The Maryland General Assembly (MGA) convened its 447^th 90-day Legislative Session (the Session) at noon on Wednesday, January 8^th, and adjourned at 11:59 pm on April 7^th. The joint legislative committee of the Maryland Psychiatric Society (MPS) and the Washington Psychiatric Society (WPS) meticulously assessed seventy-nine (79) distinct pieces of legislation, excluding cross files, and actively advocated on thirty-six (36) bills. Below is a summary of the bills that include our priority bill that almost made it to the finish line, bills that successfully passed both chambers and are now under final consideration by the Governor, and two (2) bills that we successfully defeated.

 

Prohibited Possession of Firearms – Assisted Outpatient Treatment Respondents

In 2024, the MGA passed the Assisted Outpatient Treatment (AOT) law to address the needs of individuals with serious mental illnesses who are unable to seek treatment voluntarily. This law provides for court-ordered, community-based treatment to prevent hospitalization, incarceration, or harm to themself or others. Regrettably, the law missed an important component which was to prevent individuals from having firearm access while in court-ordered AOT programs. Resolving this oversight was the Session priority of MPS and WPS.

 

We were able to secure Delegate N. Scott Phillips (D – Baltimore County) and Senator Shaneka Henson (D – Anne Arundel County) to sponsor House Bill 592/Senate Bill 509 which prohibits a person from possessing a regulated firearm, rifle, or shotgun if the person is currently a respondent subject to a court order to comply with an AOT program.  Under the legislation, if an individual is subject to this court order, the court must promptly report specified information to the National Instant Criminal Background Check System (NICS). This must be done through a secure portal approved by the Department of Public Safety and Correctional Services that has to include the date of a court determination or finding and the name and identifying information of a person: (1) determined to not be criminally responsible; (2) found to be incompetent to stand trial; or (3) found to be in need of the protection of a guardian.  A mental healthcare facility is required to similarly report to NICS: (1) the name and identifying information of a person admitted or committed to the facility; (2) the date of admission or commitment; (3) and the name of the facility to which the person was admitted or committed.

House Bill 592 successfully passed out of the House with no amendments. While the bill made it on the voting list in the Judicial Proceedings Committee (JPR) in the final days leading up to sine die, certain JPR members and the Office of the Public Defender voiced concerns with the bill in its current form. Prior to JPR’s voting session, Senator Henson attempted to make amendments to the bill, which ultimately made it more difficult for JPR to take action on the legislation. As such, the bill failed to move out of JPR to the Senate floor for final passage. We hope to work with the MGA and stakeholders during this summer and fall to increase our chances of passing this important piece of legislation during the 2026 legislative session.

Destruction of Medical Records

Delegate Jesse Pippy (R – Frederick County) introduced House Bill 1510, which requires that a notice about the destruction of a medical record or laboratory or x-ray report be sent by first-class mail or e-mail, rather than both methods. Current law requires a health care provider to keep patient records for 7 years, and for minor patients, 7 years after the patient turns 18. Additionally, current law states a health care facility that knowingly violates these provisions is subject to an administrative fine of up to $10,000 for all violations cited in a single day. House Bill 1510 passed both chambers and takes effect October 1, 2025.

 

Health Insurance – Access to Nonparticipating Providers – Referrals, Additional Assistance, and Coverage

Senator Malcolm Augustine (D – Prince George’s County) and Delegate Sheree Sample-Hughes (D – Dorchester and Wicomico Counties) introduced Senate Bill 902/House Bill 11 which, as amended, specifies that a health insurance carrier must ensure that mental health and substance use disorder (SUD) services are provided for the duration of the treatment plan at no greater cost to the covered individual than if a participating provider provided the services. Furthermore, if a member cannot access mental health or SUD services through the referral procedure, the carrier must assist the member in identifying and arranging coverage for mental health or SUD services with a nonparticipating specialist or nonphysician specialist. The provision requiring the Maryland Health Care Commission to set rates for nonparticipating providers was removed. The bill’s provisions repealing the termination date take effect June 1, 2025; provisions regarding referral procedures take effect January 1, 2026, and apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or after that date.

 

Preserve Telehealth Access Act of 2025

Senator Pamela Beidle (D – Anne Arundel County) and Delegate Joseline Pena-Melnyk (D – Prince George’s and Anne Arundel Counties) introduced Senate Bill 372/House Bill 869 which permanently authorizes audio-only telehealth on the same basis and at the same rate as if the healthcare service were delivered in person by the healthcare provider. This provision was initially set to expire on June 30, 2025. The bill also repeals the prohibition on healthcare practitioners prescribing a Schedule II opiate for the treatment of pain through telehealth, provided there is an established practitioner-patient relationship. Lastly, the MHCC is required to submit a report on telehealth every four years and report any findings or recommendations to the Governor and the MGA related to these developments. This legislation takes effect June 1, 2025.

 

Maryland Behavioral Health Crisis Response System – Integration of 9-8-8 Suicide and Crisis Lifeline Network and Outcome Evaluations

Senator Malcolm Augustine (D – Prince George’s County) and Delegate Jennifer White Holland (D – Baltimore County) introduced Senate Bill 900/House Bill 1146 which requires the Maryland Behavioral Health Crisis Response System to establish a State 9-8-8 Suicide and Crisis Lifeline in each jurisdiction, replacing the existing crisis communication centers. The system will coordinate with the national 9-8-8 network to provide support services like suicide prevention, crisis intervention, referrals to additional resources, mobile crisis teams, and crisis stabilization centers. The bill requires evaluation and reporting of outcomes from these services, including data on crisis resolution, response times, and service usage, with annual public reporting. This legislation takes effect July 1, 2025.

 

Public Health – Pediatric Hospital Overstay Patients

Senator Pamela Beidle (D – Anne Arundel County) and Delegate Joseline Pena-Melnyk (D – Prince George’s and Anne Arundel Counties) introduced Senate Bill 696/House Bill 962 which requires MDH, in coordination with the Department of Human Services, to ensure that pediatric hospital overstay patients (youth under age 22 who remain hospitalized more than 48 hours after being medically cleared) are transferred to and treated in the least restrictive setting when clinically appropriate and feasible. These overstays occur due to gaps in community-based and residential services, highlighting the need for improved placement options. To support this, each agency must establish a pediatric hospital overstay coordinator responsible for advocating for patients, coordinating care across systems, reviewing policy barriers, and maintaining data. The bill also creates a Workgroup on Children in Unlicensed Settings and Pediatric Hospital Overstays, staffed by the State Council on Child Abuse and Neglect, which must assess the scope of the issue, develop a plan to expand licensed placement options and submit findings and recommendations to the Governor and MGA by October 1, 2025. The Governor may include funding in the Fiscal Year 2026 budget for five additional beds at the John L. Gildner Regional Institute for Children and Adolescents. Additionally, the bill clarifies that Maryland’s Mental Health and Substance Use Disorder Registry and Referral System includes both private and public inpatient and outpatient services. The bill generally takes effect July 1, 2025; however, workgroup provisions take effect June 1, 2025.

 

Education – Youth Suicide Prevention School Program – Revisions

Senator Bryan Simonaire (R – Anne Arundel County) introduced Senate Bill 310 which expands the educational programs authorized under the Youth Suicide Prevention School Program to include classroom instruction designed to increase pupils’ awareness of the relationship between gambling and youth suicide. The bill also expands the findings and declarations of the MGA to include that (1) youth suicide often exists in combination with other problems, including gambling addiction, and (2) that a suicide prevention program for young people should promote recognizing student behavioral health issues, recognizing students experiencing trauma or violence out of school, and referring students to behavioral health services. This legislation takes effect July 1, 2025.

 

Public Safety – Law Enforcement Agencies – Peer Support Programs

Senator Jeff Waldstreicher (D – Montgomery County) and Delegate Jon Cardin (D – Baltimore County) introduced Senate Bill 326/House Bill 309 which prohibits, with specified exceptions, the disclosure of the contents of any written or oral communication regarding a peer support interaction by a “peer support specialist” or a peer support program participant. A peer support specialist must inform the peer support program participant in writing of the bill’s confidentiality provisions before the initial peer support interaction with a peer support program participant. This legislation takes effect October 1, 2025.

 

Behavioral Health Advisory Council and the Commission on Behavioral Health Care Treatment and Access – Plan to Implement Early and Periodic Screening, Diagnostic, and Treatment Requirements

Senator Malcolm Augustine and Delegate Jamila Woods (both D – Prince George’s County) introduced Senate Bill 790/House Bill 1083 which requires the Behavioral Health Advisory Council and the Commission on Behavioral Health Care Treatment and Access (through its workgroup on youth behavioral health, individuals with developmental disabilities, and individuals with complex behavioral health needs) to provide recommendations to implement the federal Centers for Medicare and Medicaid Services’ State Health Official letter #24-005: Best Practices for Adhering to Early and Periodic Screening, Diagnostic, and Treatment Requirements. By January 1, 2026, the Maryland Department of Health must submit a report of its findings and recommendations to the MGA. This legislation takes effect July 1, 2025.

 

Behavioral Health Crisis Response Grant Program – Funding

Senator Shelly Hettleman (D – Baltimore County) and Delegate Jessica Feldmark (D –Howard County) introduced Senate Bill 599/House Bill 1049, which reestablishes a funding mandate for a three-year period. Accordingly, the Governor must include $5.0 million in the operating budget for the Behavioral Health Crisis Response Grant Program from fiscal 2027 through 2029. This legislation takes effect July 1, 2025.

 

Cannabis – Sale and Distribution – Tetrahydrocannabinol Offenses

Senate Bill 214/House Bill 12 is departmental legislation introduced at the request of the Alcohol, Tobacco, and Cannabis Commission (ATCC). This bill seeks to give the ATCC additional enforcement authority over establishments selling tetrahydrocannabinol (THC) products that meet the “intoxicating products” definition in Maryland. With the proliferation of these products growing in Maryland, this bill passed easily and takes effect on July 1, 2025.

 

Maryland Department of Health – Forensic Review Board – Established

Senator Malcolm Augustine (D – Prince George’s County) and Delegate Lorig Charkoudian (D-
Montgomery Couty) introduced Senate Bill 43/House Bill 32 which requires the Maryland Department of Health (MDH) to establish a forensic review board at each facility that has persons committed as not criminally responsible. The boards are responsible for reviewing and determining whether to recommend to the court that a committed person is eligible for discharge or conditional release, with or without proposed conditions. A board may make recommendations relating to the release or rehabilitation of a committed person. MDH must adopt regulations to implement the bill. This legislation takes effect on October 1, 2025, and incorporates MPS/WPS amendments.

 

End-of-Life Option Act (The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act)

Senator Will Smith (D – Montgomery County) and Delegate Terri Hill (D – Howard County) reintroduced Senate Bill 926/House Bill 1328, aiming to legalize the option for terminally ill individuals in the State to request and obtain self-administered medication from a licensed attending physician to bring about their death.

 

The bill defines “aid-in-dying” as the medical practice where a physician prescribes medication to a qualified individual to end their life. A “qualified individual” must be an adult resident of the State with a terminal illness and the capacity to self-administer medication. The process involves an initial oral request followed by a written one, signed by the individual and two witnesses, with specific rules on witness eligibility. Moreover, there are mandatory waiting periods between requests, with at least one required to be made privately with the attending physician.

 

Following the request, the attending physician must verify the individual’s eligibility, ensure informed decision-making, and confirm voluntariness. Proof of residency can be established through various means, including official documentation or the physician’s knowledge. The physician must also provide comprehensive information about the individual’s medical condition, prognosis, risks, alternatives, and available treatments. Additionally, consultation with a second physician is required to validate the diagnosis and prognosis, with a mental health assessment mandated if necessary.

 

Upon approval, the attending physician may dispense the prescribed medication or facilitate its dispensation by a pharmacist with the individual’s consent. Ancillary medications for comfort may also be provided as needed.

 

Stringent documentation requirements are outlined, with records pertaining to aid-in-dying exempt from subpoena or discovery except under specified regulations. Legal safeguards protect individuals and healthcare providers acting in good faith from civil, criminal, and professional repercussions. The bill explicitly states that aid-in-dying is distinct from suicide or euthanasia and has no impact on insurance policies or contracts.

 

Finally, healthcare facilities retain the right to establish their policies on aid-in-dying participation, with physicians maintaining the freedom to opt out. Penalties are imposed for any falsification, coercion, or destruction of aid-in-dying requests.

 

There was a vigorous two-and-a-half-hour debate in a joint House hearing with the Health and Government Operations and Judiciary Committees. The Senate hearing in the Judicial Proceedings Committee was canceled by the sponsor. This legislation failed for a lack of action by both the House and Senate committees, which aligned with MPS/WPS opposition.

 

State Board of Physicians – Naturopathic Doctors – Prescriptive Authority and Administration of Medication

Delegate Bonnie Cullison (D – Montgomery County) introduced House Bill 867 which would have proposed several changes related to naturopaths – eliminate the current Naturopathic Formulary Council within the Board of Physicians, allow naturopaths to administer natural medicines via intramuscular, subcutaneous, and intravenous routes, and allow the prescribing of “prescription drugs,” including Schedule III, IV, and V controlled dangerous substances. This legislation failed for lack of action by the House Health and Government Operations Committee which aligned with MPS/WPS opposition.