At-risk populations in Northern Nevada are more at risk than ever.
Through executive orders, policies and legislation, the Trump administration has cut budgets for health and relief services that were fully funded mere months ago—and people in our region are feeling the repercussions. Federal budget cuts have decreased the abilities of Northern Nevada organizations to provide mental health, food security and health care services.
A policymaker and three service providers spoke with the RN&R about who is being affected, and how. Spoiler alert: It’s a much larger chunk of the population than you may think it is.
Health care programs for opiate users and trans youth were cut
Northern Nevada HOPES is a community health center that cares for underserved and vulnerable patients and their families. According to the HOPES website, 45% of its patients live at or below the federal poverty level, and 10% are homeless.
Federal reimbursements and grants make up a substantial part of HOPES’ funding. For instance, Medicaid makes up 15.5% percent of its revenue, while Medicare makes up 5.7%. HOPES CEO Sharon Chamberlain and her staff had to discontinue some programs completely when President Trump issued executive orders that resulted in federal Health and Human Services Department (HHS) policies the defunded certain initiatives.
One order that supposedly addressed “crime and disorder” ended funding for “discretionary grants for substance use disorder prevention, treatment and recovery (that) fund drug injection sites or illicit drug use.” Chamberlain said this order ended HOPES’ Change Point program for safe injection services, including rehab and detox, for people addicted to opiates.
Another Trump order under the rubric of “protecting children” defunded federal grants to “medical institutions” that offer gender-affirming care, which the order terms as “chemical and surgical mutilation.” HOPES, as a result, ended its gender-affirming care program for people under the age of 19, Chamberlain said.
She said the clinic is also awaiting the results of already approved cuts to Medicaid via Congress. According to the nonpartisan Congressional Budget Office, 11.8 million people on Medicaid could lose their health insurance by 2034 due to these cuts. In addition, more than 4 million more people may lose coverage if the Affordable Care Act marketplace subsidies go away, which is the major sticking point of the government shutdown that was, as of press time, still ongoing.
“Patients with high blood pressure come in to regularly adjust their medications. Without Medicaid, they would miss appointments, and their condition would worsen silently. And, with high blood pressure, you are also at risk for a stroke or a heart attack. What was once management of a condition is now a costly, lifelong ordeal.”
Northern Nevada HOPES CEO Sharon Chamberlain
“Medicaid is one of the largest populations that we serve (at HOPES),” Chamberlain said. “What (news reports) are saying about community health centers like HOPES is that more than 40 percent of community health sites across the U.S. are going to close, and that is obviously not just a policy shift, but would destroy years of hard work to provide care to more people.”
Chamberlain gave a real-world example of how people may be affected: “Patients with high blood pressure come in to regularly adjust their medications. Without Medicaid, they would miss appointments, and their condition would worsen silently. And, with high blood pressure, you are also at risk for a stroke or a heart attack. What was once management of a condition is now a costly, lifelong ordeal.”
Despite these worries, Chamberlain said HOPES is planning to expand services that are still receiving federal funding, such as Medicare-based geriatric care, which she said is “a huge need” in the region. She added that HOPES is also continuing to raise funds to keep providing as much care as possible.
Chamberlain has also seen patient care affected this year by the crackdown on immigrants.
“We are hearing a lot of things from our undocumented population, with a lot more no-shows for appointments, or people being afraid to come in or pick up life-saving medication,” Chamberlain said. “We have other individuals on the exchanges express a lot of concern about the increase in premiums. There are a lot of folks dealing with a lot of unknowns.”
Medicaid and SNAP cuts will have a domino effect
Dr. John Packham, policy director for the Nevada Public Health Association and an associate dean at the University of Nevada, Reno, School of Medicine, believes we are in the early stages of experiencing the consequences of the so-called Big Beautiful Bill, the congressional spending package that went into effect in July.
The bill includes the aforementioned cuts to Medicaid and cuts to other health-focused programs such as the Supplemental Nutrition Assistance Program (SNAP).
Two federal agencies in particular, the Centers for Disease Control and Prevention and the Health Resources and Services Administration, provide a significant amount of health funding in Nevada—$66 per person, according to a recent report from the American Public Health Association.
“The state Legislature, through the general fund, appropriates dollars for public health services roughly at the same level as the federal level,” Packham said. “So any federal funding is going to affect what we as a state can provide, because the Legislature is pretty unlikely to make up the difference.”
Packham pointed out that Nevada is especially susceptible during tough economic times.
“Nevada just has a history of being the first to go into recession and the last to get out of it,” he said. “Compared to other states, we have relatively high unemployment rates that I expect to go up next year. We also have a 10 to 11 percent uninsured rate when the national number is about 8.”
Packham is concerned that a lot of facets of health care will get worse over the next decade. He predicts that it will become harder for hospitals to recruit staff and keep fragile service areas open, such as emergency departments, obstetrics and mental health.
To that end, Packham believes a special session of the Legislature—which is not scheduled to convene again until 2027—may be in order.
“I think the Legislature should be getting together immediately to start deciding how to address Medicaid revenue shortfalls,” he said. “Those were timed (by Congress) to take effect after the 2026 election, which is about as cynical as you can get, but there is a storm cloud on the horizon.”
Even if these issues aren’t addressed immediately by state lawmakers, Packham said there are some things that people can do to help.
“It’s going to take people pressing lawmakers on this, and I think you are seeing a little of that with events like No Kings,” he said. “It’s taken some time, but there is a growing recognition that this legislation and the wave of policies from eight or nine months ago is going to hurt people. We know it’s going to happen.”
Food assistance has been cut, and is being cut further
More and more local seniors have needed food assistance in recent months, said Jocelyn Lantrip, director of marketing and communications at the Food Bank of Northern Nevada.
“They’ve seen their cost of living go up, while their incomes are not,” she said. “And health care costs are going up. So, anecdotally, a lot more seniors have been reaching out for help, and frankly, (so are) a lot more working families, all because of the same reasons— they are supporting children, perhaps, and their incomes are not keeping up with expenses, and food costs are high.”
This increase in need is happening at a time when the amount of food the organization can provide has decreased—to the tune of around 3 million pounds a year.
Lantrip said the Food Bank first faced cuts earlier this year when the U.S. Department of Agriculture informed the organization that both the Local Food Purchase Assistance program and the Home Feeds Nevada program would not be federally funded. She estimates that almost 1 million pounds of food were not received as a result.
“The state did get $800,000 from the (Nevada) Legislature for the Home Feeds Nevada program, and we were very happy to have that, but that is significantly less than we’ve had before,” she said.
But that’s not the only decrease in aid from the USDA. Its Community Credit Corporation fund slashed the Emergency Food Assistance Program. This decreased the amount of food the Food Bank can distribute by an additional 2 million pounds. Lantrip said the group distributes about 26 million pounds of food per year.
“We’re also helping absolutely record numbers of people this year: 160,000 people every single month,” Lantrip said. “That’s about 76 percent higher than before the pandemic.”
More residents may be affected depending on how the aforementioned SNAP program will be funded, or not, after the government shutdown. The USDA wrote state governments in October to warn that SNAP recipients may not receive their allotments on Nov. 1 due to the shutdown. Lantrip said that the Food Bank estimates for every meal it provides, SNAP can provide nine.
“That would have a significant impact in our area,” Lantrip said of possible SNAP cuts after Nov. 1. “The current estimate that we received would be 147,000 people that would be affected. The SNAP program is very important to what we do as a food bank, because we can’t make up that much food if those (missed allotments) take place.”
Lantrip said the Food Bank is continuing its food sourcing and fundraising strategies, and asking more grocery stores, distribution centers, manufacturers and farmers to provide food.
“We’re trying to get as much in the door as we can,” she said. “We have a lot of food drives going on right now, too, as we head into the holiday season. We really need the staples for every day.
“Some people may receive SNAP as a supplement to income, and that is what has made them food secure. They may not be accessing resources from food banks, pantries or our partners like Mobile Harvest, so we want to reach out and let them know that we are available for help.”
LGBTQ+ youth services were cut
Our Center, Reno’s LGBTQ+ community center, received notice from the Nevada Bureau of Behavioral Health, Wellness and Prevention in September that the federal government would gut some of its programs for LGBTQ+ high school and middle school students.
This HHS cut included the end of two funding sources: a Partnership for Success grant that would have totaled $240,000 a year for the next four years, to be used for programs addressing suicide prevention, mental health, anti-vaping and prescription drugs abuse prevention; and a $129,000 Substance Use Prevention, Treatment, and Recovery Services Block Grant to support alcohol, cannabis and nicotine prevention.
Stacey Spain, executive director of Our Center, said the cuts led Our Center to end two of its youth programs, involving prescription drug abuse and vaping prevention. She added that two of the programs will continue without the grant funding—those for suicide prevention and mental health support.
When Our Center received the notice, the organization had already been working for six months to set up the programs, including developing resource guides, making print materials and visiting area school groups to let them know the suicide prevention and mental health support groups were available. Spain said the group already has a connection to LGBTQ+ student groups at many area schools and often speaks with counselors and teachers to let them know what Our Center has to offer.
“That won’t change,” Spain said. “We’ll give them all access to our youth mental-health resource guide, which we developed as part of the grant. But we won’t be able to do this at the same intensity level, and not with the same amount of staffing.”
In its letter, the state’s behavioral health bureau suggested to Our Center that state or federal funds can be used for their programs, but they would need to be “open to expanding the scope of work to serve the broader youth population, rather than focusing solely on the LGBTQIA+ community.” Spain said this policy undercuts getting help to at-risk populations that are considered “special audiences” by current federal and state leaders.
“We know and understand that the most at-risk demographic group for teen suicide is LGBTQ,” Spain said. “… ‘Special audiences’ are groups of people who need (assistance) more. Not only LGBTQ+ youth, but veterans and racial minorities. Some people don’t even consider women to be a universal audience.”
Spain LGBTQ+ youth make up “a much higher percentage of children in foster care than their representation in the overall population. And LGBTQ+ youth experience homelessness at a much higher rate. They may be told to get out if they come out, and sometimes even when they haven’t finished high school. They can be suddenly homeless. So the consequence for being queer can have lasting repercussions in a young person’s life.”
This need is why Spain believes that support and programs strictly for an underserved group can be so impactful.
“We know what the risk factors are, so we think about what we can do to offset those, and that includes protective factors,” Spain said, “things like having a strong community or being able to participate in programs which uplift and help folks with a sense of belonging.
“Programs which are tailored to a specific population do not cause harm. Sometimes when you are in a program that doesn’t let you be yourself authentically or let you be your whole self, you are not able to say your whole truth. And when you are editing yourself and not being accepted when you walk in the door, you’re not able to fully participate in any kind of group.”
For now, Our Center is exploring various sources for more funding, including program fees when appropriate, private foundations, its own membership and donations from the community.