The Rich County Commission unanimously voted to sign a formal request that the county pursue Medicaid capitation for substance‑abuse services, after a presentation from Josh Barson of the Bear River Health Department.

Barson said capitation would change the county’s substance‑abuse reimbursement model from fee‑for‑service to a lump‑sum payment based on an estimate of the Medicaid‑eligible population, with an intended start date of July 1, 2026 if the process proceeds. “Capitation … they use a formula based on anticipated number of people using Medicaid in our area. And then they give us a lump sum of money. We're the last area in the state that is not capitated for substance abuse,” Barson said.

He and commissioners discussed potential benefits: improved ability to start services promptly for people who may not yet have Medicaid eligibility, local oversight of contracted providers and reduced risk of fragmented provider billing. Barson said capitation “would allow us to audit and have that oversight” and that, under capitation, treatment for Medicaid‑eligible substance‑use disorder clients would be coordinated rather than dispersed to multiple independent providers without county oversight.

Commissioners clarified that the vote at this meeting was to authorize sending a formal request to seek participation in the capitation model; Barson said the county would return to the commission with additional details before formally entering capitation and that the process to complete enrollment would likely take about a year. “There would be another [meeting] before officially entering capitation,” Barson said. The commission’s action was to assign the request and sign the initial letter; officials said they expect further board review later in the process.

Barson said most areas that have adopted capitation for substance‑use services end up with funds they can reinvest locally “to provide better services,” and emphasized that private treatment remains an option for those who can pay. Commissioners asked about financial specifics and were told the current action does not commit the county to a funding level; more detailed fiscal information will be provided in later presentations.

The motion to assign and sign the capitation request passed unanimously. The commission and Barson noted that implementation, contracting and any required county match or maintenance‑of‑effort obligations would be determined in later steps.