ANNAPOLIS – Maryland’s public mental health system is in turmoil, and legislators are determined to find out why.
Two delegates have introduced bills to study the system and determine what improvements need to be made — despite the fact that a task force was commissioned last session to study access to the system and recommend changes.
Delegate Sheila Hixson, D-Montgomery, sponsored the first proposal, which requires the department to hire a consultant for about $90,000 to design a system that would avoid the current budget problems.
The department received a $54 million bailout for prior-year deficits in mental hygiene and a base funding increase in the 2005 budget, but still projects a deficit of about $31 million for 2004.
The second proposal, sponsored by Delegate Jill Carter, D-Baltimore, creates a task force to perform a needs assessment for the system with a cost of about $10,000.
Meanwhile, a bill enacted last year created the Task Force on Access to Mental Health Services to identify barriers to mental health care and evaluate public and private sector differences to improve coordination between the systems, said chairwoman Kathleen Loughran.
“There are people falling in between the cracks,” Loughran said.
In a seeming overlap of the current proposals, the legislation creating the task force requires it to make recommendations about the structure and effectiveness of the delivery of public and private mental health service delivery.
Carter said she felt there were issues that might be addressed by the current task force that would need greater emphasis, and the very vocal concerns of mental health care advocates prompted her to draft the new proposal.
“We just think our bill was going further,” Carter said. If one of the bills passes before the other, Carter and Hixson said they would try to combine the proposals with friendly amendments.
Delegate Adelaide Eckardt, R-Dorchester, whose background is in psychiatric nursing, said the goals of the legislation are appropriate and their questions need to be answered, but creating additional burdens on the department may not be the way to go.
“There is a vehicle on the table right now that could address that,” Eckardt said. “Whether we have a task force or whether we have a consultant, I think it’s something we can do with or without legislation.”
Focusing on the structure of the system and how to fix it is not the primary goal of the current task force, Loughran said, but if the Legislature wanted to expand the task force’s scope it could more directly address those issues.
The public system’s structure, which is already being considered internally by the Department of Health and Mental Hygiene, is a key component of the current debate about bringing public mental health back under the supervision of managed care organizations.
Regardless of whether either bill passes, the health department is moving forward with an internal study to develop a “next-generation” managed care scenario, said Mental Hygiene Administration Director Dr. Brian Hepburn.
“In Maryland, we should be leading the movement toward evidence-based practices and whatever the science is saying we should be doing,” Hepburn said.
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