Judy Gallant

Impact of extending PHE on Maryland

As we know, the Federal public health emergency (PHE) was extended on July 23rd for 90 days. This is the second time it has been extended, and we don’t know what will happen after October 23rd. This has the impact of extending the allowing of treatment via teletherapy through that time. This includes payment through Medicare and Medicaid in MD, and likely through private insurances as well. It also extends the waivers of regulation around telehealth platforms, which permits providers to use platforms which are not HIPAA compliant, such as FaceTime. Remember that once the PHE is no longer in effect, the requirement to use a HIPAA compliant platform (such as Doxy.me or the professional level of Zoom) will likely return.

GWSCSW presents written testimony on COVID-19’s impact on mental health treatment

On June 23, the Commission to Study Mental and Behavioral Health, headed by Maryland’s Lt. Governor Boyd Rutherford, met specifically to discuss the pandemic’s impact on mental health treatment in Maryland. We sent written testimony about telehealth to be heard at that meeting, which is now part of the public record. The testimony was also sent to the Maryland Insurance Administration Commissioner, the Behavioral Health Administration Commissioner, and the Secretary of the Department of Health.

On behalf of the Maryland Clinical Social Work Coalition (MdCSWC) and the members the Greater Washington Society for Clinical Social Work (GWSCSW), I am writing to ask that the Commission to Study Mental and Behavioral Health advise Governor Hogan, DHMH Secretary Robert Neall, and MIA Secretary Kathleen Birrane of the urgent need for insurance companies to continue to reimburse providers for telemental health services beyond 60-90 days following the end of Maryland’s State of Emergency. Additionally, I would urge increasing accessibility to audio-only teletherapy through requiring all insurance companies practicing in Maryland to reimburse providers for these services at the same rates as in-person psychotherapy.

Providers of mental health therapy responded quickly to the need to change the way we deliver services when the state of emergency was declared. Through video conferencing, we have been able to continue life-saving treatment for most of our patients, and to help combat the sense of isolation that exacerbates many of the conditions we treat. There are still some patients who, without access to the technology or broadband at home that permits videoconferencing to occur, have been unable to continue their treatment except through audio-only phone contact. While Medicaid has been reimbursing providers, thanks to Governor Hogan’s order, most other insurance companies have not followed suit, and have left some patients without access to their clinician during this highly stressful time.

Patients and therapists alike have found video-conferencing to be a safe and effective way to engage in therapy for the large majority of diagnoses. They have expressed great concern about resuming in-person sessions in an enclosed office space where safe social distancing or protective air filtration or circulation may not be possible, and before vaccination of most of the population can take place. This is especially critical for patients and therapists who are immunocompromised, or who live with or care for someone who is immunocompromised. While there are some patients who require in-person therapy, the vast majority continue to require treatment via video-conferencing, or audio-only telephone contact.

We thank the Governor and his Administration for their pro-active care of Marylanders during this health crisis. We know that the pandemic is sparking an increased need for mental health services. We are hopeful that Maryland can lead the way in ensuring these services are more easily accessible to our citizens for the long term, to help keep people productive and able to experience greater satisfaction with their lives, especially during this particularly difficult time.

Judith Gallant, LCSW-C
Chair, MdCSWC
Director, Legislation and Advocacy, GWSCSW

Finally, to wrap up my report on the shortened Legislative Session of the MD General Assembly of 2020 (begun in the report of the June, 2020, News & Views, information about a couple of bills passed which will be of interest to some (taken from our lobbyist, Pam Metz Kasemeyer’s 2020 Session Final Report):

House Bill 1121: Maryland Mental Health and Substance Use Disorder Registry and Referral System (passed) establishes the Maryland Mental Health and Substance Use Disorder Registry and Referral System in MDH. The purpose of this Registry is to provide a statewide system through which health care providers can identify and access available inpatient and outpatient mental health and substance use services for patients in a seamless manner. It also creates an Advisory Committee to advise the Department on the development and implementation of the System.

Senate Bill 305/House Bill 607: Public Safety – Crisis Intervention Team Center of Excellence (passed) establishes a Crisis Intervention Team Center of Excellence (CITCE) in the Governor’s Office of Crime Prevention, Youth and Victim Services to provide technical support to local governments, law enforcement, public safety agencies, behavioral health agencies, and crisis service providers. The CITCE is also to develop and implement a “crisis intervention model program.” By December 1, annually, CITCE must report to the General Assembly on its activities and related criminal justice efforts.

Judy Gallant, LCSW-C, is the director of the Society’s Legislation & Advocacy program, as well as chair of the Maryland Clinical Social Work Coalition, our GWSCSW legislative committee in Maryland. She maintains a private practice in Silver Spring.

Pamela Metz Kasemeyer, JD, and her firm of Schwartz, Metz & Wise, PA, represent us in Annapolis and guide our advocacy strategy. Ms. Kasemeyer is an acknowledged authority on Maryland’s health care and environmental laws and has represented a variety of interests before the Maryland General Assembly and regulatory agencies for more than 25 years.