up
Budget Year / Version:
anchor
anchor

Mission Statement

The Department of Health and Human Services (HHS) assures delivery of a full array of services to address the somatic and behavioral health, economic and housing security, and other emergent needs of Montgomery County residents. To achieve this, the Department (directly and/or via a network of community partners) develops and implements policies, procedures, programs, and services that: 1) offer customer-focused direct care and supports; 2) maximize financial and staffing resources to deliver services through effective management, coordination, and pursuit of strategic funding opportunities; 3) pilot and evaluate innovative approaches to service delivery and systems integration; and 4) develop, enhance, and maintain a broad network of community-based organizations, public agencies, and private entities to promote and sustain partnerships which increase the availability of needed services.

anchor

Budget Overview

The total approved FY22 Operating Budget for the Department of Health and Human Services is $363,954,877, an increase of $25,102,824 or 7.41 percent from the FY21 Approved Budget of $338,852,053. Personnel Costs comprise 52.45 percent of the budget for 1,547 full-time position(s) and 333 part-time position(s), and a total of 1,770.62 FTEs. Total FTEs may include seasonal or temporary positions and may also reflect workforce charged to or from other departments or funds. Operating Expenses account for the remaining 47.55 percent of the FY22 budget.

County Priority Outcomes

While this program area supports all eight of the County Result Areas, the following are emphasized:

  • An Affordable, Welcoming County for a Lifetime
  • Thriving Youth and Families
  • A Greener County
  • Effective, Sustainable Government
  • Safe Neighborhoods

anchor

Program Performance Measures

Performance measures for this department are included below (where applicable), with multi-program measures displayed at the front of this section and program-specific measures shown with the relevant program. The FY21 estimates reflect funding based on the FY21 approved budget. The FY22 and FY23 figures are performance targets based on the FY22 approved budget and funding for comparable service levels in FY23.

anchor

Initiatives

  • Public Health Services launched a large-scale public COVID-19 testing program to expand access and combat the spread of COVID-19. Within two months, this public effort ramped up to conduct over five thousand tests each week, equal to about one-fifth of all COVID-19 testing in the County. To promote equity and maximize impact, the Department used community and public health surveillance data to select locations best positioned to reach highly impacted and traditionally underserved communities, including strategic pop-up events and home-based testing for residents experiencing barriers to access. To further support efforts to provide healthcare to residents in the County, Public Health Services is investing in a Mobile Health Unit that will travel around the County and provide health care services that will help address health disparities.
  • In response to the disproportionate impact of COVID-19 in the Latino community, the Latino Health Initiative spearheaded the Por Neustra Salud y Bienestar Initiative, a public-private partnership between Montgomery County Government and seven Latino-serving community-based organizations. The initiative developed and deployed an integrated strategy to provide holistic, culturally competent, and linguistically appropriate services in the areas of: prevention information, education, and community mobilization; testing and clinical follow-up; and case management. In response to the disproportionate impact of COVID-19 in the Black and African American community, the African American Health Program (AAHP) launched a collaborative COVID-19 prevention initiative, including testing at multiple locations weekly. AAHP has tested 6,000 residents for COVID-19 as of March 2021, with the goal of testing 15,000 African American residents by July 2021. The tests are noninvasive and self-administered, and no appointments are needed. AAHP also provides participants with free on-site COVID-19 services such as vaccine preregistration, groceries, other wraparound services, and a pandemic "swag" box containing masks, gloves, a digital thermometer, hand sanitizer, and a stop the spread of COVID postcard. The program outreach provides participants with access to wellness services, mental health counseling, referrals to Black physicians, and other resources.

  • Responding to the heavy socio-economic consequences of the COVID-19 pandemic, Children, Youth, and Family Services implemented a suite of emergency programs to support the County's most vulnerable residents. To blunt the impact of the economic recession, the Department provided direct financial assistance to low-income families who did not qualify for the federal stimulus by distributing the $10 million local Emergency Assistance Relief Payments program. To ensure access to child care for low-income families (including for school-aged children during school closures), the Department disbursed $10 million in grants from the Early Care and Education Initiative Recovery Fund to help providers cover re-opening expenses and issued $5.6 million in tuition assistance for families utilizing full-day school-aged child care. For FY22, $5 million is recommended to be added to the Early Care and Education Non-Departmental Account to provide funds for sustaining and expanding quality child care in the County and to provide greater access to affordable child care for low-income families.
  • In April 2020, Aging and Disability Services created a COVID support team to address the surge of outbreaks of COVID-19 in group homes serving developmentally disabled individuals by deploying a team of nurses to provide outreach, outbreak surveillance, guidance, and support to the County's licensed group home providers.
  • Behavioral Health and Crisis Services implemented a number of changes to better respond to the complexities of COVID-19. With the advent of the COVID-19 pandemic, the Crisis Center's Mobile Crisis and Outreach Team managed a sharp increase in activity, growing by 37% in July-December compared to the same period in 2019. As part of the reimagining public safety efforts, the County Executive is providing additional support to the Crisis Center by adding three Mobile Crisis Outreach Teams to boost the County's behavioral health crisis response to residents with a mental or substance use disorder. To further support residents, the Department is seeking grant funding that will increase access to and improve the quality of community mental and substance use disorder treatment services. In addition, the Department will expand mental health services at Linkages to Learning sites in schools with a high concentration of poverty to address the post COVID-19 mental health needs of County families with limited resources.
  • In response to COVID-19, Services to End and Prevent Homelessness (SEPH) pivoted its approach to sheltering to accommodate physical distancing requirements and protect the health and safety of shelter clients. This included rapidly expanding the number of shelter locations by April 2nd, 2020 including by opening temporary congregate sheltering facilities at two recreation centers, by adding two non-congregate sheters in hotels for those over the age of 62 or with medical conditions that place them at greater risk of COVID-19 complications, and by keeping open hypothermia shelters (usually closed during the warmer seasons) throughout the public health emergency to provide for additional space and capacity. Through these efforts, SEPH kept COVID-19 positivity rates below two percent among the County's single-adult shelter clients. In FY22, additional funding is recommended to operate a new homeless shelter and to provide year-round sheltering to people experiencing homelessness. Additional funding is also recommended in FY22 for the expansion of the Rental Assistance and Rapid Rehousing Programs.
  • Residents experiencing homelessness often encounter challenges when being discharged from hospitals, particularly when the patient has an accompanying behavioral health diagnosis. To help navigate this process, the Department will add a nurse to the Services to End and Prevent Homelessness Division to work with hospitals as a psychiatric discharge planner starting in FY22. This position will allow for the early involvement and coordination of homeless services for when housing insecure residents return to the community from a hospital or other medical facility.
  • The FY22 budget will provide $250,000 for a Preventative Dental Pilot program at 16 elementary schools to be delivered at a school-based health center or by a mobile van that would include: dental screenings; fluoride treatments; sealants; oral health education for parents and students; and guidance to a dental home.
  • To promote ready access to vital health and social services, the Department will build from lessons learned during the COVID-19 pandemic response to remove barriers to access and make it easier for clients to engage and navigate the Department remotely. Investments in FY22 include a central online client portal to make it easier to apply for and check on the status of County benefit programs such as child care subsidies; the expansion of interpretation services to overcome language barriers, including for Montgomery Cares telehealth programs; and the addition of customer service representatives to handle complex calls from clients engaging the County's MC311 hotline to help them better navigate the full spectrum of health and human services.

anchor

Innovations and Productivity Improvements

  • In order to combat social isolation and boredom, early in the pandemic Aging and Disability Services launched the Engage @ Home YouTube channel which features County staff and community partners presenting health and wellness programs, cultural activities, and caregiver resources. Engage@HOME has reached 116,000 viewers with over 417 hours viewed. To promote this and other resources, staff created Thrive at Home, an initiative that included a page on the County website (highlighting resources for residents looking for someone to talk to, activities for people with memory loss, and other supports) and the mailing of postcards with the "Thrive at Home" theme.
  • To preserve social distancing and shift client interactions and service delivery into a newly virtual environment, the Department utilized its Qless lobby management system to implement a single, streamlined process for virtual client intake to provide safe, equitable, and efficient access to the Department's social safety net programs.
  • The Community Action Agency's Volunteer Income Tax Assistance (VITA) program engaged the Internal Revenue Services (IRS) to develop and receive approval for a safe, virtual tax preparation process through Zoom, with funding from the United Way of the National Capital Area. VITA also expanded multi-lingual Earned Income Tax Credit (EITC) outreach in seven languages and launched a text alert campaign targeting thousands of households.

Budget Trends
anchor
Program Contacts

Contact Victoria Buckland of the Department of Health and Human Services at 240.777.1211 or Deborah Lambert or Lindsay Lucas of the Office of Management and Budget at 240.777.2800 for more information regarding this department's operating budget.

Related Links
Budget Summary
TitleActual
FY20
Budget
FY21
Estimate
FY21
Approved
FY22
%Chg
Bud/App
COUNTY GENERAL FUND
EXPENDITURES
Salaries and Wages96921025.00101654849.00 105064856.00 108548799.006.8
Employee Benefits33776645.0033625839.00 31152008.00 33392320.00-0.7
County General Fund Personnel Costs130697670.00135280688.00 136216864.00 141941119.004.9
Operating Expenses123343321.00116174044.00 197133784.00 126491032.008.9
Capital Outlay49219.000.00 0.00 0.000.0
County General Fund Expenditures254090210.00251454732.00 333350648.00 268432151.006.8
PERSONNEL
Full-Time885.00909.00 909.00 977.007.5
Part-Time312.00306.00 306.00 303.00-1.0
FTEs1247.311263.48 1263.48 1305.533.3
REVENUES
Core Health Services Funding3698097.004829902.00 4809321.00 4809321.00-0.4
Federal Financial Participation Reimbursements16519322.0014858007.00 16036044.00 16036044.007.9
Health and Human Services Fees968686.001228950.00 1164471.00 1265497.003.0
Health Inspection: Restaurants1750470.001896320.00 1049164.00 1870520.00-1.4
Health Inspections: Living Facilities206363.00269245.00 192120.00 236815.00-12.0
Health Inspections: Swimming Pools454780.00577400.00 330030.00 577400.000.0
Indirect Costs: Grants2369.000.00 0.00 0.000.0
Marriage Licenses187785.00226800.00 226800.00 226800.000.0
Medicaid/Medicare Reimbursement683145.001876920.00 1133886.00 1296401.00-30.9
Miscellaneous Revenues555384.000.00 0.00 0.000.0
Nursing Home Reimbursement713604.00566958.00 713604.00 713604.0025.9
Other Charges/Fees629417.00531012.00 1431555.00 1459901.00174.9
Other Fines/Forfeitures10450.004800.00 10450.00 10450.00117.7
Other Intergovernmental6441411.005414857.00 5084192.00 5084192.00-6.1
Other Licenses/Permits115346.00111360.00 55869.00 111360.000.0
County General Fund Revenues32936629.0032392531.00 32237506.00 33698305.004.0
 
GRANT FUND - MCG
EXPENDITURES
Salaries and Wages35861325.0037038559.00 37038559.00 36295128.00-2.0
Employee Benefits12872180.0012508903.00 12508903.00 12654664.001.2
Grant Fund - MCG Personnel Costs48733505.0049547462.00 49547462.00 48949792.00-1.2
Operating Expenses36618212.0037849859.00 37849859.00 46572934.0023.1
Grant Fund - MCG Expenditures85351717.0087397321.00 87397321.00 95522726.009.3
PERSONNEL
Full-Time560.00568.00 568.00 570.000.4
Part-Time30.0030.00 30.00 30.000.0
FTEs435.78451.01 451.01 465.093.1
REVENUES
American Rescue Plan Act0.000.00 0.00 6969218.000.0
Federal Grants28511821.0028372080.00 28372080.00 30554666.007.7
HB669 Social Services State Reimbursement39204920.0039679819.00 39679819.00 40031523.000.9
Medicaid/Medicare Reimbursement271258.000.00 0.00 0.000.0
Miscellaneous Revenues398936.00750000.00 750000.00 0.00-100.0
Other Charges/Fees360560.0090325.00 90325.00 345228.00282.2
State Grants13907836.0018505097.00 18505097.00 17622091.00-4.8
Grant Fund - MCG Revenues82655331.0087397321.00 87397321.00 95522726.009.3
 
DEPARTMENT TOTALS
Total Expenditures339441927.00338852053.00 420747969.00 363954877.007.4
Total Full-Time Positions1445.001477.00 1477.00 1547.004.7
Total Part-Time Positions342.00336.00 336.00 333.00-0.9
Total FTEs1683.091714.49 1714.49 1770.623.3
Total Revenues115591960.00119789852.00 119634827.00 129221031.007.9
FY22 Approved Changes
TitleExpendituresFTEs
COUNTY GENERAL FUND
FY21 ORIGINAL APPROPRIATION2514547321263.48
Changes (with service impacts)
Add: New Shelter Operating Budget Impact and Policy Shift to Year-Round Sheltering [Homeless Services for Single Adults]30812790.00
Add: Funding to Open the Wellness Center at Seneca Valley High School11423974.88
Enhance: Annualization of Six Therapist II Positions to Support Mobile Crisis Response [24-Hours Crisis Center]6589966.00
Add: Health and Human Services Call Center to Handle Tier 2 Calls from Montgomery County 311 to Address the Volume of Calls as a Result of the COVID Pandemic [Admin - Office of the Director]6357080.00
Enhance: Expand Mental Health Services at Linkages to Learning Sites in Schools with a High Concentration of Poverty [Linkages To Learning]5566730.00
Add: Creation of Three Mobile Crisis Outreach Teams [24-Hours Crisis Center]5211406.00
Add: Montgomery County Infant and Toddlers Program (ITP) Translation Services for Individual Family Service Plan (IFSP) [Early Childhood Services]4420000.00
Enhance: Funding to EveryMind Contract to Address Increase in Call Volume [Access To Behavioral Health Services]3500000.00
Add: Preventive Dental Pilot Program at 16 Elementary Schools [Dental Services]2500000.00
Add: Create a Community-Based Homeless Court Program in Accordance with the Interagency Commission on Homelessness Recommendations to Decriminalize Homelessness [Admin - Services to End and Prevent Homelessness]1000000.00
Enhance: Add One Position to Support Adult Protective Services Due to Caseload Demands [Assessment & Continuing Care Management Services]820571.00
Add: One Nurse to be a Psychiatric Discharge Planner to Help Homeless Residents Return to the Community from a Hospital or Other Medical Facility [Healthcare for the Homeless]750001.00
Add: Interpretation Services for Montgomery Cares Telehealth Program [Health Care for the Uninsured]650000.00
Enhance: MARBIDCO Maryland Market Money Program [Area Agency on Aging]502000.00
Enhance: Healthy Families Montgomery Contract to Promote the Well-Being of Children and Prevent Abuse and Neglect Through Intensive In-Home Visits and Services [Early Childhood Services]500000.00
Reduce: Early Childhood Services Community Events Due to COVID [Early Childhood Services]-103430.00
Reduce: Montgomery County Child Care Resource and Referral Center (MCCCRRC) Holding One Rather Than Two Conferences Per Year Due to COVID [Early Childhood Services]-200000.00
Reduce: Suspend Don Bosco Rey Contract Due to COVID [Child & Adolescent School & Community Based Services]-550000.00
Eliminate: Child Link Part-Time Contract Position Because the Phone Line for Family Resources is Obsolete [Early Childhood Services]-620000.00
Reduce: Budget for Broker and Temporary Clerical Services [Admin - Office of the Chief Operating Officer]-2029240.00
Other Adjustments (with no service impacts)
Increase Cost: FY21 Compensation Adjustment37841460.00
Increase Cost: FY22 Compensation Adjustment20963880.00
Increase Cost: Three Percent Inflationary Increase to Non-Profit Service Provider Contracts14808340.00
Increase Cost: Developmental Disabilities Supplement Adjustment [Community Provider Support]10251570.00
Increase Cost: Family Intervention Pilot and Family Strengthening Contract Services [Positive Youth Development]5657061.00
Shift: Community Grants Moved from the Community Grants Non-Departmental Account to the Department's Base Budget5565000.00
Increase Cost: Three Percent Inflationary Increase to the Developmental Disability Supplement [Community Provider Support]5366280.00
Increase Cost: Client Portal Project Maintenance Expenses [Admin - Office of the Chief Operating Officer]3900000.00
Increase Cost: Conversion of Broker Positions to Merit Positions in Accordance with Legal Advice32420232.00
Increase Cost: Annualization of Three Community Health Nurse II Positions [School Health Services]3031593.00
Increase Cost: Operating Budget Impact of Move to Wheaton Building [Admin - Office of the Chief Operating Officer]1977700.00
Increase Cost: HighGear Software Licensing Fees to Continue to Allow Back-Office Personnel To Work Remotely and More Effectively and Efficiently [Admin - Office of the Chief Operating Officer]1782000.00
Increase Cost: Domestic Violence Offender Treatment Program Due to Increase Contract Cost [Trauma Services]1389110.00
Increase Cost: Motor Pool Adjustment1285690.00
Increase Cost: Funding for Medical Providers to Support an Increase in the Number of Unaccompanied Minors Coming to the County [Health Care for the Uninsured]1000000.00
Increase Cost: Montgomery Cares Specialty Care due to Loss of Pro-Bono Work [Health Care for the Uninsured]1000000.00
Increase Cost: Information Technology Contractor Rate Increases [Admin - Office of the Chief Operating Officer]863850.00
Increase Cost: Enhance County Dental Services Contractual Pay Rate [Dental Services]750000.00
Increase Cost: Contractual Funding to Add Care for Kids Client Services Specialist [Health Care for the Uninsured]645740.00
Increase Cost: Provide Contractual Funding to Add Care for Kids Medical Assistant Case Manager [Health Care for the Uninsured]645740.00
Increase Cost: Montgomery Cares Psychiatric Services due to Rate Increase [Health Care for the Uninsured]631000.00
Increase Cost: Three Percent Inflationary Increase to African American Health Program Contract [Minority Programs]431690.00
Increase Cost: Print and Mail Adjustment196830.00
Increase Cost: Three Percent Inflationary Increase to the Adult Medical Day Care Supplement [Assessment & Continuing Care Management Services]195300.00
Shift: Workforce Adjustment [Admin - Children, Youth & Families]0-1.00
Technical Adj: Workforce Adjustment0-5.33
Decrease Cost: Elimination of One-Time Items Approved in FY21-121900.00
Decrease Cost: Reduce Temporary Clerical Services Budget [Admin - Office of the Director]-220000.00
Decrease Cost: Grant Writer Contracts [Admin - Office of the Chief Operating Officer]-250000.00
Decrease Cost: Reduce Broker Contract for ACCESS Program [Access To Behavioral Health Services]-320000.00
Re-align: Realignment of the Jewish Council for the Aging Escorted Transportation Budget to Reflect Expected Expenditures [Area Agency on Aging]-432860.00
Decrease Cost: Reduce Motor Pool Fuel Costs [Admin - Office of the Chief Operating Officer]-456920.00
Shift: Transfer of Funds to Office of Human Resources for the Disability Employment Initiative [Community Support Network for People with Disabilities]-188851-6.50
Decrease Cost: Decrease Shared Psychiatrists Contract Budget Due to Lack of Respondents [Local Behavioral Health Authority]-2200000.00
Decrease Cost: Retirement Adjustment-4988070.00
Decrease Cost: Annualization of FY21 Personnel Costs-19871230.00
FY22 APPROVED2684321511305.53
 
GRANT FUND - MCG
FY21 ORIGINAL APPROPRIATION87397321451.01
Federal/State Programs
Add: Funding to Support Services Provided at the Eight Service Consolidation Hubs36000001.00
Enhance: Subsidy for Rental Assistance Program10000000.00
Add: Mobile Health Clinic8792185.00
Add: Therapeutic Recreation Services for School-Age Youth7500000.00
Enhance: Rapid Rehousing Program Expansion4900000.00
Enhance: Mental Health Services for Montgomery County Public School Students and Their Families2500000.00
Other Adjustments (with no service impacts)
Technical Adj: Technical Grant Adjustment15311362.00
Technical Adj: House Bill Grant3517046.08
Increase Cost: Realignment of Budget due to Increase of Centers for Disease Control Ending the HIV Epidemic Grant [Communicable Disease & Epidemiology]3409130.00
Decrease Cost: Child Care Development Grant [Head Start]-150000.00
Shift: Reflect Reduction in Award for End the HIV Epidemic Grant [Communicable Disease & Epidemiology]-75860-1.00
Technical Adj: Local Behavioral Health Authority State Opioid Grant [Local Behavioral Health Authority]-977680.00
Decrease Cost: Realignment of Budget due to Decrease in Ryan White - Consortia Grant Award [Communicable Disease & Epidemiology]-1289381.00
Decrease Cost: Expiration of Funding of the Kresge Opportunity Ecosystems Grant Award [Admin - Children, Youth & Families]-7500000.00
FY22 APPROVED95522726465.09
Function Summary
Program NameFY21 APPR
Expenditures
FY21 APPR
FTEs
FY22 APPR
Expenditures
FY22 APPR
FTEs
Aging and Disability Services55057416173.0957254831176.59
Behavioral Health and Crisis Services44861179221.2546527020234.20
Children, Youth and Family Services91084785558.5394740688571.53
Public Health Services79917504530.1282294910542.80
Services to End and Prevent Homelessness2502707277.503135720284.50
Administration and Support42904097154.0051780226161.00
Total3388520531714.493639548771770.62
Charges to Other Departments
Charged DepartmentCharged FundFY21
Total$
FY21
FTES
FY22
Total$
FY22
FTES
COUNTY GENERAL FUND
Correction and RehabilitationGeneral Fund1062750.751081910.75
Housing and Community AffairsMontgomery Housing Initiative180629340.00179958660.00
PoliceGeneral Fund1219291.001246361.00
Total182911381.75182286931.75
Funding Parameter Items ($000s)
TitleFY22FY23FY24FY25FY26FY27
COUNTY GENERAL FUND
EXPENDITURES
FY22 Approved268432.000000268432.000000268432.000000268432.000000268432.000000268432.000000
No inflation or compensation change is included in outyear projections.
Annualization of Positions Approved in FY220.000000426.000000426.000000426.000000426.000000426.000000
New positions in the FY22 budget are generally assumed to be filled at least two months after the fiscal year begins. Therefore, the above amounts reflect annualization of these positions in the outyears.
Elimination of One-Time Items Approved in FY220.000000-558.000000-558.000000-558.000000-558.000000-558.000000
Items recommended for one-time funding in FY22, including Mobile Health Clinic, Mobile Crisis Response, Wellness Center at Seneca Valley High School, and an HHS Call Center to Handle Tier 2 Calls from MC311 Using Contractors, will be eliminated from the base in the outyears.
Restoration of Costs to Pre-COVID-19 Levels0.000000194.000000194.000000194.000000194.000000194.000000
Restoration of costs that were eliminated in the operating budget development year to return to pre-COVID-19 service delivery levels.
Labor Contracts0.0000003139.0000003139.0000003139.0000003139.0000003139.000000
These figures represent the estimated annualized cost of general wage adjustments, service increments, and other negotiated items.
Subtotal Expenditures268432.000000271633.000000271633.000000271633.000000271633.000000271633.000000