Approved Minutes of January 21, 2026

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MINUTES ORANGE COUNTY BOARD OF HEALTH January 21, 2026 arrived in Orange County since April 2025, and there has been a reduction in reimbursement rates to provide refugee health services as well as in funding available to support refugees. In response to Dr. Jonnal, Ms. Ekenna explained that this is because the current Federal administration is restricting refugee immigration at the national level. Dr. Royce asked what this might mean for the Health Department's funding for refugee health services, and Ms. Stewart explained that if the state allocated funds are not being used, then the state will likely reduce the allocation provided in future years, affecting the overall health department budget. • The Orange County Health Department assists refugees with their 1-693 applications to receive permanent residency. In 2025, they assisted 49 refugees with residency applications. Ms. Ekenna also provided a correction to a typo on her slides — in 2025, they assisted eight refugees from Venezuela and four from Iran with 1-693 applications. C. 2nd Quarter Financial Report and Billing Dashboard Frederick Perschau, Financial and Administrative Services Division Director, presented the 2nd Quarter Financial Report and Billing Dashboard. Some highlights of his presentation are below: • There have been many improvements to the clinics over the past six months, including refinished floors, more comfortable chairs, and new windows. The hope is for patients to have a better experience and to feel more cared for. In response to Mr. Whitaker's question, Ms. Stewart explained that some of the improvements were covered by countywide capital improvement funds, and some were covered by Medicaid cost settlement funds, which can only be spent in support of the program in which they were generated. Mr. Perschau added that, due to having multiple clinics and/or mobile units, the Health Department has been able to make improvements while still offering services. • Due to some lag in service revenue, current earnings are at 35% rather than the 50% expected at the midpoint of the fiscal year. By division, Environmental Health's service revenue is about even with last fiscal year, Dental Health's revenue is evening out after the challenges caused by last year's data breach, Community Health has higher service revenue compared to last year, and Personal Health's service revenue is in a bit of a deficit owing to challenges related to clinic renovations and major staffing turnovers. Dr. Royce asked if there have been no-shows related to fears of immigration enforcement and whether that might be a factor in the Personal Health deficit. Dr. Pettigrew explained that this was more of a concern in the few weeks when Immigration and Customs Enforcement (ICE) was more active in the area, but that during that period Health Department staff were very proactive about reaching out to patients and rescheduling or switching to telehealth, so there was not a meaningful increase in no-show appointments. Ms. Stewart added that there have been multiple factors in play around the Personal Health Services deficit, including clinic renovations, a provider going out on Family Medical Leave Act (FMLA) leave, and several significant staff members leaving. • It is budget season, with the proposed budget presentation forthcoming at the February BOH meeting, and the hope is to keep the fiscal year 2026-2027 budget `flat', or about the same as the budget for fiscal year 2025-2026. • Mr. Perschau also introduced the proposed changes to the delinquent accounts policy, which would increase the amount of time before a delinquent account is considered uncollectible from 12 to 24 months, as well as increasing the frequency of sending delinquent accounts to debt set off(state collection agencies) to twice rather than once a year. Because there was not a quorum present, the Board was not able to consider and vote on this policy change at this meeting. S:\Managers Working Files\BOH\Agendas &Abstracts\2026 Agenda and Abstracts\ January Page 5