Approved Minutes of September 20, 2023

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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH September 20, 2023 Dr. Crandell requested clarification of the 20% variance in option 2, asking whether it applied quarterly and was based on projections, which Mr. Perschau explained would apply across the year based on annual and quarterly projections. Commissioner Bedford expressed that she prefers option 3, as she would be concerned that the board wouldn't be performing their fiduciary duty if they weren't regularly reviewing the financial statements. Mr. Whitaker also liked option 3, as he would prefer to have a budget report in front of him at least quarterly, ideally with a summary flagging any discrepancies or aberrations. Dr. Baldwin asked if the variance caveat from option 2 should be added to option 3. Ms. Stewart clarified that it was only included in option 2, and Commissioner Bedford suggested merging options 2 and 3 so the board receives quarterly reports, but any concerning or odd trends are still flagged and brought to the board. This idea was later echoed when Dr. Jonnal asked Mr. Perschau which option he preferred and if he felt there was anything missing from the options. Mr. Perschau said that he felt quarterly reports are the best practice, so he preferred option 3, but that he also liked the idea of having a system to flag aberrations. Dr. Jonnal then suggested merging all options, adding an option to report to the board 'at the discretion of the department' if something seemed off. Mr. Bagby expressed discomfort with the 20% variance from option 2, as he felt it seemed arbitrary and that such a variance might occur naturally, for example if the government was late to send a reimbursement to the health department between fiscal periods. He said he'd rather not spend time addressing the budget if there wasn't genuine cause for concern. Dr. Crandell asked how the health department might account for a large, unexpected expense, giving the examples of medical equipment breaking or the COVID-19 pandemic. Ms. Stewart replied that during the pandemic the impact to the budget was referenced frequently during board meetings, even outside of budget presentations. She also expressed that another similar catastrophic expense seemed unlikely—for example, the clinic's medical equipment is covered outside the budget—and the board would be notified almost immediately if something serious happened. Based on the discussion, Dr. Jonnal summarized that the board wished to have the budget presentation twice per year, with quarterly reports available and the option to discuss or have the information reported in the case of exceptional items. Ms. Stewart confirmed that the board agreed to move forward with option 3, adding a caveat that exceptional items in the budget could be brought before the board as needed at the discretion of the financial department. Motion to approve the Board of Health Policy Changes was made by Dr. Bruce Baldwin, seconded by Dr. Alison Stuebe, and carried without dissent. The adopted changes are as follows: 1.0 Mission Statement and Scope of Services • Replaced old mission Statement with new one adopted at the April 26,2023 meeting. • Added the new Vision Statement to the policy. I.A. - Requests for Environmental Services and Assessments • No Changes I.B. - Fee and Eligibility Policy S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ September Page 3