Hill and others at BBH thought he would be a good fit, Sibrea said: "They knew I had a cultural background with regard to helping people who were addicted to either narcotics or alcohol."

Henry Bogdan, managing director for public policy and public affairs at the Maryland Association of Nonprofit Organizations, said he does not think Sibrea's past legal representation should constitute a "disqualifying" factor.

Bogdan's association does recommend larger boards with at least five unrelated voting members. But he said many nonprofits function well with fewer members, and the Internal Revenue Service "takes a strong position" that it does not dictate board size.

Founded in 1997, BBH mostly bills Maryland's public mental health system, principally Medicaid. A patient's main affliction must be psychiatric rather than drug addiction for treatment to be billed to that part of the taxpayer-funded system. As billings to Medicaid rose in recent years, so did the salaries of top BBH executives.

BBH, which specializes in treating people with co-occurring mental illness and drug addiction, received about $17 million in public funds in fiscal 2009 and about $11 million in fiscal 2010.

Del. Peter A. Hammen, a Baltimore Democrat and chairman of the Health and Government Operations Committee, plans to meet in coming weeks with state health officials to discuss their oversight of Baltimore Behavioral Health. He said he plans to hold a public hearing in January.

The Sun also found that BBH offers many patients a bed in unregulated rental homes around Southwest Baltimore. More than a dozen former patients and staff members described illicit drug use by patients at some of the houses and at its facilities.

The Mental Hygiene Administration, a unit of the state health department, began an investigation in May, after The Sun started its examination. The state probe led to a survey by the state Office of Health Care Quality, which flagged the law governing family members on boards that Russell cited in his letter to BBH last week.

scott.calvert@baltsun.com

The name of a new member of Baltimore Behavioral Health's board of directors was incorrect in a previous version of this story. The Baltimore Sun regrets the error.

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