Recipients of State and Local Government Funding - Reporting (Buy Maryland Reporting Requirements)
HB0905, the Safe Staffing Act of 2025, requires most Maryland-licensed hospitals to create and maintain a clinical staffing committee and to adopt a clinical staffing plan for each hospital. The committee must have equal representation from management and employees, include specified frontline staff categories, and may include a patient advocate. Each committee must develop staffing guidelines for patient care units, including suggested nurse-to-patient ratios or similar staffing matrices, and identify the number and mix of nurses, nursing assistants, technicians, environmental service workers, and other direct-care staff needed on each shift.
The bill also requires hospitals to review and update their staffing plans annually, evaluate the prior year’s effectiveness, and create a process for receiving, resolving, and tracking staffing-related complaints. Hospitals must implement the adopted plan by January 1, 2027, assign personnel in accordance with it, and publicly post the plan and actual daily staffing on each unit and on the hospital website. The bill excludes State hospitals and directs the Maryland Hospital Association, beginning in 2029, to compile hospital reports for legislative committees on how staffing committees addressed safe staffing during the prior year.
HB0905 adds a new Part XII to Title 19 of the Health-General Article, creating statutory requirements for hospital clinical staffing committees and clinical staffing plans. It imposes new governance, planning, reporting, and public-disclosure obligations on licensed hospitals, while also establishing a complaint-review process tied to staffing-plan compliance. The bill does not set a single mandatory statewide staffing ratio, but it requires hospitals to develop unit-specific staffing standards using evidence-based guidance where practicable and to align staffing assignments with those plans.
The bill appears to have been viewed favorably in the House, as reflected by the committee report of “Favorable with amendments” and adoption on second reading. The sponsor list is broad and includes many delegates, suggesting substantial support for the concept of hospital safe staffing. No vote breakdown or transcript excerpts are provided, so the available record shows general legislative support but does not reveal detailed floor or committee debate.
The main policy issue is how prescriptive the staffing requirements should be. The bill stops short of imposing fixed statewide nurse-to-patient ratios, instead requiring hospital-specific plans based on patient population, acuity, and available evidence-based standards. That structure may reflect a compromise between labor and patient-safety advocates seeking stronger staffing protections and hospitals that may prefer flexibility in how staffing levels are set and adjusted. Other likely points of discussion include the administrative burden of committee formation, annual review, public posting, and complaint tracking, as well as the exclusion of State hospitals from the bill’s coverage.