Making Strides With Behavioral Health

With so much happening this session, it’s hard to know where to focus, as a legislative wrap-up would require far more than a few paragraphs, so given the constraints of limiting my thoughts to a single subject, I’ll begin when I last ended, with the issue of behavioral health.

As anyone who follows my contributions is aware, I have a particular passion for the expansion of behavioral health resources, particularly for our adolescent population. However, with the fever pitch of the session, you may have missed something significant that occurred about halfway through. With the shuffling of legislators joining the administration of Governor Wes Moore, I was honored to be appointed as the new chair of the Public Health and Minority Health Disparities subcommittee, and I am thrilled to say that behavioral health was a big winner at this session.

Even before the new appointment, I had established an aggressive legislative agenda for behavioral health, building on the advocacy work I had done last year. It was clear, even from the campaign trail, that there was a new energy in support of mental health investment, having seen an increase in need following the pandemic, and a significant workforce shortage exacerbated by burnout, licensing delays, low reimbursement rates, and the continued issues with Optum, which had put many of our providers in financial jeopardy.

This session marked a significant commitment, not only from the General Assembly, but also the Moore administration, to build a world-class behavioral health system based on best practices. If this sounds familiar, it’s because I had a bill last year that did not make it across the finish line. However, every element of last year’s Behavioral Health System Modernization Act passed this year, and then we did even more. So, what did we do?

We invested $12 million into the 988 system to create grants for local call centers to ensure that calls from Maryland will be answered by call centers in Maryland. I was the cosponsor and championed the House bill across the chamber when the bill sponsor was appointed to the Senate. We passed a Mental Health Workforce Fund, modeled after other states, which establishes a commission to make recommendations to develop our mental health workforce, and a fund to address training, recruitment and retention of providers.

Last month, I wrote about the Collaborative Care Model, which establishes behavioral health providers in primary care settings — it passed. I’ve previously written about the need to expand our home- and community-based high fidelity wraparound services for adolescents with complex behavioral health needs. We passed that bill as well. Last year, I attempted to pass a bill to streamline the process for psychologists whose doctorates were in a non-clinical field to re-specialize to be clinicians and address the workforce shortage. The governor signed that bill into law the day after Sine Die.

In 2021, I put in a bill to give the Maryland Insurance Administration enforcement authority after Optum repeatedly failed to pay clean claims. Because it was a corrective measure, it was meant to sunset this year, but because Optum has a contract until 2024, I put in an emergency bill to extend the sunset to protect and stabilize our provider network.

Dawn Gile, our new District 33 senator, was also integral in passing the Preserve Telehealth Act, which was also encompassed in House Bill 1148, the Behavioral Health Model for Maryland, which creates a four-year commission to look at every aspect of the behavioral health system, including the criminal justice system, the opioid crisis, school-based services, community services, services for people with intellectual and developmental disabilities, and seniors with cognitive issues. The bill also requires the Maryland Department of Health to seek grant funding to extend our existing certified community behavioral health centers (CCBHCs) while creating the framework to expand CCBHCs statewide and establish a value-based pilot program to incentivize measurable quality care.

Additionally, we passed fentanyl testing in hospitals for overdose cases to ensure the correct care is provided, a mental health advanced directive law to establish a public awareness campaign on mental health advanced directives and a joint study on how best to ensure first responders and providers can access the database when responding to a behavioral health crisis. We passed a grant program for residential recovery programs.

We also worked with the new secretary of health, who is undertaking a massive audit of our behavioral health resources to update the crisis bed registry and create better care coordination across our behavioral health spectrum.

We had other efforts that did not make it across the finish line, but this session represents the largest investment in behavioral health in a generation and a commitment from this body and this administration. It’s the completion of a promise I made to our district five years ago. It is my great honor to do this work, and I’m grateful to be your delegate.