Behavioral Care Center planners say startup and professional contracts could outpace early Medicaid revenue

County staff and the contracted operator Cri (Brent, president/CEO) briefed the Budget Evaluation Team on April 9 about initial operational and professional-services costs for the planned Behavioral Care Center.

"The revenue is going to be coming from 55% estimate of Medicaid, 3% private insurance ... and so that's where the $3.7 [million] revenue comes from," Brent said, describing the operator's assumptions about payer mix in the early months. County staff characterized the packet as a placeholder and a 91-day startup plan with additional time for staff ramp-up, MIS and pharmacy set-up, and one-time infrastructure costs.

Staff and the operator presented several cost elements: property insurance for a six-month window, information-technology and pharmacy start-up, an anticipated facilities-maintenance path, and a professional-services model for clinical/operations support. On the figures presented, the operator's professional-services/operating scenario for the initial operating period was quoted at about $5.2 million while projected payer revenue under the operator's conservative census assumptions was about $3.7 million.

Commissioners and deputies pressed on the risks tied to the center's diversion model: whether Medicaid and Medicare reimbursements will apply to individuals diverted from arrest and how custody status (emergency detention, voluntary presentation or criminal custody) will affect billing and clinical liability. Cri's leadership said other facilities run by the operator bill Medicaid but acknowledged this center's diversion-and-jail-adjacent model is unusual; Brent said the operation expects to secure Medicaid reimbursement but that the arrangement and certification will require careful operational alignment.

Context and funding sources: the county has already used ARPA dollars for capital (presenters confirmed $40 million of ARPA for construction and $5.5 million from the county general fund was previously reserved). Staff said the target opening and operational ramp remain contingent on final contracts, certification and clarified transportation/logistics with the sheriff's office and DA.

What happens next: staff said they will refine operational assumptions, pursue grant offsets and confirm the payor-mix modeling; commissioners asked the operator and sheriff's office to coordinate on intake pathways to clarify both clinical custody status and revenue implications.