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

WES MOORE, Governor                              Ch. 184

Chapter 184

                   (House Bill 1015)

AN ACT concerning

Developmental Disabilities Administration – Services – Expedited Eligibility
                   Determinations for Recently Relocated Individuals
                                                 (Ralph’s Act)

FOR the purpose of requiring that the Maryland Department of Health to provide an
         expedited Medicaid eligibility determination for developmental disabilities services
         to certain individuals who were determined to be eligible to receive certain
         developmental disabilities services in another state be eligible to continue to receive
         those services received certain services in another state and relocated in the State;
         requiring the Department to establish an expedited review process for certain
         individuals relocating to the State; authorizing requiring the Department to begin
         the determination process before an individual establishes residency in the State
         under certain circumstances; and generally relating to eligibility determinations for
         developmental disabilities services in the State.

BY repealing and reenacting, without amendments,
         Article – Health – General
         Section 7–101(a) and (g)
         Annotated Code of Maryland
         (2023 Replacement Volume and 2025 Supplement)

BY adding to
         Article – Health – General
         Section 7–404.2
         Annotated Code of Maryland
         (2023 Replacement Volume and 2025 Supplement)

         SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:

                   Article – Health – General

7–101.

(a) In this title the following words have the meanings indicated.

         (g) “Developmental disability” means a severe chronic disability of an individual
that:

                  (1) Is attributable to a physical or mental impairment, other than the sole
diagnosis of mental illness, or to a combination of mental and physical impairments;

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Ch. 184  2026 LAWS OF MARYLAND

                  (2) Is manifested before the individual attains the age of 22;

                  (3) Is likely to continue indefinitely;

                  (4) Results in an inability to live independently without external support or
continuing and regular assistance; and

                  (5) Reflects the need for a combination and sequence of special,
interdisciplinary, or generic care, treatment, or other services that are individually planned
and coordinated for the individual.

7–404.2.

        (A) AN INDIVIDUAL SHALL BE ELIGIBLE TO RECEIVE SERVICES FROM THE
DEPARTMENT UNDER THIS TITLE IF:

        (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

                (2) “DEPENDENT” MEANS AN INDIVIDUAL WITH DISABILITIES WHO:

                         (I) RELIES ON SUPPORT FROM AN IMMEDIATE FAMILY
MEMBER WHO IS A RESIDENT OF THE STATE; OR

                         (II) HAS AN IMMEDIATE FAMILY MEMBER WHO IS A RESIDENT
OF THE STATE AND ACTS AS THE INDIVIDUAL’S LEGAL GUARDIAN.

                (3) “IMMEDIATE FAMILY MEMBER” MEANS A SPOUSE, A PARENT, AN
ADOPTIVE PARENT, A STEPPARENT, A GRANDPARENT, A STEPGRANDPARENT, A
SIBLING, A STEPSIBLING, A CHILD, OR A STEPCHILD.

        (B) THE DEPARTMENT SHALL PROVIDE AN EXPEDITED MEDICAID
ELIGIBILITY DETERMINATION FOR DEVELOPMENTAL DISABILITIES SERVICES,

INCLUDING A DISABILITY DETERMINATION FOR PURPOSES OF ENROLLMENT IN THE

COMMUNITY PATHWAYS WAIVER, TO AN INDIVIDUAL IF:

                (1) THE INDIVIDUAL:

                         (I) IS A DEPENDENT OF AN IMMEDIATE FAMILY MEMBER;

                         (II) RECEIVED HOME– AND COMMUNITY–BASED WAIVER

SERVICES OR SIMILAR SERVICES UNDER A SIMILAR ASSISTANCE PROGRAM IN

ANOTHER STATE FOR THE IMMEDIATELY PRECEDING 10 YEARS; AND

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          WES MOORE, Governor                                 Ch. 184

                         (III) MOVED TO THE STATE TO LIVE WITH THE IMMEDIATE
FAMILY MEMBER ON THE DEATH OR INCAPACITATION OF THE INDIVIDUAL’S
CARETAKER IN THE OTHER STATE; AND

                (2) THE IMMEDIATE FAMILY MEMBER ON WHOM THE INDIVIDUAL IS
DEPENDENT HAS RESIDED IN THE STATE FOR THE IMMEDIATELY PRECEDING 2
YEARS.

        (B) (1) THE DEPARTMENT SHALL ESTABLISH AN EXPEDITED PROCESS TO

DETERMINE WHETHER AN INDIVIDUAL MEETS THE CRITERIA UNDER SUBSECTION

(A) OF THIS SECTION AND IS ELIGIBLE TO RECEIVE SERVICES UNDER THIS TITLE.

                (2) THE PROCESS ESTABLISHED UNDER THIS SUBSECTION SHALL
REQUIRE THAT A DETERMINATION BE COMPLETED WITHIN 30 DAYS.

        (C) (1) IN PROVIDING EXPEDITED ELIGIBILITY DETERMINATIONS UNDER
SUBSECTION (B) OF THIS SECTION, THE DEPARTMENT SHALL:

          (I) PRIORITIZE COMPLETED APPLICATIONS FOR REVIEW ON

RECEIPT;

                         (II) TO THE EXTENT AUTHORIZED BY LAW, RELY ON
DOCUMENTATION, DIAGNOSTIC EVALUATIONS, ELIGIBILITY DETERMINATIONS
FROM THE INDIVIDUAL’S PREVIOUS STATE OF RESIDENCE, AND ANY OTHER
DOCUMENTATION THAT THE DEPARTMENT RELIES ON WHEN MAKING OTHER
DETERMINATIONS UNDER THIS TITLE; AND

                         (III) COMPLETE EACH EXPEDITED ELIGIBILITY DETERMINATION
WITHIN 60 BUSINESS DAYS AFTER THE RECEIPT OF A COMPLETE APPLICATION.

                (2) IN PROVIDING AN EXPEDITED ELIGIBILITY DETERMINATION
UNDER SUBSECTION (B) OF THIS SECTION, THE DEPARTMENT MAY NOT WAIVE

SUBSTANTIVE ELIGIBILITY REQUIREMENTS ESTABLISHED UNDER THIS TITLE OR
REQUIREMENTS ESTABLISHED BY REGULATION FOR THE ASSIGNMENT OF A

SERVICE PRIORITY CATEGORY.

(C) (D)   IF AN INDIVIDUAL HAS BEEN DETERMINED UNDER THIS SECTION

TO BE ELIGIBLE TO RECEIVE SERVICES, THE INDIVIDUAL SHALL BE:

          (1) PLACED IN THE CRISIS RESOLUTION CATEGORY; AND

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Ch. 184  2026 LAWS OF MARYLAND

                (2) GIVEN ACCESS TO WAIVER SERVICES THROUGH THE MOST

APPROPRIATE RESERVE CATEGORY AS DETERMINED BASED ON THE SERVICES THE

INDIVIDUAL RECEIVED IN THE INDIVIDUAL’S PREVIOUS STATE OF RESIDENCE.

        (E) IF THE DEPARTMENT DETERMINES THAT AN INDIVIDUAL WHO HAS NOT
YET ESTABLISHED RESIDENCY IN THE STATE WOULD QUALIFY FOR THE EXPEDITED

ELIGIBILITY DETERMINATION PROCESS PROVIDED MEETS THE CRITERIA

ESTABLISHED UNDER SUBSECTION (B) (B)(1)(I) AND (II) AND (2) OF THIS SECTION,
THE DEPARTMENT MAY SHALL DETERMINE WHETHER THE INDIVIDUAL HAS A

DEVELOPMENTAL DISABILITY AND THE APPROPRIATE SERVICE PRIORITY

CATEGORY AS DEFINED UNDER § 7–101(G) OF THIS TITLE.

        (D) THE DEPARTMENT MAY DETERMINE, BEFORE AN INDIVIDUAL
ESTABLISHES RESIDENCY IN THE STATE:

                (1) WHETHER AN INDIVIDUAL IS ELIGIBLE TO RECEIVE SERVICES;

                (2) THE APPROPRIATE SERVICE PRIORITY CATEGORY; AND

                (3) WHETHER THE INDIVIDUAL IS ELIGIBLE FOR CRISIS RESOLUTION
SERVICES.

         SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026 July 1, 2027.

Approved by the Governor, April 28, 2026.

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