Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the AOT topic
No spam. Unsubscribe anytime.
MDH to pilot phased assisted outpatient treatment; local cost-sharing language raises concerns
Summary
Maryland plans a phased, regional rollout of assisted outpatient treatment (AOT) with $6.7 million in FY27 support for care coordination teams. BRFAA language would phase local cost-sharing from 25% in FY28 to full reimbursement by FY31; MDH and local officials said responsibilities and cost allocations remain to be worked out.
The Maryland Department of Health told the Health and Social Services Subcommittee that it will implement assisted outpatient treatment (AOT) statewide on a phased schedule during fiscal 2027, with FY27 funding of $6.7 million to establish care coordination teams for the three implementation phases.
Secretary Meena Seshamani and MDH staff emphasized that the phased approach responds to local jurisdictional feedback and the cross-sector complexity of AOT implementation. "The department is firmly committed to the plan to ultimately roll out the AOT program statewide by the end of fiscal year 27," MDH said.
However, the Budget Reconciliation and Financing Act (BRFAA) provisions under consideration would require local jurisdictions to reimburse a rising share of AOT costs starting after the statute's implementation period: 25% in fiscal 2028, 50% in fiscal 2029, and moving to full reimbursement by fiscal 2031. Subcommittee members pressed MDH to clarify which local entities (counties, local behavioral health authorities, or other entities) would be legally responsible for reimbursement and how the $1.58 million cost-shift figure was calculated.
MDH told members the BRFAA language does not currently specify which local entity would be responsible for reimbursement and that MDH will work with regional partners during the phased rollout to better define operations, costs, and potential cost-sharing arrangements. MDH also said the phased approach was recommended by local leaders as the most practical path to successful start-up and that year-1 staffing models project an AOT regional team including a program director, part-time psychiatrist, 2— case managers, and certified peer recovery specialists.
Local leaders and advocates at the hearing welcomed a phased pilot but warned that unclear statutory cost-allocation could transfer unsustainable costs to counties, potentially undermining equitable access. NAMI Maryland and local officials asked the committee to ensure MDH provides clear cost-sharing breakdowns and that any local fiscal responsibilities be defined before broad rollout.
What happens next: Subcommittee members requested MDH provide a proposed breakdown of likely local responsibilities and a clearer explanation of the $1.58 million cost-shift figure so the legislature can assess fiscal impacts on counties and jurisdictions before final action on BRFAA provisions.
