The state's battle to overcome Maryland's heroin epidemic is underway, as the Heroin and Opioid Emergency Task Force kicks off a series of regional summits next week to better understand the nature of the problem. The summits will bring together hospitals, addiction experts, law enforcement, behavioral health professionals, those who have struggled with addiction, their families, and others to help zero in on solutions to this pervasive problem.

And the problem is getting worse. Heroin overdose deaths have jumped in recent years, from 247 in 2011 to 464 in 2013 - an 88 percent increase. In the first six months of 2014 alone, there were 296 deaths.

As you well know, many of the people suffering from heroin addiction wind up in hospitals' emergency departments, where care is most expensive, and certainly not the appropriate place to address the underlying addiction problem. That's one reason hospitals must be highly engaged with the task force and its efforts.

The task force will need your help to:

• Share information about the summits and the task force with your communities
• Understand the impact of the heroin epidemic on your community - it's important that the task force hear from hospital leaders and clinicians
• Provide concrete recommendations for solutions 

As we work on this problem together, it's important that hospitals have a leading presence at the summits and throughout this process. You can register for the summits here; questions and comments can be emailed here.

As Gov. Hogan noted in his executive orders creating the task force and the Intra-agency Heroin and Opioid Coordinating Council, heroin abuse is no less than a public health crisis for the citizens of Maryland. And when the health of the public we serve is threatened ... that's one of the many opportunities for hospitals to show what they're all about.

It is that time of session when bills are moving quickly to meet crossover deadlines. On Tuesday and Wednesday, MHA testified in support of SB188-Task Force to Study the Establishment of Health Courts, which would

Also on Tuesday, MHA testified in support of HB650 Blue Ribbon Commission to Study Maryland's Behavioral Health System sponsored by Delegate Joseline Pena Melnyk. This bill would create an independent, statewide Blue Ribbon Commission composed of experts in the field who will analyze the current problems with Maryland's behavioral health system. The commission will provide concrete, actionable recommendations to address the deficiencies contributing to this growing crisis.

On Wednesday, MHA testified on several other bills in both the Senate and House. MHA submitted written testimony in support of SB430-HB975 Maryland Medical Assistance Program-Mental Health and Substance Use Disorder Benefits-Parity, which provides that certain provisions of law apply to mental health and substance use disorder benefits provided by the Maryland Medical Assistance Program or administered by an administrative services organization; requires the Department of Health and Mental Hygiene to use certain standards in determining compliance with a certain provision of law; requires the department to use certain criteria in determining medical necessity for substance use disorder services; and generally relates to the Maryland Medical Assistance Program and mental health and substance use disorder benefits.

MHA supported via written testimony SB469-HB367 Public Health-Maryland Behavioral Health Crisis Response System, which requires the Behavioral Health Administration to create a statewide Behavioral Health Crisis Response System that provides 24/7 response through skilled clinical intervention, and to respond quickly and effectively to community crisis situations. The system would feature walk-in crisis communication centers open 24 hours a day in each Maryland jurisdiction or region, in coordination with local agencies, police and emergency medical services, and behavioral health providers, as well as provide crisis residential beds to serve as an alternative to hospitalization.

Wednesday's schedule included several bill hearings in the House Judiciary Committee. MHA was part of several panels that testified in support of HB817 Health Care Malpractice-Limitation on Noneconomic Damages, which decreases to $500,000 the cap on noneconomic damages in health care malpractice claims arising on or after October 1, 2015. This proposal would lower liability costs and the cost of health care in Maryland. Further, the practice of defensive medicine, aided by a high-value damages ceiling, unnecessarily inflates the cost of providing health care, which threatens hospitals' ability to live within the fiscal constraints of a modernized Medicare waiver.

MHA offered oral and written testimony in opposition to HB398 Civil Actions-Noneconomic Damages-Catastrophic Injury, which would increase the maximum amount of noneconomic damages that may be recovered in health care malpractice and other civil actions for a catastrophic injury under specified circumstances. This proposal would raise fees for plaintiffs' attorneys and increase malpractice insurance rates (and thus health care costs for everyone). Further, the practice of defensive medicine, encouraged by astronomical jury awards, unnecessarily inflates the cost of providing health care, which threatens hospitals' ability to live within the fiscal constraints of a modernized Medicare waiver. If the waiver is lost due to failure to meet these fiscal limits, Maryland stands to lose an estimated $2 billion each year in federal dollars.

MHA provided oral and written testimony opposing HB470 Health Care Malpractice-Certificates and Reports of Qualified Experts, which requires that, in health care malpractice cases, an objection to the sufficiency of a certificate of qualified expert or report must be filed within 14 days after the filing of the certificate or report. The bill further specifies that, if the arbitration panel chairman or the court rules that a party's certificate or report is legally insufficient, the party must file a legally sufficient certificate and report from an attesting expert within 30 days of the order's entry.

MHA testified and provided written support for HB547 Medical Liability Efficiency Act of 2015. This bill repeals the provisions relating to the Health Care Alternative Dispute Resolution Office; prohibits a person from bringing an action against a health care provider for a medical injury unless the person provides to the health care provider a specified notice, medical records, and releases at least 90 days in advance of the action; terminates the Health Claims Arbitration Fund; alters the content of specified certificates of a qualified expert. This bill takes a series of practical steps to make Maryland's liability climate more efficient and more equitable by changing liability-related regulations so that they will: discourage the practice of defensive medicine, foster better communication between doctors and patients, help patients be compensated in a fair and timely manner, reduce incidence of frivolous lawsuits and reduce liability premiums.

MHA again joined several panels and testified in support of SB585-HB553 Maryland No-Fault Injured Baby Fund, which is a critical measure to ensure that the tens of thousands of women who give birth in Maryland each year have access to quality obstetric services. In addition, for the handful of cases each year that would qualify for reimbursement from this fund, a no-fault mechanism provides timely, efficient compensation - without asking injured parties to play in the "litigation lottery," where results are uncertain and won't be determined for years.

On Thursday, MHA testified and provided written supportive testimony for SB513-HB613 Hospitals-Rate-Setting Participation in 340B Program Under the Federal Public Health Service Act, which alters the definition of "hospital services" to include a specified hospital outpatient service of a specified hospital (those that are part of a merged asset hospital system) for the purpose of allowing the hospital outpatient service to continue to participate in the federal 340B Program under rates set by the Health Services Cost Review Commission.

MHA also testified in opposition of SB572-HB1006 Hospitals-Designation of Caregivers, which would require hospitals to provide patients or the legal guardians of patients with a specified number of opportunities to designate a caregiver within a specified number of hours after the entrance of the patient to the hospital, and before the patient is discharged from the hospital; and require a hospital to document in a patient's medical record specified information. The bill requires hospital staff to develop a discharge plan that describes a patent's after-care assistance needs and how those needs will be managed at a patient's residence, and to provide designated caregivers with instructions, as well as a demonstration of after-care tasks in the discharge plan. The bill is redundant to the standards that hospitals are already meeting.