The segments below provide a brief overview of MACo’s work in the area of health and human services in the 2023 General Assembly.
Each county in Maryland has a local health department that plays a role in providing essential public health services to residents, even more so during the COVID-19 pandemic. They are also county agencies that provide human or citizen services for children, families, and persons with special needs. MACo advocates actively for policies that continue to confront the opioid crisis and to support county health and social service programs.
In addition to the swearing-in of a new governor, the 445th legislative session kicked off with more relaxed health and safety measures compared to the turbulence of the last few years. This enabled MACo’s policy team to dynamically engage with private-sector stakeholders, legislators, and representatives from all divisions of government. Under these more conventional circumstances, MACo’s advocacy led to a plethora of favorable outcomes for its members.
MACo supported HB 823/SB 480 – Mental Health Law – Assisted Outpatient Treatment Programs. This is legislation that would enable county governments to establish an Assisted Outpatient Treatment (AOT) program for individuals suffering from severe and persistent mental illness. To date, AOT programs have been established in 47 states and the District of Columbia because they are found to divert individuals who need intensive mental health treatment away from hospitals, jails, and homeless shelters. Funneling eligible individuals into these programs would preserve county and state resources in these facilities to be utilized for their intended purposes, while also facilitating the appropriate care for an individual in need. 75 pieces of testimony, both written and oral, were submitted with only 13 requests for an unfavorable report. A stakeholders workgroup was appointed in late March by HGO Chair Del. Peña-Melnyk, spearheaded by Delegate Bagnall, in order to find common ground between the advocates and the opposition, but a resolution did not materialize in time. HB 823/SB 480 failed but not without a letter of information from the Moore-Miller administration, via the Maryland Department of Health, expounding the merits of AOT and commitment to issue a report during the interim with recommendations for the 2024 session.
MACo opposed SB 503/HB 762 – Criminal Procedure – Child Advocacy Centers – Care Providers. This is legislation that would mandate several procedures by Child Advocacy Centers, including written notice to clients within 48 hours of when a change in health care provider is going to take place. For the multiple county governments and law enforcement agencies that operate these centers, the bill mistakenly placed obligations on a party that does not oversee the functions described. SB 503/HB 762 failed despite a late session effort to negotiate a stakeholders agreement with revised requirements, but the group could not come to an understanding on the existing problem.
MACo supported HB 11/SB 483 – Private Well Safety Act of 2023. This is legislation that would create the Private Well Safety Program and Fund, to be Administered by the Maryland Department of the Environment. Provided appropriations are made to the fund, this is a great opportunity for counties and eligible households to access the funds necessary to make vital repairs and upgrades to failing private wells. Both the House and Senate versions of the bill, HB 11/SB 483, passed with great efforts made by Senators Lewis Young, Hester, and Rosapepe as well as Delegate Stewart. Sen. Hester in particular showed a continued commitment to ensure when it comes to vital resources, the lines of communication between local and state programs must be open and clear.
MACo supported with amendments HB 831 – Environment – Septic Systems – Online Database. This is legislation to require the Maryland Department of the Environment (MDE) to establish an online database of all septic systems installed in the state in collaboration with local environmental health departments. Modernization in septic management serves to bolster efficiencies for local and state departments, however, MACo’s amendment reiterated that it must be implemented without reporting redundancies or additional burden on the local offices who manage this process. It remains clear that until salary adjustments are made for these local departments, progress will be stagnant. HB 831 ultimately failed as MDE is still in a transition phase with the new administration and will look to the near future for database planning in conjunction with local health departments.
MACo supported with amendments SB 830 – Environmental Health Specialists and Well and Septic Systems Permitting – Studies. This legislation would establish, update, and refine the process of managing and installing on-site sewage disposal systems across the state. The bill proposed beneficial advances, such as establishing a student loan forgiveness program for environmental health specialists, and standardized regulations and guidance for on-site sewage disposal systems. While these elements would be welcome advances, they are complementary to, rather than centered upon, the area of greatest need in this field, which is addressing the wage discrepancies for environmental health specialists. SB 830 ultimately passed, however heavily amended into a study. Senator Hester once again took the lead on driving the point home that serious and substantial changes need to be made in this area and reiterated the study will give stakeholders the force and substance to get meaningful solutions over the finish line in the future.
Public Health and Local Health Departments
MACo supported SB 399/HB 273 – Health Occupations – Environmental Health Specialists – Revisions. This is legislation that was developed in collaboration with the Board of Environmental Health Specialists and includes insights from the Conference of Environmental Health Directors. SB 399/HB 273 passed and should help streamline the integration of entry-level Environmental Health Specialists into local departments, create more consistency with other boards across the state, and clarify various regulations for existing programs.
MACo supported with amendments HB 214/SB 281 – Commission on Public Health – Establishment. This legislation would establish the Commission on Public Health to make recommendations for improving the delivery of public health services in Maryland. Recognizing the great variability in need across counties, MACo supported the amendments offered by the Maryland Association of County Health Officers, to ensure three, rather than two, county health officers were to be included on the commission and the appointments would reflect the interests of urban, suburban, and rural jurisdictions. Additionally, and in accordance with MACo amendments, multiple positions were stuck from the bill to create more efficiency and eliminate redundancies in representation. HB 214/SB 281 passed with a company of sponsors and strong support in both chambers.
Opioids and Overdose Awareness
MACo supported HB 571/SB 954 – Opioids – Opioid Restitution Advisory Council and Fund and Overdose Response Program. This is legislation that would require the Maryland Department of Health to authorize local programs that treat and reverse opioid overdoses to choose their preferred formulation of medication for these purposes. With a stronger tool for overdose reversal programs, local health departments will be better equipped to manage the deadly and unprecedented flood of fentanyl cases especially where locals teams are finding that the current single dosage amounts are not sufficient to reverse an overdose. HB 571/SB 954 passed, and was amended further to include clarifying language on the incorporation of additional opioid settlement funds from ongoing litigation into the bills funding scheme.