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Public Policy and Legislative Update


Read the February 10, 2018, Maryland Advocacy Update



Medical Expense Deduction and Tax-Exempt Financing on the Chopping Block- November 7, 2017


  Summary of 2017 Maryland General Assembly Session

  April 11, 2017


Concluding its 437th session, here is a brief summary of the highlights from the 2,681 bills introduced during the 2017 Maryland General Assembly:


  • Concerns about potential federal administration effects on Maryland:

    • Passed legislation allowing the Maryland Attorney General to sue the federal government on matters involving the environment and health care and provided $1M in funding beginning in 2019. 

    • Additionally, the legislature passed a bill requiring the State to pay for any federal elimination of Planned Parenthood funding.  

    • The “Trust Act,” which would have forbid local police from cooperating with federal immigration authorities, was significantly amended and gutted resulting in failure.  The Senate President also publicly stated that Maryland would not be a sanctuary state. 

    • The Senate passed a last-minute bill placing into state law federal internet privacy regulations that the Trump administration stopped from going into effect.  However, the House Economic Matters Chairman had concerns that the issue was too complicated and there was not enough time to fully address the subject in the final hours of the session.

  • Baltimore’s School Funding Issues:  Agreed to provide Baltimore's school system with extra funding to help close a $130 million gap. And they approved legislation pushed by Mayor Catherine Pugh to give her the sole power to appoint the city school board, authority she currently shares with the Governor.

  • Ethics:  Amidst the various indictments and indiscretions of some legislators and Prince George’s County liquor commission officials, the legislature rewrote the Governor’s ethics bill. To be signed by the Governor today, April 11.

  • Fracking:  Banned the controversial natural gas extraction technique known as fracking.  The Governor has already signed this bill

  • Governor’s Cabinet Secretaries:  Two of the Governor’s Cabinet Secretaries went unconfirmed by the Senate.  Acting Secretary Wendi Peters from the Department of Planning was rejected and the Governor withdrew the nomination of DHMH Acting Secretary Dennis Schrader after expressing frustration that it was taking the Senate to long to confirm him.  It remains to be seen how this plays out.

  • Heroin Epidemic: Devoted more resources to addressing the escalating heroin epidemic.

  • Medical Marijuana:  Failed to approve an expansion of the state's nascent medical marijuana industry. Negotiators agreed Maryland needs more minority-owned medical marijuana firms; they could not agree on the details amidst lawsuits and how best to address the lack of minority selection by the Maryland Medical Cannabis Commission.  The Chair of the Legislative Black Caucus is asking for a Special Session to take this matter up. 

  • Paid Sick Leave:  Approved a bill that would give five paid sick days to most Maryland workers.  It is still unclear if the Governor will sign this bill.

  • Price Gouging:  Passed legislation providing the Maryland Attorney General the power to sue drug companies for price gouging.  Maryland is the first in the country.

  • Tax Breaks:

    • Approved one of the governor's top initiatives, passing a bill that would grant tax breaks to manufacturing firms that bring new jobs to areas with high unemployment, including Baltimore, Western Maryland and the Eastern Shore.

    • Approved the Governor’s proposal for new tax breaks for retirement income for law enforcement



  1. Budget – Passed awaiting signature by the Governor or approval without his signature


              HB 150 Operating Budget

  • DHMH - Maintains the 2% increase over last year’s budget in Medicaid reimbursements and 3.5% for Developmental Disabilities

  • DOA - Maintains the $106,000 increase over last year’s budget for Congregate Housing



  1.       Legislation Tracked for LeadingAge Maryland


  1. Department of Aging Legislation

  • Senate Bill 47 – Reporting Abuse to the Long -Term Care Ombudsman Program and the Office of Health Care Quality.  The bill also authorizes the LTC Ombudsman to notify the Office of Health Care Quality (OHCQ) or a law enforcement agency of an alleged abuse only if the resident or the resident’s legal representative consents to the notification.  Additionally, the bill alters reporting requirements to clarify that a person who believes a resident of a facility has been abused must report the alleged abuse to OHCQ, instead of the Secretary of Health and Mental Hygiene the LTC Ombudsman Program, instead of the Maryland Department of  Aging (MDOA); as  well  as  an  appropriate  law  enforcement agency.  The bill clarifies that the person must report the alleged abuse to all three entities, instead of any one.  Department of Aging offered 3 amendments, 2 of which are technical and one ensures that there is a process for alerting the Administrator, by stakeholders except OHCQ, when an allegation is made. Passed, awaiting signature by the Governor


  •  House Bill 132 - Long-Term Care Ombudsman Program – Regulations. Requiring the Secretary of Aging to consult with the State Long-Term Care Ombudsman when adopting specified regulations that relate to the Long-Term Care Ombudsman Program, including specified annual reviews, resident councils and family councils in long-term care facilities, training and designating ombudsmen, conflicts of interest, and confidentiality of specified information and documents.  The State of Maryland has over100 volunteer ombudsman to work with seniors.  This bill codifies existing practice and aligns state statute with federal regulations.  In 2016, Congress reauthorized the Older Americans Act and DOA has been working to ensure ombudsman program is consistent with federal requirements. Passed, awaiting signature by the Governor.


  • House Bill 145 - Board of Examiners of Nursing Home Administrators - Nonlicensed Persons - Provisional Licensure  Requiring the owner of a nursing home or other appropriate nursing home authority, under specified circumstances, to immediately appoint a nonlicensed person to serve in the capacity of interim nursing home administrator; authorizing the appointed nonlicensed person to act as the interim nursing home administrator on filing an application with the State Board of Nursing Home Administrators requesting a provisional license.  To be signed by the Governor today, April 11.


  • House Bill 146 - Secretary of Aging - Administration of Commodity Supplemental Food Program and Regulatory Authority.  This bill codifies existing practice and extends the Department of Aging authority to administer the program and funds.  Food insecurity is a significant issue for low income seniors.  Maryland received USDA funding in 2015 to provide food products to low income seniors (ie in Baltimore City 2400 seniors are served under this program). To be signed by the Governor today, April 11.


  • House Bill 147 – Healthy Aging Program.   This bill authorizes Secretary to accept private or federal funds and establishes healthy aging program to innovate and provide new models of care.  Passed, awaiting signature by the Governor



    B.     Employer Issues

  • House Bill 1– This bill requires an employer with more than 14 employees to have a sick and safe leave policy under which an employee earns at least 1 hour of paid sick and safe leave, at the same rate  as  the  employee  normally  earns,  for  every  30  hours  an  employee  works.    An employer with 14 or fewer employees, based on the average monthly number of employees during the preceding year, must have a sick and safe leave policy that provides an employee with at least 1 hour of unpaid sick and safe leave for every 30 hours an employee works.  An employer is not required to allow an employee to earn or carry over more than 56 hours of earned sick and safe leave in a year, use more than 80 hours of earned leave in a year, accrue more than 80 hours at any time, or use earned sick and safe leave during the first 90 calendar days worked or first 480 hours worked, whichever is shorter. The bill takes effect January 1, 2018.  Awaiting to determine whether the Governor signs or vetoes.


  • House Bill 443 -  Assisted Living Programs - Licensure Fees – This bill allows the Governor to reduce or eliminate the licensing fee. Passed, awaiting Governor’s signature. 


    C.    Updating Maryland’s Healthcare System and Delivery of Services 

  • Senate Bill 216/House Bill 769 - Maryland Caregivers Support Coordinating Council - Renaming and Altering Membership and Duties  - This bill renames the Maryland Caregivers Support Coordinating Council (MCSCC) to be the Maryland Commission on Caregiving and adds one member of the Senate and one member of the House of Delegates to the commission. The Governor, to the extent possible in making appointments to the commission, must consider groups representing individuals (1) with disabilities, disorders, or conditions affecting the entire lifespan and (2) who reflect the diversity of the State. The bill expands the duties of the commission to include (1) providing ongoing analysis of best practices in family caregiver support programs in this and other states and (2) monitoring the implementation of its recommendations. The commission must also include in its annual report to the Governor and the General Assembly recommendations regarding family caregiver support services. Signed by the Governor today, April 11.


  • SB 571/HB 909 Maryland Health Insurance Coverage Protection Act. Establishing the Maryland Health Insurance Coverage Protection Commission to conduct an assessment of the impact of potential federal changes to specified health care programs and to provide recommendations for State and local action to protect access of residents of the State to affordable health coverage; requiring the Commission to report its findings to the Governor and General Assembly by December 31, 2017.  Enacted without Governor’s signature.


  • Senate Bill 696/HB 953 - Task Force on Long-Term Care Education and Planning This bill establishes the Task Force on Long-Term Care Education and Planning to (1) examine the status of long-term care education in the State; (2) consider options for improving efforts to educate residents of the State about planning for long-term care; and (3) make specified recommendations regarding long-term care education. The Maryland Department of Aging (MDOA) is required to provide staff for the task force. By December 1, 2017, the task force must report its findings and recommendations to the Governor and the General Assembly. The bill takes effect June 1, 2017, and terminates June 30, 2018.  Passed, awaiting Governor’s signature.



    D.    Senior Services and Issues

  • House Bill 188 - Public Health - Advance Directives - Witness Requirements, Advance Directives Services, and Fund - This bill makes multiple changes regarding advance directives and funding for the Advance Directive Program. The bill (1) alters the definition of “advance directive”; (2) alters witness requirements for an electronic advance directive; (3) requires the Department of Health and Mental Hygiene (DHMH) to issue a request for proposals (RFP) from electronic advance directives services and authorizes it to contract with multiple electronic advance directives services; (4) repeals the requirement that DHMH review and verify specified information contained in an advance directive; (5) establishes the Advance Directive Program Fund; (6) requires that an electronic advance directive that is not witnessed be submitted to an electronic advance directives service recognized by the Maryland Health Care Commission (MHCC); and (7) makes other technical, clarifying, and conforming changes. The bill also repeals the State Board of Spinal Cord Injury Research and the Spinal Cord Injury Research Trust Fund. DHMH must report to the Governor and specified committees of the General Assembly on implementation of the Advance Directive Program, the costs to establish and maintain the program, and the fees charged to registrants by January 15 each year.  Passed, awaiting Governor’s signature.


  • Senate Bill 248/House Bill 601 - Senior Call-Check Service and Notification Program – Establishment – Opt-in program where seniors 65 or older can sign-up to receive daily calls to check-in on their status.  If the senior is not available, there is an emergency contact who will be reached out to.  Passed, awaiting Governor’s signature.


  • Senate Bill 666/House Bill 233 - Disclosure of Medical Records - Guardian Ad Litem - Victims of Crime or Delinquent Acts.  This bill requires a health care provider to disclose a medical record, without the authorization of the person in interest, to a guardian ad litem appointed by a court to protect the best interest of a minor or a disabled or elderly individual who is a victim of a crime or a delinquency act under specified circumstances. The bill also prohibits a health care provider from charging a fee when a medical record is requested by a court-appointed guardian ad litem in a criminal or juvenile delinquency court proceeding. Finally, the bill creates an exception to the general prohibition against redisclosing a medical record to another person, authorizing a guardian ad litem to do so under specified circumstances.  Passed, awaiting Governor’s signature.


  • Senate Bill 562/HB498 - Health Care Decisions Act - Advance Directives and Surrogate Decision Making - Disqualified Individuals This bill expands the definition of “disqualified person” and generally prohibits an individual from serving as either a health care agent or surrogate decision maker for a declarant or patient if the individual is either (1) the subject of an interim, temporary, or final protective order where the declarant or patient is a person eligible for relief under the order or (2) a spouse of the declarant or patient, and the individual and declarant or patient have executed a separation agreement or either party has filed an application for divorce. An individual may serve as a health care agent for a declarant after the date of the execution of a separation agreement or the filing of an application for divorce if the declarant (1) is able to make a decision about the individual’s appointment as the declarant’s health care agent or (2) has otherwise indicated an intent to have the individual serve as the declarant’s health care agent.  Passed, awaiting Governor’s signature.


  • Senate Bill 584/HB 1468 Medical Records - Disclosure of Directory Information and Medical Records This bill alters the circumstances under which a health care provider may disclose directory information and medical records without the authorization of the person in interest, including information that was developed primarily in connection with mental health services.  Passed, awaiting Governor’s signature.


  • House Bill 493 - Long–Term Care Insurance – Premium Rates – caps premium rate increases and ensures transparency and due process under the Maryland Insurance Administration. Passed, awaiting Governor’s signature.


  • Senate Bill 671/HB 752 - Department of Human Resources - Public Assistance Eligibility Financial Records This bill requires the Department  of  Human  Resources  (DHR),  on  a  showing  that  an applicant has been unable to obtain the financial records necessary to establish eligibility or  ineligibility  for  public  assistance,  to  request  and  obtain  any  necessary  records  from  a fiduciary institution doing business in the State.  The amendments require DHR to adopt regulations governing procedures for requesting, obtaining and examining financial records that DHR determines are necessary to verify or confirm an individual’s eligibility for assistance.  Passed, awaiting Governor’s signature. 


  • Senate Bill 951/HB 1149 - Maryland Securities Act – Vulnerable Adults Senate Bill 951/HB 1149 - Maryland Securities Act – Vulnerable Adults Altering the Maryland Securities Act to regulate specified federal exempt broker–dealers; establishing the Securities Act Registration Fund to provide funds to administer and enforce the Maryland Securities Act; altering the types of actions that are unlawful under the Maryland Securities Act; requiring specified individuals that believe that a vulnerable adult or individual at least 65 years old is being subjected to financial exploitation to notify the Commissioner and a specified local department.  Passed, awaiting Governor’s signature. 



    E.     Tax Issues 

  • Senate Bill 180/HB 644, Independent Living Tax Credit Act This bill creates a tax credit against the State income tax for an individual that incurs qualified expenses to renovate an existing home with accessibility and universal visitability features to assist individuals with disabilities. The nonrefundable credit is equal to 50% of the qualified expenses, not to exceed $5,000 per taxpayer, and $1million in aggregate credits may be approved by the Maryland Department of Disabilities (MDOD) each year.  Passed, awaiting Governor’s signature. 



    F.     Legislation that failed

  • House Bill 65 – Labor and Employment – Maryland Healthy Working Families Act

  • House Bill 195 - Income Tax Subtraction Modification - Retirement Income (Fairness in Taxation for Retirees Act)

  • House Bill 256 – Adult Protective Services – Investigation – Time Period Increase

  • House Bill 317 – Labor and Employment – Wages and Benefits – Preemption of Local Authority

  • Senate Bill 175/House Bill 600 – Public Health – Use of Medical Oxygen in Residential Dwellings – Smoking and Open Flame Restrictions

  • Senate Bill 175 – Long Term Care Insurance – Moratorium on Renewal Premium Rate Increases

  • Senate Bill 238 – Income Tax Subtraction Modification – Retirement Income

  • Senate Bill 240 - Department of Health and Mental Hygiene - Abuser Registry Workgroup Recommendations – Report

  • Senate Bill 305/House Bill 382 – Commonsense Paid Leave Act (Governor’s Paid Sick Leave bill)

  • Senate Bill 354/House Bill 370 - Richard E. Israel and Roger "Pip" Moyer End-of-Life Option Act

  • Senate Bill 379/House Bill 932 – Hospitals – Changes in Status – Hospital Employee Retraining and Placement

  • Senate Bill 408 – Senior Apartment Facilities – Limitation on Occupancy by Person Convicted of Crime of Violence

  • Senate Bill 418/HB 411 State Highway Administration - Traffic Control Devices - Installation at Large Continuing Care Retirement Communities – bills did not pass but SHA agreed to install light as it works with Broadmead. 

  • Senate Bill 432 – Income Tax – Credit for Long Term Care Premiums

  • Senate Bill 660/House Bill 808 – Hospitals – Patient’s Bill of Rights

  • Senate Bill 732/House Bill 1460 – Hospitals – Acquisitions of Physical Offices, Group Practices and Outpatient Health Care Entities - Notice

  • House Bill 948 – Senior Apartments – Baltimore City – Security

  • Senate Bill 971/House Bill 919 - Procurement - Nondiscrimination Clauses and State Policy Prohibiting Discrimination

  • Senate Bill 1109/House Bill 1599 - Nursing Homes - Partial Payment for Services Provided

  • Senate Bill 1020 - Maryland Health Care Regulatory Reform Act of 2017 - Reorganizing the Maryland Health Care Commission and the Health Services Cost Review

  • House Bill 736. Workgroup to Recommend Possible Reforms to Maryland's Health Care System

  • Senate Bill 1199 - Long-Term Care Insurance - Sale or Transfer of Book of Business

  • House Bill 1444 – Retire in Maryland Act of 2017


Guidelines for the Advocacy Work of LeadingAge Maryland

Advocacy is an important part of LeadingAge Maryland’s mission. LeadingAge Maryland defines advocacy broadly and advocates for older adults in ways that go beyond the realm of public policy to include public and consumer education, building public will, and changing attitudes and perceptions of aging. LeadingAge Maryland’s advocacy is based on research and practice in the areas of expertise of LeadingAge Maryland and its members.


Together, LeadingAge Maryland and its members, along with other partners, also advocate for sound public policy that is good for the diversity of older adults in Maryland and that facilitates the provision of the consumer’s choice of needed supports and services.  To make certain that those supports and services are available, it is also important that the needs of organizations and their employees are addressed.

LeadingAge Maryland's Advocacy Principles

The following principles will guide LeadingAge Maryland’s advocacy as it seeks to be a trusted source of fair and balanced information:


Affirmation of the rights and responsibilities of older adults

  • To be free from abuse, neglect and exploitation.
  • To be treated with dignity and respect without regard to race, religion, national origin, gender, age, disability, marital status, sexual orientation, economic ability or source of payment.
  • To engage their talents and abilities in the wider community and across generations.
  • To exercise meaningful choices of supports and services offered in ways which promote autonomy and engagement – balanced with the obligation to protect older adults who have diminished capacity.

Access to Quality Services and Supports

  • Older adults deserve the supports and services they need, where they need them, in the place they call home, including preventive and whole-person wellness-oriented services and mental/ behavioral health services.
  • Older adults deserve access to education and information in order to make informed decisions about services.
  • Consumers, legislators, regulators, individuals and organizations that provide supports, services and care, in partnership with other stakeholders, should work together to ensure sufficient funding for quality services to older adults in a wide variety of financial circumstances.
  • A balance must be struck between a sufficient level of regulation to assure quality and accountability, and sufficient flexibility to provide space for innovation, new solutions and the ability to address the needs and preferences of individuals in cost-effective ways.
  • To ensure a skilled and compassionate work force, programs and policies should address recruitment, retention, training, and ability to work across generations and cultures.
  • Recognizing the critical roles they play, services and supports should also be provided to community caregivers.

Community Education

  • All Marylanders should be informed about: healthy aging; ways to plan for the future as they age; available services and ways to navigate health and social support systems; and other issues that affect older adults.
  • As mission-driven not-for-profit organizations, LeadingAge Maryland member organizations have unique responsibilities as guardians of values, crucibles of innovation, cultivators of volunteerism and stewards of the public interest.


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