In this subtitle the following words have the meanings indicated. “Behavioral health” includes substance–related disorders, addictive disorders, mental disorders, life stressors and crises, and stress–related physical symptoms. “Commission” means the Commission on Behavioral Health Care Treatment and Access.

There is a Commission on Behavioral Health Care Treatment and Access, which shall meet jointly with the Behavioral Health Advisory Council.

The Commission consists of the following members: One member of the Senate of Maryland, appointed by the President of the Senate; One member of the House of Delegates, appointed by the Speaker of the House; One representative of Maryland’s Congressional Delegation; The Secretary of Health, or the Secretary’s designee; The Secretary of Human Services, or the Secretary’s designee; The Secretary of Juvenile Services, or the Secretary’s designee; The Deputy Secretary for Behavioral Health, or the Deputy Secretary’s designee; The Maryland Insurance Commissioner, or the Commissioner’s designee; The Executive Director of the Health Services Cost Review Commission, or the Executive Director’s designee; The Executive Director of the Maryland Health Care Commission, or the Executive Director’s designee; The Executive Director of the Maryland Community Health Resources Commission, or the Executive Director’s designee; The Executive Director of the State–designated health information exchange, or the Executive Director’s designee; The Executive Director of the Governor’s Office of Crime Prevention and Policy, or the Executive Director’s designee; The Secretary of the Maryland Department of Disabilities, or the Secretary’s designee; The Secretary of the Department of Public Safety and Correctional Services, or the Secretary’s designee; The Special Secretary of the Governor’s Office for Children, or the Special Secretary’s designee; The Special Secretary of Opioid Response, or the Special Secretary’s designee; The Secretary of Aging, or the Secretary’s designee; and The following members appointed by the Governor: One representative of the Mental Health Association of Maryland; One representative of the National Alliance on Mental Illness; One representative of the Community Behavioral Health Association of Maryland; One representative of a provider of residential behavioral health services; One representative of an acute care hospital; One representative of an inpatient psychiatric hospital; One individual with experience as a consumer of behavioral health services; One family member of an individual with experience as a consumer of behavioral health services; One representative of a provider of substance use treatment services; One representative of a school–based health center; One individual with expertise in social determinants of health; One individual with expertise in health economics; One representative of a health insurance carrier; One representative of a managed care organization; One representative from the Office of the Public Defender; One representative of the Developmental Disability Coalition; One representative of the Maryland Chapter of the National Council on Alcoholism and Drug Dependence; One representative of the Maryland Psychological Association; One representative of Disability Rights Maryland; One representative of a Federally Qualified Health Center; One representative of a local behavioral health authority; One individual with an intellectual disability who uses self–directed behavioral health services; and One representative of the Maryland State’s Attorneys’ Association. To the extent practicable, the membership of the Commission shall reflect the geographic and ethnic diversity of the State. The Governor, the President of the Senate, and the Speaker of the House jointly shall designate the chair of the Commission. The Department shall provide staff for the Commission. A member of the Commission: May not receive compensation as a member of the Commission; but Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget. The Commission shall meet at least three times per year at the times and places determined jointly by the Commission and the Behavioral Health Advisory Council.

The purpose of the Commission is to make recommendations to provide appropriate, accessible, and comprehensive behavioral health services that are available on demand to individuals in the State across the behavioral health continuum.

The Commission shall: Conduct an assessment of behavioral health services in the State to identify needs and gaps in services across the continuum, including community–based outpatient and support services, crisis response, and inpatient care; Examine the methods for reimbursing behavioral health care services in the State and make recommendations on the most effective forms of reimbursement to maximize service delivery; Compile findings of State–specific needs assessments related to behavioral health care services; Review recommendations and reports of State commissions, workgroups, or task forces related to behavioral health care services; Conduct a needs assessment on the State’s behavioral health care workforce to identify gaps and make recommendations to ensure an adequate, culturally competent, and diverse workforce across the behavioral health care continuum; Review trends and best practices from other states regarding policy and reimbursement strategies that support access to a comprehensive array of services and ensure quality of care; Examine and make recommendations related to the behavioral health of the geriatric and youth populations in the State; Examine and make recommendations to provide appropriate and adequate behavioral health services to individuals with developmental disabilities and complex behavioral health needs, specifically youth; Assess the health infrastructure, facilities, personnel, and services available for the State’s forensic population and identify deficiencies in resources and policies needed to prioritize health outcomes, increase public safety, and reduce recidivism; Make recommendations on expanding behavioral health treatment access for the State’s court–ordered population; Make recommendations on action plans regarding the behavioral health care system’s capacity to prepare for and respond to future challenges affecting the entire State or particular regions or populations in the State, including pandemics and extreme weather events; Make recommendations to ensure that behavioral health treatment is provided in the appropriate setting, including methods to divert behavioral health patients from emergency departments by using the Maryland Mental Health and Substance Use Disorder Registry and Referral System established under § 7.5–802 of this article and 2–1–1; Examine and review the use of harm reduction strategies to facilitate access to care; Examine methods to assist consumers in accessing behavioral health services; and Make, in coordination with the Behavioral Health Advisory Council, recommendations regarding the continuation of the State’s behavioral health carve–out and the financing structure and quality oversight necessary to integrate somatic and behavioral health services and ensure compliance with the Mental Health Parity and Addiction Equity Act in the Maryland Medical Assistance Program.

The Commission shall establish the following workgroups: Geriatric behavioral health; Youth behavioral health, individuals with developmental disabilities, and individuals with complex behavioral health needs; Criminal justice–involved behavioral health; Behavioral health workforce development, infrastructure, coordination, and financing; and Improvement of health, social, and economic outcomes related to substance use. The workgroup required under subsection (a)(5) of this section shall: Evaluate and review: The availability, affordability, and accessibility of treatment for substance use disorder and recovery support services, including housing and employment services, in the State; The number and percentage of individuals who are directed to services described in item (i) of this item by the criminal justice system of the State; The health outcomes after receiving services described in item (i) of this item disaggregated by whether the services were sought voluntarily or mandated by the criminal justice system of the State; The impact of current criminal justice involvement related to substance use in the State on the health and well–being of individuals, families, and communities; The cost to the State and local governments resulting from current criminal justice involvement related to substance use in the State; The equitable application of current criminal justice involvement related to substance use in the State; The current research on the efficacy of voluntary treatment for substance use disorder compared to treatment mandated by criminal justice systems, including criminal justice systems outside the State; and The availability and accessibility of data on the issues enumerated in this item; Evaluate and review the Department’s regulations on the standards for the discharge of patients from substance use treatment programs to assess whether the standards adequately consider the patient’s mental health or substance use disorder diagnosis and the impact of the discharge standards on the patient; and Make recommendations on changes to State laws, policies, and practices needed to mitigate the harms related to the criminalization of substance use with the goal of improving the public health and safety of residents of the State; and Make recommendations on changes to State laws, policies, and practices related to the discharge of patients from substance use treatment programs to consider the patient’s mental health or substance use disorder diagnosis in making an appropriate placement. The workgroups established under subsection (a) of this section shall meet at least two times per year at the times and places determined by the workgroup. The workgroups established under subsection (a) of this section shall include members of the Commission and may include individuals invited by the Commission or the Behavioral Health Advisory Council to serve on the workgroup. On or before July 1 each year, beginning in 2024, the workgroups established under subsection (a) of this section shall report and make recommendations to the Commission and the Behavioral Health Advisory Council.

On or before January 1 each year, beginning in 2024, the Commission, in coordination with the Behavioral Health Advisory Council, shall report to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly on the Commission’s findings and recommendations, including funding and legislative recommendations, that are consistent with providing appropriate, accessible, and comprehensive behavioral health services that are available on demand to individuals in the State across the behavioral health continuum. Any legislative recommendations included in the report required under paragraph (1) of this subsection that require funding shall include an estimate of the funding required to implement the recommendation and information that supports the funding estimate. The report required on or before January 1, 2024, shall include the findings of the needs assessments required under § 13–4805 of this subtitle. On or before July 1, 2025, the Commission, in coordination with the Behavioral Health Advisory Council, shall report to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly on the Commission’s findings and recommendations regarding the continuation of the State’s behavioral health carve–out and the financing structure and quality oversight necessary to integrate somatic and behavioral health care services in the Maryland Medical Assistance Program.