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*hb0624*
HOUSE BILL 624
J1 (6lr2315)
ENROLLED BILL
— Health/Finance —
Introduced by Delegates White Holland, Addison, Allen, Bagnall, Bhandari, Boafo,
Boyce, Cullison, Fair, Guzzone, Hill, Kaufman, Martinez, McCaskill,
Pasteur, Stewart, Taveras, and Woods Woods, Alston, Lopez, Rosenberg,
Ross, 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
Hospitals – Clinical Clinical Staffing Committees and Plans – Establishment 2
(Safe Staffing Act of 2026) 3
FOR the purpose of requiring certain hospitals licensed in the State to comply with certain 4
staffing standards, to establish and maintain a clinical clinical staffing committee, 5
and to implement a clinical clinical staffing plan; requiring the chief nursin g 6
executive of each hospital to produce a draft clinical staffing plan and submit it to the 7
clinical staffing committee of the hospital; requiring each clinical clinical staffing 8
committee to develop finalize a clinical clinical staffing plan; and generally relating 9
to hospitals and clinical clinical staffing committees and plans. 10
BY adding to 11
2 HOUSE BILL 624
Article – Health – General 1
Section 19–393 through 19–397 to be under the new part “Part XIII. Clinical Clinical 2
Staffing Committees and Plans” 3
Annotated Code of Maryland 4
(2023 Replacement Volume and 2025 Supplement) 5
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That the Laws of Maryland read as follows: 7
Article – Health – General 8
19–391. RESERVED. 9
19–392. RESERVED. 10
PART XIII. CLINICAL CLINICAL STAFFING COMMITTEES AND PLANS. 11
19–393. 12
(A) IN THIS PART THE FOLL OWING WORDS HAVE THE MEANINGS 13
INDICATED. 14
(B) (1) “ANCILLARY MEMBER OF T HE FRONTLINE TEAM ” MEANS AN 15
INDIVIDUAL WHOSE PRI MARY DUTIES INCLUDE SUPPORTING INDIVIDUA LS WHO 16
PROVIDE DIRECT PATIENT CARE. 17
(2) “ANCILLARY MEMBER OF THE FRONTLINE TEAM” INCLUDES: 18
(I) A DIETARY WORKER; 19
(II) A PATIENT CARE TECHNICIAN; AND 20
(III) ANY OTHER NONLICENSED STAFF ASSISTING WITH PATIENT 21
CARE. 22
(C) “CLINICAL STAFFING STAFFING “CLINICAL STAFFING COMMITTEE” 23
MEANS A COMMITTEE ES TABLISHED BY A HOSPI TAL IN ACCORDANCE WI TH 24
SUBSECTION (C) OF THIS SECTION § 19–394(B) § 19–394(C) OF THIS SUBTITLE. 25
(D) (C) “CLINICAL STAFFING STAFFING CLINICAL STAFFING PLAN” 26
MEANS A PLAN DEVELOPED UNDER SUBSECTION (D) OF THIS SECTION § 19–394(C) § 27
19–394(D) OF THIS SUBTITLE. 28
19–394. 29
HOUSE BILL 624 3
(A) THIS PART DOES NOT APPLY TO STATE HOSPITALS. 1
(B) (1) EACH HOSPITAL LICENSE D UNDER THIS TITLE S HALL COMPLY 2
WITH THE STAFFING STANDARDS OF: 3
(I) THE ACCREDITATION BODY THAT ACCREDITS THE 4
HOSPITAL; AND 5
(II) THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID 6
SERVICES CONDITIONS OF PARTICIPATION. 7
(2) A CLINICAL STAFFING PLAN DEVELOPED UNDER THIS PART SHALL 8
COMPLY WITH THIS SUBSECTION. 9
(C) (1) EACH HOSPITAL LICENSED UNDER THIS TITLE SHALL ESTABLISH 10
AND MAINTAIN A CLINICAL CLINICAL STAFFING COMMITTEE T HAT HAS EQUAL 11
MEMBERSHIP FROM MANAGEMENT AND EMPLOYEES: 12
(I) IF THE HOSPITAL HAS 150 OR FEWER LICENSED BE DS, HAS 13
3 MANAGERS AND 2 EMPLOYEES; OR 14
(II) IF THE HOSPITAL HAS 151 OR MORE LICENSED BEDS, HAS 5 15
MANAGERS AND 4 EMPLOYEES. 16
(2) EACH CLINICAL CLINICAL STAFFING COMMITTEE E STABLISHED 17
UNDER THIS PART SHALL MAY INCLUDE AT LEAST ONE OF THE FOLLOWING 18
INDIVIDUALS: 19
(I) A CERTIFIED NURSING ASSISTANT; 20
(II) A DIETARY AIDE; 21
(III) AN EMERGENCY ROOM A LICENSED NURSE; 22
(IV) AN ENVIRONMENTAL SERVICE WORKER; 23
(V) A MEDICAL RESIDENT, IF THE COMMITTEE IS IN A TEACHING 24
HOSPITAL; 25
(VI) A STAFF PHYSICIAN WHO IS NOT A HOSPITAL EMPLOYEE OR 26
ADMINISTRATOR; AND 27
(VII) A STAFF REGISTERED NURSE WHO IS NOT AN EME RGENCY 28
ROOM NURSE; 29
4 HOUSE BILL 624
(VIII) A NURSE PRACTITIONER; AND 1
(IX) (VII) A TECHNICIAN; OR 2
(VIII) AN EMPLOYEE WHOSE DUT IES INCLUDE PATIENT 3
ADVOCACY. 4
(3) A CLINICAL STAFFING CO MMITTEE ESTABLISHED UNDER 5
PARAGRAPH (1) OF THIS SUBSECTION MAY INCLUDE A PATIENT ADVOCATE. 6
(C) (D) (1) THE CHIEF NURSE EXECU TIVE OF EACH HOSPITA L SHALL 7
PRODUCE A DRAFT CLIN ICAL STAFFING PLAN A ND SUBMIT IT TO THE CLINICAL 8
STAFFING COMMITTEE OF THE HOSPITAL. 9
(2) EACH CLINICAL CLINICAL STAFFING COMMITTEE SHALL DEVELOP 10
FINALIZE A CLINICAL CLINICAL STAFFING PLAN THAT MEETS PATIENT NEEDS USING 11
THE PLAN SUBMITTED UNDER PARAGRAPH (1) OF THIS SUBSECTION. 12
(D) (E) WHEN DEVELOPING FINALIZING A CLINICAL CLINICAL STAFFING 13
PLAN, THE CLINICAL CLINICAL STAFFING COMMITTEE SHALL CONSIDER: 14
(1) EXISTING STAFFING LEVELS; 15
(2) METHODS TO SECURE COVERAGE NEEDS AS NECESSARY; 16
(3) EXISTING GAPS IN STAFFING AND HOW TO ADDRESS THE GAPS; 17
(4) INPUT FROM INDIVIDUAL S WITH SPECIFIC EXPE RTISE IN THE 18
STAFFING CLASSIFICATIONS; 19
(4) (5) ANY AVAILABLE EVIDENC E–BASED STAFFING STAND ARDS; 20
AND 21
(5) (6) (5) A SCHEDULE FOR PERIODI C REVIEW OF THE STAF FING 22
PLAN; 23
(6) APPROPRIATE SKILL MIX AND COMPETENCY OF STAFF; 24
(7) STANDARDS REQUIRED BY: 25
(I) THE CENTERS FOR MEDICARE AND MEDICAID SERVICES 26
CONDITIONS OF PARTICIPATION; AND 27
HOUSE BILL 624 5
(II) THE ACCREDITATION BOD Y THAT ACCREDITS THE 1
HOSPITAL; 2
(8) THE AVERAGE NUMBER OF PATIENTS OF THE HOSP ITAL DURING 3
THE IMMEDIATELY PREC EDING YEAR AND RELEV ANT INFORMATION REGA RDING 4
PATIENT DISCHARGES, POTENTIAL ADMISSIONS, AND TRANSFERS; 5
(9) THE AVERAGE LEVEL OF ACUITY FOR PATIENTS OF THE HOSPITAL 6
DURING THE IMMEDIATELY PRECEDING YEAR AND THE CORRESPONDING LEVEL OF 7
NURSING CARE REQUIRED; AND 8
(10) AN ESTIMATE OF THE AP PROPRIATE COMBINATIO N OF SKILL , 9
EXPERIENCE LEVEL, AND SPECIALTY CERTIFICATION OR TRAINING OF STAFF THAT 10
IS REQUIRED TO ADEQUATELY PROVIDE CARE TO PATIENTS OF THE HOSPITAL. 11
(E) ON OR BEFORE JULY 1 EACH YEAR , EACH HOSPITAL , THROUGH THE 12
CLINICAL STAFFING CO MMITTEE, SHALL CONDUCT A REVI EW OF THE CLINICAL 13
STAFFING PLAN TO: 14
(1) EVALUATE THE EFFECTIV ENESS OF THE CLINICA L STAFFING 15
PLAN DURING THE IMMEDIATELY PRECEDING YEAR; 16
(2) UPDATE THE CLI NICAL STAFFING PLAN TO ENSURE THAT THE 17
CLINICAL STAFFING PLAN CONTINUES TO BE APPROPRIATE AND EFFECTIVE; AND 18
(3) DEVELOP A PROCESS FOR RECEIVING, RESOLVING, AND 19
TRACKING COMPLAINTS RELATED TO THE CLINICAL STAFFING PLAN. 20
(F) IN DEVELOPING THE CLI NICAL STAFFING PLAN , THE CLINICAL 21
STAFFING COMMITTEE SHALL CONSIDER: 22
(1) THE AVERAGE NUMBER OF PATIENTS ON EACH UNI T ON EACH 23
SHIFT DURING THE IMMEDIATELY PRECEDING YEAR AND RELEVANT INFORMATION 24
REGARDING PATIENT DISCHARGES, POTENTIAL ADMISSIONS, AND TRANSFERS; 25
(2) THE AVERAGE LEVEL OF ACUITY FOR PATIENTS ON EACH UNIT ON 26
EACH SHIFT DURING TH E IMMEDIATELY PRECED ING YEAR AND THE 27
CORRESPONDING LEVEL OF NURSING CARE REQUIRED; AND 28
(3) AN ESTIMATE OF THE AP PROPRIATE COMBINATIO N OF SKILL , 29
EXPERIENCE LEVEL, AND SPECIALTY CERTIF ICATION OR TRAINING OF STAFF FOR 30
EACH UNIT ON EACH SHIFT THAT IS REQUIRED TO ADEQUATELY PROVIDE CARE. 31
19–395. 32
6 HOUSE BILL 624
(A) ON OR BEFORE JANUARY JULY 1 EACH YEAR, BEGINNING IN 2028, EACH 1
HOSPITAL SHALL: 2
(1) IMPLEMENT THE CLINICAL CLINICAL STAFFING PLAN ADOPTED 3
FINALIZED UNDER § 19–394 OF THIS SUBTITLE; AND 4
(2) ASSIGN PERSONNEL TO E ACH PATIENT CARE UNI T IN 5
ACCORDANCE WITH THE CLINICAL CLINICAL STAFFING PLAN. 6
(B) A REGISTERED NURSE, A LICENSED PRACTICAL NURSE, AN ANCILLARY 7
MEMBER OF THE FRONTLINE T EAM, OR AN APPLICABLE EXC LUSIVE 8
REPRESENTATIVE MAY S UBMIT A COMPLAINT TO THE CLINICAL STAFFIN G 9
COMMITTEE REGARDING ANY VARIATION WHERE PERSONNEL ASSIGNMENT IN A 10
PATIENT CARE UNIT IS NOT IN ACCORDANCE WI TH THE ADOPTED CLINI CAL 11
STAFFING PLAN. 12
(C) THE CLINICAL STAFFING COMMITTEE SHALL DETE RMINE, BY A 13
MAJORITY VOTE, WHETHER A COMPLAINT HAS BEEN ADEQUATELY RESOLVED. 14
19–396. 15
(A) SUBJECT TO SUBSECTION (B) OF THIS SECTION , ON OR BEFORE 16
JANUARY 1 EACH YEAR, EACH EACH HOSPITAL SHALL: 17
(1) POST IN A PUBLICLY AC CESSIBLE AND CONSPIC UOUS AREA ON 18
EACH PATIENT UNIT THE CLINICAL ANNUAL STAFFING PLAN FOR THE UNIT AND THE 19
ACTUAL DAILY STAFFING FOR EACH SHIFT ON THE UNIT; AND 20
(2) ENSURE THAT A COPY OF THE CLINICAL STAFFIN G PLAN IS 21
AVAILABLE, ON REQUEST, ON EACH PATIENT UNIT PROVIDE THE CLINICAL STAFFING 22
PLAN TO STAFF ON REQUEST. 23
(B) IF A CLINICAL STAFFIN G PLAN FOR A UNIT IS AMENDED AFTER IT IS 24
IMPLEMENTED, THE HOSPITAL SHALL P OST OR PROVIDE THE A MENDED CLINICAL 25
STAFFING PLAN FOR THE UNIT IN THE MANNER REQUIRED UNDER SUBSECTION (A) 26
OF THIS SECTION IN A TIMELY MANNER. 27
19–397. 28
(A) ON OR BEFORE JULY 1 EACH YEAR , BEGINNING IN 2030, EACH 29
HOSPITAL LICENSED UN DER THIS TITLE SHALL SUBMIT A REPORT TO T HE 30
MARYLAND HEALTH CARE COMMISSION SUMMARIZIN G HOW THE HOSPITAL ’S 31
CLINICAL STAFFING CO MMITTEE HAS ADDRESSE D SAFE HOSPITAL STAF FING 32
HOUSE BILL 624 7
THROUGH THE HOSPITAL ’S CLINICAL STAFFING PLAN DURING THE IMME DIATELY 1
PRECEDING YEAR. 2
(B) THE MARYLAND HEALTH CARE COMMISSION SHALL: 3
(1) COMPILE THE REPORTS S UBMITTED UNDER SUBSECTION (A) OF 4
THIS SECTION; AND 5
(2) MAKE THE COMPILED REP ORT PUBLICLY AVAILAB LE BY 6
PUBLISHING THE COMPILATION ON THE MAIN PAGE OF ITS WEBSITE. 7
THIS PART MAY NOT BE CONSTRUED TO REQUIRE A HOSPITAL TO TAKE 8
ACTIONS THAT ARE INC ONSISTENT WITH THE CENTERS FOR MEDICARE AND 9
MEDICAID SERVICES CONDITIONS O F PARTICIPATION OR T HE ACCREDITATION 10
STANDARDS OF THE ACCREDITATION BODY THAT ACCREDITS THE HOSPITAL. 11
SECTION 2. AND BE IT FURTHER ENACTED, That each hospital shall establish 12
a clinical clinical staffing committee as required under § 19 –394 of the Health – General 13
Article, as enacted by Section 1 of this Act, on or before January July 1, 2027. 14
SECTION 3. AND BE IT FURTHER ENACTED, That each clinical staffing 15
committee hospital shall develop implement a clinical clinical staffing plan as required 16
under § 19–394 of the Health – General Article, as enacted by Section 1 of this Act, on or 17
before July 1, 2027 2028. 18
SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 19
October 1, 2026. 20
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.