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.
*hb0905*
HOUSE BILL 905
J1 5lr2142
CF SB 720
By: Delegates White Holland, Bagnall, Guzzone, D. Jones, Kerr, Lopez, McCaskill,
Phillips, Taveras, and Woods Woods, Pena–Melnyk, Cullison, Bhandari,
Hill, S. Johnson, Kaiser, Martinez, Rosenberg, Woorman, and Ross
Introduced and read first time: January 31, 2025
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 1, 2025
CHAPTER ______
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 T HE 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 2 HOUSE BILL 905
PART XII. CLINICAL STAFFING COMMITTEES AND PLANS. 1
19–388. 2
(A) (1) IN THIS PART THE FOLL OWING WORDS HAVE THE MEANINGS 3
INDICATED. 4
(2) (I) “ANCILLARY MEMBER OF T HE FRONTLINE TEAM ” MEANS AN 5
INDIVIDUAL WHOSE PRI MARY DUTIES INCLUDE SUPPORTING INDIVIDUA LS WHO 6
PROVIDE DIRECT PATIE NT CARE. 7
(II) “ANCILLARY MEMBER OF T HE FRONTLINE TEAM ” 8
INCLUDES: 9
1. A DIETARY WORKER; 10
2. A PATIENT CARE TECHNIC IAN; AND 11
3. ANY OTHER NONLICENSED STAFF ASSISTING WITH 12
PATIENT CARE. 13
(3) “CLINICAL STAFFING COM MITTEE” MEANS A COMMITTEE 14
ESTABLISHED BY A HOS PITAL IN ACCORDANCE WITH SUBSECTION (C) OF THIS 15
SECTION. 16
(4) “CLINICAL STAFFING PLA N” MEANS A PLAN DEVELOP ED UNDER 17
SUBSECTION (D) OF THIS SECTION. 18
(B) THIS PART DOES NOT AP PLY TO STATE HOSPITALS . 19
(C) (1) EACH HOSPITAL LICENSE D UNDER THIS TITLE S HALL ESTABLISH 20
AND MAINTAIN A CLINI CAL STAFFING COMMITT EE THAT HAS EQUAL MEMBERSHIP 21
FROM MANAGEMENT AND EMPLOYEES. 22
(2) EACH CLINICAL STAFFIN G COMMITTEE ESTABLIS HED UNDER 23
THIS PART SHALL INCL UDE AT LEAST ONE OF THE FOLLOWING INDIVI DUALS: 24
(I) A CERTIFIED NURSING AS SISTANT; 25
(II) A DIETARY AIDE; 26
(III) AN EMERGE NCY ROOM NURSE ; 27
(IV) AN ENVIRONMENTAL SERV ICE WORKER; 28 HOUSE BILL 905 3
(V) 1. A RESIDENT, IF THE COMMITTEE IS IN A TEACHING 1
HOSPITAL; OR 2
2. (VI) A STAFF PHYSICIAN, IF THE COMMITTEE IS IN A 3
HOSPITAL THAT IS NOT A TEACHI NG HOSPITAL WHO IS NOT A HOSPITA L EMPLOYEE 4
OR ADMINISTRATOR ; AND 5
(VI) (VII) A TECHNICIAN. 6
(3) A CLINICAL STAFFING CO MMITTEE ESTABLISHED UNDER 7
PARAGRAPH (1) OF THIS SUBSECTION M AY INCLUDE A PATIENT ADVOCATE. 8
(D) EACH CLINICAL STAFFIN G COMMITTEE SHALL DE VELOP A CLINICAL 9
STAFFING PLAN FOR THE HOSPITAL THAT ESTABL ISHES THE APPROPRIAT E NUMBER 10
OF CLINICIANS NEEDED TO ADMINISTER QUALIT Y HEALTH CARE BY SET TING THAT 11
MEETS PATIENT NEEDS . 12
(E) (1) WHEN DEVELOPING A CLI NICAL STAFFING PLAN , THE CLINICAL 13
STAFFING COMMITTEE S HALL ESTABLISH , BASED ON THE PATIENT POPULATION O F 14
THE HOSPITAL: 15
(I) SUGGESTED GUIDELINES OR RATIOS, MATRICES, OR GRIDS 16
INDICATING HOW MANY PATIENTS SHOULD BE A SSIGNED TO EACH REGI STERED 17
NURSE BY UNIT OR SET TING; AND 18
(II) THE NUMBER OF REGISTE RED NURSES , LICENSED 19
PRACTICAL NUR SES, CERTIFIED NURSING AS SISTANTS, CERTIFIED MEDICINE 20
TECHNICIANS, ENVIRONMENTAL SERVIC E WORKERS, AND ANCILLARY MEMBER S OF 21
THE DIRECT CARE TEAM THAT SHOULD BE PRESE NT ON EACH UNIT DURI NG EACH 22
SHIFT. 23
(2) TO THE EXTENT PRACTIC ABLE, THE GUIDELINES ESTABLISHED 24
UNDER PARAGRAPH (1)(I) OF THIS SUBSECTION S HALL BE BASED ON NAT IONAL 25
EVIDENCE–BASED STANDARDS WHEN DEVELOPING A CLI NICAL STAFFING PLAN , 26
THE CLINICAL STAFFIN G COMMITTEE SHALL CO NSIDER: 27
(1) EXISTING STAFFING LEV ELS; 28
(2) METHODS TO SECURE CO VERAGE NEEDS AS NECE SSARY; 29
(3) EXISTING GAPS IN STAF FING AND HOW TO ADDR ESS THE GAPS; 30
(4) ANY AVAILABLE EVIDENC E–BASED STAFFING STAND ARDS; AND 31 4 HOUSE BILL 905
(5) A SCHEDULE FOR PERIODI C REVIEW OF THE STAF FING PLAN. 1
(F) ON OR BEFORE JULY 1 EACH YEAR, EACH HOSPITAL, THROUGH THE 2
CLINICAL STAFFING CO MMITTEE, SHALL CONDUCT A REVI EW OF THE CLINICAL 3
STAFFING PLAN TO : 4
(1) EVALUATE THE EFFECTIV ENESS OF THE CLINICA L STAFFING 5
PLAN DURING THE IMME DIATELY PRECEDING YE AR; 6
(2) UPDATE THE CLINICAL S TAFFING PLAN TO ENSURE THAT THE 7
CLINICAL STAFFING PL AN CONTINUES TO BE A PPROPRIATE AND EFFEC TIVE; AND 8
(3) DEVELOP A PROCESS FOR RECEIVING, RESOLVING, AND 9
TRACKING COMPLAINTS RELATED TO THE CLINI CAL STAFFING PLAN . 10
(G) IN DEVELOPING THE CLI NICAL STAFFING PLAN , THE CLIN ICAL 11
STAFFING COMMITTEE S HALL CONSIDER : 12
(1) THE AVERAGE NUMBER OF PATIENTS ON EACH UNI T ON EACH 13
SHIFT DURING THE IMM EDIATELY PRECEDING Y EAR AND RELEVANT INF ORMATION 14
REGARDING PATIENT DI SCHARGES, POTENTIAL ADMISSIONS , AND TRANSFERS ; 15
(2) THE AVERAGE LE VEL OF ACUITY FOR PA TIENTS ON EACH UNIT ON 16
EACH SHIFT DURING TH E IMMEDIATELY PRECED ING YEAR AND THE 17
CORRESPONDING LEVEL OF NURSING CARE REQU IRED; AND 18
(3) AN ESTIMATE OF THE AP PROPRIATE COMBINATIO N OF SKILL, 19
EXPERIENCE LEVEL , AND SPECIALTY CERTIF ICATION OR TRAINING OF STAFF FOR 20
EACH UNIT ON EACH SH IFT THAT IS REQUIRED TO ADEQUATELY PROVID E CARE. 21
19–389. 22
(A) ON OR BEFORE JANUARY 1 EACH YEAR, BEGINNING IN 2026 2027, EACH 23
HOSPITAL SHALL : 24
(1) IMPLEMENT THE CLINICA L STAFFING PLAN ADOP TED UNDER § 25
19–388 OF THIS SUBTITLE; AND 26
(2) ASSIGN PERSONNEL TO E ACH PATIENT CARE UNI T IN 27
ACCORDANCE WITH THE CLINICAL STAFFING PL AN. 28
(B) A REGISTERED NURSE , A LICENSED PRACTICAL NURSE, AN ANCILLARY 29
MEMBER OF THE FRONTL INE TEAM , OR AN APPLICABLE EXC LUSIVE 30 HOUSE BILL 905 5
REPRESENTATIVE MAY SUBMIT A COMPLAI NT TO THE CLINICAL S TAFFING 1
COMMITTEE REGARDING ANY VARIATION WHERE PERSONNEL ASSIGNMENT IN A 2
PATIENT CARE UNIT IS NOT IN ACCORDANCE WI TH THE ADOPTED CLINI CAL 3
STAFFING PLAN . 4
(C) THE CLINICAL STAFFING COMMITTEE SHALL DETE RMINE, BY A 5
MAJORITY VOTE, WHETHER A COMPLAINT HAS BEEN ADEQUATELY RESOLVED. 6
19–390. 7
(A) SUBJECT TO SUBSECTION (B) OF THIS SECTION , ON OR BEFORE 8
JANUARY 1 EACH YEAR, EACH HOSPITAL SHALL : 9
(1) POST IN A PUBLICLY AC CESSIBLE AND CONSPIC UOUS AREA ON 10
EACH PATIENT UNIT THE CLINICAL STAFFIN G PLAN FOR THE UNIT AND THE ACTUAL 11
DAILY STAFFING FOR E ACH SHIFT ON THE UNI T; AND 12
(2) ENSURE THAT A COPY OF THE CLINICAL STAFFIN G PLAN IS 13
AVAILABLE, ON REQUEST, ON EACH PATIENT UNIT ; AND 14
(3) POST THE CLINICAL STA FFING PLAN ON THE HOSPITAL’S 15
WEBSITE. 16
(B) IF A CLINICAL STAFFIN G PLAN FOR A UNIT IS AMENDED AFTER IT IS 17
IMPLEMENTED , THE HOSPITAL SHALL P OST OR PROVIDE THE A MENDED CLINICAL 18
STAFFING PLAN FOR TH E UNIT IN THE MANNER REQUIRED UNDER SUBSE CTION (A) 19
OF THIS SECTION, IN A TIMELY MANNER. 20
SECTION 2. AND BE IT FURTHER ENACTED, That it is the intent of the General 21
Assembly that, beginning on or before July 1 each year, beginning in 2029, the Maryland 22
Hospital Association shall: 23
(1) compile reports provided by each hospital that summarize how the 24
hospital’s clinical staffing committee has addressed safe hospital staffing through the 25
hospital’s clinical staffing plan during the immediately preceding year; and 26
(2) provide the reports in a single transmittal, in accordance with § 2–1257 27
of the State Government Article, to the Senate Finance Committee and the House Health 28
and Government Operations Committee. 29
SECTION 2. 3. AND BE IT FURTHER ENACTED, That each hospital shall 30
establish a clinical staffing committee as required under § 19–388 of the Health – General 31
Article, as enacted by Section 1 of this Act, on or before January 1, 2026. 32
6 HOUSE BILL 905
SECTION 3. 4. AND BE IT FURTHER ENACTED, That each clinical staffing 1
committee shall develop a clinical staffing plan as required under § 19–388 of the 2
Health – General Article, as enacted by Section 1 of this Act, on or before July 1, 2026. 3
SECTION 4. 5. AND BE IT FURTHER ENACTED, That this Act shall take effect 4
October 1, 2025. 5
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.