Washington County human services projects $100,000 one-time cost to upgrade MyAvatar electronic health record

Washington County Human Services staff told the county standing committee that the department expects a one-time upgrade cost of about $100,000 to move its Netsmart MyAvatar electronic health record to the vendor's NX platform, with the timing likely in 2026 or 2027.

Julie, a Human Services staff member, said, "In 2019, the county board approved a million dollar investment into a new electronic health record for the Human Services Behavioral Health Division." She said the system improved billing and increased revenue and that Netsmart recently notified counties their MyAvatar platform is migrating to NX and that counties will be required to move in 2026'or 2027. "This cost estimate is a high estimate based on what Netsmart MyAvatar has given us as to the cost to upgrade our system to the NX," Julie said.

The presentation explained the county uses an internal process for capital improvement project (CIP) review: departments build project requests in January, standing committees vet projects in February, the Executive Committee reviews a full CIP in March, and the county board would consider approval via resolution in April. Erin, a county budget team member, framed the timeline by saying the department's request is the one new project the committee would review that month and that all projects will be packaged for executive review.

Supervisors asked whether the $100,000 estimate is an initial figure that could grow. Chris, a county supervisor who questioned the estimate, was told Netsmart provided two quoted options: a lower-cost option where the county performs most of the programming and a higher-cost option that includes vendor programming services. Julie said the estimate quoted is "a one-time cost" and that ongoing licensing and hosting fees already are budgeted in the department's regular operating budget.

Committee members also discussed whether opioid-settlement grant funds might cover the upgrade. Julie said it was "certainly worth exploring" but did not confirm any reclassification of the project's funding source.

Julie summarized fiscal effects of prior EHR implementation, saying staff reduced some county-funded positions and the department budgeted a 5% Medicaid revenue increase tied to EHR use; finance staff reported Medicaid revenue actually rose about 10% in 2025. Committee members pressed for follow-up analysis to confirm that staffing and budget outcomes matched the department's earlier expectations.

The committee did not take a recorded vote on the CIP entry during the discussion; members signaled general agreement with moving the project forward to the county executive for funding consideration.