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Maryland lawmakers seek to revamp state’s mental health system, putting all options on the table

The Maryland House of Delegates Chamber in Annapolis, Maryland.
Matt Bush
The Maryland House of Delegates Chamber in Annapolis, Maryland.

Maryland may completely overhaul how it approaches mental health services in the coming years if the General Assembly approves a bill expected to be introduced in the House Health and Government Operations Committee.

The legislation, a draft of which was obtained by WYPR, creates a new commission to study and recommend ways to improve how the state handles nearly every facet of mental health in Maryland.

That includes how services are provided, how the state holds private insurers accountable, how services are priced and the types of mental health services offered to individuals on insurance plans.

“The bill attempts to audit the state's health care system and the way we reimburse and pay for behavioral health services,” said Del. David Moon, a Montgomery County Democrat and bill sponsor. “We need to contemplate what a proper system would look like, what it would cost, what it would take in terms of a workforce and to put us on the path.”

The bill creates a commission composed of lawmakers, health experts, mental health analysts, insurance professionals and other members of the healthcare industry, that will collectively consider the overarching questions plaguing Maryland’s mental health system.

That panel would come up with ways to address problems in the system through legislation that could change the way private insurers operate in the state or public policy that may call for improved facilities, more funds for staffing or new drug treatment programs, Moon said.

Maryland residents are experiencing mental health crises more than ever, a national trend, as the general public and individuals who are incarcerated continue to suffer from poor mental health after years of stress, economic recession and a global pandemic that has spanned nearly three years.

“I think for too long we have allowed a sweeping under the rug…this failure to address health care,” Moon said. “Now we're in a situation where the Department of Justice estimates that well over 50% of [the] prison population has an untreated mental health issue.”

Hospitals across Maryland are filling up with individuals struggling with mental health as well.

In 2018, mental health accounted for 11.5% of emergency room visits statewide,according to the Maryland Department of Health. In 2021, that number ballooned to nearly 48%, according to the state.

The issue of insurance coverage continues to amplify poor health outcomes.

Insurance denials, a sprawling labyrinth of medical provider directories that are often out of date, and expensive treatments are all barriers that prohibit individuals from getting medically necessary care, according to the Center for American Progress, a public policy think tank.

“Insurers often offer providers low payment rates, limiting willingness of an already insufficient workforce to join networks and impeding compliance with network adequacy standards,” according the 2022 Center for American Progress report on behavioral health affordability.

Scott is the Health Reporter for WYPR. @smaucionewypr
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