Maryland's new governor is following through on his campaign promise to balance the state's structural deficit without raising taxes and, if he can convince legislative leadership, to lower or eliminate some taxes.

While his budget proposal attempts to tackle a long-running fiscal issue in Maryland, every sector takes a hit under the governor's plan. Health care, transportation and education, identified by the governor as top drivers of the deficit, are at the top of the list. And while many of us recognize that some reductions are necessary to get Maryland's fiscal house in order, advocates for causes like education are fighting hard and publicly to have their share of the cuts reduced.

This is where things get highly political and highly complex. If revenue is restored to other areas of the budget, health care - including as much as $200 million in state Medicaid funding - could again be on the chopping block.

That is simply not an acceptable proposition. In case you haven't seen it, MHA had an op-ed in the Center Maryland blog this week explaining how Medicaid cuts damage both health care providers and Maryland's most vulnerable. We're now working with other health care providers and advocates to make sure that our message is heard and heeded as the budget process unfolds.

It's critical to make a public and compelling case for preserving important programs like Medicaid. I encourage you to share the messages outlined in the op-ed with your local delegates and senators - that hospitals and our new waiver are part of the budget solution, that there's a strong economic development case for supporting health care spending and that cuts to this program affect 1.2 million Marylanders, one-fifth of the state's population.

On Wednesday, MHA provided written support for Senate Bill 195 Mental Health - Voluntary and Involuntary Admissions,which adds psychiatric nurse practitioners to the list of those who can approve the admission of minors to a facility for the treatment of mental disorders and for involuntary admission to such a facility or to a Veterans' Administration hospital. The bill also adds psychiatric nurse practitioners to the list of those who can submit the required certificate for involuntary admission. Under current law, a physician and a psychologist may be called on to sign a certificate for involuntary admission into a mental health treatment facility, as long as there is evidence of imminent danger to the life or safety of the individual. In areas of the state with shortages of mental health professionals, psychiatric nurse practitioners are called on to treat individuals suffering from mental health illnesses. This legislation would allow psychiatric nurse practitioners, in concert with physicians, to produce the certificate required to provide health services for those who need treatment.

On Thursday, MHA testified in support, with amendments, on HB 327 Health Ambulatory Surgical Facility Definition,which alters the definition of an ambulatory surgical facility to one that operates primarily to provide surgical services to patients who require a period of postoperative observation, but not hospitalization that lasts more than 24 hours. While the bill as originally drafted addresses the time constraints for an ambulatory surgical center, it did not precisely reflect the definition as drafted by the federal Centers for Medicare and Medicaid Services. MHA proposed an amendment to clarify this definition and mirror federal regulations, which define an ambulatory surgical facility as one operating exclusively to provide surgical services to patients who require a period of postoperative observation but not hospitalization, and in which the expected duration of services would not exceed 24 hours following admission. 

MHA staff and partners prepare for key legislative hearings in the next couple of weeks on critical policy issues. 

Contact: Jennifer Witten