5.6.26 Budget Work Session #8

The Multnomah County Board of Commissioners held their eighth budget work session on May 7, 2026, focusing extensively on the Integrated Clinical Services and Homeless Services Department budgets and operations. The Integrated Clinical Services presented their fiscal year 2027 budget, highlighting strategic investments in clinical programming, workforce development, and technology upgrades, including a significant electronic health record transformation project. They addressed challenges posed by federal Medicaid changes (HR1), emphasizing efforts to maintain and increase patient access through diversified appointment options and social support systems. The budget also included a reduction of approximately 19.1 FTEs, primarily through vacant positions, while maintaining Medicaid billable services. Capital priorities discussed included modernization of health centers and ongoing facility projects. The Homeless Services Department reviewed their budget reductions, staffing changes, and state funding updates, including an additional $2.7 million for shelter operations. They discussed system-wide coordination efforts, data management improvements with a new Homeless Management Information System (HMIS), and contract monitoring processes with providers. The session included detailed discussions on performance management, equity-focused training, and challenges related to Medicaid recertification and housing program eligibility. Several budget amendments and workforce development initiatives were proposed for future consideration.