The Montgomery County Board of Developmental Disabilities Services' (MCBDDS) budget shortfalls are not due to fiscal mismanagement or seeking money for new programs or facilities; they are the result of providing services to a growing number of people over a 15-year period with funding that has not kept pace with the ever-rising costs of doing business.
Other contributing factors include a significant number of new, unfunded state and federal mandates, revenue lost from the privatization of our adult services and transportation programs, and the growing number of individuals needing services who have complex care needs or are aging, which results in a higher cost of services. Since 2006, MCBDDS has experienced a 180 percent increase in the number of individuals actively served and a 192 percent increase in waiver enrollment.
Waiver costs alone have grown exponentially, and are the single largest contributor to the agency's funding shortfall. Waivers are a funding mechanism that uses a combination of federal and local funds to provide essential services to people with developmental disabilities. Waivers are granted when an individual meets State criteria and when funds are available. In 2006, MCBDDS had 593 people who were enrolled on Medicaid waivers. By 2024, 1,766 people were enrolled. During the same time, the average cost of an Individual Options waiver--the most common type of waiver--more than doubled*. In 2024, the cost of providing waiver services to Montgomery County residents was $25.3 million.
For the last 13 years, from 2012 to 2025, our Human Services levy allocation was approximately $28.9 million per year, which covers little more than waiver services payments. Yet waiver services comprise only 35 percent of the services provided to individuals with developmental disabilities in Montgomery County. County leaders have provided additional funds since 2012 to help supplement our budget. However, demand for services continues to grow beyond available resources.
*From 2006 to 2025, the average utilization cost of an Individual Options waiver grew from $44,270/year to $96,903/year.