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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.

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Budget Overview

The total recommended FY23 Operating Budget for the Department of Health and Human Services is $421,855,068, an increase of $57,900,191 or 15.91 percent from the FY22 Approved Budget of $363,954,877. Personnel Costs comprise 48.47 percent of the budget for 1,607 full-time position(s) and 335 part-time position(s), and a total of 1,840.66 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 51.53 percent of the FY23 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 FY22 estimates reflect funding based on the FY22 approved budget. The FY23 and FY24 figures are performance targets based on the FY23 recommended budget and funding for comparable service levels in FY24.

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Initiatives

  • The FY23 budget provides increased direct support to youth most impacted by the pandemic via mental health, therapeutic recreation, Healing Informed Positive Youth Development, and Family Strengthening and Intervention services. In addition to sustaining these needed supports initially funded via pandemic relief funds, the County Executive is further expanding supports to reach more youth and families by providing additional mental health and social services at existing High School Wellness Centers; and to provide services in more school communities by opening a new Wellness Center at Kennedy High School, new Linkages to Learning centers at Odessa Shannon Middle School and the new Gaithersburg Elementary School #8, mental health and social services at ten high schools without Wellness Centers that MCPS has prioritized as being in need of more resources, and an expansion of community-based youth crisis stabilization services and youth Mental Health First Aid trainings.
  • The Bienvenidos Initiative (Newcomers Initiative) was propelled by the unprecedented increase in the number of unaccompanied migrant children and asylum-seeking families approaching the southern U.S. border and arriving in Montgomery County. Through the application of an equity lens framework, the initiative focuses on expanding the County's capacity to address the unique needs of this subset of the newcomer population in the mental health, legal and social services realm. The initiative brings together a robust network of providers that offer consistent information and access to services regardless of point of entry. Funds are allocated to support the expansion of existing healing informed and culturally based school and community-based services; such as Wellness Center services, family reunification, Street Outreach Network supports, youth leadership development, legal screening and representation for any and all newcomers in the County.
  • In FY22, the County made important and significant changes to the approach to sheltering people experiencing homelessness. The prior policy and funding provided a limited number of year-round beds which expanded during the winter months. The new policy more than doubles the year-round shelter capacity and support services including improved access to primary care, behavioral health, and vocational services. This includes the opening of a new emergency shelter for men.
  • One of the best strategies to eradicate homelessness is to prevent households from entering the homeless continuum by resolving their housing crisis through conflict resolution, problem-solving, and flexible funding. In FY23, additional funding is recommended to implement a centralized shelter intake and homeless diversion program. This new program will include a 24-hour, 7-days-a-week shelter hotline and case management staff to help households avoid homelessness.
  • When homelessness cannot be prevented, the approach of the County is to quickly connect households to permanent housing. The FY23 budget makes permanent the funding that was provided through ARPA in FY22, as well as providing an additional $2,000,000 for Rapid Rehousing and $3,000,000 for the County Rental Assistance Program. Rapid Rehousing provides a short-term housing subsidy and intensive wraparound services to ensure households can maintain housing stability after the subsidy ends. The Rental Assistance Program provides a permanent shallow housing subsidy to those with vulnerable housing and those exiting homelessness.
  • In response to the disproportionate impact of the COVID-19 pandemic on our County's low income and immigrant population, the Department of Health and Human Services, in collaboration with the Office of Emergency Management and Homeland Security, and in partnership with multiple non-profit organizations, created eight Service Consolidation Hubs located in strategic geographical areas to provide food, diapers, and essentials as well as access to benefits and services to households in need. The FY23 budget continues the work of the hubs with an eye toward permanent post-pandemic services.
  • Students attending Montgomery County Public Schools are experiencing more complex medical issues including diabetes, mental health concerns, and need for student case management and referrals, creating the need for more school Community Health Nurses. Having a nurse in every middle school, high school, and large elementary schools will assist in addressing increasing student health and wellness needs. The FY23 budget provides additional nurses to fully meet this policy level. In addition, increasing complexity of student health and wellness needs means school Community Health Nurses and school Health Room Techs, as well as school Administrators and staff, need additional, comprehensive training. While school Community Health Nurses in schools have been asked to provide this training in the past, increased activity in health rooms, COVID, and emerging disease prevents health room staff from being able to research topics and provide training to staff. School Health Managers and Administrators are spending a significant amount of time doing trainings and new staff orientation. The FY23 budget provides for a School Health Staff Training team which will allow for more timely trainings and mentoring of new staff across School Health Services.
  • The FY23 budget provides for the establishment of an additional Adult Protective Services team which will greatly enhance the County's capacity to properly, safely, and timely meet the State mandated requirements to immediately investigate reports of abuse, neglect, and exploitation of adults age 18 and over at risk of abuse, neglect, and exploitation. As Adult Protective Services (APS) are mandated, they do not allow wait lists. APS cases have grown in the past five years driven in large part by the growth in financial exploitation cases. Continued mandated reporting by fiduciary institutions, increased awareness of abuse in the community, and the growing number of older County residents has resulted in a steady growth for investigation of allegations of financial exploitation.
  • The FY23 budget provides additional funding for the expansion of the supplement given to Medical Adult Day Care (MADC) and Developmental Disability (DD) providers. The funding for MADC will greatly help the providers of this crucial community-based service meet the growing needs in our community and offset the costs of providing services not provided or allowed by Medicaid, which funds more than eighty percent of the constituents receiving MADC services. As the number of older adults and adults with disabilities in need of this service is expected to grow over the next two decades, this investment by the County supports the infrastructure that enables delivery of service to this population and their families. The increase in the annual supplement to providers of services to adults with developmental disabilities will continue to help the DD providers network, as part of the County's long-standing commitment to residents with developmental disabilities.
  • The FY23 budget provides a 6% inflationary adjustment to non-profit contracts. This will enable the non-profit partners to continue to provide vital services to County residents in the midst of rising costs.

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Innovations and Productivity Improvements

  • The Services to End and Prevent Homelessness (SEPH) Service Area utilized an online application system for COVID-19 rent relief and virtual intake for housing stabilization services enabling clients to access services from their home, which also allowed for centralized case assignments versus by office availability. This enabled the program to process over 11,000 rent relief applications between May 2021 to February 2022, resulting in the prevention of evictions for over 5,400 households along with $55 million in direct rent relief assistance.
  • Mobile Crisis and Outreach Teams (MCOTs) are becoming a true civilian response to behavioral health crises. The Department is working on getting approval for a Common Triage and Dispatch Protocol that specifies criteria by which the MCOTs respond without police presence. In addition, the Department is in the process of adding peer support specialists to the MCOTs, so instead of two clinicians responding, a peer support specialist is paired with a clinician; thereby, enhancing the number of clients that may be served.
  • The Department is developing a central call center and point of contact to connect residents to frequently requested Department of Health and Human Services' (DHHS) services and programs. The Internal Call Center team will provide end-to-end assistance to Montgomery County residents seeking supports and services. The Call Center will be staffed by a team of highly trained, bilingual Customer Service Representatives, who also possess knowledge of resources provided by community partners. Establishing an Internal Call Center will enable residents to access DHHS' services and resources in a faster, more efficient manner.

Budget Trends
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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
FY21
Budget
FY22
Estimate
FY22
Recommended
FY23
%Chg
Bud/Rec
COUNTY GENERAL FUND
EXPENDITURES
Salaries and Wages101890603.00108548799.00 105422846.00 117949357.008.7
Employee Benefits31991995.0033392320.00 31735884.00 34179754.002.4
County General Fund Personnel Costs133882598.00141941119.00 137158730.00 152129111.007.2
Operating Expenses201614418.00126491032.00 217165422.00 170446616.0034.8
Capital Outlay236326.000.00 0.00 0.000.0
County General Fund Expenditures335733342.00268432151.00 354324152.00 322575727.0020.2
PERSONNEL
Full-Time909.00977.00 977.00 1027.005.1
Part-Time306.00303.00 303.00 305.000.7
FTEs1263.481305.53 1305.53 1374.255.3
REVENUES
Core Health Services Funding4982560.004809321.00 4842257.00 4842257.000.7
Federal Financial Participation Reimbursements15550045.0016036044.00 15831840.00 16188044.000.9
Health and Human Services Fees1327510.001265497.00 1280811.00 1265497.000.0
Health Inspection: Restaurants1694580.001870520.00 1870520.00 1870520.000.0
Health Inspections: Living Facilities175315.00236815.00 236815.00 236815.000.0
Health Inspections: Swimming Pools482690.00577400.00 577400.00 577400.000.0
Marriage Licenses229095.00226800.00 246960.00 246960.008.9
Medicaid/Medicare Reimbursement851591.001296401.00 1051925.00 1296401.000.0
Miscellaneous Revenues-609969.000.00 0.00 0.000.0
Nursing Home Reimbursement749852.00713604.00 0.00 0.00-100.0
Other Charges/Fees906733.001459901.00 1438006.00 2377100.0062.8
Other Fines/Forfeitures20000.0010450.00 10450.00 10450.000.0
Other Intergovernmental5462714.005084192.00 5088462.00 5205004.002.4
Other Licenses/Permits24670.00111360.00 111360.00 111360.000.0
Social Services State Reimbursement5567.000.00 0.00 0.000.0
County General Fund Revenues31852953.0033698305.00 32586806.00 34227808.001.6
 
GRANT FUND - MCG
EXPENDITURES
Salaries and Wages40729085.0036295128.00 36295128.00 39667328.009.3
Employee Benefits12235754.0012654664.00 12654664.00 12675122.000.2
Grant Fund - MCG Personnel Costs52964839.0048949792.00 48949792.00 52342450.006.9
Operating Expenses48344369.0046572934.00 46572934.00 46936891.000.8
Grant Fund - MCG Expenditures101309208.0095522726.00 95522726.00 99279341.003.9
PERSONNEL
Full-Time568.00570.00 570.00 580.001.8
Part-Time30.0030.00 30.00 30.000.0
FTEs451.01465.09 465.09 466.410.3
REVENUES
American Rescue Plan Act0.006969218.00 6969218.00 3500000.00-49.8
Federal Grants41460020.0030554666.00 30554666.00 32942382.007.8
HB669 Social Services State Reimbursement39977881.0040031523.00 40031523.00 41271837.003.1
Miscellaneous Revenues343005.000.00 0.00 0.000.0
Other Charges/Fees318234.00345228.00 345228.00 462574.0034.0
State Grants14707087.0017622091.00 17622091.00 21102548.0019.8
Grant Fund - MCG Revenues96806227.0095522726.00 95522726.00 99279341.003.9
 
DEPARTMENT TOTALS
Total Expenditures437042550.00363954877.00 449846878.00 421855068.0015.9
Total Full-Time Positions1477.001547.00 1547.00 1607.003.9
Total Part-Time Positions336.00333.00 333.00 335.000.6
Total FTEs1714.491770.62 1770.62 1840.664.0
Total Revenues128659180.00129221031.00 128109532.00 133507149.003.3
FY23 Recommended Changes
TitleExpendituresFTEs
COUNTY GENERAL FUND
FY22 ORIGINAL APPROPRIATION2684321511305.53
Changes (with service impacts)
Add: Newcomers Enhancements and Assistance [Admin - Children, Youth & Families]44212276.00
Add: Funding to Support the County's Response to Food Insecurity [Admin - Public Health]40000000.00
Enhance: Mental Health Services at MCPS High Schools37261802.00
Enhance: Rental Assistance Program Expansion [Rental Assistance Program]30000000.00
Enhance: Increase the FY23 Base Budget for the African American Health Program [Minority Programs]28500000.00
Enhance: Funding to Support Services Provided by the Service Consolidation Hubs [Admin - Office of the Director]26016000.00
Enhance: Increase the FY23 Base Budget for the Latino Health Initiative [Minority Programs]22357060.00
Enhance: Rapid Rehousing Expansion [Rapid Rehousing]20000000.00
Enhance: Increase the FY23 Base Budget for the Asian American Health Initiative [Minority Programs]12102630.00
Enhance: Upgrade Existing Enterprise Integrated Case Management System That is Past End-of Support [Admin - Office of the Chief Operating Officer]12000000.00
Add: Funding to Support the Transition to the 988 National Suicide Prevention Hotline [24-Hours Crisis Center]10000000.00
Enhance: Add Six Positions to Support Adult Protective Services Program Due to Increased Caseload [Assessment & Continuing Care Management Services]9548066.00
Enhance: Annualization of Kirwan Supplemental9390946.00
Enhance: Operating Budget Impact for Kennedy High School Wellness Center9205651.88
Enhance: Conversion of Ten-Month School Health Staff to Support Summer Programs [School Health Services]83025310.92
Enhance: Funding for EveryMind Contract to Address Increased Call Volume [24-Hours Crisis Center]7950000.00
Add: Diversion Hotline and Centralized Shelter Intake for Households Without Children [Homeless Services for Single Adults]7000000.00
Enhance: Consolidate Existing IT Infrastructure That is Approaching End-of-Support into a Hyper-Converged Infrastructure System That Will Provide More Efficient and Cost Effective System Management [Admin - Office of the Chief Operating Officer]7000000.00
Enhance: Add Six Nurses to Address Staffing Shortage and to Meet Staffing Policy [School Health Services]6465476.00
Enhance: Additional Health and Psychiatric Services for Increase in Year-Round Clients at Homeless Shelters [Healthcare for the Homeless]6000000.00
Enhance: Operating Budget Impact for LInkages to Learning Program at Odessa Shannon Middle School [Linkages To Learning]3594271.00
Enhance: Operating Budget Impact for Linkages to Learning Program at Gaithersburg Elementary School #8 [Linkages To Learning]2711990.00
Add: Funding to Support Non-Profit Food Provider, Nourishing Bethesda [Admin - Public Health]2500000.00
Enhance: Additional Staff on the Contract Team and Human Resources Team in the Office of the Chief Operating Officer Due to Increased Workload [Admin - Office of the Chief Operating Officer]2465213.00
Enhance: Pathways Contract to Increase Street Outreach Resources in Silver Spring and Wheaton [Homeless Services for Single Adults]1800000.00
Enhance: Funding for School Health Staff at New Gaithersburg Elementary School [School Health Services]1753471.88
Enhance: Adding Two Positions to Support Training of School Health Staff [School Health Services]1709591.50
Enhance: CivicGov Online Application for License and Regulatory Services [Admin - Office of the Chief Operating Officer]1250000.00
Add: Position to Provide Mental Health Support to the Rockville Police, Funded by the City of Rockville [24-Hours Crisis Center]1165421.00
Add: Position to Administer Contract and Coordinate Activities with Early Care and Eduation Coordinating Entity [Early Childhood Services]1155701.00
Enhance: Funding for Child Welfare Services to Meet Program Requirements and Keep Up with Increasing Demand [Child Welfare Services]1072431.00
Add: Homeless Entry Coordinator to Implement New Federal Legal Requirement [Coordinated Entry]1049601.00
Enhance: Communications and Public Engagement Team to Enhance Timely Communication With the Public Regarding Services [Admin - Office of the Director]915991.00
Add: One Position to Meet Demands of the Tuberculosis Program [Communicable Disease & Epidemiology]856661.00
Add: One Position to Support the Long-Term Ombudsman Program Due to Increased Caseload [Area Agency on Aging]826161.00
Enhance: Restoration of Costs to Pre-COVID-19 Levels736290.00
Enhance: Legally Mandated Children, Youth, and Families Translation Services [Child Welfare Services]731250.00
Enhance: Position to Perform Child Protective Service Clearances [Child Welfare Services]704401.00
Add: One Position to Support Developmental Disabilities Supplement Program [Community Support Network for People with Disabilities]687691.00
Enhance: Rental Assistance Program Administrative Support [Rental Assistance Program]644311.00
Enhance: Funding for a Position Created in County Attorneys Office and Charged Back to Child Welfare Services to Administer Child Welfare Cases [Child Welfare Services]603601.00
Enhance: Crisis Center Phone Upgrade Necessary to Effectively Perform its Mission [Admin - Office of the Chief Operating Officer]500000.00
Other Adjustments (with no service impacts)
Increase Cost: Six Percent Inflationary Increase to Non-Profit Service Provider Contracts41916180.00
Increase Cost: Annualization of FY22 Compensation Increases31387510.00
Increase Cost: FY23 Compensation Adjustment27080600.00
Shift: Community Grants Moved From the Community Grants Non-Departmental Account to Health and Human Services' Base Budget21261540.00
Increase Cost: Adult Medical Day Care Supplement Adjustment [Assessment & Continuing Care Management Services]14452480.00
Increase Cost: Developmental Disabilities Supplement Adjustment [Community Provider Support]11283030.00
Replace: Rental Assistance Program Previously Funded by ARPA with General Funds [Rental Assistance Program]10000000.00
Increase Cost: Risk Management Adjustment6274240.00
Replace: School and Community Youth Services Therapeutic Recreation Services Previously Funded by ARPA with General Funds [Child & Adolescent School & Community Based Services]4950000.00
Replace: Rapid Rehousing Previously Funded by ARPA with General Funds [Rapid Rehousing]4900000.00
Increase Cost: Annualization of FY22 Lapsed Positions4258430.00
Increase Cost: Elimination of One Time Expenses Correction to Remove FY22 ARPA Funded Items3604430.00
Increase Cost: Continue Funding For East County Opportunity Zone after Kresge Grant Ends Using General Funds [Admin - Children, Youth & Families]2609333.00
Replace: Therapeutic Recreation Services Previously Funded by ARPA with General Funds [Positive Youth Development]2550000.00
Replace: Mental Health Services for MCPS Students Previously Funded by ARPA with General Funds [Child & Adolescent School & Community Based Services]2500000.00
Increase Cost: Funding Necessary to Correct FY22 Inflationary Adjustments1620000.00
Increase Cost: Fund Contract for More Accurate Cost Allocation Plan and Random Moment Time Studies [Admin - Office of the Chief Operating Officer]1520000.00
Increase Cost: Motor Pool Adjustment743710.00
Increase Cost: Printing and Mail Adjustment725350.00
Increase Cost: Annualization of FY22 Operating Expenses473080.00
Increase Cost: Annualization of Social Worker Position [Assessment & Continuing Care Management Services]260030.00
Shift: Legal Representation Program from Health and Human Services to Community Engagement Cluster []-5511000.00
Decrease Cost: Elimination of One-Time Items Approved in FY22-5584420.00
Decrease Cost: Annualization of FY22 Personnel Costs-11698738.55
Decrease Cost: Retirement Adjustment-12886470.00
FY23 RECOMMENDED3225757271374.26
 
GRANT FUND - MCG
FY22 ORIGINAL APPROPRIATION95522726465.09
Other Adjustments (with no service impacts)
Technical Adj: Miscellaneous changes to the grants including annualization of FY22 grant changes65021610.47
Increase Cost: House Bill (HB669)12403130.85
Decrease Cost: Preschool Development PG B-5 Toolkit Grant [Admin - Children, Youth & Families]-250000.00
Decrease Cost: Mobile Health Clinic ARPA Funding Decreases From FY22 Appropriation by $120,859 (Providing $500,000 in ARPA Funding in FY23) [Admin - Public Health]-1208590.00
Shift: Mental Health Services for MCPS Students Funded in FY22 by ARPA Moved to General Fund [Child & Adolescent School & Community Based Services]-2500000.00
Shift: Rapid Rehousing Funded in FY22 by ARPA Moved to General Fund [Rapid Rehousing]-4900000.00
Decrease Cost: Service Consolidation Hubs ARPA Funding Decreases From FY22 Appropriation by $600,000 (Providing $3,000,000 in ARPA Funding in FY23) [Admin - Office of the Director]-6000000.00
Decrease Cost: Kresge Grant Expiration [Admin - Children, Youth & Families]-7500000.00
Shift: Therapeutic Recreation Services Funded in FY22 by ARPA Moved to General Fund [Admin - Children, Youth & Families]-7500000.00
Decrease Cost: Rental Assistance Program Funded in FY22 by ARPA Moved to General Fund [Rental Assistance Program]-10000000.00
FY23 RECOMMENDED99279341466.41
Function Summary
Program NameFY22 APPR
Expenditures
FY22 APPR
FTEs
FY23 REC
Expenditures
FY23 REC
FTEs
Aging and Disability Services57254831176.5962473715184.59
Behavioral Health and Crisis Services46527020234.2050828662236.20
Children, Youth and Family Services94740688571.53110235275594.53
Public Health Services82294910542.8093028751570.84
Services to End and Prevent Homelessness3135720284.504186993587.50
Administration and Support51780226161.0063418730167.00
Total3639548771770.624218550681840.66
Charges to Other Departments
Charged DepartmentCharged FundFY22
Total$
FY22
FTES
FY23
Total$
FY23
FTES
COUNTY GENERAL FUND
NDA - Early Care and EducationGeneral Fund00.006922738.00
NDA - Guaranteed IncomeGeneral Fund00.001120301.00
Correction and RehabilitationGeneral Fund1081910.751086050.75
Housing and Community AffairsMontgomery Housing Initiative179958660.00195669500.00
PoliceGeneral Fund1246361.001362171.00
RecreationRecreation00.00528530.50
Total182286931.752066892811.25
Funding Parameter Items ($000s)
TitleFY23FY24FY25FY26FY27FY28
COUNTY GENERAL FUND
EXPENDITURES
FY23 Recommended322576.000000322576.000000322576.000000322576.000000322576.000000322576.000000
No inflation or compensation change is included in outyear projections.
Annualization of Positions Recommended in FY230.000000458.000000458.000000458.000000458.000000458.000000
New positions in the FY23 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 FY230.000000-8619.000000-8619.000000-8619.000000-8619.000000-8619.000000
Items recommended for one-time funding in FY23, including one-time expenses associated with new positions, the development of the CivicGov online application for License and Regulatory Services, expenses for newcomers enhancements and assistance, and funding to support the County's response to food insecurity, will be eliminated from the base in the outyears.
Labor Contracts0.0000006864.0000006864.0000006864.0000006864.0000006864.000000
These figures represent the estimated annualized cost of general wage adjustments, service increments, and other negotiated items.
Subtotal Expenditures322576.000000321279.000000321279.000000321279.000000321279.000000321279.000000