Significant Health Funding Increases Planned in Montgomery County’s Fiscal Year 2023 Budget – State of Reform


In Montgomery County, where one in six Marylanders live, County Executive Marc Elrich unveiled his $6.3 billion budget proposal Tuesday. Approximately $421.9 million is expected for the Department of Health and Human Services (DHHS) in fiscal year 2023, a significant increase from $363.9 million in fiscal year 2022.

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Under DHHS, the Agency for Child, Youth and Family Services is set to receive $110 million in funding, with an additional $93 million allocated for public health services. The rest of the funding is for administrative support, aging and disability services, behavioral health and crisis services, and homeless services.

Elrich specifically highlighted $12.4 million proposed for services that would end and prevent homelessness in the county, which represents a 50% increase over the fiscal year 2022 funding for this area. It includes $2 million for the creation of up to 120 rapid rehousing units and $3 million to increase the maximum amount of housing assistance for families receiving DHHS services.

“We are not going to continue Montgomery County’s inhumane program of having people sleep outdoors most of the year,” Elrich said during the budget announcement. “It has always baffled me and others how much the wealthiest county in the state has people sleeping outside.”

Several line items allocate funds for long-term care and developmental disability services. The county’s Medicaid-funded long-term care services received $8.9 million to provide continuing care services that allow people to live at home and in the community, rather than institutional care.

Providers of developmental disabilities and medical adult day care programs are set to receive $1.1 million and $1.4 million in additional payments, respectively. These providers help seniors and adults with disabilities access essential services across the continuum of care, especially those not covered by Medicaid.

The fiscal year 2023 budget also proposes several investments in behavioral health services, including $3.7 million to expand mental health supports in 10 of the county’s most needy schools without a wellness center. Another million dollars is planned to support the implementation of 988, the three-digit number for the National Suicide Prevention Hotline. Another $800,000 is budgeted for EveryMind, Montgomery County’s own behavioral health hotline.

Elrich listed several budget proposals that would support health equity and the social determinants of health. For example, the budget provides about $20 million for the Early Care and Education initiative. Child care is often a family’s second or third largest expense, according to the Maryland Family Network. According to their 2019 Maryland Child Care Market Rate Investigationa Montgomery family spends an average of $255 to $327 a week on child care, making it the most expensive county for child care in the state.

“We think child care is going to come back,” Elrich said during the budget announcement. “We know that the workforce will not be able to return to work until their children are taken care of, so it is important for us to invest money in this.”

Approximately $5 million will support service consolidation centers. This network of eight community organizations and DHHS provide services such as free distribution and delivery of food, diapers and other newborn supplies, and case management services.

A total of $6.3 million is earmarked for health initiatives that specifically support racially and ethnically diverse groups, such as the African American Health Program ($2.9 million), the Latino Health Initiative (2 $.2 million) and the Asian American Health Initiative ($1.2 million).

Montgomery County Council will consider recommendations from the county executive and pass the budget by the end of May. If passed, the new budget will come into effect on July 1, 2022.


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