Certificate of Need - Intermediate Health Care Facilities
Summary
SB0444 revises Maryland’s certificate of need (CON) rules for certain intermediate health care facilities that provide substance use disorder treatment. The bill removes an existing exemption tied to changes in bed capacity for some intermediate care facilities, while also creating a new, narrower exemption for the establishment or operation of an intermediate care facility that offers medically managed residential substance use disorder treatment services. It also expands the circumstances under which a bed-capacity change at an intermediate health care facility may proceed without a CON, so long as the facility has a current state license, gives advance notice, and receives a favorable Commission finding.
Under the bill, the Health Services Cost Review Commission or other relevant Commission review remains central: facilities must generally provide at least 45 days’ written notice, and the Commission must determine that the proposal is consistent with the State health plan, will improve efficiency and effectiveness, and is in the public interest. The act takes effect October 1, 2026, and amends Health-General § 19-120 to carve out these new exceptions while preserving the broader CON framework for new facilities and bed-capacity changes.
Impact
The bill amends Maryland Health-General § 19-120 by changing when a certificate of need is required for intermediate health care facilities, especially those serving people with substance use disorders. It creates a new exemption from CON review for the establishment or operation of medically managed residential substance use disorder treatment facilities, and it modifies the bed-capacity rules for certain licensed intermediate care facilities and related health care providers. The practical effect is to reduce regulatory barriers for some addiction-treatment facilities while keeping notice and Commission review requirements in place.
Sentiment
The bill appears to have been broadly supported. It passed the Senate 44-0 and the House 128-1, indicating strong bipartisan approval and little recorded opposition. The lack of committee transcript discussion suggests the measure was not especially controversial in the available record, and the overwhelming votes indicate general agreement with easing certain certificate of need requirements for substance use disorder treatment facilities.
Contention
The main policy tension in SB0444 is between easing access to treatment facilities and preserving state oversight of health care capacity. Supporters likely viewed the bill as a way to expand or streamline medically managed residential substance use disorder treatment services by reducing CON barriers. Any opposition would most likely have centered on concerns that exempting these facilities from CON review could weaken planning controls, affect bed supply oversight, or create inconsistencies in how health care facilities are regulated, though the final vote record shows that such concerns did not generate significant resistance.