Each year, over 600,000 individuals return to their communities after incarceration, bringing with them significant health care needs such as chronic conditions, mental illness, and substance use disorders, all while facing higher risks of overdose and recurrence of legal system involvement (cdc.gov). Community Health Centers, with their accessible and community-oriented model, are uniquely equipped to serve this population and help close gaps in care.

Recently, in November 2024, HRSA announced $52 million in new funding to 54 health centers aimed specifically at supporting patients within 90 days prior to release. These resources support services such as chronic disease management, behavioral health care, and substance use treatment, critical interventions, as individuals are significantly more likely to experience overdose shortly after release.

HRSA also formalized these services through Policy Information Notice (PIN 2024‑05), allowing care to be provided to individuals “reentering the community” for up to 90 days pre-release. States like California and Washington have implemented Medicaid 1115 waivers to further fund this care.
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Fantastic work in Region X has been done, and while this is not an exclusive list, we would like to highlight some of our membership’s programs.

JAMHI Health & Wellness in Juneau AK operates a 9-month reentry program beginning three months before release and extending six months post-release. Guided by Risk–Need–Responsivity principles, a reentry case manager collaborates with the Juneau Reentry Coalition to assess criminogenic needs, such as substance use, employment, mental health, and tailor support accordingly. Participants receive integrated primary and behavioral health care, case management for housing and employment, medication assistance, and supportive housing coordination. The emphasis on early engagement inside custody and strong coalition partnerships help ensure individuals connect to insurance and evidence-based services, reducing recidivism and promoting community stability.
 
Outside In, operates a comprehensive service model that directly supports individuals transitioning from incarceration. In addition to its primary care and mental health services, the center includes a syringe exchange and fentanyl testing program with support structures that play a critical role in reducing overdose risk and facilitating connection to healthcare right when people reenter the community. In 2023, Outside In served nearly 5,600 individuals through medical, mental health, and substance use services, with over 900 youth receiving integrated support for housing, employment, and education.

Seattle Roots Community Health Center’s Reentry Clinic, supports individuals returning from incarceration by providing comprehensive follow-up care. The clinic connects patients to primary medical services, behavioral health, and chronic disease management, alongside light case coordination to address housing, transportation, food, and clothing needs. It also facilitates referrals to in-house specialty programs like HIV care, addiction services, gender health, and hepatitis treatment, ensuring continuity through warm handoffs to community partners focused on legal, employment, and family reunification support

Multnomah County Health Department is a community health center embedded in the county system, which situates them well for a comprehensive reentry program. Their ARC Transition Services brings together in-custody assessments, pre-release planning, and post-release support to smooth the path back to community life. A Health Assessment Team (HAT), a team of medical, mental health, and developmental specialists, works alongside corrections counselors to gather vital information before release, including chronic conditions and medication needs. They help enroll individuals in health insurance, provide on-site consultations, referrals, and coordinate housing and transportation. ARC also offers immediate transitional housing through contracted agencies, averaging 323 beds in 2023.

CHCs are trusted community anchors positioned to support people reentering society after incarceration. By investing in early outreach, integrated care, and community partnerships, health centers can play a vital role in promoting well-being and reducing disparities for individuals navigating complex transitions.

On a biennial basis (every other year), NWRPCA facilitates a robust salary and benefits survey with the help of the Region X CHCs that participate. The resulting report (available here) is intended to help Region X CHCs better understand what salaries & benefits are being offered in different markets (e.g. urban vs. rural) by position type (e.g. Nurse Practitioner, HR Coordinator). And in understanding this, Region X CHCs are able to better understand what kind of compensation needs to be offered to be competitive in hiring and retaining staff. Also included at no additional cost to the purchaser is a supplementary module
 
One interesting data point that came out of the most recent report is that the turnover rates for administrative support staff went from being very comparable between small (1-4 sites), medium (5-9 sites), and large CHCs (10+ sites) in 2021 to having a huge disparity in 2023. While medium and large CHCs made very significant progress in their ability to retain administrative support staff (i.e. reduce turnover), the turnover rates for small CHCs only got worse in 2023. 

We can attempt to understand what is creating this disparity by reviewing the salaries of administrative support staff and how these salaries have changed in recent years. While we do not have this data broken down by small, medium, and large CHCs per se, we do have it broken down by an overall budget threshold of more than or less than $34M. With this in mind, we can think of the budget size as somewhat of a proxy for CHC size. In other words, CHCs with budgets greater than $34M are going to primarily be medium and large CHCs. Similarly, CHCs with budgets less than $34M will primarily be small CHCs.
 
If we take “Executive Assistant” for example (one of the positions that would be categorized as administrative support staff), we can see that large budget CHCs (>$34M) paid a median salary of $61,048 in 2022—up 18.7% from 2020’s median salary of $51,459. This starts to help paint the picture as to why medium and large CHCs greatly improved their turnover rates among administrative support staff in 2023. Small budget CHCs (<$34M) on the other hand, paid a median salary of $46,280 in 2022—down 11% from 2020’s median salary of $52,000. In essence, we went from having small budget CHCs and large budget CHCs paying out median salaries very competitive with one another in 2020 to large budget CHCs paying a median salary 31.9% higher than that of small budget CHCs in 2022.
 
While the rationale for paying each individual administrative support staff position is going to vary widely across CHCs, one could look at these figures and broadly speculate that medium and large CHCs adapted themselves to the competitive market rate for these positions in 2022 and, hence, greatly reduced turnover as a result. On the flip side, one could speculate that small CHCs seemed to lag behind in this area—whether it be due to budget constraints or otherwise, offering compensation more in line with prior years. However, the good news is that this seems to have only been a temporary lag. Going back to our “Executive Assistant” example, small budget CHCs paid a median salary of $70,939 in 2024—a whopping 58.3% increase from 2022’s median of $46,280.

With large budget CHCs paying a similar median salary of $70,375 in 2024, small budget CHCs have positioned themselves much more competitively as it relates to retention for this type of position. If we were to extrapolate from this example, we would expect small budget CHCs and, by proxy, small CHCs (1-4 sites) to report significantly improved turnover rates for administrative support staff in 2025 during the next NWRPCA salary & benefits survey.
 
It is important to acknowledge that the conclusions drawn above were extrapolated from just one of the positions that comprise “administrative support staff” and are not necessarily representative. However, the point of this article is not to perform a full and robust analysis, but rather to walk readers through the thought process of noticing an interesting trend and then utilizing the report’s related data to begin to paint a picture of what could be contributing to this trend—as well as how we might expect the trend to change based on the most recent data.
 
Should your organization choose to purchase NWRPCA’s Salary & Benefits Survey Report (available here), you will also receive NWRPCA's below referenced 2025 Provider Productivity Expectations Report at no additional cost!