In July of 1997, the Public Mental Health System in Maryland changed. HealthChoice was created as the managed care program for Medicaid (Medical Assistance), and mental health care was "carved out" to be managed by Maryland Health Partners. The Health Care Financing Administration’s approval of the carve out required coordination of care between mental health and physical health systems.

The coordination of care is primarily a responsibility at the physician level. However, the Mental Hygiene Administration Coordination of Care Committee has been meeting monthly since the Fall of 1997 to improve the system’s coordination of care. Currently there is an ongoing exchange of information between the HealthChoice Managed Care Organizations (MCOs) and Maryland Health Partners to coordinate with primary care physicians. The goal is to keep the primary care physicians informed about the mental health services their patients are receiving, and to improve coordination and quality of care for consumers with special needs.

The Public Mental Health System has been working with Maryland Health Partners and the MCO's to improve coordination of care. However, a recent evaluation of the system indicates there may be a problem with coordination at the physician level. Consequently, the Public Mental Health System is requesting that psychiatrists increase the coordination with primary care physicians. The main area of concern is medication. Frequently individuals in the Public Mental Health System are prescribed multiple psychiatric medications and primary care physicians may not be aware of psychopharmacologic agents being used by their patients. The Public Mental Health System is recommending that psychiatrists notify primary care physicians each time a significant medication change (i.e., adding a new medication) is made.

Thank you for considering our recommendation. Please notify me if you have suggestions regarding improving our coordination of care or any other aspect of the Public Mental Health System. I may be reached by email at bhepburn@dhmh.state.md.us or by telephone at 410-767-6540.