Abstract
M has embarked on its own version of mental health system reform using the section 1115 Medicaid waiver to change its historic approach to providing, purchasing, and managing care. The article by Dr. Oliver (page 735) outlines the conceptual approach selected. The Maryland General Assembly voted for this plan with broad support from the mental health advocacy community. As the director of an urban comprehensive mental health service system, I offer a provider’s perspective on Maryland’s mental health plan and its implementation and raise questions relevant for future reform efforts. Well into the first year of the new system, the Mental Hygiene Administration has not clarified many details of the plan, and the leaders of the administrative service organization openly acknowledge that they were not adequately prepared for the transition. The reform’s ultimate impact remains the subject of intense speculation.
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