All Roll Calls
Yes: 139 • No: 34
MarylandSB 04112026 Regular SessionSenateWALLET
Hospitals - Clinical Staffing Committees and Plans - Establishment (Safe Staffing Act of 2026)
Sponsored By: Malcolm Augustine
Signed by Governor
Public HealthCommittees and CommissionsComplaintsDietitians and NutritionistsElectronic GovernmentEmergencies -see also- PandemicsEvaluations and ReviewsHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care CommissionHealth Occupations -see also- (specific health occupations)Hospitals -see also- Clinics; State HospitalsInternet -see also- Internet AccessNoticesNurses -see also- Nurse Practitioners; Nursing AssistantsNursing AssistantsPatientsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.Plans and ProposalsPublic InformationReportsStandards and Best PracticesWork, Labor, and Employment -see also- JobTrn; Leave; etc.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
Hospitals must create staffing plans
Starting October 1, 2026, the chief nursing executive drafts a clinical staffing plan and gives it to the hospital’s committee. The committee finalizes the plan using factors like current staffing, coverage for gaps, skill mix, CMS and accreditor rules, patient volume and flow, patient acuity, and needed training or certifications. By July 1 each year, the hospital reviews how the plan worked, updates it, and maintains a process to receive and track staffing complaints. Each hospital must develop and implement its plan by July 1, 2028.
Hospitals must set up staffing committees
By July 1, 2027, each licensed hospital has a clinical staffing committee. Small hospitals (150 or fewer beds) must seat 3 managers and 2 employees. Larger hospitals (151 or more beds) must seat 5 managers and 4 employees. The committee can include at least one frontline worker, such as a CNA, dietary aide, ER nurse, technician, or a patient advocate; teaching hospitals may include a medical resident, and a non‑employed staff physician may serve. The law defines “ancillary frontline team member” as workers who support direct patient care, including dietary workers and patient care techs.
Post staffing levels and allow complaints
Starting October 1, 2026, hospitals must post each unit’s staffing plan and the actual daily staffing for each shift in a public spot on the unit. Staff can ask for a copy, and updates must be posted quickly. Nurses, LPNs, ancillary frontline team members, or an exclusive representative can file a complaint if staffing on a unit does not match the plan. The committee must vote by majority on whether the complaint is resolved.
Statewide hospital staffing reports go public
Starting in 2030, each licensed hospital must send a yearly report by July 1 to the Maryland Health Care Commission on how its committee handled safe staffing. The Commission compiles the reports and posts the statewide compilation on its website’s main page.
Follows federal standards, exempts state hospitals
Beginning October 1, 2026, licensed hospitals must meet staffing standards set by their accreditor and the federal CMS Conditions of Participation. The law does not require any action that conflicts with those federal or accreditor rules. State‑run hospitals are exempt from this part. The Act takes effect October 1, 2026.
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Sponsors & Cosponsors
Sponsor
Malcolm Augustine
Senate
Cosponsors
Shelly Hettleman
Democratic • Senate
Benjamin F. Kramer
Democratic • Senate
Cory V. McCray
Democratic • Senate
Roll Call Votes
House vote • 4/13/2026
Third Reading Passed
Yes: 97 • No: 34 • Other: 11
Senate vote • 4/10/2026
Third Reading Passed
Yes: 42 • No: 0 • Other: 3
Actions Timeline
Approved by the Governor - Chapter 235
4/28/2026Returned Passed
4/13/2026SenateThird Reading Passed (97-34)
4/13/2026HouseFavorable Adopted Second Reading Passed
4/13/2026HouseFavorable Report by Health
4/13/2026HouseRereferred to Health
4/11/2026HouseReferred Rules and Executive Nominations
4/11/2026HouseThird Reading Passed (42-0)
4/10/2026SenateSecond Reading Passed with Amendments
4/10/2026SenateFavorable with Amendments {353621/1 Adopted
4/10/2026SenateFavorable with Amendments Report by Finance
4/10/2026SenateHearing 2/17 at 1:00 p.m.
2/3/2026SenateFirst Reading Finance
1/29/2026Senate
Bill Text
Third Reading
4/10/2026
First Reading
1/29/2026
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