.00 $65,086.00  DECREASE  REQUESTEDI BYI DEPARIMENTHEAD  RECOMMENDED BY FINANCE OFFICER Aoi lub  APPROVEDI BY COUNIYMANAGER ACTIONBYE BOARD OFCOMMISSIONERS APPROVED/ AND ENTERED ON MINUTESDATED  7/13/2021  CLERK    MACON COUNTY BUDGETAMENDMENT AMENDMENTE 5 FROM: Lindsay! Leopard DEPARTMENT: Sheriff's Office  EXPLANATION: Appropriate funds for Dodge Durango's (including tag, tax, and title), in-car camera  installation, body worn camera installation, computer, laptop, andHVACU unit  notreceived by 6/30/2021. DESCRIPTION Fund Balance. Appropriated Equpment-Vehicles Capital Equipment Non-Capital Equipment Computer Supplies Property/E Building Improvements  ACCOUNT 113840-417900 114310 - 569601 114310 - 569502 114310 : 559700 114310-556005 114321-556603  INCREASE $203,587-00 $177,052.00 $6,690.00 $6,374.00 $3,186.00 $10,285.00  DECREASE  REQUESTED BY DEPARTMENT HEAD Robbe Hblland  RECOMMENDEDBY, FINANCEOFFICER APPROVED BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED AND NIREDONMINUTESDATED  Kemlipb  7/13/2021  CLERK    MACON COUNTY BYDGETAMENDMENT AMENDMENT# Lo FROM: LindsayLeopard  DEPARTMENT: State, Federal, and Treasury Forfeiture Funds EXPLANATION: Appropriation of Fund Balance into FY: 21-22  ACCOUNT 223000-499100 224000-559700  DESCRIPTION Federal Forfeiture Funds Fund Balance Appropriated Non-Capital Equipment State Forfeiture Funds Fund Balance Appropriated Non-Capital Equipment Treasury Forfeiture Funds Fund Balance Appropriated Non-Capital Equipment  INCREASE $1,112.00 $1,112.00  DECREASE  223001-499100 224001-559700  $25,578.00 $25,578.00  223004-499100 224004-559700  $702.00 $702.00  REQUESTED BY DEPARIMENTHEAD  Robbi Hollanl  RECOMMENDED BYFINANCEOFFICER Allayzb  APPROVED BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVEDANDENDENTEREDONA MINUTESDATED  713/2021  CLERK    MACON COUMYAUDGETAMENOMENT  AMENDMENTH DEPARTMENT EXPLANATION ACCOUNT  1 Information Technology forit items not received by 6/30/2021  Carryforward balance on PO! #20210663, 20211370, and: 20211371  DESCRIPTION  INCREASE 71,565.00 6,000.00 18,051.00 47,514.00  DECREASE  113840] 417900FUND! BALANCE. APPROPRIATED 114210 556609/SERVICE CONTRACTS 114210 569502 CAPITAL EQUIPMENT 114210 569502 CAPITAL EQUIPMENT  REQUESTED BY DEPARTMENT HEAD ph  RECOMMENDEDI BY FINANCE OFFICER APPROVED BY COUNTY/MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED & ENTERED ONI MINUTESDATED  EuLOpE 7/13/2021  CLERK    MACONO COUNTY BUDGET, AMENDMENT  AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  % 11-4370-EMS 6/30/2021. DESCRIPTION  Appropriate funds for Ambulance Remount (including tag, tax, andt title), not received by  INCREASE $ 120,047.00 $ 120,047.00  DECREASE  113840 417900 Fund Balance Appropriated 114370 569601 Equipment -Vehicles  REQUESTED BY DEPARTMENTHEAD RECOMMENDED BY FINANCE OFFICER APPROVED BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED & ENTERED ON MINUTES DATED  1A4 4A48042 713/202)  CLERK    MACON COUNTY BUDGET AMENDMENT  AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  Non-departmental  Carry forward balance of Gallagher Benefit Services contract (paystudy)  DESCRIPTION  INCREASE 60,000.00 60,000.00  DECREASE  113840 417900FUND BALANCEA APPROPRIATED 119900 555104/CONSULTANT FEES  REQUESTED BY DEPARTMENT HEAD RECOMMENDEDI BY FINANCE OFFICER APPROVED! BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED & ENTERED ON MINUTES DATED  anlyss 7h3/2021  CLERK    MACON COUNTYE BUDGETA AMENDMENT  AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  /D Education  Carry forwardi funds for Cartoogechaye and FHS HVAC.  DESCRIPTION  INCREASE 79,000.00 79,000.00  DECREASE  113840 417900FUND BALANCE. APPROPRIATED 118000 571002/MACON COUNTYSCHOOISCAPTAL EXP  REQUESTED BY DEPARTMENT HEAD RECOMMENDEDI BY FINANCE OFFICER APPROVED BY COUNTYMANAGER ACTION BY BOARD OF COMMISSIONERS APPROVEDI & ENTERED ON MINUTES DATED  ifagt  7(13/0021  CLERK    MACON COUNTYBUDGETAMENDMENT AMENDMENTE_L FROM: Lindsay Leopard DEPARTMENT: Senior Services  EXPLANATION: Appropriate funds fori four GMACMAN-MsaA 6/30/2021.  ACCOUNT 113584-439601 115841-569502  DESCRIPTION CARES ActFederal Funds Capital Equipment  INCREASE $35,400.00 $35,400.00  DECREASE  QUESEDBIDIPASIMENT HEAD_ RECOMMENDEDBYFINANCEOFKER APPROVED! BY COUNTY MANAGER ACTIONB/BOABDOFCOMMESIONERS APPROVEDANDENTEREDOMMINUTESDATED  713/2021  CLERK    0 001    MACON COUNTY PUBLIC  HEALTH  FY 21-22  Billing and Collection Policies  And  Fee Schedules  Effective  Presented toand Approved by Board of Health on  Presented to and Approved by Board ofCommissioners on  MACON COUNTY PUBLICHEALTH    Macon County Public Health Billing Guide FY21-22  Effective. 7-1-2021  BILLING AND COLECTIONPOLICIES  RATIONALE  North Carolina law' allows a local board of! health to impose a fee for services to be rendered by a local health department, except where the imposition ofa fee is prohibited by statute or where an employee oft the local  health department is performing the services as an agent oft the State. Fees may be based on aj plan recommended by thel Health Director;  The plan must be approved by the Board of Health and the Board ofCounty Commissioners; And, fees collected under the authority oft this subsection: are tol be deposifed to the account oft the local health department sO that they may be expended: for public health purpgseslpaccordance with the provisions ofthe  Local Government Budget and Fiscal Control Act. the best interest of our community for the Health Center to:  The State requires local health departments toj provide certain servicesandi nod onemay be denied these services. Itisin  Assure that all residents can get all legally requiredpublic health services.  Provide as many other recommended and neededhealths services as possible, withinfheresources we still  have available to use.  The Health Director has the right to waive fefTorindividuals whoforagood cause are unable to pay,  Thej purpose of charging fees is to increase resources anduse them to meetresidents' needs in ai fair and balanced way. Fees are. necessary to helpi identify and cover thefull costo ofproviding publichealth services. As much as possible, fees are based on the true cost ofproviding a particular sefyice (caleulated as directcosts plus indirect costs). Throughout the year, ongoing cost analyses arerperfôrmed and fee schedules shallbeadjusted by theHealth Director, with approval from the BoardofHealth and theBoard ofConmissioners inthe amount of theincreased cost for prevision of said services. A Thei information in the documentbelow is the fee plan for PY21-22, effective on. July 1,2 2021. This Billing Guide for  list ofHealth Center feesis ayailable uponrèquest.  FY21-22: replacesall earlier plans, COST OF'SERVICE DETERMINATION  Costsfor services receivedthrough theHealth Center are based on the actual cost oft the service. Cost analysis takes into account all oft the resources associated vith providing aj particular service and calculates the actual cost to provide that service,, Cost analysis includes the calçulation of direct and indirect costs for services and then adding these  figures together to determine the actual cost of the service.  Calculating directcost: Directcosts are expenses that can be easily related to the provision ofas specific service, i.e., physician and support staffsalaries and benefits, mediçal supplies, labi tests, and other resources Calculating indirect costs: Indirect costs involve resources that are not directly consumed during the provision ofas service, but without them thej provision of that service would not be possible, ie., administrative staff salaries and benefits, training costs, facility costs, insurance premiums, office equipment and supplies, and recruiting  consumed at the time of the service.  and marketing expenses.  North Carolina General! Statue 130A-39(g) IAW Title X843(42CFR59.2)  Page 2    Macon County Public Health Billing Guide FY2 21-22  Effective 7-1-2021  Page 3    PAYMENT BY CONSUMER OR RESPONSIBLETIIRD PARTY (SELFPAY)  Fees are charged fors services and collected at thel Health Center. See attachment for fees schedule. All fees are the responsibility of the consumer, censumer or responsible third party and may be subject to the sliding fee scale. No consumer willl be refused: services, nor subject to variation ofs services, solely on their inability to pay for said: services. All fees may be paid by cash, check, or major credit card. Full payment is expected: at the time of service. Consumers will be informed oftheir account: status at each visit. An itemized receipts showing total charges, as well as any discounts willl be provided toi individuals upon request. Third parties authorized orl legally responsible toj pay for consumers at or below 100% ofthe Federal Poverty Level are properly billed. Feesf assiwwllwwwhaedemi is-rendered. Prepayment of co-pays for all serviçes in which co-payments: apply willl be required and collected when serviçes are rendered. Any charges incurred during a visit but not paid for on that date ofs service will be billed accordingly, Fees willl be charged to individuals in families with annual gross incomes exceeding specified levels ofas scale based on current Federal Poverty Income Guidelines. Verification ofi inçome and family size must be provided to determine a consumer'se eligibility status. Falsification of this information will permanently disqualify consumers from using sliding fee scale. Eligibility will be reevaluated: as consumer's income and household. status changes or at least annually. Ifincome cannot be verified at the time ofs screening, the charge for all services will be at 100% pay and a Payment. Agreement willl be presented to the consumer fors signature until verification is provided. Ifverification of income is received within thirty days ofaservice, the charge will ber retroactively adjusted to reflect percent based on verification: received. Verificationi received after thirty days will be applied only to future services. Eligibility pay of Medicaid will be determined where applicable. Individuals will be requested to provide all social security numbers and names used for employment purposes. Ifan individual refuses toj provide information to verify income, they will not be Customary visit services for mandatory childhood immunizations, community outreach, Tuberçulosis (TB), TB related X-rays, Sexually Transmitted: Disease control (STD), and other epidemiological investigations are provided at no cost to the consumer but may be billed to Medicaid or other third party agent. Separate fees may be charged for drugs, supplies, laboratory services, X-rays and othert technological: services, ifa appropriate. The costs of services performed by providers not affiliated with Macon County Public Health are the responsibility of the consumer. Fees may be charged or waived for educational services provided to individuals or groups, such as orientation, preceptorship, field training or  eligible for thes sliding fee scale and will be at 100% pay.  classes.  Charges not eligible for sliding scale discount include: a. Environmental: Health services b. Non-mandated: immunization services  Miscelaneousgeneral services (see Miscelaneous/Generl section below). d. Out-of-county residents (see Out-of-County Service Restrictions section below) Specific cinsurance situations (see Insurance section below for details)  Bills will be mailed monthly to individuals who have not paid charges in full for services rendered (exception Family Planning for those that request no mail be sent to their home). All bills will show total charges, as well as discount that may have been provided. Arrangements may be made. for payment plans when required for good cause. any  PAYMENT BY THIRD PARTY presentation valid contracted there is a fees the consumer fee eligibility scale.,  Verification of enrollment under Medicare, Medicaid, insurance or other third party payment plani is required ofa card at thet time of service. The Health Center is required to bill only participating third party payers by for services rendered. Services that are billed to third parties are billed at 100% of the total charge with no discount When the claim is returned from the thirdj party payer all discounts are applied. at that time. (i.e., any applicable scale adjustment) For services rendered to consumers withi insurance where the Health Center is not aj participating sliding willl be responsible for full payment of service when the servicei is delivered. The consumer is responsible provider, for charges not covered by thirdj party payers. Co-pay amounts must be paid at the time ofs services and are not subject to thes  unless applied  reimbursementi rate that must be billed per thet third party agreement.  sliding  Sliding fee scale discount does not apply int the following situations:  Page 4    a. Consumers with insurance in which. MCPH is not] participating provider. b. Consumers with any insurance who choose not to use their coverage (exception those requesting confidential services i.e. Family Planning servicesa and Communicable Disease Services). Insurance co-payments (when MCPHis aj participating provider) d. Services that are offered as specialty exams under the Adult Health Program.  ACCOUNT COLLECTIONS, AND BAD DEBT  The Health Center will issue all consumers a monthly statement oft fees that have been incurred and are due. Consumers are expected toi make payment. at the time services are rendered. Ifabalance is carried: forward, consumers who have not made aj payment on their account for any service(s) received fromMacon County Public Health for 120 shall be required to pay their past due balance before another service shallberendered (see Service Denial for further days  information).  The Health Center may use the following resources topursué collection oficonsumer accounts: billing statements, past due notices, collection agencies or credit bureaus? and the NC LocalGovernment Debt Setoff Clearinghouse (ref: NCGS 105A-1 et seq.) as administeredhyeNCI DeparmentofRenue Accounts willl be reviewed amually for bad debt statusand at that time with the approyaloft the BOH and the BOCC's1 the amounts may be written offf for accounting purposesifino further.fOllection is anticipated, Any received for write-offdebts will be accepted and credited to appropriâte accounts! Atnot time will a consumer payments be: notified that the account has been written offa as al baddebtr Bad debt may bereinstated: at time ofs service unlessit is determined  uncollectible(i.e. bankruptcy, death), at whichtmeifwill be writteno off.permanently.  CONSUMER DONATIONI POLICY  A consumer may chooset toinake a donation tothe agency, heconsumer willnever be asked to makea donation, buti if offered the donationis accepted. Donations are nôtrequitedand are not aj prerequisite for the provision of any serviceBilling requirements set out maw-ar section are not waived  because of consumer donations. (ref: Donation Policy 101.9  RETURNED CHECK POLICY  -  A'$25,00f fée willbe charged fora returned chegk-writtent toMacon County Public Health (MCPH). The consumer ill ber notified" viat télephone or lètter. All returned Checks will be made good via cash, money order, and/or certified check. Ifaconsumer hastwo retured checks within a one-year period, he/she willl be required to pay for services in advance Viaçash, money order,or certified check fort the period ofone year. After the one-year period expires, if another returned check occurs, all futurèbills must be paid with cash, money order, or certified check prior to the ofservices. (Exception: Family Planning,Child Health'and Maternal Healths services for families with income at or provision below 250%0 ofFederal Poyerty should not paymore in co-payments or additional fees than what they otherwise pay whena  Schedule ofI Discounts 1s àpplied. 42U.SC 300 et 8,2CFRS950,9).  A  REFUNDS  Int the event that a consumer or other third-party has overpaid their responsible charges, the credit balance is either: applied to future charges or refunded to the payer within thirty (30) days of discovery or request. Refunds for Environmental  Health: services are determinedi by attached policy and procedure.  SERVICE DENIAL  No individual may be denied Health Center mandated services e.g. communicable disease services (STD/TB) and immunizations. These services are provided at no charge to the consumer. Individuals who do not meet program guideline criteria may be denied specific services. Consumers covered by Medicaid who fail to make required co- payments will not be denied: services but may be subject to collections and/or bad debt set-off.  Page 5    Individuals who have not paid proper charges for previous services (unless state and federal program rules prohibit services restriction or denial) may be required toj pay fees beforehand, be denied access to services (see Account Collections and Bad Debts), or be denied subsequent services pending demonstration ofag good faith effort to make  payment within the past ninety (90) days. OUT OF COUNTY SERVICE RESTRICTIONS  Macon County supports its low-income citizens by subsidizing the cost for certain health care services. To assure that Macon County citizens have maximum access tol Health Center services only those services mandated by FederalLaw, North Carolina General Statues or approved in this plan willl be provided to non-Macon County residents. Ifa an individual moves out of Macon County, they are encouraged to obtain services from another  provider. Consumers are required to report any change of address at time ofservice. COMPLIANCE' WITHTITLE VI AND VII, OF 42 US CODE CHAPTER: 21  The MCPH complies with Title VI and Title VII oft the Civill Rights Act of 1964 and all requirements imposed by or pursuant to the regulations. Staffwill not discriminate against any consumers because of age, sex, race, creed, national origin, or disability. Staffwill ensure consumers with LEP are provided adequate Services willl bej provided, reported and billed in compliance with the most current Consolidated Agreement and  language assistance: sO they have meaningfulaccesst to the agency'ss services.  all program Agreement Addenda. PROGRAM SPECIFICI INFORMATION  COMMUNICABLEDISEASE CONTROL  Deals with the investigation: and follow-up of all reportable communicable diseases. Testing, diagnosis, treatment, and referring as appropriate, ofa a variety ofSTD's. Provides follow-upand treatment ofTB cases and their contacts. Ma5-dwaditwwsawiaege RaseNePieRMEdcad or other third party agent can be billed with the consumerspemmision,  Eligibility:  No residency or financial requirements  BREAST AND CERVICAL CANCER CONTROLPROGROGRAM(BCCCP)  Provides pap smears, breast exams and screening mammograms, assists women with abnormal breast ammatonymammogram, or abnormal cervical screenings to obtain additional diagnostic examinations.  Eligibility:  Must be a resident of Macon County; uninsured or underinsured; without Medicare Part B or Medicaid;  between ages 40- 64 for breast screening services and 18- 64 for cervical screening services; No charge fort those who qualify for the program; family size shall be determined as follows: Consumer, spouse of consumer and all children under 18 years ofa age, including step-children who live  have al householdi income at or below 250% ofthe federal poverty level.  int the home.  Proof ofi income must be provided.  Page 6    CHILDHEALTH Choice; Medicaid Eligibility:  Wello child exams conducted by (appropriate provider); exam includes medical, social, development, nutritional history, lab work, and physical exam. MCPH accepts self-pay; most Private Insurances; Health  Residents of Macon County; Birth thru 20 years;  >Discounts are used fori incomes between 101 - 250% of] Federal Poverty. Consumers whose income exceeds 250% of Federal Poverty are charged using the departments! Schedule of Fees. Consumers whose income is at or below 100% of Federal Poverty are not charged for Child Health services.  EMPLOYEEHEALTH  Provides acute episodic medical care and chronic disease management services. This program is not  intended to replace an individual's primary care provider.  Eligibility:  Newempleyees-ReAlimgperioertherheallnserameetesiart Select part-time county employees as determined by the county manager.  Macon County Employees and retirees and their dependents on the county health insurance plan  WORKSITE WELLNESS  bmpleyee-healt Worksite wellness services are available for all employers in Macon County. Employee health Worksite: wellness services are available on a per program basis or under and annual contract arrangement. Individual program fees will vary and are based on salary expense toj prepare and delivert the program; current mileage rates iftravel is required; as well as any materials, laboratory, or medical supplies costs. An administrative. supplement of 10% is added for each individual program. Comprehensivev worksite wellness programs are available under contract for organizations and companies with at least 50 employees. This program, also known as the LIFE program, provides empleyee health screenings followed by customized programs and consultation services to address the health: needs oft the employees. Fees for the LIFE program range from $30 to $50 per employee pers year depending upon the cost to provide the services, the number of programs provided, as well as the organization's: ability toj provide in-kind assistance.  IMMUNIZATIONS  Provide all required and recommended vaccines that are available fori infants, school aged children and college bound individuals.. Also provide a wide range of vaccines for adults to include foreign travel vaccinations. MCPH accepts most Private Insurances, Health Choice, Medicaid, and Medicare. In some instances, charges do not apply (e.g. based on eligibility to receive state supplied vaccine). Sliding fee scale does not apply to  immunizations. Eligibility:  No residency or financial requirements fori immunizations.  CARECOORDINATIONFORCHIEDRELDRENCC4O,Care Management for At Risk Children (CMARC) Case management assists families ini identification of and access to: services for children with special needs that  Page 7    will allow them the maximum opportunity to reach their development potential.  Eligibility:  Macon County children birth to age three who are at risk for developmental delay or disability, long term illness and/or social, emotional disorders and children ages birth to five who have been diagnosed with developmental delay or disability, long term illness and/or social, emotional disorder may be eligible for  the program. FAMILYPLANNING  Services designed to assist consumers in planning their childbearing schedule; detailed history, lab work, physiçal exam, counseling and education given by (appropriate provider). MCPHaccepts: self-pay; most  Private Insurances; Medicaid or potentially Medicaid eligible.  Eligibility:  Schedule of Discounts is used for incomes betwéen 101 -250% ofl Federal Poverty. Consumers whose income exceeds 250% of Federal Poverty are charged using the departments Schedule of Fees. Consumers whose income is at or below 100% of Federal Poverty are not charged for Family Planning Services are provided without regard to residence requirements: and withouta a referral by aj physician (42 Proofofincome: must bej provided. (Exception: for those requesting "Confidential Services" that do not have proof ofi income or by producing proof ofi income may put their confidentiality at risk, they may write as statement of declaration ofincome.) Where legally obligated or authorized to receive third party reimbursement including public or private sources all reasonable efforts must be made to obtain said payment without application of any discounts. Family Income should be accessed before determining whether co-payments or additional fees are charged. Families with income at or below 250% of] Federal Poverty should not pay more in co-payments. or additional fees than what they otherwise pay when a AFamily Planning consumer will never be refused' a Family Planning service, or asked to meet with the Health Director due to a delinquent account; however, they may be referred to Debt set-off so long as that Income information reported on the Family Planning financial eligibility screening can be used through other programs rather than re-verification ofincome or relying on the consumer declaration. Pregnancy tests will be charged based on the qualifying Schedule ofDiscounts.  services.  U.S.C. 300 et seq./42 CFR59.5()(5).  ScheduleofDiscounts is applied. (42U.S.C. 300 et seq.42 CFR 59.5()(9).  does not compromise confidentiality.  ADULTHEALTH  Services in Adult Health Include: specialty physical exams for daycare, DOT, foster care, and employment ereherspecially-hysea'ewas-Pertheseservicervicesmeinsuranes-will-bebiled: Insurances may be billed for these services at the patient's request. In order to do sO, the patient must complete al Non-Coverage Form acknowledging their ultimate responsibility for any balance not  covered. Eligibility:  18y years and older  Residents of Macon County (exception, colposcopies, pregnancy tests,)  These services are not eligible for sliding fee: scale payment. ewiseswihepitforprierioanyservie beingrendered Any additional fees associated with a visit willl be ndéedHethe-censumersaceewntand  paid in full at checkout.  Page 8    OTHER SERVICES Laboratory Services Eligibility: None Exceptions: None MATERNALHEALTH  Third party insurance can be billed; these services are not eligible for Sliding Fee Discount.  Prenatal care is medical care recommended for women during pregnancy,Thea aim of good prenatal carei is to detect any potential problems early, toy prevent them if possible (throughr recommendations on: adequate nutrition, exercise, vitamin intake etc), and to direct the woman to appropriate specialists, hospitals, etc. if necessary. Visits are monthly during the first two trimesters (from week one to week 28 of pregnancy), every two weeks from 28 to week 36 of pregnancy and weekly after wéek 36 (until the day of delivery that could be between week 38 and 40 weeks). MCPH accepts self-pay; most. Private Insurances; Medicaid or potentially  Medicaid eligible. Eligibility:  Residents ofMacon- eligibility policy and residency requirements: attached Maternal Health consumers willl be required tol have proofofr residency  Proof ofincome is required.  Schedule of Discounts is used for incomes between 101 -250% of] Federal Poverty. Consumers whose income exceeds 250% of Federal Poverty are charged using the departments Schedule of Fees. Consumers whose income is at or below 1009ofFederal Poverty are not charged. for Maternal Health  services.  OBCARECOORDINARONMANACEMENPOBEMP.Care Management for High Risk Pregnancies Case manager assists pregnant women in rèceiving needed prenatal care and pregnancy related services.  (CMHRP)  Eligibility:  Residents of Macon County  Primary Care  Provides primary care: services for Macon County residents between the ages of21-64. Consumers are required to complete an application to determine eligibility prior to: receiving services. Third party insurance will be billed appropriately. Self-pay consumers may qualify for sliding fees scale discount based on their family size and household income with the maximum discount of 60%. Sliding fee discount is based on  250% off federal poverty. Eligibility:  Resident of Macon County between the ages of21-64  WOMEN, INFANTS, AND CHILDREN: NUTRITION PROGRAM(WIO)  Supplemental nutrition and education program to provide specific nutritional foods and education servicest to  Page 9    improve health status of target groups. 5who meet the follow criteria: Bea a resident of Macon County; Be at medical and/or nutritional risk;  Eligibility: WIC is available to pregnant, breastfeeding, and postpartum women, infants, and children upt to age  Havea family income less than 185% of the USI Federal Poverty Level; Medicaid, AFDC, or food stamps automatically meet the income eligibility requirement  CHILDRENS. DENTALI PROGRAM  Thel Macon County Children'sl Dental Clinic (Molar Roller) provides comprehensive general dental services to children from birth to 20: years of age. Self-pay consumers: may qualify for sliding fee scale based on their family size and household income. Sliding fee discount is based on 250% of Federal Poverty with a maximum  discount of75%. Eligibility:  Resident of Macon County. ADULEDENTAL-PROGRAM  eMasonomy-AamaCim-pweadalslyemtsef geand-aboye.selrPwycemsumersmayPAHyereSiSngleedisumesedonamysPeeand-heusehold neome.-SHdingleediseeuntisbasedom250soFFedem!Povery-wtremNimum-diseountef759é:  Eligibility:  ReseMARCanyA  ChargesmeteigeeralyMaisaider HealChaseaméisesepartiepingpwrite: Feeseraduledentalseriewiecalesolketdheforeleserviceis-rendered,  te-Pordeireatments-oradhls)  COMMUNITYEDUCATION, ANDTRAINING  Health education/health training programslseryices are provided to individuals and/or groups.  Eligibility:  No Kcsnctionykequrememts EXAMPLE  Cardiopulmonary resuscitation(CPR) Automated external dehbrilators(AED) First Aid Training: EXPLANATION  Various components of American Red Cross Standard First Aid and/or CPR/AED for lay responders are offered on-site at Macon County Public Health Classes are offered for ai fee Pre- registration and pre-payment are required. Fees for the specific educational components are based  on current American Red Cross pricing.  Page 10    NUTRITIONSERVICHS:  Diabetes Selt-Management Education (DSME) Services:  Macon County Public Health offers Diabetes Self-Management Education/lrainings services accredited by the American! Diabetes Association The registered dietitians are credentialed: and certified providers with some third party payors. For consumers with third party insurance,,a physician. referral and medical diagnosis of diabetes is requiredin order for the insurance to be billeda and costs covered accordingly. Self-pay consumersmay qualify for a sliding fee discount based on family size and household income. Slidingfeodiscount is determined on 250% of federal poverty with a maximum discount of2 20% in whichlngcorsomerisi responsible for payment to the  health center prior to service being rendered. Diabetes Prevention Program (DPP)  Maçon County Public Health offers] Diabetés) Prevention Program accredited by The Center for Disease Control and Prevention.. Becausethere is no established billing codefor this program accepted by third party payors and to encotngepanrticipato a smallj programfee will be established for each participant. Consumers mayqualifyt for sliding fee scale discoynt based on their family size and hoiseholdpnconewith the slidingfee discount isb based on 250% of federal poverty. Medicaid or Mediçaid eligibleconsumers may be eligible fora Center: for Disease Control and Prevention (CDC) sponsored scholarshipandt thereforearehoto charged ai feei for the program, but  are eligible for the incentives. Eligibility  Declaration ofInçome  Medical Nutrition' Therapy (MNT)Services:  Macon County Publicl Health offersMedical Nutrition Therapy services. The registered dietitians are credentialed and certified providers Withs some third party payers. For consumers with third party insurance, aphysician" refèrral and a coveredmedical diagnosisi is required in order fort the insurance to be billed ànd Costs coveredaccordingly. Self-pay consumers may qualify fora a sliding fee discount based on fàmily size and household income. Sliding fee discount is determined on 250% offederal poverty with ai maximum discount of20% in which the consumer is responsible for  payment to the health center prior to service being rendered1 to consumer.  ENVIRONMENTALHEALTH  Unlike other health department fees, Environmental Health fees are determined by the Boards ofHealth and County Commissioners. Environmental Health fees from other counties are taken into consideration. Exception, water testing fees are determined based on actual costs for supplies/test kits. Fees for  EnvironmentalHealta Services are collected at time ofa application.  REFUNDPOLICY: Attached  ANIMALSERVICES  Unlike other health department fees, Animal Service fees are determined by thel Boards ofH Health and  Page 11    County Commissioners. Animal Service fees from other counties are taken into consideration. Fees for  Animal Services are due att time of Service.  Guidelines for Determining Elementsofthe: Sliding FeeScale  Eligibility S screening is required on all new consumers or when family size and/ori income changes occur, or at 12 monthi intervals. A consumer's percentage of pay is documented on the Financial Eligibility Application in the consumer'smedical record and dental record. Consumer income information reported can be used to determine eligibility for other sliding fee based programs (i.e. Adult Health, Child Health, Prenatal, Family Planning and  Dental).  Definition for FamilySizeand Countable Gross Income for the following clinics: Primary Care, Nutrition Services, Child Health, Maternal HealthFamlyl Planning and Dental  A family is defined as a group of related or non-relatedi individuals who arel livinglogether as one economic unit. Individuals are considered members ofa a single family oreconomic unit whent their poluctionofincome and  consumption of goods are related.  An economic unit must have its own source ofi income. -  Example: consumer with no income must be.considered part ofalargerconomic unit that provides, support to the household. Groups ofindividuals livingi inthesame house with other individuals may be considered. a separate economic unit. For example, iftwo sisters andtheinchildren livei in thesame house and both work and support their  own children, they would be considered: a separate household. EXCEPTIONSTOECONOMICUNIT  A. Un-emancipated minors andothers requesting confidentials services will be consideredai family unit of  one, and feeswill be assessed based on therowijncome.  B. Af foster child assigned by DSS'shall always be/consideredai family ofone.  Determination of GrossIncome  The dollaramounts represent gross annual income; they refer to total cash receipts before taxes from all sources. Household income sources include, Salarièsand wages, earnings from selfemployment (deduct business expenses, except depreçiation); interest incomeall investment and rental income; public assistance, unemployment! benefits, worker's compensation, alimony, militàry allotments; Social Security benefits, VA benefits; retirement: and pension pay; insurance or annuity plans; gaming proceeds and any other income not represented! here that contributes to the  household consumption, of goods. Thislisti is not all inclusive. Documentsarcentable for incomékerifications:  Current pay stub (noting the pay timeframei i.e.: weekly, bi-weekly etc.) business name, address and phone number and must be legible.  Signed statement from employer indicating gross earnings for as specified pay period, statement must include the  W-21 Forms Unemployment letter/notice 1099'sreceived from IRS  Award letter from Social Security Office, VA or Railroad Retirement Board must be provided in order to allow deductions for business expenses.  For Sell-employment: Accounting records or income tax retum for the most recent calendar year, entire tax return  Page 12    Macon County Public Health Fee Schedule  Code J0133 J0456 J0561 J0696 J1050 J1100 J1725 J1726 J2790 J3490 J7297 17298 J7298 J7300 J7300 J7301 17301 J7302 J7307 J7307 Q3014 Q9984 Q9984 S0030 2000F 11200 11201 11400 11401 11402 11403 11404 11406 11420 11421 11422 11423  Description  Current Fees 0.00] 0.00 .25/unit 2.50/unit 20.00 10.00 21.00 850.00 134.00 850.00 50.00 350.00 311.00 250.00 250.00 800.00 376.00 528.00 500.00 364.00 21.00 900.00 543.00 0.00 5.00 70.00] 28.00 115.00 135.00 152.00 176.00 194.00 232.00 110.00 142.00 158.00 192.00  Doxycyline/Atyclovir Azithromax Bicillin Ceftriazone 17PI Injection Makena 17P Liletta Mirena (replaces J7302) UD Mirena IUD- Medicaid Skyla IUD smallf frame UD Skyla IUD: smallf frame Medicaid Nexplanon UDI Nexplanon  Injection, Medroxyprogesterone Acetate, 150 MG (.34 per unit) Injection, Dexamethasone. sodium phosphate Rho (D) Immune Globulin (Rhlg), full dose, 300mcg  17-P used onlyf for the treatment of advanced adenocarcinoma of the uterine corpul  Intrauterine copper contraceptive device, Paragard T380A UD Intrauterine copper contraceptive device, Paragard" T380A  levonorgestrehreleasing intrauterine contraceptive system, 52 mg (Mirena)  TELE Psychiatry Origination Site Fee Kyleena IUD- hormone releasing UD Kyleena IUD- hormone releasing Medicaid Metronidazole BPV Measurement of ocular bloodf flow withi interpretation Removal ofs skin tags, up to 15 lesions Removal of skint tags each additional 101 lesions trunk, arms, or legs; excised diameter 0.5 cm or less trunk, arms, or legs; excised diameter 0.6 cm to 1.0 cm trunk, arms, orl legs; excised diameter 1.1 cm to 2.0cm trunk, arms, orl legs; excised diameter 2.1 cm to 3.0 cm trunk, arms, or legs; excised diameter 3.1 cm to 4.0cm trunk, arms, or legs; excised diameter over 4.0  Excision, benign lesion including margins. Except skin tag (unless listed elsewhere), Excision, benign lesioni including margins. Except skint tag (unless listed elsewhere), Excision, benign! lesioni including margins. Except skin tag (unless listede elsewhere), Excision, benign lesion including margins. Except skin tag (unless listed elsewhere), Excision, benign lesioni including margins. Except skint tag (unless listed elsewhere), Excision, benign lesioni including margins. Except skin tagl (unless listed elsewhere), Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm orl less Excision, benign lesion including margins. Except skint tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6t to 1.0cm Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 cm to2 2.0cm Excision, benign lesioni including margins. Except skint tag (unless listede elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 cmt to3.0cm    Excision, benign lesion including margins. Except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 cm to 4.0cm Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0c cm Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less Excision, benign lesion including margins. Except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.60 cmt to1 1.0 Excision, benign lesion including margins. Except skin tagl (unless listede elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 cm to 2.0 Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 cm to3 3.0 Excision, benign lesion including margins. Except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 cmt to4.0 Excision, benign lesioni including margins. Except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.00 cm Simple repair of superficial wounds ofs scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet); 2.5 cm or less Simple repair of superficial wounds ofs scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet); 2.6 cm to7.5 cm Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet); 7.6 cm to 12.5cm Simple repair of superficial wounds of scalp, neck, axillae, external, genitalia, trunk, and/or extremities (including! hands and feet); 12.60 cm to 20.0 cm Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet); 20.1 cm to 30.0 cm Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet); over 30.0cm Simple repair ofs superficial wounds of face, ears, eyelids, nose, lips, and/or mucous membranes (including hands and feet); 2.50 cm orl less Simple repair ofs superficial wounds off face, ears, eyelids, nose, lips, and/or mucous membranes (including hands and feet); 2.60 cm to 5.0cm Simple repair of superficial wounds of face, ears, eyelids, nose, lips, and/or mucous membranes (including hands and feet); 5.1 cm to7.5 cm Simple repair ofs superficial wounds offace, ears, eyelids, nose, lips, and/or mucous membranes (including hands andf feet); 7.60 cm to 12.5cm Simple repair ofs superficial wounds oft face, ears, eyelids, nose, lips, and/or mucous membranes (including hands and feet); 12.6 cm to 20.0cm Simple repair of superficial wounds oft face, ears, eyelids, nose, lips, and/or mucous membranes (including hands andf feet); 20.1 cm to 30.0cm Simple repair of superficial wounds off face, ears, eyelids, nose, lips, and/or mucous membranes (including hands andf feet); over 30.00 cm Treatment of superficial wound dehiscence; simple closure Treatment of superficial wound dehiscence; with packing  11424 11426 11440 11441 11442 11443 11444 11446 12001 12002 12004 12005 12006 12007 12011 12013 12014 12015 12016 12017 12018 12020 12021 11981 11982  218.00 291.00 132.00 157.00 174.00 219.00 272.00 333.00 147.00 159.00 184.00 228.00 298.00 331.00 153.00 171.00 200.00 250.00 304.00 394.00 476.00 202.00 148.00 65.00 80.00  cm cm cm cm  Nexplanon insertion Nexplanon removal    11983 17110 54050 54065 56501 56515 57170 57452 57454 57455 57456 58100 58300 58301 59025 59425 59426 59430 69210 86580 86580P G0008 G0009 G0010 Q2038 Q2037 Q2038 Q2039 90471 90472 90473 90474 90620 90621 90632 90633 90636 90645 90646 90647 90648 90649 90650 90651 90657 90658 90660 90662 90670  Nexplanon removaly with reinsertion proliferative lesions; upi to: 141 lesions Destroy Penis Lesion(s)-S Simple Chemical Destruction Penis Lesion(s)-E Extensive Cryosurgery Destroy' Vulva Lesion(s)- - Complex Diaphragm fitting withi instructions endocervical curettage  145.00 79.00 228.00 387.00 229.00 394.00 91.00 191.00 269.00 253.00 239.00 109.00 132.00 169.00 62.00 1,000.00 1,300.00 121.00 86.00 6.00 6.00 14.00 14.00 14.00 16.00 16.00 16.00] 18.00 14.00 14.00 20.00 20.00 188.00 160.00 51.00 35.00 116.00 31.00 31.00 31.00 59.00 190.00 137.00 249.00 11.00 11.00 46.00 220.00  Destruction (eg, lasers surgery, electrosurgery, cryosurger, chemosurgery, surgical curettement), of benign lesions other than skint tags or cutaneous vascular  TCA Vulva  Colposcopy oft the cervixi including upper/adjacent vagina  Colposcopy oft the cervix including upper/adjacent vagina w/biopsy of cervix or Colposcopy of cervixi including upperladjacent vagina wbiopsy of cervix Colposcopy of the cervixi including upperladjacent vaginay wlendocervical curettage Endometrial sampling (biopsy) with or withoute endocervical sampling (biopsy). without cervical dilation, any method (separate procedure)  Insert intrauterine device Removal ofl IUD Fetal Non-Stress Test Prenatal visits: 4to 6 visits Prenatal visits: 7 or more visits After Delivery Care Remove impacted ear wax TB Test TB Test- Patient Pay Administration Fee Flu Shot (Medicare) Administration Fee Pneumonia Shot (Medicare) Administration Fee Hep B( (Medicare) Influenza vaccine quadrivalent 6-36 months Flu Virus Vaccine (Fluvirin) Medicare Flu Virus Vaccine (Fluzone) Medicare Flu Virus Vaccine (Unspecified) Medicare Vaccine Administration Fee Vaccine Administration Fee- Each Additional combination vaccine/toxoid) vaccine/toxoid) Hep A- Adult Hep A- Pediatric Twinrix' Vaccine Hib- child- Hboc 4 dose schedule Hib- Adult- booster only Hib- PRP OMP 3dose schedule Hib- child PRP-T4 dose schedule Gardasil (HPV) HPVE bivalent 2VHPV (Cervarix) HPV93d dose Flu Shot (6-35 months) Flu Shot (3y yrs &>) Flumist- State Supplied Fluzone High Dose (65&>) Prevnar  Immunization administration byi intranasal or oral route; one vaccine (single or Each additional intranasal or oral route vaccine (single or combination Meningococcal B (recombinant protein serogroup B, 2 dose) Meningococcal B (recombinant lipoprotein serogroup B: 3dose)    90672 90675 90676 90680 90681 90685 90686 90687 90688 90691 90696 90698 90700 90702 90707 90710 90713 90714 90715 90716 90717 90723 90732 90733 90734 90736 90738 90744 90746 90750 92552 92567 92587 93000 93010 96110 96127 96150 96151 96160 96372 97151 97802 97803 98967 98960  Quadrivalent Flul Mist Rabies Vaccine Exposure Rabies Vaccine Preventive Rotateq Rotarix  40.00 352.00 352.00 92.00 115.00 24.00 23.00 22.00 22.00 116.00 59.00 130.00 35.00 58.00 89.00 246.00 40.00 39.00 43.00 147.00 125.00 79.00 118.00 118.00 139.00 230.00 296.00 37.00 65.00 167.00 39.00] 18.00 63.00 40.00 30.00 13.00 7.00 21.00 20.00 6.00] 20.00  Influenza virus vaccine.quadrivalent, split virus, preservative free, when administered to children 6-35 months of age, fori intramuscular use Influenza virus vacine.quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, fori intramuscular use Influenza virus vaccine.quadhyalent, split virus, when administered to children 6-35 Influenza virus vaccine.quadrivalent, split virus, when administered toi individuals 3  months of age, for intramuscular use years of age and older, for intramuscular use Typhoid Vaccine Kinrix- (DTaP-IPV) Penticil- (DTaP-IPV/Hib) DTAP DT- -Diptheria Tetanus MMR MMRV (Proquad) IPV Td Tdap Varicella Vaccine Yellow Fever Vaccine Pediarix- (DTaP- HepB-IPV) Pneumonia Vaccine Meningococcal Menactra Zostavax (Shingles Vaccine) Japanese Encephalitis Vaccine Hep B- Pediatric Hep B- Adult Shingrix Hearing Test Tympanometry EKG with Interpretation and Report EKG additional testing Developmental Screening Brief Emotional/Behavioral. Assessment Health & Behavior Assessment, per 15 min, Initial Health & Behavior Assessment, per 15 min, re-assessment Administration of Patient-Focused Health Risk Assessment  Evoked otoacoustic emissions; limited (single stimulus level, either transient)  Therapeautic Injection  Behavior identification: assessment, administered byap physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardlants/caregvert) administering: assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/nterpreting the assessment, and preparing the report/treatment plan Medical nutrition therapy; initial assessment and intervention, individual, Medical nutrition therapy; re- assessment and intervention, individual,  100.00 45.00 22.00 0.00 0.00  Telephone Education, 15min/unit Individual Education, face to face    98961 99080 99172 99173 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99381 99382 99383 99384 99385 99386 99387 G0438 99391 99392 99393 99394 99395 99396 99397 G0439 99406 99407 99408 99409 99420 99451 99452 99492 99493 99494 99495 99496 99497 99498 99499 99412 DENTAL D0120 D0140 D0145 D0150 D0160 D0170  Group Education, face toi face Visual Acuity Screening Test- Color Visual Acuity Screening Test  0.00] 15.00 5.00 5.00 83.00 124.00 180.00 280.00 326.00 43.00 72.00 121.00] 209.00 262.00 211.00 227.00 226.00 249.00] 242.00 287.00] 310.00 310.00 200.00 200.00 200.00 216.00 217.00 242.00 250.00 250.00 13.00 25.00 31.00 63.00 9.00 36.00 36.00] 131.00 105.00 55.00 121.00 209.00 180.00 180.00 25.00 91.00 38.00 66.00 48.00 69.00 100.00 44.00  Special reports such asi insurance forms & complete physical forms Office Visit (OV) new patient (pt) minor-phys time approx. 10minutes OVr new pt, moderate- phys time approx 20 minutes OV new pt, moderate-phys time approx: 30r minutes OV new pt, complex-phys time approx 45 minutes OV new pt, severe-phys time approx 60 minutes  OV established (estab) pt, minimal wiwoy phys, time approx 5 min (incli limited: speciaity OV estab. pt, minor-phys time approx 10 min. (inc. Employment PE) OV estab. pt, moderate. phys time approx 15r min. (inc. DOTPE) OVe estab. pt, severe. phys time approx 25 min. OV estab. pt, severe. phys time approx 40 min. New Patient (NP) physical exam: <1y year NP physical exam: 11 to 4 Years NP physical exam: 5t to 11 years NP physical exam: 12t to 17 years NP physical exam: 18 to 39 years NP physical exam: 40 to 64) years NP physical exam: 65y years and over Initial Visit Medicare Only Oncei ina al lifetime Established Patient (EP) physical exam: <1 year EP physical exam: 11 to4 years EP physical exam: 5 through 11 years EP physical exam: 12 to 17 years EP physical exam: 181 to 39 years EP physical exam: 40t to 64 years EPI physical exam: 65) years and older Medicare Subsequent Annual Wellness Visit Tobacco Education (3-10 min) Tobacco Education over 10 min Substance Abuse Substance Abuse over 30 min Additional Assessments  PE)  Consultant 51 minutes or more without patient being present Consultant Treating Provider 16-30r min communicating & preparing referral Initial psychiatric collabroative care management first 70 minutes Subsequent psychiatric collaborative care management 60 minutes Collaborative care management, each additional 30 mins in ar month Transitional care management: services/moderate Transitional care management: services/high Advance care planning first 30 min Advance care planning additional 30 minutes Other Evaluation and Management Services (Replaced LU202) Preventive medicine, group counseling, appx 60 minutes  Periodic oral evaluation Limited orale evaluation- problem focused Oral Evaluation, pt< 3yrs  Comprehensive oral evaluation new ore established patient Detailed and extensive oral evaluation- problem focused, by report Re-evaluation- limited, problem focused (established patient; not post-op)    D0210 DO220 D0230 D0240 D0250 D0260 D0270 D0272 D0273 D0274 D0330 D1110 D1120 D1201 D1205 D1206 D1208 D1351 D1510 D1515 D1555 D2140 D2150 D2160 D2161 D2330 D2331 D2332 D2335 D2336 D2391 D2392 D2393 D2394 D2751 D2910 D2920 D2930 D2940 D2950 D2951 D3220 D3310 D3320 D3330 D4211 D4341 D4342 D4355 D4910 D5110 D5120 D5130 D5140  intraoral- complete series (including bitewings) Intraoral -periapical first film Intraoral periapical each additional film Intraoral occlusal film Extraoral firstf film Extraoral- each additional film Bitewing singlef film Bitewings 21 films Bitewings 31 films Bitewings 4f films Panoramic film Prophylaxis adult Prophylaxis - child Topical Fluoride w/ Prophylaxis Topical Fluoride w/ Prophylaxis patients Topical application of fluoride (prophylaxis noti included) Sealant per tooth Space maintainer fixed- unilateral Space maintainer fixed- bilateral Remove Fix Space Maintainer Amalgam - 1s surface, primary or permanent Amalgam 2 surfaces, primary or permanent Amalgam 3surfaces, primary or permanent Amalgam 4 or more surfaces, primary or permanent Resin-based composite -1 surface, anterior Resin-based composite -2 surfaces, anterior Resin-based composite 3 surfaces, anterior Resin based composite- -1surface pstr perm Resin-based composite -1s surface, posterior Resin-based composite 2 surfaces, posterior Resin-based composite - 3s surfaces, posterior Resin-based composite -4 or more surfaces, posterior Crown, non- precious metal (porcelin) Recementi inlaylonlay or part Recement Crown Prefabricated stainless steel crown- primary tooth Sedative filling Core buildup, including any pins Pin retention. per tooth, in addition to restoration Therapeutic pulpotomy (excluding finalr restoration) Root canal therapy- anterior (excluding final restoration) Root canal therapy bicuspid (excluding final restoration) Root canal therapy molar (excluding final restoration) Gingivectomy or gingivoplasty 1to 3 contiguous teeth/quadrant Periodontal scaling and root planing 4 or more contiguous teeth Periodontal scaling and root planing 1to3 3t teeth/quadrant Fullr mouth debridement to enable comprehensive evaluation and diagnosis  141.00 30.00 24.00 32.00 42.00 35.00 22.00 36.00] 50.00 63.00 116.00 81.00 56.00 82.00 82.00 51.00 35.00 44.00 283.00 395.00 51.00 95.00 123.00 149.00 181.00 118.00 150.00 184.00 217.00 138.00 138.00 180.00 223.00 275.00 1,000.00 25.00 28.00 223.00 85.00 194.00 48.00 138.00 572.00] 700.00 869.00 182.00 198.00 188.00 146.00 98.00 1138.00 1138.00 1234.00 1234.00  Topical fluoride varnish; therapeutic application for moderate to high caries risk  Resin-based composite 4 orr more surfaçes ori involving incisal angle (anterior)  Periodontal Maintenance Complete Denture Maxillary Complete Denture Mandibular Immediate Denture Maxillary Immediate Denture Mandibular    D5211 D5212 D5213 D5214 D5410 D5411 D5421 D5422 D5510 D5520 D5610 D5640 D5650 D5660 D5730 D5731 D5740 D5741 D6930 D7111 D7140 D7210 D7220 D7230 D7240 D7250 D7310 D7311 D7320 D7321 D7410 D7510 D7530 D9110 D9940 LU401 OTHER SERVICES 99499 S9982 99402 T1001 86580 3510F 3510F 3510F 3510F LU121 LU122 LU123 LU124 3510F  Maxillary Partial Denture Resin Base Mandibular Partial Denture Resin Base Maxillary partial denture cast metal framework resin base Mandibular Partial Denture cast metal framework resin! base Adjust Complete Denture Maxillary Adjust Complete Denture Mandbular Adjust Partial Denture Maxillary Adjust Partial Denture Mandibular Repair Broken Complete Denture Replace Missing or Broken Tooth Repair Resin Denture Base Replace Broken Teeth Addt tooth to existing partial denture Add clasp to existing partial denture Reline Complete Maxillary Denture Reline Complete Mandibular Denture Reline Maxillary Partial Denture Reline Mandibular Partial Denture Recement bridge Extraction, coronal remnants deciduous tooth Extraction, erupted tooth or exposed root Surgical removal ofe erupted tooth Removal ofi impacted tooth- softt tissue Removal ofi impacted tooth- partially bony Removal ofi impacted tooth- completely bony Surgical removal of residual tooth roots (cutting procedure) Alveoloplasty in conjunction with extractions 4 orr more tooths spaces, per quadrant Alveoloplasty in conjunction with extractions 1 to 3t tooth spaces Alveoloplasty not in conjunction with extractions -4 or more tooths spaces, per Alveoloplasty not in conjunction with extractions -1to 3t tooth spaces, per quadrant Excision of benign lesion up to 1.25 cm Incision and drainage of abscess intraoral soft tissue Removal of foreign body from mucosa, skin, or subcutaneous tissue Palliative (emergency) treatment of dental pain minor procedure  844.00 844.00 1230.00 1230.00 62.00 62.00] 62.00 62.00 150.00 128.00 150.00 128.00 156.00 234.00] 264.00 264.00 258.00 258.00 88.00 92.00 123.00 217.00 271.00 354.00 424.00 234.00 223.00 190.00 364.00 308.00 177.56 241.00 250.00 97.00 400.00 12.25  guadrant  Occlusal Bite Guard MI Paste Lice Treatment HIVE Post-1 Test Results TB Screening Form PPD given, highr risk (State Supplied) PPD, positive result, contact PPD, negative result, contact PPD, positive result, low risk PPD, negative result, low risk TB Directly Observed Therapy (DOT) TB Directly Observed Preventive Terapy (DOPT) PPD, not read, contact PPD, notr read, lowr risk PPD, positive result, high risk  Copy of Mediçal Records (per sheet charge not to exceed $15.00)  0.25 10.00 0.00    3510F 3510F LU265 LU266 LU267 LU268 LU269 LU270 LU271 LU272 LU273 LU274 S9981 LU402 G0431 H0049 S0280 S0281 T1002 G0108 G0109 G0447 G0473 0430T 97802 97803 S9465 S9470  PPD, negative result, high risk PPD, notr read, high risk Treatment of LTBI initiated, high risk Treatment ofL LTBI, initiated, low risk Treatment of LTBI, initiated, contact Treatment of LTBI completed, highr risk Treatment ofl LTBI completed, low risk Treatment ofl LTBI completed,Contact Treatment ofL LTBI incomplete Treatment ofL LTBI incomplete, low risk Treatment of LTBI incomplete, contact PPD given, contact shipping charges) Medicaid Co-Payment Hair Drug Testing Expanded Hair Drug Testing  Miscellaneous Services (ex. Medical records payment from Disability Determination,  15.00 3.00 100.00 110.00 50.00 150.00 20.00 54.00 19.00 25.00 25.00 60.00 28.00 24.00 35.00 35.00 350.00 10.00 7.00 5.00 6.00 10.00 6.00 90.00 0.00 70.00] 90.00 70.00 0.00 0.00 110.00 70.00 35.50 20.00 40.00] 37.50 35.00 32.50 30.00  Medical home program, comprehensive care coordination and planning, Initial Plan Med home prog, comp care coord and planning, main. ofp plan (postpartum)  RN Services  TH EDUCATION SERVICES  DSMT (Individual) 1/2 Hour Units DSMT (Group) 1/2 Hour Units Diabetes Prevention Program MNT Individual/nitial (15 Min Units) MNT Re-Checklndividual (15 Min Units) Diabetic management program, dietician visit (BCBS) Nutritional counseling, dietician visit (BCBS) Baby Think It Over 4 Classes Body Fat Monitor & Calipers Body Fat Testing by Calipers Body Fat Testing by Monitor BTIO Keys Challenge Course CPR Breathing Barriers Adult 1st Aid/CPR/AED CPR w/AED (Adult & Child)- ELIMINATED Adult CPR/AED Adult & Pediatric CPRIAED Pediatric CPR/AED CPR w/AED (Child) + Infant CPR + FAB- ELIMINATED CPR w/AED (Adult & Child( + FAB-E ELIMINATED Adult & Pediatric 1st Aid/CPRIAED First Aid-Basic Healthy Heart Screening Individual Health Education Life Worksite Wellness (A) Life Worksite Wellness (B) Life Worksite Wellness (C) Life Worksite Wellness (D) Life Worksite Wellness (E)  Face To Face Behavioral Counseling for Obesity, Individual, 15 min un face To Face Behavioral Counseling for Obesity, Group, 30 min un  S9445    Locking Clips Face Shield  1.00 2.00]  *Fees listed int this section are the most commonly ordered lab services at Maçon County Public Health. Ai full listing can be referenced by accessing the "LabCorp Cost Schedule" document. A$20 fee willl be added to alll lab  LABORATORY 36415 36416 80048 80050 80051 80053 80055 80061 80069 80074 80076 G0431 80335 80156 80157 80158 80162 80164 80177 80178 80184 80185 80188 80195 80197 80198 80299 80300 80301 80302 80303 80304 80320 80335 80336 80337 81001 81002 81003 81025 81220 81240 81374 82024 82040  services listed on the LabCorp document.  ROUTINE VENIPUNCTURE CAPILLARY BLOOD DRAW BMP- METABOLIC PANEL TOTAL CA GENERAL HEALTH PANEL ELECTROLYTE PANEL CMP- COMPREHEN METABOLIC PANEL PRENATAL-OBSTETRIC PANEL LIPID PANEL RENAL FUNCTION PANEL HEPATITIS PANEL- ACUTE (A,B,C) HEPATIC FUNCTION PANEL AMITRIPTYLINE (Replaces 80152) CARBAMAZEPINE, TOTAL- TEGRETOL TEGRETOL, FREE CYCLOSPORINE- -BLOOD DIGOXIN LEVETIRACETAM LITHIUM PHENOBARBITAL DILANTIN-F PHENYTOIN, TOTAL PRIMIDONE- MYSOLINE (W/PHENOB) SIROLMUSIRAPAMUNE) BLOOD TACROLIMUS THEOPHYLLINE QUANTITATIVE ASSAY DRUG  9.00 4.00 27.00 74.00 29.00 24.00 57.00 30.00 29.00 46.00 27.00 50.00 43.00] 32.00 70.00 43.00 31.00 30.00 38.00] 31.00 39.00 32.00 41.00 49.00 82.00 38.00 137.00 50.00 50.00 50.00 50.00 50.00 73.00 40.00 40.00 40.00 22.00 16.00 17.00 19.00 130.00 110.00 42.00 50.00 29.00  DRUG SCREEN, QUALITATEMULTI w/ confirmation (Replaces 80100)  VALPROIC ACID DIPROPYLACETIC: ACID)  DRUG SCREEN, QUALITATEMULTIN w! confirmation (Replaces 80100) DRUG SCREEN MULTICHANNEL PERI DATE OF SERVICE (Replaces 80100) DRUG SCREEN SINGLE DRUG EACH PROCEDURE (Replaces 80100) DRUG SCREEN THINLAYER CHROMATOGRAPHY (Replaces 80100) DRUG SCREEN NOT OTHERWISE SPECIFIED (Replaces 80100) DRUG SCREEN. ALCOHOL (Replaces 80101) ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS10R2 ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS 3-5 ANTIDEPRESSANTS. TRICYCLIC AND OTHER CYCLICALS; 6 ORI MORE  URINALYSIS, AUTO W/SCOPE" URINALYSIS NONAUTO WIO SCOPE (P&G) URINALYSIS, AUTO, WIO SCOPE" URINE PREGNANCY TEST CYSTIC FIBROSIS GENE ANALYSIS (CFTR)  Prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis HLA Class Ityping, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each for Inflammatory Diseases, Cirrhosis, arthritis andi inflammatory  bowel response ACTH ALBUMIN    82043 82055 82075 82085 82088 82103 82104 82105 82131 82140 82150 82157 82164 82175 82232 82239 82247 82270 82248 82274 82306 82308 82310 82330 82340 82374 82375 82378 82380 82384 82390 82435 82436 82465 82491 82495 82542 82507 82523 82530 82533 82550 82552 82553 82565 82570 82575 82595 82607 82627 82652 82668 82670 82672  MICROAIBUMIN/CREAT RATION- RANDOM URINE ALCOHOL- BLOOD (ETHANOL) ALCOHOL- BREATHE ETHANOL ALDOLASE ALDOSTERONE ALPHA-ANTIRYPSIN, TOTAL" ALPHAM-ANTTRYPSIN, PHENOTYPE ALPHA-FETOPROTEIN, SERUM" AMINOACIDS, SINGLE QUANT" AMMONIA AMYLASE ANDROSTENEDIONE ANGIOTENSINIEN2YME TEST ARSENIC BETA-2 MICROGLOBULIN: SERUM BILE ACIDS, TOTAL BILIRUBIN, TOTAL" FECAL OCCULTBLOOD BILIRUBIN, DIRECT" FECAL OCCULT BLOOD,MMUNOASSAY VITAMIN D CALCITONIN, SERUM CALCIUM CALCIUM- ionized CALCIUM IN URINE CARBON DIOXIDE-BLOOD CARBON MONOXIDE-BLOOD CEACARCINOEMERYONC ANTIGEN CAROTENE, BETA THREE CATECHOLAMINES CERULOPLASMIN CHLORIDE-BLOOD CHLORIDE- URINE CHOLESTEROLELDSERUM CHROMOTOGRAPHY, QUANT, SING" CHROMIUM LAMOTRIGINE (LAMICTAL) SERUM CITRATE urine 24 hour COLLAGEN CROSSLINKS CORTISOL, FREE  URINE 24 HOUR CORTISOL-TOTAL CPKI TOTAL CPKI ISOENZYMES CPK, MB FRACTION" CREATININE  34.00 40.00] 50.00 28.00 45.00 32.00 45.00] 30.00 45.00 38.00 30.00 46.00] 31.00 60.00 41.00 37.00 29.00 25.00 29.00 50.00 40.00 40.00 29.00 30.00 31.00 36.00 38.00 33.00 37.00 54.00 32.00 29.00 29.00 29.00 125.00 50.00 58.00 45.00 125.00 37.00 31.00 25.00 34.00 114.00 25.00 30.00 31.00 29.00 30.00 37.00 38.00 32.00 47.00 45.00  CREATININE- URINE 24 HOUR/RANDOM CREATININE CLEARANCE TEST CRYOGLOBULIN- semiquant, REFLEX VITAMIN/B-12 DEHYDROEPIANDROSTERONE- DHEAS CALCITRIOL ERYTHROPOIETIN ESTRADIOL ESTROGEN    82677 82679 82705 82710 82728 82731 82746 82784 82785 82941 82947 82950 82951 82952 82952 82955 82977 82985 83001 83002 83010 83018 83020 83021 83036 83090 83497 83498 83516 83520 83525 83527 83540 83550 83615 83655 83690 83695 83701 83704 83718 83721 83735 83825 83835 83874 83880 83883 83891 83894 83898 83900 83901 83909  ESTRIOL ESTRONE, SERUM FATS/LIPIDS, FECES, QUAL" FECAL FATS, QUANTITATIVE FERRITIN FETAL FIBRONECTIN FOLIC ACID: SERUM GAMMAGLOBULIN: IgA, IgD,IgG, IgM, each GAMMAGLOBULIN: IgE GASTRIN, SERUM GLUCOSE, BLOOD QUANT" O'SULLIVAN GLUCOSE TEST GLUCOSE TOLERANCE TEST (GTT)2HR GLUCOSE TOLERANCE TEST ADDITIONAL specimen GTT-ADDED SAMPLES G6PD ENZYME- QUANT GGT GLYCATED PROTEIN FSH- GONADOTROPIN (FSH) LH- GONADOTROPIN (LH) HAPTOGLOBIN, QUANT" HEAVY METAL LEVEL SICKLE CELL TO STATE LAB HEMOGLOBIN CHROMOTOGRAPHY A1C Hgb- GLYCOSYLATED HEMOGLOBIN TEST HOMOCYSTINE HIAAH Hydroxyindolacetic: acid, 5 Qualitative OROAAPROGESIERONE 17-d alpha IMMUNOASSAY NONANTIBODY IMMUNOASSAY RIA INSULIN INSULIN-FREE IRON IRON BINDING TEST LACTATE (LD) (LDH) ENZYME LEAD (adult) LIPASE LIPOPROTEIN/A) ELECTROPHORETIC SEP & QUANT WITH! HRI REFRACTION LIPOPROTEIN PARTCLESQUANITTATON HDL- DIRECTLPOPROTEN LDLD DIRECT- LIPOPROTEIN MAGNESIUM MERCURY  41.00 44.00] 34.00 41.00] 26.00 192.00 30.00 30.00 32.00 35.00 18.00 28.00 54.00 11.00 11.00 35.00 29.00 44.00 32.00 35.00 34.00 95.00 0.00 86.00 29.00 57.00 $10/un! 45.00 100.00 100.00 30.00 33.00 25.00 10.00 29.00 29.00 30.00 36.00 45.00 75.00 25.00 29.00 25.00 54.00 49.00 39.00] 68.00 40.00 35.00 26.00 26.00 30.00 26.00 15.00  METANEPHRINES- TOTAL- 24HOUR URINE MYOGLOBIN- URINE OR SERUM QUANT BNP- T-TYPE NATRIURETIC PEPTIDE NEPHELOMETRY NOT SPEC MOLECULE ISOLATE NUCLEIC MOLECULE GEL ELECTROPHOR MOLECULEI NUCLEIC AMPLI, EACH" MOLECULE NUCLEIC AMPLI2S SEQ MOLECULE NUCLEIC AMPLI ADDON SEPARATIONHD BY HIGH RESOLUTION    83912 83914 83921 83930 83935 83945 83970 83986 84066 84075 84100 84105 84132 84133 84134 84144 84146 84153 84154 84155 84156 84165 84166 84207 84244 84295 84300 84305 84402 84403 84425 84436 84439 84443 84445 84446 84450 84460 84466 84478 84479 84480 84481 84482 84484 84520 84540 84550 84560 84585 84590 84591 84597 84630  GENETIC EXAMINATION MUTATION ID OLA/SBCE/ASPE ORGANIC ACID, SINGLE, QUANT" OSMOLALITY- BLOOD OSMOLALITY- URINE OXALATE -24! HR URINE PTH- PARATHYROID HORMONE-INTACT BODY FLUID ACIDITY Nitrazine paper PROSTATE ACID PHOSPHATASE ALKALINE PHOSPHATASE PHOSPHORUS- INORGANIC SERUM PHOSPHORUS- INORGANIÇ- URINE POTASSIUM- SERUM POTASSIUM- URINE PREALBUMIN PROGESTERONE PROLACTIN PSA, TOTAL PSA, FREE  26.00 26.00 125.00 31.00 31.00 36.00 31.00 9.00 32.00 29.00 24.00 29.00 29.00 31.00 33.00 35.00 33.00 30.00 33.00 24.00 29.00 30.00 34.00 49.00 40.00 29.00 29.00 40.00 52.00 32.00 42.00 23.00] 27.00 24.00] 77.00 37.00 29.00 29.00 33.00 29.00 28.00 32.00 34.00 49.00 110.00 29.00 32.00 25.00 29.00 37.00 40.00 125.00 200.00 30.00  PROTEIN TOTALREFLECT SERUM PROTEIN, URINE RANDOM or 24 hour PROTEIN ELEC-PHORESIS, SERUM QUANT PROTEIN LEGPHORESSURNECS: VITE B6 PLASMA RENIN SODIUM- SERUM SODIUM- URINE 24HOUR SOMATOMEDIN IESTOSTERONE-FREE IESTOSTERONE-TOTAL VITAMIN B-1 THIAMINE T4- TOTAL THYROXINE T4- FREE THYROXINE TSH- THYROID STIMI HORMONE TSI-THYROID STIMULATING IMMUNG VITE - SERUM AST SGODTRANSFERASE ALT (SGPT)ALANINE, AMINO TRANSFERRIN TRIGLYCERIDES T3orT4UPTAKE or THBR T3-T TRIODOTHYRONINE: (T3) T3-FREE ASSAY (FT-3) T3-F REVERSE TROPONIN, QUANT" BUN -UREAI NITROGEN UREA NITROGEN -24H HRI URINE URIC ACID- BLOOD URIC ACID- URINE VMA- URINE 24HOUR VITAMINA Vitamin B7- Biotin MT K-1 ZINC    84681 84702 84703 85002 85004 85007 85014 85018 85025 85027 85041 85045 85048 85049 85060 85220 85240 85250 85300 85301 85302 85303 85305 85306 85307 85379 85384 85610 85613 85651 85652 85660 85670 85705 85730 85732 86003 86005 86038 86060 86140 86146 86141 86147 86160 86162 86200 86215 86225 86226 86235 86255 86256 86300  C-PEPTIDE HCG- QUANT SERUM HCG-QUAL SERUM BLEEDING TIME TEST WBC DIFFERENTIAL AUTOMATED WBC DIFFERENTIAL- MANUAL bld smear HEMATOCRIT HEMOGLOBIN CBC WIAUTO DIFF WBC CBC COMPLETE (COMPONENT OF 80050) RBC COUNT AUTOMATED RETICULOCYTE COUNT AUTOMATED WBC-COUNT- BLOOD (LEUKOCYTE )AUTOMATED PLATELET COUNT AUTOMATED BLOOD SMEAR INTERPRETATION FACTOR VA ACTIVITY FACTOR VII ACTIVITY FACTOR IX ACTIMTY ANTITHROMBIN! III TEST ANTITHROMBIN III ANTIGEN TEST PROTEIN C ANTIGEN PROTEIN C ACTMMTY PROTEIN S, TOTAL PROTEIN SF FREE ACTIVATEDI PROTEIN C (ACP) RESISTANCE FIBRIN DEGRADATION, QUANT" FIBRINOGEN PT/INR PROTHROMBIN TIME RUSSELL VIPER VENOM, DILUTED" SED RATE, NONAUTOMATED" SEDRATE (ESR) AUTOMATED SICKLE CELL TEST-RBC REDUCTION-reflex fraction. THROMBIN TIME PLASMA THROMBOPLASTIN: INHIBITION PTI-THROMBOPLASTN TIME, PARTIAL" THROMBOPLASTIN TIME, SUBSTITUTIONEA ALLERGEN SPECIFIC IgE; MULTIALLERGEN SCREEN ANA- ANTINUCLEAR ANTIBODIES-DIRECT ANTISTREPTOLYSIN: 0, TITER" C-REACTIVE PROTEIN C-REACTIVE PROTEIN, HS- CARDIAC CARDIOLIPIN ANTIBOD, each class COMPLEMENT, ANTIGEN" COMPLEMENT, TOTAL (CH50)" CCP-CYCLIC CITRUL.. PEPTIDE, AB DNASE DEOAYRIBONUCLEASE) ANTIBODY DNA ANTIBODY- NATIVE OR DOUBLE STRAND DNA ANTIBODY, SINGLE STRAND" NUCLEAR ANTIGEN ANTIBODY-EATRACTABLE FLUORESCENT ANTIBODY, SCREEN" FLUORESCENT ANTIBODY, TITER" CAI IMMUNOASSAY TUMOR,  32.00 34.00 32.00 40.00 27.00 16.00 18.00 18.00 26.00 24.00 31.00 29.00 29.00 29.00 30.00 95.00 95.00 95.00 51.00 43.00 63.00 54.00 61.00 61.00 55.00 45.00 30.00 28.00 54.00] 29.00 29.00 100.00 44.00 75.00 28.00 75.00 126.00 24.00 30.00 29.00 30.00 32.00 31.00 37.00 33.00 31.00] 45.00 42.00] 32.00 45.00 34.00 35.00 35.00 38.00  ALLERGEN SPECIFIC IgE QUANTITATIVE OR SEMIQUANTITATIVE (24 units)  ETATCTSPOTENTATEOEN IGG, IGM- Replaces 86142    86300 86301 86304 86308 86334 86335 86336 86340 86359 86360 86376 86382 86431 86480 86580 86592 86593 86611 86617 86618 86632 86644 86645 86663 86664 86665 86677 86689 86694 86695 86696 86701 86703 86704 86705 86706 86707 86708 86709 86735 86747 86757 86762 86765 86777 86780 86787 86790 86800 86803 86803 86804 86850 86870  CA 27. 29 IMMUNOASSAY TUMOR, CA 19-9- MMUNOASSAYTUMOR, CA 125- MUNOASSAY TUMOR, MONO- HETEROPHILE MTEODESQUALTAIVE IMMUNOFIX E-PHORESIS, SERUM" IMMUNFIX E-PHORSISAURINE/CSF INHIBIN A INTRINSIC FACTOR ANTIBODY TCELLS; TOTAL COUNT CD4/CD8, ABSOLUTE COUNT/RATIO" MICROSOMAL ANTIBODY RABIES TITER NEUTRALIZATION TEST, VIRAL RA-RHEUMATOIDF FACTOR, QUANT" TB- INTERFERON GOLD TEST TBI INTRADERMAL TEST RPR- BLOOD SEROLOGY, QUALITATIVE" RPR-TITER BLOOD SEROLOGY, QUANT BARTONELLA. ANTIBODY CAT: SCRATCH LYME DISEASE AMTIBODM-CONFRWATORI WB LYME DISEASE IGMA ANTIBODY CHLAMYDIA IGM ANTIBODY CMVA ANTIBODY- IGG CMV ANTIBODY, IGM"  36.00 35.00 33.00 33.00 27.00 51.00 20.00 36.00 35.00 73.00 31.00 70.00 30.00] 69.00 21.00 28.00 30.00 50.00 58.00 45.00 40.00 31.00] 33.00 30.00 30.00 30.00 39.00 70.00 39.00 41.00 44.00 33.00 32.00 32.00 31.00 29.00 33.00] 31.00 31.00 32.00 66.00 48.00 30.00 33.00 34.00 67.00 34.00 144.00 34.00 31.00 135.00 155.00 30.00 42.00  EPSTEIN-BARR ANTIBODY-EA! EARLY ANTIGEN EPSTEIN-BARR ANTIBODY-EBNA NUCLEAR AG EPSTEIN-BARR, ANTIBODY-VIRAL CAPSID(VCA) HELICOBACTER PYLORI- IGG QUANT HTLV/HIV WB CONFIRMATORY HERPES SIMPLEX TEST-TYPE1821GM HERPES SIMPLEXT TYPE1 IGG HERPES SIMPLEXTYPE2 HIV-1 HIV-1/HIV-2, SCREENING HEP B CORE ANTIBODY, TOTAL" HEP B CORE. ANTIBODY, IGM" HEP B SURFACE ANTIBODY- QUALITAtive HEP BE ANTIBODY HEP AA ANTIBODY, TOTAL" HEPAA ANTIBODY, IGM" MUMPS TITER- IGG/ ANTIBODY PARVOVIRUS ANTIBODY-B19 IGG-IGM RICKETTSIA AB-ROCKY MTN SPOTTED FEVER RUBELLA ANTIBODY TITER IGG RUBEOLA ANTIBODY TITER IGG TOXOPLASMA GONDII IGG ANTIBODY TP-PA SYPHILIS CONFIRM TEST VARICELLA-ZOSTER, ANTIBODY TITER MIRUS ANTIBODY NOS THYROGLOBULIN. ANTIBODY HEPATITIS C AB TEST Test Code 550362- - HEP C Reflex HEP C AB TEST, CONFIRM" ANTIBODY SCREEN- RBC ANTIBODY IDENTIFICATION- RBC    86880 86900 86901 87045 87070 87071 87075 87077 87081 87086 87088 87149 87168 87172 87177 87186 87205 87207 87209 87210 87230 87324 87338 87340 87350 87389 87390 87425 87490 87491 87491 87496 87517 87521 87522 87590 87591 87623 87624 87625 87798 87799 87804 87807 87880 87902 88141 88142  COOMBS TEST, DIRECT" BLOOD TYPING, ABO" BLOOD TYPING, RH(D)" STOOL (FECES) CULTURE to State Lab CULTURE, BACTERIA, OTHER WITH PRESUMPTIVEI ID CULTURE, BACTERIA, OTHER CULTURE ANAEROBIC BACTERIA, EXCEPT BLOOD" CULTURE AEROBIC ORGANISMI IDENTIFICATION CULTURE SCREEN ONLY URINE CULTURE/COLONY COUNT URINE BACTERIA CULTURE CULTURE IDENTIFICATION BYI NEUCLEIC. ACID MACROSCOPIC EXAM ARTHROPOD (nits-lice) PINWORM EXAM OVA ANDI PARASITES SMEARS-concentraion SUSCEPTIBLE- MICROBE. MIC" GRAM STAIN- SMEAR, SMEAR, SPECIAL STAIN" SMEAR, COMPLEX STAIN- richrome, iron etc WET MOUNT, SALINE/INK" C.DIFFICILE B TOXIN - (QUAL) CLOSTRIDIUMA difficile toxin A and B, EIA HELICOBACTERI PYLORI, STOOL ANITGEN, EIA HEPATITIS B SURFACE. AG, EIA" HEPATITIS BEA AG, EIA"  36.00 30.00 38.00 0.00 25.00 25.00 88.00 25.00 60.00 26.00 22.00 25.00 17.00 15.00 30.00 39.00] 18.00 119.00 30.00 15.00 40.00 40.00 63.00 29.00 32.00 26.00 0.00 38.00 33.00 0.00 30.00 144.00 262.00 115.00 115.00 33.00 30.00 40.00 $33,$80,$54 100.00 670.00 320.00 30.00 45 48.00 228.00 20.00 37.00  Infectious agent antigen detection byi immunoassay technique, (eg, enzyme immunoassay [EIA), enzyme-linked immunosorbent: assay [ELISA), munocnemluminometric assay [IMCAJ) qualitative or semiquantitative, multiple- step method; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result  HIV-1 AG, EIA- STATELAB ROTAVIRUS AG, EIA" CHLAMYDIA TRACH BY DNAI PROBE CHLAMYDIA TRACH, DNA, TO State Lab CHLAMYDIA TRACH, DNA, LabCorp swab or ua CYTOMEGALOVIRUS. AMPLIFIED PROBE TECHNIQUE HEPATITIS B, DNA, QUANT - PCR HEPATITIS C, RNA, AMP PROBE QUAL HEPATITIS C, RNA, QUANTISURE (IU) N.GONORRHOEAE, DNA, DIRI PROB" N.GONORRHOEAE, DNA, AMP PROB HPV, DNA, AMP PROBE" (Replaces 87621) PAP/HPVI HIGH-RISK Test dependant  Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45,f performed Infectious agent detection by nucleic: acid (DNA or RNA), not otherwise specified; RAPIDFLU(591 MODIFIER FOR BOTHAA AND B ENTER CODE TWICE)  ZIKA RSV  quantification, each organism STREP A ASSAY W/OPTIC HEPATITIS C GENOTYPE, DNA, CYTOPATHOLOGY, CERVICAL OR' VAGINAL CYTOPATHOLOGY, CERVICAL OR VAGINAL THINI PREP    88175 88305 88342 Q0091 89055 89321 99000 99070 G0328 Q0114 99000 99000  90 PAP COLLECTIONFEE Level IV Pathology Read Immunohistochemisty perspecimen, initial single antibody stain PAP COLLECTION FEE- - Medicare WBC- STOOL SEMEN ANAL, SPERM DETECTION'-AMC HANDLING FEE MATERIALS AND: SUPPLIES-each container HEMOCCULTSX3 (MEDICARE) FERNTEST Handling Feel COC DRUG COLLECTION FEE Handling Fee/COC PATERNITY COLLECTION  20.00 $30/un $110/un! 20.00 33.00 30.00 25.00 7.50 18.00 20.00 25.00 25.00 500.00 500.00 250.00 500.00 1,000.00 1,000.00 1,000.00 1.65 pers gal 1.65 pergal 1.65 pergal 250.00 250.00 225.00 125.00 125.00 125.00 125.00] 0.00 .42pergal 30% standard fee 375.00 125.00 125.00 0.00 175.00 0.00  ENVIRONMENTAL HEALTH On-Site Waste' Water (OSWW)  Improvement Permit (IP Only)240-360 Gallons per day/2-3 Bedrooms Authorization to Construct (AC Only): 240-360 Gallons per day/2-3 Bedrooms Application fees for permitting a Pit Privy, Vault Privy, Incinerating Toilet ora IP/AC 240-360 Gallons per day/2-3 Bedrooms Improvement Permit (IP Only) 480-600 Gallons/4-5 Bedrooms Authorization to Construct (AC Only) 480-600 Gallons per day/4-5 Bedrooms IP/AC 480- 600 Gallons per day/4-5 Bedrooms Commercial Improvement Permit (IP)- also applies to residential over 61 bedrooms &s systems with 2 or more homes Commercial Authorization to Construct (AC) also applies to residential over6 6 bedrooms & systems with 2 or more! homes Commercial IP/AC- also applies to residential over 61 bedrooms & systems with2or more homes RVI Permit Only 0-120 Gallons per day Addition to System (Per Bedroom) -0-120 Gallons per day- IP/AC/RV Relocate Tank Consultative Visit Mobile Home Reconnect Site Visit Additions to Structure Return' Visit Fee Residential Repair Permit Commercial Repair Permit  Composting Toilet  **Engineer Option Permit (EOP) fee is 30% of standard fee Private Drinking' Water Well (PDWW) Permit  Private Drinking Water Wells (PDWW)  Consultative Visit Return Site Visit Well Repair  Abandonment of a Well (no charge if donei in conjunction with a PDWW Permit) Renewal of Permit before Expiration (no changes inp permit)  Water Test Fees/Sampling  Allf feesi include a $5 charge for handling and processing of specimens (data entry, packaging, tracking, courier costs and Panatom/mtepretation oftestresults).  Full Panel Inorganic Chemistry and Microbiology New Private Water Well  79.00    Existing Private Water Well Microbiology Inorganic Chemistry and Microbiology New Private Water Well Existing Private Water Well Inorganic Chemistry and Microbiology New Private Water Well Existing Private Water Well Inorganic Chemistry and Microbiology New Private Water Well Existing Private Water Well Inorganic Chemistry Inorganic Panel- (Metals, Anions, Nitrate/ Nitrite) Inorganic Panel- (Metals, Anions) Inorganic Panel- (Coal Ashl Testing) Hexavalent Chromium Metals Panel  79.00 20.00 30.00 31.00 50.00 34.00 35.00 45.00 34.00 30.00 73.00 68.00 73.00 57.00 64.00 50.00 70.00 34.00 34.00 34.00 31.00 34.00 79.00 79.00 79.00 79.00 79.00 79.00 79.00 79.00 129.00 200.00 150.00 200.00 200.00 100.00 75.00p per event 200.00 150.00 700.00 500.00 200.00 100.00 50.00 15.00  Individual Metals- (1-3 maximum from above + Uranium) Lead follow-up testing (upt to3: samples from same location) Anions - (Fluoride, Chloride, Sulfate) Disinfection By-Products - (Bromide, Bromate, Chlorite, Chlorate) Fluoride Physician, Dentist request Nitrate/Nitrite Arsenic speciation Organic Chemistry Pesticides Chlorinated Pesticides Nitrogen-Phosphorus Pesticides EDB, DBCP andTCP Herbicides Glyphosate Chlorinated. Acid Herbicides Carbamates Synthetic Organic Chemicals (SOC) Scan Petroleum products EHSpecialist.  Volatile Organic Chemicals (Sample collection must be performed bya al Registered  FOOD ANDI LODGING  Food Service Establishment Plan Review- New/x24 seats Food Service Establishment Plan Review- Existing/<24s seats Food Service Establishment Plan Review New/>25 seats Food Service Establishment Plan Review- Existing/>25seats Food Stand Plan Review Temporary Food Establishment Permit Tattoo Parlor Plan Review- New Tattoo Parlor Plan Review- Existing Tattoo Parlor Plan Review- Owner/Operator (annually) Tattoo Parlor Permit- Each. Additional Artist (annually) Pool Plan Review Pool Application Fee (annually) Additional Pool or Spa Microchipping for general public  ANIMALSERVICES    Adoption -C Cat Adoption Dog Adoption Feet for Veterans (Dog or Cat) Reclaim Fee Citation Option 1( (at officer's discretion) Citation- Option 2 (at officer's discretion) Pet Carrier Quarantine Fee (per day) Sponsor Fee  65.00 65.00 45.00 35.00 25.00 25.00 50.00 5.00 10.00 65.00 20.00 30.00 10.00 20.00 Fee set by sponsor 10.00 1.00/un  Adoption Special (Animals spayed or neutered prior to entering shelter)  Adoption Special Event (Festival, Fair, Holiday approved event) Cat Adoption Special Event (Festival, Fair, Holiday approved event)- Dog  Adoption Overpopulation-Cat Adoption Overpopulation- Dog Adoption Sponsored Event- fee set bys sponsor Boarding Fee (per day after notification)  Leash    CPT Code  Current Cost Per Proposed Fee Dose $ 346.00 $ 346.78 $ $ 331.00 $ 346.78 $ $ 106.00 $ 110.61 $ $ 55.00 $ 53.67 $ $ 36.00 $ 35.08 $ $ 41.00 $ 37.79 $ $ 136.00 $ 142.47 $ $ 75.00 $ 74.19 $ $ 125.00 $ 134.32 $ $ 165.00 $ 161.85 $  Discription of Service / Vaccine  New Fee 352.00 352.00 116.00 59.00 40.00 43.00 147.00 79.00 139.00 167.00  90675 Rabies Vaccine Exposure 90676 Rabies Vaccine Preventive 90691 Typhoid Vi 90696 Kinrix- (DTaP-IPV) 90713 IPV 90715 Tdap 90716 Varicella Vaccine 90723 Pediarix- (DTaP- HepB-IPV) 90734 Menactra 90750 Shingrix    STATE OF NORTH CAROLINA COUNTY OF MACON  AGREEMENTTOI PROVIDE RECREATION OPPORTUNITIES  THIS AGREEMENT made and entered into this the  day of  2021,  by and between Macon County (hereinafter "County"), a North Carolina Body Politic and Corporate, and Scaly Mountain Historical Society, Inc., (hereinafter "Historical Society"), a  North Carolina non- profit corporation.  WITNESSETH:  THAT WHEREAS the State of North Carolina by way of N.C. Gen. Stat. $ 160A-351 has established the following as policy for the State ofl North Carolina concerning recreation: "The lack of adequate recreational programs and facilities is a menace to the morals, happiness, and welfare of the people of this State. Making available recreational opportunities for citizens of all ages is a subject of general interest and concern, and a function requiring appropriate action by both State and local government. The General Assembly therefore declares that the public good and the general welfare of the citizens of this State require adequate recreation programs, the creation, establishment, and operation of parks and recreation programs is a proper governmental function, and that it is the policy of North Carolina to forever encourage, foster, and provide these facilities and programs  fora all ofits citizens."; and  WHEREAS, N.C. Gen. Stat. $ 160A-352 provides that Recreation" means activities that are diversionary in character and aid in promoting entertainment, pleasure, relaxation, instruction, and other physical, mental and cultural development and leisure time experiences;  and  WHEREAS, pursuant to N.C. Gen. Stat. $ 153A-444, the County is authorized to WHEREAS, pursuant to N.C. Gen. Stat. $ 153A-449, the County is authorized to contract with and appropriate money to any person, association, or corporation, in order to carry  establish parks and provide recreational programs; and  out any public purpose that the County is authorized by law to engage in; and  WHEREAS, there is a need for recreation opportunities in the Scaly Mountain area of WHEREAS, Scaly Mountain Historical Society, Inc., (Historical Society), does own a building known as the Old Scaly School House, located at 41 Buck Knob Road, Scaly Mountain, North Carolina 28775 (h hereinafter referred to as the Old Scaly School House) and does agree with County as provided for hereinafter for such facility to be used in part for public "recreation" as that term is defined by N.C. Gen. Stat. $ 160A-352 and provide recreational opportunities to  Macon County, North Carolina; and    the general public at such location, and County does agree with Historical Society as provided for hereinafter to appropriate and provide funds to Historical Society in accordance with the provisions ofN.C. Gen. Stat. S 153A-449 to carry out the public purpose of providing recreation  opportunities to the general public at the Old Scaly School House.  NOW THEREFORE, IN CONSIDERATION OF THE COVENANTS CONTAINED  HEREINAFTER, THE PARTIES DO HEREBY AGREE. AS FOLLOWS:  1. That Historical Society shall make the Old Scaly School House, located at 41 Buck Knob Road, Scaly Mountain, North Carolina 28775, open and available to members of the general public during reasonable days and hours for recreation as that term is defined by N.C. Gen. Stat. $ 160A-352 for the period between July 1, 2021, and the end ofJ June 30, 2022, and it shall provide recreational opportunities to the general public at such location. The Historical Society shall perform its obligations hereunder in a nondiscriminatory fashion appropriate for public activity and there shall be no discrimination by it on the County shall pay Historical Society upon the execution of this Agreement the sum of $2,500.00 for making the Old Scaly School House open and available to members of the general public during reasonable days and hours for recreation as that term is defined by N.C. Gen. Stat. $ 160A-352 for the period between July 1, 2021, and the end of June 30, 2022, and for providing recreational opportunities to the general public. Historical Society shall account to County for its expenditures and uses of the monies provided by County to Historical Society in accordance with paragraph number three above and Historical Society shall use such monies only for the public purpose of making the Old Scaly School House open and available to members of the general public during reasonable days and hours for recreation as that term is defined by N.C. Gen. Stat. $ 160A-352 for the period between July 1, 2021, and the end of June 30, 2022, and for Historical Society shall at all times properly maintain the Old Scaly School House in a  2.  basis of race, sex or religion ini its performance of such obligation.  3.  4.  providing recreational opportunities to the general public. condition for use as a safe place of public recreation. This Agreement shall not be construed to be a lease. Historical Society is an independent contractor.  5. 6. 7. 8.  Historical society shall maintain throughout the term ofthis Agreement property damage insurance and liability insurance in amounts as will protect it against any and all damages, liability, loss and claims to the Historical Society, Old Scaly School House, appurtenances and approaches thereto, in any manner caused directly or indirectly by, arising from, incident to, or in connection with its use or occupancy of the Old Scaly  School House and its performance ofits duties under this Agreement.  2    9.  County may periodically inspect and monitor Historical Society's performance of its  obligations hereunder.  10. The laws of the State of North Carolina shall control and govern this Agreement. Any controversy or claim arising out of this Agreement shall be settled by action instituted in the appropriate Division of the General Court of Justice in Macon County, North  Carolina. hereto.  11. This Agreement may be modified only by written agreement executed by the parties 12. E-VERIFY. Each Party hereto shall comply with the requirements of Article 2 of Chapter 64 of the General Statutes. Further, if any party hereto utilizes a subcontractor, such party shall require the subcontractor to comply with the requirements of Article 2 of IN WITNESS WHEREOF, the parties have made and executed this Agreement the day  Chapter 64 oft the General Statutes.  and year first above written. Scaly Mountain Historical Society, Inc.  Macon County By:  By: President ATTEST:  County Manager  Secretary  PRE-AUDIT CERTIFICATE Budget and Fiscal Control Act.  This instrument has been pre-audited in the manner required by the Local Government  This the  day of  2021  Macon County Finance Officer  3    NORTH CAROLINA MACON COUNTY  SERVICE CONTRACT  THIS CONTRACT is made, and entered into this the  day of July, 2021, by and  between the COUNTY of MACON, a political subdivision of the State of North Carolina, hereinafterrelerredr toas' "County"), MCTERANSUNAREACIAMBEOECOAMIRCL: INC.. a not for profit corporation duly authorized to do business in the State of North Carolina  (herein after referred to as "Chamber").  1.  SCOPE OF SERVICES. Chamber hereby agrees to provide the Travel and Tourism Development services under this Contract within the Franklin Travel and Tourism District pursuant to the provisions and specifications identified in "Attachment 1" (hereinafter collectivelyreferred to as "Services"). Attachment lishe herebyincorporated herein and made Further, Chamber agrees to provide Travel and Tourism Development services under this Contract within the Nantahala Travel and Tourism District pursuant to the provisions and specifications identified in "Attachment 2" (hereinafter collectively referred to as "Services"). Attachment 2 is herebyincorporated herein and made a part hereof TERM OF CONTRACT. The Term of this Contract for services is from July 1, 2021, through June 30, 2022. This contract may be renewed annually upon written agreement by PAYMENTTO CHAMBER. Except as otherwise provided for in this Paragraph #3, Chamber shall receive from County a monthly amount not to exceed the amount of the occupancy tax under S.L. 1985-969 collected by the County from hotels, motels, inns, and similar places known by County to be within The Franklin Travel and Tourism District which consists of the Franklin, Millshoal, Ellijay, Smithbridge, Cartoogechaye, Cowee and BumingiowmTownahipsofMaconCoumty, North Carolina, during the preceding month, less administrative expenses of Macon County, as compensation for the provision of Services within The Franklin Travel and Tourism District. However, notwithstanding the foregoing, all occupancy taxes heretofore and hereafter collected by Airbnb and other companies which operate in a similar fashion to Airbnb and which are remitted to Macon County with inadequate information to identify the owner of the property temporarily rented and the Township or address of the property temporarily rented for which such occupancy taxes were collected shall be used to promote travel and tourism within the following Travel and Tourism Districts in the following percentages, less any  part hereof.  2.  the County and Chamber.  3.  administrative fee due the County pursuant to applicable law:  1    A. The Highlands Travel and Tourism District: 71.04%; B. The Nantahala Travel and Tourism District: 6.22%; and C. The Franklin Travel and Tourism District: 22.74%.  The Chamber: shall receive the percentage ofsuch occupancytaxes: set forth hereinabove for The Franklin Travel and Tourism District and the same shall be additional compensation for the provision ofs Services within The Franklin Travel and Tourism District. County agrees to pay Chamber at the rates specified for Services, performed to the satisfaction of the The Occupancy' Taxes received by Chamber from County for use in the Franklin Travel and Tourism District shall be used to promote travel and tourism within the Franklin Travel and Further, Chamber shall receive from County a monthly amount not to exceed the amount of the occupancy tax under S.L. 1985-969 collected by the County from hotels, motels, inns, and similar places known by the County to be within The Nantahala Travel and Tourism District which consists ofthe NantahalaTownship ofMacon County, North Carolina, during the preceding month, less administrative expenses of Macon County, as compensation for the provision of Services within The Nantahala Travel and Tourism District. However, notwithstanding the foregoing, all occupancy taxes heretofore and hereafter collected Airbnb and other companies which operate in a similar fashion to Airbnb and which are by remitted tol Macon County with inadequate information toi identify the owner ofthe property temporarilyrented. and the' Township or addresso ofthe property temporarily rented: for which such occupancy taxes were collected shall be used toj promote travel and tourism within the following Travel: and Tourism Districts in thei following percentages, less any administrative  County, in accordance with this Contract, and Attachment 1.  Tourism District only.  fee due the County pursuant to applicable law:  A. The Highlands Travel and Tourism District: 71.04%; B. The Nantahala Travel and Tourism District: 6.22%; and C. The Franklin Travel and Tourism District: 22.74%.  The Chamber shall receive the percentage ofsuch occupancy taxes set forth hereinabove for The Nantahala Travel and Tourism District and the same shall be additional compensation for the provision of Services within The Nantahala Travel and Tourism District. County agrees toj pay Chamberat the rates specified for Services, performed to the satisfaction ofthe NOTWITHSTANDING THE FOREGOING, all such compensation for the provision of  County, in accordance with this Contract, and Attachment 2.  2    Services within The Nantahala' Travel and Tourism District by Chamber hereunder shall be held in an account by County and upon the submission ofi invoices to County by Chamber for the provision of services, overhead, materials and/or equipment for the promotion of travel and tourism in the Nantahala Travel and Tourism District in accordance with this Service Contract, County shall review the same, code them and pay the same from such account to the extent such account contains sufficient funds toj pay the same. County shall provide Chamber a monthly statement oft the occupancy taxes collected by the County for use within The Nantahala Travel and Tourism District for the preceding month in order to let Chamber know that amount, less the administrative expenses withheld by County. The Occupancy' Taxesreceived by Chamber from County for usei int thel Nantahala Traveland Tourism District shall be used toj promote travel and tourism with the Nantahala Travel and INDEPENDENT CONTRACTOR. County and Chamber agree that Chamber is an independent contractor and shall not represent itself as an agent or employee of County for any purpose in the performance of Chamber's duties under this Contract. Accordingly, Chamber shall be responsible for payment of all federal, state and local taxes as well as applicable business license fees arising out of Chamber's: activities in accordance with this Contract. Forj purposes ofthis Contract, taxes: shall include, but not be limited to, Federal and Chamber, as an independent contractor, shall perform the Services required hereunder ina professional manner and in accordance with the standards of applicable professional INSURANCE AND INDEMNITY. Tot the fullest extent permittedl byl laws andi regulations, Chamber shall indemnify and hold harmless the County and its officials, agents, and employees from and against all claims, damages, losses, and expenses, direct, indirect, or consequential (including but not limited to fees and charges of engineers or architects, attorneys, and other professionals and costs related to court action or arbitration). arising out of or resulting from Chamber's performance ofthis Contract or the actions oft the Chamber or its officials, or employees under this Contact or under contracts entered into by the Chamberinc connection withthis Contract. Thisindemmification shall survive the termination of this Contract. In addition, Chamber shall comply with the North Carolina Workers' Compensation Act and shall provide for the payment of workers' compensation to its HEALTH AND SAFETY. Chamber shall be responsible for initiating, maintaining and supervising all safety precautions and programs required by OSHA and all other regulatory NON-DISCRIMINATION IN EMPLOYMENT. Chamber shall not discriminate against any employee or applicant for employment because of age, sex, race, creed, national origin,  Tourism District only.  4.  State Income, Social Security and Unemployment Insurance taxes.  organizations.  5.  employees in the manner and to the extent required by such Act.  6.  agencies while providing Services under this Contract.  7.  3    or disability. In the event Chamber is determined by the final orderofan appropriate agency or court to be in violation ofa any non-discrimination provision of federal, state or local law orthis provision, this Contract may be canceled, terminated ors suspended in whole ori inj part by County, and Chamber may be declared ineligible for further County contracts. GOVERNINGLAW. This Contract shall be governed by and in accordance with the laws of the State of North Carolina. All actions relating in any way to this Contract shall be brought in the General Court of Justice in the County of Macon and the State of North TERMINATION OF AGREEMENT. This Contract may be terminated, without cause, by either party upon ninety (90) days written notice to the other party. This termination period shall begin upon receipt oft the notice of termination. This Contract may be terminated, for cause, by the non-breaching party notifying the breaching party in writing of a substantial failure to perform in accordance with the provisions ofthis Contract and ifthe failure is not corrected within ten (10) days oft the receipt oft the notification. Upon such termination, the parties shall be entitled to such additional rights and: remedies as may be allowed by relevant Termination of this Contract, either with or without cause, shall not form the basis ofa any  8.  Carolina.  9.  law.  claim for loss of anticipated profits by either party.  I0. RECORD KEEPING. The Chamber shall furnish to the County a copy of the Chamber's payroll: for any employees funded by County monies on at least a quarterly basis showing the wages paid to such employees who perform work pursuant to this Contract. Chamber employees' social security numbers shall be confidential in accordance with applicable Funds provided under his Contract shall not be used to pay for employees for work which isc connected with general Camhwrivitsemisisioiaumaiakantlemgenai: Contract. Funds provided under this Contract shall not be used to pay for promotional materials or activities which are connected with general Chamber activities conducted outside the scope  law(s). The hourly rate: shall be made available to the County Manager.  of this Contract.  11. SUCCESSORS AND ASSIGNS. Chamber shall not assign its interest in this Contract without the written consent of County. Chamber has no authority to cnter into contract on  behalfofCounty.  12. COMPLIANCE WITH LAWS. Chamber represents that it is in compliance with all Federal, State, and local laws, regulations or orders, as amended or supplemented. The implementation of this Contract shall be carried out in strict compliance with all Federal,  State, or local laws.  4    13. NOTICES. All notices which may be required by this Contract or any rule ofl law: shall be effective when received by certified mail sent to the following addresses:  COUNTY OF MACON ATTN: County Manager 5West Main St. Franklin, NC 28734  THE FRANKLIN COMMERCE, INC. ATTN: Linda Harbuck 981 Hyatt Road Franklin, NC 28734  AREA CHAMBER OF  14. AUDIT RIGHTS. For all Services being provided hereunder, County shall have the right to inspect, examine, and make copies of all books, accounts, invoices, records and other writings relating to the performance of said Services. Audits shall take place at times and locations mutually agreed upon by both parties. Notwithstanding the foregoing, Chamber must make thei materials tol be audited available within one (1) week oft the request for them. In addition, Chamber shall, at its own expense, cause an annual audit of its financial statements to be performed and provide County with a copy of the annual audit. 15. COUNTY NOT RESPONSIBLE FOR EXPENSES. County shall not be liable to Chamber for any expenses paidorincurred! by Canhucsahemirdn  writing.  16. EQUIPMENT. Chamber shall supply, at its sole expense, all equipment, tools, materials, and/or supplies required to provide Services hereunder, unless otherwise agreed in writing. 17. REPORTS. Chamber shall makes mamualiepisefsihsiatthaln 18. Chamber hereby acknowledges receipt of a copy of, and expressly agrees to the terms and provisions of the Macon County Commissioners' Resolution Amending in Part the Resolution Creating the Franklin-Nantahala Area and The Highlands Area Tourism and  Area Tourism Development Commission.  Development Commissions, which was adopted on. June 11,2019.  19. ENTIRE AGREEMENT. This Contract and the attached documents labeled"Attachment 1"a and "Attachment 2" shall constitute the entire understanding between County and Chamber and: shall supersede all prior understandings and agreements relating to the subject matter hereof and may be amended only by written mutual agreement of the parties. 20. HEADINGS. The: subject headings ofthe sections arei included for purpossofconvenience only and shall not affect the construction or interpretation of any ofi its provisions. This Contract shall be deemed to have been drafted by both parties and noi interpretation shall be INTESTIMONY WHEREOF, the County ofMacon! has caused these presents tol be signed ini its name byi its County Manager, and Chamber, acting under and by virtue oftheauthorityi in them vested, has hereunto set their hand and seal, the day and year first written above.  made to the contrary.  5    COUNTY OFMACON  By:  Derek Roland, County Manager  THE FRANKLIN AREA CHAMBER OF COMMERCE, INC.  By:  Authorized Representative  This instrument has been pre-audited in the manner required by the Local Government and Fiscal  Control Act.  Macon County Finance Officer  6    Attachment 1: Scope of Services:  Provide Space and Staffing for a Visitor Information Center;  Provide maintenance and supplies for a Visitor Center, including parking, public restrooms and  beautification of grounds;  Provide insurance and utilities for visitor center operations; Provide. staff for answering phones and responding to tourism requests;  Provide staff, materials and equipment for preparing and mailing tourism information packages;  Pay staff payroll expenses and insurance;  Maintain a website providing tourism information for Macon County;  Provide staffi for bookkeeping and reporting;  Prepare and distribute advertising and promotional materials and press releases; Maintain a database of local photos for use in advertising and promotion;  Maintain contacts and work cooerativelywithl local and regionalorganizationst toj promote tourism; Develop and coordinate printing and production oft brochures, guides, maps, etc.;  Produce and promote events to attract tourist to Macon County; Provide elecommunications services and equipment; and  Provide office equipment and materials.  7    Attachment 2: Scope of Services:  Provide insurance and utilities for operations;  Provide stafft for answering phones and responding to tourism requests;  Provide staff, materials and equipment for preparing and mailing tourism information packages;  Pay staff payroll expenses and insurance;  Maintain a website providing tourism information for Macon County;  Provide staff for bookkeeping and reporting;  Prepare and distribute advertising and promotional materials and press releases; Maintain a database oflocal photos for use in advertising and promotion;  Maintain contacts and work cooperativelywithl local miramlipistmepons tourism; Develop and coordinate printing and production of brochures, guides, maps, etc.;  Produce and promote events to attract tourist to Macon County; Provide elecommunications services and equipment; and  Provide office equipment and materials.  8    NORTH CAROLINA MACON COUNTY  SERVICE CONTRACT  THIS CONTRACT is made, and entered into this the.  day of July, 2021, by and  between the COUNTY of MACON, a political subdivision of the State of North Carolina, (hereinafter referred to as "County"), and HIGHLANDS AREA CHAMBER OF COMMERCE, INC., a not for profit corporation duly authorized to do business in the State of North Carolina  (herein after referred to as "Chamber").  1.  SCOPE OF SERVICES. Chamber hereby agrees to provide the Travel and Tourism Development services under this Contract within the Highlands Area Travel and Tourism District(s) pursuant to the provisions and specifications identified in Attachment 1" (hereinafter collectively referred to as "Services"). Attachment 1 is hereby incorporated TERM OF CONTRACT. The Term of this Contract for services is from July 1, 2021, through June 30, 2022. This contraçt may be renewed annually upon written agreement by PAYMENT TO CHAMBER. Except as otherwise provided for in this Paragraph #3, Chamber shall receive from County a monthly amount not to exceed the amount of the occupancy tax under S.L. 1985-969 collected by the County from hotels, motels, inns, and similar places known by County to be within The Highlands Travel and Tourism District which consists oft the Flats, Sugarfork, and Highlands Townships ofMacon County, North Carolina, during the preceding month, less administrative expenses of Macon County, as compensation for the provision of Services. However. notwithstanding the foregoing, all occupancy taxes heretofore and hereafter collected by Airbnb and other companies which operate in a similar fashion to Airbnb and which are remitted to Macon County with inadequate information to identify the owner of the property temporarily rented and the Township or address ofthej Py-pparNasamaaspugesE collected shall be used to promote travel and tourism within the following Travel and Tourism Districts in the following percentages, less any administrative fee due the County  herein and made part hereof.  2.  the County and Chamber.  3.  pursuant to applicable law:  A. The Highlands Travel and Tourism District: 71.04%; B. The Nantahala Travel and' Tourism District: 6.22 %; and C. The Franklin Travel and Tourism District: 22.74%.  Page 1of6    The Chamber.ahalireheonlyle. Prcegcofséhopmylnstbwhwsinabue for The Highlands Travel and Tourism District and the same shall be additional compensation for the provision of Services. County agrees to pay Chamber at the rates specified for Services, performed to the satisfaction oft the County, in accordance with this INDEPENDENT CONTRACTOR. County and Chamber agree that Chamber is an independent contractor and shall not represent itself as an agent or employee of County for any purpose in the performance of Chamber's duties under this Contract. Accordingly, Chamber shall be responsible for payment of all federal, state and local taxes as well as applicable business license fees arising out of Chamber'sactivities in accordance with this Contract. For purposes ofthis Contract, taxes shalli include, but not be limited to, Federal and Chamber, as an independent contractor, shall perform the Services required hereunderina professional manner and in accordance with the standards of applicable professional INSURANCE ANDINDEMNITY. Tothe fullest extent permitted byl laws and regulations, Chamber shall indemnify and hold harmless the County and its officials, agents, and employees from and against all claims, damages, losses, and expenses, direct, indirect, or consequential (including but not limited to fees and charges of engineers or architects, attorneys, and other professionals and costs related to court action or arbitration) arising out oforre resulting from Chamber's performance ofthis Contract or the actions oft the Chamber or its officials, or employees under this Contact or under contracts entered into by the Chamberincomnection witht this Contract. Thisindemnification shall survive thet termination Ina addition, Chamber shall comply witht thel North Carolina Workers' Compensation Actand shall provide for the payment of workers' compensation toi its employees in the manner and HEALTH AND SAFETY. Chamber shall be responsible for initiating, maintaining and supervising all safety precautions and programs required by OSHA and all other regulatory NON-DISCKMINATION I IN EMPLOYMENT. Chamber shall not discriminate against any employee or applicant for employment because ofage, sex, race, creed, national origin, ord disability. In the event Chamber is determined by the final order ofa an appropriate agency or court to be in violation ofany non-discrimination provision oft federal, state or local law ort this provision, this Contract may be canceled, terminatedo ors suspended in whole ori in part by County, and Chamber may be declared ineligible for further County contracts.  Contract, and Attachment 1.  4.  State Income, Social Security and Unemployment Insurance taxes.  organizations.  5.  ofthis Contract.  to the extent required by such Act.  6.  agencies while providing Services under this Contract.  7.  Page 2 of6    8.  GOVERNINGLAW. This Contract shall be governed by and in accordance with thel laws of the State of North Carolina. All actions relating in any way to this Contract shall be brought in the General Court of Justice in the County of Macon and the State of North TERMINATION OF AGREEMENT. This Contract may be terminated, without cause, by either party upon ninety (90) days written notice to: the other party. This termination period This Contract may be terminated, for cause, by the non-breaching party notifying the breaching party in writing of a substantial failure to perform in accordance with the provisions of this Contract and if the failure is not corrected within ten (10) days of the receipt of the notification. Upon such termination, the parties shall be entitled to such Termination of this Contract, either with or without cause, shall not form the basis ofany  Carolina.  9.  shall begin upon receipt of the notice oft termination.  additional rights and remedies as may be allowed by relevant law.  claim for loss ofanticipated profits by either party.  10. RECORD KEEPING. The Chamber shall furnish to the County a copy oft the Chamber's payroll for any employees funded by County monies on atl least a quarterly basis showing the wages paid to such employees who perform work pursuant to this Contract. Chamber employees' social security numbers shall be confidential in accordance with applicable Funds provided under his Contract shall not be used to pay for employees for work which isconnected with general Chamber activities conducted outside ofthe scopeofthis Contract. Funds provided under this Contract shall not be used to pay for promotional materials or activities which are connected with general Chamber activities conducted outside the: scope  law(s). The hourly rate shall be made available to the County Manager.  ofthis Contract.  11. SUCCESSORS AND ASSIGNS. Chamber shall not assign its interest in this Contract without the written consent of County. Chamber has no authority to enter into contract on  behalfofCounty.  12. COMPLIANCE WITH LAWS. Chamber represents that it is in compliance with all Federal, State, and local laws, regulations or orders, as amended or supplemented. The implementation oft this Contract shall be carried out in strict compliance with all Federal,  State, or local laws.  13. NOTICES. All notices which may be required by this Contract or any rule ofl law shall be  effective when received by certified mail sent to the following addresses:  Page 3 of6    COUNTY OF MACON ATTN: County Manager 5 West Main St. Franklin, NC28734  HIGHLANDS AREACHAMBER OF COMMERCE  ATTN: Kaye McHan P.O. Box 62 Highlands, NC28741  14. AUDIT RIGHTS. For all Services being provided hereunder, County shall have the right to inspect, examine, and make copies of all books, accounts, invoices, records and other writings relating to the performance of said Services. Audits shall take place at times and locations mutually agreed upon by both parties. Notwithstanding the foregoing, Chamber musti make thei materials tol be audited available within one( (I)weekofthe request for them. In addition, Chamber shall, at its own expense, cause an annual audit of its financial statements to be performed and provide County with a copy oft the annual audit. 15. COUNTY NOT RESPONSIBLE FOR EXPENSES. County shall not be liable to Chamber for any expenses paid or incurred by Chamber, unless otherwise agreed in  writing.  16. EQUIPMENT. Chamber shall supply, at its sole expense, all equipment, tools, materials, and/or supplies required to provide Services hereunder, unless otherwise agreed in writing. 17. REPORTS. Chamber shall make semi-annual reports of activities to the Highlands Area 18. Chamber hereby acknowledges receipt ofa copy of, and expressly agrees to the terms and provisions of the Macon County Commissioners' Resolution Amending in Part the Resolution Creating the Franklin-Nantahala Area and The Highlands Area Tourism and  Tourism Development Commission.  Development Commissions which was adopted on. June 11, 2019.  19. ENTIRE AGREEMENT. This Contract and the attached document labeled "Attachment 1"s shall constitute the entire understanding between County and Chamber and shall supersede all prior understandings and agreements relating lo the subject matter hereof and  may be amended only by written mutual agreement of the parties.  20. HEADINGS. Thesubjectheadings ofthe: sections arei included: for purposes ofconvenience only and shall not affect the construction or interpretation of any of its provisions. This Contract shall be deemed to have been drafted by both parties and noi interpretation shall be  made to the contrary.  IN TESTIMONY WHEREOF, the County of Macon has caused these presents to be signed in its name by its County Manager, and Chamber, acting under and by virtue oft the authority in them vested, has hereunto set their hand and seal, the day and year first written above.  Page 4 of6    COUNTY OF MACON  By:  Derek Roland, County Manager  HIGHLANDS AREA CHAMBER OF COMMERCE, INC.  By:  Authorized Representative  This instrument has been pre-audited in the manner required by the Local Government and Fiscal  Control Act.  Macon County Finance Officer  Page 5of6    ATTACHMENTI SCOPE OF SERVICES  The purpose of this Contract is to set forth the rights, obligations and responsibilities of the Highlands Area ChamberofCommerce to perform the functions oftravel and tourism development for the County on a contract basis. The Chamber's extensive knowledge of the Highlands area community: andi its strongrelationships with business, political, government and educational leaders allows the chamber to effectively serve the County's needs. To assist with the promotion and expansionoftravel and tourism tol Macon County, the Chamber shallj provide the following services  int the Highlands Area Travel and Tourism District(s):  1. Major Responsibilities:  A. Visitor Center Operators B. Tourism and Travel Promotion C. Marketing D.Communications Reporting:  2.  The Chamber shall furnish the County Manager or his designee the following periodic reports, including an accounting for the expenditures of County funds pertaining to the Services undertaken pursuant to this Contract, the costs and obligations incurred or to be incurred in connection therewith, and any other matters covered by this Agreement. A. Communication from the Chamberon; progresst to targeted travel and tourism sectors as requested by the County and/or the TDC, in such form as the parties may agree. B. As semi-annual report presented to the TDC each. January and July.  Additionally, the Chamber shall provide:  Page 6of6    RESOLUTION. ACCEPTING AMERICAN RESCUE PLAN ACT (ARPA)FUNDS  WHEREAS, Macon County is eligible to receive funding from the Coronavirus Stateand Local Fiscal Recovery Funds ofH.R. 1319. American Rescue Plan Act of2021 (CSLRF) directly from the US Treasury Department currently estimated in the total amount of$6,964,996, and has applied for and already received the first tranche ofs said funds in the: amount of $3,482,498; and WHEREAS, all funding received under the CSLRF must be accounted fori in a separate fund andi not co-mingled with otherr revenue for accounting purposes, and must also be spent only for certain purposes specifically authorized by the CSLRF (including applicable regulations and guidance ofthe UST Treasury Department), and also in compliance with the laws and applicable regulations oft the WHEREAS, in accordance with the foregoing, Macon County must comply with all applicable budgeting, accounting, contracting, reporting, and other compliance requirements for all CSLRF WHEREAS, the Board of Commissioners is required to take formal action through the passage of this Resolution to formally approve the application for and formally accept the CSLRF: funds. NOW,T THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Macon County as 1. That the County Manager and County Finance Officerare designated and directed to take all actions deemed reasonably: necessary on behalf ofthe Board of Commissioners to apply for, receive, and administer the CSLRF funds in accordance with all applicable federal and state laws,  State of North Carolina; and  funds; and  follows:  regulations, and guidance; ;and  2. That the previously submitted application for eligible CSLRF funding submitted by the County Manager and County Finance Officer on behalfofMacon County is hereby ratified and approved; 3. That all such CSLRF funding for which Macon County is eligible which has been or willl be distributed by the US Treasury Department and which is received by Macon County is hereby accepted subject to all applicable federal and: statel laws, regulations, and guidance.  and  Adopted this 13th day of] July 2021.  James P.Tate, Chairman Macon County Board of Commissioners  ATTEST:  Clerk tot the Board (COUNTY SEAL)    MACON COUNTY, NORTH CAROLINA GRANT PROJECT ORDINANCE AMENDMENT  WEATHERIZATION ASSISTANCE PROGRAM FY: 2021 (#8217) BE IT ORDAINED by the Macon County Board of Commissioners, Macon County, North Carolina, that, pursuant to Section 13.2 of Chapter 159 oft the General Statutes of North Carolina, SECTION 1. The project authorized is a Weatherization Assistance Program and a Heating and Air Repair and Replacement Program administered through the NC Department of SECTION2. The officers of this unit are hereby directed to proceed with the grant project within the requirements of N.C.G.S. 159-26. and the budget contained herein. SECTION: 3. The following amounts are appropriated for the project:  the following grant project ordinance is hereby amended:  Environmental Quality.  Weatherization Services DOE Weatherization Services DHHS HARRP Services DHHS Total  $184,937 49,325 27,034 $261,296  SECTION4. The following revenues are anticipated tob be available to complete the  project:  DOE WXI Funds DHHS LIHEAP WX Funds DHHS HARRP Funds Total  $184,937 49,325 27,034 $261,296  SECTION5. The Finance Director is hereby directed to maintain within the grant project fund sufficient specific detailed accounting records to satisfy the requirements of N.C.G.S. SECTION6. Copies of this grant project ordinance shall be furnished to the County  159-26.  Manager and the Finance Director for direction in carrying out this project.  ADOPTED this 13th day of July 2021.  James P. Tate, Chairman Board of Commissioners    MACON COUNTY, NORTH CAROLINA GRANT PROJECT ORDINANCE AMENDMENT  WEATHERIZATION ASSISTANCE PROGRAM FY2022  BE IT ORDAINED by the Macon County Board of Commissioners, Macon County, North Carolina, that, pursuant to Section 13.2 of Chapter 159 of the General Statutes of North Carolina, SECTION 1. The project authorized is a Weatherization Assistance Program and a Heating and Air Repair and Replacement Program administered through the NC Department of SECTION2. The officers of this unit are hereby directed to, proceed with the grant project within the requirements of N.C.G.S. 159-26 and the budget contained herein. SECTION3. The following amounts are: appropriated for the project:  the following grant project ordinance is hereby amended:  Environmental Quality.  Weatherization Services DOE Weatherization Services DHHS HARRP Services DHHS Total  $ 0 98,887 33,402 $132,289  SECTION4. The following revenues are anticipated to be available to complete the  project:  DOE WXI Funds DHHS LIHEAP WXI Funds DHHS HARRP Funds Total  $ 0 98,887 33,402 $132,289  SECTION: 5. The Finance Director is hereby directed to maintain within the grant project fund sufficient specific detailed accounting records to satisfy the requirements of N.C.G.S. SECTIONE 6. Copies of this grant project ordinance shall be furnished to the County  159-26.  Manager and the Finance Director for direction in carrying out this project.  ADOPTED this 13th day of. July 2021.  James P. Tate, Chairman Board of Commissioners        MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  CATEGORY - APPOINTMENTS  MEETING DATE: July 13, 2021  13A.  Library Board: Per Fontana Regional Library Director Karen  Wallace, the term of Wood Lovell on the Macon County Library Board of Trustees will expire this month, and Mr. Lovell has agreed to serve another term. Additionally, the term of Bill Trotter on the library board will expire next month, and Mr. Trotter has agreed to serve another term. Per Ms.  Wallace, both represent the Highlands community.