EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1149*
HOUSE BILL 1149
J1 3lr2717
CF SB 622
By: Delegates Pena–Melnyk, Cullison, Kelly, Lehman, and Taveras Taveras,
Alston, Bagnall, Bhandari, Chisholm, Guzzone, Hill, Hutchinson,
S. Johnson, Kaiser, Kerr, Kipke, R. Lewis, Lopez, Martinez, M. Morgan,
Reilly, Rosenberg, White, and Woods
Introduced and read first time: February 10, 2023
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 7, 2023
CHAPTER ______
AN ACT concerning 1
Medicaid Waiver Programs – Waitlist and Registry Reduction 2
(End the Wait Act) 3
FOR the purpose of requiring certain Medicaid funding to be used to provide community 4
services to individuals waiting for services through certain waiver programs; 5
authorizing certain Medicaid funding to be used for hiring and retaining providers 6
expanding provider capacity in certain waiver programs; altering the uses of certain 7
funding appropriated to the Dedicated Purpose Account in the fiscal year 2023 8
budget bill; and generally relating to Medicaid waiver programs. 9
BY repealing and reenacting, with amendments, 10
Article – Health – General 11
Section 15–150 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2022 Supplement) 14
BY repealing and reenacting, with amendments, 15
Chapter 484 of the Acts of the General Assembly of 2022 16
Supplemental Budget No. 5, Item 14 17
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 18
That the Laws of Maryland read as follows: 19 2 HOUSE BILL 1149
Article – Health – General 1
15–150. 2
(a) (1) (i) The Department shall develop plans to reduce the waitlists for 3
the following waiver programs by 50%, beginning in fiscal year 2024: 4
1. The Community Pathways Waiver; 5
2. The Community Supports Waiver; 6
3. The Family Supports Waiver; 7
4. The Brain Injury Waiver; 8
5. The Home– and Community–Based Options Waiver; 9
6. The Medical Day Care Services Waiver; and 10
7. The Model Waiver for Medically Fragile Children. 11
(ii) The Department shall develop a plan to reduce the registry for 12
the Autism Waiver that includes conducting eligibility determinations of individuals on the 13
registry and, beginning in fiscal year 2024, providing services to at least 50% of individuals 14
determined eligible. 15
(2) The plans required under this subsection shall include: 16
(i) An assessment of whether each waiver program needs to recruit 17
and retain new providers; 18
(ii) Measures to recruit and retain providers for each waiver 19
program to expand the capacity of the programs; 20
(iii) Any changes in reimbursement rates needed to ensure provider 21
capacity to provide services under the waiver programs; 22
(iv) The expected time frame for conducting eligibility 23
determinations for the Autism Waiver; 24
(v) The expected time frame for reducing the waitlist or registry for 25
each waiver program by 50%; and 26
(vi) The projected cost of the measures to be implemented under the 27
plans. 28
HOUSE BILL 1149 3
(3) Provisions of the plans relating to the Autism Waiver shall be developed 1
in conjunction with the Maryland State Department of Education. 2
(b) On or before January 1, 2023, the Department shall submit the plans to the 3
Governor and, in accordance with § 2–1257 of the State Government Article, the chairs of 4
the Senate Budget and Taxation Committee, the Senate Education, Health, and 5
Environmental Affairs Committee, the Senate Finance Committee, the House 6
Appropriations Committee, and the House Health and Government Operations Committee. 7
(c) (1) Beginning in fiscal year 2024, the Governor shall include in the annual 8
budget bill sufficient funds to carry out this section. 9
(2) FUNDING INCLUDED IN T HE ANNUAL BUDGET BIL L UNDER 10
PARAGRAPH (1) OF THIS SUBSECTION M AY BE ALLOCATED TO P ROGRAMS 11
IDENTIFIED UNDER SUB SECTION (A) OF THIS SECTION FOR THE PURPOSE OF HIRIN G 12
AND RETAINING PROVID ERS. 13
Chapter 484 of the Acts of 2022 14
Supplemental Budget No. 5 15
14. Y01A02.01 Dedicated Purpose Account 16
In addition to the appropriation shown on page 135 of the printed bill (first reading 17
file bill), to provide funding to support legislative operating budget priorities. Following 18
Legislative Policy Committee review, the Department of Budget and Management shall 19
process a budget amendment effective July 1, 2022 transferring most of the funds listed 20
below to the appropriate budgeted programs. 21
(1) Apprenticeships …………………………………………………...25,000,000 22
(2) [Autism Waiver Expansions ] MEDICAID WAIVER 23
EXPANSIONS ……………………………………………………………………………...30,000,000 24
(3) New Unified Financial Aid System for Higher Education …….8,000,000 25
(4) M00A01.01 Hospital Assistance/Workforce Support ………...50,000,000 26
(5) T00G00.02 Tourism Grants ……………………………………...10,000, 000 27
(6) T00G00.05 Arts Grants …………………………………………..40,000,000 28
(7) N00G00.08 Additional Benefit – Temporary Cash Assistance and 29
Temporary Disability Assistance Program ……………………………………………35,000,000 30
(8) M00A01.01 Assisted Living Facilities ………………………….20, 000,000 31
4 HOUSE BILL 1149
(9) M00A01.01 Assistance to Nursing Homes ……………………..20,000,000 1
(10) T00F00.29 Western Maryland Economic Future Investment 2
Program …………………………………………………………………………………….20,000,000 3
(11) D40W01.12 Historic Revitalization Tax Credit ……………….10,000,000 4
(12) R75T00.01 Implement Strategic Plan for the Universities at Shady 5
Grove ………………………………………………………………………………………….5,000,000 6
(13) R00A01.01 Bonus – Noncertificated Education Support 7
Professionals ………………………………………………………………………………...8,000,000 8
(14) T00F00.15 Small, Minority, Women–Owned Businesses Account for 9
Fund Managers ……………………………………………………………………………..4,000,000 10
(15) M00A01.01 Pediatric Cancer Research ………………………….5,000,000 11
(16) D15A05.05 Expand Maryland Corps Program …………………5,000,000 12
(17) M00F02.01 Loan Assistance Repayment Programs for Physicians and 13
Physicians Assistants ………………………………………………………………………3,000,000 14
(18) R62I00.54 Loan Assistance Repayment Programs for Nurses and 15
Nurses Assistants …………………………………………………………………………..1,000,000 16
(19) R00A02.07 Non–Public Special Education School Teacher 17
Salaries ………………………………………………………………………………………4,000,000 18
(20) M00F03.04 Enhanced Alzheimer’s Services and Research …...3,500,000 19
(21) W00A01.03 Establish Maryland State Police Gun Center ……3,400,000 20
(22) D21A01.04 Grants to Violence Prevention and Interruption 21
Organizations ……………………………………………………………………………….2,500,000 22
(23) R62I00 Formerly Incarcerated Youth Grant Program ……….1,200,000 23
(24) S00A24.02 Baltimore Regional Neighborhood Initiative ….…1,040,000 24
(25) S00A24.02 National Capital Strategic Economic Development 25
Fund …………………………………………………………………………………………..1,000,000 26
(26) D38I01.02 State Board of Elections Public Communications for General 27
Election …………………………………………………………………………………………500,000 28
(27) C00A00.06 Prosecutorial Transparency Reporting ………………600,000 29 HOUSE BILL 1149 5
(28) D05E01.11 State Center Redevelopment Plan ……………………500,000 1
(29) Q00C02.01 Parole & Probation review murders of offenders under 2
supervision …………………………………………………………………………………….323,00 0 3
(30) T00F00.04 Maryland New Start Act ……………………………….175,000 4
(31) A15O00.01 Disparity Grant Funding …………………………..15,368,715 5
(32) J00A01.03 Street and Sidewalk Improvements to Comply with 6
Americans with Disabilities Act – Baltimore City ……………………………… ……10,000,000 7
(33) W00A01.02 Grants to Police Departments to Acquire License Plate 8
Readers ……………………………………………………………………………………….5,000,000 9
(34) E50C00.08 Homeowner Protection Fund ………………………..1,300,000 10
(35) R00A02.13 Learning in Extended Academic Progra ms 11
(LEAP) ………………………………………………………………………………………..4,500,000 12
(36) D21A02.01 Local Management Boards ………………………….1,500,000 13
(37) D21A01.01 Grants to Domestic Violence Centers ……………..3,000,000 14
(38) M00L01.02 Operating Grant to Center for Neuroscience of So cial 15
Injustice at the Kennedy Krieger Institute ……………………………………………..2,250,000 16
(39) M00L01.02 Greater Baltimore Regional Integrated Crisis 17
System ………………………………………………………………………………………..2,000,000 18
(40) M00A01.01 Grant to Children’s National Hospital …………….1,500,000 19
(41) R00A03.01 Funds to Initiate Maryland School for the Blind Pay 20
Plan …………………………………………………………………………………………...1,200,000 21
(42) D21A01.01 Grants to Police Departments to Coordinate Task Forces 22
that Cross Jurisdictional Boundaries ……………………………………………………1,000,000 23
(43) V00E01.01 Grant to ROCA for Operations Outside 24
Baltimore City ………………………………………………………………………………1,000,000 25
(44) M00F01.01 Grant to Vision for Baltimore ………………………1,000,000 26
(45) R00A02.13 Operating Grant to Thread ………… …………………750,000 27
6 HOUSE BILL 1149
(46) R75T00.01 Grant to the University of Baltimore’s Schaefer Center for 1
Public Policy …………………………………………………………………………………...575,102 2
(47) L00A01.02 Pride of Baltimore ………………………………………300,000 3
(48) R75T00.01 Bowie State University ………………… ………………..50,000 4
Object. 12 Grants, Subsidies and Contributions …………………………….370,031,817 5
General Fund Appropriation, provided that no less than $317,031,817 of this 6
appropriation shall be transferred by budget amendment by July 1, 2022, in accordance 7
with the programs and funding amounts allocated in the purpose detail of this 8
supplemental appropriation. Funds for apprenticeships and development of a new unified 9
financial aid system for higher education along with $20,000,000 of the funds for expansion 10
of the autism waiver shall be transferred when agencies incur related expenses. 11
Further provided that no more than $250,000 of the appropriation made for 12
apprenticeships shall be used to support fiscal 2023 administrative costs associated with 13
public safety, transportation, health care, and higher education apprenticeship workgroups 14
operated by the Maryland Department of Labor. 15
Further provided that at least $10,000,000 of the appropriation made for [autism 16
waiver expansions] MEDICAID WAIVER EXPAN SIONS shall be transferred by budget 17
amendment in fiscal 2023 to program R00A02.07 Students with Disabilities. It is the 18
intention of the legislature that the Maryland Department of Health and the Maryland 19
State Department of Education shall apply to the Centers for Medicare & Medicaid Services 20
for an addendum to expand the current waiver by 1,350 slots. THE REMAINING FUNDING 21
OF THE APPROPRIATION MADE FOR MEDICAID WAIVER EXPAN SIONS MAY BE USED 22
FOR THE PURPOSE OF H IRING AND RETAINING PROVIDERS SHALL BE USED TO 23
PROVIDE COMMUNITY SE RVICES TO INDIVIDUAL S WAITING FOR SERVIC ES THROUGH 24
THE COMMUNITY PATHWAYS WAIVER, THE COMMUNITY SUPPORTS WAIVER, THE 25
FAMILY SUPPORTS WAIVER, THE BRAIN INJURY WAIVER, THE HOME– AND 26
COMMUNITY–BASED OPTIONS WAIVER, THE MEDICAL DAY CARE SERVICES 27
WAIVER, AND THE MODEL WAIVER FOR MEDICALLY FRAGILE CHILDREN. A 28
PORTION OF THESE FUN DS MAY BE USED FOR T HE PURPOSE OF EXPAND ING 29
PROVIDER CAPACITY IN THE COMMUNITY PATHWAYS WAIVER, THE COMMUNITY 30
SUPPORTS WAIVER, THE FAMILY SUPPORTS WAIVER, THE BRAIN INJURY WAIVER, 31
THE HOME– AND COMMUNITY–BASED OPTIONS WAIVER, THE MEDICAL DAY CARE 32
SERVICES WAIVER, THE MODEL WAIVER FOR MEDICALLY FRAGILE CHILDREN, 33
AND THE AUTISM WAIVER, INCLUDING HIRING AND RETAINING STAFF AND 34
PROVIDERS, INCREASING PROVIDER RATES, AND ADDRESSING OTHER ISSUES THAT 35
LIMIT PROVIDER CAPAC ITY. 36
Further provided that the $50,000,000 appropriation made for program M00A01.01 37
Executive Direction for the purpose of hospital assistance/workforce support shall be 38 HOUSE BILL 1149 7
allocated to acute and psychiatric care hospitals based on a plan developed by the Health 1
Services Cost Review Commission. 2
Further provided that the $40,000,000 appropriation made for program T00G00.05 3
Maryland State Arts Council for the purpose of supporting Arts Grants shall be allocated 4
by the Maryland State Arts Council and can include, but should not be limited to, entities 5
traditionally funded by the council. The funds shall not be included in the fiscal 2024 6
calculation of Arts Council formula funding. 7
Further provided that the $35,000,000 appropriation made for program N00G00.08 8
Assistance Payments shall be used to provide a $45 per recipient per month additional 9
benefit for Temporary Cash Assistance and Temporary Disability Assistance Program 10
recipients. 11
Further provided that the $20,000,000 appropriation made for program T00F00.29 12
Rural Maryland Economic Development shall be used to provide a grant to the Western 13
Maryland Economic Future Investment Board for the Western Maryland Economic Future 14
Investment Fund to be used for grants and loans for capital infrastructure projects and 15
business development projects that improve economic conditions in the region and expenses 16
necessary to administer the grants and loans contingent upon enactment of SB 474 or HB 17
838 establishing the fund. 18
Further provided that the $10,000,000 appropriation made for program D40W01.12 19
Maryland Historic Revitalization Tax Credit shall be used to provide continued and 20
expanded funding for the Historic Revitalization Tax Credit Program. 21
Further provided that the $8,000,000 appropriation made for program R00A01.01 22
Office of the State Superintendent shall be used to provide noncertificated education 23
support professionals with a $500 bonus. 24
Further provided that the $4,000,000 appropriation made for program T00F00.15 25
Small, Minority, and Women–Owned Businesses Account shall be split equally among the 26
fund managers. 27
Further provided that the $5,000,000 appropriation made for program M00A01.01 28
Executive Direction to provide pediatric cancer research grants shall be contingent upon 29
enactment of SB51 or HB775 establishing the Maryland Pediatric Cancer Fund. 30
Further provided that the $1,000,000 appropriation made for program R62I00.54 to 31
fund Loan Assistance Repayment Programs For Nurses and Nursing Assistants shall be 32
transferred, contingent upon the enactment of SB 696 or HB 975 establishing the program 33
within the Maryland Department of Health, instead to program M00F02.01 Office of 34
Population Health Improvement for the Maryland Loan Assistance Repayment Program 35
for Nurses and Nursing Workers. 36
Further provided that the $3,500,000 appropriation made for program M00F03.04 37
Family Health and Chronic Disease services to provide funding for enhanced Alzheimer’s 38 8 HOUSE BILL 1149
services and research shall be expended in a manner consistent with the implementation 1
of the recommendations of the Virginia I. Jones Alzheimer’s Council. 2
Further provided that the $3,400,000 appropriation made for program W00A01.03 3
Criminal Investigation Bureau to establish the Maryland State Police Gun Center within 4
the Department of State Police shall be contingent upon the enactment of SB 861. 5
Further provided that the $1,200,000 appropriation made for program R62I00 to 6
fund the Formerly Incarcerated Youth Grant Program, providing such students who receive 7
Pell Grants with an additional grant award of up to $3,000, shall be contingent upon 8
enactment of SB 904. 9
Further provided that $40,000 of the appropriation made for program S00A24.02 10
Neighborhood Revitalization – Capital for the Baltimore Regional Neighborhood Initiative 11
may be expended only for a grant to Southeast Community Development Corporation. 12
Further provided that the $600,000 appropriation made for program C00A00.06 13
Administrative Office of the Courts shall be contingent upon enactment of SB 763 or HB 14
1429. 15
Further provided that the $500,000 appropriation made for program D05E01.11 16
Miscellaneous Grants to Local Governments may only be expended to provide a grant to 17
the Baltimore City Department of Planning for the creation of a redevelopment plan for 18
State Center. 19
Further provided that the $323,000 appropriation made for program Q00C02.01 20
Division of Parole and Probation – Support Services may only be used to support new 21
personnel assigned to examine and review murders involving offenders who are supervised 22
by the division. Further provided that by December 31, 2022, and annually thereafter, the 23
division must report to the budget committees, along with the Senate Judicial Proceedings 24
Committee and the House Judiciary Committee, on (1) agency activities intended to reduce 25
the number of murders involving supervised offenders; (2) actions taken to examine and 26
review murders, including policy and program recommendations made to the Secretary; 27
and (3) the number of supervised offenders who were shooting victims, homicide victims, 28
or charged with or identified as suspects in specified crimes. 29
Further provided that the $175,000 appropriation made for program T00F00.04 30
Office of Business Development may only be expended to fund operating expenses 31
associated with establishing the Maryland New Start Grant Program and Maryland New 32
Start Microloan Program contingent upon enactment of SB 554 or HB 158. 33
Further provided that the $15,368,715 appropriation made for program A15O00.01 34
Disparity Grants may only be expended to provide supplemental funding allocated in the 35
following amounts: 36
(a) $11,316,425 to Baltimore City; 37
HOUSE BILL 1149 9
(b) $726,821 to Caroline County; 1
(c) $1,386,458 to Cecil County; 2
(d) $819,998 to Somerset County; and 3
(e) $1,119,013 to Wicomico County. 4
Further provided that the $1,000,000 appropriation made for program M00F01.01 5
Executive Direction may only be expended to provide a grant to the Baltimore City Health 6
Department for the Vision for Baltimore program. 7
Further provided that the $500,000 appropriation made for the Pride of Baltimore 8
may only be transferred by budget amendment in fiscal 2023 to program J00A01.02 9
Operating Grants–in–Aid to provide a Secretary’s grant to the Pride of Baltimore. 10
Further provided that the $50,000 appropriation made for program R75T00.01 11
Support for State Operated Institutions of Higher Education may only be expended to 12
provide funding to Bowie State University (R30B23) for a project specialist to staff the 13
Maryland Truth and Reconciliation Commission……………………… ..................370,031,817 14
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 15
1, 2023. 16
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.