SB 830
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
Third Reader - Revised
Senate Bill 830 (Senator Lam)
Finance Health and Government Operations and
Ways and Means
Secretary of Health - School-Based Health Centers - Guidelines and
Administration of Grants
This bill requires the Maryland Department of Health (MDH), in conjunction with the
Maryland State Department of Education (MSDE), to report to the General Assembly on a
plan to transfer administration of school-based health center (SBHC) grants and any related
functions from MDSE to the Bureau of Maternal and Child Health (BMCH) in MDH by
October 1, 2021. By July 1, 2022, the Governor must transfer administration of SBHC
grants and any related functions from MSDE to BMCH. The Secretary of Health, in
consultation with MSDE and other stakeholders, must develop guidelines to support the
expansion of SBHCs. The bill takes effect July 1, 2021.
Fiscal Summary
State Effect: No effect in FY 2022 as MSDE and MDH can report on a plan to transfer
administration of SBHC grants and related functions using existing budgeted resources;
any additional funding needs can be identified in that plan and funded accordingly for
FY 2023. Otherwise, MDSE general fund expenditures decline by $9.0 million annually
beginning in FY 2023 from the transfer of SBHC grants administration to MDH; MDH
general fund expenditures increase accordingly. State revenues are not affected.
Local Effect: Generally, transfer of administration of SBHCs is not anticipated to
materially affect local board of education or local health department (LHD) finances.
However, to the extent specified guidelines required under the bill support the expansion
of SBHCs, LHD sponsors of SBHCs may benefit.
Small Business Effect: Potential meaningful.
 Analysis
Current Law: SBHCs are health centers located in a school or on a school campus that
provide on-site comprehensive preventive and primary health services. Services may also
include behavioral health, oral health, ancillary, and supportive services. Currently, MSDE
is responsible for SBHC guidelines and administers SBHC State grant funds. MDH assists
MSDE through the Office of Population Health Improvement (OPHI).
According to MSDE, in fiscal 2020, there were 84 SBHCs in 12 of Maryland’s
24 jurisdictions. Most SBHCs are sponsored by LHDs or federally qualified health centers,
though there are two Maryland SBHCs with hospitals as their sponsoring agency.
Maryland Council on Advancement of School-Based Health Centers
Established by Chapter 417 of 2015, the purpose of the council is to improve the health
and educational outcomes of students who receive services from SBHCs by advancing their
integration into (1) the health care system at the State and local levels and (2) the
educational system at the State and local levels. The council must develop specified policy
recommendations to improve the health and educational outcomes of students who receive
services from SBHCs. Until 2017, MSDE provided staff support for the council.
Chapter 199 of 2017 transferred the council from MSDE to MDH and required the
Maryland Community Health Resources Commission to provide staff for the council.
The Blueprint for Maryland’s Future
Under Chapter 36 of 2021 (Blueprint for Maryland’s Future), MSDE and MDH must each
designate a liaison for SBHCs to provide technical assistance and support to the centers.
State funding for SBHCs increased to $9.0 million annually beginning in fiscal 2021
(mandated beginning in fiscal 2022). Additional State funding for local school systems to
train school staff to recognize student behavioral health issues is provided annually to assist
local school systems with their training programs. Also, local boards of education must
enhance and expand the availability of behavioral health services to students. By
November 1, 2021, each school system must report their plan to expand school behavioral
health service availability and to connect schools without an SBHC to community-based
behavioral health services to the Accountability and Implementation Board, Governor, and
the General Assembly.
State Expenditures: The bill requires the Governor to transfer administration of SBHC
grants (totaling $9.0 million annually) from MSDE to MDH on July 1, 2022 (fiscal 2023).
Thus, MSDE general fund expenditures decrease by $9.0 million annually beginning in
fiscal 2023. MDH general fund expenditures increase accordingly.
SB 830/ Page 2
Both MDH and MSDE advise that the agencies can work together to develop a plan for the
transfer of the SBHC program from MSDE to MDH with existing budgeted resources.
Additionally, MDH advises it can develop guidelines to support the expansion of SBHCs,
and MSDE advises it can consult to develop the guidelines, using existing budgeted
resources.
MDH does not currently have any staff exclusively dedicated to SBHCs within OPHI and,
therefore, cannot transfer any staff to BMCH to administer the program without disrupting
OPHI activities. However, MDH advises that the agency can provide consultation to both
subdivisions to transition program operations from one to the other. MSDE advises that, as
there is no dedicated SBHC staff position and no MSDE position funded with SBHC funds,
no positions transfer from MSDE to MDH under the bill. Therefore, MDH indicates that
additional staff will be necessary to administer grants and oversee the process of
developing appropriate clinical guidelines for SBHCs as required by the transfer. MDH
can identify any additional staffing needs as part of the development of a plan to transfer
administration of SBHCs and include any such expenses in the budget request for
fiscal 2023, when the transfer actually takes place.
Small Business Effect: To the extent guidelines developed by the Secretary of Health as
required under the bill lead to the expansion of SBHCs, small business health care
providers may benefit.
Additional Information
Prior Introductions: None.
Designated Cross File: HB 1148 (Delegate Cullison) - Health and Government
Operations and Ways and Means.
Information Source(s): Maryland State Department of Education; Maryland Department
of Health; Department of Legislative Services
Fiscal Note History: First Reader - March 1, 2021
rh/jc Third Reader - March 22, 2021
Revised - Updated Information - March 26, 2021
Analysis by: Michael E. Sousane Direct Inquiries to:
(410) 946-5510
(301) 970-5510
SB 830/ Page 3


Statutes affected:
Text - First - Secretary of Health - School-Based Health Centers - Guidelines and Administration of Grants: 1-922A Health General, 1-922A Health General, 1-922A Health General
Text - Third - Secretary of Health - School-Based Health Centers - Guidelines and Administration of Grants: 1-922A Health General, 1-922A Health General, 1-922A Health General