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County social services report: foster-care placements and Medicaid costs drive 2024 budget pressure
Summary
Washington County Department of Social Services reported a sharp rise in foster-care and adoption-related expenditures in 2024, citing placement scarcity, higher out-of-area care costs and rising county Medicaid net expenses.
A Washington County social services presenter told the Health and Human Services committee the department’s 2024 fiscal picture reflected several cost pressures—most notably higher foster-care and adoption expenses and rising county Medicaid net costs.
The presenter described a large foster-care expense increase and cited an example of an out-of-area placement that required an elevated one-on-one supplemental rate. “We have another youth right now in a, in a place that we'd had 1 in in the past where they say they will accept the child, but then they view the child as having extreme needs and they want us to pay for an additional 1 on 1 rate for each day for 3 months, which is $1,200 a day,” the presenter said.
Accounting pulled out line items showing foster-care/adoption costs rose by roughly $518,000 in the period discussed. The presenter also reported county Medicaid net cost at $11,459,000 for the reporting period and noted that statewide Medicaid spending on behalf of Washington County residents exceeded $164,000,000 (payments to hospitals, nursing homes, ambulances and other providers) over the same review.
The presenter explained that reimbursement rates for specific programs did not change in 2024; rather, the county spent more in lower-reimbursed areas (for example, safety-net services and special education placements), which reduced the overall percentage of reimbursement and increased net county cost.
Committee members asked about causes and process: the presenter said placement scarcity, higher needs among some children and the resulting need to place children farther from the county were major contributors to higher costs. The presenter also described cooperative arrangements across county departments to channel services and funding where appropriate.
The department said it will continue monitoring placements, push for alternatives when elevated supplemental rates are requested, and present budget comparisons to the board before the presenter's planned retirement.
