Maryland’s new Behavioral Health Care Treatment and Access Commission discusses behavioral health reform plan at first meeting – State of Reform

Maryland’s Behavioral Health Care Treatment and Access Commission held its first meeting last month to discuss the report’s findings and next steps.

Under House Bill 1148, which passed the Maryland Legislature earlier this year, the committee must create four working groups: one for senior behavioral health, one for youth behavioral health, and those with developmental disabilities and/or complex behavioral health Behavioral health needs of individuals; A program for behavioral health for justice-involved populations; A responsible behavioral health work group for the development, infrastructure, coordination, and financing.

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Sara Barra, director of the state Office of Behavioral Health Administration, detailed the board’s initial needs assessment.

We really want to think of behavioral health as a continuum of care. We really want to understand that all of these pillars—prevention, promotion, primary behavioral health and early intervention, acute emergency care, and treatment and recovery—they are a continuum and people may be in different places and at different times depending on their needs. point.

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Compared to 2021 data, 2022 data shows a 7.6% decrease in fatal drug overdoses in Maryland. The Maryland Department of Health (MDH) is in the first phase of its analysis and will continue to analyze data and trends from each of the four work groups. Questions for future discussion include what additional information or analysis is needed to advance task force discussions or recommendations, and how the committee can better capture unmet needs and demands for services and resources.

Jordan Fisher, MDH’s chief of staff for operations and health care systems, provided a detailed analysis of the reports used to guide the four working groups and provided recommendations for each. MDH reviewed four reports on behavioral health for older adults that focused on reviewing and evaluating crisis services for older adults, including policies, operations, and other requirements needed to promote and provide crisis services across the state.

The report also examines appropriate long-term care placements in Medicaid for seniors, identifies the current cognitive and behavioral health needs of Maryland’s senior population and provides ways to address those needs.

Recommendations from these reports focused on strengthening preadmission training and resident review programs, establishing interagency coordination processes related to aging, and an enhanced inpatient rehabilitation program model for patients with severe mental illness so that they can age in place, Fisher explain.

Other recommendations include establishing crisis walk-in and mobile crisis team models for each jurisdiction and addressing issues such as workforce shortages, funding and accountability measures, and transportation accessibility.

MDH identified nine reports from its Adolescent Behavioral Health Task Force that focus on adolescent-centered behavioral health prevention and intervention techniques.

Through this review, we identified several key recommendations, including an integrated behavioral health model, consideration of a pilot program utilizing a co-design model in Maryland, and recommendations for additional programs targeting transition-age youth, and expansion of residential treatment centers capacity, Fisher said.

MDH used a total of 19 reports in its review of complex behavioral health needs, focusing on disparities in overdose deaths and costs and expenditures related to severe, persistent mental illness. Key recommendations for addressing complex behavioral health needs include increasing data collection and analysis on opioids, evaluating medication adherence strategies, increasing treatment resources and reducing stigma.

For justice-involved populations, MDH analyzed 16 reports and focused on improving the continuity of care for mental health services and the statewide crisis response system, access to substance use disorder treatment, and improving access to care.

Fisher said the main recommendations from the reports are to increase treatment resources for those major correctional institutions, including diversion programs and access to substance use disorder treatment, increase forensic services and bed capacity.

MDH made recommendations to address behavioral health workforce, development, infrastructure and coordination issues based on 12 reports that noted how there is a lack of providers trained to treat co-occurring disorders, as well as a shortage of social workers and substance use disorder providers. Additionally, the report states that behavioral healthcare staff experience high turnover rates, which can be attributed to burnout and uncompetitive salaries. Recommendations include increasing efforts to hire and retain psychiatrists (especially in rural areas) and nurses.

MDH analyzed six reports related to behavioral health care, focusing on the need to increase spending in certain areas of the behavioral health care system, such as psychiatric rehabilitation programs, and to create new residential substance use disorder benefits.

Fisher said the reports’ recommendations focus on cost-containment strategies for psychiatric rehabilitation programs and related recommendations for public behavioral health care systems.

Since the first meeting of the Committee, four working groups have met once. Each working group is preparing reports based on the information shared at the first committee meeting and will meet again on December 18 to discuss future initiatives in further detail.

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