Safety Net Advocacy Needs You
In November, the Primary Care Coalition (PCC), the Health Centers Leadership Council, and the Montgomery Cares Advisory Board made a joint request to the County Executive to fund $9.9 million in critical needs for FY27. These requests were not based on projected demand from job losses and Medicaid cuts. They were based on needs we are already experiencing.
The county executive’s proposed FY27 operating budget—released this month—includes only 16% of the requested funding. Most of our request for sustainable compensation, payment for volume growth, and right-sizing our staffing to operate these programs was not met.
Our health care safety net is fraying. At a minimum, it is critical that the Council maintains the funds that are included in the CE’s proposed budget: $1.5 million in provider reimbursement, $19,440 in endodontic staffing, and $16,876 in specialty dental care for Care for Kids participants.
Funding our safety net—even amid deep uncertainty—is partly about putting our collective money where our values are. But it is also aout recognizing an area of clear budget wins: our ability to transform core county investments into an incredible return. Our favorite example? A roughly $400,000 investment in PCC staffing helps patients secure more than $8 million in free prescription medications through pharmaceutical assistance programs. Those are better health outcomes from patients having the tools they need to manage conditions and an exponential increase in the volume of medications we can provide with County dollars. At $200 in value for every $1 invested, it is the ultimate win.
Similarly, the estimated value of a single primary care visit at partner health centers is $250, assuming Medicaid payment rates. The FY25 reimbursement rate is $113/visit. That flat visit fee is the only direct Montgomery Cares funding partner health centers receive for the comprehensive care they provide. The entire scope of colorectal cancer screenings, educating patients on diabetes management, administering vaccinations, navigating patients to specialty care, and so much more is reimbursed at $113/visit. It is not enough to sustain this work.
Without more support, our partners will be forced to scale back. One partner already lost nurse practitioner capacity to the extra $10/hour another organization could offer. That NP did not go to concierge medicine or even private practice. That NP went to another safety net organization in Northern Virginia.
We are in danger of losing the safety net, and it would be felt community-wide. It would mean more uninsured patients relying on emergency rooms for care that is ultimately uncompensated, driving longer emergency room wait times and higher insurance premiums for us all. These are not just long-term problems but areas of existing strain across our entire community.
Investing in the safety net means neighbors getting the care they need to stay healthier, work and pay taxes, and contribute to our shared community. It is a high-value investment for us all.
If you agree, consider testifying in support of these budget requests to the Montgomery County Council. In a tough budget year that also includes an election, our voices matter more than ever. Public budget hearings are April 7th-9th, with options for submitting written testimony as well. Click here to sign up for live testimony (the deadline is April 3rd at noon) or here to submit written or video testimony.
Questions? Contact Stephanie Narayanan, Director of Development and External Relations at stephanie_narayanan@primarycarecoalition.org
Some additional advocacy resources:
Council Vice President Marilyn Balcombe has published an Advocacy Guide.
Councilmember Evan Glass has published a survey requesting feedback on budget priorities from county residents.