Medicaid increase drives GarCo DHS caseload |

Medicaid increase drives GarCo DHS caseload

Human services spending, combined with public health in this chart, accounts for about 20 percent of overall spending in Garfield County's proposed 2016 budget.
Graphic provided by Garfield County government |

A big increase in the number of Medicaid recipients in Garfield County who entered the system after the federal program expanded under the Affordable Care Act now account for nearly three-quarters of the county’s public assistance case load.

Since the end of 2013, the total number of economic security program cases administered by the county’s Department of Human Services has gone up from about 7,000 to nearly 9,500, according to the most recent DHS statistics through August.

That number includes people and families on food assistance (food stamps), plus cash assistance, help with day care costs for children, and the single largest program, Medicaid, which provides medical assistance for low-income individuals and families.

As of Aug. 31, Medicaid accounted for 74 percent of the county’s total public assistance case load, Garfield DHS Director Mary Baydarian said.

“We do run pretty high case loads between our case managers,” Baydarian said Tuesday of a requested increase in personnel that is included in her department’s proposed $22.8 million 2016 budget.

Of the six new positions requested for next year, four are in the department’s economic security division, she said.

Much of that need has been driven by the increase in Medicaid recipients since the program expanded in 2013 as part of the Affordable Care Act (ACA).

The total number of Medicaid cases has gone up this year alone from about 6,300 at the end of 2014 to 7,062 through August.

Counting family members, more than 13,800 individuals in Garfield County, or about 24 percent of the total population, are on Medicaid, according to the latest statistics.

That number is expected to go up even more as open enrollment begins next month for health insurance through Connect for Health Colorado, the state exchange used to issue insurance under the ACA.

Although the county’s $22.8 million Human Services Fund budget stands as the third-largest spending category in the overall $125.5 million county budget, only about 18 percent of that cost is covered by county taxpayers, Baydarian explained.

Because the two biggest program categories, Medicaid and food stamps, are federal programs, most of that cost is covered by the state and federal governments.

But there is an incremental impact on the county budget, Baydarian acknowledged during a budget hearing with the county commissioners on Tuesday.

Most of the new county employee positions being considered for next year are for human services, noted Commissioner Tom Jankovsky.

“And all of those are pretty much mandated,” he said.

But two recently hired workers could actually help reduce the public assistance case load, Jankovsky also noted.

Two new human services positions that were approved by the commissioners in September will oversee the new Employment First Program being implemented in Garfield County starting next month.

Under that program, roughly half of the county’s food stamp recipients will be required to participate in job skills and employment training, or they could lose their benefits.

“We have seen our economy come back in a lot of areas, but yet we haven’t seen a major reduction in food assistance,” Jankovsky said. “I think this is a good time to have an audit through Employment First … to keep people honest.”

The number of food assistance cases in Garfield County has actually gone down some this year, from just over 2,200 at the end of January to 2,073 as of the end of August.

However, the number of individuals on food stamps has remained about the same, starting the year at nearly 4,500, reaching a high of 4,621 in March, and leveling off at 4,443 in August.

The proposed 2016 Garfield DHS budget represents a $622,000 increase in spending over this year, and includes about $128,500 in various capital expenditures primarily for new document scanning equipment and software.

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