As the State of Maryland has wrestled with its budget issues for the last several years, WMHS has suffered immensely. Not only are we hit with payment reductions for the hospital-related services that we provide year after year, but we are also impacted by the elimination of funding for community health and social needs programs. We have become one of the lone resources for behavioral health patients. By the State reducing and, in some cases eliminating, funding for drug and mental health programs offered by our local health department, these services are no longer available or have been significantly diminished and the responsibility for care falls to us. A large percentage of our ED patients now have a behavioral health diagnosis since the maintenance programs which previously existed no longer exist and these patients are at their worst by the time they get to us. The Health Department continues to do what they can with their limited resources. We provide outpatient services, but they are at capacity and there is little to no funding to grow such programs. I am not sure how this situation will be resolved, but until then we will continue to serve this vulnerable population without the help from the State.