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Board hears preliminary 2026 budget; federal grant cuts reduce some public-health funding
Summary
Fargo Cass Public Health presented a preliminary 2026 budget projection and flagged several abrupt federal grant reductions, including the immunization boosting grant and portions of COVID-era funding. Staff described revenue offsets and a workforce grant that may cover some shortfalls.
Fargo Cass Public Health staff briefed the Board of Health on preliminary budget figures for fiscal 2026 at the April 4 meeting and described several recently announced federal grant cutbacks that are already affecting planned programs.
The finance presentation outlined both revenue changes and program impacts. Environmental Health realized about $110,000 last year by adding a flat-rate processing fee; nursing services reported about $110,000 for five months from a changed CPT billing code and estimated roughly $300,000 if that coding is used for a full year. Staff also noted capital requests in the $15,000 range for clinic equipment such as an exam table and colposcope.
On the reductions side, staff said the federal immunization boosting grant — described in the presentation as roughly $104,000 in local funding — was stopped effective immediately by the federal grantor. Officials also reported that funds from epidemiology-and-lab COVID-era grants, community health worker COVID-response monies, and other block grants were reduced or reclaimed. The state opioid response (SOR) grant was noted as reduced by about 10 percent, a loss Melissa Perilla quantified at roughly $29,000.
Jen Pfahl and Melissa Perilla said the department is seeking offsets. Those include continued pursuit of billing (CPT) opportunities with insurers, using a public-health workforce grant for temporary continuation of services, and internal reallocations. The department also highlighted an internal pool of temporary/seasonal staffing dollars (presented in the packet at about $1,600,000) that program directors use to hire flexible staff; leaders said many current long-term temporary positions have been requested to be converted to full-time roles to improve stability and retention.
Why it matters: Several announced grant stoppages took effect with little lead time, staff said, creating near-term uncertainty about program support for immunizations, lab capacity, and workforce activities. The department is coordinating with state and national public-health associations to track cuts and advocate for replacement funding.
Follow-up and governance: Staff will return with firmer numbers at the July 11 board meeting and will meet privately with finance and commission staff in May and June to finalize the city submission. The board discussed the desirability of converting long-term temporary positions to FTEs and asked staff to continue reporting on staffing, overtime and program impacts.
Ending: Officials said they are continuing grant-writing and insurer-billing work in hopes of offsetting lost federal dollars and preserving core services.
