December 15, 2019
Hospitals Serve as Safety Net for Behavioral Health Patients
As hospitals across the country face criticism for long emergency department wait times, the dearth of community-based behavioral health resources must be flagged as a significant cause. Many of your hospitals contend with behavioral health patients who simply have nowhere else to go—both at onset of an episode and when ready for discharge—due to lack of capacity in more appropriate care settings.

As we make the case for improved processes and more placement options for behavioral health services, we regularly look for actionable data.

With that in mind, MHA worked with Wilder Research to study behavioral health patient delays in the state’s EDs . It found 42% of behavioral health ED patients experienced a delay in discharge or transfer. These patients were delayed for 1,676 days total—an average of 20 hours per patient. Delays accounted for 48% of the time those patients spent in ED.

Of interest, three of the top five causes for a delay were related to actions—or inactions—of the prospective receiving “agency” or placement site.

To help behavioral health patients get the right care in the right place, MHA will use these findings during the upcoming Maryland General Assembly session. We will put forth a bill to allow police to take emergency petition patients directly to crisis centers for evaluation rather than solely to EDs.

This study is just the latest example of how MHA is leveraging data to advocate for policies that help you better address operational challenges and give the best care possible to your communities.
Bob Atlas
President & CEO
HSCRC Approves New Capital Policy
The HSCRC adopted a new capital funding policy Wednesday. The policy is intended to offer rate relief for large capital projects. Under the approved policy, hospitals may seek rate relief for capital projects that exceed 20% of annual hospital revenues. The commission also approved final recommendations on Quality Based Reimbursement (QBR) and the maximum amount at risk for quality policies. The commission also heard an update on performance of the Maryland Model during its meeting, and HSCRC staff proposed an intensity and innovation funding policy. Read more in this month’s issue of Newsbreak .
Maryland Moves Up in Health Rankings
Maryland advanced from No. 19 to No. 18 in the recently released America’s Health Rankings –a composite index of more than 30 metrics.

This marks the fifth year Maryland has been among the 20 healthiest states in the nation.

Maryland’s best scores this year were in smoking, the number of children living in poverty and the percentage of Marylanders who are uninsured, 6.1%. The state’s worst scores were in health disparities between people with and without a high school education, drug deaths and violent crime. The report also finds that in the past year the percentage of adults in Maryland with diabetes rose by 15%–from 10.4% to 12%.
Qlarant to Direct the QIN-QIO Program in Maryland
Medicare awarded its five-year Quality Innovation Network-Quality Improvement Organization (QIN-QIO) program contract for the region including Maryland to IPRO. Activities in Maryland , the district of Columbia and Delaware will be directed by Qlarant . Free technical support is available to health care providers that join community of care coalitions and to nursing homes that participate in the Nursing Home Quality Care Collaborative. The team will work with participating organizations to focus on critical issues including: improving access to behavioral health services, decreasing opioid use, reducing harm from adverse drug events and health care acquired infections, supporting prevention and management of chronic disease and improving care transitions to reduce unnecessary hospital utilization. For more information contact Bonnie Horvath .
MHA Hosts Statewide Human Trafficking Forum
In partnership with the University of Maryland SAFE Center, MHA hosted a statewide forum to preview the revisions to Maryland’s Human Trafficking Guidelines for Health Care Providers slated for release in January 2020. More than 70 hospital employees attended the event including emergency physicians, social workers, forensic nurse examiners and many others. The forum ended with a panel of clinical experts sharing stories and advice about developing a hospital response to human trafficking. Your MHA will be asking every hospital to sign a commitment letter to voluntarily adopt the guidelines, customizing the response to meet the needs of each hospital and community. As a field, Maryland’s hospitals are committed to the fight against human trafficking and will continue to work closely with the Maryland Human Trafficking Task Force and the University of Maryland SAFE Center.
MHA Participates in Committee Briefings in Annapolis
The Maryland Hospital Association along with other state agencies participated in two committee briefings last week in Annapolis. The Senate Finance Committee heard updates from MHA, The Maryland Healthcare Commission and the Health Service Cost Review Commission on the status of modernizing and improving the state’s certificate of need (CON) process. Brett McCone, MHA senior vice president of health care payment, emphasized the need to amend state regulations with the goals of the Maryland Model and focus on efficiencies with determination and application process. He also highlighted the importance of state agency alignment to meet future health care delivery demand. 

The same day, the Health and Government Operations Committee held a briefing on the status of the Maryland Department of Health efforts regarding behavioral health. Maryland Medicaid provided an overview of its process to vet the behavioral health system of care. The committee relayed appreciation for state’s process. MHA submitted a letter to the committee chair and members , highlighting the work underway with MHA’s Medicaid Task Force and the need to allow these efforts to continue before legislative action is considered. These comments were well received.
Government Affairs, PR Leads Attend Legislative Communications Preview
MHA hosted a Legislative Communications joint meeting of members’ government affairs and public relations leads Thursday. More than 50 people attended the event, which focused on concerns the hospital field faces in the upcoming legislative session and MHA’s legislative priorities . Attendees also discussed potential messaging that could be effective in reframing the conversation about hospitals during session and beyond. More details will be shared in the coming weeks about a fieldwide messaging campaign and the important role your hospital can play. For details, contact Nicole Stallings or Amy Goodwin .
Ending HIV Transmission: Test, Treat, and Prevent - CDC Vital Signs
The month’s CDC Vital Signs report shows the progress needed in three key areas to curb HIV transmissions–testing, treatment, and prevention. Read the report and download the fact sheet .
About 154,000 people (14%) who have HIV don’t know it and need testing.

About 37% of people who know they have HIV don’t have it under control and need treatment.
About 4 in 5 (82%) people who could benefit from medicine to prevent HIV (PrEP) aren’t getting it.
Between 2003 and 2017, there were nearly 35.2 million natural deaths in the United States. Home has surpassed the hospital as the most common place of death in the United States for the first time since the early 20th century.

Want to receive your Toward Better Health
newsletter via text message?
Click here to sign up.
Maryland Hospital Association | www.mhaonline.org