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.
*hb0962*
HOUSE BILL 962
J1, J3 5lr2475
CF SB 696
By: Delegate Pena–Melnyk Delegates Pena–Melnyk, Griffith, Cullison, Bagnall,
Bhandari, Guzzone, Hill, Hutchinson, Kaiser, Kerr, Lopez, Martinez, Reilly,
Rosenberg, Ross, Szeliga, Taveras, Woods, and Woorman
Introduced and read first time: January 31, 2025
Assigned to: Health and Government Operations and Appropriations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 15, 2025
CHAPTER ______
AN ACT concerning 1
Public Health – Pediatric Hospital Overstay Patients and Workgroup on 2
Children in Unlicensed Settings and Pediatric Overstays 3
FOR the purpose of specifying that the scope of the Maryland Mental Health and Substance 4
Use Disorder Registry and Referral System includes both private and State inpatient 5
and outpatient mental health and substance use services; requiring the Maryland 6
Department of Health, in coordination with the Department of Human Services, to 7
ensure pediatric hospital overstay patients are placed in the least restrictive setting 8
when clinically indicated and when possible; authorizing a hospital to concurrently 9
explore in–State and out–of–state placements for pediatric hospital overstay 10
patients; establishing the requiring the Maryland Department of Health and the 11
Department of Human Services to establish a Pediatric Hospital Overstay 12
Coordinator within the Governor’s Office for Children; requiring the Maryland 13
Department of Health to conduct a certain study and review of residential treatment 14
center and respite facility rates; each department; establishing the Workgroup on 15
Children in Unlicensed Settings and Pediatric Overstays in the State; and generally 16
relating to pediatric hospital overstay patients and children in unlicensed settings. 17
BY repealing and reenacting, with amendments, 18
Article – Health – General 19
Section 7.5–802(a) and (d) 20
Annotated Code of Maryland 21
(2023 Replacement Volume and 2024 Supplement) 22 2 HOUSE BILL 962
BY adding to 1
Article – Health – General 2
Section 19–388 through 19–390 to be under the new part “Part XII. Pediatric 3
Overstay” 4
Annotated Code of Maryland 5
(2023 Replacement Volume and 2024 Supplement) 6
BY repealing and reenacting, with amendments, 7
Article – State Government 8
Section 9–2801 9
Annotated Code of Maryland 10
(2021 Replacement Volume and 2024 Supplement) 11
BY adding to 12
Article – State Government 13
Section 9–2806 14
Annotated Code of Maryland 15
(2021 Replacement Volume and 2024 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18
Article – Health – General 19
7.5–802. 20
(a) (1) There is a Maryland Mental Health and Substance Use Disorder 21
Registry and Referral System in the Department. 22
(2) The purpose of the Registry and Referral System is to provide a 23
statewide system through which health care providers can identify and access available 24
PRIVATE AND STATE inpatient and outpatient mental health and substance use services 25
for patients in a seamless manner. 26
(3) Subject to the availability of funds, the Department shall develop and 27
implement the Registry and Referral System, in collaboration with the State–designated 28
Health Information Exchange. 29
(4) The Registry and Referral System shall include: 30
(i) A searchable inventory of any PRIVATE OR STATE provider of 31
mental health and substance use disorder services, including inpatient, crisis, and 32
outpatient services; 33
HOUSE BILL 962 3
(ii) The capability to allow a provider of mental health and substance 1
use disorder services to update registry information including the real–time availability of 2
services; and 3
(iii) An electronic referral system that is available to any health care 4
provider in the State to facilitate electronic referrals to mental health and substance use 5
disorder providers. 6
(d) Each PRIVATE AND STATE hospital shall ensure the availability of staff to 7
identify appropriate and available services for patients in the hospital who are in need of 8
mental health or substance use disorder services and to assist the patient in accessing the 9
services. 10
19–386. RESERVED. 11
19–387. RESERVED. 12
PART XII. PEDIATRIC OVERSTAY. 13
19–388. 14
(A) IN THIS PART, “PEDIATRIC HOSPITAL THE FOLLOWING WORDS HAVE 15
THE MEANING S INDICATED. 16
(B) “COORDINATORS ” MEANS THE PEDIATRIC OVERSTAY COORDINATOR IN 17
THE DEPARTMENT AND THE PE DIATRIC OVERSTAY COO RDINATOR IN THE 18
DEPARTMENT OF HUMAN SERVICES. 19
(C) “PEDIATRIC HOSPITAL OVERSTAY PATIENT ” MEANS A PATIENT UNDE R 20
THE AGE OF 22 YEARS WHO REMAINS IN AN INPATIENT UNIT OR EMERGENCY 21
DEPARTMENT OF A HOSP ITAL FOR MORE THAN 24 48 HOURS AFTER BEING 22
MEDICALLY CLEARED FO R DISCHARGE OR TRANS FER. 23
19–389. 24
(A) THE DEPARTMENT , IN COORDIN ATION WITH THE DEPARTMENT OF 25
HUMAN SERVICES, SHALL ENSURE THAT A PEDIATRIC HOSPITAL O VERSTAY 26
PATIENT IS TRANSFERR ED TO AND TREATED IN THE LEAST RESTRICTIV E SETTING 27
WHEN CLINICALLY INDI CATED AND WHEN POSSIBLE. 28
(B) IF A PEDIATRIC HOSPIT AL OVERSTAY PATIENT REMAINS IN THE 29
HOSPITAL FOR MORE TH AN 48 HOURS AND THE REGIST RY ESTABLISHED UNDER § 30
7.5–802 OF THIS ARTICLE INDI CATES THAT AN APPROP RIATE INPATIENT BED IS 31
AVAILABLE, THE HOSPITAL SHALL S EEK THE TRANSFER TO MAINTAIN THE CLINICA L 32
STABILITY OF THE PAT IENT. 33 4 HOUSE BILL 962
(C) NOTWITHSTANDING ANY O THER PROVISION OF LA W, TO ENSURE THAT 1
A PEDIATRIC HOSPITAL OVERSTAY PATIENT IS TREATED IN THE LEAST RESTRICTIVE 2
SETTING, A HOSPITAL MAY CONCU RRENTLY EXPLORE IN –STATE AND 3
OUT–OF–STATE PLACEMENT OPTI ONS. 4
19–390. 5
(A) THE DEPARTME NT AND THE DEPARTMENT OF HUMAN SERVICES 6
SHALL ESTABLISH A PE DIATRIC HOSPITAL OVE RSTAY COORDINATOR WI THIN EACH 7
DEPARTMENT . 8
(B) THE COORDINATORS SHAL L ACT IN THE BEST INTEREST OF A PEDIATRI C 9
OVERSTAY PATIENT BY COORDINATING BETWEEN HOSPITALS, RELEVANT STATE 10
AGENCIES AND PROGRAM S, AND PROVIDERS OF MEN TAL HEALTH AND SUBST ANCE 11
USE DISORDER SERVICE S. 12
(C) THE COORDINATORS SHAL L: 13
(1) ADVOCATE ON BEHALF OF PEDIATRIC HOSPITAL O VERSTAY 14
PATIENTS WHILE MAINT AINING APPROPRIATE P ATIENT CONFIDENTIALI TY; 15
(2) REVIEW POLICIES AND PROC EDURES OF RELEVANT STATE 16
AGENCIES AND MAKE RE COMMENDATIONS FOR NE CESSARY CHANGES TO T HE 17
POLICIES AND PROCEDU RES TO BETTER SERVE PEDIATRIC HOSPITAL O VERSTAY 18
PATIENTS; 19
(3) MAINTAIN DATA ON EACH PEDIATRIC HOSPITAL O VERSTAY 20
PATIENT, INCLUDING: 21
(I) PATIENT’S LENGTH OF STAY ; 22
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 23
(III) SERVICES NEEDED ; 24
(IV) PLACEMENT OPTIONS BEI NG SOUGHT BY THE PAT IENT; 25
(V) INFORMATION REGARDING PREVIOUS HOSPITAL 26
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGNOSIS ; AND 27
(VI) ANY OTHER RELEVANT DA TA; AND 28
HOUSE BILL 962 5
(4) REPORT ON THE DATA CO LLECTED UNDER THIS S UBSECTION TO 1
THE SECRETARY AND THE SECRETARY OF HUMAN SERVICES. 2
(A) (1) FOR FISCAL YEAR 2026, THE GOVERNOR MAY INCLUDE IN THE 3
ANNUAL BUDGET BILL AN APPROPRIATION SUF FICIENT TO FILL ALL POSITIONS 4
AUTHORIZED FOR A REGIONAL INSTITUTE FOR CHILDREN AND ADOLESCENTS IN 5
THE STATE. 6
(2) FOR FISCAL YEAR 2027 AND EACH FISCAL YEAR THEREAFTER , 7
THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL AN APPROPRIA TION 8
SUFFICIENT TO FILL A LL POSITIONS AUTHORI ZED FOR A REGIONAL INSTITUTE FOR 9
CHILDREN AND ADOLESCENTS IN THE STATE. 10
(B) THE GOVERNOR MAY USE FUND S DESIGNATED FOR THE ADOLESCENT 11
HOSPITAL OVERSTAY PROGRAM FOR THE PURPO SES IDENTIFIED IN SU BSECTION 12
(A) OF THIS SECTION. 13
Article – State Government 14
9–2801. 15
(a) In this subtitle the following words have the meanings indicated. 16
(B) “COORDINATOR ” MEANS THE PEDIATRIC HOSPITAL OVERSTAY 17
COORDINATOR WITHIN TH E GOVERNOR’S OFFICE FOR CHILDREN. 18
[(b)] (C) “Eligible neighborhood” means a neighborhood that includes census 19
tracts with more than 30% of children living in poverty and is served by, as defined by the 20
Office, a community school with a concentration of poverty level, as defined in § 5–223 of 21
the Education Article, of: 22
(1) in fiscal year 2025 and 2026, at least 80%; 23
(2) in fiscal year 2027 through fiscal year 2029, at least 75%; 24
(3) in fiscal year 2030, at least 60%; and 25
(4) in fiscal year 2031, and each fiscal year thereafter, at least 55%. 26
[(c)] (D) “Fund” means the ENOUGH Grant Fund. 27
[(d)] (E) “Office” means the Governor’s Office for Children. 28
(F) “PEDIATRIC HOSPITAL OV ERSTAY PATIENT ” HAS THE MEANING STAT ED 29
IN § 19–388 OF THE HEALTH – GENERAL ARTICLE. 30 6 HOUSE BILL 962
[(e)] (G) “Program” means the Engaging Neighborhoods, Organizations, Unions, 1
Governments, and Households (ENOUGH) Grant Program. 2
[(f)] (H) “Special Secretary” means the Special Secretary of the Governor’s 3
Office for Children. 4
9–2806. 5
(A) THERE IS A PEDIATRIC HOSPITAL OVERSTAY COORDINATOR WITHIN 6
THE OFFICE. 7
(B) THE COORDINATOR SHALL ACT IN THE BEST INTEREST OF A PEDIATRIC 8
HOSPITAL OVERSTAY PA TIENT BY COORDINATIN G BETWEEN RELEVANT STATE 9
AGENCIES AND PROGRAM S, INCLUDING PUBLIC BEH AVIORAL H EALTH CARE 10
COORDINATION PROGRAM S. 11
(C) (1) ON OR BEFORE JANUARY 1, 2026, THE OFFICE AND THE 12
COORDINATOR SHALL ENT ER INTO A MEMORANDUM OF UNDERSTANDING WIT H THE 13
MARYLAND DEPARTMENT OF HEALTH, THE DEPARTMENT OF HUMAN SERVICES, 14
AND ANY OTHER RELEVA NT STATE AGENCY FOR THE SHARIN G AND STORAGE OF 15
INFORMATION AND DATA RELATED TO PEDIATRIC HOSPITAL OVERSTAY PA TIENTS 16
IN THE STATE. 17
(2) THE MEMORANDUM OF UND ERSTANDING SHALL GOV ERN THE 18
ACCESS, USE, MAINTENANCE , DISCLOSURE, AND REDISCLOSURE OF PROTECTED 19
HEALTH INFOR MATION IN ACCORDANCE WITH FEDERAL AND STATE LAW, 20
INCLUDING THE FEDERA L HEALTH INSURANCE PORTABILITY AND 21
ACCOUNTABILITY ACT. 22
(D) THE COORDINATOR SHALL : 23
(1) WORK INDEPENDENTLY A ND IMPARTIALLY , WHILE MAINTAINING 24
APPROPRIATE PATIENT CONFIDENTIALITY , TO ADVOCATE ON BEHALF OF 25
PEDIATRIC HOSPITAL O VERSTAY PATIENTS ; 26
(2) REVIEW POLICIES AND PROCEDURES OF RELEVA NT STATE 27
AGENCIES AND MAKE RE COMMENDATIONS FOR NE CESSARY CHANGES TO T HE 28
POLICIES OR PROCEDUR ES TO BETTER SERVE P EDIATRIC HOSPITAL OV ERSTAY 29
PATIENTS; AND 30
(3) MAINTAIN DATA ON EAC H PEDIATRIC HOSPITAL OVERSTAY 31
PATIENT, INCLUDING: 32 HOUSE BILL 962 7
(I) THE PATIENT’S LENGTH OF STAY ; 1
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 2
(III) SERVICES NEEDED ; 3
(IV) PLACEMENT OPTIONS BE ING SOUGHT BY THE PA TIENT; 4
(V) INFORMATION REGARDIN G PREVIOUS HOSPITAL 5
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGN OSIS; AND 6
(VI) ANY OTHER RELEVANT D ATA. 7
(E) ON OR BEFORE OCTOBER 1 EACH YEAR, BEGINNING IN 2026, THE 8
COORDINATOR SHALL REP ORT TO THE GOVERNOR AND , IN ACCORDANCE W ITH § 9
2–1257 OF THIS ARTICLE , THE SENATE FINANCE COMMITTEE AND THE HOUSE 10
HEALTH AND GOVERNMENT OPERATIONS COMMITTEE ON THE NUMB ER OF 11
PEDIATRIC HOSPITAL O VERSTAY PATIENTS IN THE STATE AND DE –IDENTIFIED 12
INFORMATION RELATED TO ACTION PLANS IN P LACE TO ACHIEV E APPROPRIATE 13
PLACEMENT . 14
SECTION 2. AND BE IT FURTHER ENACTED, That: 15
(a) The Maryland Department of Health shall: 16
(1) review the reimbursement rates paid to residential treatment centers 17
and respite care facilities in the State and determine the reimbursement rate that would 18
be necessary to cover the cost of care and prevent future bed closures in residential 19
treatment centers and respite care facilities in the State; and 20
(2) study the implementation of a prospective payment model for 21
residential treatment centers and respite care facilities in the State with the goal of 22
incentivizing the expansion of residential treatment center and respite care facility capacity 23
in the State. 24
(b) On or before December 1, 2025, the Department shall report the findings and 25
recommendations from the review and study conducted under subsection (a) of this section 26
to the Governor and, in accordance with § 2–1257 of the State Government Article, the 27
Senate Finance Committee and the House Health and Government Operations Committee. 28
SECTION 2. AND BE IT FURTHER ENACTED, That: 29
8 HOUSE BILL 962
(a) (1) In this section, “child in an unlicensed setting” means an individual 1
under the age of 21 years in an out–of–home placement who is residing in a hotel, an office 2
building, a shelter, or any other unlicensed setting. 3
(2) “Child in an unlicensed setting” does not include an individual under 4
the age of 21 years who is receiving a self–independent living stipend, living with kin 5
awaiting approval for a placement, or on aftercare with a parent. 6
(b) (1) There is a Workgroup on Children in Unlicensed Settings and Pediatric 7
Hospital Overstays in the State. 8
(2) The Workgroup shall consist of representatives who have experience 9
and knowledge of working with children with behavioral health challenges, adverse 10
childhood experiences, and developmental disabilities, including: 11
(i) the Secretary of Health, or the Secretary’s designee; 12
(ii) the Secretary of Human Services, or the Secretary’s designee; 13
(iii) the Secretary of Juvenile Services, or the Secretary’s designee; 14
(iv) the State Public Defender, or the State Public Defender’s 15
designee; and 16
(v) the following members, appointed by the Governor: 17
1. one representative of the Maryland Association of 18
Resources for Families and Youth; 19
2. one representative of Disability Rights Maryland; 20
3. one representative of the Community Behavioral Health 21
Association of Maryland; 22
4. one representative of Maryland Legal Aid; 23
5. one representative of the Court Appointed Special 24
Advocates of Maryland; 25
6. one representative of the National Association of Social 26
Workers – Maryland who is a hospital–based clinical social worker; 27
7. one representative of the Maryland Chapter of the 28
American Academy of Pediatrics; 29
8. one representative of the Maryland Hospital Association; 30
HOUSE BILL 962 9
9. one representative of a specialty psychiatric hospital; 1
10. one representative of a residential treatment provider in 2
the State; and 3
11. one representative of a family of a child in foster care, as 4
defined in § 8–101(h) of the Human Services Article. 5
(3) The members of the Workgroup shall elect the chair and vice chair of 6
the Workgroup. 7
(4) The Workgroup shall meet before August 1, 2025, and at least once 8
every 30 days thereafter. 9
(5) The State Council on Child Abuse and Neglect shall provide staff for 10
the Workgroup. 11
(6) A member of the Workgroup: 12
(i) may not receive compensation as a member of the Workgroup; 13
but 14
(ii) is entitled to reimbursement for expenses under the Standard 15
State Travel Regulations, as provided in the State budget. 16
(c) (1) The Workgroup shall: 17
(i) complete an assessment of the number, type, and cost of the 18
additional beds and supportive services needed to place all children in pediatric overstays 19
and other unlicensed settings in the least restrictive settings; 20
(ii) develop a comprehensive and sustainable resource development 21
plan designed to increase the number of licensed settings and end the use of pediatric 22
overstays and unlicensed settings; 23
(iii) develop an implementation plan with comprehensive data to 24
inform the plan; and 25
(iv) determine the anticipated timeline for when the practice of 26
placing children in unlicensed settings will cease. 27
(2) On or before October 1, 2025, the Workgroup shall report its findings 28
and recommendations to the Governor and, in accordance with § 2–1257 of the State 29
Government Article, the General Assembly. 30
SECTION 3. AND BE IT FURTHER ENACTED, That for fiscal year 2026, the 31
Governor may include in the annual budget bill an appropriation necessary to staff five 32 10 HOUSE BILL 962
additional beds at the John L. Gildner Regional Institute for Children and Adolescents in 1
the State. 2
SECTION 4. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall take 3
effect June 1, 2025. 4
SECTION 3. 5. AND BE IT FURTHER ENACTED, That , except as provided in 5
Section 4 of this Act, this Act shall take effect July 1, 2025. 6
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.