Community Leadership Roundtable

Chaffee County
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Community Roundtable Notes:
2-3-2025

County Commissioner PT Wood started a community leadership roundtable that would be modeled after the one held by the county during COVID. The goal is to bring together individuals and organizations with shared objectives to foster open communication. He expressed concern about impending spending freezes and reductions at both the state and federal levels, with the state currently facing a significant deficit of $500M to $1B. The roundtable aims to identify local vulnerabilities and strengthen programs.

Attendance:
The meeting was attended by 63 participants, including staff from Colorado’s U.S. senators and Representative Petersen’s offices, Salida City Council members, the Buena Vista mayor, various nonprofits, and government organizations.

Key Updates:
• Beth Helmke (County Representative): The county has reviewed state and federal funding to identify vulnerabilities but did not provide specific details.
• Betsy Dittenber (Chaffee County Community Foundation):
◦ Shared insights on the impact of nonprofits in Chaffee County.
◦ Estimated there are approximately 100 nonprofits in the county, with about 75 actively operating.
◦ Conducted a survey with 37 responses: 17 respondents anticipated receiving federal funding totaling $10.5M.
◦ Noted that all federal grant proposals included a Diversity, Equity, and Inclusion (DEI) component.
◦ Warned that most federal grant funding is allocated for staffing, potentially leading to layoffs if funds are reduced.

Sector-Specific Concerns:
• A local fire chief reported difficulties hiring wildfire firefighters due to federal hiring portals being shut down. Additionally, fireworks costs may rise because of trade tariffs.
• A representative from Senator Bennet’s office pledged to help but noted challenges as federal agency contacts are transitioning with the new administration.
• Kate Garwood (Chaffee Shuttle): Reported not receiving expected funds from CDOT.
• Buena Vista Mayor Libby Fay: Stressed the need for federal funding to sustain affordable housing projects.
• Andrea Carlstrom (Public Health): Proposed the county issue a general statement for roundtable attendees to sign.
• Max Hanson (Housing Director): Highlighted that programs addressing DEI initiatives, immigrant populations, and the Green New Deal are likely to face spending freezes and cuts.

Suggestions:
• Several participants proposed establishing county, city, and town funds to provide loans to support local programs losing funding. This idea did not receive strong support from county officials.

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Here’s brief summary of 2-24-2025’s Chaffee Leadership Roundtable (CLR) discussion. The Chaffee County Commissioners started (CLR) to address the 90 day review of federal government spending and the resulting federal funding freeze.

However, the most urgent funding needs centered on Medicaid, which, in practice, is largely a state-managed program rather than a federal one. The real issue is that the state is underfunding critical services like Non-Emergency Medical Transportation (NEMT) and mental health and substance abuse care for uninsured patients.

Compounding the problem is MediRide, which provides NEMT in Colorado. MediRide recently lost its Medicaid funding due to fraud accusations involving false claims and unverified rides. This has placed enormous strain on Mountain Valley Transit (MVT) and other local providers struggling to absorb the impact. Meanwhile, Medicaid reimbursement rates remain too low to cover rising costs, and safety net funding continues to shrink, leaving vulnerable residents with fewer options for care.

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Here’s more detail on what happened in 2-24-2025’s meeting, but first some background on Medicaid.

Medicaid primer:

The federal government doesn’t directly hand out Medicaid dollars to providers or nonprofits. Instead, it sends funds to the states, usually on a quarterly basis, based on the states’ projected spending. States then manage the program—they set eligibility rules (within federal guidelines), determine payment rates for doctors and hospitals, and distribute the money to healthcare providers, including nonprofits that might offer services like community health clinics or long-term care. States have to cover their share of the costs, too, which comes from state budgets, often funded by taxes or other revenue.

The Medicaid payments to states were only briefly stopped on January 27, 2025—more like a hiccup than a full freeze. For Colorado, this brief stall might not have hit Chaffee County’s radar yet—or at all—because states often have cash buffers for Medicaid. Colorado’s quarterly federal draw—around $2.4 billion—probably wasn’t due right then, and the General Fund (over $3 billion for Medicaid in 2024) could’ve bridged any gap. The executive order’s 90-day review is ongoing—agencies are still scrubbing programs—but Medicaid’s mandatory status means its core funding should hold unless Congress rewrites the budget later.

In their September 9, 2024, report the GAO cited the Department of Health and Human Services (HHS) estimate for fiscal year 2023: Medicaid had $50.3 billion in improper payments (mistakes, over payments, and fraud). This was down from $80.6 billion in 2022, showing some cleanup, though it’s still a hefty 5.8% of Medicaid’s $870 billion total spend that year.

Community Leadership Roundtable:

Kate Garwood, head of the Mountain Valley Transit (MVT) board, said her nonprofit is buckling under the collapse of MedRide’ s Medicaid funding on February 12, 2025. Colorado’s Health First Colorado terminated MediRide’s Medicare funding contract for fraud—fake claims and unverified rides. MedRide handled over 375,000 trips yearly, mostly rural, and MVT is now catching the overflow. Bookings for MVT stretch out months ahead serving an aging county where seniors need rides to doctors or mental health care, with rural routes (50+ miles) maxing out their vans and drivers. The ripple’s so bad that county EMS, fire, and sheriff are fielding Non-Emergency Medical Transportation (NEMT) calls—think elderly folks needing dialysis or therapy, not emergencies, clogging 911 lines and straining public safety.

MVT is terrified their Medicaid funding will run dry: Colorado’s NEMT budget ($36 million in 2023-2024, split federal 50%+ and state) isn’t scaling up, and flat rates ($20-$30 per trip) lag behind rising gas and wages. The state’s fraud crackdown slows payments with audits. The brief federal hiccup in the Medicaid portal spooked them.

SolVista is equally frayed, with 80% of their funding coming from Medicaid. They’re swamped by rising demand: more Medicaid patients (1.3 million statewide), uninsured (post-COVID coverage losses), and under-insured (private plans skimping on mental health). In their response to the Behavioral Health Administration (BHA), they flagged shrinking safety net funding—state cash for the uninsured—as a crisis. Colorado’s $5.5 billion Medicaid share faces a $1.2 billion 2025 budget hole, leaving little for safety net boosts. Their $10/hour sliding fee for non-Medicaid patients—meant to keep care accessible—can’t touch the $80-$100 cost per session, while Medicaid pays maybe $50 (below private rates). MedRide’s fall cuts access—fewer rides mean fewer clients. The federal hiccup in Medicaid also shook their trust.

MedRide’s collapse floods the ride provider, strands mental health clients, and now drags in EMS, fire, and sheriff for NEMT—public safety’s stretched when it shouldn’t be. State funding’s stagnant—NEMT and mental health rates don’t budge, safety net cash shrinks, and Colorado’s budget prioritizes elsewhere. The federal hiccup proved the system’s brittle; even a day’s freeze during the ongoing 90-day review terrifies them. The county’s aging population amps the pressure—more need, less margin. MVT and SolVista are holding on, but the cracks are showing.

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