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Senate bill seeks oversight, staffing and bed-registry steps to reduce pediatric hospital overstays
Summary
Sen. Pam Bridal and hospital leaders described pediatric patients who remain in emergency departments or inpatient beds for weeks or months after medical clearance; SB 696 would staff state-operated residential treatment beds, require bed-registry participation, and create a pediatric-overstay coordinator in the governor’s office.
Senate Chair Pam Bridal presented Senate Bill 696, a package of measures aimed at reducing pediatric “overstay” patients—children who remain in emergency departments or inpatient units for extended periods after they are medically cleared for discharge because no appropriate placement is available.
Bridal told the committee of cases with stays measured in weeks and months and said the bill would take immediate steps: (1) direct the Maryland Department of Health to staff licensed but unstaffed state-operated residential treatment beds (17 beds noted in testimony); (2) require hospitals to participate in the state bed registry for mental-health and substance-use-disorder placements; (3) establish a pediatric hospital overstay coordinator in the Governor’s Office for Children to streamline placement and interagency coordination; and (4) require MDH to review reimbursement rates for residential treatment centers (RTCs) and respite facilities to incentivize capacity expansion.
Hospital and system leaders described operational impacts. Andrew Nicholas (Maryland Hospital Association) said MHA had counted 43 children in overstay status with an average of 31 excess days and nearly 20% of those in emergency departments; Johns Hopkins Children’s Center reported 1,591 Boarded days in 2024 and said some patients’ stays removed 3–5 beds from available medical-surgical use and led to admission denials. Clinicians and social-work leaders described the clinical, developmental and educational harms of long hospital stays for children and urged action.
Providers, the Department of Health Behavioral Health Administration and several advocacy groups testified in support, and the department proposed technical amendments including enhancing the bed registry and clarifying the overstay definition (48 hours referenced in related code) and ensuring EMTALA obligations are met. Stakeholders noted that many placements needed are community-based (foster, relative, group homes) rather than RTCs, and observers urged stronger community placement capacity and cross-agency coordination.
Supporters asked for a favorable report with amendments; no committee vote was recorded at the hearing’s end.
