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.
*sb0696*
SENATE BILL 696
J1, J3 5lr2222
CF HB 962
By: Senator Beidle
Introduced and read first time: January 26, 2025
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted with floor amendments
Read second time: March 18, 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 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
requiring the Maryland Department of Health to conduct a certain study and review 14
of residential treatment center and respite facility rates; each department; 15
establishing the Workgroup on Children in Unlicensed Settings and Pediatric 16
Overstays in the State; and generally relating to pediatric hospital overstay patients 17
and children in unlicensed settings. 18
BY repealing and reenacting, with amendments, 19
Article – Health – General 20
Section 7.5–802(a) and (d) 21
Annotated Code of Maryland 22
(2023 Replacement Volume and 2024 Supplement) 23
2 SENATE BILL 696
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
(ii) The capability to allow a provider of mental health and substance 34
use disorder services to update registry information including the real–time availability of 35
services; and 36 SENATE BILL 696 3
(iii) An electronic referral system that is available to any health care 1
provider in the State to facilitate electronic referrals to mental health and substance use 2
disorder providers. 3
(d) Each PRIVATE AND STATE hospital shall ensure the availability of staff to 4
identify appropriate and available services for patients in the hospital who are in need of 5
mental health or substance use disorder services and to assist the patient in accessing the 6
services. 7
19–386. RESERVED. 8
19–387. RESERVED. 9
PART XII. PEDIATRIC OVERSTAY. 10
19–388. 11
(A) IN THIS PART, “PEDIATRIC HOSPITAL THE FOLLOWING WORDS HAVE 12
THE MEANINGS INDICAT ED. 13
(B) “COORDINATORS ” MEANS THE PEDIATRIC OVERSTAY COORDINATOR IN 14
THE DEPARTMENT AND THE PE DIATRIC OVERSTAY COO RDINATOR IN THE 15
DEPARTMENT OF HUMAN SERVICES. 16
(C) “PEDIATRIC HOSPITAL OVERSTAY PATIENT ” MEANS A PATIENT UNDE R 17
THE AGE OF 22 YEARS WHO REMAINS IN AN INPATIENT UNIT OR EMERGENCY 18
DEPARTMENT OF A HOSP ITAL FOR MORE THAN 24 48 HOURS AFTER BEING 19
MEDICALLY CLEARED FO R DISCHARGE OR TRANS FER. 20
19–389. 21
(A) (1) THE DEPARTMENT , IN COORDINATION WITH THE DEPARTMENT 22
OF HUMAN SERVICES, EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS 23
SUBSECTION, THE DEPARTMENT SHALL ENSURE THAT A PEDIATRIC HOSPITAL 24
OVERSTAY PATIENT IS TRANSFERRED TO AND T REATED IN THE LEAST RESTRICTIVE 25
SETTING WHEN CLINICALLY INDI CATED AND WHEN POSSIBLE. 26
(2) THE DEPARTMENT OF HUMAN SERVICES, IN COORDINATION 27
WITH THE DEPARTMENT , SHALL ENSURE THAT A PEDIATRIC HOSPITAL O VERSTAY 28
PATIENT WHO IS A CHI LD COMMITTED TO THE CARE AND CUSTODY OF THE 29
DEPARTMENT OF HUMAN SERVICES IS TRANSFERR ED TO AND TREATED IN THE 30
LEAST RESTRICTIVE SE TTING WHEN CLINICALL Y INDICATED AND WHEN POSSIBLE. 31
4 SENATE BILL 696
(B) IF A PEDIATRIC HOSPIT AL OVERSTAY PATIENT REMAINS IN THE 1
HOSPITAL FOR MORE TH AN 48 HOURS AND THE REGIST RY ESTABLISHED UNDER § 2
7.5–802 OF THIS ARTICLE INDI CATES THAT AN APPROP RIATE INPATIENT BED IS 3
AVAILABLE, THE HOSPITAL SHALL S EEK THE TRANSFER TO MAINTAIN THE CLINICA L 4
STABILITY OF THE PAT IENT. 5
(C) NOTWITHSTANDING ANY O THER PROVISION OF LA W, TO ENSURE THAT 6
A PEDIATRIC HOSPITAL OVERSTAY PATIENT IS TREATED IN THE LEAST RESTRIC TIVE 7
SETTING, A HOSPITAL MAY CONCU RRENTLY EXPLORE IN –STATE AND 8
OUT–OF–STATE PLACEMENT OPTI ONS. 9
19–390. 10
(A) THE DEPARTMENT AND THE DEPARTMENT OF HUMAN SERVICES 11
SHALL ESTABLISH A PE DIATRIC HOSPITAL OVE RSTAY COORDINATOR WITHIN E ACH 12
DEPARTMENT . 13
(B) THE COORDINATORS SHAL L ACT IN THE BEST INTEREST OF A PEDIATRI C 14
OVERSTAY PATIENT BY COORDINATING BETWEEN HOSPITALS, RELEVANT STATE 15
AGENCIES AND PROGRAM S, AND PROVIDERS OF MEN TAL HEALTH AND SUBST ANCE 16
USE DISORDER SER VICES. 17
(C) THE COORDINATORS SHAL L: 18
(1) ADVOCATE ON BEHALF OF PEDIATRIC HOSPITAL O VERSTAY 19
PATIENTS WHILE MAINT AINING APPROPRIATE P ATIENT CONFIDENTIALI TY; 20
(2) REVIEW POLICIES AND P ROCEDURES OF RELEVAN T STATE 21
AGENCIES AND MAKE RE COMMENDATIONS FOR NE CESSARY CHANGES TO TH E 22
POLICIES AND PROCEDU RES TO BETTER SERVE PEDIATRIC HOSPITAL O VERSTAY 23
PATIENTS; 24
(3) MAINTAIN DATA ON EACH PEDIATRIC HOSPITAL O VERSTAY 25
PATIENT, INCLUDING: 26
(I) PATIENT’S LENGTH OF STAY ; 27
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 28
(III) SERVICES NEEDED ; 29
(IV) PLACEMENT OPTIONS BEI NG SOUGHT BY THE PAT IENT; 30
SENATE BILL 696 5
(V) INFORMATION REGARDING PREVIOUS HOSPITAL 1
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGN OSIS; AND 2
(VI) ANY OTHER RELEVANT DA TA; AND 3
(4) REPORT ON THE DATA COLLECTED UNDER THIS SUBSECTION TO 4
THE SECRETARY AND THE SECRETARY OF HUMAN SERVICES. 5
(A) (1) FOR FISCAL YEAR 2026, THE GOVERNOR MAY INCLUDE IN THE 6
ANNUAL BUDGET BILL A N APPROPRIATION SUFF ICIENT TO FILL ALL P OSITIONS 7
AUTHORIZED FOR A REGIONAL INSTITUTE FOR CHILDREN AND ADOLESCENTS IN 8
THE STATE. 9
(2) FOR FISCAL YEAR 2027 AND EACH FISCAL YEAR THEREAFTER , 10
THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL AN APPROPRIA TION 11
SUFFICIENT TO FILL A LL POSITIONS AUTHORI ZED FOR A REGIONAL INSTITUTE FOR 12
CHILDREN AND ADOLESCENTS IN THE STATE. 13
(B) THE GOVERNOR MAY USE FUND S DESIGNATED FOR THE ADOLESCENT 14
HOSPITAL OVERSTAY PROGRAM FOR THE PURPO SES IDENTIFIED IN SU BSECTION 15
(A) OF THIS SECTION. 16
Article – State Government 17
9–2801. 18
(a) In this subtitle the following words have the meanings indicated. 19
(B) “COORDINATOR ” MEANS THE PEDIATRIC HOSPITAL OVERSTAY 20
COORDINATOR WITHIN TH E GOVERNOR’S OFFICE FOR CHILDREN. 21
[(b)] (C) “Eligible neighborhood” means a neighborhood that includes census 22
tracts with more than 30% of children living in poverty and is served by, as defined by the 23
Office, a community school with a concentration of poverty level, as defined in § 5–223 of 24
the Education Article, of: 25
(1) in fiscal year 2025 and 2026, at least 80%; 26
(2) in fiscal year 2027 through fiscal year 2029, at least 75%; 27
(3) in fiscal year 2030, at least 60%; and 28
(4) in fiscal year 2031, and each fiscal year thereafter, at least 55%. 29
[(c)] (D) “Fund” means the ENOUGH Grant Fund. 30 6 SENATE BILL 696
[(d)] (E) “Office” means the Governor’s Office for Children. 1
(F) “PEDIATRIC HOSPITAL OV ERSTAY PATIENT ” HAS THE MEANING STAT ED 2
IN § 19–388 OF THE HEALTH – GENERAL ARTICLE. 3
[(e)] (G) “Program” means the Engaging Neighborhoods, Organizations, Unions, 4
Governments, and Households (ENOUGH) Grant Program. 5
[(f)] (H) “Special Secretary” means the Special Secretary of the Governor’s 6
Office for Children. 7
9–2806. 8
(A) THERE IS A PEDIATRIC HOSPITAL OVERSTAY COORDINATOR WITHIN 9
THE OFFICE. 10
(B) THE COORDINATOR SHALL ACT IN THE BEST INTEREST OF A PEDIATRIC 11
HOSPITAL OVERSTAY PA TIENT BY COORDINATIN G BETWEEN RELEVANT STATE 12
AGENCIES AND PROGRAM S, INCLUDING PUBLIC BEH AVIORAL HEALTH CARE 13
COORDINATION PROGRAM S. 14
(C) (1) ON OR BEFORE JANUARY 1, 2026, THE OFFICE AND THE 15
COORDINATOR SHALL ENT ER INTO A MEMORANDUM OF UNDERSTANDING WITH T HE 16
MARYLAND DEPARTMENT OF HEALTH, THE DEPARTMENT OF HUMAN SERVICES, 17
AND ANY OTHER RELEVA NT STATE AGENCY FOR THE SHARING AND STORAGE OF 18
INFORMATION AND DATA RELATED TO PEDIATRIC HOSPITAL OVERSTAY PA TIENTS 19
IN THE STATE. 20
(2) THE MEMORANDUM OF UND ERSTANDING SHALL GOV ERN THE 21
ACCESS, USE, MAINTENANCE , DISCLOSURE, AND REDISCLOSURE OF PROTECTED 22
HEALTH INFORMATION I N ACCORDANCE WITH FE DERAL AND STATE LAW, 23
INCLUDING THE FEDERA L HEALTH INSURANCE PORTABILITY AND 24
ACCOUNTABILITY ACT. 25
(D) THE COORDINATOR SHALL : 26
(1) WORK INDEPENDENTLY A ND IMPARTIALLY , WHILE MAINTAINING 27
APPROPRIATE PATIENT CONFIDENTIALITY , TO ADVOCATE ON BEHAL F OF 28
PEDIATRIC HOSPITAL O VERSTAY PATIENTS ; 29
(2) REVIEW POLICIES AND PROCEDURES OF RELEVA NT STATE 30
AGENCIES AND MAKE RE COMMENDATIONS FOR NE CESSARY CHANGES TO T HE 31 SENATE BILL 696 7
POLICIES OR PROCEDUR ES TO BETTER SERVE P EDIATRIC HOSPITAL OV ERSTAY 1
PATIENTS; AND 2
(3) MAINTAIN DATA ON EAC H PEDIATRIC HOSPITAL OVERSTAY 3
PATIENT, INCLUDING: 4
(I) THE PATIENT’S LENGTH OF STA Y; 5
(II) THE RESPONSIBLE STATE AGENCY, IF APPLICABLE; 6
(III) SERVICES NEEDED ; 7
(IV) PLACEMENT OPTIONS BE ING SOUGHT BY THE PA TIENT; 8
(V) INFORMATION REGARDIN G PREVIOUS HOSPITAL 9
ADMISSIONS FOR A BEH AVIORAL HEALTH DIAGN OSIS; AND 10
(VI) ANY OTHER RELEVANT DATA . 11
(E) ON OR BEFORE OCTOBER 1 EACH YEAR, BEGINNING IN 2026, THE 12
COORDINATOR SHALL REP ORT TO THE GOVERNOR AND , IN ACCORDANCE WITH § 13
2–1257 OF THIS ARTICLE , THE SENATE FINANCE COMMITTEE AND THE HOUSE 14
HEALTH AND GOVERNMENT OPERATIONS COMMITTEE ON THE NUMBER OF 15
PEDIATRIC HOSPITAL O VERSTAY PATIENTS IN THE STATE AND DE –IDENTIFIED 16
INFORMATION RELATED TO ACTION PLANS IN P LACE TO ACHIEVE APPR OPRIATE 17
PLACEMENT . 18
SECTION 2. AND BE IT FURTHER ENACTED, That: 19
(a) The Maryland Department of Health shall: 20
(1) review the reimbursement rates paid to residential treatment centers 21
and respite care facilities in the State and determine the reimbursement rate that would 22
be necessary to cover the cost of care and prevent future bed closures in residential 23
treatment centers and respite care facilities in the State; and 24
(2) study the implementation of a prospective payment model for 25
residential treatment centers and respite care facilities in the State with the goal of 26
incentivizing the expansion of residential treatment center and respite care facility capacity 27
in the State. 28
(b) On or before December 1, 2025, the Department shall report the findings and 29
recommendations from the review and study conducted under subsection (a) of this section 30
to the Governor and, in accordance with § 2–1257 of the State Government Article, the 31
Senate Finance Committee and the House Health and Government Operations Committee. 32 8 SENATE BILL 696
SECTION 2. AND BE IT FURTHER ENACTED, That: 1
(a) (1) In this section, “child in an unlicensed setting” means an individual 2
under the age of 21 years in an out–of–home placement who is residing in a hotel, an office 3
building, a shelter, or any other unlicensed setting. 4
(2) “Child in an unlicensed setting” does not include an individual under 5
the age of 21 years who is receiving a self–independent living stipend, living with kin 6
awaiting approval for a placement, or on aftercare with a parent. 7
(b) (1) There is a Workgroup on Children in Unlicensed Settings and Pediatric 8
Hospital Overstays in the State. 9
(2) The Workgroup shall consist of representatives who have experience 10
and knowledge of working with children with behavioral health challenges, adverse 11
childhood experiences, and developmental disabilities, including: 12
(i) the Secretary of Health, or the Secretary’s designee; 13
(ii) the Secretary of Human Services, or the Secretary’s designee; 14
(iii) the Secretary of Juvenile Services, or the Secretary’s designee; 15
(iv) the State Public Defender, or the State Public Defender’s 16
designee; and 17
(v) the following members, appointed by the Governor: 18
1. one representative of the Maryland Association of 19
Resources for Families and Youth; 20
2. one representative of Disability Rights Maryland; 21
3. one representative of the Community Behavioral Health 22
Association of Maryland; 23
4. one representative of Maryland Legal Aid; 24
5. one representative of the Court Appointed Special 25
Advocates of Maryland; 26
6. one representative of the National Association of Social 27
Workers – Maryland who is a hospital–based clinical social worker; 28
7. one representative of the Maryland Chapter of the 29
American Academy of Pediatrics; 30 SENATE BILL 696 9
8. one representative of the Maryland Hospital Association; 1
9. one representative of a specialty psychiatric hospital; 2
10. one representative of a residential treatment provider in 3
the State; and 4
11. one representative of a family of a child in foster care, as 5
defined in § 8–101(h) of the Human Services Article. 6
(3) The members of the Workgroup shall elect the chair and vice chair of 7
the Workgroup. 8
(4) The Workgroup shall meet before August 1, 2025, and at least once 9
every 30 days thereafter. 10
(5) The State Council on Child Abuse and Neglect shall provide staff for 11
the Workgroup. 12
(6) A member of the Workgroup: 13
(i) may not receive compensation as a member of the Workgroup; 14
but 15
(ii) is entitled to reimbursement for expenses under the Standard 16
State Travel Regulations, as provided in the State budget. 17
(c) (1) The Workgroup shall: 18
(i) complete an assessment of the number, type, and cost of the 19
additional beds and supportive services needed to place all children in pediatric overstays 20
and other unlicensed settings in the least restrictive settings; 21
(ii) develop a comprehensive and sustainable resource development 22
plan designed to increase the number of licensed settings and end the use of pediatric 23
overstays and unlicensed settings; 24
(iii) develop an implementation plan with comprehensive data to 25
inform the plan; and 26
(iv) determine the anticipated timeline for when the practice of 27
placing children in unlicensed settings will cease. 28
(2) On or before October 1, 2025, the Workgroup shall report its findings 29
and recommendations to the Governor and, in accordance with § 2–1257 of the State 30
Government Article, the General Assembly. 31 10 SENATE BILL 696
SECTION 3. AND BE IT FURTHER ENACTED, That for fiscal year 2026, the 1
Governor may include in the annual budget bill an appropriation necessary to staff five 2
additional beds at the John L. Gildner Regional Institute for Children and Adolescents in 3
the State. 4
SECTION 4. AND BE IT FURTHER ENACTED, That Section 2 Sections 1 and 3 of 5
this Act shall take effect June July 1, 2025. 6
SECTION 3. 5. AND BE IT FURTHER ENACTED, That , except as provided in 7
Section 4 of this Act, this Act shall take effect July June 1, 2025. 8
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.