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.

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

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.

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.

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.