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County officials warn proposed federal budget cuts would endanger multiple health programs
Summary
Health agency staff told supervisors that possible federal reductions to Medicaid and other federal grants could jeopardize many county health and behavioral health contracts that rely on federal financial participation.
County health officials told the Board of Supervisors on May 6 that proposed federal budget changes could cut federal financial participation and other grant funding, threatening a range of county health and behavioral health programs.
Veronica Kelly, director of the Health Care Agency, told the board the county is budgeted to draw down about $180 million in federal Medicaid participation this year and that cuts to Medicaid would prevent the county from drawing those funds. "If Medicaid is cut, we will not be able to draw down those dollars," Kelly said. She added that potential reductions in HRSA and SAMHSA funding would also affect public‑health block grants including HIV and communicable disease programs.
Supervisors asked whether specific contracts would be at risk. Health Care Agency and Behavioral Health staff repeatedly noted that several contracts rely on federal financial participation in the 70–85% range. For example, staff said contract renewals for HIV and STI prevention and treatment services, adult behavioral health outpatient services and multiple Full Service Partnership (FSP) behavioral health programs draw a major share of their budgets from federal Medicaid or federal grants.
Ian Kemmer, behavioral health director, told the board that the agency is budgeted to draw down $180 million in federal participation and that loss of that funding would require identification of alternate sources or reductions in services. "If that participation is cut ... we would have to find other funding sources to support these programs," Kemmer said. He described the Full Service Partnership programs as the county's highest level of outpatient treatment, providing medication, therapy, employment support and housing assistance.
Supervisors pressed for detail. When asked what would happen if drawdown dollars disappeared, staff said services might be folded into general outpatient clinics with lower intensity of support or reduced altogether. For some contracts, agencies said they could continue basic testing services using health‑realignment dollars but might lose navigation, wraparound or prevention services that enable access to care.
Board members asked staff to track federal proposals closely. The Health Care Agency said it would return with updates; supervisors also flagged the May budget revision at the state level as another potential source of change.
Several related contract items on the agenda proceeded with those cautions on the record. The board approved renewal amendments for electronic health records hosting, behavioral health outpatient provider contracts, and multiple FSP contracts, with staff noting the federal funding exposure and the need for contingency planning.
