[{"_1":2,"_110":-5,"_111":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,98],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",5981153,"mediaKeyId","5792915-5eac94aba3a706e2787b3da5d005fbc0","parentId",5792915,"title","Cook County officials briefed on federal changes to Medicaid and SNAP, timeline of local impacts through 2029","audioSeconds",1427,"startMs",118000,"endMs",1545000,"viewUrl","/Search/View?dp=1&key=5792915-5eac94aba3a706e2787b3da5d005fbc0&start=118&end=1545","thumbnailUrl","https://assets.pipeline.soar.com/5792915-5eac94aba3a706e2787b3da5d005fbc0/thumbnail_118000.jpg","articleUrl","/articles/5981153/Cook-County/Minnesota/Cook-County-officials-briefed-on-federal-changes-to-Medicaid-and-SNAP-timeline-of-local-impacts-through-2029","mediaUrl","https://secure.pipeline.soar.com/5981153-8fc40c04daea4184bee3dabf9127eae4/orig.mp4?Expires=1773646423&Signature=nALTtZn1YUUqZZaNQK1xqzT2p8vaCt4BSZK6B1q~MAMt9Ef~BwkHECRnpWg3918OrPJFSSVOXZ9jvrsLOLQ118uAGGdly60SRp4Ytc2LSfu1GZEJAxC4rzn5a0fNw6wTYbdgkCRQAUSH6NZ~1ThcAAd38BCKbcgpDDdIxnHH0NSLpMcV3RnN-zZIzc1Y0HslS1VKRdLcIbGAlHauF4wnsr7OFDPSZAB37QwyUlpnnqSN0Oa6qyKVL3fXnVuQi7ZqMwGRwIIKEdY3nTm20PW4ZjNzTfWeEkjzdZ1oy8kcllX~CCCpADez3zySrBe2H~FDBhQVFkciwdAlDGLmJ~Q08Q__&Key-Pair-Id=KUT5TJCACFTXG","author","Cook County, MN","date","2025-09-17T03:47:42Z","article","At a Sept. 16 meeting, Cook County Public Health Human Services (PHHS) staff briefed the board on federal changes to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) enacted in a bill staff identified as “House Resolution 1” and outlined which provisions will take effect through 2029 and how they may affect local services, county staff workload and providers.

The presentation, given to the Cook County Public Health Human Services Board by Grace (PHHS staff), focused on parts of the federal law that change who is eligible for benefits and how counties must administer them. Grace told the board, “the specific legislation that affects both Medicaid and the SNAP program, is House Resolution 1, which the President signed into law in July 2025.”

Why it matters: PHHS staff said the changes will increase administrative work for county eligibility staff, could reduce coverage for some residents, and may raise uncompensated care costs for local health providers. Many provisions phase in over several years; county staff urged the board to note the timeline when planning budgets.

Key federal changes summarized for the board

- More frequent Medicaid redeterminations: Beginning Jan. 1, 2027, certain adults ages 21–64 who are not disabled and do not have dependent children must complete eligibility redeterminations every six months instead of every 12 months. PHHS staff said Minnesota’s Department of Human Services (DHS) is still estimating county costs for additional redeterminations and that “recipients may lose coverage if they do not complete renewals on schedule.” (Grace, PHHS staff)

- Medicaid work requirements: Also effective Jan. 1, 2027 (with potential state extension requests), some adults will have to document 80 hours per month of “community engagement” (work, education, public service or a work program). Grace listed categories exempted from work requirements, including people who are pregnant, youth in foster care, American Indian tribal members, those considered medically frail and certain caregivers.

- Limits on retroactive Medicaid coverage: For most adults without children, retroactive coverage will be reduced (Grace read that retroactive coverage goes from three months to one month for many adults and from three months to two months for other eligibility groups). PHHS staff flagged a potential increase in uncompensated care if patients are billed for care that would previously have been covered retroactively.

- Cost sharing for some services: Effective Oct. 1, 2028, certain adults without children whose incomes exceed 100% of the federal poverty level may be required to pay up to $35 per service for certain medical services. Grace said federally qualified health center services, primary care, mental health and substance-use services are excluded; members of tribes are exempt from that cost sharing.

- Changes in eligibility for some lawful immigrants: Effective Oct. 1, 2026, Grace said the law would remove Medicaid eligibility for certain lawful immigrant adults in categories the speaker listed (refugees, humanitarian parolees, asylum grantees and some victims of abuse/trafficking).

SNAP changes described to the board

- Thrifty Food Plan reevaluation and benefit purchasing power: Grace explained the Thrifty Food Plan (the federal cost estimate used to set SNAP benefit amounts) will be reevaluated; federal guidance requires cost-neutral adjustments, which staff said could reduce SNAP purchasing power over time. The earliest change mentioned is Oct. 1, 2027.

- SNAP work requirements: Federal guidance updating the definition of “able-bodied adults without dependents” will require 80 hours per month of work or a work program for some people; Grace said the timing is “as soon as federal guidance is available.” She also said some previously exempt groups (for example, veterans and people experiencing homelessness) may no longer be exempt.

- Administrative cost sharing and funding changes: Effective Oct. 1, 2026, the federal reimbursement for state SNAP administrative costs is changing from 50% to 25%, increasing state- and county-level financial responsibility for running the program.

- Noncitizen SNAP eligibility restrictions and SNAP-Ed funding changes: Grace said one federal change will restrict eligibility for certain noncitizens as USDA guidance is released, and that SNAP-Ed (a nutrition education program) funding was eliminated effective Oct. 1 (Grace said the region recently lost a University of Minnesota Extension staff member who had served as a regional SNAP-Ed representative; Grand Portage band leadership reported they obtained local funding to continue services on the reservation).

- Payment error–rate penalties: Grace explained a new federal regime will financially penalize states with high payment error rates for SNAP and Medicaid — for SNAP the change takes effect Oct. 1, 2027, with states paying a tiered share of benefit costs based on error rates; for Medicaid the effective date called out was Oct. 1, 2029, with penalties tied to a threshold (Grace cited “over 3%” for Medicaid payment errors in available federal materials).

Local concerns and next steps

PHHS staff emphasized uncertainty about the local fiscal and administrative impact. Dagmarah Smith, economic assistance supervisor, joined the presentation and responded to questions about county SNAP and eligibility administration, including error-rate monitoring, system modernization and staffing. Commissioner Testeralli asked about error-rate oversight and fairness; Smith said statewide error-rate evaluations are ongoing, that Minnesota’s statewide SNAP error rate “is over 10%,” and that the state is “still at the discovery phase” about implementation and potential waivers.

PHHS staff recommended that the board note the implementation timeline — some changes begin in 2026 and 2027 and others (notably the Medicaid payment-error penalties) do not phase in until 2029 — and consider those dates when planning budgets and staffing.

Closing: PHHS staff said they will circulate the slides and reference links used for the presentation and that county departments will continue monitoring state and federal guidance as rules and implementation details become available.","mediaType","Video","parentTitle","Public Health and Human Services Board 16 Sep 2025","oneSentenceSummary","At a Sept. 16 meeting, Cook County Public Health Human Services (PHHS) staff briefed the board on federal changes to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) enacted in a bill staff identified as 'House Resolution 1' and outlined which provisions will take effect through 2029 and how they may affect local services, county staff workload and providers.","taxTitle","Cook County, Minnesota","taxId",73148,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},5981140,"Board approves 988 outreach campaign, COVID grant increase and resource‑directory website contract funded by grant",1629,5557000,7186000,"/Search/View?dp=1&key=5792915-5eac94aba3a706e2787b3da5d005fbc0&start=5557&end=7186","https://assets.pipeline.soar.com/5792915-5eac94aba3a706e2787b3da5d005fbc0/thumbnail_5557000.jpg","/articles/5981140/Cook-County/Minnesota/Board-approves-988-outreach-campaign-COVID-grant-increase-and-resourcedirectory-website-contract-funded-by-grant","https://secure.pipeline.soar.com/5981140-101ec51b1abd95bea8813e39911e28da/orig.mp4?Expires=1773646423&Signature=e5Ap5b-xBKLYZfMvOBspXTd6rWl645ItcGY0g1fS7hNSz27oRi~2GQvTOPayI3OFPlLMDWa3c9AIqlZPozQN7ua7YboOURzfTzyJVWbISAPV26sLtPBQ-FOxGDjdo4aJx79Pg8eAwByZEDf~Fw~8Qh4BFLF2ZSSKRYOQQfVkMOpnAiSSpCEDOo8h2f8XKHVRFlnwa6Bhwwi7GuhG0ED32mVTyaNoO1etqE1NyGKNqnA4pKMqpOKfsIrhnNS75OCoyA98dSC-GwTwcc5A6obJQALweKNy2eE0C-g1MLC-O4ztL9pNrJSuXwQDszg4zBy6eEkXoNkN8hePxGjuMnsS3Q__&Key-Pair-Id=KUT5TJCACFTXG","At the Sept. 16 Cook County Public Health Human Services Board meeting, commissioners approved three grant‑funded actions: a marketing contract to promote the 988 crisis line and mobile crisis response, a contract revision that increases a COVID implementation grant award, and a web‑development contract to build a resource directory funded by the revised COVID grant.

988 outreach campaign (Giant)

Grace (PHHS staff) described a master service agreement and statement of work with a vendor she referenced as Giant to run a campaign to increase awareness of the 988 mental‑health crisis helpline and generate more mobile crisis response referrals. The board was told the campaign uses grant funds from the county’s mobile crisis response grant and includes digital advertising, a direct‑mail piece and a billboard; Giant will compile data on digital impressions and referrals. Commissioner Campbell requested metrics that distinguish county resident traffic and non‑governmental website users; Grace said the vendor will provide digital ad data and staff will request more detailed website analytics on unique, non‑government users where available.

Motion and vote: Commissioner Brown moved to approve the master service agreement and statement of work with Giant; Commissioner Campbell and others supported the motion and the board voted unanimously to approve the agreement.

COVID implementation grant revision and resource‑directory website

Chris (PHHS staff) informed the board that regional funds not fully used by other jurisdictions are available and that the county’s COVID implementation grant award can increase by $53,569, funds that can be applied toward a resource directory website. The board approved accepting the revised grant award by motion (moved by Commissioner Sullivan) and a unanimous vote.

The board then approved a contract with a web developer identified in the materials as Andy Sites to build a resource directory website, funded entirely through the COVID implementation grant increase. Grace said the county attorney reviewed contract language and the grant previously experienced federal reporting uncertainty (a spring clawback risk); the contract structure was designed to use available grant funds while protecting the county from undue financial exposure.

Why the board acted: PHHS staff said raising awareness of 988 would connect more residents to mobile crisis response and that a centralized resource directory would aid residents and partnering providers. Commissioners requested evaluation measures (unique users, non‑government user counts, and campaign‑specific referral tracking) and staff noted Giant’s digital metrics plus county website analytics will be used to evaluate effectiveness.

Administrative note

Grace told the board that the marketing and web‑development efforts are fully grant‑funded and will not require county general fund support; the COVID implementation grant revision amount approved at the meeting was $53,569.

Board action: All three items — the Giant marketing contract, the COVID grant revision and the Andy Sites web‑development contract — were approved by unanimous vote.","Cook County PHHS approved a grant‑funded marketing campaign to promote the 988 crisis line, accepted an increase to a COVID implementation grant and authorized a grant‑funded contract to build a resource directory website.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":91,"_47":92,"_49":93,"_51":94,"_53":95,"_55":56,"_57":58,"_59":96,"_61":62,"_63":64,"_65":97,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},5981145,"Cook County PHHS reports completed investigations, data breach notifications and staffing shortfalls; director search under way",0,2682000,"/Search/View?dp=1&key=5792915-5eac94aba3a706e2787b3da5d005fbc0&start=2682&end=2682","https://assets.pipeline.soar.com/5792915-5eac94aba3a706e2787b3da5d005fbc0/thumbnail_2682000.jpg","/articles/5981145/Cook-County/Minnesota/Cook-County-PHHS-reports-completed-investigations-data-breach-notifications-and-staffing-shortfalls-director-search-under-way","https://secure.pipeline.soar.com/5981145-3a7f1e6d9dd22ffb4b08cb3dace2f21f/orig.mp4?Expires=1773646423&Signature=NC7IaCHu55JkBbAK1bsK6i281FpHyeHWrYug8Y6vt8MTHov-6cGNeawMvnB4-4e4KFWoIz4HJALpmjJ1NFf1ssLjY6QDOWYvHJDH6Mdl0l21alRZLgfZONX2NYXxELQR2P~dVhkBFs2T8w1A4fKQIKiDm7C5kf6jQW3IbRw1-t7I~rWwCYl52vRem2dThA1YhRoG4N-Y6c94fYDnQiGIPhsysfUMw3Hm8Xp6McJt-7KZRaxJ6oIg2tJY-nzqp2f0BGXHcjEGvhy2lRkCqfIYAJYZejYNGjxRvODHmkY8cDhalXSMwZIgEgsd7C1yopmzL7KGPkOZI-NTQhRYfSpf6Q__&Key-Pair-Id=KUT5TJCACFTXG","Cook County Public Health Human Services leaders updated the board Sept. 16 on completed investigations, a recent data breach, time‑reporting shortfalls and the status of recruiting for several vacant positions, including the permanent director role.

Administrator Bridal (PHHS administrator) told the board that all investigations prompted by grievances or complaints have been completed and that the agency is taking steps to address findings across four categories: policies and procedures, revenue and expenses, client services and work conditions. Bridal said the department will work with two external consultants and the county attorney’s office to implement corrective actions.

Data breach, client notification and controls

Bridal reported a data breach affecting 48 clients. She said letters have been mailed and that some have been returned; PHHS staff are actively tracing addresses and ensuring each affected person receives a notice. Bridal said the department is updating policies and system controls to mitigate future breaches and that consultants will assist with aligning social service information system (SSIS) controls to best practices.

Billing, SSIS time reporting and internal controls

Bridal said SSIS time reporting is required and that the agency currently requires 90% “real‑time” reporting. Investigations found that the 90% expectation was not consistently met, which affects the agency’s ability to collect reimbursements because accurate time entries are necessary for billing. Bridal said the agency anticipates moving to a 100% real‑time reporting policy and will deploy training and controls to support staff in meeting the standard.

Flex funds and other administrative weaknesses

Bridal identified gaps in written policy and controls for flex funds (local goods or services paid to meet clients’ needs, e.g., clothing, food or auto repair) and said policy and controls will be implemented.

Staffing, recruiting and compliance posture

Plomin (interim director) and Bridal told the board the department is meeting statutory requirements but at a cost: staff are wearing multiple hats and covering vacant roles. Plomin said he will not apply for the permanent director position; the director posting closes the day after the meeting and first‑round interviews are planned the following week. Several critical positions (adult mental health case manager, home and community‑based services supervisor, children and family services case manager) are under active recruitment.

Plomin credited recently contracted consultants (including an external behavioral health consultant approved by the board) with helping the agency remain compliant during the transition. Commissioner Gamble asked whether open positions had created compliance risk; Bridal and Plomin answered that the county is meeting requirements but noted that durability depends on filling vacancies and strengthening organizational supports.

Other items

Bridal said the wilderness treatment program audit findings have been resolved and that the state provided an “all clear” after the department worked with the county attorney’s office and staff to address the findings.

Board direction and next steps

The board asked staff to continue prioritizing compliance, improve SSIS time‑entry support and provide updates on hiring and implementation of policy changes. Bridal and Plomin said they will work with consultants to design staff training and a timeline for implementing policy and internal‑control improvements.","PHHS administrators told the board that investigations are complete, 48 clients were affected by a data breach and several operational fixes are planned; the interim director said the county is meeting requirements but staff are doing double duty while recruitment continues.",{"_33":99,"_35":36,"_37":38,"_39":100,"_41":101,"_43":102,"_45":103,"_47":104,"_49":105,"_51":106,"_53":107,"_55":56,"_57":58,"_59":108,"_61":62,"_63":64,"_65":109,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},5981150,"PHHS presents Cook County SNAP, MFIP and assistance program caseloads and year‑to‑date payments; staff warn of staffing pressure",684,2653000,3337000,"/Search/View?dp=1&key=5792915-5eac94aba3a706e2787b3da5d005fbc0&start=2653&end=3337","https://assets.pipeline.soar.com/5792915-5eac94aba3a706e2787b3da5d005fbc0/thumbnail_2653000.jpg","/articles/5981150/Cook-County/Minnesota/PHHS-presents-Cook-County-SNAP-MFIP-and-assistance-program-caseloads-and-yeartodate-payments-staff-warn-of-staffing-pressure","https://secure.pipeline.soar.com/5981150-9b4c175ed0bf2745814dc99454871e72/orig.mp4?Expires=1773646423&Signature=GVbwXKkkNl78zpP09rZn9ErX0rqJkEz5oRPSTWpFLmXcfCBIij7nqXC711FQmr7v76ohLjIkL45WoR~vMnLoaqiu1Ksi4jj6kmf1~0mUJBvt3ZG19j8sdxAdR3NP8xW-ZBgXOxAIdr3EgX-aAc7gWiQUT0zRRp7lf2EMMS9EaDXjPT9WxQAwOQipCQv4e~R2JSNWN2RHesrRxv5-gcK4crZounMcQvjz5CqBk8RVAgJwYVqrdqvacBN6PvJr9hA6qtG8UqE~Xt6hSlcq309PFpqBh7j5fseV-yq0RrlFWBw4d9F1~nMCk0tvcNtyIKRZo3StDvKcRwM7tUd9uxCJZg__&Key-Pair-Id=KUT5TJCACFTXG","Cook County Public Health Human Services staff presented a comparison of county and state caseloads and payments for major economic assistance programs during the Sept. 16 board meeting, showing lower absolute totals in the county but noting possible pressure on personnel and county budgets if federal program rules increase administrative work.

Plomin (PHHS staff) summarized the department’s fiscal exposure and caseloads, saying the department has “$9,897,000 in payroll or personnel expenses for economic assistance for the entire 2025.” He presented a line‑by‑line comparison to Minnesota totals to show the county’s share of statewide activity.

Key figures cited and local context

- SNAP (Supplemental Nutrition Assistance Program): Cook County averaged 124 cases per month in 2025, representing 213 people (some cases cover multi‑person households). Plomin reported year‑to‑date SNAP benefit payments in Cook County of $249,000 through August, compared with state year‑to‑date payments of $493 million. The average monthly payment per case in Cook County was $251; state average was $289 per case.

- General Assistance and MSA (Minnesota Supplemental Aid): Year‑to‑date payments and per‑case averages were presented; Plomin noted that for some programs Cook County averages exceeded the state average and for others they were lower (for example, Cook County MSA averages were lower than state averages, which Plomin attributed to a small number of direct $81 payments and fewer supplemental housing payments locally).

- MFIP (Minnesota Family Investment Program): State count is in the tens of thousands while Cook County had 10 average monthly cases; year‑to‑date payments and average payments per case were also presented.

Staffing, systems and eligibility contexts

Presenters and commissioners connected the caseloads to staffing and eligibility system concerns. Plomin and Dagmarah Smith (economic assistance supervisor) emphasized that federal changes to SNAP and Medicaid will likely increase the county’s workload for renewals, verifications and interviews. Commissioners commented that county demographics (a higher share of older adults in some parts of Cook County) affect program participation and that comparisons to other similar counties would help put the numbers in context.

Commissioner Frank urged staff to provide clarity about the relationship between county payroll and the county‑administered assistance funds, and Plomin said the larger payroll figure reflects staff who administer programs for federal and state funds rather than county‑paid direct client payments (those are accounted separately in the budget).

Staff noted data sources: Plomin said the numbers come from the Maxis centralized eligibility system, and the presenters offered to provide more detailed breakdowns by demographic and by comparable counties to help commissioners during budget deliberations.

Board takeaway

PHHS staff recommended the board use these figures when considering staffing and budget decisions and offered to supply further comparative data and documentation to the commissioners. Multiple commissioners urged the county to press the state for modernized eligibility systems to reduce administrative burden and error rates.","PHHS staff compared Cook County caseload and payment data against statewide figures, showing local SNAP cases average 124 per month and raising concerns that federal policy changes could increase county staffing needs.","actionData","errors"]

Article not found

Cook County officials briefed on federal changes to Medicaid and SNAP, timeline of local impacts through 2029

Board approves 988 outreach campaign, COVID grant increase and resource‑directory website contract funded by grant

Cook County PHHS reports completed investigations, data breach notifications and staffing shortfalls; director search under way

PHHS presents Cook County SNAP, MFIP and assistance program caseloads and year‑to‑date payments; staff warn of staffing pressure