Prepared by Joe Adams, M.D., Chair, MDDCSAM Public Policy Committee
(Testimony from prior years is under ‘2021’, '2020' or the ‘Archive’ section). See the links to MDDCSAM testimony. MDDCSAM’s position is indicated by ‘Support,’ ‘Oppose,’ or ‘Letter of Information.’ Any oral testimony can be viewed at the Maryland General Assembly's website. A plain English summary is generally available under the “Fiscal and Policy Note” for each bill.
This is the only cannabis legalization bill that establishes a Cannabis Public Health Advisory Council. MDDCSAM called for (1) further strengthening public health provisions and (2) conflict-of-interest provisions as guardrails against the future regulatory influence of an increasingly consolidated cannabis industry. MDDCSAM informally praised the decriminalization/expungement provisions.
For the cannabis legalization bills below, MDDCSAM plans to take a similar approach:
- SB 692 Cannabis Legalization (and Reparations for the War on Drugs Act)
- SB 833 Cannabis Legalization and Regulation
- HB 1342 Cannabis - Legalization and Regulation (Cannabis Legalization and Equity Act).
PARITY OF SUD INSURANCE COVERAGE
Establishes a consumer support program for all Marylanders, regardless of insurance coverage, to get overcome the major barriers that often prevent accessing behavioral health care. Also collects data and facilitates reporting grievances when covered services appear to be unavailable. This is a priority of the Maryland Parity Coalition, of which MDDCSAM is a member.
HB 912 / SB 707 SUPPORT Health Insurance – Provider Panels – Coverage for Nonparticipation
Carriers are required by law to provide covered behavioral health services to their members, but in practice, they often do not. When consumers get permission to see an out-of-network provider, due to limited in-network availability, they receive an unexpected, sometimes unaffordable bill, even though the service was supposed to be covered. This creates a significant barrier to access to behavioral health services. The bill requires carriers to hold members harmless for the carriers' inadequate behavioral health networks. This is a priority of the Maryland Parity Coalition, of which MDDCSAM is a member.
HB 971 SUPPORT Substance Abuse Treatment - Network Adequacy
Requires the Maryland Department of Health to ensure that Maryland Medicaid has an adequate network of providers to provide alcohol and drug abuse treatment for children under the age of 18 years.
HB 1054 / SB 784 LIKELY SUPPORT Criminal Law - Use or Possession of a Controlled Dangerous Substance - De Minimis Quantity
Decriminalizes possession of small amounts of various drugs, as in Portugal and Oregon State. Supported by both MDDCSAM and MedChi in the past.
MDDCSAM has supported this bill in years past; this would make Syringe Service Programs more effective. Among other benefits, these programs can refer patients to treatment, prevent infectious disease, and reduce the risk of overdose. Decriminalization of possession of paraphernalia also reduces other significant harms to people who use drugs.
HB 190 SUPPORT Criminal Procedure - Medical Emergency - Immunity. ("Good Samaritan Act")
Would help to reduce overdose deaths by expanding legal immunity for possible past legal violations identified as the result of calling for help for medical emergencies involving the ingestion of alcohol or drugs.
This bill prohibits overdose information reported by an emergency medical services (EMS) provider or by the Maryland Institute for Emergency Medical Services Systems (MIEMSS) from being obtained by a law enforcement officer as part of a criminal investigation or prosecution.
Expands data-driven measurement-based care, care coordination in primary care settings, the peer support workforce, care for children and youth, crisis services, and Certified Community Behavioral Health Clinics (CCBHCs). This is a top priority of the Maryland Behavioral Health Coalition, of which MDDCSAM is a member.
This is likely to benefit many of our patients who experience substance use disorder.
HB 496 SUPPORT Labor and Employment - Family and Medical Leave Insurance Program - Establishment. See above
Eliminates the requirement for prior authorization for medications for opioid use disorder in the Medical Assistance program. MDDCSAM helped to eliminate this barrier in commercial insurance in 2017. This may help alleviate the shortage of providers involved in the treatment of OUD, and would tend to reduce barriers generally.
Maryland is currently one of only 3 states that do not cover dental care.
Designates 988 to be the phone number for Maryland’s suicide prevention and behavioral health crisis hotline, part of a national program due to become available in July 2022. The bill establishes a sustainable funding source to cover implementation and coordination with existing call centers and other crisis services in Maryland.
Requires that grants awarded for crisis response proposals would give preference to those that minimize law enforcement interaction for individuals in crisis. This would also be expected to increase referrals to the most appropriate crisis or treatment service, rather than to the ED, where appropriate.
TOBACCO AND ALCOHOL
Local control, i.e. the opposite of "pre-emption," is an important and well-established principle regarding public health regulations.
Authorizes pharmacists to prescribe and dispense nicotine replacement products.
Authorizes a local licensing board to issue a Class A beer or beer and wine license to sell alcohol in certain grocery establishments.
If approved by voters, would authorize a retail grocery establishment to obtain a license to sell beer and wine, prioritizing areas with a lack of affordable healthy food options.
Establishes a state-wide Suicide Fatality Review Committee to identify factors and possible means of preventing suicide, as used effectively in other states.
Would grant clinical nurse specialists the authority to write prescriptions for the first time.
Prohibits overdose information reported in an emergency by an emergency medical services provider or the Maryland Institute for Emergency Medical Services Systems from being obtained by a law enforcement officer as part of a criminal investigation or prosecution.
Maryland's share of opioid restitution funds, from legal settlements, is ultimately expected to be up to approximately $500 million dollars. In Maryland, this must be used only for opioid-related programs and services. Many advocates feel that an Advisory Council is needed to ensure transparent and effective use of these funds.
Optum, the ASO, administers Maryland's public behavioral health system. It has been unable to track payments for the last two years and is now requiring certain providers to pay them for estimated reimbursements which they say were excessive. However, they are still unable to provide reconciliation data, which may be unreliable. Per this bill, if an independent audit is unable to provide this information (at Optum's expense), providers would not be required to make these questionable payments to Optum.
Would establish the Career Pathways for Health Care Workers Program in the MD Dept of Labor to provide grants to employers for training programs attended by health care workers.
Establishes the Qualified Resident State Subsidy Program for State premium assistance and cost-sharing reductions through the MD Health Benefit Exchange. This would be dependent on a Maryland being granted a federal waiver for the use of federal funds. A qualified resident is not eligible for the federal advanced premium tax credit (APTC), Medicaid or the Maryland Children’s Health Program, Medicare, or employer-sponsored minimum essential coverage.
Would require the MD Medical Assistance Program to provide comprehensive medical care and other health care services to noncitizen pregnant women who would qualify for the Program but for their immigration status and their children up to the age of 1 year.