Good morning. Good morning. Good morning, everyone.
I am Councilwoman Felicia Porter representing the 10th district and
chairperson for the committee. Um, this is a reminder to please turn off your
cell phones. Um, today we have joining us council members Odette Ramos from the
14th district. And we also have some wonderful interns um from John's Hopkins
University and also from Talson University today in the chambers. And
then we also have several representatives from the mayor's office
and city council president and committee staff is Margaret Kern. The committee is
reconvening the hearing for legislative oversight LO25-0024
oversight of recovery homes and substance abuse clinics and mental
health substance abuse clinics in Baltimore City. This is an opportunity
for um council members and public to further ask questions about ensuring
that individuals in recovery have access to highquality, safe and well-regulated
recovery homes and substance abuse clinics. This is also an opportunity to
evaluate existing policies, access provider accountability, and explore
opportunities to enhance support systems for individuals in recovery. This
discussion will continue to prioritize community concerns, patient safety, and
equitable distribution of recovery resources in the city. I'm now going to
turn it over to our public testimony. Um, for all that do not know, we have
public testimony at the beginning of our hearings because agencies I want you all
to hear what some of the uh community are going through so that you can alter
your presentations um once you all have the opportunity. So, we're going to now
go into public testimony. We're going to have Kim lead us into public testimony.
You're going to have five minutes. And so,
we have a new technology in the chamber today. Okay. And so you'll see on your
deis, it's going to blink yellow when it is um 15 seconds left. And so we just
ask that you wrap up when you see the blinking yellow light. All right.
All right. Very good.
And if and if you could tap your microphone. Is it on?
» Perfect. This echo. All right. Kim Wyman. I'm president of Power Recovery
Center. Delighted to be here. Thank you, Chair Porter, for the opportunity to
testify. Lure is the foundation for protecting
client safety and treatment quality, which I'm sure you'll be discussing
today. After lure, most systems can count admissions, service delivered,
discharges, and length of stay, and other measures. Those measures matter,
but they don't move from activity to impact. They don't answer the harder
question. After treatment, are people safer, more stable, and experiencing a
better quality of life? We need a practical way to see the whole picture
across all the varied fragmented systems, not a monthly report, not a
report a month later about some static measure.
We need to intervene earlier, improve treatment, and make smarter public
investments. PRC is building a platform that connects
those scattered and fragmented systems into one usable longitudinal view of a
client's recovery. Instead of looking only at a treatment episode,
PAL can now look at uh across systems and across time. By this I mean we can
examine Crisp ED and EMS and public court involvement, the 12 months prior
to treatment and the 12 months after treatment as two key factors and two key
systems to connect with treatment to help us see whether treatment is
changing health safety, stability, and the quality of life of our clients over
time. Next, we're going to pilot primary care
connection and housing stability because we see those along the continuum as
critical factors in quality of life for our clients. A longitudinal view of all
of the fragmented systems combined with claims data and clinical data in an
electronic health record can examine outcomes in our system for an
individual, for a group that's defined, or for the larger system as a whole.
This platform isn't just a management tool for PAL. Let me be clear. We want
to change public health. It's a working model for treatment outcomes that
provides intelligence that could help communities move from struggling to
count the basics to transparency across multiple systems and services over a
defined period of time. It can tell us who may need help now, what providers
can improve next, and whether people are doing better over time. Again, we want
to change public health, and we want to ask for your partnership. Thank you.
» Thank you so much, Kim. All right. Next, we're going to have Jan Elyn.
» I'm a little shorter. Thank you. I apologize if I have to take
sips of water. The air quality is not helping my voice.
[clears throat] My name is Jan Eland. I am a resident of Brooklyn in Baltimore
City. I am here on behalf of the Brooklyn Curtis Bay community. Um we
have uh recently gotten a group of neighbors together regarding this
problem and started a task force. Um and we are looking of course at two things.
The distribution of the recovery centers and community concerns. One of our
community members has written I think uh an excellent set of comments that I
would like to read. [clears throat]
This neighbor lives across the street from Garrett Park, one of our parks, and
immediately next to our library. No one should have to feel that. Oops.
Sorry, I'm starting with page two. That's bad. In December 2023,
I purchased my very first home in Brooklyn, Maryland, Baltimore City. I
was single, had no children, and was incredibly proud and excited to become a
homeowner. It was a milestone I had worked hard to achieve. When I moved in,
I felt hopeful about the future. My block was quiet, my neighbors were
friendly and respectful. Across the street was a beautiful park right next
door to a thriving Boys and Girls Club and just steps away from the Baltimore
City Library. As an educator, seeing children, families, and community
resources so close to my home made me feel proud to become part of the
neighborhood. Unfortunately, as winter turned into spring and spring into
summer, that sense of pride and security began to disappear. I started witnessing
drug transactions directly behind my home. Some captured on my security
cameras, others with my own eyes. I watched individuals struggling with
addiction gather in the alleyways, on the sidewalks, on the steps of the Boys
and Girls Club, and outside the library. Sometimes they simply sat there. Other
times, the effects of the drugs they were using were heartbreaking to
witness. I heard moaning, screaming, crying, and watched people throw
themselves into the street, roll on the payment, and cry out for help. These are
human beings in crisis, but they are also cerating an environment where
families no longer feel safe. [clears throat]
One evening, I came home to find someone charging a phone using the electrical
outlet on the front of my house. The phone was sitting on my steps, blocking
the entrance to my home. When I arrived, the individual ran over and claimed it
was his. I firmly but respectfully asked him never to use my property again and
to find somewhere else to charge his phone. I recognized him as one of the
many individuals battling addiction in the neighborhood. The encounter shook
me. It made me anxious every time I leave my house wondering if someone
would be waiting on my porch when I returned. No homeowner should have to
live with that level of uncertainty. Then one morning I was leaving for work.
I discovered my car had been broken into. Personal belongings had been
stolen. The electrical panel had been removed as though someone was attempting
to hotwire the vehicle. Thankfully, I use a steering wheel lock, so they were
unsuccessful in stealing it. After reviewing my security footage, I watched
multiple individuals, people I recognized from my own neighborhood,
take turns entering and searching my car. The feeling of violation is
difficult to put into words. Knowing strangers had been inside my vehicle,
not knowing what they touched or what their intentions truly were, made me
physical sick. It also forced me to ask myself questions I never imagined asking
after purchasing my first home. Do I need a firearm to protect myself? If
someone is willing to break into my car, what is stopping them from trying to
break into my home?
No one should have to feel this way in a place they work so hard to own. Today,
there are 34 drug treatment and rehab centers located within the Brooklyn,
Brooklyn Park, and Curtis Bay communities. 34. Let that sink in. As
residents, we deserve answers. How [clears throat] are these facilities
regulated? Are they all meeting state and federal standards? Are they
providing effective treatment and long-term recovery? or are they simply
contributing to a revolving door that leaves both clients and surrounding
neighborhoods struggling? Residents regularly witness drug dealers waiting
in the alley behind Third and Horton Avenue for methanone doses to wear off
so they can sell drugs to vulnerable individuals. How is this acceptable? How
has this become normal? [clears throat] I also have to ask our
elected officials, why are there so many treatment facilities concentrated in our
communities? Why aren't these same facilities distributed more equitably
throughout surrounding areas, including places like Annapolis, Canton, or other
communities with the resources to help share the responsibility. The people who
live in Brooklyn, Brooklyn Park, and Curtis Bay, matter. We are hardworking
people. We are homeowners. We are parents, grandparents, educators,
veterans, and small business owners. We work every day to provide for our
families and invest in our community. We deserve to feel safe when we walk
outside, when our children play in the park, and when we come home after a long
day of work. This is not about lacking compassion for those battling addiction.
They deserve access to treatment, dignity, and every opportunity to
recover, but compassion for those struggling with addiction should never
come at the expense of the safety, peace, and quality of life of the
residents who call these neighborhoods home. I will continue standing alongside
my neighbors and speaking up for our community because we deserve better. So
I ask our elected leaders and decision makers, what are your solutions? Please
don't tell us nothing can be done because of laws and regulations.
Communities across the country have found ways to balance treatment
accountability and neighborhood safety. We deserve that same commitment. The
people of Brooklyn, Brooklyn Park, and Curtis Bay have waited long enough.
» [clears throat] >> That is one of my neighbors. I have
comments from another neighbor, but I see I have 56 seconds. Um, so I will
just stress uh the 34 drug treatment centers. Apparently, the state of
Maryland is not aware there are 34. Their census doesn't seem to include
them. And the last time they testified before this committee, they came up with
six. And we having eyes can see 34. Um [clears throat] the community
concerns of course are one particular center 800 patients per day coming into
our community many coming from outside and it's next to the park one block from
an elementary school and half a block from a high drug traffic intersection.
We ask that the city council and our elected officials take action with
respect to these problems. Thank you. >> Thank you Jan. All right. Is there
anyone else that would like to testify today? Vin McCormack.
» Good morning, Madam Chair, and [clears throat] fellow attending members
uh of city council. My name is Vim McCormack. Uh I'll Is it three minutes?
Three minutes. Okay. >> It's a great honor to be down here to
talk about recovery houses in Baltimore City. I'm going to make an admission uh
before the council. Uh I've been operational
since 2019. uh I took some advice, some suggestions
from some fellow providers who had a housing element attached to them. Uh so
I opened up some recovery houses and we were 2.1
and uh OP and IOP initially. Uh I learned after a few years that I was out
of order. In fact, uh, Optum at the time had set out put out a, uh, an alert that
if you were operating in 2.1 IOP, you were not supposed to have housing
attached. Now, I can tell you that
many providers who have IOP have housing attached. Of course, I won't say their
names because they say snitches get stitches. But I'll tell you what I did
was because I sought to be in order and do what's expected of
me as a provider. I took the time, the money, and the effort to go and get 3.1
and 3.3 residential treatment, which is what's supposed to happen.
» So, we went ahead and did that. Um, and we also took the time I was I was not
advised by some of the fellow providers uh that I took uh suggestions from that
you're supposed to go down to the permit office and get reasonable accommodations
through those wonderful folks and they come out and do a proper inspection and
then at which you can operate uh as an entity having more than four unrelated
people in your house. I didn't know that. I was taking suggestions from some
people who was doing it before me. What does that say?
That says you got to be careful where you get your resources from and your
information. So I can tell you that since that time I take great pains to
make sure that the houses we have currently recovery houses in east and
west Baltimore are residential properties meaning they're under the
residential license uh under Caroline and BHA. They also have taken we've
taken the time to go through the proper process to get reasonable accommodations
through the permit office. Now I'm I'm really glad that we're having this
conversation. We're going to have I think we're going to have to have more
than this meeting T Porter because it's it's a broad it's something that's
happening. You and I talk about it quite a bit. So I appreciate the effort uh and
just putting the spotlight on it because it starts and ends with the provider. If
you're in the neighborhood, you have recovery house.
» The neighborhood and I appreciate this lady sharing. The neighborhood shouldn't
know. I think that you're you should your footprint should be liked and it
should make the you should make that neighborhood better because you're
there, not worse. Thank you for the time. Thank you so much, Vinn.
All right. Does anybody else would like to testify before we transition into
agency reports? >> Yes, ma'am. Thank you.
» Hello. My name is Tanya Richardson. >> Yes, ma'am. If you can pull the mic
down, please. >> Yes. My name is Tanya Richardson and I
um am administrative director for a behavioral health program. Um the change
came about the housing. When a change came about the housing, I have been down
to housing on Fed Street plenty of times. The application is so complicated
sometimes and it's no help. They say that they help you. They give you a
packet. They highlight some stuff. if I go through it and then the packet
doesn't even look like what's on the screen and then you wait too late for
the special accommodation and then they cancel it then you have to go back down
there. I feel like if we're going to follow the law that maybe we should get
some support. It's no one down there that's going to do the application. I'm
not familiar with the application. So, I do the best that I can and the one
application that I keep trying to do keep getting cancelled because I don't
know exactly how to fill all the information out
» and I think they give you like two days to finish the special accommodation that
they don't even tell you that you have to do. You just keep checking the email
and then all of a sudden it pops up. Oh, I have a special accommodation. I think
that it's like helping some individuals to feel
defeated in the situation when they're trying to do the right thing.
» So that's >> No, I appreciate that. I appreciate that
an aspect and and just to you know, I've been on the side of being a consultant
for for many uh clinics and so one one of the thing that I encourage is one to
get a mentor. uh getting with like-minded people um within the
industry that can help you kind of navigate, but then also um making sure
that you are um you're crossing your tees and dotting your eyes because
unfortunately uh lack of knowledge or lack of support
is by no means any type of um excuse for not following the law. And so, you know,
we we have that built in. We're going to be, you know, sharing some of that
technical assistance because I hear that quite often. um and you shouldn't have
to hire a very expensive consultant to um provide that technical assistance for
you. So, totally agree with you. Um and I look forward if you know I'll stay
after the hearing and I look forward to helping where I can.
» Okay. >> All right. Thank you so much, ma'am.
» All right. We're going to now turn it over to BHSB for your presentation.
» Great. Thanks, Councilwoman. Good morning, everyone. Uh, council, uh,
committee members, madam chair, for the record, my name is Dan Rabbit. I'm the
policy director at Behavioral Health System Baltimore. It's good to be with
you.
Um, so what I want to do today is go over just sort of the the framework and
the regulations that govern substance use disorder clinics and recovery homes
in the city uh, and in Maryland. share just some updates from some that have
occurred since the last time I came and um you answer any questions that folks
have. Um before I get into my presentation, I I do just want to um
share you might have seen a article in the Baltimore banner like last week um
news around budget cuts that were coming to Baltimore. Um and so I just wanted to
share that um that is happening. Uh it's across the state. It's not just
Baltimore. Um BHA, the behavioral health administration shared that all local
behavioral health authorities need to cut uh 13% from their grants and
operations. So that is happening. Um we are working you know ultimately BHA
makes the decision. We are working to develop recommendations on where we
think that uh those cuts can be made. Uh but no decisions have been made at this
time. We're happy to come back uh in a you know two months or something to
share where things landed if that would be of interest.
Um but that's not exactly what we're talking about today. Just wanted to put
that out there first. Um where should I point it?
Sorry.
Could Are you able to advance it? Can I just ask the Okay, just since got
technical difficulties.
Yep. Yes. The next slide, please. Um, just as a reminder, behavioral
health system Baltimore has been around since 1986. We merged uh with the
substance uh use system in 2013 and have been the local behavioral health
authority since then. We're an independent nonprofit uh that serves in
that role. Next slide, please. Um local behavioral health authorities uh fulfill
a number of functions. We manage public funds. We contract with providers to
provide mental health and substance services, provide public education on
behavioral health, um and oversee the system. and um providers to some extent.
Next slide, please. And so want to go over substance use
disorder programs and recovery residences. Those are two separate
things. Um and so it's important to keep that in mind. It's a little technical.
Members of the community, you know, may not be able to tell the difference
between one and the other, but regul from a regulatory perspective, they're
two separate types of programs. Next slide, please.
So, substance use disorder clinics must be licensed by the Maryland Department
of Health. They must uh obtain an agreement to cooperate with the local
behavioral health authority. And um they are regulated by uh COMAR 1063.
Um and they're traditionally what you think of when you think of like clinical
treatment for substance use disorder. We have outpatient programs, we have
residential programs, we have opioid treatment programs, which often called
methadone clinics. Um, and so all of those clinics, we know where all of
those clinics are. They have a license with the state if they are billing
Medicaid for any services and they have an agreement to cooperate with us. Um
and so we have a better sense of where these programs are and um you more
access to to what um to what sort of services are being provided there. Uh
next slide. um certain programs uh psych uh psych
rehabilitation programs, PRPs, um substance use partial hospitalization
programs, PHPs, and substance use intensive outpatient programs, IOPS have
had a pause on new enrollments with Medicaid for those three provider types.
That pause has been in effect since July 1st, 2024 and was recently extended
through December 31st, 2026. So that's two and a half years of a pause that the
state has uh put in effect and gotten permission from the federal government
to put in effect to try to figure out what's going on with these sorts of
programs and uh put in place new regulations to address concerns about um
you know a proliferation of these types of programs and a big increase in
spending and reimbursement for these sorts of programs. Um and some things
have been put in place and uh you know we hope that they will help kind of uh
prevent so many of these sorts of programs from opening up. Next slide
please. Recovery residences on the other hand
are not clinical treatment. They do not need to receive a license from BHA. They
do not need an agreement to cooperate with us. Um they can uh receive
certification from the state. Um but that is a a less rigorous process than
lensure and they don't have to and also like at the end of the day a recovery
residence is just a house. Um clinical treatment is not being provided. They
may market themselves as a safe and appropriate place for uh people early in
recovery. Um but it's essentially just a house. And um if they want to receive
funding from the state, they need to be certified. And certified recovery
residences do receive an inspection from the state um every year or two depending
on the circumstances. Um but they are sort of um a parallel thing to licensed
uh clinical substance use treatment. Um next slide please.
One thing just I wanted to lift up is that there is a new we have sort of
rebranded a existing program. It was called the substance use crisis
stabilization center. It is now called the substance use urgent care center to
better align sort of the nomenclature and the regulations that exist in the
state. Um this uh urgent care center uh accepts walk-ins. It's open 24/7 and
this is where someone can go who needs immediate support with a substance use
need. They can go they can uh receive, you know, meals somewhere place safe to
stay, referrals to ongoing treatment. Um and so we just want to let you all know
that that exists. That is a a licensed program um and a really important, you
know, kind of component to the continuum of services we provide. Next slide.
Um, one of the main things the state is doing to try to address some of the
concerns around PHPs, PRPs, and IOPS is updating the Comar 1063 regulations.
Next slide, please. These regulations uh govern lensure and
accountability and oversight for uh the public behavioral health system. Um, and
the revisions are putting in place a number of new expectations,
new tools for system accountability, and they also require all recovery
residences to get certified. So, we're excited about this. Um, and, um, you
know, it's been an ongoing process. It's been going on since, uh, again, July
2024. Next slide, please. Um, you know, just looking through the
timeline, um, an official draft was issued in May of 2025.
Um, there were a lot of concerns about that draft and then the state rescended
the those draft regulations and then worked more intently with uh
stakeholders to develop sort of a new draft. A new draft was um has been
shared and updated over the last you know uh year. And um next slide please.
And at this stage we are happy to say that the the most recent draft was
shared with the committee for administrative executive and legislative
review uh at the state level at the in the state legislature. AALR. This is
sort of the first like the step that happens before draft rags are published
in the register. um they must be submitted at least 15 days before
publication. So they were submitted July 10th last
week. So maybe 2 3 weeks from then uh we might see them published in the register
at which point there is a 30-day comment period and then um the formal
promulgation. So we might see these new regs in place done and and in effect
maybe two months from now which is nice. We've been on quite a quite a journey.
So so that's some news to to share share with the committee.
Next slide please. Um, and I just want to go over once
again like the provider accountability um, functions that BHSB provides. And
um, again just really emphasize our our interest in partnering with the
community, with this committee, with the city council to make sure that any
provider in Baltimore City that is licensed and billing Medicaid and
serving our residents is providing highquality services. you we want to be
a partner and we want to you know help however we can to make sure that that's
occurring. Um next slide please. Um
the main again we um conduct regular audits and site visits to certain
provider types. Um we work with the state on corrective action plans,
performance improvement plans. Um we have to get a or providers have to get
an agreement to cooperate with us before they can seek lensure and we track and
respond to critical incidents and formal complaints.
Next slide please. Um we also have a provider relations
manager and team that you know goes beyond reactions to issues to providing
best practices and meeting with licensed providers a quarterly basis. We um
attempt to meet directly with any organizations seeking lensure. Uh we
provide trainings um and update the provider network on any any changes that
are coming. Uh next slide please. And you know the one thing we want to
emphasize with this group and with any community members is that if there is a
concern about a licensed behavioral health provider, please submit a
complaint. We have a team that responds to those complaints and investigates
them. You can scan that QR code. You can also go to our website. You can also
email any member of the BHSB team for support and we will enter that
complaint. It will be investigated and any findings will be kind of sent up the
chain to the state which is where uh any uh corrective action would occur. Um and
so so that's like the main like one of the main ways that we get information
about what's going on in the community. So we encourage uh folks to use that
that complaint portal. Next slide, please.
And so that's sort of just an overview of our role um and what's what's been
going on and some news since the last time we we came to present. Um, again,
just want to emphasize that we want to be a partner in addressing concerns
about whether providers are being good neighbors and providing high quality
services. >> Thank you so much, Dan. Um, I really
appreciate it. And and colleagues, I know that these hearings have been um
very long and and arduous process, but it seems like we're almost to the finish
line. Um, Komar63 has been something that I know I've worked on for the past
few years. Um and so it's really exciting um that we are close to the
finish line and it'll finally give us um some opportunities within our roles um
to really um have the the type of quality of life issues that we're seeing
in community actually to be seen and heard um and also being taken accounted
for. [snorts] Um so I'm going to start colleagues we're going to have um DHCD I
know you all don't have a presentation but would you like to provide any
comment before we go into our round of questioning?
I'd like to ask a question if I could. >> Sure.
» Um, with the recovery homes being certified,
» what role will you guys provide with that? Um, is it anything similar to what
you provide now for licensed? >> No. So, um, recovery residences are
handled more centrally at the state level. They do the certification. They
maintain the list of recovery homes. They respond to complaints. They do the
inspections. I think we we hope that we will we will have an opportunity to work
with the state on getting the word out on um educating community recovery
residences providers about the changes that are occurring in Comar 1063. So, we
want to be a partner and we hope that we will be a partner with the state, but
recovery residences are just more managed more centrally.
» Yeah. So, that's what I figured was going to be the answer. And and so DHC's
comments would be that, you know, Miss Evelyn testified about um one neighbor
and and the impact that the recovery homes have on that neighbor and the
neighborhood. And uh DHCD he's hears this constantly and we're expected to
step up and do enforcement on these homes and pull their permits or stop
them from, you know, getting the zoning >> um cite them, you know, take them to
court. And really, >> most of what goes on is outside of
DHCD's control or oversight or ability to regulate. Um, and I would have hoped
that the state in in doing the regulations for um, 6310
would have actually pushed recovery houses to that licensed status
» because I think that then gets you to the point where
» there is someone >> who can deal with these problems. And
when the complaints come into DAC and we're going out and sending inspectors
and all we can do is sight for the trash or the high grass or um you know
[clears throat] make sure they're properly permitted.
» Can't shut them down, but we can get them to to have the right permits in
place >> usually, but that there would be someone
that those referrals could go to that would then
» be able to revoke a license and shut a place down
» if they're needing to be shut down. Um, and that's the frustration we share with
the community in that we're here to try and help and serve and make better
Baltimore, make Baltimore a better place.
» Um, and a lot of times our hands are tied and it is very difficult for us to
then, >> you know, properly respond without
» being the the fall guy. >> Yeah. No, Jason, I appreciate that. And
and I want to just take that a little bit further. And um I I want to take
that a little bit further because I I I think that
outside of citation and high grass and weeds, I think that there are things
that DHCD could be doing. So we could possibly revoke their rental license. we
could possibly um you know have some sort of connectivity with BHSB to say
hey this is um a site that we haven't seen that is registered you know have we
looked into do they have any Medicaid complaints do they have any complaints
with the state like I want us to think a little bit more strategically than
exactly what is on paper because again and this kind of flows into my first
question how do you all and I suspect from your answer that there's not much
that has been done, but like how do you all handle any type of 311 complaints um
that come in related to said uh said residences? Like walk me through that
process and walk me through how you all are um again citation or fines or
anything. How how do you all walk through that process?
» Sure. So I it does depend on what kind of complaints are coming in. So, if it's
just the standard um sanitation related complaints, that usually lands with uh
um the property maintenance inspections division and they will respond like they
respond to any home. >> Um if they see trash or high grass and
weeds or other sanitation issues, they would issue a citation
» and that really is the the end of that until there's another complaint. um if
it does rise to that level where it's egregious, then it may get referred to
the legal section to do a pattern practice case or something.
» And how how many do you know like what is the threshold for the legal section?
Um because I mean for example in Brooklyn and Curtis Bay, there are key
um key sites that I know on the over the past 5 years that have been cited and
pushed through 311, but they haven't hit that legal threshold yet.
» Yeah. I mean, there's not a set number, but it's the where the complaints are
and the citations exist and then the citations aren't getting a response. So,
when we take a case like that to court, usually we're looking at multiple
citations within a three-month period. >> Um, not something that has dragged out
over, you know, like three citations in three years would not be a a place that
would rise to that level. But when you're getting um regular calls and
going out and seeing the same issue that isn't being addressed by the property
owner or the property manager, whoever may be in responsible, that's that's
when those things can be elevated. Um >> but if they're not enough inspectors or
only minimal inspectors that kind of handle a quadrant, um how are they going
to get out the repeated, you know, how how are they going to get out there to
the repeated calls if they're going to other places? And so like that three
month >> it
» yeah it is a constant challenge. Um they 311 calls are um prioritized you know so
where things fall off more is when it's reinspections and violation notices and
those things but they do go out >> um and if there is a violation we'll
issue the citation or a notice as appropriate. Um,
» what would happen if we pull a reasonable accommodation from a
residence?
» The reasonable accommodation itself,
» nothing really. >> So, they wouldn't have to shut down. So,
in order for them to >> we'd have to pull the use permit.
» The use permit. So, yeah. What would it be if we pull even even if we pulled the
use permit, what would that would that shut them down?
um they they would be operating without a use at that point,
» which would be a violation. >> Which would be a violation. And then
» um you our our revocation of a use permit is not the same as health
department shutting down a restaurant for code violation or even the fire
department like shutting down. It's it's not immediate in that sense. So if they
continue to operate, they'd be operating illegally and then we would take them to
court. We could also find them and other things, but
» And what's the uh duration um from for when we take them to court?
» Uh >> are we looking at a three month, six
month? What are we looking at? >> Yeah, the court process is usually we
would get into court within four to six weeks
» and then they could ask for postponements.
» So it could be three months, six months, you know, just
» depends on the case and then to an appeal.
» Yeah. And so Trey, I I had asked the last hearing, I asked for a tiger team
related to to this. Have you all developed this tiger team? And do you
all have any outputs for today's hearing?
» Uh, thank you for the question, Councilwoman Porter. Uh, I'm not 100%
sure. Um, however, I can take it back uh um to Tylure and uh and also ask Isaiah
if he has any insight on that. >> Yeah. And so I would just love to know
the status of that Tiger team and any type of report out if we can get a um a
formal response within a week. Um that would be great to the committee.
» Colleague Billy, >> thank you colleagues. I'm going to um
turn it over to you all um for your line of question. I'm going to start with
Councilman uh Conway. [clears throat]
» Thank you, Madam Chair, and I appreciate you continuing to focus on this issue.
Um, as everyone knows here, this is a pretty nuanced issue in our communities
and we're trying to make sure that we address it appropriately and so I
appreciate uh all the leadership from BHSB um and the work you guys are doing.
Uh, I I had a question um uh very recently there was a a treatment
center that opened up in my district and I did not know about it [clears throat]
and it sort of sparked a question for myself.
um about how that could happen. Are there instances in which folks may not
necessarily have to go through certain procedures in order to open a treatment
center? Um, for instance, if they're not um is there are there instances in which
they don't necessarily need a license in order to open or
» uh if they want to be a licensed behavioral health provider in the public
behavioral health system and bill Medicaid, they have to then no, they
they need a license. Okay. if they are not providing clinical behavioral health
services. If they're you know providing mentorship or
» um [clears throat] you know after school care like there's a variety of different
you know kind of social services or health and human services that an entity
might provide um in which case like that that that's not going through the
Maryland Department of Health behavioral health license process. Um, but if they
are billing Medicaid for behavioral health services, then no, they need to
get a license from us and then we we email y'all um every other month with
with new um licensed providers that open up in your uh district.
» And if they weren't billing Medicaid, >> then then no. But but at that point,
like what are they doing? You know, like how are they serving people? I guess
they could they might if they're just billing private insurance, maybe if if
they have a grant to do something outside of the public behavioral health
system, then maybe. But um but if they're providing mental health or
substance use services, then they essentially need to be licensed. Would
you guys be notified in those instances or
» No, we're, you know, there's there's a wide range of different sorts of, you
know, social services that could be provided and so we we're only involved
with uh licensed behavioral health providers and um and other and and the
folks that we directly contract with. >> Got it. Um, and then I guess there's a a
broader question um for the um for the services that we end up
having these issues that the folks have testified earlier today about um
are these folks that only are receiving Medicaid or are the ones that are maybe
only relying on private insurance or out of pocket um do they don't they have the
same issues? Um, and in light of those issues, should we also be making sure
that we know when they open up in order that we can make sure we better support
our communities in those instances as well? I don't have the answers to those
questions, but that's one of the things that came to mind for myself. Um, so I
don't know if you want to add anything to that.
Um, yeah. I think
it's just hard for me to like it's hard for me to
envision like what these entities are doing if they didn't get a license like
um you know like a someone can call
themselves whatever they they want. Um but
» and I I think we we did respond like we worked with your office on on this one
particular uh program that you had concerns about that the the um community
had concerns about and they just weren't providing mental health and substance
use treatment. They were doing other things. Um, and so, um, I think we're
we're happy to to to to get involved and to to help help
figure out what's going on in any instance, but but it's just hard to know
like how we would how we would get informed in the first place if they're
not like applying for lensure or something.
» I appreciate I I'll follow up with you guys about the one that I have in mind.
Um I I don't know how they're being paid if they apply for a license or otherwise
and but I I'll follow up with you guys on that and figure out if this is one of
those instances. But I was curious like how it kind of slipped through the
cracks and we didn't get that notification.
» But thank you Madam Chair. >> Sure.
» Thank you so much. Any other questions, colleagues?
» Councilman Bullock. >> Madam Chair. Um, not so much a question,
but just um, thank you um, Chair Porter for holding this hearing again and just
thank you for everyone here today. Um, one of the things that's not lost on me
and it's also driven by your line of questioning as as well as that of uh,
Councilman Conway. Uh, the reality is that's a difficult situation for us to
navigate and on one side we're trying to make sure that folks are getting the
help and the care they need at the same time trying to balance that with some of
the quality of life concerns that you mentioned within our neighborhoods. So
again, appreciate housing, but also appreciate uh BHSB and uh Council Member
Porter again, just as we emphasize trying to balance these issues and what
we could do in terms of the state regulations as well. So it is much more
complicated than folks realize and all of our districts are impacted by it. Um
it's evidenced by some of the questions and comments, too. So thank you for
doing this. >> Thank you so much, Councilman. All
right, Councilwoman Ramos. >> Uh thank you, Madam Chair. Uh and thank
you again for your attention to this issue in the committee. Um I had a
couple of questions. One is uh the last hearing we asked for specific lists from
DHCD about um the uh I guess they're called recovery homes um that uh have
reasonable accommodation. Uh the answer was we don't have that list. Uh the
other uh request was how many um of these uh homes are uh classified under
the bill that we uh passed several years ago around the supportive housing. Um
and uh the answer was we don't have that list. And so uh I think there's two
things happening here. One is there may be a confidentiality HIPPA issue I
guess. Um and if that is the case, that should have been the answer. Uh but the
other answer may be that um for some reason we're not collecting the data
after we're approving these reasonable accommodations, which does not make any
sense to me. Um I I think it should be done in a way that is uh similar to what
we do with rental licensing uh but maybe not as public because there could be
some HIPPA issues. Um but more around like you know we we need to know where
where some of these are so that we can h have conversations with BHSB
uh and the state uh as to the challenges that we're seeing and um so I just want
to hear a little bit more from DHCD about this issue. Uh again I I'm trying
to approach this as a client- centered approach. I mean, yes, we care about our
neighborhoods, but I don't think we'll be able to legislate anything unless
we're really concentrating on making sure that the clients are getting the
care that they need. Um, so we don't have these lists, even though we're
asking people to certify themselves or apply for these um these these issues.
» So, the the reasonable accommodation process, I don't remember the exact time
frame, but when it was created, it was created post litigation when the city
had been um denying permits for more than four individuals in a property, use
permits for more than four individuals in a property. And that was deemed
discriminatory. And um one of the resolutions was to create the reasonable
accommodation process so that we could grant an exception to the no more than
four unrelated people in a property based off of a legitimate need um to to
have that reasonable accommodation. Um so they
at the time it was never um thought of as a tracking method. it was just a
check and balance to issuing a use permit. Um, so we're we did pull and
we're able to pull um from the use permit data any use permits where it
mentions reasonable accommodation or um residential treatment or substance abuse
treatment. So that all by word search for you know lack of a better term
» that can be done but >> to the best of my knowledge no list was
ever generated because also um the reasonable accommodations come in um but
they may not actually go through with it and get the actual use permit to do
that. So sometimes they fall off or they they go through they open up and then
they close down. And so there's they just never created a list,
» right? >> Simple.
» And so I think we we I think we're going to need that in the new format relative
to, you know, especially if we're going to have these certified. Um and again,
we can talk about whether or not they're private or public in terms of who has
access. Uh but because also there's ADA and fair housing concerns. Um, but I
also know that um, you know, we want to figure out um, how to how to do that.
And I did see the the outline on the spreadsheet where you did have, you
know, based on whatever the permit was uh, but it was, you know, it's not
necessarily a consolidated list as well as uh, sometimes in the an early list
that I saw at the beginning of my uh, being a council person, these were like
historic. I mean, they they may not be, you know, reasonable accommodation
anymore. I just think we don't we don't we haven't built that kind of
infrastructure yet. And so, um, I think we're going to have to, and that might
be part of the tiger team that Madam Chair is suggesting is sort of a soup to
nuts approach, um, to figuring out how we're, um, having a better
accountability for making sure that the care that people are getting is the high
quality care that they're supposed to get. Um, so I will follow up um I guess
with you on that because I think that we do need to have you know something like
that. And then the the um and that's probably the same for the other piece
around a bill that we passed um in terms of figuring out the um supportive
housing um bill uh and making sure that we're actually figuring out what
properties are under that bill um and go from there. So, um, be happy to to work
with you on that because that's going to be critical information for resident for
us, um, as well. And we do I I understand the the confidentiality
concerns. Uh, but I do think that we've got to have some way of talking about
it. And then um I'd like to add and maybe this is a committee request um for
uh the um person who came in to talk about all the information that she did
not have uh to try to address this. I mean that's information not just for
providers but for the public to know so that we know what to expect um and what
certifications are needed for certain things if people are seeing things in
the neighborhood. And so we may want to develop uh that kind of public
information. Uh and madam chair, I don't know if you want to add that to the
tiger team work or if that's something to add as a committee request.
» Yeah. So I'm going to help her navigate because BHSB actually does that and so
I'm going to help her navigate through that process. Yep. Thank you.
» Sure. Sure. Um well I was also thinking that there could be you know um some of
this as well. And then the last thing I'll say is that you know my um you can
anticipate that um one of my neighborhoods does have a concentration
of uh these places and we hear from them a lot and uh I'd like to try to get some
folks together to really look at each one because sometimes it may not be that
and sometimes it is and we want to make sure that folks are are really taken
care of. So, I'll bring be pulling people together to to take a look at I
mean, they may not let us in, but at least we can knock um and and see see
what happens. Um so, thank you. And Madam Chair, I'm sorry I have to excuse
myself. I have to represent us uh at Mako um this morning.
» That's fine. Thank you so much. All right, Councilman Blanchard.
» Thank you, Madam Chair. Uh thank you, everyone. I before my question, I'll
just briefly say to uh the chair's point about the mentor program. Um recently I
had a um uh inpatient recovery facility in the district that had had some some
constituents were reaching out about it. Um you know, I'm not sure if that was
accurate or if it was stereotyping or whatever, but reached out, had a meeting
with the owners. They they were definitely reluctant to talk, but once
we talked and we had a you know decent conversation and then they had I think
it was a paid consultant but it is someone else who does this work and so
like well let me put you in touch with him and like talked to him and like 2
days later they had a here's our good neighbor policy here's our like here's
the line of contact here's like a program description like do you want us
to come talk at like a neighborhood assessment and I was like why why can't
it always be this Um, and and so I think I think there was like one slight change
that they made. And obviously some of these entities are bad actors that are
being predatory and negligent of their neighbors, but I think a lot of times
it's not the case. And so I was that was just really interesting to me because
that is not often my experience in in a situation like this. So that was really
interesting. Um, my question is for I believe it's Mr. T, so it might be for
the deputy commissioner Hler. Um so under Baltimore zoning code res recovery
residences fall under the residential care facility use uh which covers not
just addiction rehab but also other residential facilities where supervision
is required. In 2017 under transform Baltimore and to my understanding under
the guidance of a lawsuit settlement exits the city. Our zoning code was
changed to allow these facilities in every residential area with effectively
no restrictions. This is in a very significant contrast with other major
jurisdictions in the state like PG County which has bed caps in Montgomery
County which has a lot size requirement for bed. Um, I think this lack of
regulation becomes a particular problem in neighborhoods where the property
values are lower because then it ends up being the highest and best use where
you're seeing this and I think this has to do with the the overconentration that
we're hearing about and this concern that we're hearing about in so many of
our communities. Um, had these regulations been reviewed and changes
proposed over the last I guess it's 9 years since um, you know, transform
Baltimore has come into place and as as the effects have become clearer.
» Uh, good morning madam chair, members of the committee, Eric Tiso for the
department of planning. Um there has not been changes recently and uh if other
jurisdictions have found a way to uh add additional requirements that we are not
doing. I would want to defer that to the law department to see if we can apply
that here. Um so that would be the the first thing that we would want to check
with. Um, yeah, we share similar concerns where some of our middle market
uh neighborhoods have homes that are just big enough uh to meet the needs for
residential care facilities uh but are also just affordable enough uh to meet
their needs and that is a competition factor that we are aware of. So, I'm
happy to to look into that as well. U we're also aware of um what could
potentially be uses that try to fit into other land use categories. Right. I was
a few minutes late to this hearing because I was actually answering a
question for someone else about a use that may fit that filed for a permit for
one thing but may fit under another but that use is not available so they're
applying under the use that they may fit through. Um, so this happens with some
degree of frequency and so we'd be happy to to help with that. And I think the
concerns that we have more are not licensed facilities because there's an
avenue of getting at those, right? Zoning is more like a hammer than a
scalpel. Um, it's the supportive housing that is not licensed, that is not
medical, that is, you know, something to that effect that is difficult to address
in any meaningful way in zoning. um without another more specific tool that
does not then get at protected classes. >> Sure. And and thank you, Mr. Chie. So, a
specific followup uh regarding the um the zoning as it compares to to other
counties. Um and I know there's an important, you know, set of legal
questions based off the lawsuit and concerns around that and whatnot. Um,
have you ever seen an example where like Baltimore City couldn't do something in
the zoning code that other counties were doing in the zoning code? Like in the
state of Maryland? >> Uh, I've not looked at that specific
angle before. Um, Maryland is an interesting state where it has three
different categories of county that have different rights and privileges to them
and land use specifically is delegated in different ways. Baltimore City is in
its own subcategory of the land use article under the state. Um so in some
ways this is apples and orangutangs in comparison. U but again I would need to
get some help from the law department to see if there's a tool that someone else
has that we have not looked at. >> Okay. Yeah. because I've had this
conversation with law before and I I just
I personally struggle to sort of imagine a situation where other large counties
are doing something with their zoning code that we can't just also do in our
zoning code. Um, thank you, Madam Chair. >> Thank you so much, Councilman Parker.
» No. All right. Any other questions? All right. I'm going to go back um to DHCD.
Just want to um ask one final question related to um inter agency coordination
with the health department um the environmental control board and how you
all handle some of these issues. So like if you see a recovery home um in the
district it has various citations. Are you all sharing that data uh with other
agencies so that they can also add on their particular realm or scope of
practice from a citation perspective? >> Um
not particular to recovery homes but in but in general. Yes. Um and actually
we DHD pushed um the mayor's office uh to create the multi- agency task force.
Um that was something that um we felt like a lot of times we were calling the
other agencies for support. And so we felt it was better that it be led by the
mayor's office. And so um that's a group that meets every Thursday and tackles
some problems that are really cross agency. Mhm.
» Um so we'll work with department transportation, uh fire department,
health department, uh liquor board. >> So the reason Yeah. The reason why I
asked this because I have a um specific list of SRS um that I would love to see
um I would love to see if they've been discussed within the MAFE. Um because
there hasn't been really there hasn't been much um movement on those SRs. They
were just closed. If you want to send I don't need the SRS but the addresses.
» The addresses. Okay. Perfect. >> Send those over to us and we can take a
look at them. >> Okay. Perfect. And I mean even some that
were mentioned today within Brooklyn and Curtis Bay. I would love to see I mean
those are just addresses right off the top of my head without going to the
office. >> Having the addresses would be
» okay. Perfect. >> Any other questions colleagues?
» All right. Hearing and seeing none. Thank you all so much for joining us
today. Um I really appreciate it. Um I believe we have just one second. I
believe we have one more person. Um, Janet Allen that wanted to provide
testimony. I'll allow uh two minutes. Miss Janet.
Miss Janet.
All right. If you are on mute, you're you need to unmute, Miss Janet.
Okay. All right. Um well, we're going to close out um public testimony for the
second time. And thank you all so much for joining us today. Have a great day.