Orange County Board of Health approves $10.73 million budget request and countywide fee changes

The Orange County Board of Health voted Feb. 25 to approve and forward a $10,734,044 budget request for fiscal year 2026-27 and a set of proposed fee changes to the Board of County Commissioners.

Frederick Perschau, the countys Financial and Administrative Services Director, told the board the request is based on "the net of the total authorized expenditures minus the service revenue," and reviewed FY25-26 figures that totaled about $10.1 million after accounting for $14.35 million in authorized expenditures and $4.193 million in service revenue. He said projected personnel costs for the health department total about $13.1 million, a figure separate from the departments requested operating budget.

"The goal for this years Health Department budget is to remain 'flat' — that is, to minimize any new expenditures without corresponding new revenue," Perschau said. He described an upcoming outside operational audit and noted available funds in a Medicaid cost-settlement account totaling about $11.3 million across divisions, with roughly $529,000 in interest revenue to date.

Commissioner Earl McKee told the board the county faces a $18 million shortfall and that he expects further cuts may be necessary during the BOCC budget process. At the meeting, McKee said he planned to advocate for the departments needs and asked board members to do the same.

Board members voted to approve the departments total budget request. Dr. Alison Stuebe moved the motion and Dr. Lee Pickett seconded; the motion carried without dissent. Dr. Lee Pickett then moved to approve all FY26-27 fee changes and Dr. Aparna Jonnal seconded; that motion also carried without dissent. Both approvals will be forwarded to the Board of County Commissioners for final action.

The board and staff discussed budget assumptions tied to a not-yet-passed state budget, the countys planned standardization of fees, and a March timeline for departmental follow-up to identify mandated services versus items that could be reduced if countywide cuts proceed. Perschau and staff emphasized that certain costs, such as building renovations, are paid from other county funds, while equipment replacements and many program expenses come from the departments operating budget.

The board also heard that Local Workforce Development funds (similar in purpose to ARPA dollars) have been used for training and consulting, and may be available to support workforce development without increasing county-funded expenses. The board asked staff to prepare additional information about mandated functions and potential cuts to feed into the countys broader budget deliberations.

The Board of Health will forward the approved request and fee schedule to the county manager and the Board of County Commissioners, which will formally adopt the county budget in June.