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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1468*
HOUSE BILL 1468
J3, J1 6lr2235
By: Delegates Ruff, Addison, Boyce, Conaway, Fennell, J. Long, Pasteur, Phillips,
Simmons, Simpson, Smith, Spiegel, Stinnett, Terrasa, Wells, Wolek, Wu, and
Young
Introduced and read first time: February 13, 2026
Assigned to: Health
A BILL ENTITLED
AN ACT concerning 1
Hospitals – Patients in Active Labor – Safe Discharge Labor Plans 2
FOR the purpose of requiring a hospital to prepare a safe discharge labor plan before 3
discharging or transferring a patient in active labor, subject to a certain exception; 4
requiring a hospital to maintain records of safe discharge labor plans for a certain 5
period of time; requiring each hospital to conspicuously post copies of a patient in 6
active labor’s rights; requiring a hospital to provide annual training to certain staff 7
members; and generally relating to safe discharge labor plans. 8
BY adding to 9
Article – Health – General 10
Section 19–342.1 11
Annotated Code of Maryland 12
(2023 Replacement Volume and 2025 Supplement) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Health – General 16
19–342.1. 17
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 18
INDICATED. 19
(2) “PATIENT IN ACTIVE LAB OR” MEANS A PREGNANT IND IVIDUAL 20
WHO PRESENTS AT A HOSPITAL WITH SIGNS OR SYM PTOMS OF LABOR, ACCORDING 21
TO GENERALLY ACCEPTED STANDARDS OF OBSTETRIC PRACTICE. 22
2 HOUSE BILL 1468
(3) “SAFE DISCHARGE LABOR PLAN” MEANS A WRITTEN PLAN THAT 1
MUST BE COMPLETED BE FORE A PATIENT IN ACTIVE LABOR MAY BE DISCHARGED 2
OR TRANSFERRED. 3
(B) THIS SECTION DOES NOT APPLY TO AN EMERGENCY TRANSFER O F A 4
PATIENT IN ACTIVE LABOR. 5
(C) A HOSPITAL MAY NOT DISCHARGE OR TRANSFER A PATIENT IN ACTIVE 6
LABOR UNLESS THE HOS PITAL AND THE PATIEN T IN ACTIVE LABOR FIRST 7
COMPLETE A SAFE DISCHARGE LABOR PLAN. 8
(D) A SAFE DISCHARGE LABOR PLAN SHALL INCLUDE: 9
(1) THE C LINICAL JUSTIFICATIO N FOR THE DI SCHARGE OR 10
TRANSFER OF THE PATIENT IN ACTIVE LABOR BASED ON THE MEDICAL ASSESSMENT 11
OF A HEALTH CARE PRACTITIONER LICENSED UNDER THE HEALTH OCCUPATIONS 12
ARTICLE WHO IS INVOLVED IN THE LABOR AND DELIVERY PROCESS; 13
(2) AN ASSESSMENT OF THE DISTANCE BETWEEN THE HOSPITAL AND 14
THE INTENDED DESTINATION OF THE P ATIENT IN ACTIVE LABOR , INCLUDING AN 15
EVALUATION OF WHETHER THE TRAVEL IS SAFE CONSIDERING THE CONDITION OF 16
THE PATIENT IN ACTIVE LABOR; 17
(3) A WRITTEN, PLAIN–LANGUAGE ACKNOWLEDGEMENT, SIGNED BY 18
THE PATIENT IN ACTIVE LABOR, EXPLAINING: 19
(I) THE RISKS ASSOCIATED WITH BEING DISCHARGED; 20
(II) A LIST OF SIGNS OR SYM PTOMS INDICATING THA T THE 21
PATIENT IN ACTIVE LABOR SHOULD RETURN TO A HOSPITAL; AND 22
(III) CONTACT INFORMATION FOR THE HOSPITAL OR AN 23
ALTERNATIVE FACILITY FOR REASSESSMENT; AND 24
(4) DOCUMENTATION THAT CONFIRMS THE PATIENT IN ACTIVE 25
LABOR UNDERSTANDS THE SAFE DISCHARGE LABOR PLAN, INCLUDING THE RISKS, 26
POTENTIAL COMPLICATI ONS, AND WHAT TO DO IF LA BOR IN TENSIFIES OR 27
COMPLICATIONS OCCUR. 28
(E) A HOSPITAL SHALL: 29
HOUSE BILL 1468 3
(1) MAINTAIN RECORDS OF A LL SAFE DISCHARGE LA BOR PLANS 1
COMPLETED UNDER THIS SECTION, INCLUDING THE SIGNED ACKNOWLEDGMENT OF 2
THE SAFE DISCHARGE LABOR PLAN, FOR AT LEAST 21 YEARS AFTER THE PATIENT IN 3
ACTIVE LABOR IS DISCHARGED OR TRANSFERRED; 4
(2) PROVIDE ANNUAL TRAINI NG TO ALL PATIENT CARE STAFF 5
MEMBERS WHO WORK IN OBSTETRIC , LABOR, DELIVERY, AND EMERGENCY CARE 6
THAT ADDRESSES: 7
(I) MATERNAL HEALTH AND P REGNANCY–RELATED 8
CONDITIONS; 9
(II) BEST PRACTICES IN COM MUNICATION AND 10
PATIENT–CENTERED CARE; 11
(III) RACIAL AND ETHNIC DISPARITIES IN MATERNAL CARE; AND 12
(IV) RESPECTFUL TREATMENT OF ALL PATIENTS IN ACTIVE 13
LABOR, REGARDLESS OF RACE , ETHNICITY, SOCIOECONOMIC STATU S, OR 14
INSURANCE COVERAGE; AND 15
(3) CONSPICUOUSLY POST CO PIES OF A PATIENT’S RIGHTS UNDER 16
THIS SECTION, INCLUDING THE RIGHT OF A PATIENT IN ACTI VE LABOR TO HAVE A 17
SAFE DISCHARGE LABOR PLAN BEFORE BEING DISCHARGED OR TRANSFERRED, ON 18
THE HOSPITAL’S WEBSITE AND IN THE LABOR AND DELIVERY DEPARTMENT. 19
(F) A HOSPITAL MAY USE A T RAINING DEVELOPED AND ACCREDITED BY A 20
THIRD PARTY TO SATISFY THE TRAINING REQUIRED UNDER SUBSECTION (E)(2) OF 21
THIS SECTION IF THE TRAINING OTHERWISE S ATISFIES THE REQUIREMENTS OF 22
SUBSECTION (E)(2) OF THIS SECTION. 23
(G) (1) IF THE DEPARTMENT FINDS A HOSPITAL HAS VIOLA TED 24
SUBSECTION (C) OF THIS SECTION, THE DEPARTMENT SHALL: 25
(I) IMPOSE A CIVIL MONETA RY PENALTY OF $25,000 PER 26
VIOLATION; 27
(II) REQUIRE THE HOSPITAL TO ESTABLISH A PLAN OF 28
CORRECTION TO PREVENT FUTURE VIOLATIONS; AND 29
(III) IF APPLICABLE, REFER A HEALTH CARE PRACTITIONER 30
RESPONSIBLE FOR THE VIOLATION TO THE APPROPRIATE HEALTH OCCUPATIONS 31
BOARD FOR DISCIPLINE. 32
4 HOUSE BILL 1468
(2) IF THE DEPARTMENT FINDS A HOSPITAL HAS VIOLA TED 1
SUBSECTION (E)(1) OR (3) OF THIS SECTION, THE DEPARTMENT SHALL: 2
(I) FOR A FIRST VIOLATION, PROVIDE WRITTEN NOTICE TO THE 3
HOSPITAL OF THE VIOL ATION AND ALLOW THE HOSPITAL TO ADDRESS THE 4
DEFICIENCY; 5
(II) FOR A SECOND VIOLATION , IMPOSE A CIVIL MONET ARY 6
PENALTY OF $5,000; AND 7
(III) FOR EACH SUBSEQUENT VIOLATION , INCREASE THE 8
FREQUENCY WITH WHICH THE DEPARTMENT INSPECTS THE HOSPITAL FOR 9
COMPLIANCE WITH THIS SECTION. 10
(3) IF THE DEPARTMENT FINDS THAT A HOSPITAL HAS VIO LATED 11
SUBSECTION (E)(2) OF THIS SECTION, THE DEPARTMENT SHALL: 12
(I) IMPOSE A CIVIL PENALT Y OF $5,000 FOR EACH YEAR THE 13
HOSPITAL HAS FAILED TO PROVIDE THE REQUIRED TRAINING; AND 14
(II) REQUIRE THE HOSPITAL TO PROVIDE THE MANDA TORY 15
TRAINING WITHIN 90 DAYS AFTER NOTICE OF THE VIOLATION IS PROVIDED. 16
(H) ON OR BEFORE APRIL 1 EACH YEAR , BEGINNING IN 2028, EACH 17
HOSPITAL SHALL SUBMIT AN ANONYMIZED REPORT TO THE DEPARTMENT FOR THE 18
IMMEDIATELY PRECEDING CALENDAR YEAR THAT INCLUDES: 19
(1) THE NUMBER OF DISCHAR GES OR TRANSFERS OF PATIENTS IN 20
ACTIVE LABOR MADE WITH SAFE DISCHARGE LABOR PLANS; 21
(2) THE NUMBER OF DISCHAR GES OR TRANSFERS OF PATIENTS IN 22
ACTIVE LABOR MADE WITHOUT A SAFE DISCHARGE LABOR PLAN AND THE REASON 23
THOSE DISCHARGES OR TRANSFERS WERE MADE WITHOUT A SAFE DISCH ARGE 24
LABOR PLAN; AND 25
(3) ANY ADVERSE EVENTS TH AT OCCURRED FOLLOWIN G THE 26
DISCHARGE OR TRANSFE R OF A PATIENT IN ACTIVE LABOR , INCLUDING ANY 27
REPORTS OF BIRTHS OCCURR ING OUTSIDE THE HOSP ITAL AND ANY 28
COMPLICATIONS. 29
(I) ON OR BEFORE AUGUST 1 EACH YEAR , BEGINNING IN 2028, THE 30
DEPARTMENT SHALL: 31
HOUSE BILL 1468 5
(1) COMPILE THE REPORTS SUBMITTED UNDER SUBSECTION (H) OF 1
THIS SECTION; AND 2
(2) SUBMIT THE COMPILATION AND ANY RELATED 3
RECOMMENDATIONS TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH § 2–1257 4
OF THE STATE GOVERNMENT ARTICLE. 5
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 6
January 1, 2027. 7