Trinity County health director warns HR 1 will increase eligibility redeterminations and workload for Medi‑Cal, CalFresh
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Summary
Health & Human Services Director Liz Hamilton told supervisors that federal HR 1 changes will shift eligibility redeterminations from 12 to 6 months and introduce work requirements that could affect about 2,387 local Medi‑Cal recipients; county staffers are preparing workforce and outreach measures.
Liz Hamilton, director of Trinity County Health & Human Services, told the Board of Supervisors on Feb. 17 that federal changes packaged as HR 1 (signed July 4, 2025) will require counties to return to six‑month eligibility redeterminations for expanded Medi‑Cal benefits and add work requirements that could significantly raise local administrative workload.
Hamilton said about 4,538 county residents were enrolled in Medi‑Cal and 2,783 in CalFresh as of Feb. 1. She estimated that 2,387 people in Trinity County could be subject to the new Medi‑Cal work requirement (80 hours per month) and that roughly 1,100 CalFresh recipients without dependents could face new verification obligations. The county also faces a change to retroactive Medi‑Cal coverage, from 90 to 30 days, which Hamilton said affected 22 recipients in a recent month.
"This is a heavy workload," Hamilton said, describing the staffing strain of moving to six‑month reviews and the training needed for eligibility staff. She warned that the federal‑to‑state shift in funding could result in higher administrative costs for counties if California does not fully backfill the changes. Hamilton said some federal changes already took effect in January and the county expects full program implementation by October 2028.
Board members asked about supports for people who might lose benefits. Hamilton said eligibility programs already connect able‑bodied recipients to the county's employment and training services and that the department will need to bolster that division to help potentially thousands meet the new hour requirements. She identified the Shasta College SMART Center as a partner for training and said the county will expand outreach to employers, volunteer opportunities and education programs.
Hamilton urged data‑driven advocacy and collaboration with statewide groups (CWDA, CSAC) to press for funding and policy clarity; she said the county will continue to monitor California's budget process through the May revise and June budget decisions.
The board did not take action on HR 1 at the meeting; Hamilton asked supervisors to help communicate changes to their districts and to participate in outreach when the county opens public sessions and releases its assessments.