EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0905*
HOUSE BILL 905
J1 5lr2142
CF SB 720
By: Delegates White Holland, Bagnall, Guzzone, D. Jones, Kerr, Lopez, McCaskill,
Phillips, Taveras, and Woods
Introduced and read first time: January 31, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Hospitals – Clinical Staffing Committees and Plans – Establishment 2
(Safe Staffing Act of 2025) 3
FOR the purpose of requiring certain hospitals licensed in the State to establish and 4
maintain a clinical staffing committee and to implement a clinical staffing plan; 5
requiring each clinical staffing committee to develop a clinical staffing plan; and 6
generally relating to hospitals and clinical staffing committees and plans. 7
BY adding to 8
Article – Health – General 9
Section 19–388 through 19–390 to be under the new part “Part XII. Clinical Staffing 10
Committees and Plans” 11
Annotated Code of Maryland 12
(2023 Replacement Volume and 2024 Supplement) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Health – General 16
19–386. RESERVED. 17
19–387. RESERVED. 18
PART XII. CLINICAL STAFFING COMMITTEES AND PLANS. 19
19–388. 20
2 HOUSE BILL 905
(A) (1) IN THIS PART THE FOLLOWING WORDS HAVE THE MEANINGS 1
INDICATED. 2
(2) (I) “ANCILLARY MEMBER OF T HE FRONTLINE TEAM ” MEANS AN 3
INDIVIDUAL WHOSE PRI MARY DUTIES INCLUDE SUPPORTING INDIVIDUA LS WHO 4
PROVIDE DIRECT PATIE NT CARE. 5
(II) “ANCILLARY MEMBER OF THE FRONTLINE TEAM ” 6
INCLUDES: 7
1. A DIETARY WORKER ; 8
2. A PATIENT CARE TECHNICI AN; AND 9
3. ANY OTHER NONLICENSED STA FF ASSISTING WITH 10
PATIENT CARE. 11
(3) “CLINICAL STAFFING COM MITTEE” MEANS A COMMITTEE 12
ESTABLISHED BY A HOS PITAL IN ACCORDANCE WITH SUBSECTION (C) OF THIS 13
SECTION. 14
(4) “CLINICAL STAFFING PLA N” MEANS A PLAN DEVELOP ED UNDER 15
SUBSECTION (D) OF THIS SECTION. 16
(B) THIS PART DOES NOT APPLY TO STATE HOSPITALS . 17
(C) (1) EACH HOSPITAL LICENSE D UNDER THIS TITLE S HALL ESTABLISH 18
AND MAINTAIN A CLINICAL STAFFING COMMITTEE T HAT HAS EQUAL MEMBER SHIP 19
FROM MANAGEMENT AND EMPLOYEES. 20
(2) EACH CLINICAL STAFFIN G COMMITTEE ESTABLIS HED UNDER 21
THIS PART SHALL INCLUDE AT LEAST ONE OF THE FOLLOWING INDIVIDUALS: 22
(I) A CERTIFIED NURS ING ASSISTANT; 23
(II) A DIETARY AIDE; 24
(III) AN EMERGENCY ROOM NUR SE; 25
(IV) AN ENVIRONMENTAL SERVIC E WORKER; 26
(V) 1. A RESIDENT, IF THE COMMITTEE IS IN A TEACHING 27
HOSPITAL; OR 28
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2. A PHYSICIAN, IF THE COMMITTEE IS IN A HOSPITAL 1
THAT IS NOT A TEACHI NG HOSPITAL; AND 2
(VI) A TECHNICIAN. 3
(3) A CLINICAL STAFFING CO MMITTEE ESTABLISHED UNDER 4
PARAGRAPH (1) OF THIS SUBSECTION MAY INCLUDE A PATIEN T ADVOCATE. 5
(D) EACH CLINICAL STAFFIN G COMMITTEE SHALL DE VELOP A CLINICAL 6
STAFFING PLAN FOR THE HOSPITA L THAT ESTABLISHES T HE APPROPRIATE NUMBE R 7
OF CLINICIANS NEEDED TO ADMINISTER QUALIT Y HEALTH CARE BY SET TING. 8
(E) (1) WHEN DEVELOPING A CLI NICAL STAFFING PLAN , THE CLINICAL 9
STAFFING COMMITTEE S HALL ESTABLISH, BASED ON THE PATIENT POPULATION OF 10
THE HOSPITAL: 11
(I) SUGGESTED GUIDELINES OR RATIOS, MATRICES, OR GRIDS 12
INDICATING HOW MANY PATIENTS SHOULD BE A SSIGNED TO EACH REGI STERED 13
NURSE BY UNIT OR SET TING; AND 14
(II) THE NUMBER OF REGISTE RED NURSES , LICENSED 15
PRACTICAL NURSES , CERTIFIED NURSING ASSIS TANTS, CERTIFIED MEDICINE 16
TECHNICIANS, ENVIRONMENTAL SERVIC E WORKERS, AND ANCILLARY MEMBER S OF 17
THE DIRECT CARE TEAM THAT SHOULD BE PRESE NT ON EACH UNIT DURI NG EACH 18
SHIFT. 19
(2) TO THE EXTENT PRACTIC ABLE, THE GUIDELINES ESTAB LISHED 20
UNDER PARAGRAPH (1)(I) OF THIS SUBSECTION S HALL BE BASED ON NAT IONAL 21
EVIDENCE–BASED STANDARDS . 22
(F) ON OR BEFORE JULY 1 EACH YEAR, EACH HOSPITAL , THROUGH THE 23
CLINICAL STAFFING CO MMITTEE, SHALL CONDUCT A REVI EW OF THE CLINICAL 24
STAFFING PLAN TO : 25
(1) EVALUATE THE EFFECTIVENESS OF THE CLINICAL STAFFIN G 26
PLAN DURING THE IMME DIATELY PRECEDING YE AR; 27
(2) UPDATE THE CLINICAL S TAFFING PLAN TO ENSU RE THAT THE 28
CLINICAL STAFFING PL AN CONTINUES TO BE A PPROPRIATE AND EFFEC TIVE; AND 29
(3) DEVELOP A PROCESS FOR RECEIVING, RESOLVING, AND 30
TRACKING COMPLAINTS RELATED TO THE CLINI CAL STAFFING PLAN . 31
4 HOUSE BILL 905
(G) IN DEVELOPING THE CLI NICAL STAFFING PLAN , THE CLINICAL 1
STAFFING COMMITTEE S HALL CONSIDER : 2
(1) THE AVERAGE NUMBER OF PATIENTS ON EACH UNI T ON EACH 3
SHIFT DURING THE IMMEDIATELY PRECEDIN G YEAR AND RELEVANT INFORMATION 4
REGARDING PATIENT DI SCHARGES, POTENTIAL ADMISSIONS , AND TRANSFERS ; 5
(2) THE AVERAGE LEVEL OF ACUITY FOR PATIENTS ON EACH UNIT ON 6
EACH SHIFT DURING TH E IMMEDIATELY PRECED ING YEAR AND THE 7
CORRESPONDING LEVEL OF NURSING CAR E REQUIRED; AND 8
(3) AN ESTIMATE OF THE AP PROPRIATE COMBINATIO N OF SKILL, 9
EXPERIENCE LEVEL , AND SPECIALTY CERTIF ICATION OR TRAINING OF STAFF FOR 10
EACH UNIT ON EACH SH IFT THAT IS REQUIRED TO ADEQUATELY PROVID E CARE. 11
19–389. 12
(A) ON OR BEFORE JANUARY 1 EACH YEAR, BEGINNING IN 2026, EACH 13
HOSPITAL SHALL : 14
(1) IMPLEMENT THE CLINICA L STAFFING PLAN ADOP TED UNDER § 15
19–388 OF THIS SUBTITLE ; AND 16
(2) ASSIGN PERSONNEL TO E ACH PATIENT CARE UNI T IN 17
ACCORDANCE WITH THE CLINICAL STAFFING PL AN. 18
(B) A REGISTERED NURSE , A LICENSED PRACTICAL NURSE, AN ANCILLARY 19
MEMBER OF THE FRONTL INE TEAM , OR AN APPLICABLE EXC LUSIVE 20
REPRESENTATIVE MAY S UBMIT A COMPLAINT TO THE CLINICAL STAFFIN G 21
COMMITTEE REGARDING ANY VARIATION WHERE PERSONNEL ASSIGNMENT IN A 22
PATIENT CARE UNIT IS NOT IN ACCORDANCE WITH T HE ADOPTED CLINICAL 23
STAFFING PLAN . 24
(C) THE CLINICAL STAFFING COMMITTEE SHALL DETE RMINE, BY A 25
MAJORITY VOTE , WHETHER A COMPLAINT HAS BEEN ADEQUATELY RESOLVED. 26
19–390. 27
(A) SUBJECT TO SUBSECTION (B) OF THIS SECTIO N, ON OR BEFORE 28
JANUARY 1 EACH YEAR, EACH HOSPITAL SHALL : 29
HOUSE BILL 905 5
(1) POST IN A PUBLICLY AC CESSIBLE AND CONSPIC UOUS AREA ON 1
EACH PATIENT UNIT TH E CLINICAL STAFFING PLAN FOR THE UNIT AN D THE ACTUAL 2
DAILY STAFFING FOR E ACH SHIFT ON THE UNI T; 3
(2) ENSURE THAT A COPY OF THE CLINICAL STAFFING PLAN IS 4
AVAILABLE, ON REQUEST, ON EACH PATIENT UNIT ; AND 5
(3) POST THE CLINICAL STA FFING PLAN ON THE HO SPITAL’S 6
WEBSITE. 7
(B) IF A CLINICAL STAFFIN G PLAN FOR A UNIT IS AMENDED AFTER IT IS 8
IMPLEMENTED , THE HOSPITAL SHALL POST OR PROVIDE THE AMENDED CLINICAL 9
STAFFING PLAN FOR TH E UNIT IN THE MANNER REQUIR ED UNDER SUBSECTION (A) 10
OF THIS SECTION, IN A TIMELY MANNER . 11
SECTION 2. AND BE IT FURTHER ENACTED, That each hospital shall establish 12
a clinical staffing committee as required under § 19–388 of the Health – General Article, 13
as enacted by Section 1 of this Act, on or before January 1, 2026. 14
SECTION 3. AND BE IT FURTHER ENACTED, That each clinical staffing 15
committee shall develop a clinical staffing plan as required under § 19–388 of the 16
Health – General Article, as enacted by Section 1 of this Act, on or before July 1, 2026. 17
SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 18
October 1, 2025. 19