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ED Boarding & Crowding State Legislative Tracking Weekly Report


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1. ED Boarding Bills 29 Bills

Title: An Act to promote high value and evidence-based behavioral health care

Current Status: Introduced

Introduction Date: February 27, 2025

Last Action Date: Hearing scheduled for 11/10/2025 from 01:00 PM-05:00 PM in A-2. October 31, 2025

Summary: This bill forms committees to assess the need for inpatient psychiatric care and specialty behavioral health beds. It also proposes changes to Accountable Care Organization (ACO) standards to integrate evidence-based behavioral health practices and improve data collection on healthcare costs and outcomes.

Description: By Representative Arciero of Westford, a petition (accompanied by bill, House, No. 2192) of James Arciero for legislation to promote high value and evidence-based behavioral health care. Mental Health, Substance Use and Recovery.

Location: US-MA

Title: An Act reducing emergency department boarding

Current Status: Introduced

Introduction Date: February 27, 2025

Last Action Date: Hearing scheduled for 10/06/2025 from 01:00 PM-05:00 PM in A-2. September 26, 2025

Summary: This bill amends Section 12 of Chapter 123 of the Massachusetts General Laws to address emergency department (ED) crowding and psychiatric patient boarding. It prohibits involuntary holds exceeding 72 hours at facilities not authorized to perform evaluations under Section 12(b), requiring the release of individuals held beyond this limit. Additionally, it mandates that any psychiatric hold longer than 48 hours at an unauthorized facility be referred to the Committee for Public Counsel Services for the appointment of legal counsel. These provisions aim to reduce ED boarding and improve patient rights.

Description: By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 2198) of Marjorie C. Decker relative to emergency department boarding. Mental Health, Substance Use and Recovery.

Location: US-MA

  • Behavioral Health
  • Title: Behavioral Health Managing Entities

    Current Status: Passed

    Introduction Date: February 14, 2025

    Last Action Date: Chapter No. 2025-137. June 16, 2025

    Summary: This bill mandates the Department of Children and Families (DCF) to contract for specified functions and recommend transparency improvements. DCF must prepare and present a final report to the Governor and Legislature by a specified date. Managing entities must submit required information to DCF in a standardized electronic format with specific metadata and report designated performance measures. Additionally, certain licensed providers must report bed availability to DCF to enhance service coordination and accessibility.

    Description: Requires DCF to contract biennially for specified functions; requires department to contract for recommendations for certain transparency improvements; requires department to prepare & present to Governor & Legislature specified final report by specified date; requires managing entities to report required data to department in standardized electronic format; provides requirements for such format; requires managing entities to electronically submit to department certain documents in specified format & with specified metadata; requires managing entities to submit certain specific measures to department; requires department to post & maintain such measures on its website by specified date every month; provides exception; provides requirements for such measures; requires managing entities to report each measure using standard methodology determined by department; provides requirements for such measures; provides that implementation of specified requirements is contingent on certain appropr....

    Location: US-FL

  • Bed Database
  • Behavioral Health
  • Title: A communication from the Office of the Child Advocate (see Section 10 of Chapter 18C of the General Laws) submitting its annual report of the office’s accomplishments and activities for fiscal year 2024

    Current Status: Introduced

    Introduction Date: May 01, 2025

    Last Action Date: Placed on file. May 01, 2025

    Summary: Behavioral or Physical Health Complaints Of the 18 inquiries related to behavioral or physical health (13 and 5 respectively), complaints mostly related to medication errors or medication mismanagement by non-parental caregivers, hospital or emergency department boarding, hospitalizations, and adequacy or quality of therapeutic services.

    Location: US-MA

  • Pediatric
  • ED Boarding
  • Behavioral Health
  • Title: An Act making appropriations for the fiscal year 2026 for the maintenance of the departments, boards, commissions, institutions, and certain activities of the commonwealth, for interest, sinking fund, and serial bond requirements, and for certain permanent improvements

    Current Status: Introduced

    Introduction Date: April 17, 2025

    Last Action Date: Published as amended, see H4001. April 30, 2025

    Summary: This bill allocates $1,980,000 in grant funding to improve reproductive health access, infrastructure, and security. Grants may be awarded to organizations such as Tides for Reproductive Freedom, the Abortion Rights Fund of Western Massachusetts, and the Eastern Massachusetts Abortion Fund. By March 3, 2026, the Department of Public Health must report to the House and Senate Committees on Ways and Means with details on how grants were distributed, a full list of applicants, and information on recipients, including award amounts and supported projects.

    Location: US-MA

  • Mental Health
  • EMS
  • Behavioral Health
  • Title: AN ACT CONCERNING EMERGENCY DEPARTMENT BOARDING AND CROWDING.

    Current Status: Introduced

    Introduction Date: March 19, 2025

    Last Action Date: File Number 713 (LCO). April 16, 2025

    Summary: This bill requires an evaluation of the feasibility of establishing an expedited conservator process for emergency department patients to alleviate emergency department boarding and crowding.

    Description: To require an evaluation of the feasibility of establishing an expedited conservator process for emergency department patients to alleviate emergency department boarding and crowding.

    Location: US-CT

  • ED Boarding
  • Emergency Department
  • Title: House Bill 1128

    Current Status: Introduced

    Introduction Date: April 04, 2025

    Last Action Date: Referred to Human Services. April 04, 2025

    Summary: The bill establishes a formal system in Pennsylvania to address delays in transferring Medicaid patients from emergency departments or inpatient settings to appropriate post-acute care. It mandates the Department of Human Services to implement policies within 180 days that require Medicaid-managed care plans and similar responsible entities to create care transition units. These units must assist hospitals in securing timely placements, escalate unresolved cases to state officials if delays exceed 72 hours, and work through clinical, administrative, or payment barriers. The department must track these interventions, require corrective actions when needed, and issue annual reports to the legislature detailing program implementation, case data, and outcomes.

    Location: US-PA

    Title: Department of Mental Health Annual Expedited Psychiatric Inpatient Admission (EPIA) Advisory Council 2023 Report

    Current Status: Introduced

    Introduction Date: February 20, 2025

    Last Action Date: Placed on file. February 20, 2025

    Summary: The 2023 Annual Expedited Psychiatric Inpatient Admission (EPIA) Advisory Council Report, submitted under Section 26 of Chapter 177 of the Acts of 2022, outlines data on emergency department (ED) boarding of patients seeking mental health and substance use disorder services, categorized by age, gender identity, race, ethnicity, insurance status, diagnosis, and admission delays. The report provides policy recommendations to reduce ED boarding, including legislative and regulatory proposals such as mandating 24/7 admission and discharge operations and enforcing penalties for noncompliance.

    Description: Report of the Department of Health (pursuant to Section 26 of Chapter 177 of the Acts of 2022) submitting its Annual Expedited Psychiatric Inpatient Admission (EPIA) Advisory Council 2023 report

    Location: US-MA

  • Mental Health
  • Substance Abuse Disorder
  • Title: Senate Bill 58

    Current Status: Introduced

    Introduction Date: January 22, 2025

    Last Action Date: Referred to Institutional Sustainability & Innovation. January 22, 2025

    Summary: This bill, the Medicaid Care Transition Program Act, aims to address emergency department (ED) boarding for Medicaid patients by establishing a program within the Department of Human Services to expedite post-acute care placements. It requires Medicaid-managed care plans and other responsible entities to create care transition units, facilitate patient transfers, and escalate unresolved cases to the department within specific timelines. The department must intervene when barriers persist, coordinate with other agencies, address network adequacy and payment issues, and collect data for reporting. Annual reports will detail program compliance, barriers, and corrective actions.

    Location: US-PA

  • ED Boarding
  • Medicaid
  • CT SB 487
    High Priority
    Support

    Title: AN ACT CONCERNING EMERGENCY DEPARTMENT BOARDING AND CROWDING.

    Current Status: Introduced

    Introduction Date: January 10, 2025

    Last Action Date: Referred to Joint Committee on Public Health. January 10, 2025

    Summary: This bill proposes amending Title 19a of the Connecticut General Statutes to mitigate emergency department (ED) boarding and crowding by implementing quality criteria, requiring public reporting, and evaluating statewide bed capacity. It also aims to address common causes of inpatient discharge delays.

    Description: To address emergency department boarding and crowding.

    Location: US-CT

  • ED Boarding
  • Title: A communication from the Massachusetts Health Policy Commission (see Section 74 of Chapter 177 of the Acts of 2022) submitting a report of behavioral health managers in the Commonwealth

    Current Status: Introduced

    Introduction Date: November 13, 2024

    Last Action Date: Placed on file. November 13, 2024

    Summary: This Massachusetts bill addresses mental health service provision through behavioral health managers (BHMs) contracted by health plans. It mandates the Health Policy Commission (HPC) to study BHM effectiveness in improving accessibility, quality, and cost-effectiveness of mental health care, including ADHD-related services. The bill also requires reporting on BHM oversight practices, compliance with parity requirements, and potential impacts of state licensure on mental health access. Finally, it includes recommendations for transparency, integration with physical health services, and quality monitoring to enhance mental health service delivery across Massachusetts.

    Location: US-MA

    CT SB 181
    High Priority
    Support

    Title: AN ACT CONCERNING EMERGENCY DEPARTMENT CROWDING.

    Current Status: Passed

    Introduction Date: February 21, 2024

    Last Action Date: Signed by the Governor. May 09, 2024

    Description: To require the Commissioner of Public Health to report data regarding emergency department crowding.

    Location: US-CT

  • ED Boarding
  • Title: An Act relative to emergency response and preparedness in the event of a surge in pediatric or adult hospitalizations

    Current Status: Introduced

    Introduction Date: February 16, 2023

    Last Action Date: Accompanied a study order, see H4634. May 09, 2024

    Description: By Representative Driscoll of Milton, a petition (accompanied by bill, House, No. 733) of William J. Driscoll, Jr., relative to emergency response and preparedness in the event of surges in pediatric or adult hospitalizations. Emergency Preparedness and Management.

    Location: US-MA

    Title: Establishes the "Safe Staffing for Hospital Care Act"

    Current Status: Failed

    Introduction Date: February 13, 2023

    Last Action Date: REFERRED TO HEALTH. January 03, 2024

    Description: Establishes the "Safe Staffing for Hospital Care Act"; establishes minimum staffing levels for various health care workers in different health care facilities; requires submission of staffing plans; prohibits most mandatory overtime.

    Location: US-NY

    Title: Establishes the "Safe Staffing for Hospital Care Act"

    Current Status: Failed

    Introduction Date: January 23, 2023

    Last Action Date: REFERRED TO HEALTH. January 03, 2024

    Description: Establishes the "Safe Staffing for Hospital Care Act"; establishes minimum staffing levels for various health care workers in different health care facilities; requires submission of staffing plans; prohibits most mandatory overtime.

    Location: US-NY

  • Nurse Ratio
  • Title: Relating To Behavioral Health Crisis Stabilization Beds.

    Current Status: Failed

    Introduction Date: January 25, 2023

    Last Action Date: Carried over to 2024 Regular Session.. December 11, 2023

    Description: Appropriates funds to the Adult Mental Health Division of the Department of Health to support increased behavioral health crisis stabilization beds. Creates a working group to get county input on possible sites for these crisis stabilization beds. Effective 7/1/2023.

    Location: US-HI

    Title: Extended Stay And Boarding Patients

    Current Status: Passed

    Introduction Date: March 29, 2023

    Last Action Date: Governor Signed. June 05, 2023

    Description: The act requires the department of health care policy and financing to analyze how directed payment authority can be used as part of a comprehensive plan to facilitate an adequate network of services for children and youth by requiring each managed care entity to pay no less than state department-established fee schedule rates for services needed to promote clinical stabilization. The act creates the high-acuity treatment and services cash fund (cash fund). The act authorizes the department of human services (CDHS) to retain any unspent money appropriated in fiscal year 2022-23 and 2023-24 from the general fund for counties during the initial allocations for the administration of child welfare services, core services, or child welfare staffing. On June 30, 2023, and June 30, 2024, the act requires the state treasurer to transfer any money retained to the cash fund. The act requires CDHS to expend money from the cash fund to provide additional resources to licensed providers to help rem....

    Location: US-CO

  • Pediatric
  • Title: LB552 - Change requirements for the Legislative Mental Health Care Capacity Strategic Planning Committee

    Current Status: Failed

    Introduction Date: January 17, 2023

    Last Action Date: Provisions/portions of LB552 amended into LB254 by AM1461. June 01, 2023

    Location: US-NE

    Title: To permit a hospital to hold a patient experiencing a psychiatric emergency for up to 72 hours

    Current Status: Passed

    Introduction Date: January 31, 2023

    Last Action Date: Chapter 267, Acts, Regular Session, 2023. May 01, 2023

    Location: US-WV

    Title: An Act establishing the Medicaid Care Transition Program; and imposing duties on the Department of Human Services.

    Current Status: Failed

    Introduction Date: April 17, 2023

    Last Action Date: Referred to State Government. April 17, 2023

    Location: US-PA

    MD SB 387
    High Priority
    Support

    Title: Task Force on Reducing Emergency Department Wait Times

    Current Status: Failed

    Introduction Date: February 01, 2023

    Last Action Date: Referred Rules and Executive Nominations. April 10, 2023

    Description: Establishing the Task Force on Reducing Emergency Department Wait Times to identify root causes of wait times in emergency departments in the State and make recommendations, including legislative, regulatory, or other policy initiatives, regarding best practices for reducing emergency department wait times that should be implemented in the State; and requiring the Task Force to report its findings and recommendations to the Governor and the General Assembly on or before January 1, 2024.

    Location: US-MD

  • ED Boarding
  • Title: Task Force on Reducing Emergency Department Wait Times

    Current Status: Considering

    Introduction Date: January 25, 2023

    Last Action Date: Third Reading Passed (47-0). April 10, 2023

    Description: Establishing the Task Force on Reducing Emergency Department Wait Times to study and make recommendations for reducing emergency department wait times; and requiring the Task Force to report its findings and recommendations, including legislative, regulatory, or other policy initiatives regarding best practices for reducing emergency department waits times, to the Governor and the General Assembly by January 1, 2024.

    Location: US-MD

    Title: An Act directing the Massachusetts Department of Public Health to study the feasibility of incentivizing inpatient psychiatric hospitals to admit patients directly from community behavioral health centers

    Current Status: Introduced

    Introduction Date: March 30, 2023

    Last Action Date: Senate concurred. March 30, 2023

    Description: By Representative Ayers of Quincy, a petition (accompanied by bill, House, No. 3604) of Bruce J. Ayers that the Department of Public Health study the feasibility of incentivizing inpatient psychiatric hospitals to admit patients directly from community behavioral health centers. Public Health.

    Location: US-MA

    Title: AN ACT relating to the healthcare workforce, making an appropriation therefor, and declaring an emergency.

    Current Status: Passed

    Introduction Date: February 07, 2023

    Last Action Date: signed by Governor (Acts Ch. 65). March 22, 2023

    Description: Create new sections of KRS 164 to define terms; establish the Kentucky healthcare workforce investment fund to enable the CPE, healthcare programs, and healthcare providers and facilities to match public and private dollars for the purpose of awarding scholarships to eligible students and healthcare incentives to eligible healthcare programs; provide that the moneys in the fund appropriated by the General Assembly shall lapse after the second year in a biennium budget; direct CPE to promulgate regulations to administer the Act; require at least 65% of all net moneys in the fund to be used to fund partnership proposals between healthcare programs and healthcare partners to issue scholarships to students enrolled in the healthcare program; require CPE to establish a process to prioritize certain partnership proposals; require a written partnership contract and establish the minimum contents; require that scholarships be issued directly to students and establish employment requirements fo....

    Location: US-KY

  • Workforce
  • Title: An Act relative to ending unnecessary hospitalizations and reducing emergency department boarding

    Current Status: Introduced

    Introduction Date: February 16, 2023

    Last Action Date: Senate concurred. February 16, 2023

    Description: By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1980) of Marjorie C. Decker and Lindsay N. Sabadosa relative to the involuntary hospitalization of individuals if no less restrictive alternatives exist to reduce the likelihood of serious harm by reason of mental illness. Mental Health, Substance Use and Recovery.

    Location: US-MA

    Title: AN ACT relating to the healthcare workforce, making an appropriation therefor, and declaring an emergency.

    Current Status: Failed

    Introduction Date: February 09, 2023

    Last Action Date: to Appropriations & Revenue (S). February 14, 2023

    Description: Create new sections of KRS 164 to define terms; establish the Kentucky healthcare workforce investment fund to enable the Council on Postsecondary Education (CPE), healthcare programs, and healthcare providers and facilities to match public and private dollars for the purpose of awarding scholarships to eligible students and healthcare incentives to eligible healthcare programs; provide that the moneys in the fund appropriated by the General Assembly shall lapse after the second year in a biennium budget; direct CPE to promulgate regulations to administer the Act; require at least 65% of all net moneys in the fund to be used to fund partnership proposals between healthcare programs and healthcare partners to issue scholarships to students enrolled in the healthcare program; require CPE to establish a process to prioritize certain partnership proposals; require a written partnership contract and establish the minimum contents; require that scholarships be issued directly to students and....

    Location: US-KY

  • Workforce
  • Title: Emergency Department Care Management Grant Program and Fund; established and created, report.

    Current Status: Failed

    Introduction Date: January 10, 2023

    Last Action Date: House: Left in Appropriations. February 07, 2023

    Description: Emergency Department Care Management Grant Program and Fund; report. Establishes the Emergency Department Care Management Grant Program and the Emergency Department Care Management Grant Fund. The bill provides that the Program is established to provide grants to eligible hospitals that provide care management and medical services to frequent users of hospital emergency departments, with grants to be awarded to (i) reduce patient usage of emergency departments for routine, nonurgent, primary medical care; (ii) support emergency department case management staff; (iii) identify and analyze the comprehensive health care needs of patients; (iv) identify social determinants of health and barriers to care; (v) facilitate collaboration with providers and payers to develop a plan for community care; and (vi) improve the ability of patients to manage their care in the community. The bill directs the Department of Health to evaluate the effectiveness of the Program and requires the State Health ....

    Location: US-VA

  • ED Boarding
  • Title: An Act amending the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, in general provisions, repeals and effective date, providing for acute care mental health bed registry and referrals.

    Current Status: Failed

    Introduction Date: January 19, 2023

    Last Action Date: Referred to Health & Human Services. January 19, 2023

    Location: US-PA

  • Mental Health
  • Bed Database
  • Title: An Act relative to transparency in behavioral health boarding

    Current Status: Failed

    Introduction Date: March 29, 2021

    Last Action Date: Accompanied a study order, see H5222. September 15, 2022

    Description: By Ms. Decker of Cambridge, a petition (accompanied by bill, House, No. 203) of Marjorie C. Decker and others relative to the coordination of services for children and adolescents awaiting clinically-appropriate behavioral health services. Children, Families and Persons with Disabilities.

    Location: US-MA


    1. ED Boarding Regulations 1 Regulations

    Type: Notice

    Agency: Department of Health Care Finance

    Publication Date: May 30, 2025

    Summary: The Department of Health Care Finance (DHCF) has issued a public notice announcing updates to the Medicaid Fee Schedule for the Home and Community-Based Services (HCBS) Waiver for Individuals with Intellectual and Developmental Disabilities (ID/DD Waiver), effective July 1, 2025. The updated reimbursement rates reflect Year 3 of the ID/DD Renewal Waiver methodology and include the 2025 D.C. Living Wage where applicable. Rates will increase for 19 specific services, including Assistive Technology, Behavioral Support, Day Habilitation, Supported Employment, and others. For Personal Care and Skilled Nursing Services, providers will be reimbursed according to the Medicaid State Plan fee schedule. For Dental Services, reimbursement will continue at the State Plan rate plus 20%. All rates are subject to waiver-specific service limitations.

    Location: US-DC