At the March 19, 2024, Ottawa County Health and Human Services Committee meeting, the health director said the quiet part out loud. The number of people on government assistance programs is purposefully being increased. Yes, you read that correctly. Government programs are supposed to be there to help those in need, but rather than assisting those in need, some programs are designed to actually create dependence by increasing the number of consumers receiving assistance. (46:00-55:00)
During the meeting, Ottawa County Health Director Adeline Hambley asked the board of commissioners to approve funding to reactivate two positions that were not part of the FY2024 budget. Hambley made the following statements. (46:25)
“Because of funding increases in Title X [] there was an increase of $250,000, because there was an increase for the total number of patients we have to see.”
“The two positions we would like to reactivate are on that sheet. The first is for a nurse practitioner. [] Under the past Title X funding we had to have 603 unduplicated users of the service for the funding they provided. With the increase in funding the grant requirement is 715.”
“The other position we are looking to reactivate is a 0.6 full time employee (FTE). The point of this one is to act as a coordinator for Title X and to increase and reach those people that are qualified for services, and meeting those grant requirements.”
Commissioner Gretchen Cosby asked, “I heard a number of patient requirements. Has the demand gone up? [] Do we have an increased need? Is that what you are concerned about?”
Hambley answered, “We do need to increase the number of patients that we see per the grant requirements.”
Commissioner Sylvia Rhodea asked, “You have a need to increase the patient set that you see. How would you foresee doing that?”
Hambley answered, “There are specific requirements for Title X patients. There is specific targeted outreach to reach those people and make them aware of services. For example, there can be training or education about birth control, and I think they wrap in, what is consent; at the jail. We partner with the sheriff’s office and do some classes specifically in the jail, and then make them aware of services that they can seek when they are not in the jail. We try to do very specific targeted outreach to help those people that may not be aware that those services are offered and are very specific for a segment of the population.”
More discussion revealed that the requirements to increase the number of consumers from the federal government are based on demographics of the county such as income and population.
Commissioner Rhodea asked, “Do you anticipate having any difficulty reaching that increased number?”
Hambley answered, “I don’t think so. I think that she’s [another health employee who tracks consumer levels] seeing some level of increase.”
Unfortunately, increasing the number of consumers on government assistance through targeted outreach to specific populations is not unique to this request, but rather a pattern. Reaching out to targeted populations to offer them services does not increase independence, but rather increases the number of people dependent on government services. Here are several more examples of populations that have been targeted for increasing the percentage of people receiving government services.
The goal of the Man Therapy grant was to increase the number of consumers receiving mental health services by reaching out to veterans.
Mental Health Millage money is used to fund the Momentum Center that provides referrals to CMH by reaching out to those with substance use disorder and mental illness.
One aim of the CCBHC grant was to increase the number of consumers by reaching out to the Hispanic and youth populations through health and wellness fairs, informational flyers, and classes.
The Ottawa Community School Network (OCSN) provides outreach to children in schools and provides information for receiving all different types of government services including mental health services, housing, and food assistance among others.
Thrive Ottawa reaches out to those who have had Adverse Childhood Experiences and helps them find services.
More evidence of government programs creating dependence can be seen in looking at the number of people on state and federal insurance plans. Coincidentally, these numbers were also discussed during the March 19, 2024 HHS meeting. Ottawa County has a population of roughly 300,000. Of these, 35,201 people are on Medicare and 13,443 people are on the Healthy Michigan Plan, for a total of nearly 50,000. (1:09).
Commissioner Gretchen Cosby asked about these numbers. “I’m kind of concerned here, honestly, with the numbers that you are sharing with us. Ottawa County is supposed to be the healthiest, and the wealthiest, and the most insured county in the state, and so I’m hearing approximately one-sixth of our population is receiving some sort of services through DHHS. Why do you think that is?”
Director of Ottawa County Health and Human Services (HHS) Kendra Spanjer answered. “When I was here last, I talked about education. I think there is more information out there about the availability of programs. So, I would say, since COVID, we have continued to see a rise in our programming, and I do believe it’s accessibility. It’s easier to access. Education is out there. In the past, I don’t think people were as quick to want to get assistance, but now they have options and choices, and they know it’s an option for them.”
The numbers of people on assistance are increasing due to outreach programs that help link people to services. None of these programs seem to have a goal of teaching people how to be independent and getting them off services, as their primary goal is to meet patient count numbers set by various state and federal grant programs.
This is a recipe to continuously grow government and enrich people and organizations that know how to navigate public health funding sources. But, hey, who doesn’t love spending other people’s money?