HB 1071
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
First Reader
House Bill 1071 (Delegate Hill)
Health and Government Operations and
Judiciary
Health - Health and Wellness Standards - Correctional Facilities and Health
Care Facilities
This bill requires the Secretary of Public Safety and Correctional Services, with the advice
of the Secretary of Health, to update the minimum mandatory standards for inmate food
services by January 1, 2022, and at least every five years thereafter. The Secretary of Health
must adopt health and wellness standards for specified hospitals and residential treatment
centers. The standards apply to food and beverage contracts for additional facilities,
including correctional facilities, as specified. Uncodified language establishes a
Correctional Facilities Health and Wellness Pilot Program to establish minimum
mandatory standards for inmate food services. The Secretary of Public Safety and
Correctional Services must designate four State correctional facilities to participate in the
pilot program and, by October 1, 2023, report specified information to the Office of
Minority Health and Health Disparities and the General Assembly. The Secretary of Health
must set health and wellness standards for the pilot program. The pilot program
terminates September 30, 2023.
Fiscal Summary
State Effect: General fund expenditures increase by $42,600 in FY 2022 and by $11,400
in FY 2023 for the Maryland Department of Health (MDH) to adopt the standards.
General fund expenditures increase minimally for the Department of Public Safety and
Correctional Services (DPSCS) in FY 2022 through 2024 to implement the pilot program.
General fund revenues may decrease minimally in FY 2022 through 2024, as discussed
below.
(in dollars) FY 2022 FY 2023 FY 2024 FY 2025 FY 2026
GF Revenue (-) (-) (-) $0 $0
GF Expenditure $42,600 $11,400 - $0 $0
Net Effect (-) (-) (-) $0 $0
Note:() = decrease; GF = general funds; FF = federal funds; SF = special funds; - = indeterminate increase; (-) = indeterminate decrease
Local Effect: Potential minimal increase in expenditures for local correctional facilities
to comply with the bill, as discussed below. Revenues are not affected.
Small Business Effect: Minimal.
Analysis
Bill Summary:
Standards for Inmate Food Services
The minimum mandatory standards for inmate food services must (1) include a procedure
for an inmate to elect to change food or beverage options, without requiring a religious or
medical exception, to kosher, halal, diabetic, or any other diet available to an inmate and
(2) require an inmate to provide adequate notice of any dietary requirements.
An election to change food and beverage options or a notice of dietary requirements must
remain valid for six months and be renewed automatically unless the inmate provides
additional notice, in writing, of a change to the inmate’s diet.
Health and Wellness Standards
The Secretary of Health must adopt health and wellness standards for all hospitals and
residential treatment centers for which the Secretary adopts specified regulations. The
regulations must include:
 requiring the facility to offer plant-based meal options, food options, and beverages
for general consumption, as specified;
 providing information and resources to health care providers who provide services
in the facilities on available training and board certification, as specified; and
 guidelines that increase the availability of plant-based meal options, food options,
and beverages in alternative food locations in the facility, as specified.
The standards may exceed the standards set by federal law. The existing requirement for
the Secretary of Health to adopt reasonable rules and regulations that set standards of
specified services in the area of dietary matters is expanded to include requiring, by
October 1, 2022, that the menus and alternative food locations for specified facilities
comply with the health and wellness standards.
HB 1071/ Page 2
Application to Existing and Future Contracts
The requirements that a facility offer plant-based meal, food, and beverage options on
request at each meal under the bill must apply to (1) food and beverage contracts entered
into or renewed by a facility on or after October 1, 2021, and (2) a contract, an agreement,
or any other arrangement between a correctional facility and a food and beverage contractor
entered into on or before that date if the standards can be implemented without an increase
of the price for the food or food services or the appropriate local agency approves any price
increase that would result from the implementation of the standards.
Correctional Facilities Health and Wellness Pilot Program
Each correctional facility participating in the pilot program must (1) comply with health
and wellness standards set by the Secretary of Health; (2) offer plant-based meal, food, and
beverage options for general consumption, as specified; (3) provide information and
resources to health care providers who provide services in the correctional facility on
available training and board certification, as specified; (4) provide information to all
inmates on the benefits and availability of plant-based meal, food, and beverage options;
(5) establish guidelines that increase the availability of plant-based options in alternative
food locations in the facility; and (6) establish guidelines for the preparation of plant-based
meal options by the facility that considers the taste preferences of the population served,
as specified.
Funding to Develop and Implement the Health and Wellness Standards
The bill expresses the intent of the General Assembly that the health and wellness standards
developed by MDH pursuant to the bill and implemented by DPSCS under the pilot
program must be developed, adopted, and implemented using the department’s existing
resources.
Current Law: Hospitals and residential treatment centers must be licensed by the State
to operate. There are various standards and practices that each must meet as a condition of
licensure. MDH may conduct inspections to ensure compliance with requirements. MDH
may also conduct inspections to investigate and resolve any complaint concerning patient
care, safety, medical and nursing supervision, physical environment, sanitation, or dietary
matters. In addition, federal guidelines govern facilities that receive funding through
Medicaid and Medicare.
State regulations generally require that the food and nutritional needs of residents in
hospitals meet medical orders. Further, by regulation, milk and meat, fish, poultry, or eggs
must be offered daily in varying amounts.
HB 1071/ Page 3
The State Advisory Council on Health and Wellness within MDH must (1) promote
evidence-based programs for healthy lifestyles and the prevention, early detection, and
treatment of chronic disease and (2) make recommendations to MDH related to chronic
disease prevention, health, and wellness.
The Secretary of Public Safety and Correctional Services is required to adopt regulations
that establish minimum mandatory standards applicable to, among other things, inmate
food services. The minimum mandatory standards apply to all State and local correctional
facilities. The Secretary is also required to establish approved standards applicable to,
among other things, training; the approved standards apply to all State correctional
facilities and may be adopted by a local correctional facility. The standards adopted under
these provisions must be consistent with federal and State law.
By regulation, the managing official of a correctional facility is responsible for having
written policies and procedures, including (1) providing for a menu approved annually by
a registered dietitian; (2) ensuring that three meals a day are served with not more than a
14-hour interval between the evening meal and breakfast; and (3) ensuring that the food
service operation is licensed and meets State sanitation and health regulations as verified
by inspection as required by the health department.
State Fiscal Effect: Although the bill establishes the intent of the General Assembly that
the health and wellness standards developed by MDH under the bill and implemented by
DPSCS under the pilot program must be developed, adopted, and implemented using
existing resources, initial implementation likely results in a minimal increase in
general fund expenditures for both MDH and DPSCS. Without actual experience under the
bill, it is unclear to what extent health care costs and/or food costs may decrease over time
as a result of the bill.
Maryland Department of Health
MDH advises that it needs one registered dietician in fiscal 2022 to develop the dietary
guidelines and one part-time permanent staff beginning in fiscal 2023 to handle the ongoing
responsibilities of the bill. The Department of Legislative Services disagrees and advises
that MDH must develop the standards for implementation by October 1, 2022, but there
are no ongoing requirements for developing the standards.
Thus, MDH general fund expenditures increase by $42,561 in fiscal 2022, which accounts
for the bill’s October 1, 2021 effective date. This estimate reflects the cost of hiring
one contractual registered dietician to review and provide advice for the development of
dietary guidelines. It includes a salary, fringe benefits, one-time start-up costs, and ongoing
operating expenses.
HB 1071/ Page 4
 Contractual Position 1.0
Salary and Fringe Benefits $36,980
Operating Expenses 5,581
Total FY 2022 MDH Expenditures $42,561
Future year expenditures reflect a full salary with annual increases and employee turnover,
ongoing operating expenses, and termination of the contractual position after the
first quarter of fiscal 2023.
This estimate does not include any health insurance costs that could be incurred for
specified contractual employees under the State’s implementation of the federal Patient
Protection and Affordable Care Act.
Department of Public Safety and Correctional Services
DPSCS advises that, in order to update the minimum mandatory standards for inmate food
services by January 1, 2022 (and at least every five years thereafter), it needs to redirect
staff time to develop the standards and either amend or promulgate regulations to align
with the newly developed standards. While this is an operational impact for DPSCS, it can
likely be absorbed within existing budgeted resources.
DPSCS further advises that until the Secretary of Health develops the standards for the
pilot program, the bill’s effect on DPSCS expenditures relating to inmate food services
cannot be reliably estimated. DPSCS currently provides vegetarian meal plans on a daily
basis as well as plant-based meal options to regular diet inmates on four out of the
five weekly menu cycles. DPSCS advises that providing a plant-based meal on the
fifth weekly menu cycle increases costs by up to $0.65 per meal. Under the bill – for
four State correctional facilities participating in the pilot program – DPSCS must provide
at least one plant-based meal option and at least one plant-based beverage to all inmates at
each meal at least one day each week. In December 2020, the average daily population for
the Division of Correction was 15,647 inmates spread out across 18 prisons and pre-release
centers. For illustrative purposes only, assuming an increase of 10.4 additional plant-based
meals offered annually to approximately 3,477 inmates across four State correctional
facilities at an increased cost of $0.65 per meal, general fund expenditures could increase
by approximately $23,504 annually during the two years of the pilot program. To the extent
that the pilot program is extended beyond two years and/or expanded to additional
correctional facilities, general fund expenditures increase beyond fiscal 2024.
State revenues may also be affected. According to DPSCS, a decrease in the purchase of
meat-based products by State facilities may result in a decrease in revenues for the food
processing plant in the Maryland Correctional Enterprises (MCE). MCE operates as a
self-supporting agency within DPSCS that includes a food processing plant. Nearly all
HB 1071/ Page 5
products produced by MCE’s food processing plant are meat-based products. Without
actual experience under the bill, any reduction in revenues for MCE cannot be quantified.
Local Expenditures: The bill applies the health and wellness standards to a contract,
agreement, or other arrangement between a correctional facility and a food and beverage
contractor entered into on or before October 1, 2021, if (1) the standards can be
implemented without an increase of the price for the food or food services or (2) the
appropriate local agency approves any such price increase. Therefore, expenditures for
local correctional facilities may increase. However, any increase is expected to be minimal.
Additional Comments: The applicability of the health and wellness standards under the
bill is unclear. Uncodified language in Section 4 applies standards to contracts for
correctional facilities such that they can be implemented without additional cost or any
price increase is approved by the local government. This appears to apply the bill’s
standards to all State and local correctional facilities if they can be implemented at no cost,
even during the two-year pilot program, which requires only four State correctional
facilities to implement the standards.
Additional Information
Prior Introductions: SB 768 of 2020, a similar bill, received a hearing in the Senate
Judicial Proceedings Committee, but no further action was taken. Its cross file, HB 819,
received a hearing in the House Health and Government Operations Committee, but no
further action was taken.
Designated Cross File: SB 322 (Senator Benson) - Finance.
Information Source(s): Anne Arundel, Montgomery, and Prince George’s counties;
Department of Public Safety and Correctional Services; Maryland Department of Health;
Department of Legislative Services
Fiscal Note History: First Reader - March 5, 2021
rh/jc
Analysis by: Amber R. Gundlach Direct Inquiries to:
(410) 946-5510
(301) 970-5510
HB 1071/ Page 6


Statutes affected:
Text - First - Health - Health and Wellness Standards - Correctional Facilities and Health Care Facilities: 8-103 Correctional Services, 19-308 Health General, 21-1302 Health General, 21-1301 Health General, 21-1302 Health General, 7-517 Health General