Community Mental Health Center requests $23.1 million budget; county subsidy remains about half

The Community Mental Health Center presented a $23,077,000 budget request for fiscal year 2025–26, asking Douglas County commissioners to continue funding roughly half the cost of its operations.

The presentation, delivered by Randy Walter, finance and contracts analyst for the Community Mental Health Center, said the request represents a roughly 1.5% increase over the prior year and keeps the center “within our given target.” Walter said total staff head count is about 157, with approximately 125 full‑time‑equivalent positions.

Walter described revenues and expenses as generally in line and said the center projects roughly $11.2 million in non‑county revenues for the year, with the county subsidy near $11.3 million — approximately 50% of the center’s operating budget. He identified pharmacy operations as a major and growing revenue source and cost driver: pharmacy receipts have increased from about $2.7–2.8 million in 2022 to an expected roughly $3.5 million for the current year.

Commissioner John Cavanaugh (first reference: Commissioner John Cavanaugh) asked the presenters to confirm the center’s total expenses and the share covered by non‑Douglas County sources. Walter and other staff responded that 67–74% of the health center’s revenue comes from non‑Douglas County sources (Medicaid, Medicare, Region 6, private insurance and other payers) and that Medicaid and Medicare together represent roughly half the center’s revenue.

Walter said revenue growth has been modest and linked to better billing and collections work, including closer coordination with billing staff. He described Region 6 funding as a relatively steady payer that now represents roughly 15% of revenue (down from earlier years because of Medicaid expansion) and said Region 6 has not increased rates recently, which adds pressure to management of expenses.

The presentation included multi‑year trend slides showing expenses averaging about a 4.5% increase year over year across five years, with personnel and benefits totaling about $15 million of the $23 million request. Walter said the center has come in under budget in four of the last four years and emphasized efforts to reduce accounts receivable, increase collections and manage pharmacy costs.

Walter outlined several revenue and expense management strategies — improving billing/collections, marketing to raise census, and several ways to reduce non‑personnel costs — and recommended continuing the center’s current approach while watching payer rate movement. Chair Commissioner Roger Garcia (first reference: Chair Commissioner Roger Garcia) asked staff to continue to report key revenue trends.

Why it matters: Commissioners repeatedly framed the center as a regional provider whose services are paid largely by non‑Douglas County revenue sources (Medicaid, Medicare, Region 6 and private payers). That mix affects the county subsidy and makes the center’s financial outlook sensitive to payer rate decisions and to collection performance.

Meeting context and next steps: The presentation was informational; no formal vote was taken on the budget request during the June 24 meeting. Commissioners and staff flagged follow‑up questions about payer rate trends and the center’s ability to shift census or services to pursue higher reimbursement. The center’s budget materials will be considered in the county’s broader budget process.