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Placer County HHS touts housing and behavioral-health gains but warns of indigent-care funding risk
Summary
Health and Human Services reported progress: hundreds of units of permanent supportive housing opened or in development, expanded recovery residences and improved behavioral-health metrics. Director Dr. Rob Old warned the county may face increased indigent-care obligations if state policy and coverage changes increase the uninsured rate.
Placer County Health and Human Services (HHS) presented a broad program update and the department’s FY 2026–27 budget, highlighting progress on permanent supportive housing, behavioral-health capacity and prevention work — while flagging an emerging fiscal risk tied to indigent-care obligations.
HHS Director Dr. Rob Old summarized the department’s housing accomplishments: more than 230 permanent supportive-housing units are open and another 55 units are expected to come online within the next year; the county has added recovery-residence beds co-located with supportive housing to improve service coordination and stability for tenants. Old credited the collaborative efforts of county staff and community partners, and noted the county’s use of state programs including Homekey to capitalize projects that would otherwise be expensive for local government.
On behavioral health the department pointed to strong quality metrics, expansion of crisis and post-acute capacity (including construction of a psychiatric health facility), and ongoing coordination with hospitals and managed-care plans. He said the county’s behavioral-health penetration rate and follow-up metrics compare favorably with state benchmarks.
But Old cautioned that a likely change in coverage — and the prospect of a higher uninsured population — could increase Placer County’s statutory obligation to provide indigent medical care. He told supervisors the county is evaluating options, including coordination with the County Medical Services Program (CMSP) and other state-level solutions, and warned that the county’s general fund may be asked to fill gaps if state or federal resources do not keep pace. "We anticipate those needs could more than double in the next few years," Old said, referring to potential uninsured counts if coverage is reduced.
HHS presented a proposed FY 2026–27 budget that relies heavily on state and federal grants — roughly 85% of the department’s revenues come from external sources — and noted a mix of new, grant-funded positions were included in the submission. Old said HHS continues to prioritize flexible local funds for programs with limited external support, such as animal and veteran services and homeless-shelter operations, and asked the board to consider long-term strategies to ensure stable funding for core safety-net services.
