Legislative Overview:
The Maryland General Assembly convened on January 8, 2025, and adjourned at midnight on April 7, 2025.
The Governor and Legislature’s main focus was to tackle a $3 billion shortfall in the state budget. To bridge the budget gap, targeted cuts and delays in program and agency funding were implemented. Additionally, new revenue was generated by increasing various fees and sales and services taxes. At the conclusion of the Session the Legislature and Governor agreed on a balanced budget that leaves a bit of a budget surplus heading into the 2026 Session (Fiscal Year 2027). However, future State Operating budget decisions will depend on what changes come from Congress in Washington DC regarding Medicaid and other federal revenue streams that Maryland benefits from. In the instance of substantial cuts, the General Assembly is poised to come back in for a Special Session later this fall.
Working with MaCCRA leadership we successfully worked to shape and secure passage of multiple pieces of legislation that provides for the following:
- Resident Voice in CCRCs: Legislation passed that provides an additional voice for residents and more transparency into the affairs of the governing boards of Continuing Care Retirement Communities (CCRCs).
- State Operating Budget: MaCCRA was actively advocating with the Budget leaders in the Maryland General Assembly to retain the ability for the itemized deduction of expenses including medical expenses. There was also concern regarding the Governor’s proposal to eliminate the Inheritance Tax and adjustment to the Estate Tax Threshold as part of the Budget Reconciliation Financing Act (HB0352 and SB0321). In the final budget adopted by the Legislature itemized deductions were by and large retained and no action was taken with respect to the inheritance or estate taxes.
- Collaborations: MaCCRA in ongoing efforts to collaborate with like-minded groups endorsed the policy goals that were shared by Caring Across Maryland. Their efforts focused on improving transparency and accountability of long term care facilities as well as advocating for increased staffing for hospitals and nursing homes. MACCRA actively supported and advocated for a number of those bills, many of which are highlighted below.
The most significant accomplishment was the passage of House Bill 938 (detailed below) which was the product of strong legislative support over the initial resistance of the providers. After a couple of meetings between MaCCRA, key legislators, and the providers compromise was reached and the result was House Bill 938. The bill is an important step forward, building on the success of 2024’s legislation, and will require governing boards to add an alternate resident member. That alternate will be able to attend all meetings, but can only vote in the instance the resident member is absent. This law will take effect on January 1, 2026. The Providers have pledged to work with their boards and board process to make whatever adjustments necessary to include the alternate members.
The following pages details this and the other bills that we took action on in coordination with MaCCRA leadership and the Legislative Working Group.
Priority Legislation:
HB 0938 (Del. Dana Stein) Continuing Care Providers – Governing Bodies – Membership – [Passed]
MaCCRA Position: Supported with In Person and Written Testimony
This bill requires the governing body of a continuing care provider that has only one subscriber to authorize the appointment of an alternate subscriber to serve as a regular member of the governing body if the regular subscriber is unable to fulfill the subscriber’s duties. The alternate subscriber may (1) attend all meetings of the governing body and (2) vote only if the regular subscriber is unable to fulfill the subscriber’s duties as a regular member of the governing body. The bill also makes conforming changes relating to regular and alternate subscribers. The bill takes effect January 1, 2026.
Our message to members of the House and Senate Committees was as clear and direct as possible. CCRC residents are the primary stakeholders of the CCRCs and bear the greatest financial risk of these enterprises. You need to have the opportunity given by law to at least participate in the governance of the facility to ensure the best interests of the residents are being heard and do in fact guide the decision-making.
CCRC governing boards understandably treat the CCRC as a business and their decision-making is guided by the goal of having a successful business. But, for residents, their CCRC is not simply a business – it is their home, more often than not for life. Resident members bring a different perspective encompassing matters not always fully understood and appreciated by the non-resident members of the governing board. It is essential that the governing board have significant resident input in the ultimate decision-making process.
Having two residents, 1 active member and 1 alternate, will double that input. Two different perspectives on resident concerns and objectives to be considered by the board in making financial decisions which directly impact the residents more so than any other stakeholders. We will continue to work with our legislative supporters to ensure the bill is implemented as intended and within the allotted timeframe.
HB 1454 (Del. Lily Qi) Maryland Department of Aging – Continuing Care Retirement Communities and Continuing Care At-Home Providers Licensing and Regulation – Study [Withdrawn by Sponsor]
MaCCRA Position: Amend to include resident representation
This bill arose from the Sponsor’s attempt to help a constituent resolve concerns with a CCRC. The Delegate in their efforts to help thought it would be helpful to have a deeper look at CCRC licensing and regulation. Her bill would have required the Department of Aging to contract an independent consultant to complete a study on the licensing and regulation of continuing care retirement communities and continuing care at-home providers; and would have required the Department to submit the results of the study on or before December 1, 2026.
We initiated discussions with the Delegate and asked that MaCCRA be part of any group or study. Ultimately, the Delegate withdrew the bill, but we will continue discussions to engage her further on MaCCRA issues.
HB 0429 (Del. Bonnie Cullison)/ SB 0376 (Sen. Ben Kramer) – Health Facilities – Delegation of Inspection Authority – Nursing Homes – [Senate Bill Passed]
MaCCRA Position: Supported with written testimony
This bill requires the Maryland Department of Health (MDH), beginning July 1, 2025, and every three months thereafter, to report to the Senate Finance Committee and the House Health and Government Operations Committee the number of nursing home surveys conducted in each county. The data must be disaggregated by the following types of surveys: standard; complaint; follow-up; revisit; special focus facility; abbreviated; and life safety code. Beginning July 1, 2025, and every six months thereafter, the Office of Health Care Quality (OHCQ) must report to each area agency on aging (AAA) the name of each nursing home in the county that was surveyed in the immediately preceding six months and the date each survey was conducted. The bill takes effect June 1, 2025, and terminates May 31, 2029.
Other Legislation of Note:
Facilities: Hospital and Long-Term Care Facilities
HB 0933 (Delegate Ashanti Martinez)/ SB 0679 (Senator Jim Rosapepe) Nursing Homes – Cost Reports [House Bill PASSED]
MaCCRA Position: Signed up Support no testimony
This bill requires the Maryland Department of Health (MDH) to review the cost reports and other data submitted by each nursing home that participates in Medicaid, including data related to revenue allocated to (1) contracted nursing care services and (2) salaries and wages of all direct care nonadministrative staff, including certified nurse aides, directors of nurses, licensed practical nurses, noncertified or resident care aides, registered nurses, housekeepers, dietary workers, and in-house clerical staff who regularly interact with residents, Medicaid recipients, and caregivers. By October 1, 2025, and annually thereafter through 2029, MDH must report the findings resulting from this review to the Governor, the Senate Finance Committee, and the House Health and Government Operations Committee. The bill takes effect June 1, 2025.
HB 1291 (Del. Greg Wims)/ SB 0751 (Sen. Shaneka Henson) – Health Facilities – Assisted Living Programs – Family Councils [Failed to Pass]
MaCCRA Position: Supported with Written Testimony
This bill would have authorized the owner, operator, or staff of an assisted living program with 15 or more beds to create a “family council” (a group of individuals who work together to protect the rights of and improve the quality of life of the residents). An owner, operator, or staff of an assisted living program could lead the family council for up to six months, at which time the family council must be led by a member of the family council. A family council could consist of members of a resident’s family, or an individual appointed by the resident or the resident’s family, as specified. On written request of a family council, an assisted living program could assist the family council with administrative functions in a mutually agreed upon manner. An assisted living program would maintain specified records, responded to a family council within a certain timeframe, and provided each new or prospective resident specified written information about the family council.
HB 0905 (Del. Jennifer White Holland)/ SB 0720 (Sen. Malcolm Augustine) Hospitals – Clinical Staffing Committees and Plans – Establishment (Safe Staffing Act of 2025)
[Failed to Pass]
MaCCRA Position: Supported with Written Testimony and a Letter to the Chair of Finance urging a hearing on the bills.
This bill would have required each hospital to establish and maintain a clinical staffing committee that has equal membership from management and employees. Each clinical staffing committee would develop a clinical staffing plan that meets patient needs. By January 1 each year, each hospital must have implemented the plan, assigned personnel to each patient care unit in accordance with the plan, and posted specified information about the plan. By July 1 each year, each clinical staffing committee would conduct a review of the plan to (1) evaluate its effectiveness during the immediately preceding year; (2) update the plan to ensure that it continues to be appropriate and effective; and (3) develop a process for receiving, resolving, and tracking complaints related to the plan. Specified individuals could submit a complaint and the committee must determine by a majority vote whether a complaint has been resolved. The bill expressed the intent of the General Assembly that, by July 1, 2029, and annually thereafter, the Maryland Hospital Association (MHA) must compile and provide specified reports. The bill would not have applied to State hospitals.
HB 0576/SB 0465 (By Request – Office of the Attorney General) – Health Care Facilities – Nursing Homes and Assisted Living Programs – Video Recordings [Failed to Pass]
MaCCRA Position: Supported with Written Testimony
This bill would have required licensed nursing homes and assisted living programs to install, operate, and maintain video surveillance equipment in a “common area” of the facility for the purpose of detecting the abuse, neglect, or exploitation of residents. Nursing homes and assisted living programs would have had to ensure that the video surveillance is continuous and without interruption, does not capture images within a “private space,” and complied with the Federal Electronic Communications Privacy Act (ECPA) of 1986 and the Maryland Wiretap Act. The Maryland Department of Health (MDH) may have adopted regulations to carry out the bill.
HB 0604/SB 0466 (By Request – Office of the Attorney General) Vulnerable and Senior Adults – Theft of Property by Caregiver, Family Member, or Household Member – Prohibition [Failed to Pass]
MaCCRA Position: Signed up support with no testimony
This bill would have prohibited a person who is a caregiver to or a family member or household member of an individual from knowingly and willfully obtaining the individual’s property with the intent to deprive the individual of their property if (1) the individual is a vulnerable adult or an individual who is at least 68 years old and (2) the person knows or reasonably should know that the individual is a vulnerable adult or is at least 68 years old. Violators would have been subject to the existing penalties under §8-801 of the Criminal Law Article (exploitation of a vulnerable adult). A sentence imposed for a conviction under this new prohibition would have to have been concurrent with and not consecutive to a sentence for any crime based on the act or acts establishing the violation.
HB 0828 (Del. Nicholaus R. Kipke) Health Care Facilities – Rights of Comprehensive and Extended Care Facility Residents – Hospice Comfort Care [Failed to Pass]
MaCCRA Position: Signed up Support no testimony
This bill would have established an exception to a specified basic right of residents in a comprehensive care or extended care facility. The bill would have specified that each resident has the right to be free from physical and chemical restraints, except for sedatives, anti-anxiety medication, a bed rail, or a Geri chair (geriatric chair) ordered or authorized by a prescriber, and used in compliance with the order, for a patient receiving hospice care.
HB 1363 (Del. Harry Bhandari) Places of Public Accommodation – Captioning for Motion Picture Houses – Alterations [Failed to Pass]
MaCCRA Position: Supported with Written Testimony
This bill would have extended statutory provisions that govern movie captioning requirements to apply to a motion picture house with at least four screens. The bill also required, on or before the 10th day of the month, each month, a motion picture house that is a place of public accommodation to report to the Maryland Commission on Civil Rights (MCCR) and the Attorney General on (1) the motion pictures screened during the preceding month that used closed movie captioning in accordance with statute; (2) if applicable, the motion pictures screened during the preceding month that used open movie captioning in accordance with statute; and (3) the times and dates that such motion pictures were screened.
Health Care and Well Being:
HB 1142 (Delegate Heather Bagnall)/ SB 0920 (Sen. Dawn Gile) – Public Health – Maryland Interested Parties Advisory Group – Establishment [PASSED]
MaCCRA Position: Signed up Support no testimony
This bill generally codifies the federally required Maryland Interested Parties Advisory Group (IPAG) in the Maryland Department of Health (MDH). The primary purpose of IPAG is to advise and consult on Medicaid payment rate sufficiency, ensuring adequate access to “applicable service” categories (homemaker, home health aide, personal care, and habilitation services). IPAG must (1) evaluate the sufficiency of Medicaid payment rates for applicable service categories and (2) evaluate challenges to accessing care for applicable Medicaid home- and community-based services (HCBS). The Deputy Secretary of Health Care Financing (or their designee) must appoint the initial members of IPAG by October 1, 2025. Beginning November 1, 2025, IPAG must meet annually, and IPAG must report by September 1 each year (starting in 2026) on its activities and recommendations to the Governor and the General Assembly. The bill takes effect July 1, 2025.
HB 1004 (Delegate Ashanti Martinez)/ SB 0748 (Sen. Ben Kramer) Public Health – Alzheimer’s Disease and Related Dementias – Information on Prevalence and Treatment [PASSED]
MaCCRA Position: Supported with written testimony
This bill expands the information that the Maryland Department of Health (MDH), in partnership with specified entities, must incorporate into relevant public health outreach programs to include information (1) for health care providers on treatments approved by the U.S. Food and Drug Administration (FDA) for Alzheimer’s disease and related dementias, including relevant information on treatment use and outcomes and (2) to increase public understanding and awareness of early treatment of Alzheimer’s disease and related dementias and FDA-approved treatments and relevant information on treatment use and outcomes. MDH, in collaboration with the State-designated health information exchange (HIE), must establish and maintain a publicly accessible website that includes specified information regarding Alzheimer’s disease and related dementias in a downloadable format, which must be updated annually to include any newly available data. The bill also makes conforming changes and corrects an obsolete reference to the Virginia I. Jones Alzheimer’s Disease and Related Disorders Council.
HB 0141 (Del. Joe Vogel) Task Force on Loneliness and Isolation [Failed to Pass]
MaCCRA Position: Supported with Written Testimony via letter to Sponsor
This bill would have established a Task Force on Loneliness and Isolation. By June 30, 2026, the task force would have had to report its findings and recommendations to the Governor, the Senate Finance Committee, and the House Health and Government Operations Committee. The Maryland Department of Health (MDH) would have had to provide staff for the task force. A member of the task force would not have received compensation but would have been entitled to reimbursement for expenses. The bill would have taken effect July 1, 2025, and terminated June 30, 2027.
HB 1328 (Del. Terri Hill)/ SB 0926 (Sen. William Smith) – End-of-Life Option Act (The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act) – [Failed to Pass]
MaCCRA Position: MONITOR
This bill creates a process by which an individual may request and receive aid in dying from the individual’s attending physician. The bill exempts, from civil or criminal liability, State-licensed physicians who, in compliance with specified safeguards, dispense or prescribe a lethal dose of medication following a request made by a qualified individual. Criminal penalties are established for violating specified provisions of the bill. The bill’s provisions are severable.
Financial:
SB 0357 (Sen. Dawn Gile)/ HB 0424 (Del. Bonnie Cullison) – Prescription Drug Affordability Board – Authority for Upper Payment Limits (Lowering Prescription Drug Costs for All Marylanders Now Act) [Passed]
MaCCRA Position: Supported with Written Testimony
This bill repeals reporting requirements for the Prescription Drug Affordability Board (PDAB) regarding upper payment limits (UPLs). Instead, PDAB must determine whether it is in the best interest of the State to set UPLs for purchases and payor reimbursements of prescription drug products in the State that have led or will lead to an affordability challenge. If PDAB makes this determination, it must establish a specified process and set UPLs accordingly. The bill also (1) authorizes PDAB to reconsider a UPL for a drug that becomes a “current shortage”; (2) prohibits PDAB from taking specified actions that pertain to UPLs; (3) modifies the requirements and criteria for setting UPLs; (4) repeals obsolete language related to the Prescription Drug Affordability Fund (PDAF); (5) imposes additional reporting requirements on PDAB; and (6) adds new members to the Prescription Drug Affordability Stakeholder Council. The bill’s requirement that PDAB set UPLs for purchases and payor reimbursements is contingent on specified actions taking place by September 30, 2030.
HB 1276 (Del. Seth A. Howard) – Income Tax – Credit for Long-Term Care Premiums [Failed to Pass]
MaCCRA Position: Supported with Written Testimony
This bill would have made various alterations to the existing, one-time income tax credit for long-term care premiums. Under the bill, the credit could have been claimed only with respect to policies purchased after December 31, 2025; however, the credit may be claimed in any taxable year in which the policy is in force. The maximum value of the credit would have been reduced from $500 to $250. Additionally, the bill would have disallowed the credit for long-term care premiums for an insurance contract covering an individual who is younger than age 45. The bill would have taken effect July 1, 2025, and applied to tax year 2026 and beyond.
HB 0327 (Del. Vaughn Stewart)/ SB 0155 (Sen. Jack Bailey) Income Tax – Credit for Long-Term Care Premiums (Long-Term Care Relief Act of 2025) [Failed to Pass]
MaCCRA Position: Supported with Written Testimony
This bill would have made several alterations to the existing, one-time income tax credit for long-term care premiums. Under the bill, the credit could have been claimed only if the insured individual was covered by long-term care insurance purchased on or before December 31, 2004; however, the credit could have been claimed in any taxable year in which the policy is in force. In addition, the bill (1) disallowed the credit for taxpayers younger than age 85 or with Maryland adjusted gross income (AGI) of $100,000 or more (for joint filers, $200,000 or more) and (2) specified that the maximum value of the credit is equal to the lesser of 15% of the eligible long-term care premiums paid during the taxable year or $1,500. The bill would have taken effect July 1, 2025, and applied to tax year 2025 and beyond.
HB 1153 (Del. Chris Adams) Maryland Estate Tax – Unified Credit – [Failed to Pass]
MaCCRA Position: MONITOR
This bill conforms the Maryland estate tax to the value of the unified credit under the federal estate tax for decedents dying on or after January 1, 2026, thereby increasing the amount that can be exempted under the State estate tax. The bill takes effect July 1, 2025.
Looking Ahead:
Our work won’t stop as the Summer and Fall months will be busier than most. This session sets the stage for future actions and now is the time to focus on what needs to be done in advance of January 2026 to keep MaCCRA’s issues at the fore.
The Legislature is keeping an eye on actions at the federal level and in the event additional budgetary actions are necessary a special session may be convened later this year. This will also be a time of fundraising and community events as legislators and candidates eye the upcoming elections after the 2026 Legislative Session.
Keep up the great work of reaching out and meeting with your Chapter’s legislators. This outreach only helps to increase the number of legislative champions that understand what it means to be a resident in a CCRC.
We look forward to our continued work together!
~ Barbara Brocato and Dan Shattuck