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Behavioral health companies could not afford $15 minimum wage

A rally is held at City Hall in favor of raising the minimum wage to $15 across Maryland. (Kennth K. Lam, Baltimore Sun video)

The Baltimore Sun ran a thorough piece (“Support grows for raising Maryland's minimum wage, but not all agree. Debate could focus on how much — and where, Dec. 25) detailing the various perspectives on proposed legislation to raise Maryland’s minimum wage to $15 per hour.

One consideration not mentioned is the effect that a higher minimum wage would have on health care providers who deliver crucial treatment services to Marylanders dealing with mental health and substance use disorders. The state must provide an increase in funding for community behavioral health providers in order to offset the cost of implementing a minimum wage increase.

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Here’s why: Reimbursement for behavioral health providers is set by the state and is not adjusted to account for rising costs. In addition, most public behavioral health services are subject to regulated staffing ratios, so there is no ability to reduce staff — although we don’t ever like to see job losses anyway. Therefore, if providers are forced to bear the burden of increased staffing costs without a commensurate increase in rates from the state, they may be forced to reduce or eliminate services.

Eliminating services for people in need of treatment is unacceptable — especially as the opioid epidemic continues to ravage Maryland families. In 2017, Maryland overdose deaths increased for the seventh year in a row, marking an all-time high of 2,282 deaths in a year. The death toll continued to climb in the first six months of 2018 alone. At the same time, demand for mental health and substance use disorder services has steadily increased. More than 1 in 5 Marylanders will experience a mental health or substance use disorder in any given year, and more than 260,000 Marylanders now rely on the state’s public behavioral health system for treatment services.

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Maryland has made significant progress on behavioral health over the past several years. The HOPE Act, a package of legislation that included multiyear budget commitments to improve resources for community behavioral health providers, passed nearly unanimously in 2017. Legislation to help combat the opioid epidemic, expand crisis response services and improve access to telemedicine for Marylanders with behavioral health needs also received bipartisan support from the General Assembly and the Hogan Administration. We must not undermine these efforts, purposely or not.

Twenty-six percent of our members’ workforce currently earns less than $15 an hour, and they deserve a raise. In the coming debates on the minimum wage, we need to make sure we support workers but do not undo the progress we’ve made to increase access to community behavioral health services and our ability to address the ongoing opioid epidemic.

Shannon Hall

The writer Executive Director, Community Behavioral Health Association of Maryland.

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