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Health Department reports multiple state and federal grant losses; board approves technical rebalance
Summary
The county health department reported several lost grants affecting public health, behavioral health and integrated clinical services, including vaccine outreach, a BJA STOP award, and an Afghan refugee screening grant; the board approved the budget modification.
Trista Zugel, the Health Department budget director, briefed the Multnomah County Board of Commissioners on Oct. 16 about a fall fiscal rebalance driven by lost federal and state grant awards across Public Health, Behavioral Health and Integrated Clinical Services.
Zugel listed losses that include a second supplemental REACH vaccine grant (eliminating a train-the-trainer model for culturally specific vaccine outreach); the Department of Justice STOP grant (about $350,000) that funded violence-prevention contracts with Sun School leads; and a roughly $348,000 grant for Afghan refugee screening services. Zugel said that, in most cases, contracts funded by the lost grants were still in progress when the awards were canceled.
The integrated clinical services (ICS) team also reported a change in administration for the CareAssist (340B) program that reduced pharmacy revenue; the Oregon Health Authority provided a $350,000 backfill to cover positions in the HIV clinic, producing a net revenue loss for ICS of about $100,000.
Zugel said the department did receive some new and reallocated funding, including $185,000 from the state for Family Connects (a nurse home-visiting program for families with newborns) and $1.13 million in Oregon Health Authority residential housing pass-through funds to cover rate increases for residential behavioral health providers.
Deputy public-health staff and Integrated Clinical Services interim COO Debbie Powers explained the pharmacy funding change. Powers said the state now routes CareAssist business through preferred commercial and mail-order pharmacies, which moved revenue away from the county'run pharmacy even as the state backfilled staff positions previously funded by that revenue.
Commissioners asked whether the pharmacy change affected access to HIV medications and pre-exposure prophylaxis (PrEP). Powers said the county retained positions for pharmacy support but that clients using CareAssist will now receive medications from commercial or mail-order pharmacies rather than county-run pharmacy services; staff said they would verify whether any supply or access problems emerge.
The budget modification covering the health department rebalance was moved, seconded and approved by roll-call vote.
