Grandparents Raising Grandchildren in Maryland: School and Medical Rights

One in every ten children in the United States lives with a grandparent, and in many of those homes the grandparent is the primary caregiver. In Maryland, the law provides a specific path for grandparents and other relatives to manage a child's school enrollment and medical care without going to court — but the rules depend on who you are in relation to the child.

Who Qualifies as a Kinship Caregiver in Maryland

Maryland's informal kinship care affidavits — under Education § 7-101(c) for school enrollment and Health-General § 20-105 for health care consent — are available to adults related to the child within the fifth degree of consanguinity or affinity.

That includes:

• Grandparents and great-grandparents — the most common kinship caregivers
• Aunts and uncles — including by marriage
• Great-aunts and great-uncles
• Adult siblings — an older brother or sister who is 18 or older
• First cousins

It does not include godparents, family friends, neighbors, or other non-relatives — even if they've been caring for the child for years. Maryland law calls these "fictive kin" and excludes them from the informal affidavit system. Fictive kin have other options (court guardianship, McKinney-Vento enrollment for housing-unstable situations), but the statutory affidavit isn't one of them.

The Same Affidavit, Same Rights, Regardless of Which Relative

Whether you're a grandmother or an uncle or an adult older sibling, the affidavit process is identical. You complete the sworn affidavit documenting the child's identity, your relationship, the fact that the child lives with you 24/7, and the qualifying family hardship. You file the health care affidavit (Form DHS/SSA/554) with DHS and your county's school affidavit with the local school system.

With valid affidavits and no conflicting court order or parental objection, you have authority to:

• Enroll the child in your local school district
• Sign school permission slips, attend parent-teacher conferences, and make educational decisions
• Consent to medical care, dental treatment, and vaccinations
• Apply for the Maryland Children's Health Program (Medicaid) on the child's behalf
• Participate in IEP meetings and make special education decisions

This authority is the same whether you're a grandparent or a first cousin. The statute draws no distinction between relative types, as long as you fall within the fifth degree.

Challenges Specific to Different Caregiver Types

While the legal framework is the same, the practical experience varies.

Grandparents are the most recognized kinship caregivers. Schools and doctors' offices have usually encountered a grandparent with an affidavit before. The bigger challenge for grandparents is often physical: managing school runs, medical appointments, and the energy demands of raising a young child while aging. Support groups through local DSS offices and organizations like AARP GrandFacts are built specifically for grandparents.

Aunts and uncles sometimes face more skepticism from institutions. A registrar who readily accepts a grandmother's affidavit may question an uncle's. The law makes no distinction — if you're within the fifth degree, you qualify — but be prepared to explain the statute and bring a printed copy of Education § 7-101(c).

Adult siblings face a unique dynamic. An 18- or 19-year-old raising a younger sibling may be questioned about their own stability or housing. The statute doesn't impose an age floor beyond legal adulthood. If you're 18, living independently, and the child is with you because of a qualifying hardship, you can file the affidavit.

Multiple caregivers in one household. If more than one relative shares day-to-day care, confirm with the local school system and DHS whether each caregiver should file an affidavit so the intended decision-maker is recognized.

What Every Relative Caregiver Should Do First

Regardless of your relationship to the child:

1. Gather the hardship documentation. Know which of the six qualifying hardships applies (death, serious illness, drug addiction, incarceration, abandonment, or an active-duty assignment in the uniformed services) and have supporting evidence ready.
2. File the affidavit for the authority you need. The school and health care affidavits (DHS/SSA/554) are separate and cover different decisions. File both if you need both school and health care authority.
3. Notify the parent where possible. The school affidavit requires reasonable efforts to inform the parent; the health affidavit calls for notice where feasible. If the parent is unreachable, document your attempts.
4. Mark your renewal date. The school affidavit must be re-filed at least two weeks before the start of each school year. Set a reminder.

For a step-by-step walkthrough of the entire process — from executing the affidavits to enrolling in school to knowing when an affidavit isn't enough and court is the right path — see our Maryland School and Medical Consent Guide.

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