Hospitals, clinics and CMSP warn of funding shocks from HR1 and federal grant changes
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Summary
Local hospitals, clinics and the County Medical Services Program told supervisors the state/federal policy shifts could reduce Medi‑Cal funding, risk reimbursement declines, and—in at least one case—have already caused abrupt federal grant terminations impacting local substance use treatment.
Representatives from Adventist Health, Mendocino Coast Clinics and Partnership Health Plan briefed the board on emerging state and federal budget pressures and their potential local effects.
Lucretia Renteria, executive director of Mendocino Coast Clinics, said that in late‑night notifications the clinic learned a SAMHSA grant supporting medication‑assisted treatment (Suboxone) was terminated, affecting roughly 150 patients and costing approximately $400,000 per year in lost support. "They just said ... this is your last day," Renteria said in the presentation; she said the clinic will try to pivot and absorb patients where possible but warned of gaps for some patients who lack ability to pay.
Buck Ellingson (Partnership Health Plan) and Adventist Health representatives explained the wider picture: uncertainty around the managed‑care organization tax and the state budget, expected Medi‑Cal disenrollments under HR1 and the January 1 eligibility changes that began rolling out. Partnership said the governor’s January budget projects lower disenrollment numbers than earlier estimates but still warned of major fiscal uncertainty and urged county advocacy to secure administrative resources for eligibility offices.
County Health Services officials (Dr. Janine Miller) explained how changes to FMAP and Medi‑Cal scope could reduce access to behavioral health services for affected beneficiaries and that mobile crisis response, currently funded with enhanced FMAP rates, may become optional for counties and require additional county funding by April 2027.
The County Medical Services Program (CMSP) presented program background and risks: CMSP supports smaller counties with a pooled program that has historically covered medically necessary care; board staff said they are modeling scenarios in which large numbers of people displaced from Medi‑Cal might move onto CMSP, creating potential fiscal shortfalls. CMSP leaders described a current fund balance but said the CMSP board will evaluate eligibility, benefit and budget changes in early 2026 to address federal reductions and enrollment shifts.
County leaders and health partners emphasized the need for coordinated enrollment outreach, increased county eligibility staff, and advocacy with state lawmakers to mitigate service disruptions and uncompensated care burdens.
