Requiring coverage of home blood pressure monitoring devices for certain Medicaid recipients

2025 Regular Session Introduced by Laura Chapman and 1 co-sponsor

Maryland removes a fixed first aid/CPR staff ratio for care centers and lets MSDE set the new ratio by regulation, while maintaining basic certifications.

Do pass, but first to Finance

#health

Main purpose

To remove a fixed statutory staffing ratio for first aid/CPR–certified staff at certain child care centers and authorize the Maryland State Department of Education (MSDE) to set the required ratio by regulation. The bill preserves the requirement that at least one person on‑site hold approved basic first aid and CPR certification.

Key provisions / changes

Removes the statute’s fixed numeric ratio that required child care centers serving more than 20 children to have “one certificate holder for every 20 children.”

Retains the existing mandate that a child care center must always have at least one staff member responsible for supervision who holds:

Basic first aid certification (American Red Cross or equivalent), and
CPR certification (American Heart Association or equivalent) appropriate to the ages served.

Authorizes MSDE to establish, by regulation, the appropriate certificate-holder-to-children ratio (i.e., the department will set the numeric ratio rather than statute).

Other child care licensing requirements in statute (emergency preparedness, health/sanitation, minimum teacher age, nutrition/screen-time rules, etc.) remain in place.

Who is affected

Child care centers and child care center operators across Maryland (including small and family‑run centers).

Child care staff (training requirements and scheduling may change depending on the new regulatory ratio).

Families and children served by licensed child care centers (potentially affected by staffing availability and continuity).

Implementation, timing, and procedure

The law takes effect July 1, 2025.

MSDE must adopt regulations (rulemaking) to set the certificated‑staff ratio. The department indicated it can implement the change using existing resources.

MSDE signaled an intention (per departmental analysis) to set a different ratio for school‑age programs — for example, lowering the number of required certified staff to one per 30 school‑age children — but the final ratio will be determined through the regulatory process.

Fiscal & small‑business impacts

State fiscal impact: MSDE reports implementation can be handled with existing resources; no direct revenue effects.

Small business impact: MSDE determined the bill will have a meaningful economic impact on small child‑care businesses by reducing training costs and easing staffing barriers, which may improve recruitment and retention and could encourage new providers to enter the market.

Context and intent

The statutory change responds to workforce shortages in child care by giving the regulatory agency flexibility to set ratios that reflect operational and staffing realities while preserving minimum safety training requirements (first aid/CPR).

The regulatory route lets MSDE adjust requirements in response to evolving workforce conditions and program types (e.g., school‑age versus infant/toddler care).

If you want, I can:
- Summarize the MSDE proposed regulatory timeline or draft language (when available), or
- Identify how the change interacts with local licensing inspections and provider compliance steps.

Bill