DLS recommends technical correction; MDH and Board of Nursing describe progress on licensure backlog and staffing

Victoria Martinez of the Department of Legislative Services presented the fiscal 2026 analysis of Maryland's health professional boards and commissions on Feb. 13, reporting a proposed allowance increase of about $6.2 million (13.4%) to $53 million, mostly funded by special funds from licensing fees.

DLS identified a $6 million miscellaneous personnel appropriation included in the governor's allowance that MDH said was inserted in error; DLS recommended reducing the allowance to correct that technical error and the department concurred. DLS also reviewed proposed fund-balance transfers under the BRFAA (budget reconciliation and financing act) and recommended adjustments to avoid leaving boards with overly high or negative fund balances; DLS recommended eliminating the proposed transfer for the Board of Optometry to prevent a negative balance.

On the Board of Nursing, DLS reported substantial progress in closing a backlog of investigations but noted that the board's timely-completion rate remains affected by administrative closures used to resolve older cases. Exhibit data in the DLS presentation showed the Board of Nursing completed a large number of investigations in fiscal 2024, including administrative closures of pre-2020 cases; about 800 investigations since fiscal 2020 remain outstanding and the board is working to administratively close or resolve many of those cases.

MDH representatives told the subcommittee that the Board of Nursing's operational functions were moved temporarily under MDH (in 2024) and that partnership has accelerated improvements in licensing, constituent services and technology. Erin McClellan, MDH chief of staff, said the Board voted to remain under departmental oversight for an additional five years and that the board will still need fee adjustments to become self-sustaining; MDH concurred with DLS's recommendation to remove the $6 million technical appropriation.

DLS also discussed the board fee study and a phased fee-increase plan to address structural shortfalls; MDH said the Board of Nursing has plans to implement a phased fee schedule through fiscal 2029. Committee members questioned the proposed BRFAA transfers and sought details on vacancy and recruitment progress; the board and MDH officials described targeted recruitment efforts, updated job descriptions and recent hires that have reduced vacancy rates.

A witness from the Maryland Occupational Therapy Association urged the committee to avoid proposed fund transfers that would reduce board balances, noting that retained funds are needed for licensing-compact implementation and other board functions.

DLS recommendation: reduce the fiscal 2026 allowance by $6 million to correct the technical error and consider the recommended BRFAA adjustments; MDH concurred with the technical correction and emphasized continued partnership with the Board of Nursing to complete outstanding reforms.