(AP) — For nonprofits in McDowell County, West Virginia, the federal cuts in the One Big Beautiful Bill Act threaten a lifeline.

Many of McDowell’s 17,000 residents rely on federal programs and the nonprofits they fund to get by. The county’s tax base and population have significantly declined since 1950, when McDowell was the top coal-producing county in the nation and had about 100,000 residents.

Now, more than half the children in the county receive federal Children’s Health Insurance Program benefits, and about one-third of seniors are on Medicaid, the federal health insurance program for the poor. Decades after the Kennedy administration made the county a first test of food stamps, nearly half the county’s residents receive supplemental nutrition assistance, or SNAP, the Food Stamp Program’s successor.

The strains created by new eligibility restrictions on SNAP as a result of the passage of President Trump’s domestic policy bill will be especially dire in places like McDowell County, where more than one-third of the population lives below the federal poverty line, said Rosemary Ketchum, executive director of the West Virginia Nonprofit Association.

“These federal cuts are starving people,” she said.

Since the interruption in federal support tied to President Trump’s January executive orders barring grants related to “gender ideology”; diversity, equity, and inclusion; and environmental justice, Ketchum said many of the 9,000 or so nonprofits in her state have laid off staff. Others, she said, are dipping into whatever reserves they have to pay their employees.

Those reserves are slim, if they exist at all. Taken together, the seven nonprofits that receive federal grants in McDowell County run on a 3 percent operating margin, according to data tabulated by the Urban Institute’s National Center for Charitable Statistics. If all federal support disappeared, the center found, all the county’s nonprofits would be at risk of going under unless other funding was provided.

In a poor state like West Virginia, which is already facing a budget deficit and lacks the legions of philanthropic donors who got rich on Wall Street or in Silicon Valley, nonprofits don’t have a plan B, said Kathy Gentry, executive director of Safe Housing and Economic Development, or SHED, a McDowell nonprofit housing provider.

The nonprofit’s clients, many of whom are elderly or disabled, rely on U.S. Housing and Urban Development support to cover the rent at the 94 housing units SHED manages.

Gentry’s pay was temporarily cut for six weeks this spring because part of her salary comes from a HUD capacity-building grant that the administration deemed at cross-purposes with Trump’s anti-DEI policy agenda. Her full paycheck resumed, but Gentry worries further cuts will force her to lay off staff.

Already the nonprofit operates at a loss. In its 2023 tax filing, the most recent available, SHED’s $663,000 in expenses outstripped its revenue by nearly $200,000.

“We’re in a quandary here — all nonprofits are,” Gentry said. “Are we going to exist? Will we have to dissolve?”

Since 2015, Heidi Binko and her team at the Just Transition Fund have worked with economic development agencies and nonprofits in areas where the coal industry once flourished. That can mean helping a local organization identify or write a grant or provide a matching grant. The fund was created by the Rockefeller Family Foundation and Appalachian Funders Network to help coal towns capture some of the dollars provided in the 2015 Clean Power Plan, or POWER Act, passed during the Obama administration.

Since then, the fund says it has helped coal communities in West Virginia and throughout the nation secure more than $2 billion in federal grants.

Binko hopes the fund can continue to attract federal resources to towns with high poverty rates.