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HHS warns Board that HR 1 and state changes could raise recurring county costs by $6–$10M and increase homelessness
Summary
Health and Human Services briefed supervisors on phased federal HR 1 changes (work requirements, tightened immigrant eligibility, reduced retroactive coverage and SNAP match shifts) that will increase administrative workload and create recurring county exposure estimated at $6–$10 million annually by FY28 without mitigations.
Health and Human Services Director Dr. Lisa Varhoes and senior staff presented a detailed briefing on federal HR 1 changes and state policy shifts that are expected to increase county-level fiscal risk and operational workload. Carrie Buhrman (Social Services) summarized HR 1 provisions: broader work requirements for Medi‑Cal (expansion population and ages 19–64 requiring 80 hours/month), expanded Able-Bodied Adults Without Dependents (ABAWD) work rules for CalFresh (20 hours/week), tightened immigrant eligibility for full-scope Medi‑Cal,…
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