SB 721 Maryland Senate · 2026 Regular Session

Developmental Disabilities Services - Expedited Eligibility Determinations for Recently Relocated Individuals (Ralph's Act)

SB 721 (Ralph's Act) ensures that individuals with developmental disabilities who were previously eligible for services in another state can continue receiving those services in Maryland after relocating. It directly affects people who moved to live with immediate family following the death or incapacity of their caretaker in another state, provided they received community-based services there for 10 years and their family has resided in Maryland for two years. The bill requires the state Department to establish a 30-day expedited review process for eligibility and allows pre-residency determination of service needs. It mandates placing eligible individuals into appropriate service categories based on their prior state services, ensuring continuity of care without requiring full residency verification first. The law takes effect October 1, 2026.
Bill status passed 3 of 5 stages cleared
Introduction
Feb 2026
Committee Review
Apr 2026
Senate Passage
Apr 2026
House of Delegates Passage
Governor
Introduced Feb 6, 2026 Last action Apr 9, 2026
Maddy AI version diff · 1 comparison

What changed between versions

First - Developmental Disabilities Administration - Services - Eligibility for Recently Relocated Individuals (Ralph's Act) Third - Developmental Disabilities Services - Expedited Eligibility Determinations for Recently Relocated Individuals (Ralph's Act) · 6 edits
MODERATE
The bill was amended to clarify that the Department of Health must actively provide expedited eligibility determinations for relocated individuals, rather than just establishing a process. The text was also updated to explicitly require the Department to begin this review before an individual establishes residency in Maryland under certain circumstances, ensuring faster access to services for those moving from other states.
Scope change
The bill's scope was expanded to explicitly mandate the Department of Health's role in providing expedited Medicaid eligibility determinations and to authorize pre-residency eligibility reviews, moving from a passive process description to an active requirement.
REQUIREMENT

The purpose statement was rewritten to explicitly require the Maryland Department of Health to provide expedited Medicaid eligibility determinations for recently relocated individuals with developmental disabilities.

The bill was changed to authorize the Department to begin the eligibility determination process before an individual officially establishes residency in the state, allowing for earlier intervention.

A new provision was added stating that while the expedited process is streamlined, the Department cannot waive substantive eligibility requirements or service priority category regulations established by law.

TECHNICAL

The legislative mechanism was changed from adding a new section to repealing and reenacting existing sections of the Health General Article, likely to correct statutory citations or align with current code structure.

DEFINITION

Definitions were added and clarified, specifically defining 'dependent' to include individuals relying on immediate family members who are residents or legal guardians, and expanding the list of 'immediate family members'.

TIMELINE

New procedural requirements were added to mandate that the Department prioritize completed applications, rely on documentation from the individual's previous state of residence, and complete each expedited determination within 60 business days.

Floor votes · Senate Mar 20, 2026

How they voted

440
Passed · 5 other
Total votes 49
Mar 20, 2026
D Democratic36
31 Yea 5
86% Yea
R Republican13
13 Yea
100% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
8
Key actions
4
Committee
4
Apr 9, 2026
Committee
Referred Rules and Executive Nominations
lower
Apr 8, 2026
Upper · Passed
Third Reading Passed
upper
Apr 8, 2026
Upper · Passed
Favorable with Amendments {
upper
Apr 8, 2026
Upper · Passed
Favorable with Amendments Report by Finance
upper
Mar 20, 2026
Senate · Passed
Senate Vote: pass (44-0-5)
senate
Feb 6, 2026
Committee
First Reading Finance
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Jeff Waldstreicher
Jeff Waldstreicher
DDemocratic
MD
18