Joint Montgomery County committees recommend supplemental funds for Montgomery Cares, defer new clinic approval to FY26

A joint session of the Montgomery County Council’s Government Operations & Fiscal Policy Committee and Health and Human Services Committee on an item tied to Supplemental Appropriation 25‑58 recommended that the full council fund a supplemental appropriation for the Montgomery Cares program and defer final approval of adding the Islamic Center of Maryland clinic to the Montgomery Cares provider network until FY2026 budget deliberations.

Co‑chair Council Member Albinaz presented the item on behalf of the joint committee. The committees recommended funding the immediate supplemental at $851,152, with the funding source listed as general funds undesignated reserves, and to handle the request to add the Islamic Center of Maryland (ICM) to the network as part of the FY26 budget process. The motion to accept the staff recommendation was moved by Council Member Albanese and seconded by Council Member Katz; the committees recorded five votes in favor and one abstention.

Montgomery Cares provides primary medical services for uninsured adults who live in Montgomery County and make less than 250% of the federal poverty level. Committee staff said clinics are seeing increased utilization and are at risk of expending their budgets before the fiscal year ends. Packet materials and presenters noted the system was budgeted for 72,000 primary care encounters at a reimbursement rate of $102.15 per encounter and is projected to reach roughly 76,449 encounters this year.

Department staff told the committees the FY25 supplemental request was intended to avoid clinic closures and shortfalls similar to recent shortfalls experienced in the county’s Care for Kids program. Dr. Rogers of the county public health team said the department had budgeted for an additional 6,000 Montgomery Cares adult primary care encounters to reflect higher utilization and that the county executive’s FY26 recommended budget maintains funding for increased utilization. Department presenters also described program components covered by the supplemental: primary care encounters, specialty care support, behavioral health capacity, community pharmacy medication purchases (MedBank), and a small staffing supplement tied to onboarding a new clinic.

On the specific request to add ICM to the Montgomery Cares network, committee members pressed for more detail. Staff described the department’s estimate that ICM would serve roughly 267 Montgomery Cares patients and said the ICM startup request included funding for primary care reimbursements and modest staff support (a 0.2 FTE behavioral health care manager and a 0.25 FTE client service specialist for the MedBank program). Department staff reported the calculated primary care reimbursement portion for ICM was about $123,000 before Primary Care Coalition indirect costs and about $136,000 when those indirect costs were included. Several council members said bringing a new clinic into the network warrants fuller review in the HHS committee and during FY26 budget hearings rather than approving the clinic on a short interim appropriation that would cover only a few weeks of operations.

Committee members also discussed recent state law changes. Staff explained that the Maryland General Assembly’s Access to Care Act, effective January 1, 2026, will allow undocumented immigrants to purchase qualified health plans through the Maryland Health Connection but that many of those plans may be unaffordable because individuals made newly eligible under the law are not eligible for federal subsidies. To preserve access, county staff said Montgomery Cares eligibility was revised so residents may remain eligible for Montgomery Cares if they attest that a qualified health plan is unaffordable; clinics verify Medicaid enrollment status through the enrollment verification system.

Members raised several oversight questions before voting: whether the Primary Care Coalition contract has had a recent independent evaluation (staff said a systemwide network adequacy study was completed in recent years but that an evaluation of the contractor’s contract was not known to staff), inconsistencies in packet line items and encounter calculations (staff acknowledged presentation errors and provided clarifying math on encounter rates), and why the supplemental was brought late in the fiscal year. Office of Management and Budget staff said conversations with the ICM provider have been ongoing and that the May startup date reflected the provider’s realistic timeline rather than an attempt to fit work at year‑end.

The committees recorded a single formal action on the item: a recommendation to the full council to fund the supplemental appropriation in the amount of $851,152 from general funds undesignated reserves and to treat the ICM network request as part of FY26 deliberations. The joint committees will forward that recommendation to the full council for final action.

“I'm glad to see we are forecasting the needs and ensuring that no one will be turned away for service,” Council Member Sales said during the discussion, emphasizing concern for recently displaced workers, uninsured residents and immigrant communities. HHS committee members said they will hold a more detailed review in the HHS budget session later the same day.