Approved Minutes of February 26, 2025

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MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2025 "billing providers" and others are not, and revenue estimations are partially generated by the Epic system. Ms. Stewart added that the proposed revenue generation figures for the Interpreter role factor in the cost savings for not using outside contractors. Mr. Perschau noted that the revenue generation estimate for the Family Planning Nurse could be revisited, as it looks low in comparison. Dr. Baldwin asked why the Certified Medical Assistant positions have such high estimated revenue generation, to which Mr. Perschau explained that they each permit an additional 2-4 visits per day due to the amount of work they save advanced practitioners. Mr. Perschau added that the health department requested a Mobile Dental Clinic Coordinator position last year, but it was not approved — however, now there is more evidence of how impactful such a position would be and how much it would help with clinic maintenance and event coordination. Dr. Nickelson asked if the mobile clinic has its own providers, and Caroline Shumaker, Dental Office Manager, said that the mobile clinic is staffed by regular dental clinic staff. Dr. Nickelson suggested applying for another dentist in the future. • Mr. Whitaker applauded the deep view of the budget process and noted the need for the Board of Health to be mindful of budget limitations, especially for ideas that are more long-term and may need sustained funding. He asked how much reallocation can happen due to unexpected expenses, to which Ms. Stewart replied that there is some funding allocated for Board of Health projects and that they can also lean into the Finance and Administrative Services division to cushion unexpected costs. Mr. Whitaker observed that the board needs to be proactive about creating and giving feedback on the budget. • In response to Dr. Stuebe's question about Federal cuts to Medicaid, Ms. Stewart explained that we haven't seen any yet, but that there may be some effects next year. Ms. Stewart clarified that these effects would be related to how much revenue the health department receives from Medicaid reimbursement. • Dr. Royce asked why the county had asked the health department to increase their Medicaid settlement contribution, to which Commissioner Fowler replied that it is a tight budget year. Ms. Stewart added that the health department had some savings intended for a future capital improvement project but were asked to use these savings to help support ongoing operations due to tight budget times. • Mr. Perschau reviewed the revenue by each division: Dental Health Services had no net change; Community Health Services had a $10K net increase in revenue due to a new Formerly Incarcerated Transitions (FIT) program grant; Environmental Health Services had a $63K net increase in revenue owing primarily to increased state funding and service fee changes; Personal Health Services had a $121 K net increase in expenses due to increased demand for language services and labs as well as an end to COVID funds; and Finance and Administrative Services had a $6K net increase in expenses due to an upcoming HIPAA audit. • Proposed Fee Changes for the 2025-2026 fiscal year include: Environmental Health Services is adding a fee and deleting a fee; Dental Health Services is in their second year of benchmark fee increases to bring their costs in alignment with national standards; and Personal Health Services has 462 new fees, 9 fee changes, 165 fee increases, and 72 fee deletions. • Commissioner Fowler asked if the overall budget request has decreased from last year, to which Ms. Stewart replied yes, because of some vacant positions and turnover. Dr. Stuebe asked about the amount of the overall county budget, to which Commissioner Fowler replied it is a couple hundred million dollars. Dr. Stuebe noted that this helps keep the health department budget of$9M in perspective. Dr. Rodgers added that the health department also generates revenue, allowing for a smaller budget request. S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts/ February Page 6