Joint committees recommend supplemental funding for Montgomery Cares; debate centers on timing and adding Islamic Center clinic

A joint meeting of Montgomery County's Government Operations & Fiscal Policy and Health & Human Services committees considered Supplemental Appropriation 25-58 — a request tied to the Montgomery Cares program to address higher-than-expected clinic utilization — and voted to recommend the staff proposal to the full council.

Miss Killemins Johnson, who presented the request, said Montgomery Cares clinics were budgeted for about 72,000 primary-care encounters at $102.15 per encounter but are projected to reach roughly 76,449 encounters this fiscal year. The executive's supplemental request identified a total amount of $974,664 and cited general funds/undesignated reserves as the source; committee discussion focused on corrected packet figures and a staff recommendation to forward $851,152 to the full council.

Why it matters: Committee members said the supplemental aims to keep safety-net clinics solvent so they can continue to serve uninsured residents and avoid additional emergency department use. Several council members and DHHS officials said repeated supplemental requests reflect broader federal and state budget pressures that have increased demand on county safety-net services.

State law and eligibility: Council Member Lukey asked about a packet note that eligibility rules changed on April 1. Dr. Rogers explained that Maryland's Access to Care Act (effective Jan. 1, 2026) will allow undocumented immigrants to enroll in qualified health plans but without federal premium subsidies, which staff said could leave those plans unaffordable for many. To preserve access, the county adjusted Montgomery Cares eligibility so residents who attest a qualified plan is unaffordable may still be considered uninsured and remain eligible for Montgomery Cares. Dr. Rogers emphasized that being technically eligible for a plan does not guarantee affordability.

Timing and program details: Several council members pressed staff to explain why the county would authorize supplemental funding that covers only a short period (two to three months) instead of waiting to fund the expansion in the FY26 budget. Office of Management and Budget representative Grace Peterson said provider readiness drove the May start date: conversations with the proposed new provider (Islamic Center of Maryland, ICM) indicated that was the earliest practical date to begin accepting patients, so the supplemental timing reflects provider availability as well as enrollment pressures.

Packet discrepancies and staffing: Miss Killemins Johnson and other staff acknowledged inconsistencies in the packet's line-item math. Staff clarified that the supplemental includes approximately 6,000 additional adult primary-care encounters at the $102.15 encounter reimbursement, funds for behavioral-health capacity (noted as 0.2 FTE behavioral health care management), 1.25 FTE client-service support for the MedBank program, and pharmacy-purchase funding for community pharmacy. When indirect costs are included, the ICM contract subtotal is higher; some line-item amounts in the packet were not clearly labeled and committee members asked for corrected, transparent budget tables during subsequent HHS deliberations.

Evaluation and program performance: Council Member Veil asked when the Primary Care Coalition contract was last formally evaluated. DHHS said each vendor has an annual contract-monitoring report; the coalition contract itself has not had a recent formal reprocurement evaluation, but the department completed a network adequacy study assessing site access, hours, language access and patient satisfaction. Staff cited program metrics such as an average county cost of about $515 per participant per year and high reported patient satisfaction in recent surveys.

Adding a new clinic: The supplemental packet also included a request to add the Islamic Center of Maryland's clinic to the Montgomery Cares network. Miss Killemins Johnson said the clinic is currently operating independently and is requesting to join the network; committee members agreed that a fuller HHS committee discussion of network adequacy, contract terms and readiness was appropriate before final network designation.

Vote and next steps: With some members urging immediate funding to prevent service gaps and others urging a fuller FY26 review, the joint committees moved the staff recommendation. A motion was made and seconded; the committee recorded five votes in favor and three abstentions and recommended the staff proposal (staff-recommended funding level listed in the packet as $851,152) to the full Montgomery County Council for final action. Committee members will continue in-depth FY26 budget deliberations upstairs in the HHS committee session.

What remains unresolved: Committee members requested clearer, corrected budget worksheets showing encounter counts and line-item math (including the exact MedBank line), a timeline and plan for onboarding ICM if accepted into the network, and clarity about any evaluation plans for Primary Care Coalition contract performance. Staff committed to deeper follow-up in the HHS FY26 budget meeting.

Ending: The joint committee concluded its recommendation and referred the matter to the full council; the HHS committee will take a deeper budget dive on FY26 Montgomery Cares planning shortly afterward.