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A bipartisan group of Maryland senators came together Friday to share their vision for a more robust system of mental health care in the state.
“We know this has been a policy issue for decades, and frankly long before any of us got here, and in some cases before any of us were born,” Senate President Bill Ferguson (D-Baltimore City) said. “But today we are here saying that in this post-pandemic period, we are going to do what it takes in Maryland to create a world-class mental health care system.”
The lawmakers are backing a package of seven bills they say would accomplish “twin pillars” of the plan: to improve access to mental health treatment and to modernize the mental health care system in Maryland.
To improve access, the lawmakers are supporting bills that preserve telehealth policies that were expanded in the state during the COVID pandemic, grow a “collaborative care” model that encourages mental and physical health treatment in the same medical setting, and expand intensive in-home behavioral care for youth.
To modernize the system, lawmakers are supporting bills that would establish a network for community behavioral health clinics throughout the state, reform mental health reimbursement programs to reward providers with positive outcomes, and establish a behavioral health commission to make other recommendations to improve care.
The Senate Finance committee has held hearings on three of the bills already, and another three are scheduled for consideration in the next few weeks. One bill in the package, to dedicate $12 million to fund the state’s transition to a new national 9-8-8 crisis hotline, has already passed the Senate chamber by a unanimous vote.
Five of the seven bills are cross-filed in the House of Delegates and are under consideration in that chamber.
Republican members of the committee were on hand in Annapolis for a press conference highlighting the legislative package. Senate Minority Leader Stephen S. Hershey Jr. (R-Upper Shore) said it seems everyone knows someone who is grappling with concerns about mental health or substance abuse.
“This package of bills helps ensure that any Marylander struggling with a behavioral health issue can get treatment and support needed to realize the same things that we all want in life: to be successful at school or work, to enjoy close relationships with family and friends, and to live a life of purpose,” he said.
Denise Evans, president of the Maryland affiliate of the National Alliance on Mental Illness, said one in five people are living with mental illness at any point in time, which would amount to about 780,000 Marylanders. That estimate would include about 181,000 state residents with serious mental illness.
While some of the bills have multi-million-dollar fiscal notes, the lawmakers said expanded mental health coverage would yield lower overall costs for more expensive services like emergency and in-patient treatment.
At a hearing last month, Dan Martin, senior director of public policy at the Mental Health Association of Maryland, said when Texas considered a bill akin to Senate Bill 101, the measure to establish a collaborative care model, it originally came with a high fiscal note. But analysts in Austin revised the fiscal note to $0 after estimating savings from decreased hospitalization and other factors, he said.
Sen. Guy Guzzone (D-Howard), chair of the Budget and Taxation Committee, said the plan to establish a network of community behavioral health clinics includes a spike in Health Department expenditures — $542.8 million once several clinics are established — but replaces current acute care that is “less efficient and more costly.” The bill is expected to become cost-neutral within three years, he said.
“I wouldn’t be standing here, quite frankly, if I didn’t believe in my heart that we could achieve this package and do it in a responsible way,” Guzzone said.
Senate President Pro Tem Malcolm Augustine (D-Prince George’s) is lead sponsor of three of the bills, including the measure to establish a commission to examine the state’s behavioral health system in more depth and provide recommendations for reform.
He said mental health care needs to be treated with the same urgency as physical health issues.
“Could you imagine just walking by someone with a broken leg? We wouldn’t do that,” Augustine said. “We would immediately get to work to get them the care that they need.”
Augustine acknowledged that “our system of care is complicated” and the legislative package can’t resolve all issues, including a shortage in health care workers. If passed, the Commission on Behavioral Health Care Treatment and Access could provide recommendations on workforce and other issues to be taken up in the future, he said.cus
The bills included in the package are:
- Senate Bill 3 — Fully funding the 988 Trust Fund
- Senate Bill 101 — Reimbursement for Collaborative Care Model services
- Senate Bill 255 — Home- and community-based services for children and youth
- Senate Bill 362 — Establishment of Certified Community Behavioral Health Clinics
- Senate Bill 534 — Preserve Telehealth Access Act of 2023
- Senate Bill 581 — Value-based reimbursement for behavioral health care
- Senate Bill 582 — Establishing the Commission on Behavioral Health Care Treatment and Access