Session mixed bag for mental health; wins for Md. hospitals

As the General Assembly entered its final hours Monday, a bill supporters said would provide critical funding to organizations that offer addiction services and mental-health treatment inched its way toward final approval by passing two key votes in the House of Delegates.

But the measure was ultimately a casualty of the ticking clock, as the differences between the versions passed by the House and Senate weren’t resolved before time ran out.

Known as the Keep the Door Open Act, the bill would have tied the rate at which community-based programs get reimbursed by the state to the Consumer Price Index for medical care so it keeps pace with inflation.

“It’s unfortunate we couldn’t get something passed,” said Dan Martin, director of public policy for the nonprofit Mental Health Association of Maryland. Between the rising cost of doing business and increased demand, these providers have had to do more with less, Martin said.

Community-based facilities make sure patients get the specialized care they need and keeping them from going to emergency rooms; but in the past 20 years, these organizations have seen only 6 rate increases, only one of which kept pace with inflation; supporters argued.

But there was still some good news for behavioral health: The fiscal 2017 budget includes a 2 percent increase in the reimbursement rate, and while advocates were hoping for a more permanent fix, Martin said they were “very thankful” that Republican Gov. Larry Hogan included that allocation.

The state budget also included an additional $3 million to support mental health services at three facilities – Sheppard Pratt Health System, Adventist Behavioral Health and Brook Lane Health Services – that care for Marylanders with the most serious behavioral health needs. That funding helps compensate for a shortfall in federal funding for these facilities, according to the Maryland Hospital Association.

The hospital association also had a win this session with the passage of a bill creating an exemption in the state’s often-lengthy Certificate of Need process for hospitals that wanted to convert to freestanding medical facilities – which focus on outpatient care and emergency services rather than inpatient care.

Hospitals need flexibility to respond quickly to the changing health care needs of a community, and inpatient admissions have been declining for a decade, according to MHA.

“It’s about retaining access as opposed to shutting down buildings,” said Jim Reiter, MHA spokesman.

A bill requiring county boards of health to approve the closure or partial closure of a hospital – proposed after some Prince George’s County lawmakers and community members were caught off guard by plans to convert Laurel Regional Hospital to an outpatient facility – was opposed by the hospital association and died in committee.

Other health care-related bills that failed during this year’s legislative session include:

— A proposed increase in the state tax on a pack of cigarettes from $2 to $3, as well as increases on the tax of other tobacco products, such as smokeless tobacco and non-premium cigars.

— A proposal creating a birth-injury fund, which would allow families of babies who suffer neurological injuries during birth to be compensated without filing malpractice claims – but also require them to give up their right to sue.

— A bill allowing terminally ill patients to request fatal doses of medication – advocates don’t want to call it “assisted suicide.”

— A trio of bills from Del. Dan K. Morhaim, D-Baltimore County, that would have drastically changed state drug policy by legalizing small amounts of drugs and allowing safe, supervised drug use for some addicts who haven’t responded to previous treatment attempts.

— A proposal requiring more healthy snacks to be offered in vending machines on state property, including public university campuses.

Lawmakers also approved a bill, sponsored by Senate President Thomas V. Mike Miller Jr., locking in state funding for a new regional medical center in Prince George’s County; the governor is now required to allocate a $55 million operating subsidy and $115 million in capital funding from fiscal 2018 through fiscal 2021.