County, Alluvion in discussions over missing billing funds, back rent

Alluvion Health split from the county as of the first of the year, but has been operating in some county facilities and handling the billing for the Cascade County City-County Health Department.

There’s been other areas of crossover as well, including Tanya Houston continuing her duties as the health officer for the county after moving to Alluvion. The non-profit health center took a substantial number of county employees with it in the split leaving the county health department struggling to fill key vacancies.
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The county has not charged Alluvion rent for use of government buildings, nor is there a lease or other written agreement pertaining to the arrangement.

Last week, Alluvion officials told The Electric that they were moving non-clinical staff out of the county health department building.

On Friday, Alluvion sent an email to the county notifying commissioners that it’s vacating the county health department building entirely.

During the Nov. 12 commission meeting, Commissioner Jane Weber said she “laments the decision” because the co-location was beneficial to the community.

There had been discussions of outsourcing more county health functions to Alluvion, but when commissioners asked for financial information, Alluvion withdrew from consideration.
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Last week, Weber said the county had been willing to put off collecting lease payments while Alluvion settled after the split from the county. She said during the Nov. 12 meeting that the county had drafted three separate lease agreements for the three separate spaces Alluvion occupied since the formal split on Jan. 1.

Weber said that since Alluvion became an independent agency from the county as of Jan. 1, it would be appropriate that the agency pays rent for county facilities.

In May, Besich told The Electric that Alluvion paid half the operating costs for the county health department building.
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Earlier this year, county staff discovered a significant issue with the billing revenues in that, as of September, about $355,000 hadn’t been paid to the county. In September, both Alluvion and county officials said they were working on a plan to pay that amount back to the county, but as of Nov. 6, the county had not received payment.

“The county needs those funds,” Weber said last week.

Commissioners have said in multiple public meetings that auditors noticed the missing funds over the summer, but multiple county staffers have told The Electric they notified commissioners of the missing money in budget meetings in January and March. During the Nov. 12 meeting, Rina Moore, the county clerk and recorder and auditor, said she wanted it on record that her staff had raised the issue during those budget meetings.

“We were all asked to cut our budgets,” Moore said. “This is money that belongs to the health department.”
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During the Nov. 12 meeting, Weber said that the county legal staff had drafted a promissory note for Alluvion that includes the missing funds from the billing, the back rent and phones and computers that the county allowed Alluvion to retain for a total of $480,961.

Last week, Alluvion’s CEO Trista Besich told The Electric that they were in negotiations with the county over the lease and that they intended to begin making payments on the billing funds that week. On Nov. 8, a $25,000 check arrived at the county, Weber said. That was the first payment of the billing funds that had been missing since January, according to county officials.

Last week, Besich told The Electric that Alluvion intends to pay back those billing funds within four months.

The county had also allowed Alluvion employees to stay under the county’s health insurance plan but they were supposed to make the contributions for their employees.
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Earlier this year, Weber said the county was notified that Alluvion had not been making those payments and the county had been covering the cost. Weber said Alluvion had paid those monies back and has since found it’s own health insurance provider for its employees.

Commissioner Jim Larson had served on the Alluvion board of directors, but resigned effective Sept. 24.

In an email to The Electric, Larson said it was “just getting to be too much conflict of interest since Alluvion left the county.”
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During the Nov. 12 meeting, Larson said that for at least two years there was a faction on the Alluvion board that wanted to split from the county, but the majority felt they weren’t ready. The board and the county asked that Alluvion have at least $1 million in cash reserves before making the split, Larson said.

Though the county is seeking the funds it is owed, commissioners and Carey Ann Haight, the deputy county attorney, said they appreciated the partnership.

“We still consider ourselves partners,” Haight said. “It’s exciting. It’s been good that the partners have been able to work together.”

Alluvion is the Community Health Care Center, which is a registered 501c3 and when it was struggling financially years ago, the county absorbed the entity and subsidized their budgets.

CHCC notified the county formally last year of its intention to split as an independent agency and that split was formal as of Jan. 1.

The partnership and colocation in the CCHD building was beneficial for the community for many years, Weber said, but now it’s time to finalize the lease agreement and recoup the funds that are owed to the county.

During a Nov. 6 Board of Health meeting, Weber told CCHD staff that she wanted the $355,000 owed to the county reflected in the CCHD financial reports.

In October, Alluvion notified the county that it would no longer handle billing for the county health department. In late October, the commission pulled a contract with the software vendor for billing from the agenda and has not yet entered into a new contract for billing software.

The Electric asked commissioners in late October how billing would be handled until the county has a new vendor but the county has not yet provided a response.

During the Nov. 6 health board meeting, Weber said the county was “actively working it” and she had a call with a potential vendor that afternoon.

She told the board that the county was not currently restructuring CCHD. She said for now, the focus was filling vacancies, to include the health officer and the directors of both prevention and environmental services.

As of last week, officials said there were six applicants for the health officer position and interviews are beginning this week. She said the interviews will include three panels, one will be a community panel, one will be leadership at CCHD and the third will be government leadership.

The panels will make a recommendation to the County Commission on which candidates should advance to a second interview, which would be conducted with the commission and Board of Health.

Weber said the county has been operating without a health officer of record since Aug. 31 and that it was a necessity to have such a person.

She said the county was working with a local doctor who was willing to serve in that capacity but had run into issues with insurance and what the county’s insurance provider required related to malpractice coverage.