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 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

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.

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.

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.