Tuesday, March 6, 2018


SB765 / HB772:  Maryland Medical Assistance Program –Services Provided by Certified Peer Recovery Specialists


Currently, there are upwards of fifteen incorporated non-profit organizations throughout Maryland that were founded and are currently operated by individuals with lived experience in providing solutions to the ‘opioid epidemic’.  Among the services they currently provide are ‘peer recovery services’.  These Peer Recovery Specialists are either individuals who have survived and recovered from a substance use disorder themselves, or parents (caregivers) who have supported an adolescent or young adult child struggling to recover from their disorder. 

They provide services to those desperate for solutions –to those caught in the grips of their own disorder, or their parent caregivers who are assisting them with accessing help.  The services they provide include: 1) educating those who are impacted about aspects of addiction based on scientifically valid information; 2) assisting individuals seeking treatment and recovery services in accessing these services; 3) facilitating family peer support and bereavement groups; 4) providing one-to-one peer coaching; 5) serving as diversion advocates in the courtroom –assisting judges and legal counsel in creating treatment plans as an alternative to incarceration; 6) providing impacted individuals and their family members with Naloxone; 7) linking individuals without funding for treatment and recovery services with private scholarships and public grant funding; and 8) providing evidence-based training and mentoring to other peer specialists.  These organizations are often providing higher deliverables at a lower cost than other service providers or government programs. 

Some of these incorporated Maryland business owners have been operating for more than a decade on the efforts of volunteers often working the equivalent of a full-time job, or with very limited funding derived from small grants and private donations, despite the fact that they are a valuable and very visible resource within their community.  In order to sustain and maintain the life-saving services they provide to those struggling with an often fatal disorder, their services must be fairly compensated. 


Peer Recovery Specialists providing vital and often life-saving services to individuals with a substance use disorder and their families, should be able to be reimbursed through the Maryland Medical Assistance Program.  However, the current legislation fails to address several important issues: 
1)      The services which would be reimbursable are not specified, and we suggest that these should minimally include educating the individual and/or family caregiver, assisting the individual in accessing treatment and recovery services, providing individual coaching, justice system diversion and/or courtroom advocacy, and Naloxone training. 

2)   Currently, most business owners solely providing Peer Recovery Services are not certified under any certifying entity, nor does a certification path even exist whereby they are able to become certified.  Most of these registered Maryland businesses are owned and operated by parent caregivers.  Also, there are organizations which have historically provided peer support in the mental health arena, and train their own specialists.  We are concerned that a single entity or organization seeking to ‘corner the market’ on peer certification, and subsequently peer training and peer credentialing, would emerge as a result of this bill.  This may have the effect of excluding already existing businesses that have been effectively providing these services.  While we are not opposed to a certification process –provided that it is developed by stakeholders, and the process is inclusive of those currently in the business of providing these services, this does not yet exist.  Therefore, the “certification” stipulation should either be dropped until a future time when this component can be addressed in a fair and comprehensive way, or addressed within this bill so as not to unfairly exclude business owners who have been providing services well before any Maryland certifying entity even existed.   

3)      In order to ensure that these two provisions are adequately addressed, this bill should make provision for a work group to be convened, which includes all current Maryland business owners who have legitimate incorporated businesses that currently provide peer support services.  

THE SPONSORS: Senator James Mathias / Delegate Antonio Hayes

FOR FURTHER INFORMATION: EMAIL info@faceaddictionmd.org / CALL 301-525-6183

Wednesday, February 28, 2018


Call / Write members of the Senate Finance Committee (below)
SB921 / HB1531:  Task Force on the Premature Discharge of Patients with Substance Use Disorders


Patients diagnosed with an often fatal co-occurring disorder and admitted to an inpatient treatment facility are routinely kicked out of treatment –often for extremely trivial infractions.  Patients who are assessed as needing inpatient treatment in order to recover, and who fail to receive it, are at high risk of death as a result –a death that could have been prevented.  Patients have been kicked out of treatment for sneaking a cigarette; walking into another person’s room; talking to, holding hands with, or kissing another patient; leaving treatment for a couple hours after notifying staff in order to say goodbye to a dying parent in a hospital; cursing at a staff member; making an inappropriate gesture to another patient; using a cell phone; and other behaviors that would not merit discharging a suicidal patient, or a cancer patient, or a kidney dialysis patient from necessary treatment.  These actions would not even warrant expelling an adolescent from high school regardless of the fact that many of these infractions are disallowed in Maryland’s high schools.  Regardless of students’ rule-breaking behavior, society still believes that these students are better off with a high school education than expulsion for “breaking the rules”.

Patients are discharged before their planned discharge date, often with very little notice (sometimes mere minutes), despite the fact that they have been diagnosed with an acute, chronic, often fatal disorder; and have been admitted to a healthcare facility or program on the basis that this level of care is necessary in order for them to recover from it.  The sudden and unexpected dismissal –often to immediate homelessness, triggers feelings of extreme distress, crisis, depression, failure and hopelessness –the very feelings that caused or exacerbated their substance use in the first place.  With a lowered tolerance to opiates, due to the time they have spent in detox, they are at extremely high risk of overdose.  If they are prematurely discharged from an outpatient Suboxone provider –often because they were late for, or unable to make an appointment due to transportation issues or work conflicts, the onset of withdrawal is imminent.  All gains that have been made while in treatment quickly unravel. 


This bill establishes a Task Force to collect and analyze treatment data regarding the frequency and circumstances of premature discharge from treatment.  It requires the Task Force to suggest steps which would mitigate the dangers of premature patient discharge.  It is unconscionable that providers continue to place patients’ lives in jeopardy by premature discharge –often for committing the very behaviors that they have been diagnosed as needing professional assistance to overcome. 
Senator Steve Hershey / Delegate Seth Howard                                                     

EMAIL info@faceaddictionmd.org / CALL 301-525-6183


Thomas Middleton:  

John Astle: 

Joanne Benson:  

Brian Feldman: 

Stephen Hershey:  
Phone: 410-841-3639 | 301-858-3639 | Toll-free in MD: 1-800-492-7122 ext. 3639

J.B. Jennings:  
Phone: 410-841-3706 | 301-858-3706 | Toll-free in MD: 1-800-492-7122 ext. 3706

Katherine Klausmeier:  
Phone: 410-841-3620 | 301-858-3620 | Toll-free in MD: 1-800-492-7122 ext. 3620

James Mathias:  
Phone: 410-841-3645 | 301-858-3645 | Toll-free in MD: 1-800-492-7122 ext. 3645

Nathaniel Oaks:  
Phone: 410-841-3697 | 410-301-3697 | Toll-free in MD: 1-800-492-7122 ext. 3697

Edward Reilly:  
Phone: 410-841-3568 | 301-858-3568 | Toll-free in MD: 1-800-492-7122 ext. 3568

Jim Rosapepe:  
Phone: 410-841-3141 | 301-858-3141 | Toll-free in MD: 1-800-492-7122 ext. 3141

Monday, February 26, 2018


Take the opportunity this week to weigh in on whatever matters to you.  There are a lot of really good bills in the Maryland General Assembly, that may not pass unless your legislators hear from you.  

On TUESDAY 2/27, the following bills will be heard in the House and Government Operations Committee:   

1) HB445 Health – Certified Recovery Residences – Urine Testing: Requires residents and employees of a certified recovery residence to submit to urine testing.  

2) HB499 Health – Standards for Involuntary Admissions and Petitions for Emergency Evaluation – Modification: Makes a provision for Involuntary Commitment for an individual who has experienced an overdose --but only for those individuals who have "health insurance coverage as a dependent under the individual's parent's health insurance plan.  SB527 is a similar bill which was heard in the Senate on 2/14, but DOES NOT have the provision that the individual must be covered under their parent's insurance plan.  Advocates ask that you support HB499 ONLY WITH the amendment that the requirement for coverage under a parent's insurance plan be struck from the bill.  SERIOUSLY --DO ONLY PARENTS WITH GOOD INSURANCE GET TO TRY TO SAVE THEIR KID'S LIFE, WHILE ALL OTHER PARENT'S GET TO WATCH HELPLESSLY AS THEIR KID IS DISCHARGED TO NOWHERE?

3) HB601 Public Health - Opioids - Dispensing Requirement: Requires that an opioid be dispensed with a material that permanently deactivates the drug when the patient disposes of it.  

4) HB772 Maryland Medical Assistance Program – Clinical Services Provided by Certified Peer Recovery Specialists:  Allows Medicaid to reimburse for "clinical services" provided by Peer Recovery Specialists to individuals with substance use disorders or mental health disorders.  

5) HB922 Maryland Department of Health – “Pill Mill” Tip Line:  Establishes a "tip line" for citizens to report doctors who they suspect are over-prescribing medication, and requiring an investigation.  

6) HB1207 Public Health – Ibogaine Treatment Study Program:  Establishes a study to evaluate the effectiveness and safety of Ibogaine treatment for Opioid Dependence and to compare the effectiveness of Ibogaine treatment with conventional treatment methods and interventions, including opioid replacement therapy. 

7) HB1577 Human Services – Family Navigation Services – Provision and Funding: Appropriates $1,665,915 for Family Navigation Services to support parents and caregivers of children or youth with behavioral health needs or developmental disabilities and that addresses one of the following priorities: 1) reducing impact of parental incarceration; 2) preventing youth between 16 and 24 from becoming disconnected; 3) reducing childhood hunger; and 4) preventing youth homelessness.  Navigators help parents / caregivers understand and address their child's behavioral health needs, identify community resources, and obtain needed services.  

8) HB499 Public Health – Opioid Overdoses – Prohibition and Rehabilitation Order:  Makes it illegal for individuals to overdose, and makes it OPTIONAL for a first responder to administer Naloxone (Narcan) in order to resuscitate them. If the first responder CHOOSES TO administer Naloxone, and the individual is successfully resuscitated, the first responder will then issue a citation for a fine (<= $50) and a "rehabilitation order" requiring the individual to attend treatment.  The fine will be waived by the court under certain conditions.  Fines collected will go toward purchasing Naloxone.  If the individual fails to pay the fine or attend treatment, they may be held in contempt by the court, and sentenced to AT LEAST 30 days in jail.  

On THURSDAY, 3/1, the following bill will be heard in the Senate Finance Committee:

9) SB921 Task Force on the Premature Discharge of Patients With Substance Use Disorders: Establishes a task force to collect data and study the following: 1) the impact of premature discharges from treatment on patients diagnosed and admitted for a substance use disorder, 2) the reasons why patients assessed as needing inpatient treatment are kicked out of treatment before their discharge date, and 3) any applications of the patient abandonment law; and to 4) make recommendations regarding changes to improve patient discharge practices; and to 5) propose training for staff members at facilities designed to treat SUD that could help mitigate any risks associated with early patient discharge; and to 6) determine whether facilities designed to treat substance use disorders should be required to report on the frequency of early patient discharge.  

On FRIDAY, 3/2, the following bill will be heard in the House and Government Operations (HGO) Committee:

10)  HB1531 Task Force on the Premature Discharge of Patients With Substance Use Disorders: Same as #9.

11) HB1579 Alcohol and Drug Abuse Program Facilities – ASAM Criteria Assessments: Requires a treatment provider to provide a copy of the patient's assessment to the patient; Requires the provider to meet with the patient to review the assessment and to explain how the assessment impacts discharge planning --within 72 hours after admission; Requires the provider to discuss the patient's discharge options based on the assessment; Requires the provider to identify potential treatment providers appropriate for the next level of care; Requires the provider to send appropriate application documents to the next level of care within the 72 hour time frame; Requires the provider to make direct patient referrals to any other treatment providers identified as necessary for the patient's recovery (specified in the assessment); Allows a patient to request that an individual of the patient's choosing be designated as the patient's personal representative to advocate for services to be included in the discharge plan based on the patient's assessment.

Thank you for your support.