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Benton and Linn County Community Health Centers report large revenue renegotiation, urge caution on federal funding
Summary
The Community Health Centers (CHC) presented a reshot budget showing recent revenue increases after a renegotiation of payment rates, but warned of risks from uncertain federal funding and a reliance on enterprise revenues; CHC leaders asked the committee to preserve contingency while confirming a manager position.
Lacey Malle, executive director of the Community Health Centers of Benton and Linn Counties, told the budget committee the CHC has completed a budget "reshoot" and is proposing a markedly larger budget than adopted two years ago, driven by staff expansions, negotiated payment‑rate increases and federal grant timing.
Malle said the CHC fund is an enterprise fund that must be self‑sustaining and that the fund includes several cost centers: primary care clinics in Benton and Linn counties, dental services, an in‑house pharmacy, health navigation and integrated behavioral health. "Our payment methodology is known as being federally qualified health center," Malle said, referencing the federal program that supports CHCs.
She and CHC staff described a recent successful renegotiation of a prospective payment rate with the Oregon Health Authority and other payers that, they said, materially increased the center's revenue going forward and produced some retrospective payments in March. Malle said the renegotiated rate provides a stronger financial footing but cautioned the committee that federal funding changes could quickly reverse the gains.
Key program details presented: - CHC current service level includes roughly 160.6 FTE, with approximately 65.95 behavioral‑health staff in the CHC budget (and other behavioral‑health FTE counted in the health department budget). - CHC leaders said primary revenue sources include Medicaid billing and negotiated contracts with coordinated care organizations (CCOs), grant funds and patient payments; CHC also operates an in‑house pharmacy participating in the 340B program to capture drug‑purchase savings.
Malle said the CHC does not request new general‑fund support for operations and that the department reduced an anticipated general‑fund transfer by $1.6 million because revenue improvements make the operation more self‑sustaining. She asked the committee to consider making the limited‑duration fairgrounds/operations position permanent and to preserve contingency while monitoring federal policy changes.
Commissioners asked about the CHC service goals, emergency operations planning, and outreach to migrant and seasonal agricultural workers; Malle said the CHC seeks to increase primary‑care access by 15% in the biennium through standardized hours and operational efficiencies, and that emergency operations plans were a federal compliance requirement in advance of a fall operational review.
CHC staff and county finance staff recommended holding some policy packages in reserve until the committee sees how new revenue flows in from renegotiated rates and federal grants. No formal action or vote occurred during the session.
