February 9, 2018
A Roadmap for Behavioral Health
The most recent data on fatal overdoses in Maryland, released at the end of January, offer at least one positive sign: the total number of heroin-related and prescription opioid-related deaths shows a slight drop. Through the third quarter of 2017, the number of heroin-related deaths fell by 56 and the number of prescription opioid-related deaths fell by 11, compared to the same period in 2016.
Among the factors contributing to positive movement is the work of hospitals to implement emergency department prescribing guidelines, and the dispensation of the life-saving opioid reversal drug Naloxone.
Still, there is much work to be done. Despite the drop in heroin and prescription opioid deaths, the total death count rose, to 1,705 for the first nine months of 2017. The Maryland Department of Health pointed to fentanyl, a powerful synthetic opioid, as the culprit.
One of the ways hospitals as a field are addressing this critical state issue is by sharing with legislators our Roadmap to an Essential, Comprehensive System of Behavioral Health Care for Maryland . This plan was produced by MHA's Behavioral Health Task Force after the more than 20 hospital CEOs and other leaders who volunteered to be on this ongoing task force spent more than two years examining the state's behavioral health crisis and response. It offers five comprehensive recommendations to help the estimated one in five Marylanders who face mental health or substance use disorders:  
  • Provide all patients with behavioral health screenings and, if necessary, referrals, as part of their routine care, regardless of setting.
  • Create the infrastructure needed to provide immediate access to care for those experiencing a behavioral health crisis.
  • Integrate and coordinate behavioral health care so it is delivered in the appropriate setting.
  • Invest in the highly skilled workforce and physical capacity needed to proactively manage behavioral health conditions.
  • Invest in and make available prevention and harm reduction services like syringe exchanges and mental health first aid.
While no omnibus behavioral health legislation has materialized this session, some of these recommendations may be included in individual bills. Keep an eye on the "At Work in Annapolis" weekly feature in MHA's Friday Update to get the latest on behavioral health legislation and other health-related bills.

At Work in Annapolis
With the Senate and House bill introduction deadlines now behind us, MHA this week reviewed a substantial number of bills that could affect the hospital field. On Thursday, MHA testified in opposition to legislation that would significantly expand the circumstances under which a hospital is required to contribute to a hospital employee retraining fund through the Department of Labor, Licensing, and Regulation. Today, the Department of Legislative Services and the Maryland Board of Revenue Estimates held a briefing on the impact of federal tax reform on the state budget. The hospital field will have several key bill hearings next week on priority issues, including Patient Bill of Rights and behavioral health. Throughout the legislative session, you can track MHA's activities via our dashboard that provides an overview of the previous week and a look at important hearings and events coming the following week.
MHA Submits Comments on HSCRC White Paper
On Wednesday, MHA submitted to HSCRC a comment letter responding to a number of policy changes proposed by commissioners John Colmers and Jack Keane at the November 2017 public HSCRC meeting. MHA's letter addresses policies related to rate readjustment, readmissions, complications, Medicare performance adjustment, scaling, potentially avoidable utilization, and market shift.
Contact: Mike Robbins
MHA, HFAM Comment on Medicaid Participation
MHA and the Health Facilities Association of Maryland this week sent a joint comment letter to the Maryland Department of Health on a proposed amendment to the Medical Assistance Program regulations on provider enrollment.  The proposal would allow the Medical Assistance Program to terminate participation in Medicaid by the affiliated providers of a terminated provider or entity, using an ownership threshold of just 5 percent to determine "affiliation."  The comment letter raises concerns about the broad nature of this authority, asking MDH to evaluate its goals under the proposal and accordingly tailor the scope of any regulation it promulgates.

Contact: Maansi Raswant
Equity Institute Changes Name
The Institute for Diversity and Health Management has changed its name to the Institute for Diversity and Health Equity (the Institute) to reflect the integral relationship diversity and health equity have in health care. The Institute also became part of the American Hospital Association's core benefits, which means all AHA hospital and health system members have access to the Institute's resources and education events. A special message and video went out to hospitals from AHA President & CEO Rick Pollack, Ninfa Saunders, immediate past chair of the Institute and president and CEO of Navicent Health in Macon, Ga., and Nicholas Tejeda, Institute chair and CEO of The Hospitals of Providence Transmountain Campus in El Paso, Texas, sharing additional details of what's to come in 2018.
Making Your MHEI Membership Work for You
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Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services. Sg2 delivers an easy access platform of predictive analytics and consulting services that helps more than 1,400 hospitals and health systems - from small community hospitals to large integrated delivery networks - understand current and future market dynamics and capitalize on opportunities for growth and performance.

Guidance for Treating Pregnant Women with Opioid Use Disorder Released
The Substance Abuse and Mental Health Services Administration this week issued new clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants.

Monday, February 12
MHA Council on Legislative & Regulatory Policy meeting
MHA Certificate of Need and State Health Plan Work Group meeting

Tuesday, February 13
MHA Council on Clinical & Quality Issues meeting

Wednesday, February 14
Health Services Cost Review Commission meeting

Thursday, February 15
MHA Technical Work Group meeting
Capital Gazette , By Phil Davis, February 5
Maryland Reporter , By Jo Martin, February 5
ABC 2 News , By Nadia Singh, February 6
WJLA , By Tom Roussey, February 6
The Baltimore Sun , By Meredith Cohn, February 6
The Baltimore Sun , By Meredith Cohn, February 6
The Baltimore Sun , By David Anderson, February 7
Washington Business Journal , By Tina Reed, February 7