County Health Will Restore 15 Positions After Layoffs

After months of painful budget cuts, layoff notices, and scaled-back services, Santa Barbara County's Health Department is getting a shot of unexpected relief — courtesy of a last-minute decision in Sacramento.

A Unanimous Vote Brings Workers Back

On July 7, 2026, the Santa Barbara County Board of Supervisors voted 5-0 to approve a budget revision restoring 15 full-time positions in the County Health Department (CHD) — roles that had been eliminated as part of a sweeping austerity plan adopted just weeks earlier. The decision, reported by Noozhawk, came after the state finalized its own budget and chose to extend a critical Medi-Cal reimbursement rate that the county had feared would be cut.

The restored positions span the front lines of clinic operations: seven staff nurses, two administrative office professionals, two financial office professionals, two medical assistants, one health education assistant, and one pharmacy technician, according to an official county press release published by Edhat. The rehires will push the department's support staff-to-provider ratio from 2.50 to 2.85 — a meaningful improvement in how many staff members back up each clinician in county-run health centers.

"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," County Health Director Mouhanad Hammami told the Board of Supervisors, as reported by Noozhawk. "So, it is welcome news."

What Changed in Sacramento

The financial turnaround traces back to a single policy decision by state budget writers. The state had previously planned to shift Medi-Cal patients with what it classifies as Unsatisfactory Immigration Status (UIS) — immigrants who are not eligible for full Medi-Cal benefits — from the higher Prospective Payment System (PPS) reimbursement rate to a lower fee-for-service model, a change that was originally slated to begin July 1, 2026. Had that happened, the county stood to lose approximately $6.6 million in annual health revenue.

Instead, California's adopted budget extended the higher PPS rate for one additional year, through the end of fiscal year 2026-27, according to the Lompoc Record. That $6.6 million reversal is what made the 15 restored positions possible.

"We are grateful for the state's decision to maintain the higher reimbursement rate for another year," Hammami said in the county's official statement. "This allows us to increase health center positions to accommodate new workflows and increase productivity so that we can sustain these roles beyond next year."

Third District Supervisor Joan Hartmann, who had pushed Hammami on the department's longer-term strategy during the board meeting, summed up the news simply: "We were hoping it would happen," she told the Santa Barbara News-Press.

How the County Got Here

The road to this moment was long and difficult. Santa Barbara County spent much of spring 2026 grappling with a structural budget crunch driven by reduced state and federal support — including changes tied to the federal "One Big Beautiful Bill Act" — that forced county officials to consider eliminating hundreds of positions. At its low point, the county was looking at potentially cutting as many as 373 employees, before narrowing the list through a combination of transfers, retirements, and restored funding.

When the Board of Supervisors unanimously adopted a $1.66 billion operating budget on June 16 — a spending plan reflecting a 1.7% reduction from the prior year — 77 county employees were still slated for layoff effective July 1. In the weeks that followed, departments worked to absorb some of those workers through internal transfers and voluntary departures, ultimately reducing the number of actual separations on July 1 to 51. With the latest 15 positions restored, the net number of county employees who lost jobs through this budget cycle drops to 36.

The Health Department bore the brunt of the cuts. County Public Health was looking at 47 layoffs alone when the June budget was finalized — more than any other department.

Service Changes That Remain in Place

The restored jobs are good news, but county clinic patients should know that a number of service changes that took effect July 1 are still in place and are not being reversed by the budget revision.

The Health Department eliminated in-house blood drawing and transitioned it to contracted laboratories, consolidated pharmacy services to the Lompoc Health Care Center Pharmacy, and discontinued four specialty services — nephrology, urology, neurology, and gastroenterology — at the Santa Barbara Health Center. Those patients are now being referred to specialists within the CenCal Health network, with the county reporting it has already begun transitioning care. Roughly 792 patients per year were using those discontinued specialty services, according to prior reporting.

On the pharmacy side, prescriptions for uninsured patients and those in the Patient Assistance Program will continue to be filled at the Lompoc facility and delivered for pickup to the Santa Barbara and Santa Maria Health Centers. Pharmacy services at the Franklin and Carpinteria Health Centers will not be affected. The county also established a 24-hour information line at (805) 681-5100 for patients with questions about service changes.

The Health Department has already begun putting new operational practices in place, including enhanced scheduling, an expanded centralized appointment line, and more proactive management of no-shows and cancellations, according to county officials.

A One-Year Window — and a Warning

Hammami and county officials were candid with the board: the relief is temporary. The extended PPS reimbursement rate covers only fiscal year 2026-27 and does not automatically carry into 2027-28. If state policy reverts, the department will lose the $6.6 million again.

"It's going to buy us a year," Hammami told supervisors, as reported by Noozhawk. "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."

Officials said the goal is to use the coming year to boost clinic throughput and revenue enough that the restored positions can be justified even if the reimbursement rate falls. Hammami noted the renewed funding will also allow the department to rely less on its existing fund balance — preserving reserves for future shortfalls.

The county also set aside $9.5 million during the June budget hearings specifically to hedge against next year's anticipated deficit, a signal that leadership knows another difficult budget cycle may be coming.

The County Executive Office is scheduled to brief the Board of Supervisors on the full impact of the state's adopted budget on August 18, 2026 — a date residents and county workers alike should watch closely.