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Santa Barbara County details clinic and pharmacy cuts as state policy shifts squeeze budget
Summary
County leaders told supervisors April 13 that changes to state Medicaid/realignment (HR1) and falling intergovernmental revenue require reductions across health and social services, including consolidating three county pharmacies into one and trimming specialty clinic hours while preserving core primary care.
Santa Barbara County supervisors heard a detailed budget briefing April 13 laying out proposed cuts across health and human services driven by state and federal funding changes. County health leaders said the board must choose between deeper service reductions or using limited discretionary reserves to soften the impact.
Dr. Hamami, the county health director, told the board that the health department’s operating budget will face a substantial shortfall in FY 2026–27 after state policy changes reduce clinic reimbursements and other intergovernmental revenues. To mitigate an anticipated deficit, the department proposes consolidating its three pharmacies into a single central location (estimated savings of about $8.5 million) and trimming specialty services that are the largest drivers of operating losses. The plan would reduce clinic operating costs by roughly $13.2 million overall, the director said.
Katrina Fernández, principal budget analyst, framed the broader functional-group picture: the health and human services cluster represents roughly 35% of the county’s operating expenditures and a significant share of full-time staff, and it has absorbed recurring reductions to federal and state funding. Fernández warned that some of the revenue declines reflect permanent state realignment changes and that staff were trying to preserve primary care access while reducing higher-cost specialty services.
During Q&A supervisors probed the county’s reserve and maintenance policies and asked staff to clarify which cuts are operational versus those that would reduce essential services. Officials emphasized that no clinics will close fully under the current proposal, but several specialty services would be reduced and some positions would be eliminated or left vacant. Supervisors and public speakers repeatedly urged the board to prioritize restorations for child welfare and safety-net programs if one-time funds are available.
Public commenters—including union representatives and community health advocates—warned that reduced specialty services and pharmacy access will shift demand to emergency departments and worsen health outcomes for low-income residents. Several speakers asked the board to preserve funding for clinics, restore child-protection positions and delay permanent layoffs while the county pursues state advocacy and maximizes Medi‑Cal revenue.
Board members directed staff to return with more precise maintenance‑fund accounting, clarifying which reductions would be temporary, and to bring back additional options on Friday and at subsequent meetings. The board did not take formal votes on the proposals on April 13; workshops will continue later in the week.
