Guest Post by Dan Martin, Public Policy Director MHAMD
Maryland currently provides mental health services in the public system primarily through a fee-for-service system that is carved out from managed care and provides addiction services through a mixture of managed care and grants. Due to concern that for individuals with co-occurring conditions these differences resulted in inefficient delivery of services, the General Assembly in 2011 required the Department of Health and Mental Hygiene (DHMH) to convene a workgroup of interested parties to develop an integrated system of care. The DHMH integration process focuses on three specific areas:
Regulations: Creation of a single set of behavioral health regulations.
Administration: Consolidation of the Mental Hygiene Administration and the Alcohol and Drug Abuse Administration into a single Behavioral Health Administration.
Financing: Development of a new financing structure to support integrated care across medical and behavioral health services. DHMH will issue a draft report on the financing model by September 30, 2012, which will be presented for public comment and incorporated into a specific proposal for the 2013 legislative session. DHMH has identified three potential models that will be evaluated against a specific set of criteria. The work to be completed by September will be done in four separate workgroups:
- Systems Linkage – Considering factors that should be present to promote integration. What factors indicate “integrated” care, and what factors indicate “collaborative” care? Should there be a shared electronic health record among all providers within a Managed Care Organization?
- State/Local and Non-Medicaid – Considering what services/financing should be left outside a Medicaid integrated care model to accommodate non-Medicaid eligible populations, or non-Medicaid-eligible services, as well as the roles that state and local government should perform.
- Evaluation and Data – Determining what data is available and relevant to the recommendation on the model and what potential measures should be used to evaluate the selected model.
- Chronic Health Homes – Evaluating the new “Health Home” service under the federal Affordable Care Act and recommending how the new service could be developed to support any integration model.
The Mental Health Association of Maryland and the Maryland Mental Health Coalition have been actively involved in the process, attending all meetings to date. A letter from the Mental Health Coalition, co-signed by 60+ organizations, provided the Department with a unified stakeholder perspective on the process to date, offering initial comments and concerns, asked for clarification on issues related to stakeholder involvement, and requested DHMH provide stakeholders with certain information to ensure the decision-making process is informed and transparent. The Department responded formally on June 11th.
There is much work to be done and ample opportunity for input. More information about the process is available on the DHMH Behavioral Health Integration website. Interested parties can also write to bhintegration@dhmh.state.md.us receive emails about the process or submit questions/comments. For more information on the Mental Health Coalition, contact Dan Martin at dmartin@mhamd.org
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