Item:
Title
Approve the Department of Public Health (DPH) to Administratively Write-Off $996,162.75 in Uncollectible Debt from Two Electronic Health Records (EHR) Systems No Longer in Use
Body
Date of BOCC Meeting: June 23, 2025
Request for Board Action:
Agenda Text
The Board is requested to approve the Department of Public Health (DPH) to administratively write-off $996,162.75 in uncollectible debt from two electronic health records (EHR) systems no longer in use.
DPH previously operated two legacy EHR platforms: Patagonia for medical records (2013-2021) and Dentrix for dental records (2009-2021). Both systems have been replaced by EPIC, which now serves all medical and dental clinic operations.
DPH has undertaken extensive efforts to recover these debts over the years, including mailing statements and payment notices to last known addresses, resulting in high return rates due to outdated contact information. Conducting phone outreach campaigns using available phone numbers, with most calls reaching disconnected or incorrect numbers. Sending final demand notices before initiating write-off procedures. These efforts have been largely unsuccessful due to the age of the accounts (some dating back over 15 years) and significant patient mobility, particularly among the uninsured and underinsured populations typically served by the public health department.
Maintaining these obsolete systems cost DPH $55,810 in FY25 alone, with expenses increasing annually. Recovery efforts have proven ineffective, yielding only $1,448.51 (0.02% of total debt) from the Patagonia system in 2024. The cost of continued collection efforts now exceeds potential recovery amounts. The requested write-off amount is not reflected in DPH's current budget projections as anticipated revenue, given the age and uncollectible nature of these accounts.
DPH will concentrate debt recovery efforts on the current EPIC system, utilizing modern tools including MyChart patient portal, structured payment plans, and the North Carolina Debt Setoff program. The Board of Health has approved this request.
Alignment with Strategic Plan: This item aligns with Durham County Strategic Goal: Healthy and Inclusive Community.
Resource Persons: Rodney Jenkins, DrPH, MHA, Public Health Director
County Manager’s Recommendation: The County Manager recommends that the Board approve the Department of Public Health (DPH) to administratively write-off $996,162.75 in uncollectible debt from two electronic health records (EHR) systems no longer in use.
Signature
County Manager: ____________________________