| Old | New | Differences | |
|---|---|---|---|
| 1 | 1 | ||
| 2 | 2 | ||
| 3 | 3 | EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. | |
| 4 | 4 | [Brackets] indicate matter deleted from existing law. | |
| 5 | - | Underlining indicates amendments to bill. | |
| 6 | - | Strike out indicates matter stricken from the bill by amendment or deleted from the law by | |
| 7 | - | amendment. | |
| 8 | 5 | *sb0637* | |
| 9 | 6 | ||
| 10 | 7 | SENATE BILL 637 | |
| 11 | 8 | J1, J5 2lr1432 | |
| 12 | - | CF | |
| 9 | + | CF 2lr1433 | |
| 13 | 10 | By: Senator Augustine | |
| 14 | 11 | Introduced and read first time: February 3, 2022 | |
| 15 | 12 | Assigned to: Finance | |
| 16 | - | Committee Report: Favorable with amendments | |
| 17 | - | Senate action: Adopted | |
| 18 | - | Read second time: March 27, 2022 | |
| 19 | 13 | ||
| 20 | - | ||
| 14 | + | A BILL ENTITLED | |
| 21 | 15 | ||
| 22 | 16 | AN ACT concerning 1 | |
| 23 | 17 | ||
| 24 | 18 | Health and Health Insurance – Behavioral Health Services – Expansion 2 | |
| 25 | 19 | (Behavioral Health System Modernization Act) 3 | |
| 26 | 20 | ||
| 27 | 21 | FOR the purpose of requiring the Maryland Medical Assistance Program to provide 4 | |
| 28 | 22 | reimbursement for certain behavioral health peer recovery, measurement–based 5 | |
| 29 | 23 | care, and crisis response services, subject to certain limitations; requiring the 6 | |
| 30 | 24 | Maryland Department of Health to expand access to and provide reimbursement for 7 | |
| 31 | 25 | certain behavioral health collaborative care, case management, and wraparound 8 | |
| 32 | 26 | services; requiring the Governor to include in the annual budget bill certain 9 | |
| 33 | 27 | appropriations to fund certain behavioral health services and supports; requiring 10 | |
| 34 | 28 | certain insurers, nonprofit health service plans, and health maintenance 11 | |
| 35 | 29 | organizations to provide coverage and reimbursement for certain behavioral health 12 | |
| 36 | - | services Maryland Department of Health to review and consider options for adopting 13 | |
| 37 | - | existing programs or services to provide wraparound services to children and youth 14 | |
| 38 | - | with primary substance use disorders and review and make recommendations 15 | |
| 39 | - | regarding eligibility requirements for the 1915(i) waiver and mental health case 16 | |
| 40 | - | management; requiring the Maryland Insurance Administration, in consultation 17 | |
| 41 | - | with certain stakeholders, to study and make recommendations on certain issues 18 | |
| 42 | - | related to commercial carrier reimbursement of behavioral health clinical peer 19 | |
| 43 | - | specialists and crisis response services; and generally relating to the expansion of 20 | |
| 44 | - | the provision, funding, and coverage of and eligibility for behavioral health services. 21 | |
| 30 | + | services; and generally relating to the expansion of the provision, funding, and 13 | |
| 31 | + | coverage of behavioral health services. 14 | |
| 45 | 32 | ||
| 46 | - | BY adding to 22 | |
| 47 | - | Article – Health – General 23 2 SENATE BILL 637 | |
| 33 | + | BY adding to 15 | |
| 34 | + | Article – Health – General 16 | |
| 35 | + | Section 7.5–901 to be under the new subtitle “Subtitle 9. Funding for Wellness and 17 | |
| 36 | + | Recovery Centers, Recovery Community Centers, and Peer Recovery 18 | |
| 37 | + | Services”; 15–101(a–1), (a–2), and (e–1) and 15–103(a)(2)(xviii); and 15–1101 19 | |
| 38 | + | and 15–1102 to be under the new subtitle “Subtitle 11. Home – and 20 | |
| 39 | + | Community–Based Services for Children and Youth” 21 | |
| 40 | + | Annotated Code of Maryland 22 | |
| 41 | + | (2019 Replacement Volume and 2021 Supplement) 23 | |
| 42 | + | ||
| 43 | + | BY repealing and reenacting, without amendments, 24 | |
| 44 | + | Article – Health – General 25 | |
| 45 | + | Section 15–101(a) and 15–103(a)(1) 26 | |
| 46 | + | Annotated Code of Maryland 27 | |
| 47 | + | (2019 Replacement Volume and 2021 Supplement) 28 | |
| 48 | + | 2 SENATE BILL 637 | |
| 48 | 49 | ||
| 49 | 50 | ||
| 50 | - | Section 7.5–901 to be under the new subtitle “Subtitle 9. Funding for Wellness and 1 | |
| 51 | - | Recovery Centers, Recovery Community Centers, and Peer Recovery 2 | |
| 52 | - | Services”; 15–101(a–1), (a–2), and (e–1) and 15–103(a)(2)(xviii); and 15–1101 3 | |
| 53 | - | and 15–1102 to be under the new subtitle “Subtitle 11. Home – and 4 | |
| 54 | - | Community–Based Services for Children and Youth” 5 | |
| 55 | - | Annotated Code of Maryland 6 | |
| 56 | - | (2019 Replacement Volume and 2021 Supplement) 7 | |
| 51 | + | BY repealing and reenacting, with amendments, 1 | |
| 52 | + | Article – Health – General 2 | |
| 53 | + | Section 15–101(a–1) and (a–2), 15–103(a)(2)(xvi) and (xvii), and 15–141.1 3 | |
| 54 | + | Annotated Code of Maryland 4 | |
| 55 | + | (2019 Replacement Volume and 2021 Supplement) 5 | |
| 57 | 56 | ||
| 58 | - | BY | |
| 59 | - | Article – | |
| 60 | - | Section 15– | |
| 61 | - | Annotated Code of Maryland | |
| 62 | - | ( | |
| 57 | + | BY adding to 6 | |
| 58 | + | Article – Insurance 7 | |
| 59 | + | Section 15–717 and 15–857 8 | |
| 60 | + | Annotated Code of Maryland 9 | |
| 61 | + | (2017 Replacement Volume and 2021 Supplement) 10 | |
| 63 | 62 | ||
| 64 | - | BY repealing and reenacting, with amendments, 13 | |
| 65 | - | Article – Health – General 14 | |
| 66 | - | Section 15–101(a–1) and (a–2), 15–103(a)(2)(xvi) and (xvii), and 15–141.1 15 | |
| 67 | - | Annotated Code of Maryland 16 | |
| 68 | - | (2019 Replacement Volume and 2021 Supplement) 17 | |
| 63 | + | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11 | |
| 64 | + | That the Laws of Maryland read as follows: 12 | |
| 69 | 65 | ||
| 70 | - | BY adding to 18 | |
| 71 | - | Article – Insurance 19 | |
| 72 | - | Section 15–717 and 15–857 20 | |
| 73 | - | Annotated Code of Maryland 21 | |
| 74 | - | (2017 Replacement Volume and 2021 Supplement) 22 | |
| 66 | + | Article – Health – General 13 | |
| 75 | 67 | ||
| 76 | - | ||
| 77 | - | ||
| 68 | + | SUBTITLE 9. FUNDING FOR WELLNESS AND RECOVERY CENTERS, RECOVERY 14 | |
| 69 | + | COMMUNITY CENTERS, AND PEER RECOVERY SERVICES. 15 | |
| 78 | 70 | ||
| 79 | - | ||
| 71 | + | 7.5–901. 16 | |
| 80 | 72 | ||
| 81 | - | SUBTITLE 9. FUNDING FOR WELLNESS AND RECOVERY CENTERS, RECOVERY 26 | |
| 82 | - | COMMUNITY CENTERS, AND PEER RECOVERY SERVICES. 27 | |
| 73 | + | THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL THE 17 | |
| 74 | + | FOLLOWING AMOUNTS FO R WELLNESS AND RECOV ERY CENTERS , RECOVERY 18 | |
| 75 | + | COMMUNITY CENTERS , AND PEER RECOVERY SE RVICES: 19 | |
| 83 | 76 | ||
| 84 | - | ||
| 77 | + | (1) $15,000,000 FOR FISCAL YEAR 2024; 20 | |
| 85 | 78 | ||
| 86 | - | THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL THE 29 | |
| 87 | - | FOLLOWING AMOUNTS FO R WELLNESS AND RECOV ERY CENTERS, RECOVERY 30 | |
| 88 | - | COMMUNITY CENTERS , AND PEER RECOVERY SE RVICES: 31 | |
| 79 | + | (2) $18,000,000 FOR FISCAL YEAR 2025; 21 | |
| 89 | 80 | ||
| 90 | - | ( | |
| 81 | + | (3) $21,000,000 FOR FISCAL YEAR 2026; AND 22 | |
| 91 | 82 | ||
| 92 | - | (2) $18,000,000 FOR FISCAL YEAR 2025; 33 | |
| 83 | + | (4) $24,000,000 FOR FISCAL YEAR 2027 AND EACH FISCAL YEAR 23 | |
| 84 | + | THEREAFTER . 24 | |
| 93 | 85 | ||
| 94 | - | (3) $21,000,000 FOR FISCAL YEAR 2026; AND 34 | |
| 86 | + | 15–101. 25 | |
| 87 | + | ||
| 88 | + | (a) In this title the following words have the meanings indicated. 26 | |
| 89 | + | ||
| 90 | + | (A–1) “BEHAVIORAL HEALTH CRI SIS RESPONSE SERVICE S” MEANS 27 | |
| 91 | + | EVIDENCE–BASED RESOURCES DESI GNED TO SERVE INDIVI DUALS EXPERIENCING A 28 | |
| 92 | + | MENTAL HEALTH OR SUB STANCE USE EMERGENCY , INCLUDING: 29 | |
| 93 | + | ||
| 94 | + | (1) CRISIS CALL CENTERS A ND HOTLINE SERVICES ; 30 | |
| 95 | 95 | SENATE BILL 637 3 | |
| 96 | 96 | ||
| 97 | 97 | ||
| 98 | - | (4) $24,000,000 FOR FISCAL YEAR 2027 AND EACH FISCAL YEAR 1 | |
| 99 | - | THEREAFTER . 2 | |
| 98 | + | (2) MOBILE CRISIS SERVICE S; AND 1 | |
| 100 | 99 | ||
| 101 | - | ||
| 100 | + | (3) CRISIS RECEIVING AND STABILIZATION SERVICES. 2 | |
| 102 | 101 | ||
| 103 | - | (a) In this title the following words have the meanings indicated. 4 | |
| 102 | + | (A–2) “CERTIFIED PEER RECOVERY SPECIALIST ” MEANS AN INDIVIDUAL WHO 3 | |
| 103 | + | HAS BEEN CERTIFIED B Y AN ENTITY APPROVED BY THE DEPARTMENT FOR THE 4 | |
| 104 | + | PURPOSE OF PROVIDING PEER SUPPORT SERVICE S, AS DEFINED UNDER § 7.5–101 5 | |
| 105 | + | OF THIS ARTICLE. 6 | |
| 104 | 106 | ||
| 105 | - | (A–1) “BEHAVIORAL HEALTH CRI SIS RESPONSE SERVICE S” MEANS 5 | |
| 106 | - | EVIDENCE–BASED RESOURCES DESI GNED TO SERVE INDIVI DUALS EXPERIENCING A 6 | |
| 107 | - | MENTAL HEALTH OR SUB STANCE USE EMERGENCY , INCLUDING: 7 | |
| 107 | + | [(a–1)] (A–3) “Dental managed care organization” means a pre–paid dental 7 | |
| 108 | + | plan that receives fees to manage dental services. 8 | |
| 108 | 109 | ||
| 109 | - | (1) CRISIS CALL CENTERS A ND HOTLINE SERVICES ; 8 | |
| 110 | + | [(a–2)] (A–4) “Dental services” means diagnostic, emergency, preventive, and 9 | |
| 111 | + | therapeutic services for oral diseases. 10 | |
| 110 | 112 | ||
| 111 | - | (2) MOBILE CRISIS SERVICE S; AND 9 | |
| 113 | + | (E–1) “MEASUREMENT –BASED CARE” MEANS AN EVIDENCE –BASED PRACTICE 11 | |
| 114 | + | THAT INVOLVES THE SY STEMATIC COLLECTION OF DATA TO MONITOR T REATMENT 12 | |
| 115 | + | PROGRESS, ASSESS OUTCOMES , AND GUIDE TREATMENT DECISIONS, FROM INITIAL 13 | |
| 116 | + | SCREENING TO COMPLET ION OF CARE, THAT IS USED TO EVAL UATE: 14 | |
| 112 | 117 | ||
| 113 | - | ( | |
| 118 | + | (1) SYMPTOMS; 15 | |
| 114 | 119 | ||
| 115 | - | (A–2) “CERTIFIED PEER RECOVE RY SPECIALIST” MEANS AN INDIVIDUAL WHO 11 | |
| 116 | - | HAS BEEN CERTIFIED B Y AN ENTITY APPROVED BY THE DEPARTMENT FOR THE 12 | |
| 117 | - | PURPOSE OF PROVIDING PEER SUPPORT SERVICE S, AS DEFINED UNDER § 7.5–101 13 | |
| 118 | - | OF THIS ARTICLE. 14 | |
| 120 | + | (2) FUNCTIONING AND SATIS FACTION WITH LIFE ; 16 | |
| 119 | 121 | ||
| 120 | - | [(a–1)] (A–3) “Dental managed care organization” means a pre–paid dental 15 | |
| 121 | - | plan that receives fees to manage dental services. 16 | |
| 122 | + | (3) READINESS TO CHANGE ; AND 17 | |
| 122 | 123 | ||
| 123 | - | [(a–2)] (A–4) “Dental services” means diagnostic, emergency, preventive, and 17 | |
| 124 | - | therapeutic services for oral diseases. 18 | |
| 124 | + | (4) THE TREATMENT PROCESS . 18 | |
| 125 | 125 | ||
| 126 | - | (E–1) “MEASUREMENT –BASED CARE” MEANS AN EVIDENCE –BASED PRACTICE 19 | |
| 127 | - | THAT INVOLVES THE SY STEMATIC COLLECTION OF DATA TO MONITOR T REATMENT 20 | |
| 128 | - | PROGRESS, ASSESS OUTCOMES , AND GUIDE TREATMENT DECISIONS, FROM INITIAL 21 | |
| 129 | - | SCREENING TO COMPLET ION OF CARE, THAT IS USED TO EVAL UATE: 22 | |
| 126 | + | 15–103. 19 | |
| 130 | 127 | ||
| 131 | - | (1) SYMPTOMS; 23 | |
| 128 | + | (a) (1) The Secretary shall administer the Maryland Medical Assistance 20 | |
| 129 | + | Program. 21 | |
| 132 | 130 | ||
| 133 | - | (2) | |
| 131 | + | (2) The Program: 22 | |
| 134 | 132 | ||
| 135 | - | (3) READINESS TO CHANGE ; AND 25 | |
| 136 | - | ||
| 137 | - | (4) THE TREATMENT PROCESS . 26 | |
| 138 | - | ||
| 139 | - | 15–103. 27 | |
| 140 | - | ||
| 141 | - | (a) (1) The Secretary shall administer the Maryland Medical Assistance 28 | |
| 142 | - | Program. 29 4 SENATE BILL 637 | |
| 133 | + | (xvi) Beginning on January 1, 2021, shall provide, subject to the 23 | |
| 134 | + | limitations of the State budget and § 15–855(b)(2) of the Insurance Article, and as permitted 24 | |
| 135 | + | by federal law, services for pediatric autoimmune neuropsychiatric disorders associated 25 | |
| 136 | + | with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, 26 | |
| 137 | + | including the use of intravenous immunoglobulin therapy, for eligible Program recipients, 27 | |
| 138 | + | if pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections 28 | |
| 139 | + | and pediatric acute onset neuropsychiatric syndrome are coded for billing and diagnosis 29 | |
| 140 | + | purposes in accordance with § 15–855(d) of the Insurance Article; [and] 30 | |
| 141 | + | 4 SENATE BILL 637 | |
| 143 | 142 | ||
| 144 | 143 | ||
| 144 | + | (xvii) Beginning on January 1, 2022, may not include, subject to federal 1 | |
| 145 | + | approval and limitations of the State budget, a frequency limitation on covered dental 2 | |
| 146 | + | prophylaxis care or oral health exams that requires the dental prophylaxis care or oral 3 | |
| 147 | + | health exams to be provided at an interval greater than 120 days within a plan year; AND 4 | |
| 145 | 148 | ||
| 146 | - | (2) The Program: 1 | |
| 149 | + | (XVIII) BEGINNING ON JANUARY 1, 2023, SHALL PROVIDE , 5 | |
| 150 | + | SUBJECT TO THE LIMIT ATIONS OF THE STATE BUDGET , AND AS PERMITTED BY 6 | |
| 151 | + | FEDERAL LAW , REIMBURSEMENT FOR : 7 | |
| 147 | 152 | ||
| 148 | - | (xvi) Beginning on January 1, 2021, shall provide, subject to the 2 | |
| 149 | - | limitations of the State budget and § 15–855(b)(2) of the Insurance Article, and as permitted 3 | |
| 150 | - | by federal law, services for pediatric autoimmune neuropsychiatric disorders associated 4 | |
| 151 | - | with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, 5 | |
| 152 | - | including the use of intravenous immunoglobulin therapy, for eligible Program recipients, 6 | |
| 153 | - | if pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections 7 | |
| 154 | - | and pediatric acute onset neuropsychiatric syndrome are coded for billing and diagnosis 8 | |
| 155 | - | purposes in accordance with § 15–855(d) of the Insurance Article; [and] 9 | |
| 153 | + | 1. SERVICES PROVIDED BY CERTIFIED PEER RECOVERY 8 | |
| 154 | + | SPECIALISTS; 9 | |
| 156 | 155 | ||
| 157 | - | (xvii) Beginning on January 1, 2022, may not include, subject to federal 10 | |
| 158 | - | approval and limitations of the State budget, a frequency limitation on covered dental 11 | |
| 159 | - | prophylaxis care or oral health exams that requires the dental prophylaxis care or oral 12 | |
| 160 | - | health exams to be provided at an interval greater than 120 days within a plan year; AND 13 | |
| 156 | + | 2. MEASUREMENT –BASED CARE PROVIDED IN 10 | |
| 157 | + | BEHAVIORAL HEALTH SE TTINGS, INCLUDING OUTPATIENT MENTAL HEALTH 11 | |
| 158 | + | CENTERS; AND 12 | |
| 161 | 159 | ||
| 162 | - | (XVIII) BEGINNING ON JANUARY 1, 2023, SHALL PROVIDE , 14 | |
| 163 | - | SUBJECT TO THE LIMIT ATIONS OF THE STATE BUDGET , AND AS PERMITTED BY 15 | |
| 164 | - | FEDERAL LAW , REIMBURSEMENT FOR : 16 | |
| 160 | + | 3. BEHAVIORAL HEALTH CRI SIS RESPONSE SERVICE S. 13 | |
| 165 | 161 | ||
| 166 | - | 1. SERVICES PROVIDED BY CERTIFIED PEER RECOV ERY 17 | |
| 167 | - | SPECIALISTS; 18 | |
| 162 | + | 15–141.1. 14 | |
| 168 | 163 | ||
| 169 | - | 2. MEASUREMENT –BASED CARE PROVIDED IN 19 | |
| 170 | - | BEHAVIORAL HEALTH SETTIN GS, INCLUDING OUTPATIENT MENTAL HEALTH 20 | |
| 171 | - | CENTERS; AND 21 | |
| 164 | + | (a) [(1)] In this section [the following words have the meanings indicated. 15 | |
| 172 | 165 | ||
| 173 | - | 3. BEHAVIORAL HEALTH CRI SIS RESPONSE SERVICE S. 22 | |
| 166 | + | (2)], “Collaborative Care Model” means an evidence–based approach for 16 | |
| 167 | + | integrating somatic and behavioral health services in primary care settings that includes: 17 | |
| 174 | 168 | ||
| 175 | - | ||
| 169 | + | [(i)] (1) Care coordination and management; 18 | |
| 176 | 170 | ||
| 177 | - | (a) [(1)] In this section [the following words have the meanings indicated. 24 | |
| 171 | + | [(ii)] (2) Regular, proactive outcome monitoring and treatment for 19 | |
| 172 | + | outcome targets using standardized outcome measurement rating scales and electronic 20 | |
| 173 | + | tools, such as patient tracking; and 21 | |
| 178 | 174 | ||
| 179 | - | (2)], “Collaborative Care Model” means an evidence–based approach for 25 | |
| 180 | - | integrating somatic and behavioral health services in primary care settings that includes: 26 | |
| 175 | + | [(iii)] (3) Regular systematic psychiatric and substance use disorder 22 | |
| 176 | + | caseload reviews and consultation with a psychiatrist, an addiction medicine specialist, or 23 | |
| 177 | + | any other behavioral health medicine specialist as allowed under federal regulations 24 | |
| 178 | + | governing the model. 25 | |
| 181 | 179 | ||
| 182 | - | [( | |
| 180 | + | [(3) “Pilot Program” means the Collaborative Care Pilot Program.] 26 | |
| 183 | 181 | ||
| 184 | - | [(ii)] (2) Regular, proactive outcome monitoring and treatment for 28 | |
| 185 | - | outcome targets using standardized outcome measurement rating scales and electronic 29 | |
| 186 | - | tools, such as patient tracking; and 30 | |
| 182 | + | (b) This section may not be construed to prohibit referrals from a primary care 27 | |
| 183 | + | provider to a specialty behavioral health care provider. 28 | |
| 187 | 184 | ||
| 188 | - | [( | |
| 189 | - | ||
| 185 | + | [(c) There is a Collaborative Care Pilot Program in the Department. 29 | |
| 186 | + | SENATE BILL 637 5 | |
| 190 | 187 | ||
| 191 | 188 | ||
| 192 | - | any other behavioral health medicine specialist as allowed under federal regulations 1 | |
| 193 | - | governing the model. 2 | |
| 189 | + | (d) The purpose of the Pilot Program is to establish and implement a 1 | |
| 190 | + | Collaborative Care Model in primary care settings in which health care services are 2 | |
| 191 | + | provided to Program recipients enrolled in HealthChoice. 3 | |
| 194 | 192 | ||
| 195 | - | | |
| 193 | + | (e) The Department shall administer the Pilot Program. 4 | |
| 196 | 194 | ||
| 197 | - | ( | |
| 198 | - | ||
| 195 | + | (f) (1) The Department shall select up to three sites at which a Collaborative 5 | |
| 196 | + | Care Model shall be established over a 4–year period. 6 | |
| 199 | 197 | ||
| 200 | - | [(c) There is a Collaborative Care Pilot Program in the Department. 6 | |
| 198 | + | (2) The sites selected by the Department shall be adult or pediatric 7 | |
| 199 | + | nonspecialty medical practices or health systems that serve a significant number of 8 | |
| 200 | + | Program recipients. 9 | |
| 201 | 201 | ||
| 202 | - | (d) The purpose of the Pilot Program is to establish and implement a 7 | |
| 203 | - | Collaborative Care Model in primary care settings in which health care services are 8 | |
| 204 | - | provided to Program recipients enrolled in HealthChoice. 9 | |
| 202 | + | (3) To the extent practicable, one of the sites selected by the Department 10 | |
| 203 | + | under paragraph (1) of this subsection shall be located in a rural area of the State. 11 | |
| 205 | 204 | ||
| 206 | - | (e) The Department shall administer the Pilot Program. 10 | |
| 205 | + | (g) The sites selected by the Department under subsection (f) of this section shall 12 | |
| 206 | + | ensure that treatment services, prescriptions, and care management that would be 13 | |
| 207 | + | provided to an individual under the Pilot Program are not duplicative of specialty 14 | |
| 208 | + | behavioral health care services being received by the individual. 15 | |
| 207 | 209 | ||
| 208 | - | ( | |
| 209 | - | ||
| 210 | + | (h) The Department shall provide funding to sites participating in the Pilot 16 | |
| 211 | + | Program for: 17 | |
| 210 | 212 | ||
| 211 | - | ( | |
| 212 | - | ||
| 213 | - | ||
| 213 | + | (1) Infrastructure development, including the development of a patient 18 | |
| 214 | + | registry and other monitoring, reporting, and billing tools required to implement a 19 | |
| 215 | + | Collaborative Care Model; 20 | |
| 214 | 216 | ||
| 215 | - | (3) To the extent practicable, one of the sites selected by the Department 16 | |
| 216 | - | under paragraph (1) of this subsection shall be located in a rural area of the State. 17 | |
| 217 | + | (2) Training staff to implement the Collaborative Care Model; 21 | |
| 217 | 218 | ||
| 218 | - | (g) The sites selected by the Department under subsection (f) of this section shall 18 | |
| 219 | - | ensure that treatment services, prescriptions, and care management that would be 19 | |
| 220 | - | provided to an individual under the Pilot Program are not duplicative of specialty 20 | |
| 221 | - | behavioral health care services being received by the individual. 21 | |
| 219 | + | (3) Staffing for care management and psychiatric consultation provided 22 | |
| 220 | + | under the Collaborative Care Model; and 23 | |
| 222 | 221 | ||
| 223 | - | ( | |
| 224 | - | ||
| 222 | + | (4) Other purposes necessary to implement and evaluate the Collaborative 24 | |
| 223 | + | Care Model. 25 | |
| 225 | 224 | ||
| 226 | - | (1) Infrastructure development, including the development of a patient 24 | |
| 227 | - | registry and other monitoring, reporting, and billing tools required to implement a 25 | |
| 228 | - | Collaborative Care Model; 26 | |
| 225 | + | (i) The Department shall: 26 | |
| 229 | 226 | ||
| 230 | - | (2) Training staff to implement the Collaborative Care Model; 27 | |
| 227 | + | (1) Collaborate with stakeholders in the development, implementation, 27 | |
| 228 | + | and outcome monitoring of the Pilot Program; and 28 | |
| 231 | 229 | ||
| 232 | - | ( | |
| 233 | - | ||
| 230 | + | (2) Collect outcomes data on recipients of health care services under the 29 | |
| 231 | + | Pilot Program to: 30 | |
| 234 | 232 | ||
| 235 | - | (4) Other purposes necessary to implement and evaluate the Collaborative 30 | |
| 236 | - | Care Model. 31 | |
| 237 | - | ||
| 238 | - | (i) The Department shall: 32 6 SENATE BILL 637 | |
| 233 | + | (i) Evaluate the effectiveness of the Collaborative Care Model, 31 | |
| 234 | + | including by evaluating the number of and outcomes for individuals who: 32 | |
| 235 | + | 6 SENATE BILL 637 | |
| 239 | 236 | ||
| 240 | 237 | ||
| 238 | + | 1. Were not diagnosed as having a behavioral health 1 | |
| 239 | + | condition before receiving treatment through the Pilot Program; 2 | |
| 241 | 240 | ||
| 242 | - | | |
| 243 | - | ||
| 241 | + | 2. Were not diagnosed as having a behavioral health 3 | |
| 242 | + | condition before being referred to and treated by a specialty behavioral health provider; 4 | |
| 244 | 243 | ||
| 245 | - | | |
| 246 | - | Pilot Program | |
| 244 | + | 3. Received behavioral health services in a primary care 5 | |
| 245 | + | setting before receiving treatment through the Pilot Program; and 6 | |
| 247 | 246 | ||
| 248 | - | | |
| 249 | - | ||
| 247 | + | 4. Received specialty behavioral health care services before 7 | |
| 248 | + | being identified as eligible to receive treatment through the Pilot Program; and] 8 | |
| 250 | 249 | ||
| 251 | - | 1. Were not diagnosed as having a behavioral health 7 | |
| 252 | - | condition before receiving treatment through the Pilot Program; 8 | |
| 250 | + | [(ii)] (C) [Determine whether to] THE DEPARTMENT SHALL 9 | |
| 251 | + | implement AND PROVIDE REIMBURSEMEN T FOR SERVICES PROVIDE D IN 10 | |
| 252 | + | ACCORDANCE WITH the Collaborative Care Model statewide in primary care settings that 11 | |
| 253 | + | provide health care services to Program recipients. 12 | |
| 253 | 254 | ||
| 254 | - | 2. Were not diagnosed as having a behaviora l health 9 | |
| 255 | - | condition before being referred to and treated by a specialty behavioral health provider; 10 | |
| 255 | + | [(j) The Department shall apply to the Centers for Medicare and Medicaid 13 | |
| 256 | + | Services for an amendment to the State’s § 1115 HealthChoice Demonstration waiver if 14 | |
| 257 | + | necessary to implement the Pilot Program. 15 | |
| 256 | 258 | ||
| 257 | - | 3. Received behavioral health services in a primary care 11 | |
| 258 | - | setting before receiving treatment through the Pilot Program; and 12 | |
| 259 | + | (k) For fiscal year 2020, fiscal year 2021, fiscal year 2022, and fiscal year 2023, 16 | |
| 260 | + | the Governor shall include in the annual budget an appropriation of $550,000 for the Pilot 17 | |
| 261 | + | Program. 18 | |
| 259 | 262 | ||
| 260 | - | 4. Received specialty behavioral health care services before 13 | |
| 261 | - | being identified as eligible to receive treatment through the Pilot Program; and] 14 | |
| 263 | + | (l) On or before November 1, 2023, the Department shall report to the Governor 19 | |
| 264 | + | and, in accordance with § 2–1257 of the State Government Article, the General Assembly 20 | |
| 265 | + | on the Department’s findings and recommendations from the Pilot Program.] 21 | |
| 262 | 266 | ||
| 263 | - | [(ii)] (C) [Determine whether to] THE DEPARTMENT SHALL 15 | |
| 264 | - | implement AND PROVIDE REIMBURS EMENT FOR SERVICES P ROVIDED IN 16 | |
| 265 | - | ACCORDANCE WITH the Collaborative Care Model statewide in primary care settings that 17 | |
| 266 | - | provide health care services to Program recipients. 18 | |
| 267 | + | SUBTITLE 11. HOME– AND COMMUNITY–BASED SERVICES FOR CHILDREN AND 22 | |
| 268 | + | YOUTH. 23 | |
| 267 | 269 | ||
| 268 | - | [(j) The Department shall apply to the Centers for Medicare and Medicaid 19 | |
| 269 | - | Services for an amendment to the State’s § 1115 HealthChoice Demonstration waiver if 20 | |
| 270 | - | necessary to implement the Pilot Program. 21 | |
| 270 | + | 15–1101. 24 | |
| 271 | 271 | ||
| 272 | - | (k) For fiscal year 2020, fiscal year 2021, fiscal year 2022, and fiscal year 2023, 22 | |
| 273 | - | the Governor shall include in the annual budget an appropriation of $550,000 for the Pilot 23 | |
| 274 | - | Program. 24 | |
| 272 | + | (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 25 | |
| 273 | + | INDICATED. 26 | |
| 275 | 274 | ||
| 276 | - | (l) On or before November 1, 2023, the Department shall report to the Governor 25 | |
| 277 | - | and, in accordance with § 2–1257 of the State Government Article, the General Assembly 26 | |
| 278 | - | on the Department’s findings and recommendations from the Pilot Program.] 27 | |
| 275 | + | (B) “FAMILY–CENTERED TREATMENT ” MEANS AN EVIDENCE ‐BASED 27 | |
| 276 | + | PRACTICE USED TO STA BILIZE YOUTH IN THE HOME BY ADDRESSI NG UNDERLYING 28 | |
| 277 | + | FUNCTIONS OF BEHAVIO R IN ORDER TO REDUCE DISRUPTIONS IN THE HOME, 29 | |
| 278 | + | SCHOOL, AND COMMUNITY . 30 | |
| 279 | 279 | ||
| 280 | - | SUBTITLE 11. HOME– AND COMMUNITY–BASED SERVICES FOR CHILDREN AND 28 | |
| 281 | - | YOUTH. 29 | |
| 282 | - | ||
| 283 | - | 15–1101. 30 | |
| 284 | - | ||
| 285 | - | (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 31 | |
| 286 | - | INDICATED. 32 SENATE BILL 637 7 | |
| 280 | + | (C) “FUNCTIONAL FAMILY THE RAPY” MEANS A FAMILY ‐BASED 31 | |
| 281 | + | PREVENTION AND INTER VENTION PROGRAM FOR HIGH–RISK YOUTH THAT 32 SENATE BILL 637 7 | |
| 287 | 282 | ||
| 288 | 283 | ||
| 284 | + | ADDRESSES COMPLEX AN D MULTIDIMENSIONAL P ROBLEMS THR OUGH CLINICAL 1 | |
| 285 | + | PRACTICE THAT IS FLE XIBLY STRUCTURED AND CULTURALLY SENSITIVE . 2 | |
| 289 | 286 | ||
| 290 | - | (B) “FAMILY–CENTERED TREATMENT ” MEANS AN EVIDENCE –BASED 1 | |
| 291 | - | PRACTICE USED TO STA BILIZE YOUTH IN THE HOME BY ADDRESSING UNDERLYING 2 | |
| 292 | - | FUNCTIONS OF BEHAVIO R IN ORDER TO REDUCE DISRUPTIONS IN THE H OME, 3 | |
| 293 | - | SCHOOL, AND COMMUNITY . 4 | |
| 287 | + | (D) “MENTAL HEALTH CASE MA NAGEMENT PROGRAM” MEANS A PROGRAM 3 | |
| 288 | + | THAT PROVIDES AN IDE NTIFIED SUBSET OF WR APAROUND SERVICES . 4 | |
| 294 | 289 | ||
| 295 | - | (C) “FUNCTIONAL FAMILY THE RAPY” MEANS A FAMILY –BASED 5 | |
| 296 | - | PREVENTION AND INTER VENTION PROGRAM FOR HIGH–RISK YOUTH THAT 6 | |
| 297 | - | ADDRESSES COMPLEX AN D MULTIDIMENSIONAL P ROBLEMS THROUGH CLIN ICAL 7 | |
| 298 | - | PRACTICE THAT IS FLE XIBLY STRUCTURED AND CULTURALLY SENSITIVE . 8 | |
| 290 | + | (E) “1915(I) MODEL” MEANS THE 1915(I) INTENSIVE BEHAVIORAL HEALTH 5 | |
| 291 | + | SERVICES FOR CHILDREN, YOUTH, AND FAMILIES PROGRAM ESTA BLISHED UNDER 6 | |
| 292 | + | TITLE 10, SUBTITLE 9, CHAPTER 89 OF THE CODE OF MARYLAND REGULATIONS. 7 | |
| 299 | 293 | ||
| 300 | - | (D) “MENTAL HEALTH CASE MA NAGEMENT PROGRAM ” MEANS A PROGRAM 9 | |
| 301 | - | THAT PROVIDES AN IDE NTIFIED SUBSET OF WR APAROUND SERVICES . 10 | |
| 294 | + | (F) “WRAPAROUND SERVICES ” MEANS SERVICES PROVI DED TO CHILDREN 8 | |
| 295 | + | AND YOUTH WITH INTEN SIVE MENTAL HEA LTH NEEDS AND THEIR FAMILIES IN 9 | |
| 296 | + | THEIR COMMUNITIES , INCLUDING: 10 | |
| 302 | 297 | ||
| 303 | - | (E) “1915(I) MODEL” MEANS THE 1915(I) INTENSIVE BEHAVIORAL HEALTH 11 | |
| 304 | - | SERVICES FOR CHILDREN, YOUTH, AND FAMILIES PROGRAM ESTA BLISHED UNDER 12 | |
| 305 | - | TITLE 10, SUBTITLE 9, CHAPTER 89 OF THE CODE OF MARYLAND REGULATIONS. 13 | |
| 298 | + | (1) INTENSIVE CARE COORDI NATION; 11 | |
| 306 | 299 | ||
| 307 | - | (F) “WRAPAROUND SERVICES ” MEANS SERVICES PROVI DED TO CHILDREN 14 | |
| 308 | - | AND YOUTH WITH INTEN SIVE MENTAL HEALTH NEEDS AND THE IR FAMILIES IN 15 | |
| 309 | - | THEIR COMMUNITIES , INCLUDING: 16 | |
| 300 | + | (2) CHILD AND FAMILY TEAM MEETINGS; AND 12 | |
| 310 | 301 | ||
| 311 | - | (1) INTENSIVE CARE COORDI NATION; 17 | |
| 302 | + | (3) PLANS OF CARE THAT AR E INDIVIDUALIZED TO EACH FAMILY AND 13 | |
| 303 | + | INCLUDE: 14 | |
| 312 | 304 | ||
| 313 | - | (2) CHILD AND FAMILY TEAM MEETINGS; AND 18 | |
| 305 | + | (I) FORMAL SUPPORTS , INCLUDING INDIVID UAL AND FAMILY 15 | |
| 306 | + | THERAPY; AND 16 | |
| 314 | 307 | ||
| 315 | - | (3) PLANS OF CARE THAT AR E INDIVIDUALIZED TO EACH FAMILY AND 19 | |
| 316 | - | INCLUDE: 20 | |
| 308 | + | (II) INFORMAL SUPPORTS , INCLUDING INTENSIVE IN–HOME 17 | |
| 309 | + | SERVICES, RESPITE CARE, MOBILE CRISIS RESPON SE AND STABILIZATION , FAMILY 18 | |
| 310 | + | PEER SUPPORT , EXPERIENTIAL THERAPI ES, AND FLEXIBLE FUNDS F OR GOODS AND 19 | |
| 311 | + | SERVICES THAT ARE ID ENTIFIED IN THE PLAN OF CARE . 20 | |
| 317 | 312 | ||
| 318 | - | (I) FORMAL SUPPORTS , INCLUDING INDIVIDUAL AND FAMIL Y 21 | |
| 319 | - | THERAPY; AND 22 | |
| 313 | + | 15–1102. 21 | |
| 320 | 314 | ||
| 321 | - | ( | |
| 322 | - | SERVICES | |
| 323 | - | ||
| 324 | - | SERVICES | |
| 315 | + | (A) THE DEPARTMENT SHALL ENSU RE THAT C ARE COORDINATORS 22 | |
| 316 | + | DELIVERING SERVICES UNDER THE 1915(I) MODEL OR A MENTAL HEALTH CASE 23 | |
| 317 | + | MANAGEMENT PROGRAM RECEIVE TRAI NING IN THE DELIVERY OF WRAPAROUND 24 | |
| 318 | + | SERVICES. 25 | |
| 325 | 319 | ||
| 326 | - | ||
| 320 | + | (B) THE DEPARTMENT SHALL PROVIDE R EIMBURSEMENT FOR: 26 | |
| 327 | 321 | ||
| 328 | - | ( | |
| 329 | - | ||
| 330 | - | ||
| 331 | - | SERVICES | |
| 322 | + | (1) WRAPAROUND SERVICES DELIVERED BY CARE COORDIN ATORS 27 | |
| 323 | + | UNDER THE 1915(I) MODEL OR A MENTAL HEALTH CASE MANAGEMENT PROG RAM 28 | |
| 324 | + | THAT IS COMMENSURATE WITH IN DUSTRY STANDARDS FOR THE REIMBURSEMENT 29 | |
| 325 | + | OF THE DELIVERY OF WRAPAROUND SERVICES; AND 30 | |
| 332 | 326 | 8 SENATE BILL 637 | |
| 333 | 327 | ||
| 334 | 328 | ||
| 335 | - | (B) THE DEPARTMENT SHALL PROVIDE R EIMBURSEMENT FOR : 1 | |
| 329 | + | (2) INTENSIVE IN–HOME SERVICES DELIVERED BY PROVIDE RS USING 1 | |
| 330 | + | FAMILY–CENTERED TREATMENT , FUNCTIONAL FAMILY TH ERAPY, AND OTHER 2 | |
| 331 | + | EVIDENCE–BASED PRACTICES UNDER THE 1915(I) MODEL THAT IS COMMENSURATE 3 | |
| 332 | + | WITH INDUSTRY STANDA RDS FOR THE REIMBURSEMENT OF THE DELIVERY OF 4 | |
| 333 | + | FAMILY–CENTERED TREATMENT , FUNCTIONAL FAMILY TH ERAPY, AND OTHER 5 | |
| 334 | + | EVIDENCE–BASED PRACTICES . 6 | |
| 336 | 335 | ||
| 337 | - | ( | |
| 338 | - | ||
| 339 | - | ||
| 340 | - | ||
| 336 | + | (C) BEGINNING IN FISCAL YEAR 2023, THE BEHAVIORAL HEALTH 7 | |
| 337 | + | ADMINISTRATION SHALL FUND 100 SLOTS IN THE MENTAL HEALTH CASE 8 | |
| 338 | + | MANAGEMENT PROGRAM F OR CHILDREN OR YOUTH WHO ARE NOT EL IGIBLE FOR 9 | |
| 339 | + | PROGRAM SERVICES AND AT RISK OF OUT–OF–HOME PLACEMENT . 10 | |
| 341 | 340 | ||
| 342 | - | (2) INTENSIVE IN–HOME SERVICES DELIVE RED BY PROVIDERS USI NG 6 | |
| 343 | - | FAMILY–CENTERED TREATMENT , FUNCTIONAL FAMILY TH ERAPY, AND OTHER 7 | |
| 344 | - | EVIDENCE–BASED PRACTICES UNDE R THE 1915(I) MODEL THAT IS COMMEN SURATE 8 | |
| 345 | - | WITH INDUSTRY STANDA RDS FOR THE REIMBURSEMENT OF THE DELIVERY OF 9 | |
| 346 | - | FAMILY–CENTERED TREATMENT , FUNCTIONAL FAMILY TH ERAPY, AND OTHER 10 | |
| 347 | - | EVIDENCE–BASED PRACTICES . 11 | |
| 341 | + | (D) THE GOVERNOR SHALL INCLUD E IN THE ANNUAL OPER ATING BUDGET 11 | |
| 342 | + | BILL THE FOLLOWING A MOUNTS TO FUND CUSTOMIZED GOODS AND SERVICES FOR 12 | |
| 343 | + | YOUTH RECEIVING SERVICES U NDER THE 1915(I) MODEL OR MENTAL HEALTH CAS E 13 | |
| 344 | + | MANAGEMENT PROGRAM : 14 | |
| 348 | 345 | ||
| 349 | - | (C) BEGINNING IN FISCAL Y EAR 2023, THE BEHAVIORAL HEALTH 12 | |
| 350 | - | ADMINISTRATION SHALL FUND 100 SLOTS IN THE MENTAL HEALTH CASE 13 | |
| 351 | - | MANAGEMENT P ROGRAM FOR CHILDREN OR YOUTH WHO ARE NOT ELIGIBLE FOR 14 | |
| 352 | - | PROGRAM SERVICES AND AT RISK OF OUT–OF–HOME PLACEMENT . 15 | |
| 346 | + | (1) $150,000 FOR FISCAL YEAR 2024; 15 | |
| 353 | 347 | ||
| 354 | - | (D) THE GOVERNOR SHALL INCLUD E IN THE ANNUAL OPER ATING BUDGET 16 | |
| 355 | - | BILL THE FOLLOWING A MOUNTS TO FUND CUSTO MIZED GOODS AND SERV ICES FOR 17 | |
| 356 | - | YOUTH RECEIVIN G SERVICES UNDER THE 1915(I) MODEL OR MENTAL HEAL TH CASE 18 | |
| 357 | - | MANAGEMENT PROGRAM : 19 | |
| 348 | + | (2) $250,000 FOR FISCAL YEAR 2025; AND 16 | |
| 358 | 349 | ||
| 359 | - | (1) $150,000 FOR FISCAL YEAR 2024; 20 | |
| 350 | + | (3) $350,000 FOR FISCAL YEAR 2026 AND EACH FISC AL YEAR 17 | |
| 351 | + | THEREAFTER . 18 | |
| 360 | 352 | ||
| 361 | - | ||
| 353 | + | Article – Insurance 19 | |
| 362 | 354 | ||
| 363 | - | (3) $350,000 FOR FISCAL YEAR 2026 AND EACH FISCAL YEAR 22 | |
| 364 | - | THEREAFTER . 23 | |
| 355 | + | 15–717. 20 | |
| 365 | 356 | ||
| 366 | - | Article – Insurance 24 | |
| 357 | + | (A) IN THIS SECTION, “CERTIFIED PEER RECOVERY SPECIAL IST” MEANS AN 21 | |
| 358 | + | INDIVIDUAL WHO HAS B EEN CERTIFIED BY AN ENTITY APPROVED BY T HE 22 | |
| 359 | + | MARYLAND DEPARTMENT OF HEALTH FOR THE PURPOS E OF PROVIDING PEER 23 | |
| 360 | + | SUPPORT SERVICES, AS DEFINED UNDER § 7.5–101 OF THE HEALTH – GENERAL 24 | |
| 361 | + | ARTICLE. 25 | |
| 367 | 362 | ||
| 368 | - | ||
| 363 | + | (B) THIS SECTION APPLIES TO: 26 | |
| 369 | 364 | ||
| 370 | - | (A) IN THIS SECTION, “CERTIFIED PEER RECOV ERY SPECIALIST” MEANS AN 26 | |
| 371 | - | INDIVIDUAL WHO HAS B EEN CERTIFIED BY AN ENTITY APPROVED BY T HE 27 | |
| 372 | - | MARYLAND DEPARTMENT OF HEALTH FOR THE PURPOS E OF PROVIDING PEER 28 | |
| 373 | - | SUPPORT SERVICES , AS DEFINED UNDER § 7.5–101 OF THE HEALTH – GENERAL 29 | |
| 374 | - | ARTICLE. 30 | |
| 375 | - | ||
| 376 | - | (B) THIS SECTION APPLIES TO: 31 | |
| 365 | + | (1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 27 | |
| 366 | + | PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 28 | |
| 367 | + | ON AN EXPENSE –INCURRED BASIS UNDER HEALTH I NSURANCE POLICIES OR 29 | |
| 368 | + | CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 30 | |
| 377 | 369 | SENATE BILL 637 9 | |
| 378 | 370 | ||
| 379 | 371 | ||
| 380 | - | (1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 1 | |
| 381 | - | PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 2 | |
| 382 | - | ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 3 | |
| 383 | - | CONTRACTS THA T ARE ISSUED OR DELI VERED IN THE STATE; AND 4 | |
| 372 | + | (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 1 | |
| 373 | + | HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 2 | |
| 374 | + | CONTRACTS THAT ARE I SSUED OR DELIV ERED IN THE STATE. 3 | |
| 384 | 375 | ||
| 385 | - | (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 5 | |
| 386 | - | HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 6 | |
| 387 | - | CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 7 | |
| 376 | + | (C) IF A POLICY OR CONTRACT SUBJECT TO THIS SECTI ON PROVIDES FOR 4 | |
| 377 | + | REIMBURSEMENT FOR A SERVICE THAT IS WITH IN THE LAWFUL SCOPE OF 5 | |
| 378 | + | ACTIVITIES OF A CERTIFIED PEER RECOVERY SPECIA LIST PROVIDING SERVICES 6 | |
| 379 | + | UNDER THE SUPERVISIO N OF A BEHAVIORAL HEALTH PROGRAM LICENS ED BY THE 7 | |
| 380 | + | SECRETARY OF HEALTH UNDER § 7.5–401 OF THE HEALTH – GENERAL ARTICLE, 8 | |
| 381 | + | THE INSURED OR ANY O THER PERSON COVERED BY THE POLICY OR C ONTRACT IS 9 | |
| 382 | + | ENTITLED TO REIMBURS EMENT FOR THE SERVIC E. 10 | |
| 388 | 383 | ||
| 389 | - | (C) IF A POLICY OR CONTRA CT SUBJECT TO THIS SECTION P ROVIDES FOR 8 | |
| 390 | - | REIMBURSEMENT FOR A SERVICE THAT IS WITH IN THE LAWFUL SCOPE OF 9 | |
| 391 | - | ACTIVITIES OF A CERT IFIED PEER RECOVERY SPECIALIST PROVIDING SERVICES 10 | |
| 392 | - | UNDER THE SUPERVISIO N OF A BEHAVIORAL HE ALTH PROGRAM LICENSE D BY THE 11 | |
| 393 | - | SECRETARY OF HEALTH UNDER § 7.5–401 OF THE HEALTH – GENERAL ARTICLE, 12 | |
| 394 | - | THE INSURED OR ANY O THER PERSON COVERED BY THE POLICY OR CON TRACT IS 13 | |
| 395 | - | ENTITLED TO REIMBURS EMENT FOR THE SERVIC E. 14 | |
| 384 | + | 15–857. 11 | |
| 396 | 385 | ||
| 397 | - | 15–857. 15 | |
| 386 | + | (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 12 | |
| 387 | + | INDICATED. 13 | |
| 398 | 388 | ||
| 399 | - | (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 16 | |
| 400 | - | INDICATED. 17 | |
| 389 | + | (2) “BEHAVIORAL HEALTH CRI SIS RESPONSE SERVICE S” MEANS 14 | |
| 390 | + | EVIDENCE–BASED SERVICES DESIGNED TO SERVE INDIVIDUALS EXPERIENCING A 15 | |
| 391 | + | MENTAL HEALTH OR SUB STANCE USE EMERGENCY , INCLUDING: 16 | |
| 401 | 392 | ||
| 402 | - | (2) “BEHAVIORAL HEALTH CRISI S RESPONSE SERVICES ” MEANS 18 | |
| 403 | - | EVIDENCE–BASED SERVICES DESIG NED TO SERVE INDIVID UALS EXPERIENCING A 19 | |
| 404 | - | MENTAL HEALTH OR SUB STANCE USE EMERGENCY , INCLUDING: 20 | |
| 393 | + | (I) CRISIS CALL CENTERS AND HOTLINE SERVICES; 17 | |
| 405 | 394 | ||
| 406 | - | ( | |
| 395 | + | (II) MOBILE CRISIS SERVIC ES; AND 18 | |
| 407 | 396 | ||
| 408 | - | ( | |
| 397 | + | (III) CRISIS RECEIVING AND STABILIZATION SERVIC ES. 19 | |
| 409 | 398 | ||
| 410 | - | (III) CRISIS RECEIVING AND STABILIZATION SERVIC ES. 23 | |
| 399 | + | (3) “MEASUREMENT –BASED CARE ” MEANS AN EVIDENCE –BASED 20 | |
| 400 | + | PRACTICE THAT INVOLV ES THE SYSTEMATIC CO LLECTION OF DATA TO MONITOR 21 | |
| 401 | + | TREATMENT PROGRESS, ASSESS OUTCOMES , AND GUIDE TREATMENT DECISIONS, 22 | |
| 402 | + | FROM INITIAL SCREENI NG TO COMPLETION OF CARE, THAT IS USED TO EVAL UATE: 23 | |
| 411 | 403 | ||
| 412 | - | (3) “MEASUREMENT –BASED CARE ” MEANS AN EVIDENCE –BASED 24 | |
| 413 | - | PRACTICE THAT INVOLV ES THE SYSTEMATIC CO LLECTION OF DATA TO MONITOR 25 | |
| 414 | - | TREATMENT PROGRESS , ASSESS OUTCOMES , AND GUIDE TREATMENT DECISIONS, 26 | |
| 415 | - | FROM INITIAL SCREENING TO COM PLETION OF CARE , THAT IS USED TO EVAL UATE: 27 | |
| 404 | + | (I) SYMPTOMS; 24 | |
| 416 | 405 | ||
| 417 | - | ( | |
| 406 | + | (II) FUNCTIONING AND SATI SFACTION WITH LIFE ; 25 | |
| 418 | 407 | ||
| 419 | - | ( | |
| 408 | + | (III) READINESS TO CHANGE ; AND 26 | |
| 420 | 409 | ||
| 421 | - | ( | |
| 410 | + | (IV) THE TREATMENT PROCESS. 27 | |
| 422 | 411 | ||
| 423 | - | (IV) THE TREATMENT PROCES S. 31 10 SENATE BILL 637 | |
| 412 | + | (B) THIS SECTION APPLIES TO: 28 | |
| 413 | + | 10 SENATE BILL 637 | |
| 424 | 414 | ||
| 425 | 415 | ||
| 416 | + | (1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT ISSUE 1 | |
| 417 | + | OR DELIVER HEALTH INSURANCE POL ICIES OR CONTRACTS I N THE STATE; AND 2 | |
| 426 | 418 | ||
| 427 | - | (B) THIS SECTION APPLIES TO: 1 | |
| 419 | + | (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 3 | |
| 420 | + | COVERAGE TO INDIVIDUALS OR GR OUPS UNDER CONTRACTS THAT ARE ISSUED OR 4 | |
| 421 | + | DELIVERED IN THE STATE. 5 | |
| 428 | 422 | ||
| 429 | - | (1) INSURERS AND NONPROFIT HEALTH SER VICE PLANS THAT ISSU E 2 | |
| 430 | - | OR DELIVER HEALTH IN SURANCE POLICIES OR CONTRACTS IN THE STATE; AND 3 | |
| 423 | + | (C) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE COVERAGE FOR : 6 | |
| 431 | 424 | ||
| 432 | - | (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 4 | |
| 433 | - | COVERAGE TO INDIVIDU ALS OR GROUPS UNDER CONTRACTS THAT ARE I SSUED OR 5 | |
| 434 | - | DELIVERED IN THE STATE. 6 | |
| 425 | + | (1) BEHAVIORAL HEALTH CRISIS RESPON SE SERVICES; AND 7 | |
| 435 | 426 | ||
| 436 | - | (C) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE COVERAGE FOR : 7 | |
| 427 | + | (2) MEASUREMENT –BASED CARE PROVIDED IN A BEHAVI ORAL 8 | |
| 428 | + | HEALTH SETTING . 9 | |
| 437 | 429 | ||
| 438 | - | | |
| 430 | + | SECTION 2. AND BE IT FURTHER ENACTED, That: 10 | |
| 439 | 431 | ||
| 440 | - | (2) MEASUREMENT –BASED CARE PROVIDED IN A BEHAVIORAL 9 | |
| 441 | - | HEALTH SETTING . 10 | |
| 432 | + | (a) (1) On or before December 1, 2022, the Maryland Department of Health 11 | |
| 433 | + | shall obtain any federal authority necessary to implement a plan for the expansion of 12 | |
| 434 | + | certified community behavioral health clinics in the State, including applying to the 13 | |
| 435 | + | Centers for Medicare and Medicaid Services for an amendment to any of the State’s 1115 14 | |
| 436 | + | waivers or the State plan. 15 | |
| 442 | 437 | ||
| 443 | - | SECTION 2. AND BE IT FURTHER ENACTED, That: 11 | |
| 438 | + | (2) The Department’s implementation plan shall ensure access to certified 16 | |
| 439 | + | community behavioral health clinics in all counties in the State. 17 | |
| 444 | 440 | ||
| 445 | - | (a) (1) On or before December 1, 2022, the Maryland Department of Health 12 | |
| 446 | - | shall obtain any federal authority necessary to implement a plan for the expansion of 13 | |
| 447 | - | certified community behavioral health clinics in the State, including applying to the 14 | |
| 448 | - | Centers for Medicare and Medicaid Services for an amendment to any of the State’s 1115 15 | |
| 449 | - | waivers or the State plan. 16 | |
| 441 | + | (b) The Maryland Department of Health shall review and consider options for 18 | |
| 442 | + | expanding the services provided under § 15–1102 of the Health – General Article, as 19 | |
| 443 | + | enacted by Section 1 of this Act, or adopting other existing programs or services to provide 20 | |
| 444 | + | wraparound services to children and youth with primary substance use disorders. 21 | |
| 450 | 445 | ||
| 451 | - | (2) The Department’s implementation plan shall ensure access to certified 17 | |
| 452 | - | community behavioral health clinics in all counties in the State. 18 | |
| 446 | + | (c) On or before December 1, 2023, the Maryland Department of Health shall 22 | |
| 447 | + | review current eligibility requirements for the model established under § 1915(i) of the 23 | |
| 448 | + | Social Security Act, and mental health case management generally, and submit 24 | |
| 449 | + | recommendations for expanding eligibility and enrollment in these programs to the General 25 | |
| 450 | + | Assembly, in accordance with § 2–1257 of the State Government Article. 26 | |
| 453 | 451 | ||
| 454 | - | (b) (a) The Maryland Department of Health shall review and consider options for 19 | |
| 455 | - | expanding the services provided under § 15–1102 of the Health – General Article, as 20 | |
| 456 | - | enacted by Section 1 of this Act, or adopting other existing programs or services to provide 21 | |
| 457 | - | wraparound services to children and youth with primary substance use disorders. 22 | |
| 452 | + | SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all 27 | |
| 453 | + | policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 28 | |
| 454 | + | after January 1, 2023. 29 | |
| 458 | 455 | ||
| 459 | - | (c) (b) On or before December 1, 2023, the Maryland Department of Health shall 23 | |
| 460 | - | review current eligibility requirements for the model established under § 1915(i) of the 24 | |
| 461 | - | Social Security Act, and mental health case management generally, and submit 25 | |
| 462 | - | recommendations for expanding eligibility and enrollment in these programs to the General 26 | |
| 463 | - | Assembly, in accordance with § 2–1257 of the State Government Article. 27 | |
| 464 | - | ||
| 465 | - | SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all 28 | |
| 466 | - | policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 29 | |
| 467 | - | after January 1, 2023. 30 | |
| 468 | - | ||
| 469 | - | SECTION 2. AND BE IT FURTHER ENACTED, That: 31 | |
| 470 | - | SENATE BILL 637 11 | |
| 471 | - | ||
| 472 | - | ||
| 473 | - | (a) The Maryland Insurance Administration, in consultation with carriers, 1 | |
| 474 | - | behavioral health providers, advocates, and other stakeholders, shall conduct a study on 2 | |
| 475 | - | operational issues related to commercial carrier reimbursement of behavioral health 3 | |
| 476 | - | clinical peer specialists and crisis response services and make recommendations for how to 4 | |
| 477 | - | address these issues. 5 | |
| 478 | - | ||
| 479 | - | (b) On or before November 15, 2022, the Maryland Insurance Administration 6 | |
| 480 | - | shall report the findings and recommendations of the study required under subsection (a) 7 | |
| 481 | - | of this section to the General Assembly, in accordance with § 2–1257 of the State 8 | |
| 482 | - | Government Article. 9 | |
| 483 | - | ||
| 484 | - | SECTION 4. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 10 | |
| 485 | - | October June 1, 2022. 11 | |
| 486 | - | ||
| 487 | - | ||
| 488 | - | ||
| 489 | - | ||
| 490 | - | Approved: | |
| 491 | - | ________________________________________________________________________________ | |
| 492 | - | Governor. | |
| 493 | - | ________________________________________________________________________________ | |
| 494 | - | President of the Senate. | |
| 495 | - | ________________________________________________________________________________ | |
| 496 | - | Speaker of the House of Delegates. | |
| 456 | + | SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 30 | |
| 457 | + | October 1, 2022. 31 |