All right, good afternoon, and welcome to the Health and Human Services briefing.

We are going to have a work session today.

I want to welcome my colleagues, council members Andrew Friedson and Dawn Lukey.

Council staff, our DHS leadership, community health partners, and everyone joining us in chambers or online.

Our two briefings connect the capacity of our health care safety net with the consequences of HR 1.

When federal policy takes away health coverage, the need for care remains.

Residents still need prescriptions, treatment, and trusted guidance.

County agencies and community providers must respond with finite resources.

The staff reports identify pressures that warn our attention, declining care for kids participation, growing Montgomery Care's utilization, and an estimated 700 to 1,200 county residents who may be affected by the October Medicaid eligibility changes.

Today I want us to move from identifying risk to establishing responsibility for addressing them across both briefings.

We should clarify what we know, what action is underway, who is responsible, and when we will assess progress.

Communicate local impacts, and pursue available assistance.

Our goal is to anticipate gaps before residents experience a crisis and identify decisions the council needs to make.

So item one health care for the uninsured programs.

We will begin with care for kids, Montgomery CARES, and the Montgomery Perrinatal Program.

Our focus is whether residents are reaching care and whether providers have the capacity to meet current and emerging needs.

Declining participation warrants investigation, just as increasing demand requires preparation.

Ms.

Tara Clemens Johnson, please introduce the item and if you can summarize the staff findings as well.

Thank you.

Good afternoon.

Thank you, Chair Sells, and hello to our other DJS Committee members.

We are starting with item number one, which is the health care for the uninsured programs update.

I just want to clarify for the millions watching at home that there are two separate staff reports and two presentations that will be given on the different items.

The health care for the uninsured report includes the HR1 as part of the update for this item, but we will discuss that with the next item.

So in going through the staff report, uh, one thing that I wanted to highlight is the health care for the uninsured programs also includes the health care for the homeless program.

Because that program lives in the services to end and prevent homelessness area of the department.

The HHS committee received an update on that program on October 15th when we met a few weeks ago.

If there's any follow-up from that meeting, please let me know and we can provide that for you.

In going through the packet, I just wanted to call attention to just a few items.

On page number two, uh the care for kids visits.

Historically, we have not been able to get visit encounter data from the school-based health centers or Kaisers.

So that is a significant portion of the children that are seen within the program.

So it's great to have these numbers, but it does not represent the full number of visits that are happening in those programs.

I think Kaiser alone sees 700 to maybe a thousand care for kids kids, and then the vast majority of our children are seen at school-based health centers.

So significantly underreported, and it's always been a data concern, but they're they've always been working on it in terms of the department.

I wanted to call attention to the reproductive health program on page three.

It was funded in for the first time in FY26.

However, the program is just ramping up to being able to see clients just by the time the budget was approved and trying to establish contracts, um, you know, um medication that would be needed, that there was not uh the ability to spend the funds, my understanding, in FY26.

So 180,000 was approved for that program, and they are working to begin providing services.

And then on page four and five, we uh received an update on the maternity partnership program.

I just want to note that the committee discussed um maternity partnership and the other maternal health programs within DHHS February 16th earlier this year.

Uh, that was more so related to the OLO report on racial disparities in maternal and infant help.

And there was some follow-up that occurred after that.

So that we will hear from the department today on any um changes to MPP.

Also want to note that there was related to MPP, um, is the babies born healthy program during the budget.

There was a one and a half FTE that was not able to be funded, which was a nurse and a health educator.

So we have received a supplemental request from the department for that position, those positions to be considered for funding because uh the program is not able to see as many women as they were previously due to the loss of staff.

And then we'll just touch on Montgomery Care as the last item on page six of your packet.

I want to note that the number of encounters that have increased over the last four years.

In FY23, there was 61,000 encounters, and in FY26, we have gone up to 82,000 encounters.

So that has been a significant funding investment from the county.

Um we pay a rate as of FY27 of 130.82 cents per encounter.

So when we're talking about thousands of encounters, we're talking about millions of dollars in funding.

Uh so I'll just say we didn't include any budget information as we will be uh discussing the supplementals on November 18th.

The county overall has an investment in the the programs, the health care for the uninsured programs of around 20 million dollars plus of general funds that includes primary care, behavioral health, um, personnel within DHHS, personnel on the contracts.

So they are quite large programs that have been around for years and see uh collectively probably around 30,000 plus uh resident.

So I will stop right there and see if there's any questions.

All right, thank you, Miss Clemens Johnson.

I'll turn it over to HHS staff.