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Maryland Department of Health Plan to Improve Court-Ordered Evaluations and Placements Garners Praise
Key stakeholders have positive feedback for department’s work to mitigate decade-long issue and improve care
With patient care and recovery the priority, the Maryland Department of Health is making monumental strides on court-ordered evaluations and placements:
  • The Department introduced powerful legislation to address structural issues that contribute to delays in the court-ordered placements process, addressing more than a decade-long issue.
  • In the report before the joint committees, the Department laid out a number of transformative initiatives and administrative actions to reverse backlogs involving individuals requiring court-ordered placement for mental illness treatment at its hospitals.
  • The Department formed a workgroup to assess, make improvement recommendations, and devise solutions to this problem.
  • Over the past year, the Department worked in earnest to implement the recommendations as well as expand capacity to improve customer service and restore partnerships.
  • The actions taken by the Department will result in 95 new beds being added for court-ordered placements by April 2018.
  • The Department strives to make all placements as soon as possible upon receipt of the court’s order and well within the required 21 days.
  • “We’ve worked hard to usher in a new spirit of bipartisan cooperation in Annapolis and to create an environment of trust and cooperation where the best ideas rise to the top based upon their merit regardless of which side of the aisle they come from. By this April, we will have added nearly 100 new treatment beds to our system, both at state hospitals and through public-private partnerships with local hospitals.” — Department Secretary Robert Neall
  • “This is a longstanding problem and one that the Department has worked hard to address,” said Neall. “We are committed to delivering the right care, in the right environment, for the right period of time across our entire system of care.” — Department Secretary Robert Neall

The Department is committed to:
Providing treatment in the least restrictive environment appropriate for each individual:
  • “Praises to the Department for its screening and its doctors.  Very clear information from local evaluators … excellent opinions.” — Judge George Lipman
  • “MDH worked very hard to remedy this situation.” — Judge George Lipman
  • “Compliments to the Department for its hard work.” — Judge George Lipman
  • “Over the past 1 or 2 months the Department has made some positive strides and has been sincere in getting this in order.” — Delegate Barron 
Operating an integrated system of care that encompasses a range of services across a variety of environments:
  • “All the actors – State and County government employees all agree that addressing the needs of these individuals is paramount; not just under the law.” — Chief Judge John Morrissey
Leveraging community provided services that have become the leading practice nationally over recent decades, in order to develop a true patient-first, efficient infrastructure:
  • “I applaud Dr. Bazron and the Department of Health for responding and creating the efficiencies in the system. Did an incredible job.” — Robert Green, Director, Montgomery County Department of Corrections
  • “A lot of praise and respect needs to go to the Department. They have addressed the issues and have reduced the number of days mentally ill are being held by bringing in new staff.” — Senator Thomas “Mac” Middleton
  • “I want to commend Secretary Neall, Webster Ye, Dennis Schrader and staff for working hard. Met a dozen times over the last year and give them credit for bringing the times down.” — Chief Judge John Morrissey, Maryland District Court
  • “The Department has made great strides in the last 6 months.” — Judge George Lipman

Over the past year, the Department has worked tirelessly to improve court-ordered evaluations and placements. Efforts made by the Department include:
  • The wait list has been cut roughly in half (more than half relative to the summertime peak) while also cutting cycle times roughly in half.
  • Expanded bed capacity across the entire hospital system to mitigate wait times and to make placements within 30 days or less.
  • Have met and fulfilled the 21-day requirement for placement for 8-507 orders, achieving vast improvement since FY17.
  • Promote a culture of workplace safety for employees, achieving a 28% reduction in “struck by patient or third party” injury claims at Behavioral Health Administration hospitals from FY15 to FY17.
  • Addressed identified issues in discharge policies and practices so as to improve the rate of placement back into the community.
  • Launched its Centralized Admissions Office on Oct. 13, 2017. This office will serve as the single point of contact to process all court ordered patients to the Department for evaluation and treatment services for substance use disorders or mental health issues.
  • Enlisted a range of stakeholders (the courts, advocacy groups, providers, clinicians, and counsel) to assess and recommend a modernized evaluation method for competence to stand trial, and criminal responsibility from the perspective of consistent, effective care for patients in different court settings (so-called definitive vs. screening methods).
  • Revised triaging policy and prioritized individuals for placements into the treatment beds operated by the Department and its newly enlisted community partners.
  • Enabled “real-time” bed management from the previous decades-old system for the Department hospitals. With this new system, the Department can now support the revised admissions policy, engage in productive dialog with customers, and manage the hospital system more efficiently and effectively.
  • The Department has a renewed commitment to improving customer service and in partnership and collaboration with stakeholders for delivering the right care, in the right environments, for the right period of time — across the whole system of care.
The full hearing on HB111 can be found here.