Behavioral Health Policymaking in Maryland JHSPH Health Policy - PowerPoint PPT Presentation

Behavioral Health Policymaking in Maryland JHSPH Health Policy Internship 2019-2020 Elizabeth Stone, MSPH

Senator Malcolm Augustine – District 47

Maryland General Assembly

2020 Legislation SB0155 Consumer Protection – Mobile Home Purchasers SB0305 Public Safety – Crisis Intervention Team Center of Excellence SB0313 Plastics and Repackaging Reduction Act SB0334 Health Insurance – Coverage for Mental Health & SUD Benefits – Treatment Criteria SB0355 Health Occupations – Pharmacists – Administration of Vaccinations SB0611 Health – Mental and Emotional Disorders – Consent SB0661 Health Insurance – Prostate Cancer Screening – Prohibiting Cost-Sharing SB0716 Maryland Council on Health in All Policies – Establishment SB0766 State Board of Professional Counselors and Therapists – MD Music Therapists Act

2020 Legislation SB0155 Consumer Protection – Mobile Home Purchasers SB0305 Public Safety – Crisis Intervention Team Center of Excellence SB0313 Plastics and Repackaging Reduction Act SB0334 Health Insurance – Coverage for Mental Health & SUD Benefits – Treatment Criteria SB0355 Health Occupations – Pharmacists – Administration of Vaccinations SB0611 Health – Mental and Emotional Disorders – Consent SB0661 Health Insurance – Prostate Cancer Screening – Prohibiting Cost-Sharing SB0716 Maryland Council on Health in All Policies – Establishment SB0766 State Board of Professional Counselors and Therapists – MD Music Therapists Act

SB0334 – Background Establishes accountability at the state level for insurance carrier compliance with the federal parity act through requiring annual data and compliance reports and enacting penalties for violations. Federal Mental Health Parity and Addiction Equity Act (2008) Prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. 1

SB0334 – Public Health Context In Maryland only 41.6% of adults with any mental illness received mental health services. 2 Individuals seeking mental health and substance use disorder services face substantial barriers to treatment including financial obstacles, lack of availability, perception of need, and stigma. 3-5

SB0334 – Challenges & Lessons Stakeholder negotiations Balance between state benefits and broader implications

SB0334 – Legislative Outcome Passed with amendments Requires insurance carriers to submit two reports to the Maryland Insurance Administration, one before March 2022 and a second before March 2024, on their five health plans with the highest enrollment

SB0766 – Background Creates state licensure for music therapists by establishing the Music Therapist Advisory Committee within the State Board of Professional Counselors and Therapists

SB0766 – Public Health Context Differentiation from non-music therapists providing music in healthcare settings Special education, Medicaid waiver funding, and private insurance regulations often require official state recognition of a credential in order to support and reimburse services

SB0766 – Challenges & Lessons Legislative timeline Understanding of regulatory system

SB0776 – Legislative Outcome Did not pass out of committee

Reflection Understanding stakeholders and arguments on all sides of an issue Appreciation of the legislative timeline Knowing what can and cannot be compromised How to provide oral testimony

Thank you

References 1. Centers for Medicare and Medicaid Services. (2016). Mental Health Parity and Addiction Equity Act . https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet 2. Substance Abuse and Mental Health Services Administration. (2019). Behavioral Health Barometer: Maryland, Volume 5: Indicators as measured through the 2017 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services. HHS Publication No. SMA-19-Baro-17-MD. Rockville, MD: Substance Abuse and Mental Health Services Administration. 3. Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., ... & Kessler, R. C. (2011). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychological medicine , 41 (8), 1751-1761 4. Sharma, A., Kelly, S. M., Mitchell, S. G., Gryczynski, J., O’Grady, K. E., & Schwartz, R. P. (2017). Update on barriers to pharmacotherapy for opioid use disorders. Current psychiatry reports, 19(6), 35. 5. Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. D. (2016). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: an integrative literature review. Journal of substance abuse treatment, 61, 47-59.