Foster-care costs push Rutherford County DSS program spending over budget; county gains 12 Medicaid positions

Rutherford County Department of Social Services staff told the board on May 29 that program spending through April was over budget, driven largely by foster-care placements and higher out-of-county placement costs.

Budget presenter Price (S4) reviewed the budget for the period ending April 30, 2024: administrative expenses were at 60.49% of budget, while program spending stood at "104.56% spending, which is 21.23% over budget for this period," Price said. Price warned foster-care costs are already significantly over the original foster-care line and that finance director Paul Roche is preparing a budget amendment to move additional general-fund contribution into foster care.

Price and board members said the county originally budgeted roughly "400,500" for state foster care but had spent about "835" (thousand) year-to-date in state foster-care costs, leaving the county approximately "$435,000" over that line item, according to comments during the presentation. Price and Hunt said rising costs are tied to having more children in custody and using out-of-county placements that carry higher rates.

Separately, staff reported enrollment under Medicaid expansion at 3,420 people; Hunt said the county’s estimated goal was 4,054. "We're up to 3,420," Bridal (S6) said. Board members also heard that the county received authorization for 12 Medicaid positions and will move to onboard and train those employees; staff described this as important to managing workload tied to expansion and to keeping services running.

Chair and members noted broader county budget deliberations: commissioners were expected to vote on the county budget the next Monday, and board members expressed concern that the DSS requested increases for positions and other items had not been fully funded. Board members requested continued quarterly budget monitoring and possible use of temporary staff where needed.

The board did not take a vote on a budget amendment at the meeting; staff said they will continue to monitor foster-care spending and bring recommended adjustments to the board as needed.