In a 4-3 decision, the Supreme Court of Maryland, upheld sanctions against the Maryland Department of Health, requiring payments to some local detention centers that incur the costs of the agencies non-compliance. 

As previously covered on Conduit Street, the Supreme Court of Maryland accepted a petition to consider whether the Appellate Court of Maryland acted within its authority when it imposed sanctions against the Maryland Department of Health (MDH) for not complying with Maryland law. Yesterday, the high court upheld the lower court decision, requiring MDH to pay monetary sanctions to local detention centers based on the court orders. The sanctions stem from cases where MDH has failed to admit to a hospital facility individuals found not competent to stand trial.

Due to what the department says is a lack of bed space in state hospitals, these individuals end up in local detention centers for, sometimes, hundred of days, where they do not have access to appropriate care. Local detention centers have been in the position of housing and caring for these individuals within their own limited means while they wait for the state to transfer them, while the backlog is in the hundreds.

From a prior Conduit Street article:

The courts have been issuing judgements against MDH to pay sanctions associated with the prolonged detention in local facilities. Some estimates are nearing $2M in sanctions since the bill passed in 2018. Since then the wait list for admission has only grown longer despite the agency saying they are working to address the problem.

The Maryland Association of Counties, Maryland Correctional Administrators Association, and Maryland Sheriffs Association, in collaboration with the Anne Arundel County Office of Law, signed on to an amicus brief to further impress upon the courts not only the extent to which the state’s non-compliance compromises local government operations but also the severity of the injustice to the individuals who have been afforded the right to be a patient and not an incarcerated individual.

From the MD Supreme Court opinion:

We disagree with the Department on all points and affirm the judgment of the Appellate Court.

While accountability is severely needed with many of the state agencies, the payment of sanctions will only further drain agency budgets while pulling resources from other projects that could increase the speed and quality of care the agency is capable of providing. MDH already boasts the largest budget of any state agency in Maryland, and is now facing another multi-million dollar problem in sanctions and service delivery. With a multi-billion dollar budget problem looming over the 2027 General Assembly session even before this opinion was issued, state leadership will need to weigh whether to uphold the standard of care they established in 2018 or find funding to start chipping away at the problem.

Read the full opinion in MARYLAND DEPARTMENT OF HEALTH v. JEFFREY BOULDEN, ET AL..