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Md. bill would let behavioral health patients go to crisis centers

Lyle Sheldon, president and CEO of University of Maryland Upper Chesapeake Health. (The Daily Record / Tim Curtis)

Lyle Sheldon, president and CEO of University of Maryland Upper Chesapeake Health. (The Daily Record / Tim Curtis)

ANNAPOLIS — Legislation to allow law enforcement to take behavioral health patients to a crisis center instead of an emergency department would help patients get better care sooner and allow emergency departments to operate more efficiently, the bill’s supporters said Tuesday.

The legislation would allow the Maryland Department of Health to add behavioral health and substance use crisis centers to the list of facilities where law enforcement can take patients with an emergency petition. Currently, behavioral health patients can only be taken to emergency departments.

Crisis services are an essential component of any comprehensive system for behavioral health,” Sen. Antonio Hayes, D-Baltimore and the legislation’s sponsor, told the Senate Finance Committee. “Crisis services significantly reduce preventable behavioral health crisis and offer early prevention to stabilize crisis more quickly at the lowest level of care.”

Crisis centers offer staffing, hotlines, urgent care and short-term residential treatment for patients with behavioral health issues.

They can be a better place for these patients to receive help than the emergency department, which can be loud, busy and where other patients may have more urgent needs. Some patients get worse because they have to go to the emergency department before they can be transferred to a more appropriate setting.

“We expect better outcomes, resulting in a shorter length of stay and less medication,” Lyle Sheldon, president of University of Maryland Upper Chesapeake Health, told the committee, explaining why crisis centers are better for treatment than an emergency department. “We have more appropriate specialized mental health and substance abuse disorder staff in a crisis center than the emergency room. It also allows a better use of emergency department services. It also allows law enforcement to get back into the field quicker.”

Upper Chesapeake Health last year opened the Klein Family Harford Crisis Center in partnership with the local government. Since that facility opened last June it has had about 260 walk-in/urgent care clients a month and about 40 residential clients a month.

At similar specialized facilities across the state, patients have to go to the emergency department before they can go to a setting with specialized behavioral health services.

Marcel Wright, vice president for behavioral health services at Adventist HealthCare, explained to the committee that patients with behavioral health needs might be sent to emergency departments at Greater Baltimore Medical Center in Towson or Shady Grove Medical Center despite the presence of behavioral health facilities better equipped to handle those patients minutes, or even yards away.

In addition to not providing the care those patients need, it also takes up space in the emergency department that could go toward other patients.

Wright said that 40% of pediatric emergency department beds at Shady Grove are held by behavioral health patients, despite a behavioral health facility on the same campus.

At GBMC, 18 of 40 emergency department beds are taken up by behavioral health patients who can stay for days, weeks and even months — unlike the typical hours-long stay of other patients, said Jeffrey P. Sternlicht, chairman of emergency medicine at GBMC.

“Our safety net is really compromised right now,” he said. “The number of behavioral health patients taking up beds in the ED really impacts the ability to take care of patients coming in with strokes, heart attacks, sepsis, trauma and those types of things.”


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