Since the passage of the American Rescue Plan Act in 2021, a number of cities and counties in Ohio and around the nation have used ARPA funding to retire medical debt.

Over the summer, Akron became the latest community in Ohio to adopt a plan to retire such debts.

The city council allocated $500,000 to purchase debts through the non-profit RIP Medical Debt. RIP in turn negotiates with hospitals and debt collectors to buy old debts for pennies on the dollar and then forgives them.

Akron Ward 1 City Council Representative Nancy Holland said these debts take a toll on the community.

"Medical debt is one of the leading causes of personal bankruptcy," said Holland. "It's also a leading cause of divorce, of job disruption, of inability to qualify for most major loans like home loans, it can also cause trouble in a rental application, just to rent an apartment. "

Akron joins Lucas County, Toledo, and Cleveland in using ARPA funds to eliminate medical debts. The anticipated value of retired debts from Akron's allocation is up to $50 million.

After entering into a contract with a local government, RIP Medical Debt reviews hospital debt portfolios to determine which ones will be retired.

Residents who qualify must earn less than 400% of the federal poverty level, and their medical debts must be at least 5% of their annual income.

Allison Sesso is the president and CEO of RIP, and says medical debt can be hard to avoid.

"I think medical debt is different than other kinds of debt, because of the fact that it's inherent in the system," said Sesso. "And it's sort of a trap, you can't avoid it. You can have insurance and yet you still have medical debt. You can do all the right things and you still have medical debt. You don't control the pricing. It is not transparent as a system and so it's really hard to avoid. "

Pre-pandemic research found that 23 million Americans have medical debt, with 3 million owing more than $10,000.

While these debts are accumulated in countless ways, and at different types of healthcare organizations, Sesso said RIP will negotiate with anyone to buy qualifying medical debt belonging to those most financially burdened.

"There's often been questions about whether or not we'll work with certain kinds of hospitals, that maybe are seen as bad actors," said Sesso. "And at the end of the day, we really focus on the patient. If you have debt at a bad actor hospital, you shouldn't be punished for that."

Sesso said to date, RIP has retired $10 billion of debt for 7 million people nationally.

The word "fraud" is likely to circulate in the upcoming Minnesota legislative session. One political expert said state agencies are being targeted but the response requires careful thought.

The recent Feeding our Future scandal has spurred demand for more oversight of government spending in Minnesota. There are renewed concerns about organizations claiming to provide various medical services but engage in phony Medicaid billing.

Tim Lindberg, associate professor of political science at the University of Minnesota-Morris, said larger entities are making a more coordinated effort to defraud key agencies. He pointed out it mirrors global crime rings preying on consumers.

"There is some legitimate concern out there but it is also a global phenomenon that is increasing in size and importance," Lindberg observed. "I think government from the top down needs to sort of figure out a new way to deal with this."

Lindberg pointed out the state has investigative resources and internal controls but he thinks the public sector at large likely has some outdated monitoring approaches, especially as technology evolves. He argued it is important to remember agencies in the spotlight are helping people in need who are not part of these scams, and even with the best controls, completely eliminating fraud is impossible.

The cases have garnered headlines and since Democrats have the upper hand in controlling Minnesota government, Lindberg predicted Republicans will use the trend as part of their push for restrictions or cutbacks. He believes Democrats might agree to certain moves to win back public trust but stressed fraud against government is not a partisan issue.

"People doing these frauds, they don't care who's in office," Lindberg asserted. "They don't care who's in power. And Republicans and Democrats themselves have been in various levels, in various states, overseeing governments where this happens."

Taxpayer dollars are at the center of what's happening. Lindberg added the private sector must also mitigate fraud with steps like major retailers locking up essential items in cases. He suggested lawmakers have to avoid veering off-path.

"What are these ways in which government can work better, more efficiently, but also not eliminate the benefits that these programs are designed to do?" Lindberg asked.


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Four east Texas communities will share more than $1 million in grant money to upgrade their radio infrastructure systems.

The grants are funded by House Bill 442 from 2011 and construction is slated to start next year.

Lindsay Vanderbilt, director of communications for the East Texas Council of Governments, said smaller communities do not have the budgets to upgrade equipment regularly and the funds will improve security for first responders and the community.

"It's kind of a lot of technology that people don't think about," Vanderbilt pointed out. "In the governmental world, these are systems that are in place to handle emergency response and to back up that response system for safety. "

The projects will take place in Rains, Harrison and Van Zandt counties and the City of Kilgore.

Funds in the State Emergency Radio Infrastructure program are distributed by the governor's office. Vanderbilt noted the council of governments is the primary planning entity for 911 communications in 14 east Texas counties.

"It's very common for these opportunities to get proposed to us by the state, and then we connect with our local governments and we reach out to them to see who has needs and who would be eligible to apply," Vanderbilt outlined.

She added the Rains County project will address a serious communications problem.

"They're currently having severe operability issues and it's actually keeping their officers and their dispatch from being able to communicate effectively all the time," Vanderbilt observed. "That's a safety risk for the officers, it is for the public."

Other projects include construction of new Motorola towers and expansion of the TX-WARN program, which works with water and wastewater utilities during system outages.


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A new study provides New York State with an outline of necessary updates to its school funding formula.

The Rockefeller Institute study called for improving several areas such as the Regional Cost Index, which has not been updated in 18 years. Other focus areas include the poverty metric, which does not give a comprehensive picture of students' needs.

Randi Levine, policy director for Advocates for Children of New York, said other updates should have been considered.

"We're disappointed that there are no recommendations to add weight for students experiencing homelessness and students in foster care so that schools can better meet their needs to provide per-pupil funding for preschoolers in pre-K and 3-K," Levine explained.

She added the provisions could be passed through bills introduced by lawmakers.

More than 155,000 New York State public school students were homeless during the 2022-2023 school year. Of those, 120,000 were New York City Public School students. Columbia University found the current Foundation Aid formula uses poverty numbers from the 2000 Census and cost-of-living averages from 2006.

The Rockefeller Institute study suggested numerous ways for lawmakers to update the school funding formula. However, Levine argued some of them must be assessed for their efficacy, including a recommendation to update the poverty measure and provide a different way to measure it.

"The study provides a few different ways of doing that," Levine observed. "The study notes one of the proposals for how to change that weight would result in New York City seeing a projected decrease of around $392 million."

Other recommendations in the report included using a scaling aid approach to better supply funding for students with disabilities, a new adjustment based on instruction service hours for English Language Learners and letting school districts use Foundation Aid dollars for general education purposes, rather than regimented direct spending.


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