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• Expenditures in this chart include Aid to County Funds (Aid), Environmental Health (EH) <br />and Categorical (Cat) funds. It does not include outside funded grant programs such as <br />the Smart Start grants (except for the local portion) and direct federal grants (Medical <br />Reserve Corps). It does include the public health preparedness funds. <br />• Categorical funds can generally be thought of as "program" funds that are in service <br />categories such as family planning, women and children's health, communicable <br />disease, etc. <br />• Local funds include receipts from fees, Medicaid and other third party reimbursement <br />sources and any county general funds. <br />• Orange County ranks the lowest in state and federal funds allocations. One historic <br />reason for this is the Women's, Children and Infants (WIC) nutrition program. It is <br />offered by all health departments except for Orange, Chatham, and Person counties. <br />Piedmont Health Services, Inc. applied for and received the contract for services in <br />these counties in the early 90's. <br />• The county ranks 61St in per capita local funding. <br />• The chart shows that in overall funding for public health services, Orange County ranks <br />74 among the 85 health departments that reported data for this report. <br />• The Statewide average per capita funding was $59.45 and Orange County's per capita <br />funding was $37.97. <br />Commissioner Jacobs referred to the Local Health Department Expenditures -Selected <br />County Comparison chart in their agenda packet and said one of the things that occurred to him <br />as he looked at the chart was the education spending for the same counties listed on the chart. <br />Orange County spends $354 more per capita than Alamance County, $359 more than <br />Davidson, $434 more than Harnett, $324 more than Pitt, $187 more than New Hanover, $446 <br />more than Robeson, $303 more than Rowan, and $404 more than Wayne. He said that schools <br />are a huge constraint, because half of the budget goes to education in Orange County. This <br />affects the flexibility for other services. He said that the Board needs to show the Health <br />Department what the County's restraints really are. He said that the numbers are useful and <br />sobering, but there has been a choice as a County for how to spend the budget. <br />Timothy Carey said that the demographics trends are not going away and planning <br />should start now rather than later, when they cannot meet core services, because they would be <br />broke. <br />Christina Harlan said that she does not want to compete with the schools or other <br />services. She also does not want to blame immigrants. She said that Orange County has one <br />of the widest splits in income of any county in the United States. She said that nobody could <br />have quality of life if the community has terrible diversity issues. <br />Chair Carey said that these are good points and the comments from Board of County <br />Commissioners are just the facts. At first glance, he is depressed at the figures from the BOH, <br />but they have to be put into context. He asked the Board of Health to keep this in mind and <br />convey the need to voters about the referendum for the local option revenue source. <br />With no further items to discuss, the meeting was adjourned at 7:15 p.m. <br />Moses Carey, Jr., Chair <br />Donna S. Baker, CMC <br />Clerk to the Board <br />