The federal government's decision to stop a pilot program that helped fund behavioral health treatment in Maryland is causing quite a challenge for hospitals. That's because the state, which had been informed about the funding decision months ago, did not take any budgetary steps to fill the gap, estimated by some to be as much as $20 million a year. Instead, the state has capped payments for those services, and told hospitals not to send patients to Maryland's three institutes for mental disease without first making at least four phone calls to try to place the patient in an inpatient hospital psych bed.

 

The details of the problem are many and complex, but its crux is simple: The treatment of thousands of Maryland's patients should not be compromised by the state's inaction on funding these critical services. Our job is to get people the right care, at the right time, in the right setting. And if that setting is an institute for mental disease, then that's where they need to be ... not a hospital emergency department while the hospital desperately tries to find an alternative to either Sheppard Pratt, Brook Lane, or Adventist Behavioral Health.

 

How is MHA working to solve the issue? The state has submitted a request to the Centers for Medicare & Medicaid Services for a waiver to restore federal funding; MHA submitted a letter in support of the application. Earlier, the state's budget cap on treatment for the patients affected by the federal funding was an act that, because it came with no notice, is a clear violation of the Administrative Procedures Act. We have briefed DHMH Secretary Van Mitchell on the overall problem as well as our legal concerns, and we are sincerely hoping that legal action will not be necessary. We also briefed Budget Secretary David Brinkley's team, to look for funding solutions. We updated the Lt. Governor's team, reminding them that this oversight flies in the face of the governor's behavioral health priorities. And we are drafting a letter to Maryland's congressional delegation seeking their support for the waiver that can re-open up the federal funding flow.