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MarylandHB 09622025 Regular SessionHouse

Public Health - Pediatric Hospital Overstay Patients and Workgroup on Children in Unlicensed Settings and Pediatric Overstays

Sponsored By: Joseline A. Peña-Melnyk (Democratic)

Signed by Governor

Public HealthHealth Care Facilities and RegulationAdministrative AgenciesAppropriationsBudgets -see also- Capital BudgetsChildren (4-12)Committees and CommissionsData -see also- Census; DemographicsGovernorHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care Facilities -see also- Clinics; Hospices; etcHealth, Department ofHealth Insurance -see also- ACA; HMOs; MCOsHealth Occupations -see also- (specific health occupations)Hospitals -see also- Clinics; State HospitalsHuman Services, Department ofIntergovernmental Cooperation -see also- AdmAgn; Cmts; etc.Medical TreatmentsMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.Minors -see also- Age of Majority; YouthPatientsPediatriciansRecords -see also- Land Records; Vital RecordsReportsStandards and Best PracticesStudies -see also- Commitees & Commissions; ReportsSubstance AbuseSubstance Abuse TreatmentTeenagers (13-19)

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 5 benefits, 1 costs, 0 mixed.

More placement help for young patients

Beginning July 1, 2025, Maryland’s health department must ensure overstay patients get the least restrictive care when clinically appropriate and possible. The human services department must coordinate placement with the health department for children committed to its custody. Hospitals must seek a transfer when an overstay patient remains over 48 hours and the state registry shows an appropriate inpatient bed. This duty aims to maintain the patient’s clinical stability. Hospitals may search for placements inside and outside Maryland at the same time.

More help finding behavioral health care

Beginning July 1, 2025, Maryland expands its statewide mental health and substance use registry, subject to available funding. It covers private and state inpatient, crisis, and outpatient services, with searchable listings, real-time availability updates, and electronic referrals. The law does not provide ongoing funding for the registry. Private and state hospitals must have staff available to find suitable services and help patients access them.

Optional funding for five youth beds

The law authorizes the Governor to include fiscal year 2026 funding to staff five additional beds. The beds are at the John L. Gildner Regional Institute for Children and Adolescents. This authority takes effect June 1, 2025. Funding is optional, and the law sets no dollar amount or requirement to open the beds.

Planning more licensed placements for children

Beginning June 1, 2025, a Maryland workgroup must assess needed beds, support services, and costs for children awaiting suitable placements. It must develop sustainable resource and data-backed implementation plans, including a timeline to end unlicensed placements and address hospital overstays. Covered unlicensed placements include hotels, offices, and shelters used for people under 21 in out-of-home care. Exclusions cover independent-living stipend recipients, children with kin awaiting placement approval, and children on aftercare with a parent. The workgroup must meet before August 1, 2025, then at least every 30 days, and report by October 1, 2025. Separately, the health department may review residential treatment and respite rates and study prospective payments to encourage more capacity. Its findings are due December 1, 2025; these steps do not themselves change rates or immediately end unlicensed placements.

State advocates for young hospital patients

Beginning July 1, 2025, Maryland’s health and human services departments must each designate a pediatric hospital overstay coordinator. They must advocate for patients, protect confidentiality, connect hospitals and providers, and recommend policy changes. They must track stays, responsible agencies, needed services, placement searches, and prior behavioral health admissions, and report to both department secretaries. Annual reports begin October 1, 2026, to the Governor and the Senate Finance and House Health and Government Operations committees. Those reports must include overstay counts and action-plan information without patient identities.

Longer wait for hospital overstay status

Beginning July 1, 2025, Maryland raises the wait for pediatric hospital overstay status from more than 24 to more than 48 hours. This covers patients under 22 who remain in a hospital inpatient unit or emergency department after medical clearance for discharge or transfer. The change delays when patients meet the definition used for overstay protections.

Sponsors & Cosponsors

Sponsor

  • Joseline A. Peña-Melnyk

    Democratic • House

Cosponsors

  • Heather Bagnall

    Democratic • House

  • Harry Bhandari

    Democratic • House

  • Bonnie Cullison

    Democratic • House

  • Mike Griffith

    Republican • House

  • Pam Lanman Guzzone

    Democratic • House

  • Terri L. Hill

    Democratic • House

  • Thomas S. Hutchinson

    Republican • House

  • Anne R. Kaiser

    Democratic • House

  • Kenneth Kerr

    Democratic • House

  • Lesley J. Lopez

    Democratic • House

  • Ashanti Martinez

    Democratic • House

  • Teresa E. Reilly

    Republican • House

  • Samuel I. Rosenberg

    Democratic • House

  • Kim Ross

    Democratic • House

  • Kathy Szeliga

    Republican • House

  • Deni Taveras

    Democratic • House

  • Jamila J. Woods

    Democratic • House

  • Teresa Woorman

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 297 • No: 8

House vote • 4/7/2025

Third Reading Passed

Yes: 134 • No: 4 • Other: 2

Senate vote • 4/4/2025

Third Reading Passed

Yes: 43 • No: 0

House vote • 4/1/2025

Third Reading Passed

Yes: 120 • No: 4 • Other: 11

Actions Timeline

  1. Approved by the Governor - Chapter 479

    5/13/2025

  2. Passed Enrolled

    4/7/2025House

  3. Third Reading Passed (134-4)

    4/7/2025House

  4. House Concurs Senate Amendments

    4/7/2025House

  5. Third Reading Passed (43-0)

    4/4/2025Senate

  6. Second Reading Passed with Amendments

    4/4/2025Senate

  7. Floor Amendment {613129/1 (Senator Beidle) Adopted

    4/4/2025Senate

  8. Favorable with Amendments {783420/1 Adopted

    4/4/2025Senate

  9. Favorable with Amendments Report by Finance

    4/4/2025Senate

  10. Rereferred to Finance

    4/3/2025Senate

  11. Referred Rules

    4/1/2025Senate

  12. Third Reading Passed (120-4)

    4/1/2025House

  13. Second Reading Passed with Amendments

    4/1/2025House

  14. Favorable with Amendments {693024/1 Adopted

    4/1/2025House

  15. Favorable with Amendments Report by Health and Government Operations

    4/1/2025House

  16. Hearing 2/26 at 1:00 p.m. (Health and Government Operations)

    2/4/2025House

  17. First Reading Health and Government Operations and Appropriations

    1/31/2025House

Bill Text

  • Enacted

    5/13/2025

    PDF

  • Enrolled

    4/7/2025

    PDF

  • Third Reading

    4/1/2025

    PDF

  • First Reading

    1/31/2025

    PDF

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