County restores 15 health department positions after state payment delay gives one‑year reprieve

On July 7 the Santa Barbara County Board of Supervisors unanimously approved a County Health Department budget revision that staff said is enabled by a one‑year delay in a state prospective payment rate change. Department leadership said that the delay will allow the county to recognize up to $6.6 million in observed revenue and to restore 15 positions cut earlier in the budget process.

Director Hamami (Behavioral Health and Health Department statements appear in the record) told the board the funding will restore clinical staffing in county health centers: approximately 6–7 nurses (increasing the nurse-to‑provider ratio), several AOPs (administrative/office positions), and two medical assistants to float across five clinics. Staff said the action buys one year to redesign workflows, centralize scheduling (pilot in North County beginning in August) and improve productivity before the state rate change takes effect.

Board members pressed for clarity on whether restored employees could be sustained beyond the one‑year window and whether any portion of the restored staffing would be paid from general‑fund reserves. CEO office staff said the board’s stated intent was to reduce layoffs and restore services; staff will return in August with additional information on state impacts and fiscal scenarios.

The measure required a four‑fifths explanation on the agenda but was moved, seconded and approved on the administrative floor unanimously. Supervisors framed the action as a stopgap to avoid layoffs while staff pursue longer‑term productivity improvements.

What’s next: staff will return with updated fiscal information and options in August and execute clinic workflow changes and a North County centralized scheduling pilot beginning in August.