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*hb1015*
HOUSE BILL 1015
J1 (6lr2113)
ENROLLED BILL
— Health/Finance —
Introduced by Delegates Solomon, Shetty, and Kaufman Kaufman, Alston, Bagnall,
Cullison, Guzzone, Hill, Hutchinson, Kipke, Lopez, Martinez, M. Morgan,
Reilly, Rosenberg, Ross, Szeliga, White Holland, 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
Developmental Disabilities Administration – Services – Expedited Eligibility 2
Determinations for Recently Relocated Individuals 3
(Ralph’s Act) 4
FOR the purpose of requiring that the Maryland Department of Health to provide an 5
expedited Medicaid eligibility determination for developmental disabilities services 6
to certain individuals who were determined to be eligible to receive certain 7
developmental disabilities services in another state be eligible to continue to receive 8
those services received certain services in another state and relocated in the State; 9
requiring the Department to establish an expedited review process for certain 10
individuals relocating to the State; authorizing requiring the Department to begin 11
the determination process before an individual establishes residency in the State 12
2 HOUSE BILL 1015
under certain circumstances; and generally relating to eligibility determinations for 1
developmental disabilities services in the State. 2
BY repealing and reenacting, without amendments, 3
Article – Health – General 4
Section 7–101(a) and (g) 5
Annotated Code of Maryland 6
(2023 Replacement Volume and 2025 Supplement) 7
BY adding to 8
Article – Health – General 9
Section 7–404.2 10
Annotated Code of Maryland 11
(2023 Replacement Volume and 2025 Supplement) 12
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 13
That the Laws of Maryland read as follows: 14
Article – Health – General 15
7–101. 16
(a) In this title the following words have the meanings indicated. 17
(g) “Developmental disability” means a severe chronic disability of an individual 18
that: 19
(1) Is attributable to a physical or mental impairment, other than the sole 20
diagnosis of mental illness, or to a combination of mental and physical impairments; 21
(2) Is manifested before the individual attains the age of 22; 22
(3) Is likely to continue indefinitely; 23
(4) Results in an inability to live independently without external support or 24
continuing and regular assistance; and 25
(5) Reflects the need for a combination and sequence of special, 26
interdisciplinary, or generic care, treatment, or other services that are individually planned 27
and coordinated for the individual. 28
7–404.2. 29
(A) AN INDIVIDUAL SHALL B E ELIGIBLE TO RECEIV E SERVICES FROM THE 30
DEPARTMENT UNDER THIS TITLE IF: 31
HOUSE BILL 1015 3
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 1
INDICATED. 2
(2) “DEPENDENT” MEANS AN INDIVIDUAL WITH DISABILITIES WHO: 3
(I) RELIES ON SUPPORT FRO M AN IMMEDIATE FAMIL Y 4
MEMBER WHO IS A RESIDENT OF THE STATE; OR 5
(II) HAS AN IMMEDIATE FAMILY MEMBER WHO IS A RESIDENT 6
OF THE STATE AND ACTS AS THE INDIVIDUAL’S LEGAL GUARDIAN. 7
(3) “IMMEDIATE FAMILY MEMBER” MEANS A SPOUSE, A PARENT, AN 8
ADOPTIVE PARENT , A STEPPARENT , A GRANDPARENT , A STEPGRANDPARENT , A 9
SIBLING, A STEPSIBLING, A CHILD, OR A STEPCHILD. 10
(B) THE DEPARTMENT SHALL PROV IDE AN EXPEDITED MEDICAID 11
ELIGIBILITY DETERMIN ATION FOR DEVELOPMEN TAL DISABILITIES SER VICES, 12
INCLUDING A DISABILITY DETERMINATION FOR PURPOSES OF ENROLLMENT IN THE 13
COMMUNITY PATHWAYS WAIVER, TO AN INDIVIDUAL IF: 14
(1) THE INDIVIDUAL: 15
(I) IS A DEPENDENT OF AN IMMEDIATE FAMILY MEMBER; 16
(II) RECEIVED HOME – AND COMMUNITY –BASED WAIVER 17
SERVICES OR SIMILAR SERVICES UNDER A SIM ILAR ASSISTANCE PROG RAM IN 18
ANOTHER STATE FOR THE IMMEDIATELY PRECEDING 10 YEARS; AND 19
(III) MOVED TO THE STATE TO LIVE WITH TH E IMMEDIATE 20
FAMILY MEMBER ON THE DEATH OR INCAPACITAT ION OF THE INDIVIDUA L’S 21
CARETAKER IN THE OTHER STATE; AND 22
(2) THE IMMEDIATE FAMILY MEMBER ON WHOM THE INDIVIDU AL IS 23
DEPENDENT HAS RESIDED IN THE STATE FOR THE I MMEDIATELY PRECEDING 2 24
YEARS. 25
(B) (1) THE DEPARTMENT SHALL ESTABLISH AN EXPEDITED PROCESS TO 26
DETERMINE WHETHER AN INDIVIDUAL MEETS THE CRITERIA UNDER SUBSE CTION 27
(A) OF THIS SECTION AND IS ELIGIBLE TO RECEIVE SERVICES UNDER THIS TITLE. 28
(2) THE PROCESS ESTABLISHED UNDER TH IS SUBSECTION SHALL 29
REQUIRE THAT A DETERMINATION BE COMPLETED WITHIN 30 DAYS. 30
4 HOUSE BILL 1015
(C) (1) IN PROVIDING EXPEDITED ELIGIBILITY DETERMINATIONS UNDER 1
SUBSECTION (B) OF THIS SECTION, THE DEPARTMENT SHALL: 2
(I) PRIORITIZE COMPLETED APPLICATIONS FOR REV IEW ON 3
RECEIPT; 4
(II) TO THE EXTENT AUTHORI ZED BY LAW , RELY ON 5
DOCUMENTATION, DIAGNOSTIC EVALUATIO NS, ELIGIBILITY DETERMIN ATIONS 6
FROM THE INDIVIDUAL ’S PREVIOUS STATE OF RESIDENCE, AND ANY OTHER 7
DOCUMENTATION THAT T HE DEPARTMENT RELIE S ON WHEN MAKING OTH ER 8
DETERMINATIONS UNDER THIS TITLE; AND 9
(III) COMPLETE EACH EXPEDITED ELIGIBILITY DETERMINATION 10
WITHIN 60 BUSINESS DAYS AFTER THE RECEIPT OF A COMPLETE APPLICATION. 11
(2) IN PROVIDING AN EXPED ITED ELIGIBILITY DET ERMINATION 12
UNDER SU BSECTION (B) OF THIS SECTION , THE DEPARTMENT MAY NOT WA IVE 13
SUBSTANTIVE ELIGIBIL ITY REQUIREMENTS EST ABLISHED UNDER THIS TITLE OR 14
REQUIREMENTS ESTABLI SHED BY REGULATION F OR THE ASSIGNMENT OF A 15
SERVICE PRIORITY CATEGORY. 16
(C) (D) IF AN INDIVIDUAL HAS BEEN DETERMINED UNDER THIS SECTION 17
TO BE ELIGIBLE TO RECEIVE SERVICES, THE INDIVIDUAL SHALL BE: 18
(1) PLACED IN THE CRISIS RESOLUTION CATEGORY; AND 19
(2) GIVEN ACCESS TO WAIVE R SERVICES THROUGH T HE MOST 20
APPROPRIATE RESERVE CATEGORY AS DETERMINED BASED ON THE SERVICES THE 21
INDIVIDUAL RECEIVED IN THE INDIVIDUAL’S PREVIOUS STATE OF RESIDENCE. 22
(E) IF THE DEPARTMENT DETERMINES THAT AN INDIVIDUAL WHO HAS NOT 23
YET ESTABLISHED RESIDENCY IN THE STATE WOULD QUALIFY FOR THE EXPEDITED 24
ELIGIBILITY DETERMIN ATION PROCESS PR OVIDED MEETS THE CRITERIA 25
ESTABLISHED UNDER SUBSECTION (B) (B)(1)(I) AND (II) AND (2) OF THIS SECTION, 26
THE DEPARTMENT MAY SHALL DETERMINE WHETHER TH E INDIVIDUAL HAS A 27
DEVELOPMENTAL DISABI LITY AND THE APPROPRIATE SERVICE PRIORITY 28
CATEGORY AS DEFINED UNDER § 7–101(G) OF THIS TITLE. 29
(D) THE DEPARTMENT MAY DETERM INE, BEFORE AN INDIVIDUAL 30
ESTABLISHES RESIDENCY IN THE STATE: 31
(1) WHETHER AN INDIVIDUAL IS ELIGIBLE TO RECEIVE SERVICES; 32
HOUSE BILL 1015 5
(2) THE APPROPRIATE SERVICE PRIORITY CATEGORY; AND 1
(3) WHETHER THE INDIVIDUAL IS ELIGIBLE FOR CRISIS RESOLUTION 2
SERVICES. 3
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 4
October 1, 2026 July 1, 2027. 5
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.