AGENDA ITEM #11
February 8,2011
Public Hearing
MEMORANDUM
February 4,2011
TO:
FROM:
County Council
Amanda Mihill, Legislative
AnalystYhvii~'j\I
Linda McMillan, Senior Legislative Analyst
(yJIJtlJ...../
Public Hearing:
Bill 1-11, Administration - Department of Health and Human
Services - Duties
SUBJECT:
Bill 1-11, Administration - Department of Health and Human Services - Duties, sponsored by
Councilmembers Leventhal, Navarro, and Rice, was introduced on January 18,2011. A Health
and Human Services Committee worksession is tentatively scheduled for February 17 at 9:30
a.m.
Bill 1-11 would:
• authorize the Department of Health and Human Services to provide direct access
to health care;
• authorize the Department to administer programs to reduce disparities in access to
health care, preventative health services, and human services based on gender,
race, ethnicity, and poverty;
• authorize the Department to provide health education and promotion programs;
• amend the functions of the Commission on Health; and
• generally amend the law regarding health and human services and health and
sanitation.
Background
The 2009 US Census American Community Survey estimates that approximately 110,000 county
residents do not have health insurance that would provide a regular source of primary care. In
FYI0, the Montgomery Cares safety net clinics saw over 26,000 adult uninsured patients, a 25%
increase over the number of patients seen in FY09. A majority of those receiving care were aged 40
to 64 and 65% were women. Over half identified themselves as Hispanic.
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A lack of a primary care medical home can cause people to seek medical care in emergency rooms
for conditions that can be treated in a much less costly setting. In FYIO, 3,052 low income
uninsured or Medicaid insured patients were referred from Montgomery County hospital emergency
rooms to community clinics through the Primary Care Coalition's Emergency Room Diversion
project.
In FYIO, the Care for Kids Program provided 5,000 primary care visits and 3,224 routine dental
visits to 3,366 children who are not eligible for Maryland's Children's Health Insurance Program.
Almost one-half of these children were from families with incomes below 100% of the Federal
Poverty Level ($22,050 for a family of four).
There are disparities in access to health care and preventive health services, including health
education and promotion, and they can adversely impact health conditions among races and ethnic
groups in Montgomery County. For example, the 2009 infant mortality rate for Black babies was
10.7 per 1,000 births compared to 3.9 for Whites and 5.5 for all races. The African American
Health Program's 2009 Strategic Plan notes that 7.6% of Black residents in the county report having
been diagnosed with diabetes compared to 5.5% for the general population; Blacks comprise over
72% of all county AIDS cases; and, Black women are less likely to be diagnosed with breast cancer
but are more likely to die from it than Whites. In its 2008 health priorities report, the Asian
American Health Initiative noted that Asian Americans have a 60% higher prevalence of diabetes
compared to non-Hispanic Whites and that Asian Americans and Pacific Islanders account for over
one-half the chronic Hepatitis B cases and deaths from Hepatitis B in the United States. In 2008,
the Latino Health Initiative reported in its Blueprint that in Maryland in 2005, Latinos had 1.6 times
as many new HIV diagnoses as non-Hispanic Whites; that diabetic and hypertensive end-stage renal
failure was significantly higher than for non-Latino Whites; and that the rate of obesity is a growing
problem for Latinos. All three Minority Health Initiatives have called for improved data and
research on the social determinants of health and increased access to culturally competent health
care and preventive health services.
This packet contains:
Bill
1-11
Legislative Request Report
Circle
1
5
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DHHS·Duties\Public Hearing Memo.Doc
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Bill No.
1-11
Concerning: Administration
Department of Health and Human
Services - Duties
Draft No. 4
Revised:
2/3/2011
Introduced:
January 18, 2011
Expires:
July 18, 2012
Enacted: _ _ _ _ _ _ _ _ __
Executive: _ _ _ _ _ _ _ __
Effective: _ _ _ _ _ _ _ _ __
N""'on"->e=-----:::--_ _ __
Sunset Date: ..........
Ch. _ _, Laws of Mont. Co. _ __
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: Councilmembers Leventhal, Navarro, and Rice
AN
ACT to:
(1)
(2)
authorize the Department of Health and Human Services to provide direct access to
health care;
authorize the Department to administer programs to reduce disparities in access to
health care, preventative health services, and human services;
authorize the Department to provide health education and promotion programs;
amend the functions ofthe Commission on Health; and
generally amend the law regarding health and human services and health and
sanitation.
(3)
(4)
(5)
By amending
Montgomery County Code
Chapter 2, Administration
Section 2-42A
Chapter 24, Health and Sanitation
Sections 24-22 and 24-24
Boldface
Underlining
[Single boldface brackets]
Double underlining
[[Double boldface brackets]]
*
*
*
Heading or defined term.
Added to existing law
by
original
bill.
Deletedfrom existing law
by
original
bill.
Added
by
amendment.
Deleted from existing law or the bill by amendment.
Existing law unqlJected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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BILL
No. 1-11
1
Sec.
1.
Sections 2-42A, 24-22, and 24-24 are amended as follows:
Division 7A. Department of Health and Human Services.
2-42A. Functions, powers, and duties.
2
3
4
5
*
(c)
*
*
*
Powers ofthe Department.
The Department may:
6
7
8
*
(4)
*
collect data on the health status of County residents, including
health disparities and inequities, and on the need for services and
the effectiveness of programs;
9
10
11
12
*
*
*
(15) conduct studies and investigations; [and]
(16) provide direct access to health care;
13
14
15
Q.1}
administer programs to reduce disparities in access to health care,
preventive health services, and human services based on gender,
race, ethnicity, and poverty;
{l[}
provide health education and promotion programs; and
16
17
Q2l
carry out any other functions that are necessary to achieve the
purposes of this Section.
(d)
Duties ofthe Department.
18
19
20
21
*
(3)
*
*
The Department provides staff support to [the]:
(A) the Commission on Children and Youth;
(B) the Commission on Aging;
(C) the Community Action Committee;
(D) the Commission on Child Care;
(E) the Commission on People with Disabilities;
(F) the Alcohol and Other Drug Abuse Advisory Council.
22
23
24
25
26
27
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BILL
No. 1-11
28
29
30
31
32
33
(G)
(H)
the Mental Health Advisory Council.
the Juvenile Court Committee;
the Commission on Health;
the Board of Social Services;
the Adult Public Guardianship Review Board; [and]
the Victim Services Advisory Board;
the Advisory Board for the Montgomery Cares Program;
and
(1)
(J)
(K)
(L)
(M)
34
35
36
llil
24-22. Policy.
(a)
any program created to achieve health equity among
County residents.
37
38
39
It
is the policy of Montgomery County to protect and promote the
40
41
42
public health and safety and general welfare by fostering the
development of a health care system that provides for all citizens,
fmancial and geographic access to quality health care at a reasonable
cost.
To accomplish this purpose it is essential that plans for
43
44
45
maintaining the health of the citizenry and developing health services to
meet the current and future health needs of the citizens of the county be
prepared, programs to implement these plans be developed and
executed, and proposed developments or alterations of health services
be publicly reviewed and commented upon. Health planning should
address the overall health status of County residents and health
disparities within social, economic, geographic, racial and ethnic
groups.
46
47
48
49
50
51
52
*
*
*
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BILL
No. 1-11
53
54
55
56
57
58
59
24-24. Functions.
(a)
To advise the County Executive and the County Council, the
Commission must:
(l)
Periodically reVIew available County public health programs,
services, and facilities and data on the health status of the County
population and subgroups within
i1;
(2)
Comment on gaps, deficiencies, or duplication in County public
health programs, services, and
disparities and inequities;
facilities~
60
61
including health status
62
63
*
(5)
status data;
*
*
Advise on local public health planning needs based on health
64
65
*
Approved:
*
*
66
67
Valerie Ervin, President, County Council
Date
68
Approved:
69
Isiah Leggett, County Executive
Date
70
This is a correct copy o/Council action.
71
Linda M. Lauer, Clerk of the Council
Date
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LEGISLATIVE REQUEST REPORT
Bill 1-11
Administration - Department of Health and Human Services - Duties
DESCRIPTION:
Bill 1-11 would authorize the Department of Health and Human
Services to provide direct access to health care; authorize the
Department to administer programs to reduce
di~parities
in access to
health care, preventative health services, and human services based
on gender, race, ethnicity, and poverty; authorize the Department to
provide health education and promotion programs; amend the
functions of the Commission on Health; and generally amend the law
regarding health and human services and health and sanitation.
The 2009 US Census American Community Survey estimates that
approximately 110,000 county residents do not have health insurance
that would provide a regular source of primary care. A lack of a
primary care medical home can cause people to seek medical care in
emergency rooms for conditions that can be treated in a much less
costly setting.
To authorize the Department to provide direct access to health care,
administer programs to reduce disparities in access to health care, and
provide health education and promotion programs
Department of Health and Human Services, Commission on Health
To be requested.
To be requested.
To be requested.
To be researched.
Amanda Mihill, Legislative Analyst, 240-777-7815
To
be
researched.
PROBLEM:
GOALS AND
OBJECTIVES:
COORDINATION:
FISCAL IMPACT:
ECONOMIC
IMPACT:
EVALUATION:
EXPERIENCE
ELSEWHERE:
SOURCE OF
INFORMATION:
APPLICATION
WITHIN
MUNICIP ALITIES:
PENALTIES:
N/A
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