Maryland Behavioral Health Coalition
2020 Keep the Door Open Agenda

(Available for download here)

Maryland has taken several critical steps in recent years to address longstanding and pervasive barriers to treatment for children and adults with mental health and substance use disorders. We are making progress, but we are not out of the woods yet.

Overdose deaths increased in 2018 for the eighth year in a row, reaching an all-time high of 2,406. And while these deaths decreased slightly during the first six months of 2019, 1,182 Marylanders still lost their lives to overdose during that time. Maryland suicides have increased dramatically since 1999, and demand for mental health and substance use treatment has risen steadily since 2008, with over 300,000 Maryland children and adults currently using and depending on the state’s public behavioral health system.

The Coalition will continue working this year to ensure that every Marylander has access to high quality behavioral health treatment. Our priorities for 2020 are:

IMPROVE ACCESS TO AND COORDINATION OF QUALITY COMMUNITY BEHAVIORAL HEALTH SERVICES
Marylanders with commercial insurance still struggle to access timely in-network behavioral health care, and many Medicaid consumers are unable to take advantage of everything our nationally recognized public behavioral health system has to offer, including integrated models like certified community behavioral health clinics (CCBHC). The Behavioral Health Coalition’s 2020 platform addresses these challenges through:

≫ Systemwide implementation of measurement-based care and value-based purchasing; strengthening accountability within local system management and the provider network; and ensuring integration of non-Medicaid services and systems such as housing, education, criminal justice and non-Medicaid health services in the Public Behavioral Health System.

≫ Parity legislation to include consumer payment protections for out of network care, parity compliance and data reporting.

The state must adopt the Behavioral Health Coalition’s multi-pronged platform for modernizing Maryland’s public behavioral health system and enact policies to ensure the appropriate enforcement of federal and state parity laws.

FULLY FUND PRIOR KEEP THE DOOR OPEN AND MINIMUM WAGE BUDGET COMMITMENTS
Long-overdue multi-year behavioral health provider rate increases were included in the HOPE Act of 2017 and minimum wage legislation in 2019. In 2018, the legislature enacted multi-year funding initiatives to expand crisis response services and improve the delivery of behavioral health care in primary care settings. We must keep these prior budget commitments in FY 2021 to prevent a reduction in access to community mental health and substance use disorder services.

INCREASE SCHOOL BEHAVIORAL HEALTH SUPPORTS TO IMPROVE STUDENT OUTCOMES
The Kirwan Commission issued a report in January 2019 that included a comprehensive set of strategies for enhancing school-based behavioral health services, which have been shown to improve student health and educational outcomes. In addressing the full range of Kirwan recommendations, the legislature must prioritize the adoption of, and ensure adequate funding for, those related to school behavioral health.

EXPAND ACCESS TO CRISIS RESPONSE SERVICES, OVERDOSE AND SUICIDE PREVENTION EFFORTS
An inability to access quality mental health and substance use disorder services in the community is forcing more Marylanders into costly emergency departments or discouraging them from seeking care at all. This crisis in access is tied to an exponential increase in the number of Marylanders lost to suicide, unintentional overdose and other preventable deaths. We must prioritize the development of a statewide comprehensive crisis response system and increase the availability of harm reduction interventions.