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.
*hb1396*
HOUSE BILL 1396
J1 4lr3085
HB 1198/23 – HGO
By: Delegates Howard, Arentz, Buckel, Griffith, Hinebaugh, Hornberger,
McComas, Miller, Mireku–North, T. Morgan, Munoz, Taylor, and Tomlinson
Tomlinson, Pena–Melnyk, Cullison, Alston, Bagnall, Chisholm, Guzzone,
Hill, Hutchinson, S. Johnson, Kaiser, Kerr, Kipke, R. Lewis, Lopez,
Martinez, M. Morgan, Reilly, Rosenberg, Szeliga, Taveras, White Holland,
and Woods
Introduced and read first time: February 9, 2024
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 7, 2024
CHAPTER ______
AN ACT concerning 1
Drug and Alcohol Treatment Programs – Discharge of Patients and Referral 2
Services – Standards 3
Maryland Department of Health – Substance Use Disorder Treatment and 4
Recovery Levels of Care – Study 5
FOR the purpose of requiring the Maryland Department of Health to establish by 6
regulation standards relating to the discharge of patients from drug and alcohol 7
treatment programs and certain referral services offered to patients by certain drug 8
and alcohol treatment programs conduct a certain study on linkages between levels 9
of care within the substance use disorder treatment and recovery continuum of care; 10
and generally relating to the Maryland Department of Health and standards 11
applicable to drug and alcohol treatment programs in the State a study on linkages 12
between levels of care within the substance use disorder treatment and recovery 13
continuum of care. 14
BY adding to 15
Article – Health – General 16
Section 7.5–402.1 17
Annotated Code of Maryland 18
(2023 Replacement Volume) 19 2 HOUSE BILL 1396
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2
(a) The Maryland Department of Health shall conduct a study regarding the 3
linkages between the various levels of care within the substance use disorder treatment 4
and recovery continuum of care. 5
(b) The study required under subsection (a) of this section shall examine: 6
(1) linkages from high–intensity outpatient treatment programs to a 7
patient’s need for comprehensive services, including: 8
(i) additional treatment; 9
(ii) housing; and 10
(iii) other social services support; and 11
(2) existing requirements related to discharge planning in accreditation 12
standards, statute, and regulation. 13
(c) The Department shall make recommendations on improvements to existing 14
discharge and linkage requirements and improvements to the process for enforcing the 15
discharge and linkage requirements. 16
(d) On or before December 1, 2024, the Department shall report to the Senate 17
Finance Committee and the House Health and Government Operations Committee, in 18
accordance with § 2–1257 of the State Government Article, on the study conducted under 19
subsection (a) of this section. 20
Article – Health – General 21
7.5–402.1. 22
(A) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 23
INDICATED. 24
(1) “ASAM LEVEL 3.1 SERVICES” HAS THE MEANING STAT ED IN § 25
7.5–601 OF THIS TITLE. 26
(2) “TREATMENT PROGRAM ” MEANS AN ENTITY THAT : 27
(I) PROVIDES TREATMENT , CARE, OR REHABILITATION FO R 28
PATIENTS WHO SHOW TH E EFFECTS OF DRUG OR ALCOHOL ABUSE ; 29
HOUSE BILL 1396 3
(II) REPRESENTS OR ADVERTI SES ITSELF AS AN ALC OHOL OR 1
OTHER DRUG ABUSE TREATMENT PROGRAM ; AND 2
(III) IS REQUIRED TO OBTAIN A CERTIFICATION FROM THE 3
ADMINISTRATION TO PRO VIDE DRUG AND ALCOHO L TREATMENT SERVICES IN THE 4
STATE. 5
(B) (1) THE DEPARTMENT SHALL ESTA BLISH BY REGULATION 6
STANDARDS FOR THE DI SCHARGE OF PATIENTS FROM TREATMENT PROGRAMS . 7
(2) THE STANDARDS ESTABLI SHED IN REGULATION U NDER 8
PARAGRAPH (1) OF THIS SUBSECTION S HALL: 9
(I) REQUIRE THAT A DISCHA RGE FROM A TREATMENT 10
PROGRAM BE APPROPRIA TE FOR THE PATIENT ’S MENTAL HEALTH OR S UBSTANCE 11
USE DISORDER DIAGNOS IS; 12
(II) 1. PROHIBIT A TREATMENT PROGRAM FROM 13
DISCHARGING THE PATI ENT IF THE PATIENT : 14
A. WILL BE HOMELESS OR R ESIDE IN A HOMELESS 15
SHELTER ON DISCHARGE ; AND 16
B. NEEDS TO RECEIVE CARE IN A RESIDENTIAL 17
PROGRAM BASED ON THE ASSESSMENT CONDUCTED OR UNDER THE TREATMENT 18
PLAN PREPARED FOR TH E PATIENT; AND 19
2. REQUIRE A TREATMENT P ROGRAM TO REFER THE 20
PATIENT WHO MEETS TH E CRITERIA UNDER ITE M 1 OF THIS ITEM TO RECE IVE CARE 21
IN A HALFWAY HOUSE T HAT PROVIDES ASAM LEVEL 3.1 SERVICES OR AN 22
APPROPRIATE RECOVERY RESIDENCE IF THE PAT IENT IS WILLING TO R ECEIVE THIS 23
LEVEL OF CARE; 24
(III) BEFORE OR AT THE TIME OF DISCHARGE , REQUIRE A 25
TREATMENT PROGRAM TO REFER AND FACILITATE ENTRY OF A PATIENT I NTO A 26
PROGRAM OR SERVICE I DENTIFIED AS A NEED FOR THE PATIENT UNDE R THE 27
ASSESSMENT CONDUCTED OR UNDER THE TREATME NT PLAN PREPARED FOR THE 28
PATIENT, INCLUDING PROGRAMS O R SERVICES TO: 29
1. ADDRESS NEEDS RELATIN G TO: 30
A. PHYSICAL AND MENTAL H EALTH; 31
B. EMPLOYMENT OR FINANCI AL SUPPORT; 32 4 HOUSE BILL 1396
C. DRUG AND ALCOHOL TREATMENT AT THE ASAM 1
LEVEL APPROPRIATE FO R THE PATIENT; 2
D. LEGAL REPRESENTATION AND ASSISTANCE ; 3
E. FAMILY AND SOCIAL MAT TERS; AND 4
F. EDUCATION; AND 5
2. PROVIDE APPROPRIATE I NDIVIDUALIZED 6
INTERVENTIONS FOR TH E PATIENT, INCLUDING: 7
A. SHORT– AND LONG–RANGE TREATMENT ; 8
B. CLINICAL SERVICES , INCLUDING INDIVIDUAL , 9
GROUP, AND FAMILY COUNSELIN G; 10
C. SELF–HELP GROUPS ; AND 11
D. OTHER ANCILLARY SERVI CES SPECIFIED IN THE 12
TREATMENT PLAN ; 13
(IV) IF THE PATIENT IS TRA NSITIONING FROM ONE 14
RESIDENTIAL TREATMEN T PROGRAM TO ANOTHER RESIDENTIAL TREATMEN T 15
PROGRAM, REQUIRE THAT THE REF ERRAL FOR ANY OUTPAT IENT SERVICES LISTED 16
UNDER ITEM (III) OF THIS ITEM AND NOT PROVIDED BY THE RECE IVING TREATMENT 17
PROGRAM BE IN PLACE BEFORE THE TRANSFER OF THE PATIENT TO THE REC EIVING 18
TREATMENT PROGRAM ; AND 19
(V) IF THE PATIENT IS TRA NSITIONING TO A HOME LESS 20
SHELTER, REQUIRE THAT THE REF ERRAL FOR ANY OUTPAT IENT SERVICES LISTED 21
UNDER ITEM (III) OF THIS ITEM AND NOT PROVIDED BY THE HOME LESS SHELTER BE 22
IN PLACE BEFORE THE TRANSFER OF THE PATIENT TO TH E HOMELESS SHELTER . 23
(C) (1) THIS SUBSECTION APPLI ES TO: 24
(I) AN ASAM LEVEL 3.3 CLINICALLY MANAGED M EDIUM 25
INTENSITY TREATMENT PROGRAM; AND 26
(II) AN ASAM LEVEL 3.5 CLINICALLY MANAGED H IGH 27
INTENSITY RESIDENTIA L PROGRAM. 28
HOUSE BILL 1396 5
(2) THE DEPARTMENT SHALL ESTA BLISH BY REGULATION 1
STANDARDS FOR REFERR AL SERVICES OFFERED TO PATIENTS BY TREAT MENT 2
PROGRAMS SUBJECT TO THIS SUBSECTION . 3
(3) THE STANDARDS ESTABLI SHED BY REGULATION U NDER 4
PARAGRAPH (2) OF THIS SUBSECTION S HALL: 5
(I) 1. REQUIRE A TREATMENT P ROGRAM TO IMPLEMENT AN 6
AGREEMENT REFERRING A PATIENT TO RECEIVE SERVICES WITHIN 3 WORKING 7
DAYS OF SIGNING AN I NDIVIDUALIZED TREATM ENT PLAN WHEN THE PL AN INCLUDES 8
REFERRAL SERVICES FO R: 9
A. MEDICAL CARE; 10
B. SERVICES THROUGH THE MARYLAND DIVISION OF 11
REHABILITATION SERVICES; 12
C. MENTAL HEALTH SERVICE S; 13
D. SUBSTANCE ABUSE TREAT MENT; 14
E. LEGAL REPRESENTATION OR ASSISTANCE; 15
F. FAMILY SERVICES ; OR 16
G. SOCIAL SERVICES; AND 17
2. REQUIRE THE INDIVIDUALIZED TREAT MENT PLAN TO 18
INCLUDE A PLAN FOR H OW THE PATIENT WILL ACCESS THE SERVICES LISTED UNDER 19
ITEM 1 OF THIS ITEM; AND 20
(II) REQUIRE THAT TREATMEN T PROGRAM REFERRAL 21
AGREEMENTS REMAIN VA LID IN THE EVENT OF A PATIENT’S DISCHARGE FROM A 22
TREATME NT PROGRAM TO ENSURE THE CONTINUITY OF RE CEIPT OF THE REFERRA L 23
SERVICES BY THE PATI ENT. 24
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before December 1, 25
2024, the Maryland Department of Health shall submit a report to the Governor and, in 26
accordance with § 2–1257 of the State Government Article, the General Assembly that 27
includes: 28
(1) the status of the adoption and revision of regulations to implement the 29
requirements of this Act and Chapter 580 of the Acts of the General Assembly of 2017; and 30
6 HOUSE BILL 1396
(2) a plan for the enforcement of the statutory and regulatory requirements 1
under this Act and Chapter 580 of the Acts of the General Assembly of 2017. 2
SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
June 1, 2024. 4
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.