Commissioners press for clarity as Columbia Valley Recovery Center presenters outline costs, capacity and payer‑mix risks

Franklin County commissioners used a Jan. 14 workshop to press for clearer numbers and agreements tied to the Columbia Valley Center for Recovery, a tri‑county behavioral health facility under development whose operation and patient mix will determine whether it relies on county subsidies.

Jason Bliss, chairman of the bi‑county advisory board, opened by saying his priority was transparency: "I want there to be full transparency ... I have no desire for anything to be hidden," he said, noting local revenue from the "one tenth of 1%" funding that supported the project. Bliss and advisory board members emphasized that the center was intended to prioritize residents of both Benton and Franklin counties.

Courtney Hesla, chief quality officer at Comprehensive Healthcare (the contracted operator), described the services proposed for the Columbia Valley Center for Recovery: crisis stabilization, a 23‑hour observation or relief center, secure detox and a substance use disorder residential program. "We offer outpatient mental health and SUD services in addition to residential mental health and SUD services progressing into inpatient ... We provide these services for youth and adults," Hesla said, adding that Comprehensive has operated similar facilities and would pursue payer sources before asking counties to cover uncompensated care.

Mark Kettner, Comprehensive’s chief financial officer, presented scenario analyses showing the project’s sensitivity to occupancy and payer mix. He said payroll accounts for roughly 80% of operating costs and non‑payroll operations comprise about 20%. The group provided an illustrative operational estimate of approximately $13.8 million annually for some service lines and explained that lower payer mix or occupancy could create multi‑million‑dollar shortfalls, while higher payer mix and occupancy could approach break‑even or modest surplus.

Commissioners sought specifics on what Franklin County will receive for its contributions and whether the county could guarantee priority beds. Staff said statutory and contractual limits complicate reserving beds exclusively for one county, but offered contracting options — including county purchase of bed capacity or an agreement making Franklin County the payer of last resort for uncompensated clients — as mechanisms to protect county interests. Commissioners also read a letter from Benton County saying it would not seek a joint operating agreement; presenters said that alternative contracting arrangements could still be negotiated between Franklin County and Comprehensive.

Presenters described the center as a "no wrong door" facility for the 23‑hour relief center, meaning the facility must accept arrivals who meet medical criteria, and explained triage, overflow and coordination with designated crisis responders, EMS and law enforcement to avoid turning away people brought for care. Comprehensive said the facility would include roughly 68 beds total (three 16‑bed units and a 20‑recliner 23‑hour relief unit) and that some units require DCR (designated crisis responder) gatekeeping based on acuity.

No formal action on the center was taken at the workshop. Commissioners requested follow‑up information, including clearer cost‑per‑day or per‑bed figures and options for contract language that would protect Franklin County residents’ access or financial exposure.