The Sheppard Pratt Center for Public Policy and Innovation was created to provide a national leading voice on health care issues relating to behavioral health solutions that can impact the health of populations. From school-based services, to community services, to crisis services, to complex inpatient units, Sheppard Pratt has proven expertise across the most comprehensive continuum of care with services at-scale and best practice implementation as core strengths.
As the nation’s largest private, nonprofit provider of mental health, substance use, special education, developmental disability, and social services in the country, Sheppard Pratt is the only place where someone can access the care they or their family need, regardless of ability to pay. And, Sheppard Pratt is consistently ranked as a top national psychiatric hospital by U.S. News & World Report. Our world-class investigators are changing lives daily, identifying new and effective ways to treat some of the most common mental illnesses. Leading the nation and meeting unmet needs is in our DNA, and our mission is founded in transforming lives and helping people achieve better health.
The Center for Public Policy and Innovation was born to disseminate our collected knowledge and expertise to impact care nationally and internationally. Our aim is to help health systems, governmental agencies, philanthropic donors, and change agents influence public policy and advance care globally.
Improving Mental Healthcare Systems in the United States: Policy Questions Arising from a Case Study of Sheppard Pratt
Our nation is facing an unprecedented mental health crisis. The RAND Corporation’s recent case study on Sheppard Pratt examined our continuum of care and the ways we’re addressing challenges as mental health policymakers.
From Crisis to Care - Sheppard Pratt's Model
A report for state leaders prepared by the National Association of State Mental Health Program Directors exploring Sheppard Pratt's care model as a scalable solution for use in responding to and preventing psychiatric crises.
Responding to and Preventing Crises
CCBHCs, Urgent Care, and an example of one health system in Maryland and its approach to crisis services within an accessible psychiatric care continuum.
Our Legislative Priorities at a Glance
Federal Priorities
Mental Health Parity
The federal Institutions for Mental Disease (IMD) exclusion hampers Maryland’s efforts to address mental health parity. The Medicaid IMD exclusion is an outdated, discriminatory federal rule that creates significant barriers to treatment for adults with severe mental illness. Under this rule, federal Medicaid reimbursements to states are prohibited for non-geriatric adults receiving psychiatric care in a treatment facility with more than 16 beds.
State Priorities
Establishment of Certified Community Behavioral Health Clinics (CCBHCs)
Outpatient mental health clinics across Maryland have forever struggled to cover their costs to provide effective mental health and addiction services to vulnerable and frequently low-income children and adults. CCBHCs have now been approved in six states through state plan amendments with another five states approved through a federal CCBHC Medicaid demonstration program. Simply put, Maryland is falling behind nationally.
These states have shown adherence to a strict set of mental health and addiction services, quality measures, and expanded access to care for their communities. In exchange for adherence to certification rules that hold providers accountable for evidence-base coordinated treatment and programs, CCBHCs receive a bundled payment rate that covers the cost of services.
Data from Sheppard Pratt's three CCBHC grants, coupled with national data show actual hospitalization costs drop when providing CCBHC services with a bundled rate. By providing high quality and "high touch" services, CCBHCs can be part of the solution to reduce overall expensive Medicaid hospitalization costs.
Address Hospital Overstays and Emergency Room Backlogs
Several simple steps can be taken to address both hospital inpatient overstays as well as the mental health patient burden on the State’s emergency rooms. It is important to stress two points: 1) parents and families should not have to relinquish custody to the State for youth to access care, and 2) adults should not lose their civil liberties by being unduly held on inpatient units. While Sheppard Pratt is actively participating with the Maryland Hospital Association and the Department of Health on tracking youth inpatient overstays, the problem runs deeper than just youth—extending to adults and a lack of invested resources.
Establishing a Workgroup on Behavioral Health Rate Methodology Modernization
Sheppard Pratt strongly supports House Bill 772, which establishes the Workgroup on Behavioral Health Rate Methodology Modernization within the Maryland Health Care Commission (MHCC).
As the nation’s largest private, nonprofit behavioral health provider, and a statewide safety-net system serving more than 80,000 people annually, we see firsthand how outdated and non-transparent rate structures undermine Maryland’s ability to deliver timely, high-quality, community-based mental healthcare. We operate outpatient mental health centers (OMHCs), certified community behavioral health clinics (CCBHCs), crisis services, inpatient hospitals, residential programs, and school-based services across 16 counties. Across this continuum, the challenges that HB772 seeks to address are both urgent and system-defining.
Mental Health Law – Danger to the Life or Safety of the Individual or of Others – Definition (Right to Treatment)
Sheppard Pratt supports Senate Bill 707, which updates and clarifies the statutory definition of “danger to the life or safety of the individual or of others” for purposes of emergency evaluations and involuntary admissions under Maryland mental health law.
Establishment of a Nonpublic Special Education School Renovation Program
Sheppard Pratt supports House Bill 854, which establishes the Nonpublic Special Education School Renovation Program within the Interagency Commission on School Construction. This is an important step toward ensuring that Maryland’s most vulnerable students, particularly those placed in Residential Treatment Centers (RTCs), learn and heal in safe, modern, therapeutic environments.
Health Care Decisions Act – Surrogate Decision Making – Mental Disorder
We strongly support Senate Bill 550, which modernizes Maryland’s Health Care Decisions Act to allow legally recognized surrogate decision-makers to authorize treatment for a mental disorder when an individual has been certified as incapable of making an informed medical decision.
Voluntary Placement Agreements for Children in Out-of-Home Placements
Every week at Sheppard Pratt, our pediatric inpatient units care for children who are clinically ready for discharge but remain hospitalized solely because Maryland’s Voluntary Placement Agreement (VPA) process is slow, confusing, inconsistent across counties, and functionally unworkable. Roughly 75% of our pediatric overstay cases are specifically delayed by the VPA process.