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Mission Statement

The Department of Health and Human Services (DHHS) 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.

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Budget Overview

The total recommended FY25 Operating Budget for the Department of Health and Human Services is $511,596,523, an increase of $35,186,451 or 7.39 percent from the FY24 Approved Budget of $476,410,072. Personnel Costs comprise 49.60 percent of the budget for 1,803 full-time position(s) and 318 part-time position(s), and a total of 2,014.27 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 50.40 percent of the FY25 budget.

County Priority Outcomes

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

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

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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 FY24 estimates reflect funding based on the FY24 approved budget. The FY25 and FY26 figures are performance targets based on the FY25 recommended budget and funding for comparable service levels in FY26.

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Initiatives

  • Shifts the focus of the Services to End and Prevent Homelessness (SEPH) service area toward prevention services and away from distribution of Federal funding for emergency rental assistance, as prevention services are more cost effective than shelters or motels. The Federal Emergency Rental Assistance Program (eRAP), which began during the COVID-19 pandemic, ends in FY24. Funding of almost $842,000 is recommended in FY25 for a team within DHHS to work directly with households to help them stay housed.
  • Adds funding of $1,900,000 to upgrade the existing enterprise Integrated Case Management system (eICM).
  • Provides approximately $3.3 million to support various school health initiatives, including approximately $1.3 million to annualize new school health room staff in community schools, $908,000 for seven new community schools that are expected to be designated in FY25, $580,000 for the opening of a School Based Health Center at South Lake Elementary School, almost $385,000 to cover inflation in school based health center contracts, and $150,000 in additional funding to improve recruitment and retention of bilingual therapists in the Linkages to Learning program.
  • Provides $1.5 million general funds to replace an ending Federal grant to continue Mobile Crisis Outreach Team (MCOT) services and expand capacity from five to seven teams. MCOTs are a crucial intervention for individuals with behavioral health issues and prevent unnecessary hospitalizations, interactions with law enforcement, and incarcerations.

  • Expands capacity in the dental program to meet increased demand. There are over 750 youth and 450 adults waitlisted for DHHS' dental services. In a promising development for dental care access, Medicaid has recently expanded dental care eligibility to adults ages 19-59, a population that did not previously have access to Medicaid dental coverage. This $860,000 expansion provides essential dental care to the County's most vulnerable residents while offsetting costs with newly available Medicaid revenues. With additional staff, the dental program will be able to reduce its waitlists and improve access to dental services through the Mobile Health Clinic.

  • Allocates $800,000 to reduce long-standing waitlists and increase capacity in programs serving vulnerable populations, older adults, and individuals with disabilities. The CE Recommended budget increases capacity for the following programs, each of which have over 150 waitlisted individuals: Adult Protective Services case management ($197,000); Home Care Services ($161,000); and Coordination of Community Services for individuals with intellectual and developmental disabilities ($63,000). The Medicaid Community First Choice Nurse Monitoring program budget increases by $180,000 and is fully offset by revenue. Almost $200,000 is allocated to continue services that were previously made possible with federal funds, including Senior Lunch site at the Silver Spring Recreation and Aquatic Center ($148,000) and prenatal engagement initiatives for vulnerable populations ($50,000).

  • Enhances supplemental funding for reimbursements to critical providers, including $697,000 for a 3% increase to the Developmental Disability Provider Supplement and the Adult Medical Day Care Provider Supplement. This budget also includes $112,000 to increase respite care provider reimbursement rates by $2 per hour on average.

  • Supports the Health Care for the Uninsured Programs with a $1.8 million (24%) increase for Montgomery Cares reimbursement rates, the second consecutive year of double-digit rate increases. Compared to FY23, the CE recommended FY25 rate increase reimburses providers with $50 more per encounter, an increase of over 66 percent in two years. In addition, the Care for Kids (CFK) programs are supported with an additional $180,000 to improve reproductive health care access, and $140,000 for administrative support to accommodate increased CFK enrollment and ensure clients' Medicaid or insurance providers are properly billed for services rendered.

  • Provides additional funding of $300,000 for the Latino Health Initiative for an expanded Community Health Worker program, an expansion of the Welcome Back Center to transition internationally trained health professionals to obtain health care credentials in the County that will help address healthcare workforce shortages, and enhanced funding for communications with this community.
  • Provides additional funding of $150,000 for the Asian American Health Initiative to expand the Asian American Center of Excellence Micro-grants program and to increase funds for a multi-lingual health navigation service and a medical interpretation program for Asian American residents.

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Innovations and Productivity Improvements

  • DHHS' enterprise Integrated Case Managment (eICM) Modernization system project updates the current DHHS eICM system for improved functionality, support, and cybersecurity. The contractor has been meeting with stakeholders to refine requirements and consolidate an inventory of all enterprise-wide reports applicable across DHHS service areas. In parallel, the contractor has started to design and prototype the new application to obtain early user feedback. The goal is to complete design and prototyping by mid-May 2024 and then start the build phase of the project.
  • eICM includes an interface with the Maryland Department of Health CARES system. The CARES system was replaced by the MD THINK Eligibility and Enrollment (E&E) system at the end of 2021. The conversion from CARES to E&E was supposed to be an "as is" conversion but the eICM support team discovered numerous issues with the data sent by E&E. Over the course of the previous year, a significant collaborative effort between the E&E and eICM teams resolved all the data issues. This work involved numerous rounds of requesting data, testing, and then requesting changes in the E&E system to resolve the issues identified in testing.
  • QLESS is a lobby management system that was implemented in DHHS' heavily trafficked locations in 2017. The initial implementation focused on serving some programs at some locations. Based on the success of this system in helping programs manage the lobbies, the Department has expanded to nine locations over the past year. Additional functionalities implemented or planned in FY24 include the ability to track service request volumes, virtually queue so clients no longer need to physically enter DHHS spaces, tracking clients by location, enabling individuals to view their place in a queue for services, working with MC311 to queue individuals requesting Office of Eligibility and Support Services (OESS) assistance, installing commercial displays that can easily change content to not only show QLESS information but other HHS priority information for customers, and replacing kiosks at all locations with larger screens for easier sign-in access for customers.
  • Licensure and Regulatory (L&R) Services selected the commercial CivicGov software to process applications, receive payment, better communicate with businesses, and combine multiple databases. DHHS Information Technology (IT), L&R, and the vendor have been working with County stakeholders to implement the software and expect to "Go Live" by the end of March 2024. CivicGov will also make processing the applications and payments easier for the County and the almost 4,400 constituents or businesses that will use CivicGov.
  • The DHHS Community Connect Application will improve the client experience and increase the efficiency of Case Workers in providing benefits and services to the community, such as reduced foot traffic, increased flexibility, improved document sharing, reduced application intake time, application tracking, screening for other needs, and easier reporting of changes. DHHS is currently in user acceptance and community testing and expects to "Go Live" with the first two phases of implementation in the fourth quarter of FY24. In FY25, the focus will be on development of the provider portal module of the platform which will be aimed at providing improved invoicing and transactions processing related to customer benefits approved by the County.
  • DHHS Information Technology team completed the Hyper-Converged Infrastructure (HCI) system project. All HHS applications that were at their end of life for maintenance support were successfully transferred to this newer, more efficient, and secure hardware.
  • The Services to End and Prevent Homelessness (SEPH) division worked with DHHS Information Technology to implement additional updates to the online application system for COVID Rent Relief and emergency Rental Assistance Program (CRR and eRAP). FY24 updates included creating duplicate applications to support households with additional funds, updating the reporting capability to more easily respond to data requests, and enhancing data validation and alerts for required fields to improve the accuracy of the applications.

Budget Trends
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Program Contacts

Contact Mark Hodge of the Department of Health and Human Services at 240.777.1568 or Deborah Lambert of the Office of Management and Budget at 240.777.2794 for more information regarding this department's operating budget.

Related Links
Budget Summary
TitleActual
FY23
Budget
FY24
Estimate
FY24
Recommended
FY25
%Chg
Bud/Rec
COUNTY GENERAL FUND
EXPENDITURES
Salaries and Wages104177133.00127560972.00 122951671.00 147272518.0015.5
Employee Benefits30963674.0038029293.00 35655986.00 43228137.0013.7
County General Fund Personnel Costs135140807.00165590265.00 158607657.00 190500655.0015.0
Operating Expenses209338057.00191492843.00 210316434.00 200922728.004.9
County General Fund Expenditures344478864.00357083108.00 368924091.00 391423383.009.6
PERSONNEL
Full-Time1043.001108.00 1108.00 1200.008.3
Part-Time305.00289.00 289.00 287.00-0.7
FTEs1390.251449.94 1449.94 1520.094.8
REVENUES
Health Inspection: Restaurants1935580.001870520.00 1881600.00 1881600.000.6
Health Inspections: Living Facilities279762.00236815.00 235675.00 235675.00-0.5
Health Inspections: Swimming Pools524670.00577400.00 582480.00 582480.000.9
Marriage Licenses240930.00246960.00 246960.00 246960.000.0
Other Licenses/Permits115567.00111360.00 110885.00 110885.00-0.4
Health and Human Services Fees1116285.001647119.00 1622634.00 1628774.00-1.1
Core Health Services Funding7002804.005171831.00 5592428.00 5592428.008.1
Federal Financial Participation Reimbursements16040624.0016727916.00 17967652.00 17967652.007.4
Medicaid/Medicare Reimbursement1219290.002336505.00 2336505.00 4196517.0079.6
Other Intergovernmental6150196.005752410.00 5943163.00 5675457.00-1.3
Miscellaneous Revenues1125.000.00 0.00 0.000.0
Other Charges/Fees2474063.002377100.00 2454078.00 4357743.0083.3
Other Fines/Forfeitures7950.0010450.00 10500.00 10500.000.5
County General Fund Revenues37108846.0037066386.00 38984560.00 42486671.0014.6
 
OPIOID ABATEMENT
EXPENDITURES
Salaries and Wages0.000.00 0.00 511797.000.0
Employee Benefits0.000.00 0.00 103476.000.0
Opioid Abatement Personnel Costs0.000.00 0.00 615273.000.0
Operating Expenses0.000.00 0.00 948000.000.0
Opioid Abatement Expenditures0.000.00 0.00 1563273.000.0
PERSONNEL
Full-Time0.000.00 0.00 5.000.0
Part-Time0.000.00 0.00 0.000.0
FTEs0.000.00 0.00 5.000.0
REVENUES
Other Intergovernmental0.000.00 0.00 1563273.00
Opioid Abatement Revenues0.000.00 0.00 1563273.000.0
 
GRANT FUND - MCG
EXPENDITURES
Salaries and Wages43623465.0043512004.00 43512004.00 47657250.009.5
Employee Benefits12862704.0014295317.00 14295317.00 14989614.004.9
Grant Fund - MCG Personnel Costs56486169.0057807321.00 57807321.00 62646864.008.4
Operating Expenses92939433.0061519643.00 61519643.00 55963003.00-9.0
Grant Fund - MCG Expenditures149425602.00119326964.00 119326964.00 118609867.00-0.6
PERSONNEL
Full-Time580.00614.00 614.00 598.00-2.6
Part-Time30.0030.00 30.00 31.003.3
FTEs466.41498.54 498.54 489.18-1.9
REVENUES
Other Charges/Fees61413.000.00 0.00 0.000.0
Federal Grants77254448.0034153544.00 34153544.00 41476951.0021.4
HB669 Social Services State Reimbursement44951579.0042188713.00 42188713.00 48698232.0015.4
State Grants18643152.0022517875.00 22517875.00 28283814.0025.6
Miscellaneous Revenues294133.000.00 0.00 150870.000.0
American Rescue Plan Act0.0020466832.00 20466832.00 0.00-100.0
Grant Fund - MCG Revenues141204725.00119326964.00 119326964.00 118609867.00-0.6
 
DEPARTMENT TOTALS
Total Expenditures493904466.00476410072.00 488251055.00 511596523.007.4
Total Full-Time Positions1623.001722.00 1722.00 1803.004.7
Total Part-Time Positions335.00319.00 319.00 318.00-0.3
Total FTEs1856.661948.48 1948.48 2014.273.4
Total Revenues178313571.00156393350.00 158311524.00 162659811.004.0
FY25 Recommended Changes
TitleExpendituresFTEs
COUNTY GENERAL FUND
FY24 ORIGINAL APPROPRIATION3570831081449.94
Changes (with service impacts)
Enhance: Food for Service Consolidation Hubs [Admin - Office of the Director]30000000.00
Enhance: Emergency Shelter Capacity, Hypothermia Overflow, and Security Services [Homeless Services for Single Adults]28656860.00
Enhance: Upgrade Existing Enterprise Integrated Case Management System That is Past End of Technical Support [Admin - Office of the Chief Operating Officer]19000000.00
Enhance: Annualization of Dedicated School Health Room Staffing for New Community Schools added in FY24, Partially Offset by State Revenue [School Health Services]127102410.00
Enhance: State-Mandated Dedicated Nurses for New Community Schools, Partially Offset by State Revenue [School Health Services]9083186.87
Enhance: Expand Dental Program to Meet Increased Demand (Offset Medicaid Revenues) [Dental Services]8600127.00
Enhance: Prevention Services due to Discontinuation of Federal Emergency Rental Assistance Program (eRAP) [Prevention]8419668.00
Enhance: Operating Budget Impact for Opening of School Based Health Center at South Lake Elementary School5803641.87
Enhance: Office of Eligibility and Support Services (OESS) Navigators - Converts Three Brokers Previously Funded by Grant to Merit Staff to Reduce Wait Times at OESS Offices [Office of Eligibility and Support Services]3047293.00
Enhance: Latino Health Initiative Steering Committee Request for Expanded Community Health Worker Training Program, Welcome Back Center Expansion, and Enhanced Communications [Minority Programs]3000000.00
Enhance: Operating Support for WUMCO Help, Inc. [Admin - Public Health]2320000.00
Enhance: Summer Electronic Benefit Transfer (EBT) Summer and Winter School Break Children's Food Program [Office of Eligibility and Support Services]2110900.00
Enhance: Add Three Peer Support Specialists at Interfaith Works to Address Behavioral Health Needs at Progress Place [Homeless Services for Single Adults]2079500.00
Enhance: Reduce Waitlist for Adult Protective Services Case Management [Assessment & Continuing Care Management Services]1967563.00
Add: Improve Access to Reproductive Health Services in the Care for Kids Program [Health Care for the Uninsured]1800000.00
Enhance: Medicaid Community First Choice Nurse Monitoring Services [Medicaid Funded Long-Term Care Services]1798000.00
Enhance: Increase Home Care Services to Meet Demand and to Serve Clients Experiencing Homelessness [Home Care Services]1609571.00
Enhance: Asian American Health Initiative Request to Expand the Asian American Center of Excellence Micro-Grants and Patient Navigator Programs [Minority Programs]1500000.00
Enhance: Linkages to Learning Bilingual Therapist Contractor Salaries to Improve Recruitment and Retention [Linkages To Learning]1500000.00
Add: Administrative Support to Accommodate Care for Kids Program Enrollment Increases and Billing Capacity [Health Care for the Uninsured]1400000.00
Enhance: Add Two Community Service Aides to Child Welfare Services for Service Delivery and Transportation [Child Welfare Services]1007932.00
Enhance: Add Staff to Increase Review Capacity and Assist County Businesses with Attaining Licensure and Complying with Regulations [Licensure and Regulatory Services]891671.00
Enhance: Increase Services to Meet Increased Demand for the Coordination of Community Services Program [Medicaid Funded Long-Term Care Services]628261.00
Eliminate: MD Vietnamese Mutual Association Contract [Child & Adolescent School & Community Based Services]-873210.00
Other Adjustments (with no service impacts)
Increase Cost: Annualization of FY24 Compensation Increases99736150.00
Increase Cost: FY25 Compensation Adjustment77465080.00
Restore: FY24 One-time Budget Adjustment to Reflect Higher Than Expected Vacant Positions38014370.00
Increase Cost: Three Percent Inflationary Adjustment to Non-Profit Service Provider Contracts36480910.00
Increase Cost: FY25 One-time Budget Adjustment to Reflect Higher Than Expected Contractor Services31482610.00
Restore: Continue Overflow Sheltering In Motels - One Time Only [Homeless Services for Families]25944160.00
Increase Cost: Increase Montgomery Cares Reimbursement Rate to 50 percent of the Cost of Care [Health Care for the Uninsured]18000000.00
Increase Cost: Annualization of FY24 Lapsed Positions16177800.00
Replace: Continue Mobile Crisis Outreach Team Services After Federal Grant Funding Ends and Increase Capacity from Five to Seven Teams [24-Hours Crisis Center]14833596.00
Increase Cost: DHHS Administrative Infrastructure to Administer New Programs and Services and to Ensure Ability to Bill for Revenue - Fully Offset by Revenue98090211.00
Restore: Continuation of Youth Safety Initiative Program Funding [Admin - Children, Youth & Families]7792920.00
Increase Cost: FY25 One-time Budget Adjustment to Reflect Higher Than Expected Overtime7500000.00
Increase Cost: Three Percent Increase to the Developmental Disability Provider Supplement [Community Provider Support]6318660.00
Replace: Ongoing Infectious Disease Prevention, Response, and Community Support [Public Health Emergency Preparedness & Response Program]5959560.00
Increase Cost: Support Cost Increases in Existing School Based Health Center Contracts [School Health Services]3849150.00
Replace: Psychiatric Services in Shelters Previously Funded by Grant [Healthcare for the Homeless]3000250.00
Increase Cost: Language Assistance Services Due to Increased Demand [Equity and Language Access]2526900.00
Replace: Continue Senior Lunch at Silver Spring Recreation and Aquatic Center After One-Time Federal Funding Ends [Area Agency on Aging]1478750.00
Increase Cost: Respite Care Rate Increase [Respite Care]1120450.00
Increase Cost: Final Year of Phased Merit Conversion of Previously Contractual Dental Program Staff [Dental Services]1107295.00
Increase Cost: Printing and Mail803550.00
Increase Cost: Three Percent Increase to the Adult Medical Day Care Provider Supplement [Assessment & Continuing Care Management Services]647430.00
Increase Cost: Annualization of FY24 Contractual Staff Conversion6469324.00
Increase Cost: Replace Ending Federal Funding to Ensure Prenatal Program Engagement with Vulnerable Populations [Community Health Services]480000.00
Technical Adj: Contractual Lactation Specialist Conversion to Merit Staff, Personnel Cost Increase Fully Offset by Operating Expenses Decrease [Community Health Services]01.00
Technical Adj: Technical Adjustment for Mid-Year Position Transactions0-4.34
Decrease Cost: Motor Pool Adjustment-380430.00
Shift: Transfer Long-term Vacant Position from DHHS Office of Eligibility and Support Services to Office of Labor Relations to Support Countywide Labor and Employee Relations Functions [Office of Eligibility and Support Services]-64889-1.00
Re-align: Elimination of Long-Term Vacancy [Admin - Office of the Director]-73762-0.75
Shift: Move Tax Supported Charge Backs from Department of Health and Human Services to Office of County Attorney [Child Welfare Services]-105175-0.50
Decrease Cost: Retirement Adjustment-2361530.00
Decrease Cost: Risk Management Adjustment-2596200.00
Shift: Grant Fund Availability to Replace General Funds for 988 Services [24-Hours Crisis Center]-3202980.00
Shift: Transfer Food Security Contracts to Office of Food Systems Resilience-2238296-1.00
Decrease Cost: Annualization of FY24 Personnel Costs-28901580.00
Decrease Cost: FY25 One-time Budget Adjustment to Reflect Higher Than Expected Vacant Positions-38982610.00
Decrease Cost: Elimination of One-Time Items Approved in FY24-11458740-14.00
FY25 RECOMMENDED3914233831520.09
 
OPIOID ABATEMENT
FY24 ORIGINAL APPROPRIATION00.00
Changes (with service impacts)
Enhance: Annualization of Special Appropriation #24-22 to Continue Opioid Abatement Initiatives and Staff the Office of Prevention and Harm Reduction [Admin - Behavioral Health & Crisis Services]15632735.00
FY25 RECOMMENDED15632735.00
 
GRANT FUND - MCG
FY24 ORIGINAL APPROPRIATION119326964498.54
Federal/State Programs
Add: Federal Grant to Enhance the Detection, Response, and Prevention of Emerging Infectious Diseases24335050.00
Add: 988 Crisis Hotline Services Grants13172190.00
Add: Maryland Department of Health Grant for School Based Health Centers11444820.50
Add: Local Health Departments Health Disparities Grant5483870.00
Add: Strengthening Maryland's Public Health Infrastructure Grant4302381.00
Eliminate: Ending Substance Abuse and Mental Health Services Administration (SAMSHA) Grant for Mobile Crisis Teams-16263800.00
Eliminate: Ending of Emergency Housing Program (EHP) Grant-26652600.00
Eliminate: Ending of Emergency Rental Assistance Program (ERAP) Grant-14016832-28.00
Other Adjustments (with no service impacts)
Increase Cost: House Bill 669 Grant [Admin - Office of the Director]650952513.44
Technical Adj: Miscellaneous Grant Changes [Admin - Office of the Director]52080193.70
FY25 RECOMMENDED118609867489.18
Function Summary
Program NameFY24 APPR
Expenditures
FY24 APPR
FTEs
FY25 REC
Expenditures
FY25 REC
FTEs
Aging and Disability Services66882925202.2573345531211.25
Behavioral Health and Crisis Services53321125249.3561821484266.55
Children, Youth and Family Services120724974618.57124956003613.98
Public Health Services105214148581.72118980779617.96
Services to End and Prevent Homelessness59372899119.4049415716117.40
Administration and Support70894001177.1983077010187.13
Total4764100721948.485115965232014.27
Charges to Other Departments
Charged DepartmentCharged FundFY24
Total$
FY24
FTES
FY25
Total$
FY25
FTES
COUNTY GENERAL FUND
NDA - Early Care and EducationGeneral Fund117961612.00258620026.00
NDA - Guaranteed IncomeGeneral Fund1120301.001120301.00
Correction and RehabilitationGeneral Fund1106530.751228170.75
Housing and Community AffairsMontgomery Housing Initiative195669500.00195669500.00
PoliceGeneral Fund1143971.001325431.00
RecreationRecreation528530.50528530.50
Total2113649915.252257339329.25
Funding Parameter Items ($000s)
TitleFY25FY26FY27FY28FY29FY30
COUNTY GENERAL FUND
EXPENDITURES
FY25 Recommended391423.000000391423.000000391423.000000391423.000000391423.000000391423.000000
No inflation or compensation change is included in outyear projections.
Annualization of Positions Recommended in FY250.0000001713.0000001713.0000001713.0000001713.0000001713.000000
New positions in the FY25 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 Recommended in FY250.000000-6709.000000-6709.000000-6709.000000-6709.000000-6709.000000
Items recommended for one-time funding in FY25, including overflow sheltering in motels, contract services increase, overtime increase, and lapse increase will be eliminated from the base in the outyears.
Restore One-Time Lapse Increase0.0000003898.0000003898.0000003898.0000003898.0000003898.000000
Restores in FY26 the one-time lapse increase made in the FY25 budget.
Labor Contracts0.0000005009.0000005009.0000005009.0000005009.0000005009.000000
These figures represent the estimated annualized cost of general wage adjustments, service increments, and other negotiated items.
Subtotal Expenditures391423.000000395334.000000395334.000000395334.000000395334.000000395334.000000
 
OPIOID ABATEMENT
EXPENDITURES
FY25 Recommended1563.0000001563.0000001563.0000001563.0000001563.0000001563.000000
No inflation or compensation change is included in outyear projections.
Subtotal Expenditures1563.0000001563.0000001563.0000001563.0000001563.0000001563.000000