Delegate Bonnie Cullison (D – Montgomery) is a member of the Maryland House Health and Government Operations Committee. The 2022 Legislative Session began earlier this month and the committee is currently reviewing over 60 health bills, including nine from Cullison.
In this Q&A, Cullison shares her health care priorities which include behavioral health during the pandemic, home and community-based services (HCBS), and addressing COVID-19.
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State of Reform: Can you first share how you and your constituents are faring, especially with the spread of the Omicron variant?
Delegate Bonnie Cullison: “Our county is really trying to stay as much on top of [the pandemic] as you can. They’re trying to abide by the latest recommendations from the CDC and our health department. The struggle is with the schools … I’m very much in favor of students being in school in person, but I also want to make sure that we’re not accelerating [the spread of] Omicron by putting large groups of people together.
That’s one of the things I worry about with kids going back to school. I believe and understand that Omicron is not as dangerous as the previous [variants], but it won’t go away unless we try to mitigate it. We have to keep thinking about that. As a state I think we’re trying some very targeted approaches in terms of testing and encouraging vaccines, but it’s not as pervasive as it is here locally.”
SOR: Can you walk us through some of the health bills you have lined up for this legislative session?
BC: “House Bill 80 is a bill that I have, but it’s actually been in the legislature at least five times. What we’re trying to resolve with this bill is, the state of Maryland has … 7,500 waiver slots for people who are on Medicare and Medicaid who need significant help with activities of daily living and who want to stay in their homes, as opposed to going into a nursing home.
Typically, what happens with these individuals is that when they don’t have the resources to pay for in-home care, they are put into nursing homes. Medicaid covers the nursing home expenses, which is federal and state money. So far the state of Maryland has only filled about 4,000 of those slots.
[The Department of Health has] a waiting list of 20,000 people and that waiting list has not gone down at all. What the bill specifically said is that they would make outreach to 600 people on the waiting list every month to try to winnow that list down. I spoke with the Secretary of Health about a month ago. They have been doing 300 a month but nothing has changed. They say that they only get about 20% return when they reach out to folks in the way that they’re doing it. I expect [the bill] will be amended to work with them to come up with a system that better addresses the waiting issue.”
SOR: Switching bases to another bill—H.B. 106 aims to increase diversity within non-profit health plans. Can you tell us about that as well?
BC: “This [bill] in Maryland speaks to CareFirst. That’s our non-profit payer. What we did was look through the current regulations and policy legislation around what their board looked like. We felt that given the experience that we’ve had, now that they’ve been our primary non-profit since the early 2000s, what does the board actually need to look like based now on an actual experience?
The most important part for me, and I’m working with CareFirst on this, is to make sure that we have people on the board who are going to look at these issues from all perspectives and have different experiences with the health care system. The part of the bill that addresses the diverse range of experience is really around my interest in having all those different aspects covered.
As a state, we are committed to health equity. We just passed legislation in 2021 that said that and it created a commission that’s going to help us focus on that. So we need our non-profit insurance carrier to be really highly aware and conscientious and diligent around health equity issues. That’s part of what we’re trying to do with this bill. We want a board that is going to best address the needs of how this carrier can best provide the services that will meet a very diverse population.”
SOR: You also did some work to help establish the 211 behavioral health hotline in Maryland. What are your top concerns regarding Marylanders’ access to behavioral health care?
BC: “I’m a huge advocate of 211 Maryland and 211 nationally. I’ve served on their board and know the work that they do. I know the numbers of people who are calling for not only mental health issues, but ‘How do I find food, how do I find help for electricity? How do I find childcare?’ They’re really a full service help center.
I was having a conversation with Sen. Craig Zucker last December and he and I were discussing our concerns about mental health issues. He said we dedicated some money to 211 last year to create a hotline in general … what we intended it to be was a suicide prevention hotline. If you’re thinking about suicide and then make the call to a hotline, that may only be temporary [help].
What mental health experts tell us is that the best thing we can do to help folks is to provide them with human connections and relationships. What the Thomas Bloom Raskin Act did was provide that personal contact … My understanding is that there are people who are using the program and I can only hope as I heard [U.S. Rep. Jamie Raskin] say at a press conference: ‘If it saves one life it was worth doing.’ I’m hoping it’s more than that.”
SOR: What else will you focus on during the session?
BC: “We’re going to be struggling to find policies that are going to help us transition out of the pandemic. There’s a dearth of health care professionals. We’re really going to have to figure out how to [draft legislation] in a responsible way to address that staffing issue. And, how do we beef up mental services? Not just in very targeted programs, but in general, because the need coming out of this [pandemic] is going to be so great.
There has to also be a message. I think there is still a little bit of a stigma around mental health. I am so grateful that the [Affordable Care Act] acknowledged it as a legitimate health need, but there’s still somewhat of a stigma across the country. We’ve got to be clear. We don’t want to stigmatize these folks more than ever, because it can cause them to spiral. We need to be understanding, compassionate, and gracious in our policy creation around how we deal with that accelerated need in mental health issues.”
This interview was edited for clarity and length.