By now, most county residents are aware that Medicaid, which provides health insurance nationwide for about one-fifth of our citizens–70 million low-income, elderly, or disabled Americans–is deeply imperiled. Congress has directed the committee that oversees Medicaid to cut $880 billion from the next budget. What many local residents may not know is Nevada County has a higher than average percentage–roughly one-third of our total population, nearly 30,000 residents–who are facing cuts to their Medicaid coverage, known in California as Medi-Cal.
No one is more aware of local Medi-Cal statistics and issues than Ryan Gruver, the Director of Health and Human Services for Nevada County, the agency responsible for administering Medi-Cal.
“We try hard at HHS not to be reactive to every headline, every news cycle,” says Ryan. “It’s a long way from the headlines to actual cuts, so we are trying hard to temper overreaction. Yet we certainly stay on top of potential impacts.”
Fortunately for our county, Ryan has the experience and expertise needed to keep Health and Human Services afloat during the turbulent fiscal and political storms ahead. Raised in Nevada County, a graduate of Nevada Union High School, Ryan received his undergraduate degree from UC Berkeley in 2001, then served two years in the Peace Corps, where he discovered, like so many other government workers, that helping people in need was his calling. “On the small island nation of Dominica, I discovered my passion: making a difference for people in need.”
After his Peace Corps service, Ryan returned home to Nevada County where he married, started a family, and began a career in social services. “In 2006, I was hired as a Child Support Caseworker, and I must tell you, it was very humbling. I had a Berkeley degree and years of Peace Corps experience, but I soon realized helping people in a government social assistance agency is complex. Nothing frustrates people more than someone getting involved with their kids and their money. But once they see you are dedicated to supporting them, anger quickly turns to appreciation.”
As an ex-collegiate swimmer, Ryan’s height and stature are imposing. One day, being new to the agency, he was asked by a colleague–a petite, experienced public guardian–to accompany her on a visit to several clients in a secured psychiatric hospital. “Here I was, this big guy, entering an incarceration facility for the first time. I was terrified. But my colleague was bold and confident. I learned that day an important lesson.The people we serve don’t always receive a lot of empathy from others. But no matter where they are on their journey of recovery, when they know you are in their corner, it goes a long way to your success as a social worker.”
In Ryan’s 19 years at Health and Human Services, he has served in many roles, interacting with the Agency’s many divisions that include Behavioral Health, Child Support, Public Health, Social Services, Probation, Public Defender, and Veterans Services. Before being appointed as director in 2019, Ryan served for years as the Agency’s Chief Fiscal/Administrative Officer.
“Despite my experience and training, I wasn’t prepared for what soon happened. None of us were. Steering the agency through the pandemic was a challenge. Yet public service agencies must be nimble and shift to meet the needs of emerging public health and social issues.”
Yet always, the core mission of HHS consists of established programs to support vulnerable citizens. As an example of how the agency helps people in need, Ryan highlights the story of Lisa Hay, a single mom who appeared before the Nevada County Board of Supervisors in the spring of 2023 to express her appreciation for all that Health and Human Services has done for her and her family.
“For a while, my two boys and I were homeless,” says Lisa. “We were living in an RV and parking it wherever we could find a spot. I was unable to keep a job since my older son was running away from school every day, and my other son showed signs of PTSD.”
Once Lisa reached out to Health and Human Services, she obtained the support she needed. The RV was the family’s only source of transportation, so she received CalWorks for gas, along with CalFresh coupons for food, and Medi-Cal for her family’s health insurance. She and her sons were able to enroll in counseling through Medi-Cal, while a Housing Support Program provided funds for a 9-month stay at the Booth Family Center. Through Connecting Point, Lisa learned job skills, eventually securing an internship at Social Services. From there, she was hired at Safeway, then returned to school earning an AA Degree in psychology from Sierra College in 2021. In April of 2022, she was hired as a Human Services Specialist 1 at HHS.Today she and her boys have their own place and are all doing well in school and work.
“I love the way so many departments within our agency were able to support Lisa and her boys,” says Ryan.“This is what our agency does: we help people every day with severe challenges. Veterans. Disabled people. The mentally ill. The homeless. Single mothers. The elderly. People who need a public defender. Often,we are helping people who are having a hard time, perhaps on the most difficult day of their lives.”
Asked what his greatest source of pride is as director, Ryan does not hesitate. “I’m most proud of the things in this agency which don’t generate headlines. I’m speaking of the core services my staff of 334 people provide every day. I’m so very privileged to be a part of our agency team. It may not sound splashy, but every time a person or a family in need walks out of here with Medi-Cal, it is an achievement.”
Yet Ryan, echoing experts in and out of government, says there is simply no way to meet the budget cuts Congress is demanding without slashing Medicaid and SNAP. “Right now, Nevada County is sound financially, and we have some tools to weather reductions in federal funding– cuts that will, of course, be passed along to the states– but it depends on how deep the cuts are and for how long they are sustained.”
The Yale Budget Lab, a nonpartisan think tank, recently concluded that slashing safety net programs like Medicaid and SNAP to pay for tax cuts represents a concerted effort by the Federal Government to transfer money from low-income people to high-income earners. The Budget Lab researchers project that millions of low-income taxpayers will see an average loss of $1,125 in medical care benefits per person, not to mention the peril to the health and well being of their families. The wealthiest taxpayers will realize an average of $180,000 annually in tax reductions and will be unaffected by benefit cuts. A median taxpayer will see a modest annual tax benefit of about $300 to $400.
President Franklin Roosevelt once said that the test of our progress as a nation,”is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”
Ryan Gruver, here’s to you and to the Nevada County Health and Human Services Agency, a group of dedicated professionals who provide support for those who have too little, focusing on human problems that government and government alone is equipped to solve.
Timothy May and his pup Zorba live in Grass Valley.