Mental Health Association of Maryland
2008 End of Session Wrap-Up

The 425th Session of the Maryland General Assembly came to its customary end at midnight on its 90th day, Monday, April 7, 2008.  This was an unusual Session because it followed so closely behind the Special Session held in November 2007 which was principally devoted to raising taxes and righting the State deficit.  There was a certain lack of energy as the regular Session began, described by some as a “hang over” from the earlier Special Session.

Despite the slow start to the 2008 Legislative Session, the Mental Health Association of Maryland (MHAM) was very successful in advancing its agenda and was able to positively impact the passage of a number of initiatives it supported.  This report provides a summary of a number of bills the MHAM either supported or opposed.  A more detailed legislative report will be prepared in the coming weeks.  

Budget Initiatives

The Mental Health Association was successful in its efforts to add language to the operating budget that will require the Division of Corrections to report back to the legislature on a number of issues that have been identified by the Criminal Justice & Mental Health Work group.  That Workgroup was formed as a result of 2005 legislation to address issues regarding incarcerated individuals with mental illness. 

The Division of Corrections will be required to report 1) how many inmates have submitted applications to receive state or federal entitlements/benefits prior to release and how many successfully secured benefits; 2) the criteria used to determine if an inmate diagnosed with a mental illness is entitled to a 30-day supply of medication upon release; how many individuals who met the criteria received a 30-day supply; how many received less than a 30-day supply and why; what additional costs were incurred as a result of the mandate; and how many inmates who received medication for a mental illness while incarcerated were discharged and did not meet the criteria that enabled them to be eligible for a 30-day supply.  Further, the budget contains language that requires the Division of Corrections in conjunction with the Mental Hygiene Administration to report on the implementation of an alternative plan to assure that discharged inmates with serious mental illness secure an appointment with a community mental health provider within 2 weeks of discharge. 

There is also language that indicates that the budget committees request the Maryland Health Care Commission-convened (MHCC) task force include the ideal components of Maryland’s mental health crisis response system, as the task force develops a plan for the appropriate continuum of mental health services.

The MHAM also supported the efforts of community mental health and developmental disability workers to receive a cost-of-living adjustment (COLA).  The Senate passed a COLA of 3% but the House only approved a 2% COLA.  The Senate held firm in its position and the 3% COLA was retained in the final budget.  With respect to the Commission that recommends the COLA each year, legislation was passed (HB 1059) that extended the Commission for another 3 years and updated the methodology for determining the COLA each year. 

The General Assembly cut funding to the Regional Institute for Children and Adolescents (RICA)-Southern Maryland, resulting in a closure of the facility scheduled for the end of June 2008.  A small remainder of funds will be used to serve children and adolescents at other residential treatment centers or community-based services.

As recommended in the budget analyst’s report, the General Assembly cut $9.4 million from the Children’s Cabinet Interagency Fund.  In addition to that cut, they removed the mandate that had required the State to contribute money from the general fund to the Children’s Cabinet Interagency Fund.

Veterans Issues

The Administration introduced a comprehensive initiative on veterans’ mental health needs that the MHAM strongly supported.  The Administration’s bills (HB 372/SB 210 – Maryland Veterans Behavioral Health) were enacted albeit in a significantly amended version.  The amended legislation requires the Administration to develop a plan and to apply to the federal government for funding before the State will fund the provision of services.  While these amendments will slow and potentially limit the range of services to be provided, given the significant fiscal issues the State is facing, this initiative is nonetheless a potential commitment of new State resources at a time when little if any new funding is being provided.

Department Reorganization

The MHAM strongly supported the passage of HB 450 – Department of Health and Mental Hygiene – Behavioral Health and Disabilities advanced by Delegate Peter Hammen.  The enactment of this legislation will result in the appointment of a Deputy Secretary for Behavioral Health and Disabilities with the stated objective of improving the coordination of systems and services for individuals with co-occurring disorders.  The new Deputy Secretary will be responsible for the Mental Hygiene Administration, the Developmental Disabilities Administration and the Alcohol and Drug Abuse Administration.  It is believed that better communication and coordination between these administrations will enhance the efficiency and effectiveness of the programs and services administered to these populations.

Youth Issues

Legislation was enacted (SB 96/HB 285) that will require the implementation and or expansion of Positive Behavioral Intervention and Supports (PBIS) or similar behavior modification programs in schools with truancy rates that exceed specified levels.  It will serve to expand the use of a successful initiative now in place in nearly 500 schools throughout the State.

House Bill 199 – Public Schools – Bullying, Harassment and Intimidation – Policy Disciplinary Standards was enacted.  It requires the State Department of Education to develop a model policy on bullying and harassment and directs the local Boards to adopt policies in that regard as well.  Unfortunately the legislation does not recognize the need for incorporation of behavior modification or positive behavioral intervention and support programs in the model policy, but hopefully those initiatives continue to be advanced through other mechanisms. 

Senate Bill 1 – Maryland Youth Advisory Council was passed and included an amendment requested by the MHAM to include suicide prevention as an issue to be considered by the Council.  

Legislation was also passed (HB 115) that will require the Comptroller to provide information regarding eligibility for Medicaid and the Maryland Children’s Health Program (MCHP) when state issued checks are sent to residents.  A broader version – HB 1391 – Kids First Act requires DHMH to develop and the Comptroller to send out enrollment applications to those families who are eligible for MCHP but not otherwise covered based on their income tax returns.  The bill also requires the Maryland income tax return form to ask those with children whether or not the children have health insurance without penalizing them for failure to answer.

Senior Issues

MHAM supported legislation (HB 29/SB918) that will prohibit the use of genetic tests and information in the issuance of long term care insurance.  Legislation was enacted to require the Department of Health and Mental Hygiene and Department of Human Resources to develop a consolidation plan for long term care eligibility (HB 1452/SB 682).  MHAM also supported HB 1492/SB 906 that provides a subsidy to close the “donut hole” in the Medicare Part D prescription coverage.  Finally, MHAM supported SB 566 which gives domestic partners certain rights including the right to make healthcare decisions and visit their partner in healthcare facilities.

Other Issues

The Flexible Leave Act (HB 40) passed during the last hour of the Session.  That bill allows employees to use their earned leave time for a sick spouse, child or parent.  The bill only applies to employers of 15 or more individuals.

Bills that Were Not Enacted

An effort to enact a “Patients Bill of Rights” for individuals in psychiatric facilities was not enacted (HB 726/SB 815).  Neither was an effort to establish a task force to study involuntary outpatient commitment (HB 810).  The Psychiatric Society’s effort to correct issues regarding access to medical records in provider disciplinary cases (HB 876/SB 443) was unsuccessful, as was their effort to eliminate tiered co-payments for privately insured individuals’ outpatient mental health visits (HB 1468).  Legislation regarding Taser guns (HB 108) passed the House of Delegates but remained in Committee in the Senate.  An effort to establish a task force to study the commitment of sexually violent predators to facilities of the Department of Health and Mental Hygiene also failed (SB 26).  Legislation to change the standard for involuntary medication in a facility also failed, but will be the subject of summer study instead (HB 1339).  A bill sponsored by Senator Pugh would have required the Motor Vehicle Administration to provide State identification cards for inmates upon release (SB 446).  That legislation also died in Committee. 

Lisa M. Cuozzo, J.D.
lcuozzo@mhamd.org