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.
Italics indicate opposite chamber/conference committee amendments.
*hb0962*
HOUSE BILL 962
J1, J3 (5lr2475)
ENROLLED BILL
— Health and Government Operations and Appropriations/Finance —
Introduced 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
Read and Examined by Proofreaders:
_______________________________________________
Proofreader.
_______________________________________________
Proofreader.
Sealed with the Great Seal and presented to the Governor, for his approval this
_______ day of _______________ at ________________________ o’clock, ________M.
______________________________________________
Speaker.
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 and the Department of Human Services, 7
under certain circumstances, to ensure pediatric hospital overstay patients are 8
placed in the least restrictive setting when clinically indicated and when possible; 9
authorizing a hospital to concurrently explore in–State and out–of–state placements 10
for pediatric hospital overstay patients; establishing the requiring the Maryland 11
Department of Health and the Department of Human Services to establish a 12
Pediatric Hospital Overstay Coordinator within the Governor’s Office for Children; 13 2 HOUSE BILL 962
requiring the Maryland Department of Health to conduct a certain study and review 1
of residential treatment center and respite facility rates; each department; 2
establishing the Workgroup on Children in Unlicensed Settings and Pediatric 3
Overstays in the State; and generally relating to pediatric hospital overstay patients 4
and children in unlicensed settings. 5
BY repealing and reenacting, with amendments, 6
Article – Health – General 7
Section 7.5–802(a) and (d) 8
Annotated Code of Maryland 9
(2023 Replacement Volume and 2024 Supplement) 10
BY adding to 11
Article – Health – General 12
Section 19–388 through 19–390 to be under the new part “Part XII. Pediatric 13
Overstay” 14
Annotated Code of Maryland 15
(2023 Replacement Volume and 2024 Supplement) 16
BY repealing and reenacting, with amendments, 17
Article – State Government 18
Section 9–2801 19
Annotated Code of Maryland 20
(2021 Replacement Volume and 2024 Supplement) 21
BY adding to 22
Article – State Government 23
Section 9–2806 24
Annotated Code of Maryland 25
(2021 Replacement Volume and 2024 Supplement) 26
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 27
That the Laws of Maryland read as follows: 28
Article – Health – General 29
7.5–802. 30
(a) (1) There is a Maryland Mental Health and Substance Use Disorder 31
Registry and Referral System in the Department. 32
(2) The purpose of the Registry and Referral System is to provide a 33
statewide system through which health care providers can identify and access available 34
PRIVATE AND STATE inpatient and outpatient mental health and substance use services 35
for patients in a seamless manner. 36
HOUSE BILL 962 3
(3) Subject to the availability of funds, the Department shall develop and 1
implement the Registry and Referral System, in collaboration with the State–designated 2
Health Information Exchange. 3
(4) The Registry and Referral System shall include: 4
(i) A searchable inventory of any PRIVATE OR STATE provider of 5
mental health and substance use disorder services, including inpatient, crisis, and 6
outpatient services; 7
(ii) The capability to allow a provider of mental health and substance 8
use disorder services to update registry information including the real–time availability of 9
services; and 10
(iii) An electronic referral system that is available to any health care 11
provider in the State to facilitate electronic referrals to mental health and substance use 12
disorder providers. 13
(d) Each PRIVATE AND STATE hospital shall ensure the availability of staff to 14
identify appropriate and available services for patients in the hospital who are in need of 15
mental health or substance use disorder services and to assist the patient in accessing the 16
services. 17
19–386. RESERVED. 18
19–387. RESERVED. 19
PART XII. PEDIATRIC OVERSTAY. 20
19–388. 21
(A) IN THIS PART, “PEDIATRIC HOSPITAL THE FOLLOWING WORDS HAVE 22
THE MEANING S INDICATED. 23
(B) “COORDINATORS ” MEANS THE PEDIATRIC OVERSTAY COORDINATOR IN 24
THE DEPARTMENT AND THE PE DIATRIC OVERSTAY COO RDINATOR IN THE 25
DEPARTMENT OF HUMAN SERVICES. 26
(C) “PEDIATRIC HOSPITAL OVERSTAY PATIENT ” MEANS A PATIENT UNDE R 27
THE AGE OF 22 YEARS WHO REMAINS IN AN INPATIENT UNIT OR EMERGENCY 28
DEPARTMENT OF A HOSP ITAL FOR MORE THAN 24 48 HOURS AFTER BEING 29
MEDICALLY CLEARED FO R DISCHARGE OR TRANS FER. 30
19–389. 31
4 HOUSE BILL 962
(A) (1) THE DEPARTMENT , IN COORDINATION WITH TH E DEPARTMENT 1
OF HUMAN SERVICES, EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS 2
SUBSECTION, THE DEPARTMENT SHALL ENSURE THAT A PEDIATRIC HOSPITAL 3
OVERSTAY PATIENT IS TRANSFERRED TO AND T REATED IN THE LEAST RESTRICTIVE 4
SETTING WHEN CLINICALL Y INDICATED AND WHEN POSSIBLE. 5
(2) THE DEPARTMENT OF HUMAN SERVICES, IN COORDINATION WITH 6
THE DEPARTMENT , SHALL ENSURE THAT A PEDIATRIC HOSPITAL O VERSTAY 7
PATIENT WHO IS A CHI LD COMMITTED TO THE CARE AND CUSTODY OF THE 8
DEPARTMENT OF HUMAN SERVICES IS TRANSFERRED TO AND T REATED IN THE 9
LEAST RESTRICTIVE SE TTING WHEN CLINICALL Y INDICATED AND WHEN POSSIBLE. 10
(B) IF A PEDIATRIC HOSPIT AL OVERSTAY PATIENT REMAINS IN THE 11
HOSPITAL FOR MORE TH AN 48 HOURS AND THE REGIST RY ESTABLISHED UNDER § 12
7.5–802 OF THIS ART ICLE INDICATES THAT AN APPROPRIATE INPAT IENT BED IS 13
AVAILABLE, THE HOSPITAL SHALL S EEK THE TRANSFER TO MAINTAIN THE CLINICA L 14
STABILITY OF THE PAT IENT. 15
(C) NOTWITHSTANDING ANY O THER PROVISION OF LA W, TO ENSURE THAT 16
A PEDIATRIC HOSPITAL OVERSTAY PATIENT IS TREATED IN THE LEAST RESTRICTIVE 17
SETTING, A HOSPITAL MAY CONCU RRENTLY EXPLORE IN –STATE AND 18
OUT–OF–STATE PLACEMENT OPTI ONS. 19
19–390. 20
(A) THE DEPARTMENT AND THE DEPARTMENT OF HUMAN SERVICES 21
SHALL ESTABLISH A PE DIATRIC HOSPITAL OVE RSTAY COORDINATOR WI THIN EACH 22
DEPARTMENT . 23
(B) THE COORDINATORS SHAL L ACT IN THE BEST INTEREST OF A PEDIATRI C 24
OVERSTAY PATIENT BY COORDINATING BETWEEN HOSPITALS, RELEVANT STATE 25
AGENCIES AND PROGRAM S, AND PROVIDERS OF MEN TAL HEALTH AND SUBST ANCE 26
USE DISORDER SERVICE S. 27
(C) THE COORDINATORS SHALL : 28
(1) ADVOCATE ON BEHALF OF PEDIATRIC HOSPITAL O VERSTAY 29
PATIENTS WHILE MAINT AINING APPROPRIATE P ATIENT CONFIDENTIALI TY; 30
(2) REVIEW POLICIES AND P ROCEDURES OF RELEVAN T STATE 31
AGENCIES AND MAKE RE COMMENDATIONS FOR NE CESSARY CHANGES TO THE 32
POLICIES AND PROCEDU RES TO BETTER SERVE PEDIATRIC HOSPITAL O VERSTAY 33
PATIENTS; 34
HOUSE BILL 962 5
(3) MAINTAIN DATA ON EACH PEDIATRIC HOSPITAL O VERSTAY 1
PATIENT, INCLUDING: 2
(I) PATIENT’S LENGTH OF STAY ; 3
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 4
(III) SERVICES NEEDED ; 5
(IV) PLACEMENT OPTIONS BEI NG SOUGHT BY THE PAT IENT; 6
(V) INFORMATION REGARDING PREVIOUS HOSPITAL 7
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGN OSIS; AND 8
(VI) ANY OTHER RELEVANT DA TA; AND 9
(4) REPORT ON THE DATA CO LLECTED UNDER THIS SUBSECTION TO 10
THE SECRETARY AND THE SECRETARY OF HUMAN SERVICES. 11
(A) (1) FOR FISCAL YEAR 2026, THE GOVERNOR MAY INCLUDE IN THE 12
ANNUAL BUDGET BILL A N APPROPRIATION SUFF ICIENT TO FILL ALL P OSITIONS 13
AUTHORIZED FOR A REGIONAL INSTITUTE FOR CHILDREN AND ADOLESCENTS IN 14
THE STATE. 15
(2) FOR FISCAL YEAR 2027 AND EACH FISCAL YEAR THEREAFTER , 16
THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL AN APPROPRIA TION 17
SUFFICIENT TO FILL A LL POSITIONS AUTHORI ZED FOR A REGIONAL INSTITUTE FOR 18
CHILDREN AND ADOLESCENTS IN THE STATE. 19
(B) THE GOVERNOR MAY USE FUND S DESIGNATED FOR THE ADOLESCENT 20
HOSPITAL OVERSTAY PROGRAM FOR THE PURPO SES IDENTIFIED IN SU BSECTION 21
(A) OF THIS SECTION. 22
Article – State Government 23
9–2801. 24
(a) In this subtitle the following words have the meanings indicated. 25
(B) “COORDINATOR ” MEANS THE PEDIATRIC HOSPITAL OVERSTAY 26
COORDINATOR WITHIN TH E GOVERNOR’S OFFICE FOR CHILDREN. 27
[(b)] (C) “Eligible neighborhood” means a neighborhood that includes census 28
tracts with more than 30% of children living in poverty and is served by, as defined by the 29 6 HOUSE BILL 962
Office, a community school with a concentration of poverty level, as defined in § 5–223 of 1
the Education Article, of: 2
(1) in fiscal year 2025 and 2026, at least 80%; 3
(2) in fiscal year 2027 through fiscal year 2029, at least 75%; 4
(3) in fiscal year 2030, at least 60%; and 5
(4) in fiscal year 2031, and each fiscal year thereafter, at least 55%. 6
[(c)] (D) “Fund” means the ENOUGH Grant Fund. 7
[(d)] (E) “Office” means the Governor’s Office for Children. 8
(F) “PEDIATRIC HOSPITAL OV ERSTAY PATIENT ” HAS THE MEANING STAT ED 9
IN § 19–388 OF THE HEALTH – GENERAL ARTICLE. 10
[(e)] (G) “Program” means the Engaging Neighborhoods, Organizations, Unions, 11
Governments, and Households (ENOUGH) Grant Program. 12
[(f)] (H) “Special Secretary” means the Special Secretary of the Governor’s 13
Office for Children. 14
9–2806. 15
(A) THERE IS A PEDIATRIC HOSPITAL OVERSTAY COORDINATOR WITHIN 16
THE OFFICE. 17
(B) THE COORDINATOR SHALL ACT IN THE BEST INTEREST OF A PEDIATRIC 18
HOSPITAL OVERSTAY PA TIENT BY COORDINATIN G BETWEEN RELEVANT STATE 19
AGENCIES AND PROGRAM S, INCLUDING PUBLIC BEH AVIORAL HEALTH CARE 20
COORDINATION PROGRAM S. 21
(C) (1) ON OR BEFORE JANUARY 1, 2026, THE OFFICE AND THE 22
COORDINATOR SHALL ENT ER INTO A MEMORANDUM OF UNDERS TANDING WITH THE 23
MARYLAND DEPARTMENT OF HEALTH, THE DEPARTMENT OF HUMAN SERVICES, 24
AND ANY OTHER RELEVA NT STATE AGENCY FOR THE SHARING AND STORAGE OF 25
INFORMATION AND DATA RELATED TO PEDIATRIC HOSPITAL OVERSTAY PA TIENTS 26
IN THE STATE. 27
(2) THE MEMORANDUM OF UND ERSTANDING SHALL GOV ERN THE 28
ACCESS, USE, MAINTENANCE , DISCLOSURE, AND REDISCLOSURE OF PROTECTED 29
HEALTH INFORMATION I N ACCORDANCE WITH FE DERAL AND STATE LAW, 30 HOUSE BILL 962 7
INCLUDING THE FEDERA L HEALTH INSURANCE PORTABILITY AND 1
ACCOUNTABILITY ACT. 2
(D) THE COORDINATOR SHALL : 3
(1) WORK INDEPENDENTLY A ND IMPARTIALLY , WHILE MAINTAINING 4
APPROPRIATE PATIENT CONFIDENTIALITY , TO ADVOCATE ON BEHAL F OF 5
PEDIATRIC HOSPITAL O VERSTAY PATIENTS ; 6
(2) REVIEW POLICIES AND PROCEDURES OF RELEVA NT STATE 7
AGENCIES AND MAKE RECOMMENDAT IONS FOR NECESSARY C HANGES TO THE 8
POLICIES OR PROCEDUR ES TO BETTER SERVE P EDIATRIC HOSPITAL OV ERSTAY 9
PATIENTS; AND 10
(3) MAINTAIN DATA ON EAC H PEDIATRIC HOSPITAL OVERSTAY 11
PATIENT, INCLUDING: 12
(I) THE PATIENT’S LENGTH OF STAY ; 13
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 14
(III) SERVICES NEEDED ; 15
(IV) PLACEMENT OPTIONS BE ING SOUGHT BY THE PA TIENT; 16
(V) INFORMATION REGARDIN G PREVIOUS HOSPITAL 17
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGN OSIS; AND 18
(VI) ANY OTHER RELEVANT DATA. 19
(E) ON OR BEFORE OCTOBER 1 EACH YEAR, BEGINNING IN 2026, THE 20
COORDINATOR SHALL REP ORT TO THE GOVERNOR AND , IN ACCORDANCE WITH § 21
2–1257 OF THIS ARTICLE , THE SENATE FINANCE COMMITTEE AND THE HOUSE 22
HEALTH AND GOVERNMENT OPERATIONS COMMITTEE ON THE N UMBER OF 23
PEDIATRIC HOSPITAL O VERSTAY PATIENTS IN THE STATE AND DE –IDENTIFIED 24
INFORMATION RELATED TO ACTION PLANS IN P LACE TO ACHIEVE APPR OPRIATE 25
PLACEMENT . 26
SECTION 2. AND BE IT FURTHER ENACTED, That: 27
(a) The Maryland Department of Health shall: 28
(1) review the reimbursement rates paid to residential treatment centers 29
and respite care facilities in the State and determine the reimbursement rate that would 30 8 HOUSE BILL 962
be necessary to cover the cost of care and prevent future bed closures in residential 1
treatment centers and respite care facilities in the State; and 2
(2) study the implementation of a prospective payment model for 3
residential treatment centers and respite care facilities in the State with the goal of 4
incentivizing the expansion of residential treatment center and respite care facility capacity 5
in the State. 6
(b) On or before December 1, 2025, the Department shall report the findings and 7
recommendations from the review and study conducted under subsection (a) of this section 8
to the Governor and, in accordance with § 2–1257 of the State Government Article, the 9
Senate Finance Committee and the House Health and Government Operations Committee. 10
SECTION 2. AND BE IT FURTHER ENACTED, That: 11
(a) (1) In this section, “child in an unlicensed setting” means an individual 12
under the age of 21 years in an out–of–home placement who is residing in a hotel, an office 13
building, a shelter, or any other unlicensed setting. 14
(2) “Child in an unlicensed setting” does not include an individual under 15
the age of 21 years who is receiving a self–independent living stipend, living with kin 16
awaiting approval for a placement, or on aftercare with a parent. 17
(b) (1) There is a Workgroup on Children in Unlicensed Settings and Pediatric 18
Hospital Overstays in the State. 19
(2) The Workgroup shall consist of representatives who have experience 20
and knowledge of working with children with behavioral health challenges, adverse 21
childhood experiences, and developmental disabilities, including: 22
(i) the Secretary of Health, or the Secretary’s designee; 23
(ii) the Secretary of Human Services, or the Secretary’s designee; 24
(iii) the Secretary of Juvenile Services, or the Secretary’s designee; 25
(iv) the State Public Defender, or the State Public Defender’s 26
designee; and 27
(v) the following members, appointed by the Governor: 28
1. one representative of the Maryland Association of 29
Resources for Families and Youth; 30
2. one representative of Disability Rights Maryland; 31
HOUSE BILL 962 9
3. one representative of the Community Behavioral Health 1
Association of Maryland; 2
4. one representative of Maryland Legal Aid; 3
5. one representative of the Court Appointed Special 4
Advocates of Maryland; 5
6. one representative of the National Association of Social 6
Workers – Maryland who is a hospital–based clinical social worker; 7
7. one representative of the Maryland Chapter of the 8
American Academy of Pediatrics; 9
8. one representative of the Maryland Hospital Association; 10
9. one representative of a specialty psychiatric hospital; 11
10. one representative of a residential treatment provider in 12
the State; and 13
11. one representative of a family of a child in foster care, as 14
defined in § 8–101(h) of the Human Services Article. 15
(3) The members of the Workgroup shall elect the chair and vice chair of 16
the Workgroup. 17
(4) The Workgroup shall meet before August 1, 2025, and at least once 18
every 30 days thereafter. 19
(5) The State Council on Child Abuse and Neglect shall provide staff for 20
the Workgroup. 21
(6) A member of the Workgroup: 22
(i) may not receive compensation as a member of the Workgroup; 23
but 24
(ii) is entitled to reimbursement for expenses under the Standard 25
State Travel Regulations, as provided in the State budget. 26
(c) (1) The Workgroup shall: 27
(i) complete an assessment of the number, type, and cost of the 28
additional beds and supportive services needed to place all children in pediatric overstays 29
and other unlicensed settings in the least restrictive settings; 30
10 HOUSE BILL 962
(ii) develop a comprehensive and sustainable resource development 1
plan designed to increase the number of licensed settings and end the use of pediatric 2
overstays and unlicensed settings; 3
(iii) develop an implementation plan with comprehensive data to 4
inform the plan; and 5
(iv) determine the anticipated timeline for when the practice of 6
placing children in unlicensed settings will cease. 7
(2) On or before October 1, 2025, the Workgroup shall report its findings 8
and recommendations to the Governor and, in accordance with § 2–1257 of the State 9
Government Article, the General Assembly. 10
SECTION 3. AND BE IT FURTHER ENACTED, That for fiscal year 2026, the 11
Governor may include in the annual budget bill an appropriation necessary to staff five 12
additional beds at the John L. Gildner Regional Institute for Children and Adolescents in 13
the State. 14
SECTION 4. AND BE IT FURTHER ENACTED, That Section 2 Sections 1 and 3 of 15
this Act shall take effect June July 1, 2025. 16
SECTION 3. 5. AND BE IT FURTHER ENACTED, That , except as provided in 17
Section 4 of this Act, this Act shall take effect July June 1, 2025. 18
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.