1. Uma Ahluwalia October 15, 2012

2.  Most populous county in Maryland  Immigration was the largest component of population change since 2000 2 Source: U.S. Census Bureau Population Growth (K)

3. 3 Source: U.S. Census Bureau

4. 4 The Foreign Born Population has more than doubled since 1990 1990 140,000 2010314,498 Source: U.S. Census Bureau 1990, American Community Survey 2000, 2005, 2008, 2010 Foreign Born Population Growth 1990 - 2010

5. Adult + infant + Monthly Costs Adultinfantpreschoolerschoolageteenagerschoolageteenager2 Adults Housing $1,479$1,677 $1,479 Child Care $0$1,049$1,174$608$0$1,656$1,049$0 Food $256$382$389$457$486$576$604$506 Transportation $181 $362 Health Care $155$393 $405$424$417$436$443 Miscellaneous $207$368$381$333$277$451$395$279 Taxes $727$1,245$1,322$1,070$844$1,557$1,240$793 Earned Income Tax Credit (-) $0 Child Care Tax Credit (-) $0-$50 $0-$100-$50$0 Child Tax Credit (-) $0-$83 -$167 $0 Self-Sufficiency Wage (per adult) Hourly $17.07$29.33$30.59$26.12$21.62$35.50$30.48$10.97 Monthly $3,005$5,161$5,384$4,597$3,806$6,249$5,365$3,862 Annual $36,060$61,936$64,606$55,161$45,666$74,983$64,378$46,340 5

6. 6 Public Assistance Needs  Caseloads continue to increase since FY07 and, as of August 31, 2012, are at the following levels:  Temporary Cash Assistance (TCA): 980 (41% increase)  Food Supplement Program (FS): 28,514 (152% increase); and  Medicaid (MA): 48,718 (66% increase). The Food Supplement Program caseload has more than doubled since FY07.  Total applications for these programs increased dramatically from FY07 through FY12: TCA by 72%; FS by 117%; and MA by 58%.  Applications for the first 2 months of FY13 continue to remain high. We are projecting an additional increase of 2% from our FY12 level in combined application volume.

7. 7 Caseloads Increase FY07 - FY12 Cumulative increase from FY07 to Fy12 is 65% Cumulative increase from FY07 to FY12 of 145%

8. 8 Heat and Housing Needs  Home Energy Assistance requests decreased 6.5% to 11,555 in FY12 over FY11 but remain 28% higher than in FY08 when the economic downturn began. Due to reduced benefit levels, less financial assistance was available to help eligible households to afford utility costs.  All 95 family shelter beds and all year-round, single adult shelter beds continue to be at capacity.  Requests for Emergency Assistance Grants decreased 10% in FY12 over FY11 but demand remains high. A total of 6,428 households sought assistance in FY12. Changes to State eligibility guidelines late in FY12 has reduced the assistance available to families.

9.  Patient load in Montgomery Cares for FY12 was 26,814 patients, a 27% increase over FY09. However, expansion in the number of patients served has grown very modestly since FY10, due to budget restrictions. As a result of expanded FY 13 funding, Montgomery Cares capacity is expected to grow by 15% in FY13.  The number of patient visits provided each year has expanded by 36% since FY09, to 77,162 visits in FY12. As with patient numbers, the number of visits has grown modestly over the past several years. FY13 promises a comparable increase in the number of patient visits. 9

10. 10 Complexity of Need  Child welfare investigations increased 14% from 2,581 in FY11 to 2,945 in FY12. During the same period there were 1,327 cases of physical and sexual abuse and 172 cases of removals to foster care.  In FY12 the Montgomery County Hotline conducted more than 1,400 suicide assessments, up almost 200 from FY11. January – March of 2012 were extremely busy months with more than 100 calls.

11. FY13 DHHS Budget by Service Area

12. FY 13 Budget Overview  Budget increased to $252,303,160 ($10.2 million more than FY12 funding levels)

13. The Last Few Years  From FY09 to FY13, the Approved General Fund Budget has been reduced by $19.5 million and 38.81 Work Years (WYs)  The overall Departmental budget over the same time span (including grant funds) has been reduced by over $21.2 million and 50.40 WYs  FY12 was the first year since FY08 that we did not have to implement a savings plan 13

14. 14 FY12 County Council Approved Health and Human Services Budget Overview  FY13 County General Fund Approved Expenditures = $181,733,140 (5.8% increase from the FY12 Approved budget of $171,748,980)  FY13 Approved Budget from all revenue sources = $252,303,160 and a total of 1,558.6 work years (4.2% increase from FY12 level of $242,074,280)

15.  Possible Federal sequestration will require Federal agencies to cut their budget by 10%.  MD State Department of Budget and Management estimates that these cuts would reduce federal grants to State and Local Governments by approximately $150 million.  Based on current funding levels, there could be a reduction of $-3.8 million in local funding for Health and Human services.

16. DHHS has over 500 contracts with 300 service provider. 16 Provider Type FY11FY12FY13 Non-Profit$65.4m$63.5m$62.2m For Profit$23.4m$26.0m$22.6m Government$2.0m $1.2m Funding by Provider Type (FY11-FY13)

17. July 11, 201217