Under the One Big Beautiful Bill Act, passed on July 4, low-income adult Medicaid recipients must now have their eligibility redetermined every six months instead of once a year – a change that could double the workload for the Montezuma County Department of Social Services.
“We know that about 15,000 folks in Montezuma County access and utilize Medicaid,” said Social Services Director Hargraves during a meeting with the County Commissioners. “That is a lot of additional renewals throughout the year.”
In addition to the increased Medicaid paperwork, the department faces cuts in federal-to-state funding, reduced support for transportation and child welfare, rising hotline costs, and criticism from Colorado about spending.
The department also manages senior services, public transportation, health care, food assistance and child support services.
Hargraves outlined the impact on Sept. 29 as officials work to finalize next year’s proposed budget, which is due by Oct. 15, per Colorado law.
Hargraves cited a funding cut from the Colorado Department of Health Care Policy and Financing.
“Services that allow residents to qualify for Medicaid are administered through HCPF,” she said. “HCPF did reel back their allocation. They issue those allocations at the very end of June so that we can plan our fiscal year.”
Hargraves attributed “lots of cuts” to the One Big Beautiful Bill Act.
“They were supposed to have (allocation numbers) to us by tomorrow, but they have told us they're not sure when they're going to be able to let us know the impacts,” she said.
Hargraves said HCPF cut rates for nonemergent medical transportation – a service that helps people reach medical appointments. She added that HCPF is planning to hire a broker to manage NEMT Medicaid billing.
She also said she is talking with the town of Dolores about funding support for senior services.
County officials discussed a call center contract for a state-mandated hotline that allows residents to report abuse or neglect involving youths and adults.
The contractor raised its rates since last year, Hargraves said.
“We received our annual contract for the hotline,” she said. “I was a little surprised to receive this contract because it was 28% higher than last year. That's a gigantic leap.”
The contract increased from nearly $12,000 last year to almost $16,000 this year, she said. Running a call center in-house would cost more, but building a regional center could be considered in the future.
Hargraves said she asked the contractor for call log data to justify the increase. She received no data and was told “there wasn’t wiggle room.”
“My concern continues to be if it bumps up by 28%, we continue to see cuts. … Where do we come up with it?” asked Commissioner Jim Candelaria.
A letter from the Joint Budget Committee and Michelle Barnes, director of the Colorado Department of Human Services, regarding Temporary Assistance for Needy Families, allocations and cost-saving measures caught Hargraves’ attention.
“They indicated that counties weren't prioritizing TANF in reasonable and meaningful ways, which felt like a big generalization,” Hargraves said.
“It's really important conversations because as a department we're going to cut TANF contracts again this year. We have to. There's no question about it.”
Hargraves said TANF dollars are essential to preventing youths from entering the child welfare system.
She added that the Colorado Child Care Assistance Program is also underfunded because of new federal regulations.
