There is a Behavioral Health Administration in the Department.
The head of the Administration is the Director and shall be appointed by the Secretary.
The Director serves at the pleasure of the Secretary.
The Director is entitled to the salary provided in the State budget.
The Director exercises the powers, duties, and responsibilities of office subject to the authority of the Secretary.
The Director shall report to the Deputy Secretary for Behavioral Health.
The Secretary may exercise any power or perform any duty of the Administration.
The Director is responsible for carrying out the powers, duties, and responsibilities of the Administration.
In addition to the powers set forth elsewhere in this title, the Director may:
Within the amounts made available by appropriation or grant, make any agreement or joint financial arrangement to do or have done anything necessary, desirable, or proper to carry out the purposes of this title and Titles 8 and 10 of this article;
Organize and manage the Administration in a manner that will enable it best to discharge the duties of the Administration;
Appoint the number of assistant directors and staff provided for in the State budget;
Remove an assistant director for incompetence or misconduct; and
Unless expressly provided otherwise by law, assign to any subordinate unit or individual in the Administration any function that is imposed by law on the Director.
In addition to the duties set forth elsewhere in this title, the Director shall do anything necessary or proper to carry out the scope of this title and Titles 8 and 10 of this article.
It is the policy of the State that the Director may collaborate with other State agencies to promote coordinated care and treatment of individuals who have behavioral health disorders.
The Secretary shall provide facilities for the care and treatment of individuals who have mental disorders.
The Administration shall:
Supervise the custody, care, and treatment of individuals in State facilities who have mental disorders;
Provide oversight of community–based services for persons with behavioral health disorders; and
Establish programs for research and development of care and treatment for individuals who have behavioral health disorders.
The Administration may provide funds for a public or nonprofit organization to carry out pilot or demonstration projects relating to individuals who have behavioral health disorders.
The Secretary shall adopt regulations to carry out the provisions of this title and Titles 8 and 10 of this article, including provisions for the issuance of licenses.
The Administration may establish an outpatient civil commitment pilot program to allow for the release of an individual who is involuntarily admitted for inpatient treatment under § 10–632 of this article on condition of the individual’s admission into the pilot program.
If the Administration establishes a pilot program under subsection (a) of this section, the Administration shall:
Adopt criteria an individual must meet in order to be admitted into the pilot program;
Establish application, hearing, and notice requirements;
Specify the rights of an individual who may be or who has been admitted into the pilot program;
Allow an eligible individual to request enrollment into the pilot program; and
Allow an immediate family member of an eligible individual to request that the individual be voluntarily enrolled into the pilot program.
If the Administration establishes a pilot program under subsection (a) of this section, on or before December 1 each year the pilot program is in existence, the Administration shall submit to the Senate Finance Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article, a report that includes:
The number of individuals admitted into the pilot program during the immediately preceding 12–month period;
The number of applications for admission into the pilot program submitted during the immediately preceding 12–month period;
The cost of administering the pilot program for the immediately preceding 12–month period;
For individuals admitted into the program voluntarily and involuntarily:
The percentage of individuals admitted into the pilot program who adhered to the treatment plan established for the individual under the pilot program;
Treatment outcomes; and
The type, intensity, and frequency of services provided to individuals admitted into the pilot program; and
Any other information that may be useful in determining whether a permanent outpatient civil commitment program should be established.
No otherwise–qualified individual with a behavioral health disorder, solely by reason of the individual’s status as an individual with a behavioral health disorder, shall be denied the services of, or be subjected to discrimination by, any public or private hospital or community–based treatment program.
Subject to subsection (b) of this section, the Administration shall establish crisis treatment centers that provide individuals who are in a mental health or substance use disorder crisis with access to clinical staff who:
Perform assessments and level of care determinations 24 hours a day and 7 days a week; and
Connect the individuals to care immediately.
At least one crisis treatment center shall be established on or before June 1, 2018.
The Administration shall establish the crisis treatment centers required under subsection (a) of this section in a manner that is consistent with the strategic plan developed by the Behavioral Health Advisory Council, as required by Chapters 405 and 406 of the Acts of the General Assembly of 2016.
On or before September 1, 2017, and on or before September 1 each year thereafter until the Administration establishes the crisis treatment centers required under subsection (a) of this section, the Administration shall submit, in accordance with § 2–1257 of the State Government Article, a report on the status of the establishment of crisis treatment centers under this section to the Joint Committee on Behavioral Health and Opioid Use Disorders.
In this section the following words have the meanings indicated.
“Mobile crisis team” has the meaning stated in § 10–1401 of this article.
“Program” means the Behavioral Health Crisis Response Grant Program.
There is a Behavioral Health Crisis Response Grant Program in the Department.
The purpose of the Program is to provide funds to local jurisdictions to establish and expand community behavioral health crisis response systems.
The Department shall administer the Program.
The Program shall award competitive grants to local behavioral health authorities to establish and expand behavioral health crisis response programs and services that:
Serve local behavioral health needs for children, adults, and older adults;
Meet national standards;
Integrate the delivery of mental health and substance use treatment; and
Connect individuals to appropriate community–based care in a timely manner on discharge.
Funds distributed to a local behavioral health authority under the Program:
May be used to establish or expand behavioral health crisis response programs and services, such as:
Mobile crisis teams;
On–demand walk–in services;
Crisis residential beds; and
Other behavioral health crisis programs and services that the Department considers eligible for Program funds; and
Shall be used to supplement, and not supplant, any other funding for behavioral health crisis response programs and services.
A local behavioral health authority may submit a proposal requesting Program funding to the Department.
In awarding grants under this section, the Department shall prioritize proposals that:
Make use of more than one funding source;
Demonstrate efficiency in service delivery through regionalization, integration of the behavioral health crisis program or service with existing public safety and emergency resources, and other strategies to achieve economies of scale;
Serve all members of the immediate community with cultural competency and appropriate language access;
Commit to gathering feedback from the community on an ongoing basis and improving service delivery continually based on this feedback;
Demonstrate strong partnerships with community services that include family member and consumer advocacy organizations and regional stakeholders;
Evidence a plan of linking individuals in crisis to peer support and family support services after stabilization; and
Evidence a strong plan for integration into the existing behavioral health system of care and supports to provide seamless aftercare.
In awarding grants under this section, the Department shall require that proposals contain response standards that prioritize mobile crisis units over law enforcement when responding to individuals in crisis.
For each service or program that receives funding under the Program, a local behavioral health authority shall report to the Department and make available to the public all:
Outcome measurement data required by the Department; and
Public feedback received from the community through a combination of surveys, public comments, town hall meetings, and other methods.
The Department shall establish:
Application procedures;
A statewide system of outcome measurement to:
Assess the effectiveness and adequacy of behavioral health crisis response services and programs; and
Produce data that shall be:
Collected, analyzed, and publicly reported back at least annually; and
Disaggregated by race, gender, age, and zip code;
Guidelines that require programs to bill third–party insurers and, when appropriate, the Maryland Medical Assistance Program; and
Any other procedures or criteria necessary to carry out this section.
The Governor shall include in the annual operating budget bill the following amounts for the Program:
$3,000,000 for fiscal year 2020;
$4,000,000 for fiscal year 2021;
$5,000,000 for fiscal year 2022;
$5,000,000 for fiscal year 2023;
$5,000,000 for fiscal year 2024;
$5,000,000 for fiscal year 2025; and
$5,000,000 for each of fiscal years 2027 through 2029.
Beginning in fiscal year 2023, at least one–third of the appropriation required under subsection (e) of this section shall be used to award competitive grants for mobile crisis teams.
On or before December 1 each year beginning in 2020, the Department shall submit to the Governor and, in accordance with § 2–1257 of the State Government Article, to the General Assembly a report that includes, for the most recent closed fiscal year:
The number of grants distributed;
Funds distributed by county;
Information about grant recipients and programs and services provided; and
Outcome data reported under the statewide system of measurement required in subsection (d)(7)(ii) of this section.
In consultation with interested stakeholders, the Director shall prepare an annual report on behavioral health services for children and young adults in the State.
The report shall include:
The number and the percentage of children and young adults who, during the reported year:
Were eligible for public behavioral health services;
Used a public behavioral health service, including:
An outpatient service;
An inpatient service;
An emergency room service;
A residential treatment center service;
An intensive public behavioral health service, including targeted or mental health case management services, respite care services, services provided under § 1915(i) of the Social Security Act, and psychiatric rehabilitation services; and
A substance–related disorders program service; and
Used a public behavioral health service provided through telehealth;
The total expenditure and expenditure per child and young adult using a public behavioral health service, including:
An outpatient service;
An inpatient service;
An emergency room service;
A residential treatment center service;
An intensive community service; and
A substance–related disorders program service;
The total cost per child or young adult for all behavioral health services provided to the child or young adult;
The total expenditure and expenditure per child and young adult for:
Targeted case management services;
Respite care services;
Services provided through a plan under § 1915(i) of the Social Security Act; and
Psychiatric rehabilitation services;
The median length of time children and young adults spent:
In the hospital emergency room pending psychiatric inpatient hospitalization; and
Waiting for placement in a residential treatment center from the date of the referral, as determined by the referral source, to the date of the placement;
The number of children and young adults who were readmitted within 30 days at:
The same hospital;
The same residential treatment center; or
Any other hospital or residential treatment center;
The median length of stay for children and young adults at:
A residential treatment center;
A psychiatric unit at a hospital; and
A residential substance–related disorders program; and
For residential treatment centers:
The total number of children and young adults admitted during the report year; and
The total number of children and young adults discharged
during the report year.
The report shall group the information required under subsection (b) of this section by jurisdiction and by the following age groups:
Birth through 6 years old;
7 through 12 years old;
13 through 17 years old;
18 through 21 years old; and
22 through 25 years old.
The report shall group the information required under subsection (b) of this section by the following races and ethnic groups:
Hispanic or Latino of any race; and
For individuals who are non–Hispanic or non–Latino:
American Indian or Alaskan Native;
Asian;
Black or African American;
Native Hawaiian or other Pacific Islander;
White; or
Two or more races.
On or before December 1 each year, the Director shall submit the report required under this section to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly.
In this section the following words have the meanings indicated.
“Eligible individual” means:
A service member;
A veteran;
The spouse of a service member or veteran;
A child of a service member or veteran; or
A stepchild of a service member or veteran.
“Program” means the Sheila E. Hixson Behavioral Health Services Matching Grant Program for Service Members and Veterans.
There is a Sheila E. Hixson Behavioral Health Services Matching Grant Program for Service Members and Veterans.
The purpose of the Program is to provide funds to local nonprofit organizations to establish and expand community behavioral health programs to serve service members, veterans, and their families.
The Department shall administer the Program.
The Program shall award competitive matching grants to local nonprofit organizations to establish and expand community behavioral health programs that:
Serve the behavioral health needs of eligible individuals in the locality served by the nonprofit organization;
Meet national standards;
Integrate the delivery of mental health and substance use treatment; and
Connect eligible individuals to appropriate community–based care in a timely manner on discharge from the community behavioral health program.
To be eligible for a grant from the Program, a nonprofit organization must have a mission to:
Provide behavioral health services; or
Provide services to active service members, veterans, or their families.
An eligible nonprofit organization shall secure contributions for the proposal in an amount of money or other consideration at least equal in value to the amount of money requested from the Program.
In awarding matching grants under the Program, the Department shall develop selection criteria for evaluating applicant proposals.
The selection criteria developed under this paragraph shall include positive scoring for proposals that:
Demonstrate fiscal controls, including by making use of multiple sources of funding;
Evidence project effectiveness, including by showing how the grant awarded by the Program will be used to augment existing services to create seamless behavioral health treatment;
Show an applicant’s previous successful experience administering grants; and
Meet any other criteria the Department considers relevant.
In awarding matching grants under this section, the Department shall give priority to proposals that best meet the selection criteria regardless of the projected cost.
The Department shall establish application procedures that implement the requirements of this subsection.
The Department shall establish a statewide system of outcome measurement to assess the effectiveness and adequacy of services provided by each nonprofit organization receiving a matching grant under the Program.
A nonprofit organization receiving a matching grant under the Program shall submit any information that the Department determines is necessary for the statewide system of outcome measurement.
The Department shall establish:
Guidelines that require nonprofit organizations that receive a matching grant under the Program to bill third–party insurers and, when appropriate, the Maryland Medical Assistance Program; and
Any other procedures necessary to carry out this section.
Beginning in fiscal year 2022, and each fiscal year thereafter, the Governor may include in the annual budget bill an appropriation of $2,500,000 for the Program.
On or before December 1 each year, beginning in 2023, the Department shall submit to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly a report that includes, for the most recently closed fiscal year:
The number of grants distributed;
Funds distributed by county;
Information about grant recipients and the services provided through grant funding; and
Outcome data reported under the statewide system of measurement required under subsection (f) of this section.