More Than 100 Immigrants in Rutherford County at Risk Under Medicaid Changes, Social Services Says

Rutherford County DSS Faces Major Program Shifts, 114 Immigrants at Risk Under Federal Medicaid Changes, Staff Says

The Rutherford County Department of Social Services (DSS) is navigating a wave of program changes affecting hundreds of residents, including local immigrants who rely on Medicaid and food assistance programs. At the Jan. 21 board meeting, Director Dee Hunt and staff detailed ongoing services and the challenges posed by new federal regulations under H.R. 1, also known as OBBBA, the One Big Beautiful Bill Act, signed into law last year by President Donald Trump.

Board members in attendance included Leon Godlock (Chairman), David Herndon (newly elected Vice Chairman) by phone, Suzanne Porter, Sydney Pellegrini Moore, and Lynn Hoppes.

The meeting highlighted both routine service statistics and emerging policy complexities, particularly regarding eligibility for immigrant residents. According to DSS staff, 114 immigrants in Rutherford County currently receive Medicaid benefits, and staff warned that recent federal changes could impact their coverage.

“This is one of the most complex periods we’ve seen in years,” Hunt said. “H.R.1 is introducing new rules, and anytime you have new rules, the likelihood of errors increases. That can affect the accuracy of benefits determinations and add stress to both staff and families.”

The board also noted leadership changes at the state level. Karen Powell, the former Rutherford County Health Department Director under the Foothills Health District, is now the executive director of the NC Association of County Directors of Social Services, which guides county DSS offices across North Carolina.

Powell left that role quietly, following a time of controversy when she led the agency with oversight over the county animal shelter.

Numerous topics were covered during the meeting, which lasted less than an hour.

• Adult Services: Guardianship and protective payee programs served 60 adults in December 2025. Adult care home monitoring covered 59 residents, and the in-home aide program supported 17 clients.

• Child Protective Services: Staff handled 196 CPS reports in December, including 74 screen-ins and 28 confirmed reports. Ongoing cases totaled 26.

• Foster Care: 18 children were in foster care, with 10 legally free for adoption. DSS oversees 26 licensed foster homes and several non-agency home studies.

• Economic Services: DSS processed 4,778 Medicaid cases in December, along with 12,024 food assistance cases, supporting 6,379 households.

• Work First Programs: In December, DSS assisted 73 families with Work First Family Assistance and 63 children with Work First Child-Only programs. Refugee cash assistance and employment services continue to support local immigrant families.

• Child Support Enforcement: DSS collected $421,846 in December from 3,087 active cases, an increase from $362,691 in November.

• Crisis Programs: DSS handled 265 LIHEAP cases and administered emergency services to 200 households in December.

• Medicaid Transportation: 451 trips were provided for recipients in December, totaling nearly 7,000 miles, costing $15,133.89.

• Program Complexity: DSS staff noted that H.R.1 has introduced “a lot of complexity” in eligibility rules, especially for food and nutrition programs, increasing the potential for administrative errors.

  
  

Hunt stressed that while the exact impact on immigrant families is still unfolding, DSS is preparing staff and systems to handle the anticipated changes. “We are committed to helping every eligible resident access the services they need, but these new rules are going to create challenges,” she said.

Medicaid eligibility for immigrants in the United States is primarily determined by immigration status, length of residency, and state-specific policies. Under federal law, Medicaid funding is generally restricted to citizens and "qualified" non-citizens, with most immigrants subject to a five-year waiting period. However, states have options to extend coverage to specific groups, such as children and pregnant individuals, regardless of status, according to NCDHHS.

The board adjourned with plans to monitor H.R.1 implementation closely and to report further updates as federal guidance becomes available.

For more details, view the agenda packet here.