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Delegates press agencies to fix pediatric hospital overstays as bill seeks beds, coordination and reporting (HB 9 62)
Summary
Lawmakers heard testimony on HB 9 62 after widespread examples of children remaining in EDs and inpatient units beyond medical need; the bill would staff existing state residential beds, require real‑time registry participation, create a pediatric overstay coordinator and direct rate and placement reforms.
House Bill 9 62, presented by Committee Chair Jocelyn Pena Milnick, arose from numerous examples committee members and witnesses described of children remaining in hospital emergency departments and inpatient units when medically ready for discharge because appropriate community placements were unavailable. Supporters said the practice is traumatic for children and strains hospital capacity, including pediatric trauma, ICU and specialty services.
The bill would require the state to staff 17 currently unstaffed state residential treatment beds, require state hospitals to participate in a statewide bed registry, establish a pediatric hospital‑overstay coordinator in the Governor’s Office for Children with annual reporting requirements, and direct the Health Department to review reimbursement and admission policies for residential treatment centers (RTCs).
Hospital witnesses, including Johns Hopkins Children’s Center and Children’s National, described days‑equivalents of boarding, denied admissions when beds were unavailable and the diversion of critical pediatric capacity. Johns Hopkins reported 1,591 boarding days in 2024 and said sustained overstays contributed to admission denials including for ICU‑level patients. Pediatric psychiatrists and social‑work leaders described patients who remained hospitalized for months beyond medical necessity, missed school and psychosocial supports, and the resource intensity required for long‑stay care.
Department of Human Services (DHS) and Maryland Department of Health (MDH) officials said they have been working to reduce overstays: DHS reported policy changes, a full‑time hospital coordinator, kinship care supports and out‑of‑home licensing updates, and MDH said it is procuring a statewide bed registry and referral system. Both agencies proposed technical amendments — DHS suggested changing the overstay threshold to 48 hours for emergency department stays and clarifying coordination with MDH — and asked for time to align budget and operational plans. DHS said youth in hotel placements and out‑of‑state placements are being tracked and the number has fallen in recent months.
Public defenders and advocates cautioned against a rush to out‑of‑state RTC placements without quality safeguards; they also cited a federal inquiry into some RTC operators’ practices and urged robust oversight. Committee members pressed agencies to return with a fiscal plan; the chair asked state leaders and the governor’s office to identify funding and reporting steps before session deadlines.
Ending: Agencies agreed to continue coordination and to provide committee members with fiscal and implementation details; the committee did not vote at the hearing.
