The Santa Barbara County Health Department will restore 15 positions after laying off dozens of employees due to budget cuts.
On Tuesday, the Board of Supervisors unanimously approved a revised budget for the Health Department after the state delayed changes to Medi-Cal reimbursements that would have resulted in less revenue for the department.
Health Director Mouhanad Hammami told the board that the state will delay Medi-Cal changes that would have affected patients with so-called unsatisfactory immigration status.
The new changes would have moved these patients from managed care to charging them a fee for individual services beginning this year.
Instead, the state’s adopted budget will extend the higher Prospective Payment System reimbursement rate for those patients for at least one more year, and the county will have $6.6 million more in revenues than it expected.
“It will allow us to restore 15 positions, specifically in the clinics, in order to increase productivity and get us to the new ratio that we are working on,” Hammami said. “Specifically in redesigning some of the workflows. So, it is welcome news.”
The restored roles include seven staff nurses, two administrative office professionals, two financial office professionals, two medical assistants, one health education assistant, and one pharmacy technician.
Hammami added that the renewed funding will allow the department to rely less on its fund balance and prepare for rainy days.
Hammami explained to the board that there is still a chance the lower Medi-Cal reimbursement rates will go into effect next year. The department will again see lower revenue next year if that happens.
“It’s going to buy us a year,” Hammami said. “Next year, if the budget goes, then that 6.6 million is going to be gone. So, we’re hoping that within this time frame, we are going to increase our efficiency and increase our productivity.”
Heading into the current fiscal year, which started July 1, the county was preparing for a leaner budget due to cuts at the state and federal level.
The Board of Supervisors approved a budget of $1.66 billion in June, which is 1.7% lower than last year’s total budget.
The county directed department heads to prepare for the smaller budget by reducing services and eliminating vacant positions. The county ended up eliminating 299.2 positions, which were mainly positions that had not been filled.
The county announced that it anticipated laying off 77 employees earlier this year, but that number was ultimately reduced to 51 employees.
County officials were able to lower the number of layoffs by moving employees into new roles. Some employees also chose to retire.
Now that County Health will be restoring 15 positions, the total number of people laid off has been reduced to 36.
As part of its efforts to reduce costs, the department announced it would eliminate blood drawing, select specialist services and some pharmacy services.
Many of these services would be moved over to outside providers.
During his budget presentation in June, Hammami said moving services to outside providers would give patients more consistent hours since they are open more days of the week and have longer business hours.
Hammami said the county only provided these services for a few hours a month.
He also stated that providers within two miles of county clinics would still provide a sliding scale to patients.
Discontinued specialist services include nephrology, urology, neurology and gastroenterology. Patients now will be referred to specialists in the CenCal Health network.
The county also moved many of its pharmacy services to Walgreens. Patients will now use other local pharmacies or the Lompoc Health Care Center Pharmacy to fill their medications.
Prescriptions for uninsured patients or those with limited finances will be filled at the Lompoc Health Care Center and delivered for pickup to Santa Barbara and Santa Maria.
Pharmacy services at Franklin and Carpinteria Health Care Centers will not be affected by the changes.
Third District Supervisor Joan Hartmann asked Hammami how the department plans to handle a reduced budget next year if the reimbursement rules are changed.
Hammami told the board the overall goal is to improve efficiency in the Health Department’s services so that it is generating more revenue even if the number of patients decreases.
He told the board that the one-year delay is a welcome opportunity for the department to at least soften the blow.
The County Executive Office will provide a full report on the impacts of the new state budget to the Board of Supervisors on Aug. 18.
