Clallam County leaders weigh TrueStar shared‑services plan while rushing to meet HCA grant deadlines

Clallam County commissioners and staff spent the work session outlining next steps to implement a shared‑services model for TrueStar behavioral‑health services and to meet urgent Washington Health Care Authority (HCA) Medicaid reentry grant requirements.

The discussion centered on staffing, budgets and transition planning. County leaders said HCA requires certain positions (a reentry target case manager, reentry care coordinators and related clinical oversight) to be defined and recruiting steps taken to preserve Medicaid reimbursement eligibility. Commissioners and staff agreed those positions must be advertised and tied to a finalized budget for the two HCA grants covering jail and juvenile detention services.

Why it matters: the county is trying to balance three client groups—people in custody, a hybrid population involved with courts but not in custody, and community members seeking external services—while preserving intensive outpatient capacity for youth. Officials warned that shifting clinicians out of existing TrueStar roles without a transition plan could create service gaps for juveniles and others who rely on intensive outpatient care.

County staff said the Civil Service Commission has approved draft job descriptions and that the positions were posted. Leaders identified immediate next steps: finalize the HCA grant budgets, continue recruitment or internal notifications for required roles, and convene a care coordination council of local providers to map capacity and transition needs. They also proposed reallocating funding from two currently vacant juvenile nursing positions (an RN and an LPN) to add behavioral‑health positions if needed in the short term.

Officials noted several operational requirements for the grants: a licensed clinician must serve as reentry target case manager (the list is limited to medical or licensed mental‑health professionals), a clinical director should be hired to lead implementation, and the program must be able to provide medications for opioid use disorder (MOUD) with a 30‑day supply on release. Staff said those elements are in place or being finalized for a July 1 implementation milestone tied to billing and reimbursement activities.

Budget and revenue questions were raised repeatedly. Staff said TruSTAR’s revenue streams are commingled in current records, making it hard for the county finance office to verify a previously cited figure of about $500,000. Commissioners asked for a more detailed, line‑item TrueStar budget showing revenues by source (including ‘‘hard growth’’ allocations) and expenditures to evaluate sustainability beyond the current fiscal year. One commissioner emphasized that roughly $450,000 of hard growth funds currently flows to county departments to support services, reducing funds available to community providers.

On recruitment and transition, staff reported three juvenile‑facility employees expressed interest in the HCA‑required positions; leaders stressed no one is being forced to apply. Several commissioners urged external outreach if internal applicants are unwilling or unavailable. The group discussed a phased transition (60–90 days) with repeated case reviews to avoid service gaps.

No formal motion or vote was recorded during the work session; the board asked staff to return with finalized HCA budgets and recommended recruitment updates and to convene the care coordination council to identify community capacity and gaps.

Ending: County leaders said they will prioritize meeting HCA deadlines and return to the board with the finalized budgets, recruitment status and a plan for care coordination that aims to preserve intensive outpatient services for youth while pursuing Medicaid reimbursement opportunities.