Manatee County reviews nonprofit investment process, readies September recommendations and raises question of emergency set‑aside

Manatee County officials reviewed the county’s nonprofit investment process during a work session Wednesday, outlining how applications are scored, when recommendations will come to the Board of County Commissioners and where potential gaps — particularly emergency funding for human services and indigent care — could leave nonprofits waiting for support.

Tracy Adams, deputy director of the county’s Community and Veteran Services (CVS) department, said the county runs three “funnels” of nonprofit funding: children’s services (funded by a dedicated millage and routed through the Children’s Services Advisory Board), adult human services (administered by CVS) and health services (administered by the Public Safety Department). “For health and adult human services, CVS and Public Safety combined review all of those applications together,” Adams said. She told commissioners the board would receive recommended investments for fiscal year 2025–26 at its Sept. 16 meeting, and that resulting agreements would be effective Oct. 1, 2025, even if final signatures follow.

Why it matters: the three funding streams have different rules and review bodies. Children’s services is governed by ordinance (listed in the presentation as 91‑42) and the advisory board sets a three‑year investment plan and reviews and scores applications before bringing final recommendations to the commission. Health and adult human services awards come from the county general fund and are staff‑reviewed; there is no separate advisory board for those awards. That distinction affects timing, available dollars and how emergency requests are handled.

How grants are evaluated: staff and the CSAB use a scoring matrix adopted by the board in May 2023. Adams and CSAB Chair Exdavia Bailey described a process that scores applications against priorities (for children: early care and education, food and shelter, special needs, stabilizing families and parent education, youth development, and mental/physical health) and then funds priority programs first when dollars are limited. Bailey said CSAB members re‑score applicants annually and debate line‑by‑line before making recommendations.

Health and indigent care: James Crowfield, deputy director of Public Safety, said health services uses a 100‑point application and a funding threshold of 80 points. For the health services portfolio Crowfield said roughly 67% of funded contracts this year were health care, 20% homeless and housing, and 13% behavioral health. Public Safety is recommending funding for multiple behavioral health, health care and homeless/housing programs and told commissioners the division had received 22 applications for 2025–26 and planned to recommend 18 programs (presentation noted a total around $2.6 million for one group of recommendations).

Commissioners pressed staff on indigent care. Crowfield and CVS staff described a mix of county low‑income pool funding (an intergovernmental transfer to the state that generates federal matching) and a separate county indigent health enrollment and fee‑for‑service model called Manatee We Care. “Low income pool funding is…where the county does an intergovernment transfer to the state, and it’s matched for a 2‑for‑1,” Crowfield said. He added that the county had encountered legal and data reporting limitations when passing some funds to hospitals, and that some hospitals were unable to provide the data required under county contracts.

Nonprofit perspective and public comment: leaders from local providers urged the commission to consider the downstream savings of community‑based care. Dr. Melvin Price, CEO of MCR Health, said the organization’s emergency‑room‑diversion program helped thousands of residents and argued county investment yields larger savings: “For every dollar invested by the county, it saved five million dollars in medical expenses to the taxpayers and to the actual recipient,” Price said. Cara Onorado, MCR’s chief financial officer, added that MCR absorbs substantial uncompensated care and receives federal and low‑income‑pool payments but still faces a gap; she told commissioners that county reimbursements for EMS transport could multiply the county’s investment in primary‑care diversion. Other public commenters — including Turning Points, Boys & Girls Clubs of Manatee County and Genesys Health Services — described how county grants fit with large pass‑through federal programs (such as HUD rental assistance) and urged careful measurement of financial stability and outcomes.

Emergency funding and process questions: multiple speakers and commissioners noted there is currently no standing pot of money dedicated for nonprofit emergency requests under health and adult human services. Adams confirmed that children’s emergency funding requests are first reviewed by the CSAB and brought to the commission, while health and adult requests must be found within the general fund or approved through a budget amendment. Several commissioners proposed creating a set‑aside for true emergencies; Adams and staff said commissioners could, at the Sept. 16 approval meeting, make a motion to add emergency dollars or direct staff to return with process changes for the next investment year. “We don’t have anything separate…they still have to comply with what is required in our nonprofit agreement process,” Adams said, noting that emergency funding recipients would be required to meet contract reporting and compliance terms.

Timing and next steps: staff said informational briefings for commissioners on recommended awards begin the week after the work session and that the Sept. 16 agenda will include one item to approve recommended investments across the three funding arenas. Staff urged commissioners to provide any direction for immediate changes quickly, because the application cycle for the next funding year opens in December.

Discussion and oversight: commissioners and CSAB members repeatedly emphasized the time volunteers and staff invest in the review process. CSAB members described multi‑month review sessions, public data reviews and debates over scoring. Commissioners asked staff to consider additional briefing arrangements so CSAB members can participate in commissioner briefings; staff agreed to invite advisory board representatives to individual briefings when possible.

What was not decided: the board took no formal votes at the work session. No additional funding or policy changes were approved; staff will return to the commission on Sept. 16 with formal recommendations and contracts slated to be effective Oct. 1, 2025.

A note on terminology and authorities: speakers referenced Manatee County’s Children’s Services ordinance (presented as “91‑42” in the briefing), the county’s low‑income pool intergovernmental transfer, and the federal Emergency Medical Treatment and Active Labor Act (EMTALA) in describing hospital obligations. Staff also noted the county’s nonprofit contract template is under legal review for possible additions (including data reporting requirements on client eligibility status).