_{Thumbnail photo by Paul Critz}

Del Norte is joining a statewide effort that seeks to shield counties from the “health and human services tsunami” that’s coming with the implementation of H.R. 1, the “One Big Beautiful Bill Act.”

In an April 14 letter conveying a “multi-year countywide H.R. budget request” to state lawmakers, county supervisors stated that California counties may see an impact of between $6 billion and $9.5 billion due to the federal legislation.

The demand for indigent care is expected to increase, which will force counties to expand their workforce, according to the letter. H.R. 1 will also strain other safety net programs due to people losing access to MediCal as a result. 

But there are so many parts, it’s unclear how much of an impact Del Norte County itself will feel.

“I understand there are so many moving parts and nobody has all the answers specifically yet,” District 2 Supervisor Valerie Starkey said, adding that she asked Del Norte Health and Human Services Director Ranell Brown to provide “real actual data” to enable her and her colleagues to brace for potential changes. “I believe it’s prudent of us to be very interactive with this — very engaged — to have the data brought to us on a very regular basis so that when we go to CSAC, the legislative conference in May, we know exactly what we’re arguing for.”

CSAC is the California State Association of Counties, which, along with a coalition of county governments statewide, is asking state lawmakers to allocate $1.9 billion in the 2026-27 state budget and $4.5 billion in 2027-28 to address the ramifications from H.R. 1.

According to District 3 Supervisor Chris Howard, who represents Del Norte County at CSAC, the association is also concerned with the potential impact implementing H.R. 1 will have on public safety budgets in rural counties. CSAC has reached out to the California State Sheriff’s Association and other public safety organizations to join in the advocacy.

“We got some good news Friday that the state legislature is talking about it more openly (about) impacts to the county if they do push it downhill,” Howard told Redwood Voice Community News on Monday.

On Tuesday, Starkey, Howard and their colleagues voted unanimously in favor of sending their letter to Senate Pro Tempore Monique Límon and State Sens. John Laird and Roger Niello, chair and vice chair of the Senate Committee on Budget and Fiscal Review.

In an April 10 email to the Board of Supervisors and county staff, Brown said results from CSAC’s advocacy concerning H.R. 1 are anticipated to be clear after the state issues a revision of its 2026-27 budget May 14.

H.R. 1 will impact CalFresh clients, MediCal beneficiaries and the In-Home Supportive Services program, Brown said. She also anticipates that Del Norte County will need to rebuild its indigent care infrastructure as a result of the federal legislation.

Under the California Welfare and Institutions Code, counties are required to provide medically-necessary care, which is typically emergency care. Del Norte is a County Medical Services Program county — CMSP administers the indigent care program and Del Norte covers the costs, though its participation fee was paused due to the Affordable Care Act.

The Affordable Care Act expanded MediCal coverage to individuals, limiting the need for indigent care, Brown said. Indigent care costs are currently covered by Public Health Realignment funding.

“Likely, those funds will not cover the increased cost of indigent care, which could impact the county general fund,” Brown said in her email. “Also the county’s CMSP participation fee of $39,424 is not eligible to be paid by realignment fees and will also likely need to be covered by the county general fund.”

According to Brown, CSAC estimates that CMSP counties would have to pay $551 per person per month to provide coverage for those who seek indigent care.

Of the 12,083 individuals, or roughly 44% of the county’s population, that are on MediCal, about 3,600 will be subject to work requirements to continue to receive those benefits, Brown said. And of the 3,796 individuals who receive CalFresh benefits, also known as food stamps, about 850 individuals will be impacted by the new work requirements, she said.

The DHHS director told supervisors that she and her staff aren’t yet sure how many individuals will be eligible for work requirement exemptions.

“We also estimate that approximately 200 individuals will lose their MediCal due to their unsatisfactory immigration status or as noncitizens,” Brown stated. “CSAC estimates that 33% (of) individuals who lose MediCal coverage will seek indigent care.”

As for IHSS, the “One Big Beautiful Bill Act” includes proposed reductions in client hours, which would impact the care they receive and increase share of costs to counties, Brown states. 

In its letter, the Del Norte County Board of Supervisors state that the only program with a work requirement is the cash assistance program. As a result, the county would need to train a significant number of its employees, most of whom focus on determining client eligibility. The county would also need to hire more workers.

Supervisors also raise concerns about the burden the new requirements will put on county staff, noting that they already have high caseloads. 

Last week, Howard said CSAC is hoping the California State Association of Sheriffs and other advocacy groups will influence the legislature’s decision, urging them to include funding with the mandates they’ll have to pass to the county level.

“It’s incredibly true that we don’t know what it looks like yet, but we know it’s coming,” he said. “This does mean a substantial impact to us, especially in the indigent care category where we’re looking at, essentially $551 per person in that category and that will add up quite quickly.”

Starkey said another component she and her colleagues should advocate for is that if state lawmakers do agree to tie some funding into the changes Del Norte and other counties are forced to make as a result of H.R. 1, there shouldn’t be an expiration date.

“We don’t want it to sunset like some of the other programs do,” she said.