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Editorial: Sharfstein’s report card

Dr. Joshua M. Sharfstein’s days as running one of the state’s most vital agencies are drawing to a close. Let’s look at the highlights first.

During his time as secretary of the Department of Health and Mental Hygiene — it will end up being almost exactly four years when he leaves in January — Sharfstein brought to the job energy, new ideas and a commitment to improving the health of all Marylanders.

The state is better off for many of his initiatives. His team worked hard to revitalize the public health system, a part of the nation’s health care infrastructure neglected for too long. Issues of mental health and substance abuse were given a higher priority.

He was willing to tackle the state’s system for financing health care services, which previously had been larded with perverse incentives to the point of incoherence. Sharfstein also tried to modernize the department when it came to coordinating emergency health services, prescription drug monitoring and other services.

Sharfstein should be saluted for these accomplishments.

We’ll set aside the whole debacle of the unsuccessful Maryland Health Benefit Exchange. Not to give Sharfstein a free ride, but that failure should be laid at the doorsteps of the governor and lieutenant governor.

There are two other matters that we hope Sharfstein’s successor makes a high priority. The state, as an audit recently showed, routinely ignored the legally required inspections for many of Maryland’s assisted-living facilities and facilities for the developmentally disabled. Yes, Sharfstein inherited this tawdry record and, yes, the state isn’t exactly swimming in staffing resources. But these are essential inspections designed to ensure that appropriate care is offered at those facilities. It appears Sharfstein is moving to rectify this shortcoming, and we hope the next secretary continues down that path.

Finally, the record for openness and transparency shown by the health exchange under Sharfstein’s leadership is … Actually, there is no record of openness and transparency. The Maryland Open Meetings Compliance Board concluded in May that the insurance exchange board repeatedly violated a law requiring an explanation for closed meetings. This is a board that is quite fond of closed meetings, holding dozens of them since its creation.

Requests for access to the exchange’s records under the state’s Public Information Act don’t fare well, either. The responses often trickle in well after deadlines set out in the act. And when records are produced, they often are heavily redacted, an Office of Legislative Audits report found.

For Maryland citizens to have confidence in the operations of the health exchange — or any government body, for that matter — they have to believe those proceedings are conducted in the open, not cloaked in secrecy, and that comprehensive records of those proceedings are available to all. It was inevitable that, when the exchange ran into problems, a citizenry shielded from its activities would be disinclined to be forgiving.