Approved Minutes of February 25, 2026

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MINUTES ORANGE COUNTY BOARD OF HEALTH February 25, 2026 • The Orange County Government is working to standardize fees countywide, and all fees are ultimately approved by the BOCC. Mr. Perschau reminded the Board that it is the final year of the Dental Divisions stepwise fee increases, after which the fees should be in line with national standards. • Mr. Perschau clarified that the budget request is based on the net of the total authorized expenditures minus the service revenue. For FY25-26, this worked out to be about $10.1 M, with $14.35M in authorized expenditures and $4.193M in revenue streams. • Mr. Perschau reviewed the timeline for the annual budget process and reminded the Board that the FY26-27 budget will be formally adopted by the BOCC in June. • Because of ongoing budget cuts and uncertainty, the goal for this year's Health Department budget is to remain "flat"—that is, to minimize any new expenditures without corresponding new revenue. Mr. Perschau clarified that personnel and capital expenditures are considered separate processes to the main budget process. • At Mr. Whitaker's request, Mr. Perschau shared several assumptions that are relevant to the budget request, including an ongoing lack of a state budget and projected service revenue amounts for FY26-27. • Mr. Perschau highlighted the Public Health Infrastructure Local Workforce Development funding and said that it is similar to American Rescue Plan act (ARPA) funding in that it can be used for workforce development such as training, consulting, and conferences without needing county funds. Ms. Stewart shared that Local Workforce Development funds were used to pay for consulting services from the Carden Group last year. • Mr. Perschau shared that the Health Department is working with a team of consulting graduate students to improve the clinic's front desk and billing operations, as well as that Travis Myren, County Manager, has tapped the Orange County Health Department for an audit to assess staffing needs and operational efficiency. This audit will consist of an outside vendor coming in to examine staffing needs, scheduling, and operations to ensure staffing is adequate based on service levels. Ms. Stewart explained that the county government is trying to audit one department per year, with last year being focused on the Sheriff's Office. In response to Dr. Jonnal's question, Erica Pettigrew, Medical Director, commented that she is feeling hopeful that the results of the audit will be positive. • There has been a net operating expense decrease of$47,465 due to operational optimization and increased efficiency, leading to an overall net operating decrease of $8K. In response to Dr. Crandell's question, Kim Quatrone, Business Officer II, said that the projected personnel cost of the Health Department for FY26-27 is $13.1 M, which is higher than the total budget request (which excludes personnel costs. • Mr. Perschau reviewed the Medicaid Cost Settlement process, in which previously provided Medicaid services are partially reimbursed by the state, and reminded the Board that any funds received in the Cost Settlement process must be used in the program in which they were originally generated. There is currently a fund with a balance of$11.31M across all divisions, and this fund has so far generated $529K in interest revenue. In response to Commissioner McKee's question, Ms. Stewart explained that the interest revenue account is new and is not yet earmarked for anything specifically but that it still must be used to support the program where the funds were originally generated. She added that the Health Department is prepared to use some of these funds to help cover shortfall expenses where possible or to support additional positions if it is determined in the upcoming audit that these are needed. Ms. Quatrone added that a certain amount of funding must be allotted to certain programs to meet requirements to receive state funding, and Commissioner McKee expressed concern that the state funds may not come through regardless. S:\Managers Working Files\BOH\Agendas &Abstracts\2026 Agenda and Abstracts\ February Page 4