SB 411 Maryland Senate · 2026 Regular Session

Hospitals - Clinical Staffing Committees and Plans - Establishment (Safe Staffing Act of 2026)

SB 411 requires non-state hospitals in Maryland to establish clinical staffing committees with equal representation from management and frontline staff, including nurses, technicians, and other caregivers. These committees must develop evidence-based staffing plans considering patient acuity, staffing gaps, and daily patient needs, which hospitals must implement starting January 1, 2028. Hospitals must annually review these plans, publicly post staffing data on units, and submit annual reports to the Maryland Health Care Commission beginning in 2030. The bill directly affects hospital operations, staffing decisions, and transparency for frontline workers and patients.

Bill status signed all 5 stages cleared

Introduction

Jan 2026

Committee Review

Apr 2026

Senate Passage

Apr 2026

House of Delegates Passage

Apr 2026

Signed into Law

Apr 2026

Introduced Jan 29, 2026 Signed Apr 28, 2026

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What changed between versions

First - Hospitals - Clinical Staffing Committees and Plans - Establishment (Safe Staffing Act of 2026) → Third - Hospitals - Clinical Staffing Committees and Plans - Establishment (Safe Staffing Act of 2026) · 5 edits

MODERATE

The bill was amended to add a favorable committee report and adopt the text as Senate action. Substantively, the requirements for clinical staffing committees were modified to include specific minimum numbers of managers and employees based on hospital bed count, and the list of required committee members was expanded to include patient advocates and medical residents in teaching hospitals. The timeline for implementing staffing plans was adjusted to begin in 2028, and the review of these plans was moved to July 1 of each year.

Scope change

The bill's applicability remains the same for licensed hospitals, but the specific composition requirements for the required clinical staffing committees were expanded to include more diverse representation based on hospital size.

REQUIREMENT

Added a requirement for a draft clinical staffing plan to be produced by the Chief Nursing Executive and submitted to the committee.

Changed committee composition rules to require specific numbers of managers and employees based on whether the hospital has 150 or fewer beds versus 151 or more beds.

Updated the list of factors the committee must consider when developing staffing plans to include 'appropriate skill mix and competency of staff' and specific CMS and accreditation standards.

DEFINITION

Added 'medical resident' and 'employee whose duties include patient advocacy' to the list of individuals who must or may be included on the clinical staffing committee.

TIMELINE

Adjusted the effective date for implementing clinical staffing plans to January 1, 2028, and moved the annual review deadline to July 1.

Floor votes · Senate Mar 24, 2026 · House of Delegates Apr 2, 2026

How they voted

44–0

Passed · 5 other

Total votes 49

Mar 24, 2026

D Democratic36

33 Yea 3

91% Yea

R Republican13

11 Yea 2

84% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Apr 28, 2026

Signed into law

Approved by the Governor - Chapter 235

executive

Apr 13, 2026

Upper · Passed

Returned Passed

upper

Apr 13, 2026

Lower · Passed

Third Reading Passed

lower

Apr 13, 2026

Lower · Passed

Favorable Adopted Second Reading Passed

lower

Apr 13, 2026

Lower · Passed

Favorable Report by Health

lower

Apr 11, 2026

Committee

Rereferred to Health

lower

Apr 11, 2026

Committee

Referred Rules and Executive Nominations

lower

Apr 10, 2026

Upper · Passed

Third Reading Passed

upper

Apr 10, 2026

Upper · Passed

Favorable with Amendments {

upper

Apr 10, 2026

Upper · Passed

Favorable with Amendments Report by Finance

upper

Apr 2, 2026

House Of Delegates · Passed

House of Delegates Vote: pass (98-34-10)

house of delegates

Mar 24, 2026

Senate · Passed

Senate Vote: pass (44-0-5)

senate

Jan 29, 2026

Committee

First Reading Finance

upper

4 primary · 0 co-sponsors