Montgomery Proposes $4.6 Million From Reserves, Including $1.2 Million to Keep Care for Noncitizens Who Lost Medicaid

The Montgomery County Council will take public testimony Tuesday, Nov. 10, on eight requests from County Executive Marc Elrich to spend a combined $4,567,760 from the county’s General Fund Undesignated Reserves, most of it on health and human services. The largest, $1.2 million, would keep residential and personal support services going for high-need residents who lost Medicaid coverage on Oct. 1 under H.R. 1, the 2025 federal budget law.

The eight hearings are set for 1:30 p.m. in the Council Hearing Room at 100 Maryland Ave. in Rockville, according to the Council’s Nov. 10 agenda. Each staff report lists the purpose as “To receive testimony – no vote expected.” Joint Government Operations and Health and Human Services committee worksessions on seven of the requests are scheduled for Nov. 18, and the Government Operations Committee is scheduled to take up the eighth, for Kids in Need of Defense, on Nov. 19.

Four of the eight requests say the money would replace outside funding that ended or was cut: the H.R. 1 Medicaid change, a state behavioral health grant reduction, expired COVID-19 grant money for shelter cleaning, and a terminated federal subcontract for children’s immigration lawyers. Those four total $2,741,506. The other four would add women’s shelter beds, staff a stalled health enrollment office, match new state money for an immigrant services program and pay for immigration legal services.

The eight requests

Request (agenda item)	Amount	Department	What it pays for	Reason given	People served, as stated
#27-29 (Item 9)	$1,200,000	Health and Human Services, Aging and Disability Services	Residential and personal support services for high-need clients who were in Medicaid waiver programs	Federal: H.R. 1 ended Medicaid coverage Oct. 1 for certain noncitizens, refugees, asylees and humanitarian parolees; the Maryland Department of Health says it cannot keep serving them	Not stated
#27-30 (Item 10)	$486,506	Health and Human Services, Behavioral Health	Two positions ($242,160) and operating costs ($244,346) to keep services such as jail-based addiction treatment and older adult mental health outreach	State: about $964,888 in fiscal 2027 behavioral health grant reductions; 13 programs defunded or reduced	Not stated
#27-37 (Item 11)	$885,000	Health and Human Services, Services to End and Prevent Homelessness	Nine months of seven-day custodial and day-porter service at emergency shelters for adults	COVID-19 grant funding that paid for it at some shelters is no longer available	Up to 582 people a day in winter, about 383 a day the rest of the year, plus about 75 a day at the Progress Place drop-in center
#27-38 (Item 12)	$619,158	Health and Human Services	Raises the Rainbow Place Shelter for Homeless Women contract from $130,842 to $750,000 to expand from 28 to 50 beds	Demand: more than 70 women could not be placed in fiscal 2026; waits routinely topped 30 days. No funding cut cited	50 beds, up from 28
#27-39 (Item 13)	$487,096	Health and Human Services	Seven “broker” positions for 10 months to process Care for Kids and Senior Dental applications	Applications are not being processed because there is no staff to process them. No funding cut cited	9,226 current enrollees (8,002 Care for Kids, 1,224 Senior Dental); backlog projected at about 1,899 applications
#27-40 (Item 14)	$220,000	Health and Human Services	County share of an Immigrant Services Corps run with Identity, Inc.	Request from the Governor’s Office of Immigrant Affairs; the state would put in $550,000, pending grant approval	25 corps members placed in the county
#27-41 (Item 15)	$500,000	Health and Human Services, Lighthouse	Competitive grants for immigration legal services, including removal defense and family preparedness planning	Elrich cites “a sharp rise in immigration enforcement.” No funding cut cited	Not stated; the county estimates 10,000 to 30,000 residents are at risk (see below)
#27-43 (Item 16)	$170,000	Community Engagement Cluster, Office of Community Partnerships	Raises the Kids in Need of Defense contract from $159,564 to $329,564	Federal: KIND’s Office of Refugee Resettlement subcontract was terminated July 1, 2026	41 active Montgomery County cases involving unaccompanied children
Total	$4,567,760

Who lost Medicaid, and what the $1.2 million covers

Council staff wrote that, effective Oct. 1, 2026, “changes to federal Medicaid eligibility under H.R. 1 have resulted in the loss of Medicaid coverage for certain noncitizens, refugees, asylees, and humanitarian parolees.” Elrich’s Oct. 8 memo says full-scope Medicaid “will generally no longer be available to refugees, asylees, victims of human trafficking, humanitarian parolees, and other individuals who have historically qualified for coverage under these programs.”

The $1.2 million request is aimed at the subset of those residents who were getting help at home or in residential settings through state Medicaid waiver programs. The memo names home and community-based services run by the state Developmental Disabilities Administration, Community First Choice, Community Personal Assistance and Nurse Monitoring. The Maryland Department of Health “has indicated that it does not have the financial resources to continue serving these clients,” the memo says, and without county support many “could ultimately require emergency intervention through hospital systems or Adult Protective Services.”

The memo does not say how many people the $1.2 million would serve. It says the county has received “some preliminary information” from the state health department about affected clients, but “it is not clear that this information represents a comprehensive list,” so the request “assumes that additional clients affected by the H.R. 1 changes may not yet have been identified.” Council staff describe the money as a one-time expense with no fiscal impact in future years.

The broader coverage loss is larger than this request. As Moderately MOCO reported Oct. 30, a county health official told the Council’s Health and Human Services Committee on Oct. 29 that 1,082 Montgomery County residents “no longer have Medicaid” under the H.R. 1 change.

State behavioral health cuts

The Maryland Department of Health’s Behavioral Health Administration told local jurisdictions about statewide grant reductions after fiscal 2027 had already started, according to the Council staff report on Supplemental Appropriation #27-30. The county’s Local Behavioral Health Authority announced about $964,888 in reductions to administrative, substance use and mental health grants, and 13 programs “were either defunded or now have reduced funding,” staff wrote. The $486,506 request would restore part of that amount. Elrich’s memo calls it money to preserve “the most critical” services.

Shelters: cleaning and 22 more beds for women

The county’s emergency shelters for adults serve up to 582 people a day in winter and about 383 a day the rest of the year, according to Elrich’s memo on Supplemental Appropriation #27-37. The $885,000 would pay for seven-day custodial and day-porter service, including supplies such as toilet paper and soap, for nine months. “In previous years, the County used COVID-19 grant funding to support these services at some shelters; however, those grants are no longer available,” the memo says.

Supplemental Appropriation #27-38 would raise the county’s contract with Rainbow Place Shelter for Homeless Women from $130,842 to $750,000 and expand the program from 28 to 50 beds, which the memo calls a 79% increase. The county’s Health Care for the Homeless program documented “more than 70 women who could not be housed due to shelters operating at full capacity” during fiscal 2026, and women “routinely experience wait periods exceeding 30 days before securing a shelter bed,” according to the memo. The contract is a non-competitive award, so the request also amends the Council’s list of entities eligible for one.

WTOP reported in May that Rainbow Place, which has operated from a Rockville church with 28 beds and typically opened Nov. 1 through April 1, was working with the county health department to find a new space. Rainbow Place’s September newsletter says its women’s shelter “will be at 600 E. Gude Dr in Rockville” for the 2026-27 season, in space offered by the county. The Council packet does not say where the 50 beds would be or when they would open, and the contract’s stated purpose is “seasonal emergency shelter.”

Care for Kids and Senior Dental

Supplemental Appropriation #27-39 would pay for seven “broker” positions for the remaining 10 months of the fiscal year to process applications for Care for Kids and Senior Dental, two county-funded programs for uninsured residents with incomes at or below 250% of the federal poverty level. “Applications are not currently being processed for CFK and Senior Dental because there aren’t staff to process them,” the Council staff report says. Moderately MOCO reported on the stalled applications Oct. 23.

Immigrant services and legal help: $890,000

Three requests totaling $890,000 are for immigrant services. The $220,000 for the Immigrant Services Corps would cover the gap between a $550,000 state contribution, which is pending grant approval, and what the Gaithersburg nonprofit Identity, Inc. needs to place 25 corps members in county programs, including Lighthouse, a county health department program that provides case management to people facing challenges related to immigration status.

The $500,000 for Lighthouse would be awarded through a competitive grant process for services such as removal defense in immigration court, help for residents in immigration detention, and family preparedness and guardianship planning for children. “The County estimates approximately 10,000-30,000 County residents are at-risk of facing removal proceedings or being held in an immigration detention center,” Council staff wrote.

The $170,000 for Kids in Need of Defense, Inc. (KIND) would keep lawyers on 41 active Montgomery County cases involving unaccompanied children. “KIND’s Federal Office of Refugee Resettlement subcontract was terminated on July 1, 2026,” Elrich’s memo says, and “without additional County funding to offset the loss of Federal dollars, these 41 active cases will lose legal representation.”

How the Council votes on these

Under Section 307 of the county charter, as quoted in each draft resolution, a supplemental appropriation that carries out a grant or a federal, state or county law, or one approved after Jan. 1, needs six votes on the 11-member Council. Any other supplemental approved before Jan. 1 needs seven. The Council can approve several supplementals in one action, and the County Executive can reduce or disapprove one.

How to testify or comment

The deadline to sign up to speak at the Nov. 10 hearings is 2 p.m. Monday, Nov. 9, according to the Council’s hearing calendar. Speakers can testify in person or on Zoom after registering on the Council’s live testimony page, which lists each hearing separately.

Residents can also send written, audio or video testimony through the Council’s online form, which says testimony may be posted on the Council website and limits audio and video files to 3 minutes. Testimony can also be mailed to County Council, 100 Maryland Ave., Rockville, MD 20850, according to the Council’s Oct. 9 hearing announcement. The announcement says residents can call 240-777-7803 for information on testifying by phone, or 240-777-7900 to express an opinion.

The hearings will be shown live on County Cable Montgomery and streamed on the Council website, the announcement says.

Still unanswered

• How many residents would the $1.2 million in Supplemental Appropriation #27-29 serve, and how was the amount estimated?
• Which 13 behavioral health programs were defunded or reduced, and which would the $486,506 restore?
• Would Rainbow Place’s 50 beds be at 600 E. Gude Dr., when would all 50 open, and would any be year-round?
• What will the General Fund Undesignated Reserve balance be if all eight requests are approved?

We have not yet put these questions to the Department of Health and Human Services or the County Council; this story will be updated with any response.

---