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Douglas County delays $1M supplemental request for Bert Nash TRC pending independent review
Summary
After a detailed presentation from Bert Nash leadership about lower-than-expected Medicaid revenue at the Treatment & Recovery Center (TRC), the commission voted to defer a supplemental funding decision until a memorandum of agreement, site visit and preliminary consultant report are complete.
The Douglas County Commission voted Dec. 3 to defer action on a supplemental funding request for the Bert Nash Treatment & Recovery Center (TRC) until an external operational and financial review is under way.
Bert Nash interim CEO Dr. Kirsten Watkins and finance director Danny Edwards described a changing payer mix and operational challenges since the TRC opened 30 months ago. They said the TRC now averages about 225 distinct individuals served each month with about 159 monthly admissions to its crisis-stabilization unit. Staff explained that prospective payment system (PPS) Medicaid revenue is lower than earlier models anticipated: Bert Nash reported an agencywide Medicaid share of roughly 53% but said TRC-specific Medicaid revenue is only about 26% of total TRC funding—well below earlier 60% assumptions used in initial budget modeling.
County staff and Bert Nash finance staff presented a refined 2026 budget informed by 30 months of actuals, changes in staffing and adjustments to revenue assumptions. Bert Nash requested supplemental funding for 2026 to maintain TRC operations while it pursues improved revenue-cycle processes, grant opportunities and workforce stability.
Several commissioners recommended an independent review of TRC operations and finances before authorizing a large supplemental payment. Staff recommended a memorandum of agreement between the county and Bert Nash, a site visit by a contracted consultant, and a preliminary report as benchmarks before releasing supplemental funds.
Public comment included both advocates for Bert Nash’s services and residents urging caution and independent verification of financial controls. Commissioners said the $1 million set aside for crisis-system contingency during budget deliberations could be used once a collaborative review provides sufficient assurance. Commissioner motioned to delay action until the MOA is executed, a site visit completed and a preliminary report provided; the motion passed 5–0. Commissioners requested a January update on MOA progress and said they expect the review to inform the 2027 budget process.
The vote does not prevent Bert Nash from receiving other routine reimbursements or the approved SS&C support contract for finance operations; it pauses consideration of a large supplemental allocation pending independent review.
