Health and Social Services subcommittee adopts wide-ranging DLS budget recommendations, orders reports on pediatric overstays and foster care

The Health and Social Services Subcommittee met for decision day and adopted a series of DLS-recommended budget actions and committee narratives affecting multiple state health and human services programs. The subcommittee approved funding modifications and reporting requirements across Maryland Department of Health (MDH), Maryland Department of Human Services (DHS), Behavioral Health Administration (BHA) and related units, including a modified reduction to the Department of Aging, a restriction of funds tied to pediatric hospital overstays, and several new or revised reporting deadlines.

The actions cover standard concurrence with the governor's allowance for several small agencies, technical corrections and staff-position adjustments, and substantive changes in Medicaid and child-welfare-related budget language. The subcommittee adopted DLS language requesting multiple reports and studies intended to clarify provider reimbursements, enrollment trends, and specific program costs.

Most votes were procedural and passed with the committee voice vote of "Aye." Chair Pena Melnick paused during the meeting to emphasize the importance of one item, saying, "Pediatric hospital overstays has been a massive, massive issue for the state for a really long time and this is going to make some very meaningful progress." A delegate who worked on a study request on certified community behavioral health clinics told the chair the language was intended to help the state "get a strong understanding of the cost savings that these programs present."

Votes at a glance (selected substantive actions and outcomes): - Office of the Deaf and Hard of Hearing: DLS recommendation to concur with the governor's allowance adopted (decision document, page 1). Outcome: adopted. - Department of Disabilities: DLS recommendation to concur with the governor's allowance adopted (page 2). Outcome: adopted. - Department of Aging: DLS recommendation initially to reduce the senior care program by $2,500,000 was modified after agency data; the subcommittee adopted a reduced cut of $900,000 (page 3). Outcome: modified and adopted. - Maryland Commission on Civil Rights: Committee narrative requesting a report on the effect of new positions on case assignment and backlog management adopted (page 4). Outcome: adopted. - Maryland Health Benefit Exchange: Multiple actions adopted including a reduction for new positions funded in fiscal 2025 and annual narrative requesting a reinsurance report; a provision tying part of young adult subsidy funding to follow-on legislation was adopted in part (page 7). Outcome: adopted/modified as noted. - Clifton T. Perkins Hospital Center: Committee narrative requesting a report on patient length of stay adopted for MDH administration (page 8). Outcome: adopted. - Inspector General for Health: DLS recommendation to delete four new positions added in the supplemental budget adopted (blue packet page 1). Outcome: adopted. - Public Health / Provider Reimbursement: The subcommittee modified how provider-reimbursement data will be submitted and adopted language authorizing certain interprogram transfers and annual language affecting provider reimbursement programs (white and blue packets, pages 14'16). Outcome: adopted as modified. - Pediatric hospital overstays: DLS recommendation on page 15 was modified in the blue packet to reduce $6,900,000 (from a prior $9,900,000 recommendation) and add budget language restricting $3,000,000 specifically for pediatric hospital overstays; the subcommittee adopted the modified recommendation. Outcome: modified and adopted; chair highlighted the item's significance. - Deletion of 1% provider rate increase funding: For one set of programs the subcommittee moved to reject deletion of the 1% provider rate increase (page 15 and page 22 for different agencies). Outcome: rejection of the deletion (i.e., retain the 1% rate increase appropriation where applicable). - Medicaid and MCO rates: Multiple Medicaid items were acted on, including adoption of annual language restricting funds to Medicaid purpose (page 23), modification to reduce MCO rates by $25,100,000 based on updated agency information (item 4), and other rate and program-level adjustments; the subcommittee adopted the revised reductions where recommended by DLS or rejected them where DLS recommended reduction but the subcommittee voted otherwise. Outcome: mixed; see actions list for specific items. - Biomarker testing funding: A DLS recommendation to reduce funding moved to reject the reduction (blue packet page 10) and the subcommittee rejected the reduction. Outcome: reduction rejected. - Certified community behavioral health clinics: The subcommittee adopted DLS narrative requesting a study on cost savings associated with implementing certified community behavioral health clinics (blue packet pages 4'5). Outcome: adopted. - MD THINK: A committee narrative requesting a report on MD THINK costs, implementation progress and long-term sustainability was adopted with a modified due date of Dec. 1, 2025 (page 31). Outcome: adopted as modified. - Child welfare and foster care reporting: Multiple items requiring reports on child welfare caseloads, hospital stays and hotel stays for children in out-of-home placements were adopted; two related reports were combined and the subcommittee modified the due date to Dec. 1, 2025 (white packet pages 33'37 and blue packet adjustments). Outcome: adopted as modified. - Child fatality review report: The committee modified the due date to Jan. 7, 2026, and adopted the revised schedule when the agency asked for a later due date (page 39). Outcome: adopted as modified. - Foster care maintenance payments: Annual language restricting general funds appropriated for foster care maintenance payments to that use only was adopted; related requests for data on hotel placements and cost subprograms were adopted and clarified (pages 42'43 and blue packet). Outcome: adopted. - Fiscal adjustments and positions: DLS recommendations to delete some long-term vacant positions were adopted in modified form (e.g., delete remaining 8 positions after supplemental transfers) and other technical position deletions were adopted (pages 29, 36, blue packet). Outcome: adopted as modified. - Rainy day fund transfer: DLS revised a recommendation tied to risk corridor recoveries and the subcommittee adopted a motion modifying a recommendation to reduce $100,000,000 to account for a rainy day fund transfer that had not yet been accounted for in the budget (page 29 and later discussion). Outcome: modified and adopted.

Discussion and context: Most items were acted on quickly and procedurally in page order of the decision document and supplemental blue packet. The meeting included several technical corrections to the supplemental budget (BRFA line references and clarifying language for the authorized use of opioid restitution funds). The subcommittee frequently accepted agency concurrence but also adopted DLS-recommended reductions or narrative restrictions when agencies disagreed. Chair Pena Melnick and multiple delegates and analysts briefly explained the policy or procedural significance of selected items, notably pediatric hospital overstays and the certified community behavioral health clinics study.

What to expect next: Many DDA-related items and broader legislative decisions will be discussed at full committee, as the chair noted at the start. Several adopted committee narratives require agency reports by modified due dates (examples: MD THINK by 12/01/2025; combined child-welfare hotel/hospital stays report by 12/01/2025; child-fatality report by 01/07/2026). These reports will return as deliverables for future committee or subcommittee review.