WES MOORE, Governor Ch. 879
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Chapter 879
(Senate Bill 59)
AN ACT concerning
Safe Sleep for Infants – Awareness and Certification
Hospitals – Care of Infants After Discharge
(Safe Sleep Act of 2024)
FOR the purpose of requiring the Maryland Department of Health to develop and
implement a public awareness campaign to promote education regarding safe sleep
for infants; establishing the Maryland Safe Sleep Certification Program and
requiring child care centers to be certified by the Program; requiring hospitals and
freestanding birthing centers to be certified by a certain safe sleep certification
program; and generally relating to safe sleep for infants a hospital to take certain
actions relating to the care of infants as soon as practicable before the hospital
discharges an infant after the birth of the infant, including providing oral and
written educational resources to the parent or legal guardian on how to provide a
safe sleep environment and providing a list of resources available for an infant’s
parent or legal guardian; requiring a hospital, on or before a certain date each year,
to establish a process for providing certain educational resources and confirming
receipt of the resources; requiring the Maryland Department of Health to develop a
list of resources available for an infant’s parent or legal guardian; and generally
relating to the care of infants after discharge from a hospital.
BY adding to
Article – Health – General
Section 13–5201 through 13–5203 to be under the new subtitle “Subtitle 52. Safe
Sleep Certification Program”; 19–310.4 and 19–3B–03.1; and 20–2401 to be
under the new subtitle “Subtitle 24. Safe Sleep for Infants Public Awareness”
19–308.10
Annotated Code of Maryland
(2023 Replacement Volume)
BY repealing and reenacting, without amendments,
Article – Education
Section 9.5–401(a) and (c)
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
BY adding to
Article – Education
Section 9.5–405(g)
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
Ch. 879 2024 LAWS OF MARYLAND
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BY repealing and reenacting, with amendments,
Article – Education
Section 9.5–418
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – Health – General
Section 19–301(a) and (f) and 19–3B–01(a) and (d)
Annotated Code of Maryland
(2023 Replacement Volume)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
19–308.10.
(A) IN THIS SECTION, “SAFE SLEEP ENVIRONME NT” MEANS, AS DESCRIBED
IN THE MOST RECENT AMERICAN ACADEMY OF PEDIATRICS POLICY STA TEMENTS,
AN ENVIRONMENT IN WH ICH A NEWBORN MAY SL EEP THAT REDUCES THE RISK OF
SLEEP–RELATED INFANT DEATH S, INCLUDING THROUGH :
(1) THE USE OF SUPINE POS ITIONING;
(2) THE USE OF A FIRM, FLAT SLEEP SURFACE ;
(3) THE USE OF ROOM SHARI NG WITHOUT BED SHARI NG;
(4) THE AVOIDANCE OF SOFT BEDDING AND OVERHEAT ING; AND
(5) THE AVOIDANCE OF EXPO SURE TO SMOKE .
(B) (1) AS SOON AS PRACTICABL E BEFORE A HOSPITAL DISCHARGES AN
INFANT AFTER THE BIR TH OF THE INFANT , THE HOSPITAL SHALL P ROVIDE ORAL
AND WRITTEN EDUCATIO NAL RESOURCES TO THE PARENT OR LEGAL GUAR DIAN ON
HOW TO PROVIDE A SAFE SLEEP ENVIRON MENT.
(2) THE ORAL AND WRITTEN EDUCATIONAL RESOURCE S REQUIRED
UNDER PARAGRAPH (1) OF THIS SUBSECTION M AY BE SUPPLEMENTED B Y AN
EDUCATIONAL VIDEO.
WES MOORE, Governor Ch. 879
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(C) (1) AS SOON AS PRACTICABL E BEFORE DISCHARGING AN INFAN T
AFTER THE BIRTH OF T HE INFANT, A HOSPITAL SHALL :
(I) ASK THE INFANT ’S PARENT OR LEGAL GU ARDIAN TO
DESCRIBE THE SLEEP E NVIRONMENT THAT THE PARENT OR LEGAL GUAR DIAN WILL
PROVIDE AT HOME ;
(II) INFORM THE PARENT OR LEGAL GUARDIAN OF TH E
IMPORTANCE OF ENSURI NG THAT THE INFANT HAS A SAFE SLEEP ENV IRONMENT
AND THE RISKS OF SUF FOCATION AND SUDDEN INFANT DEATH IN UNSA FE SLEEP
ENVIRONMENTS ; AND
(III) DOCUMENT THAT THE EDU CATIONAL RESOURCES
DESCRIBED UNDER SUBSECTION (B) OF THIS SECTION AND THE INFORMATION
DESCRIBED UNDER ITEM (II) OF THIS PARAGRAPH WE RE PROVIDED TO THE P ARENT
OR LEGAL GUARDIAN .
(2) THE HOSPITAL SHALL PROVI DE A LIST OF RESOURC ES AVAILABLE
FOR THE PARENT OR LE GAL GUARDIAN TO OBTA IN THE ITEMS NECESSA RY TO
PROVIDE A SAFE SLEEP ENVIRONMENT FOR THE INFANT.
(D) ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL SHALL ESTABLISH A
PROCESS FOR:
(1) PROVIDING EACH PARENT OR LEGAL GUARDIAN WI TH:
(I) ORAL AND WRITTEN EDUC ATIONAL RESOURCES AS
REQUIRED UNDER SUBSE CTION (B) OF THIS SECTION; AND
(II) THE INFORMATION DESC RIBED UNDER SUBSECTI ON
(C)(1)(II) OF THIS SECTION;
(2) A PARENT OR LEGAL GUAR DIAN TO CONFIRM THE RECEIPT OF
THE EDUCATIONAL RESO URCES PROVIDED UNDER SUBSECTION (B) OF THIS
SECTION; AND
(3) MAINTAINING RECORDS O F CONFIRMATIONS MADE UNDER ITEM
(2) OF THIS SUBSECTION .
(E) (1) ON OR BEFORE JANUARY 1, 2025, THE DEPARTMENT , IN
CONSULTATION WITH LO CAL HEALTH OFFICERS , SHALL DEVELOP FOR
DISTRIBUTION TO BIRT HING PARENTS AND LEG AL GUARDIANS A LIST OF
RESOURCES AVAILABLE BY COUNTY TO OBTAIN THE ITEMS NECESSAR Y TO PROVIDE
A SAFE SLEEP ENVIRON MENT FOR AN INFANT . Ch. 879 2024 LAWS OF MARYLAND
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(2) EACH LOCAL HEALTH DEP ARTMENT SHALL PROVID E AN UPDATED
LIST OF RESOURCES TO THE DEPARTMENT EACH YEAR TO ASSIST THE DEPARTMENT
IN DEVELOPING THE LI ST OF RESOURCES REQU IRED UNDER PARAGRAPH (1) OF
THIS SUBSECTION .
SUBTITLE 24. SAFE SLEEP FOR INFANTS PUBLIC AWARENESS.
20–2401.
(A) THE DEPARTMENT SHALL DEVE LOP AND IMPLEMENT A PUBLIC
AWARENESS CAMPAIGN T O PROMOTE EDUCATION REGARDING SAFE SLEEP FOR
INFANTS.
(B) TO IMPLEMENT THE PUBL IC AWARENESS CAMPAIGN, THE
DEPARTMENT SHALL :
(1) REACH OUT TO THE GENE RAL PUBLIC AND SPECI FIC
POPULATIONS DETERMIN ED TO BE AT HIGH RIS K FOR SUDDEN UNEXPEC TED INFANT
DEATH OR SUDDEN INFANT DEATH SYNDROME AND MOST IN NEED OF EDUCATION
REGARDING SAFE SLEEP FOR INFANTS;
(2) DISSEMINATE PLAIN –LANGUAGE MESSAGING T HROUGH VARIOUS
MEDIA AND MODES OF C OMMUNICATION ;
(3) COLLABORATE WITH THE DEPARTMENT OF HUMAN SERVICES TO
PROMOTE BEST PRACTIC ES AND EDUCATION FOR PARENTS, GUARDIANS, AND
OTHER CAREGIVERS OF INFANTS;
(4) PLACE EDUCATIONAL MAT ERIALS IN RELEVANT H EALTH CARE
FACILITIES, INCLUDING LABOR AND DELIVERY UNITS IN HO SPITALS AND BIRTHING
CENTERS; AND
(5) PARTNER WITH LOCAL HE ALTH DEPARTMENTS , HEALTH CARE
PROVIDERS, INSTITUTIONS OF HIGH ER EDUCATION , NONPROFIT ORGANIZATIONS ,
AND OTHER RELEVANT E NTITIES.
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
as follows:
Article – Education
9.5–401.
WES MOORE, Governor Ch. 879
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(a) In this subtitle the following words have the meanings indicated.
(c) (1) “Child care center” means an agency, institution, or establishment that,
for part or all of a day, or on a 24–hour basis on a regular schedule, and at least twice a
week, offers or provides child care to children who do not have the same parentage except
as otherwise provided for in law or regulation.
(2) “Child care center” shall include a nonpublic nursery school in which
an instructional program is offered or provided for children who are under the age of 5
years.
(3) “Child care center” does not include:
(i) A nonpublic kindergarten in which an instructional program is
offered or provided for children who are at least 5 years old;
(ii) A nonpublic elementary school in which an instructional
program is offered or provided for children who are in grades 1 through 8;
(iii) A child care home, a child care institution, or other child care
facility that offers or provides a residential placement for a child and is established,
licensed, or registered under this title, Title 9 of the Human Services Article, or Title 10 of
the Health – General Article; or
(iv) A family child care home or large family child care home that is
required to be registered or is registered under this title.
9.5–405.
(G) (1) A CHILD CARE CENTER SH ALL BE CERTIFIED BY THE MARYLAND
SAFE SLEEP CERTIFICATION PROGRAM.
(2) A CHILD CARE CENTER CE RTIFIED BY THE MARYLAND SAFE
SLEEP CERTIFICATION PROGRAM SHALL SUBMIT PROOF OF THE CERTIFI CATION TO
THE PROGRAM AND THE DEPARTMENT .
9.5–418.
(a) Except as provided in subsection (b) of this section and subject to the
provisions of subsection (d) of this section, a person who violates any provision of this
subtitle or any rule or regulation adopted under this subtitle is subject to a civil penalty
imposed in a civil action not exceeding $1,000 for each violation.
(b) A person who violates § 9.5–405(a), [or] (e), OR (G) or § 9.5–416 of this subtitle
and is served a civil citation under that section is subject to a civil penalty as follows:
Ch. 879 2024 LAWS OF MARYLAND
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(1) $250 for the first violation;
(2) $500 for the second violation; and
(3) $1,000 for the third and each subsequent violation.
(c) Each day a violation occurs is a separate violation under this section.
(d) The total amount of civil penalties imposed in an action under this section
may not exceed $5,000.
Article – Health – General
SUBTITLE 52. SAFE SLEEP CERTIFICATION PROGRAM.
13–5201.
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(B) “CHILD CARE CENTER ” HAS THE MEANING STAT ED IN § 9.5–401 OF THE
EDUCATION ARTICLE.
(C) “PROGRAM” MEANS THE MARYLAND SAFE SLEEP CERTIFICATION
PROGRAM.
(D) “SAFE SLEEP BEST PRACT ICES” MEANS BEST PRACTICES FOR KEEPING
AN INFANT SAFE AND H EALTHY WHILE THE INF ANT IS SLEEPING, THOUGHT TO BE
SLEEPING, OR IN A SLEEPING ARE A.
13–5202.
(A) THERE IS A MARYLAND SAFE SLEEP CERTIFICATION PROGRAM WITHIN
THE DEPARTMENT .
(B) THE DEPARTMENT SHALL ADMI NISTER THE PROGRAM.
(C) (1) THE PROGRAM, IN COLLABORATION WIT H CRIBS FOR KIDS,
SHALL ESTABLISH CERT IFICATION STANDARDS FOR CHILD CARE CENTERS THAT
ARE IN ACCORDANCE WI TH SAFE SLEEP BEST P RACTICES.
(2) THE PROGRAM SHALL :
WES MOORE, Governor Ch. 879
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(I) CERTIFY A CHILD CARE CENTER THAT DEMONSTR ATES
COMPLIANCE WITH THE CERTIFICATION STANDA RDS ESTABLISHED BY T HE
PROGRAM UNDER PARAGRA PH (1) OF THIS SUBSECTION; AND
(II) RETAIN A COPY OF EACH CERTIFICATION .
(D) THE PROGRAM SHALL EVALUAT E CHILD CARE CENTERS FOR
COMPLIANCE WITH SAFE SLEEP BEST PRACTICES .
(E) THE PROGRAM SHALL PROVIDE RESOURCES TO HELP CH ILD CARE
CENTERS ADOPT AND MA INTAIN SAFE SLEEP BEST PRACTICES .
13–5203.
THE DEPARTMENT SHALL ADOP T REGULATIONS TO CAR RY OUT THIS
SUBTITLE.
19–301.
(a) In this subtitle the following words have the meanings indicated.
(f) “Hospital” means an institution that:
(1) Has a group of at least 5 physicians who are organized as a medical
staff for the institution;
(2) Maintains facilities to provide, under the supervision of the medical
staff, diagnostic and treatment services for 2 or more unrelated individuals; and
(3) Admits or retains the individuals for overnight care.
19–310.4.
(A) A HOSPITAL SHALL BE CE RTIFIED BY THE CRIBS FOR KIDS’ NATIONAL
SAFE SLEEP HOSPITAL CERTIFICATION PROGRAM AT LEAST AT THE BRON ZE
LEVEL.
(B) A HOSPITAL CERTIFIED B Y THE CRIBS FOR KIDS’ NATIONAL SAFE
SLEEP HOSPITAL CERTIFICATION PROGRAM SHALL SUBMIT PROOF O F THE
CERTIFICATION TO THE SECRETARY.
19–3B–01.
(a) In this subtitle the following words have the meanings indicated.
Ch. 879 2024 LAWS OF MARYLAND
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(d) (1) “Freestanding birthing center” means a facility that provides nurse
midwife services under Title 8, Subtitle 6 of the Health Occupations Article.
(2) “Freestanding birthing center” does not include:
(i) A hospital regulated under Subtitle 2 of this title; or
(ii) The private residence of the mother.
19–3B–03.1.
(A) A FREESTANDING BIRTHIN G CENTER SHALL BE CE RTIFIED BY THE
CRIBS FOR KIDS’ NATIONAL SAFE SLEEP HOSPITAL CERTIFICATION PROGRAM AT
LEAST AT THE BRONZE LEVEL.
(B) A FREESTANDING BIRTHIN G CENTER CERTIFIED B Y THE CRIBS FOR
KIDS’ NATIONAL SAFE SLEEP HOSPITAL CERTIFICATION PROGRAM S HALL SUBMIT
PROOF OF THE CERTIFI CATION TO THE SECRETARY.
SECTION 3. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall take
effect October 1, 2025.
SECTION 4. 2. AND BE IT FURTHER ENACTED, That , except as provided in
Section 3 of this Act, this Act shall take effect October 1, 2024.
Approved by the Governor, May 16, 2024.