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61 Commissioner Gustaveson asked what would be the consequences to the other counties should Orange County withdraw from the district in regard to the on-going programs. Mr. Johnson replied that the only effect he could speak to would 'be the effect of cost. He added that the Counties could assume that the administrative, cost would increase. Mr. Gustaveson asked if Mr. Johnson knew of other counties who were not part of a district, but had joint programs to provide professional services through an inter-local agreement. Mr. Johnson stated he know of services being provided only in the administrative area. Commissioner Gustaveson inquired if Mr. Johnson had any experience of negative impact to other counties in terms of programs. Mr. Johnson stated that there would be little ar no effect, except the fact that since Orange County had the Medical Center located here, it could be more difficult for other counties within the district to obtain the special medical expertise, since the Medical School would no longer be within their district. This is a concern particularly within the Prenatal Program. Chairman Whitted summarized Mr. Johnson's presentation. He stated that from what he had heard, should the district split, there would nd~. be any serious curtailment of programs provided by the State in the District. The increase cost would be in administrative cast of personnel. Commissioner Pinney asked if it was not true that there was a cost saving by use of district personnel. Mr. Johnson replied, "yes". Chairman Whitted asked Dr. Fuller the number of personnel that is shared by more than one county within the district. Dr. Fuller stated there was a nurse supervisor, an assistant supervisor, a sanitarian and health director, two secretaries, one physical therapist, one health educator, a dental hygienist and a dentist. . Mr. Johnson stated that additional concerns were should Orange County withdraw from the district, it could possible result in further split of other counties from the district and a further split would cause severe proglems, since the other counties were small. Another concern was the existing personnel. Some serve the entire district and some work only for Orange County. He added that if Orange County withdrew there would be a suzplus of employees within the District Health Department. These employees are those working for the district within Orange County. He suggested that the Orange County Board of Commis- sioners go on record stating that employees would be rehired to work for the Orange County Health Department. He stated that the reasons the Orange County Commissioners had stated for desiring to withdraw were somewhat obscure. He urged the Board to be as specific as possible in identifying the problems and to be logical in seeking a solution. Chairman Whitted read a resolution from the Chatham County Board of Commissioners expressing the desire that the five county health district remain as it is presently constructed. Representatives from Lee and Person Counties stated that their Boards - of Commissioners concurred with the resolution presented from Chatham County. Jack Woods, a Commissioner from Caswell County stated that Caswell County had some question of the possibility of Caswell County joining with Region G for health services. The Orange County Finance Director reviewed with the Board a financial feasibility report of the County's withdrawing from the Health District. He stated that it appears that it would cost Orange County approximately $-80,000 additional dollars over and aboard what is being allocated now to fund a health department similar to what the County is now receiving and with additional administrative staff. He added that if Orange County chose to remain in the district, and to work to strengthen the present arrange- ment, the cost would be approximately $42,OOD to pay for programs the County had stated they desired.