Health commissions face auditing, trauma funding questions and a push to restore school-behavioral health grants

The Health and Human Services Subcommittee heard budget briefings Feb. 28 from the Maryland Health Care Commission (MHCC), the Health Services Cost Review Commission (HSCRC) and affiliated regulatory entities on fiscal 2026 budgets, trauma-center funding, an impending federal AHEAD model and a legislatively created consortium that funds school behavioral-health services.

Anne Braun of DLS summarized the fiscal 2026 picture for the MDH regulatory entities and noted key items: a proposed $17 million increase for the Maryland Trauma Physician Services Fund supported by vehicle-registration surcharges, the winding down of a $15 million Health Equity Resource Community mandate in fiscal 2026, and an expected reduction in the user-fee cap for HSCRC that the commission said would create a shortfall unless legislation restores the prior cap formula. DLS also asked MHCC and HSCRC to clarify the amount of vehicle-registration surcharge revenue that should be distributed to Shock Trauma and whether budget documents have consistent figures.

John Cromm, Executive Director of HSCRC, said HSCRC serves as a pass-through for an appropriation intended to pay CRISP for Doctor First services; CRISP had not invoiced HSCRC because the contract between Doctor First and CRISP had not been finalized, so the $375,000 set aside had not been spent. Cromm said HSCRC expects to complete two audits of trauma-center costs in the second half of fiscal 2026 in response to a commission report that found higher trauma costs driven largely by outliers at three hospitals.

HSCRC and MHCC staff discussed preparing for the Advancing Health Equity and Development (AHEAD) model, a new federal agreement with CMS that will expand all-payer rate-setting goals to limit cost growth and add primary-care investment requirements starting in calendar 2026. DLS asked for continued evaluation of the Maryland Primary Care Program and clarification on how savings from new advanced primary-care initiatives would be shared with managed-care organizations; HSCRC concurred with continued evaluation and said it will develop the requested work products.

Separately, DLS presented figures on the consortium on coordinated community supports, which funds school-based prevention, early intervention and treatment services. DLS noted wide variation in per-student grant amounts across jurisdictions and that $109 million in active grants had been approved through fiscal 2025, serving more than 143,000 students. The proposed budget, however, contained a contingent reduction that would reduce annual consortium funding to $40 million beginning fiscal 2026. Members of the consortium and advocates urged restoring full funding. Rhea Gupta of Strong Schools Maryland and Anne Geddes of the Mental Health Association of Maryland told the committee the consortium is serving tens of thousands of students and that cutting funding would reduce services at a time of rising youth mental-health needs.

Tom Scalia, chief of the Shock Trauma Center, described how recent allocations have been used: adding two operating rooms (from six to eight scheduled weekdays), reducing length of stay for surgically treated patients by more than two days, decreasing transfers that resulted from capacity constraints and increasing programmatic services including stop-the-bleed training and violence-intervention participants. Scalia said Shock Trauma had markedly reduced time spent on capacity alert.

The Prescription Drug Affordability Board and the Maryland Patient Safety Center also spoke: MHCC reported the $750,000 earmark for a workplace-violence public awareness campaign has been spent on outreach and digital ads, and the Maryland Patient Safety Center, which receives a separate $1 million grant mandate starting fiscal 2024, told the committee the organization’s work on maternal safety and infection reduction is at risk if legislative funding is not continued.

DLS recommended releasing certain withheld funds for HSCRC after its compliance review and requested timelines on trauma audits and AHEAD-model preparations; HSCRC and MHCC agreed to provide further details and to complete the audits and analysis requested by the committee.