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Yahoo
6 days ago
- Business
- Yahoo
Federal uncertainty complicates Pa. budget haggling over transit, education
Spotlight PA is an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania. Sign up for our free newsletters. HARRISBURG — Competing priorities and possible federal cuts to Medicaid are complicating negotiations as top Pennsylvania lawmakers attempt to hammer out a budget deal by the June 30 deadline. The Republicans who control the state Senate say their biggest concern is overspending. With the state facing a structural deficit, they see a need to pick priorities. 'Whether it's education, whether it's transit, whether it's Medicaid, whether it's transportation infrastructure, there's going to be a need for a ranking of those priorities,' Majority Leader Joe Pittman (R., Indiana) told Spotlight PA, 'because we're not going to be able to reach them all.' Democrats who control the state House say their counterparts haven't offered many solutions that could lead to a compromise on those issues in a divided Harrisburg. 'Whether it's our health system, the minimum wage, cannabis legislation — at some point, whether it's the public or the press, someone needs to say, 'When will the Senate be heard on these issues and what are they for?'' Majority Leader Matt Bradford (D., Montgomery) told Spotlight PA. Democratic Gov. Josh Shapiro's opening budget pitch in February called for spending $51 billion next fiscal year, and would require the state to use $4 billion from its cash reserves to balance the books. The state has about $11 billion in reserves it built up over the pandemic; at current spending rates, those dollars will run out sometime in 2026. Pennsylvania runs a structural deficit, spending more than it takes in year over year. Previous budgets approved by members of both parties have routinely increased spending and used accounting tricks to balance the books instead of making sustainable changes, like spending cuts or new taxes. But Pittman said his top priority this year is putting the books in order. 'If we don't make some changes soon, in a few years, we're going to have some very unpleasant conversations in this building,' Pittman said. He pitched cuts to Medical Assistance, the state's health insurance program for low-income individuals, noting that the cost has rapidly ballooned. He specifically wanted to reduce eligibility and expand cost sharing for weight-loss drugs like Ozempic. While members have proposed new sources of revenue, the biggest ones — the legalization of recreational marijuana and the regulation and taxation of skill games — are politically complicated, and getting just one into a budget deal this year would be a major achievement. Instead, most of Harrisburg's biggest debates involve various factions of lawmakers competing for a slice of the budgetary pie. Public transit agencies are facing budget deficits due to a rise in remote work and an end to pandemic-era federal aid. These agencies range from rural services that bring aging customers to grocery stores, to sprawling, intercounty bus and rail systems. SEPTA, the transit agency that serves Philadelphia and its suburbs, faces the worst fiscal headwinds. That has made its financial plight a big political issue for Democrats, who overwhelmingly represent SEPTA's service area. If it doesn't get more state funding, SEPTA says it will cut its current service levels in half starting in late August. Such cuts would lead to longer commutes, could hurt property values, and would end game-night subway service to Philadelphia's sports stadiums. Shapiro wants to send an additional $292 million in sales tax revenue to these agencies. State Senate Republicans have so far rejected the call, saying they'll only agree to a funding boost if it comes with a new, dedicated source of state revenue and more money for roads and bridges. Pittman told Spotlight PA that SEPTA and transit allies' public warnings of the potential impact of cuts for the city and region appear to be 'a way to try to manufacture a crisis.' 'I think the state taxpayer has been quite generous so far,' Pittman said, adding that he was 'very open to giving the counties that use the service more flexibility to manage this issue on their own.' While it is a major issue for many of their constituents, Democrats have so far refrained from making transit the centerpiece of their comments about the budget. State Rep. Ben Waxman (D., Philadelphia) described that as a political tactic, saying Democrats 'cannot forget that there's a lot of other things that will be talked about … Would I vote for a budget that included SEPTA, but defunded Philadelphia public schools? No.' 'Senate Republicans want to back us into a corner and give themselves more power, and I don't want to give them that,' he said. In 2023, a state court ruled the commonwealth's public education funding system was so inequitable that it violated some students' constitutional rights. Lawmakers agreed on a fix the following year. They adopted a formula that routes extra money to 348 schools with 'adequacy gaps' — defined as the difference between the amount a district spends per student and the amount that district would need to spend to serve each child at an acceptable level. Last year's budget put $500 million toward these poor schools, and estimated that nine years of these payments would be necessary to close the gap. If lawmakers don't continue making this kind of investment, the plaintiffs who brought the original school funding case say they'll go back to court. This year, Shapiro again called for about $500 million in adequacy payments, though he asked for significantly smaller increases for K-12 and special education than last year's budget included. State House Democrats are on board with that approach, though many public education advocates have said more funding is necessary. State Senate Republicans say they have reservations, though their precise vision for how the education funding scheme should change remains unclear. Pittman told Spotlight PA that he thinks the state is spending too much money on public education, period. 'We have invested historic levels of funding in public education,' he said. 'We continue to spend more money to educate fewer students. We cannot sustain, in my opinion, the level of growth that has occurred over the last three or four years now, and we have to take a hard look at figuring out how we can contain those costs overall.' State Rep. Pete Schweyer (D., Lehigh), who chairs his chamber's Education Committee, said his caucus just introduced a bill that would make a slate of changes to Pennsylvania's much-scrutinized cyber charter schools, including a flat tuition rate, which would reduce the amount public schools must pay to cybers for students who opt to attend them. That, he noted, would bring 'significant savings for our school districts.' Schweyer said he is 'smart enough to know that budget season is budget season, anything can happen.' But he said he doesn't plan to compromise on adequacy funding. 'I'll just point to how we got here in the first place — 30 years of chronically underfunding the poorest school districts,' he said. 'If we change the formula, we're going right back into court, and we all know it.' So-called sin taxes are the only major sources of new revenue lawmakers have pitched for this budget, but the path to a compromise requires crossing political minefields. The question of how to tax skill games, for instance, is one of Harrisburg's longest-running special interest wars. It remains heated. These slot-like terminals have sprung up, unregulated, in bars and convenience stores across the state. Through years of court fights that have ultimately allowed them to keep operating, supporters have argued the devices help small businesses stay afloat, while opponents say skill games cut into the state's regulated gaming revenue and open a door to problem gambling. Brick-and-mortar casino owners are among skill games' staunchest opponents. Both they, and skill games operators, have spent hundreds of thousands on lobbyists and campaign donations to protect their share of the multibillion-dollar industry. Riven by internal differences over the debate, state Senate Republicans were relatively slow to stake out a position on regulation. Leadership released a proposal in May that pitches a 35% tax on the machines alongside an unspecified assessment — to be set by the state Department of Revenue — to cover the cost of regulating them. In a letter to lawmakers last week, representatives for Pennsylvania's 17 casinos said they welcomed the measure as a starting point for negotiations. But a spokesperson for Pace-O-Matic, a Georgia-based firm that makes skill games machines, said in a statement soon after the bill's release that it 'intentionally imposes an unreasonably high, anti-business tax rate that could devastate small businesses and organizations that count on the supplemental revenue the games provide.' The industry's favored bill proposes a levy of 16%. The casino representatives, who pay a 54% rate on their slot machines, called Pace-O-Matic's ideal rate 'miserly.' State House Democratic leaders haven't united behind a skill games proposal, deferring to Senate Republicans to start talks on the issue. Still, members of the lower chamber's majority caucus also have a wide range of opinions on the best approach — from high taxes on the machines to stricter crackdowns aimed at limiting their use. Legalizing recreational marijuana would require navigating a similarly treacherous political path. State House Democrats launched an opening salvo in that negotiation, passing a bill to legalize adult-use cannabis and sell it through state-run stores, similar to Pennsylvania's liquor model. The bill was summarily rejected in the state Senate, failing to pass its first committee vote. Bradford, the state House majority leader, said any further action will need to originate in the Senate. Bradford specifically urged state Sen. Dan Laughlin (R., Erie) — a longtime legalization advocate and chair of the committee that would handle the bill — to advance his own proposal. 'He has the opportunity now to immediately and expeditiously move a marijuana legalization bill,' Bradford told reporters after a state Senate panel rejected the House's preferred approach. 'I look forward to him getting those votes … and sending something over.' Laughlin has been noncommittal about when he and state Sen. Sharif Street (D., Philadelphia) will introduce their bill, saying the two have been 'making tweaks and going back and forth with the Legislative Reference Bureau' on language. State Sen. Marty Flynn (D., Lackawanna) said he plans to introduce a bill designed to be more appealing to existing medical marijuana companies than the doomed state store bill was. Flynn said he wanted to give the state Senate a concrete option and 'have a vehicle in place' in case the legislature decides to act before the June 30 budget deadline. 'They can't say that no one introduced anything,' Flynn told Spotlight PA. Pittman has not signaled that cannabis legalization is a priority in upcoming budget negotiations. He declined to say whether the issue is on the table, instead dismissing the state House bill as a 'completely unserious proposal.' Pennsylvania's budget is undergirded by a lot of federal money. By June 30, the commonwealth is projected to receive $50 billion in federal funding for the current fiscal year, accounting for 40% of the state's operating expenses. These dollars flow to things like education and transportation. But human services line items, which include programs like SNAP and Medicaid, are by far the biggest recipient category, accounting for 70 cents of every federal dollar received by the state government. This money could be at risk. While the details are in flux, President Donald Trump and congressional Republicans have indicated that they plan to cut Medicaid, a low-income health insurance program administered by the states and funded partially with federal dollars. If they move forward with such a plan, Pennsylvania would need to make corresponding cuts or fill the hole with state revenue. And the price tag may be hefty. According to a rough analysis that the progressive Pennsylvania Policy Center conducted before federal Republicans formally passed their sweeping tax plan, the state would be on the hook for at least $133 million more in costs in 2026 if the federal cuts were enacted. That total, the center noted, would only grow in the coming years. The GOP tax plan hasn't passed the U.S. Senate, and could change significantly before becoming law. But financial uncertainty remains in Pennsylvania, and one option for dealing with it would be passing a short-term budget to keep the state government's lights on until Trump signs a spending bill. The legislature made a similar move in 2020 due to the COVID-19 pandemic. State Senate Appropriations Chair Scott Martin (R., Lancaster) told Spotlight PA that a partial budget might make sense. 'I will never shut the door on that,' Martin added. However, such a move would only delay big decisions on the state's finances, not eliminate them. Bradford told reporters in May that any talk of temporary budgets is 'premature.' 'I think we have an obligation to pass a budget,' Bradford said, adding: 'I think we should do that by June 30 or shortly thereafter.' If you learned something from this article, pay it forward and contribute to Spotlight PA at Spotlight PA is funded by foundations and readers like you who are committed to accountability journalism that gets results. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
27-05-2025
- Business
- Yahoo
Here's why delivery of social services is so complicated
Photo illustration by Getty Images. A few months ago, I was having coffee with a friend who was helping a relative apply for Medical Assistance. He looked at me, astonished, and maybe a little outraged, and said, 'You have to mail a piece of paper to change an address.' I nodded, looking down at my coffee. Anyone who has worked in human services braces themselves for these stories. They range from headache-inducing bureaucratic annoyances all the way to horror stories of people so caught up in red tape nightmares that they can't access life-saving care or treatment. Why is this? Why are human services so complicated? The answer starts with us — the attitudes of the American people — and is reinforced through all other levels of the policy process, from budgeting to service delivery. America's attitude toward poverty is shaped by 16th century English Poor Laws, particularly the idea of 'deserving' and 'undeserving' poor. This manifests itself in our nation's reliance on means-tested programs. Means-testing means only low-income people qualify for a service. Other rich democracies rely more on services that are available to everyone. Means-tested programs rely on complex eligibility processes — both for initial application and to prove continued eligibility. Sometimes, people must report various information on a monthly basis to remain eligible for benefits or services. It's a continuous requirement to prove that you really need help. While some process is necessary, the number of rules and the degree of complexity to follow them reflects the public ambivalence toward these services. These values can get muddled in the largest U.S. means-tested program, Medicaid (called Medical Assistance in Minnesota). Medicaid is largely thought of as a health care program for low-income families. It is means-tested. At times over the past two decades, Republicans have referred to Medicaid as 'welfare health care' to justify budget cuts. At the same time, Medicaid provides health care and long-term care for low-income seniors and people with disabilities. Health care for seniors and people with disabilities has broad public support, and many believe this basic dignity is a right, not a privilege. Yet the process of getting grandma into the nursing home or helping a person with disabilities live and work in the community is complicated by the fact that these services are paid for by Medicaid, a means-tested program. As a result, families trying to help a grandparent or another relative often find themselves caught in a morass of rules and red tape. All because the best our nation could do for vulnerable people needing long-term care was to cobble some services onto Medicaid. This ambivalence about helping poor people also plays into another facet of the policy process: budget cutting. Human services are some of the largest and fastest growing programs: Medicaid and SNAP are two of the larger programs in the federal budget, and Medicaid is the largest program in many states' budgets. Whether reductions are made for political reasons or to address budget deficits doesn't matter: Human services programs will be at the center, because that's where the money is. But few politicians really want to cut low-income people off benefits, especially not health care for people in their districts, and especially not elderly people in nursing homes or people with disabilities. So, instead of simple changes that would reduce benefits or coverage, the budget cutting solutions are often more complex policy changes wrapped in messaging about 'work' or 'fraud and abuse.' We see this happening right now at the federal level with Medicaid and SNAP. A skittish Congress has backed off from direct cuts to Medicaid, opting instead for work requirements and other eligibility changes — under the guise of weeding out the people who don't deserve health care. In other words, Congress is intentionally creating complex hoops designed to cause people to lose health care, all in order to cut the budget to pay for tax cuts. Once these policies are passed by Congress, federal agencies create regulations to further detail how policies must be implemented by states. At the state level, additional legislation may be required to sort out any areas of state discretion under the new federal laws. And then state agencies develop rules or guidance for counties, tribes or private entities that deliver the services. Each step adds more specificity — and more complexity. And the constant changes in policy from year to year compounds the problem. It all lands on people trying to get necessities like health care and groceries — and the frontline workers who are just trying to help their clients obtain these simple human needs. I've focused on eligibility policies, but this complexity has infected other policies as well. The decisions regarding who gets into a nursing home or what services a person with disabilities can get in the community had, in the past, relied partly on discretion by a local social worker. Now these decision factors are fixed in law and supported by structured, mandatory assessment tools. This ensures consistency, but when people are denied services, it can feel like the decision was made in a black box. I'm not sure it is possible to undo this cycle. There are never enough resources to meet all the needs. Combine that with our ambivalence about who deserves help, and it's a self-perpetuating mess. The best hope for fixing this problem — to make it simpler for people to get the services they need — is at the point of service delivery. Of course, as I wrote here in 2023, that requires us to overcome another challenge: We focus a lot on public policy and not enough on the the operational mechanics of programs and how they work (or don't) for the person who needs it. Yet I have some optimism for this solution for two reasons: It is in the control of state and local officials who care about human services, and digital tools offer real opportunities for simplifying the consumer experience. But we need the will to do it — to put the needed focus on efforts to improve service delivery, while still managing the unstoppable policy machine. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
06-05-2025
- Health
- Yahoo
Here's how the House plans to cut $300 million from the disability services agency
Thousands of protestors gathered at the Minnesota State Capitol as part of the nationwide "Hands Off" protests condemning several actions of the Trump administration Saturday, April 5, 2025. (Photo by Nicole Neri/Minnesota Reformer) The Minnesota House passed a bill Monday with significant cuts to the Department of Human Services through 2027. DHS programs account for nearly one-third of state spending, and are expected to get more expensive in the coming years due to the aging population and increasing health care costs. Most of the spending is on Medical Assistance, Minnesota's Medicaid program, which allocates more money per participant than nearly any other state. Because DHS is such a large portion of the budget — rivaled only by education — state leaders have targeted the agency for cuts in the coming years to avert a looming deficit. With the House tied 67-67, Republican and Democratic-Farmer-Labor leaders agreed to find $300 million in savings. The cuts to Medical Assistance come ahead of proposed cuts at the federal level. Because the federal government pays for more than half of Medical Assistance, any federal spending reductions would likely force additional state cuts. Republicans in the U.S. House are prepared to reduce Medicaid spending to pay for tax cuts; Senate Republicans are wary of the move. Party leaders are considering eliminating a tax loophole that allows states, including Minnesota, to get extra Medicaid money from the federal government. The state Senate has not yet passed its DHS budget bill. Any discrepancies between the two budgets must be hashed out in a conference committee and re-passed by both chambers before the session ends on May 19; without a budget by June 30, the government will shut down. House budget cuts spending on services, pushes costs onto counties and federal government The biggest piece of savings in the two year, $17.7 billion DHS budget bill (HF2434) comes from changes to 'rate exceptions,' or higher-than-usual payments to providers who care for people with extraordinary needs. The bill requires extra documentation from providers, and limits what can be considered when determining if a patient and their provider qualify for the exception. The bill also shifts part of the cost of rate exceptions to county governments, which could lead to higher taxes for property owners across the state. Together, the changes would save the state around $200 million in the next budget cycle. The bill would also increase costs on county governments by increasing how much they pay for substance use disorder treatment, and for certain people detained at the Minnesota Sex Offender Program starting in 2027. The budget would limit the inflation adjustments for some Medical Assistance reimbursements to 4% per year, saving $162 million over the next two years, and even more in future years. (Gov. Tim Walz proposed limiting that inflation adjustment to 2% per year.) The move is expected to squeeze providers, as their reimbursements may not keep up with the real cost of providing care. The bill contains a maneuver that would save the state money by pushing costs onto the federal government. It more than doubles the annual per-bed licensing fees for nursing facilities, from $2,815 to $5,900, and also more than doubles one component of the facilities' reimbursement rates. In short: the state would collect licensing fees from the nursing homes, then return it using a mix of state and federal resources. This saves the state $73 million over two years. The budget would also raise licensing fees for home and community-based service providers, substance use disorder treatment centers, and detox and withdrawal facilities. It would also eliminate payments made to providers to cover the cost of unplanned absences, saving around $67 million in the next budget. Medical Assistance currently pays providers the same amount for night supervision duties whether the worker is asleep or awake; the bill would create a new category for 'asleep night supervision,' with lower payouts, saving $23 million over two years. It's not all cuts The House bill codifies raises for nursing home workers set by the Nursing Home Workforce Standards Board. The new minimum wage for all nursing home workers would be $19 per hour, which would increase to $20.50 per hour starting in 2027. Specialists like certified nurse assistants, trained medication aides and nurses all have higher minimum wages. It also codifies raises for disability services workers as part of a contract agreement with SEIU, the workers' union. The Trump administration is cutting funding for HIV research and prevention efforts, and the House bill would allocate $6 million to community-based HIV/AIDS services providers to replace the lost federal funds. The bill would direct $5.5 million to preventing fraud by autism services providers.
Yahoo
01-05-2025
- Business
- Yahoo
Federal Medicaid cuts would wreak havoc on the state budget — and the lives of 230,000 Minnesotans
Thousands of protestors gathered at the Minnesota State Capitol as part of the nationwide "Hands Off" protests condemning several actions of the Trump administration Saturday, April 5, 2025. (Photo by Nicole Neri/Minnesota Reformer) Gov. Tim Walz and the Legislature are busy working on the state's budget for the next two years. Their efforts to reduce state spending, however, are focused on two other realities: the state budget deficit forecast in 2028-29, and what is happening in Washington, D.C. The chaos in Washington is the bigger wild card. The actions of the Trump administration create two problems for the state budget. First, an increased risk of a recession. And, second, direct cuts of federal funds to the state. The funding cuts have already started, with reductions impacting public health, behavioral health, food shelves, transportation, housing projects and more. Whether it's DOGE or Congress, there is no sign the cutting will stop any time soon. The biggest budgetary threat for Minnesota — and most states — is cuts to federal Medicaid spending. The U.S. House budget plan proposes to reduce funding for Medicare and Medicaid by $880 billion over the next ten years. Most observers expect Medicare will be held harmless and the bulk of the cuts will come from Medicaid. Medicaid, called Medical Assistance in Minnesota, serves about 1.3 million Minnesotans. It provides health coverage to low-income families and individuals, and long-term care for seniors and people with disabilities. Minnesota spent $18.5 billion on Medical Assistance in fiscal year 2024. Sixty percent of that funding — $11.1 billion — came from the federal government. Medical Assistance is the largest program in the state budget, and it is growing fast: Due to the rising cost of health care and the aging of the population, spending will exceed $26 billion in fiscal year 2029 — a 42% increase over five years according to the Department of Human Services. If the $880 billion federal reduction is spread proportionately across all states, DHS estimates Minnesota would lose about $1.4 to $1.6 billion per year in federal Medicaid funding. The actual impact depends on what policy changes Congress adopts. One of the most likely changes is adding work requirements for some Medicaid enrollees. Work requirements are a bad idea for a variety of reasons, as nicely summarized in this space a few weeks ago. It's a bad policy, and it also doesn't save a lot for the federal budget. A similar proposal in 2017 was estimated to save $109 billion over ten years, only a fraction of the $880 billion Congress is now pursuing. It's not clear where Congress will look for additional Medicaid savings, but targeting the expansion population — a new group of people that were added to Medicaid coverage as part of the Affordable Care Act — is a definite possibility. The 'expansion population,' as it is called, consists of adults without children. Prior to the Affordable Care Act, which enacted the Medicaid expansion, health coverage for these low-income adults was a significant gap in our nation's health care system. Some states — including Minnesota — cobbled together some basic coverage, but it is difficult for a state to provide broad access to health care coverage without federal funding. Dismantling a part of the ACA — aka, Obamacare — may be politically appealing to the GOP-controlled Congress. There would also be no impact on the 10 states that do not cover the expansion group — nine of which are solidly Republican, including Florida and Texas. KFF, an independent source for health care research and news, says one prominent proposal is to end the enhanced 90% federal funding match for the expansion population. States could continue to serve the expansion population but would get their normal rate of federal reimbursement. That normal match rate for Medicaid is called the Federal Medical Assistance Percentage, or FMAP. These rates vary by state based on per capita income, ranging from 50% to 77%. Minnesota's current FMAP is 51.16%. If all states continued to cover the expansion population at the lower rate, KFF estimates the federal government would save $656 billion over the ten-year horizon. But it is likely many — probably most — states would discontinue Medicaid coverage for the expansion group because they could not afford to make up the lost federal funding. It would cost Minnesota about $1.2 billion in fiscal year 2026 to continue covering the adults without kids expansion group. It is hard to see how the state could afford $1.2 billion a year under normal budget conditions, much less with the looming deficit and the threat of a recession. In Minnesota, 230,000 people would lose coverage. This population is one of the most marginalized groups in our society. Access to Medicaid has been particularly helpful in providing better access to mental health and substance use services. If this coverage goes away, it puts pressure on counties and underfunded community resources; many people will simply lose access to health care and behavioral health services. Uncompensated care — when people without insurance receive care in an emergency room, for instance — would increase, impacting community hospitals and shifting costs onto people who have insurance. The need for health care doesn't go away — it just gets delayed, more serious and shifted to other budgets. Federal funding cuts across the state budget will force hard choices. The usual default is to say that the state can't plug holes from federal cuts. And you can't plug all the holes. But if the cuts are deep and broad, the state may need to reprioritize its own funds to fill the most crucial gaps. In this instance, recreating full Medicaid coverage is probably fiscally impossible. Some cobbled together gap filler, maybe. Progress is not a straight line going up — it is often two steps forward and one step back. But this would be a deeply harmful step back. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
19-04-2025
- Health
- Yahoo
Renville County Human Services navigates staff, funding challenges
Apr. 19---- A high staff turnover rate while demand for services grew in some areas made for a challenging year for Renville County's Human Services department. The coming year is likely to bring its own challenges. In a report to the Board of Commissioners on April 15, Human Services Director Kaitlyn Frederickson said she expects that demand in most service areas will remain at current levels or increase, while the complexity of cases will rise in many cases. All of this comes with the possibility of increased costs for the county as state and federal governments look at cost-cutting measures. "We are facing some really great changes. I try to stay positive," Frederickson said by way of introducing the report along with members of her staff. The department experienced a 35 percent employee turnover rate in 2024, which meant supervisors had to contend with the additional demands of interviewing and conducting the hiring process for 22 new employees, not all of whom remained. Frederickson said the department is now one position short of full staffing, although in some areas, the case load per staff member is higher than what is in state guidelines. Highlights from her report point to the importance that local, state and federal programs administered by the department play in the lives of many county residents. Based on the department's numbers, 9% of the county's population receives public assistance for their basic needs. The report state that Renville County has a population of 14,348, according to the 2023 census. Larger shares of the population rely on specific programs for help. According to the report, 27%, or 3,879 of the county's 14,348 residents, participated in Medical Assistance for the costs of their health care in 2024. Minnesota's Medicaid program is known as Medical Assistance, which provides health care coverage for people with low income. In Renville County in 2023, Medical Assistance provided $50,686,467 in revenues for health care providers serving the population. The federal government provided $50,662,365 of that total, according to the report. A little more than $24,000 came from the state. Final financial numbers for 2024 are not yet available. Another program serving a significant number of residents is the Supplemental Nutritional Assistance Program, formerly known as food stamps. The program helped 1,074 residents in 2024. SNAP represented $1,849,426 in revenues for food retailers serving the population. The federal government funded $1,846,916 of the total, according to the report, and about $2,500 from the state. The department had seen the number of adult protection cases — those providing help to vulnerable adults — trend upward for a few years before leveling off in the last couple. The director expects the numbers will remain steady. The department conducted 182 assessments for child protection cases last year, and had 62 active child protection management cases at year's end. Child care remains a significant issue in the county. The number of licensed providers has remained stable in recent years, with 23 licensed providers and three licensed day care centers currently operating. The county is meeting 76 percent of its child care needs. It is 154 openings short of full capacity, according to the director. "This will be an ongoing topic," said Frederickson. "We need to figure out how to get more day care providers here." The director and County Administrator Lisa Herges noted that the county is working on a project to increase child care services with plans to open space in the Meadows on Main facility in Renville for providers to operate.
