Maryland 2022 Regular Session

Maryland House Bill HB1084 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	hb1084
6	6
7	7	HOUSE BILL 1084
8	8	J1, J3, J2 EMERGENCY BILL 2lr1575
9	9	CF SB 840
10	10	By: Delegate Pena–Melnyk
11	11	Introduced and read first time: February 10, 2022
12	12	Assigned to: Health and Government Operations
13	13
14	14	A BILL ENTITLED
15	15
16	16	AN ACT concerning 1
17	17
18	18	COVID–19 Response Act of 2022 2
19	19
20	20	FOR the purpose of establishing and altering certain requirements related to COVID–19, 3
21	21	including requirements related to planning by institutions of higher education, home 4
22	22	health agencies, nursing homes, and assisted living programs, the provision of 5
23	23	coverage by the Maryland Medical Assistance Program, the Maryland MyIR Mobile 6
24	24	immunization record service, and reporting by the Maryland Department of Health; 7
25	25	establishing that certain urgent care centers are not subject to the rate–setting 8
26	26	jurisdiction of the Health Services Cost Review Commission; requiring the State 9
27	27	Board of Nursing to establish an apprentice geriatric nursing assistant program; 10
28	28	altering the authority of pharmacists to refill prescriptions, administer certain 11
29	29	vaccines, and delegate certain functions to pharmacy technicians; and generally 12
30	30	relating to public health, the provision of health care services, and responding to 13
31	31	COVID–19 in the State. 14
32	32
33	33	BY repealing and reenacting, with amendments, 15
34	34	Article – Education 16
35	35	Section 11–1702(a) 17
36	36	Annotated Code of Maryland 18
37	37	(2018 Replacement Volume and 2021 Supplement) 19
38	38	(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 20
39	39	Special Session) 21
40	40
41	41	BY repealing and reenacting, without amendments, 22
42	42	Article – Health – General 23
43	43	Section 15–103(a)(1) 24
44	44	Annotated Code of Maryland 25
45	45	(2019 Replacement Volume and 2021 Supplement) 26
46	46
47	47	BY repealing and reenacting, with amendments, 27
48	48	Article – Health – General 28 2 HOUSE BILL 1084
49	49
50	50
51	51	Section 15–103(a)(2)(xvi) and (xvii) 1
52	52	Annotated Code of Maryland 2
53	53	(2019 Replacement Volume and 2021 Supplement) 3
54	54
55	55	BY adding to 4
56	56	Article – Health – General 5
57	57	Section 15–103(a)(2)(xviii), 18–9A–02(g), 18–9A–03(d), 18–9A–03.1, 18–9A–03.2, 6
58	58	18–9A–05, and 19–211.1 7
59	59	Annotated Code of Maryland 8
60	60	(2019 Replacement Volume and 2021 Supplement) 9
61	61
62	62	BY repealing and reenacting, without amendments, 10
63	63	Article – Health – General 11
64	64	Section 18–9A–02(a) and (b), 18–9A–03(a), and 18–9A–04(a) and (b) 12
65	65	Annotated Code of Maryland 13
66	66	(2019 Replacement Volume and 2021 Supplement) 14
67	67	(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 15
68	68	Special Session) 16
69	69
70	70	BY repealing and reenacting, with amendments, 17
71	71	Article – Health – General 18
72	72	Section 18–9A–04(c), 19–411(b), 19–14C–02(a), and 19–1815(b) 19
73	73	Annotated Code of Maryland 20
74	74	(2019 Replacement Volume and 2021 Supplement) 21
75	75	(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 22
76	76	Special Session) 23
77	77
78	78	BY repealing and reenacting, without amendments, 24
79	79	Article – Health Occupations 25
80	80	Section 8–6A–05(a) 26
81	81	Annotated Code of Maryland 27
82	82	(2021 Replacement Volume) 28
83	83
84	84	BY adding to 29
85	85	Article – Health Occupations 30
86	86	Section 8–6A–05(d) 31
87	87	Annotated Code of Maryland 32
88	88	(2021 Replacement Volume) 33
89	89
90	90	BY repealing and reenacting, with amendments, 34
91	91	Article – Health Occupations 35
92	92	Section 12–101(g) and (i), 12–506, 12–508, and 12–6B–06 36
93	93	Annotated Code of Maryland 37
94	94	(2021 Replacement Volume) 38
95	95
96	96	BY repealing and reenacting, with amendments, 39
97	97	Chapter 29 of the Acts of the General Assembly of the 2021 Special Session 40 HOUSE BILL 1084 3
98	98
99	99
100	100	Section 5 1
101	101
102	102	BY repealing and reenacting, with amendments, 2
103	103	Chapter 31 of the Acts of the General Assembly of the 2021 Special Session 3
104	104	Section 5 4
105	105
106	106	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5
107	107	That the Laws of Maryland read as follows: 6
108	108
109	109	Article – Education 7
110	110
111	111	11–1702. 8
112	112
113	113	(a) For calendar [year] YEARS 2021, 2022, AND 2023, an institution of higher 9
114	114	education that has residence halls for students shall establish a COVID–19 security plan 10
115	115	that includes both screening and testing procedures that will keep students, faculty, and 11
116	116	staff safe while on campus for face–to–face instruction during the pandemic. 12
117	117
118	118	Article – Health – General 13
119	119
120	120	15–103. 14
121	121
122	122	(a) (1) The Secretary shall administer the Maryland Medical Assistance 15
123	123	Program. 16
124	124
125	125	(2) The Program: 17
126	126
127	127	(xvi) Beginning on January 1, 2021, shall provide, subject to the 18
128	128	limitations of the State budget and § 15–855(b)(2) of the Insurance Article, and as permitted 19
129	129	by federal law, services for pediatric autoimmune neuropsychiatric disorders associated 20
130	130	with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, 21
131	131	including the use of intravenous immunoglobulin therapy, for eligible Program recipients, 22
132	132	if pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections 23
133	133	and pediatric acute onset neuropsychiatric syndrome are coded for billing and diagnosis 24
134	134	purposes in accordance with § 15–855(d) of the Insurance Article; [and] 25
135	135
136	136	(xvii) Beginning on January 1, 2022, may not include, subject to federal 26
137	137	approval and limitations of the State budget, a frequency limitation on covered dental 27
138	138	prophylaxis care or oral health exams that requires the dental prophylaxis care or oral 28
139	139	health exams to be provided at an interval greater than 120 days within a plan year; AND 29
140	140
141	141	(XVIII) SHALL PROVIDE COVERAG E FOR COVID–19 TESTS 30
142	142	AND RELATED SERVICES FOR THE ADMINISTRATI ON OF COVID–19 TESTS TO 31
143	143	UNINSURED INDIVIDUAL S, AS AUTHORIZED BY THE FEDERAL FAMILIES FIRST 32
144	144	CORONAVIRUS RESPONSE ACT AND THE CORONAVIRUS AID, RELIEF, AND 33
145	145	ECONOMIC SECURITY (CARES) ACT. 34 4 HOUSE BILL 1084
146	146
147	147
148	148
149	149	18–9A–02. 1
150	150
151	151	(a) On or before June 1, 2021, the Department, in collaboration with local health 2
152	152	departments in the State and the Maryland State Department of Education, shall adopt 3
153	153	and implement a 2–year plan to respond to the outbreak of COVID–19. 4
154	154
155	155	(b) The plan required under this section shall: 5
156	156
157	157	(1) Include measures to enhance public health efforts at the State and local 6
158	158	level to monitor, prevent, and mitigate the spread of COVID–19; 7
159	159
160	160	(2) (i) Assess the COVID–19 public and private testing infrastructure 8
161	161	in place both statewide and in each local jurisdiction; 9
162	162
163	163	(ii) Identify and address the unmet needs for COVID–19 testing 10
164	164	statewide and in each local jurisdiction, including the number and location of public and 11
165	165	private testing providers required to ensure access to testing on demand for all residents of 12
166	166	the State; 13
167	167
168	168	(iii) Establish specific monthly goals for COVID–19 testing statewide 14
169	169	and in each local jurisdiction to ensure access to testing for all residents of the State, 15
170	170	including: 16
171	171
172	172	1. A goal to achieve the capacity to perform the surveillance 17
173	173	testing required to safely reopen and keep open schools, institutions of higher education, 18
174	174	workplaces, and other community facilities in the State while minimizing the community 19
175	175	spread of COVID–19 in calendar years 2021, and 2022, through a network of public and 20
176	176	private testing providers; and 21
177	177
178	178	2. For each local jurisdiction, a goal to establish the required 22
179	179	number of public or private COVID–19 testing locations to achieve the surveillance testing 23
180	180	goal described in item 1 of this item; and 24
181	181
182	182	(iv) Estimate the funding required to implement the surveillance 25
183	183	testing goal described in item (iii)1 of this item and the extent to which federal funding 26
184	184	already received by the State in fiscal year 2021, and federal funding that is provided to 27
185	185	the State and received after March 1, 2021, can be used to cover the cost required to achieve 28
186	186	that goal; 29
187	187
188	188	(3) (i) Assess the contact tracing infrastructure in place for COVID–19 30
189	189	both statewide and in each local jurisdiction; 31
190	190
191	191	(ii) Determine the optimal number of contact tracing, case 32
192	192	management, care resource coordination, and other personnel per 100,000 residents needed 33
193	193	in each jurisdiction to effectively monitor, prevent, and mitigate the spread of COVID–19; 34
194	194	HOUSE BILL 1084 5
195	195
196	196
197	197	(iii) Identify and address the unmet needs for COVID–19 contact 1
198	198	tracing and related outbreak prevention and mitigation efforts both statewide and in each 2
199	199	local jurisdiction; and 3
200	200
201	201	(iv) 1. Establish goals for identifying, locating, and testing 4
202	202	individuals who have been in close contact with individuals who test positive for 5
203	203	COVID–19 that are in alignment with Centers for Disease Control and Prevention guidance 6
204	204	for effective contact tracing programs; and 7
205	205
206	206	2. Include a mechanism for monitoring performance of 8
207	207	contact tracing and testing of contacts both statewide and for each local jurisdiction; 9
208	208
209	209	(4) Require the Department to assist local jurisdictions that adopt 10
210	210	strategies to: 11
211	211
212	212	(i) Accelerate access to and the use of at–home collection and 12
213	213	point–of–care tests for COVID–19; and 13
214	214
215	215	(ii) Incentivize and encourage pharmacies and health care providers, 14
216	216	including primary care providers, to provide COVID–19 testing; and 15
217	217
218	218	(5) Allow each local jurisdiction to establish and implement a program for 16
219	219	COVID–19 contact tracing that is independent from the contact tracing program performed 17
220	220	by the State or the entity with whom the State has contracted to perform contact tracing 18
221	221	for the State. 19
222	222
223	223	(G) ON OR BEFORE JUNE 1, 2022, THE DEPARTMEN T, IN COLLABORATION 20
224	224	WITH LOCAL HEALTH DE PARTMENTS IN THE STATE AND THE STATE DEPARTMENT 21
225	225	OF EDUCATION, SHALL DEVELOP AND SU BMIT TO THE GENERAL ASSEMBLY, IN 22
226	226	ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, AN UPDATE TO 23
227	227	THE PLAN REQUIRED UN DER THIS SECTION THAT INCLUDES : 24
228	228
229	229	(1) SUBJECT TO ITEMS (2) THROUGH (5) OF THIS SUBSECTION , THE 25
230	230	INFORMATION DESCRIBE D IN SUBSECTION (B) FOR CALENDAR YEARS 2022, AND 26
231	231	2023; 27
232	232
233	233	(2) (I) SPECIFIC MONTHLY GOAL S STATEWIDE AND IN E ACH LOCAL 28
234	234	JURISDICTION TO ACHI EVE THE CAPAC ITY TO PERFORM DIAGN OSTIC TESTING AND 29
235	235	SCREENING TESTING RE QUIRED TO SAFELY REO PEN AND KEEP OPEN SC HOOLS, 30
236	236	INSTITUTIONS OF HIGH ER EDUCATION , WORKPLACES , AND OTHER COMMUNITY 31
237	237	FACILITIES IN THE STATE WHILE MINIMIZIN G THE COMMUNITY SPRE AD OF 32
238	238	COVID–19 IN CALENDAR YEARS 2022, AND 2023, THROUGH A NETWORK OF PUBLIC 33
239	239	AND PRIVATE TESTING PROVIDERS; 34
240	240
241	241	(II) MONTHLY GOALS TO ESTA BLISH THE REQUIRED N UMBER 35 6 HOUSE BILL 1084
242	242
243	243
244	244	OF PUBLIC OR PRIVATE COVID–19 TESTING LOCATIONS TO ACHIEVE THE TESTING 1
245	245	GOALS DESCRIBED IN I TEM (I) OF THIS ITEM; AND 2
246	246
247	247	(III) AN ESTIMATE OF THE FU NDING REQUIRED TO IM PLEMENT 3
248	248	THE TESTING GOALS DE SCRIBED IN ITEMS (I) AND (II) OF THIS ITEM AND TO THE 4
249	249	EXTENT TO WHICH FEDE RAL FUNDING ALREADY RECEIVED BY THE STATE IN FISCAL 5
250	250	YEAR 2022, AND FEDERAL FUNDING THAT IS PROVIDED TO THE STATE AND 6
251	251	RECEIVED IN SUBSEQUE NT FISCAL YEARS , CAN BE USED TO COVER THE COST 7
252	252	REQUIRED TO ACHIEVE THESE GOALS; 8
253	253
254	254	(3) A REQUIREMENT THAT THE DEPARTMENT KEEP TRACK OF THE 9
255	255	QUANTITY OF COVID–19 TESTS THAT IT WILL H AVE AVAILABLE FOR DI STRIBUTION 10
256	256	AND WHEN T HE TESTS WILL BE AVA ILABLE FOR DISTRIBUT ION; 11
257	257
258	258	(4) A METHOD FOR RESIDENTS OF THE STATE TO SELF –REPORT 12
259	259	POSITIVE COVID–19 TEST RESULTS TO THE DEPARTMENT ; AND 13
260	260
261	261	(5) FOR CALENDAR YEARS 2022, AND 2023, THE OPTIMAL NUMBER 14
262	262	OF CONTACT TRACING , CASE MANAGEMENT , CARE RESOURCE COORDIN ATION, AND 15
263	263	OTHER PERSONNEL PER 100,000 RESIDENTS NEEDED IN EACH JURISDICTION 16
264	264	DURING PERIODS OF SU RGES AND NONSURGES O F COVID–19 CASES IN THE STATE. 17
265	265
266	266	18–9A–03. 18
267	267
268	268	(a) (1) On or before June 1, 2021, the Department, with input from subject 19
269	269	matter experts and other relevant stakeholders, shall develop and submit to the General 20
270	270	Assembly a comprehensive plan for vaccinating residents of the State against COVID–19. 21
271	271
272	272	(2) The plan required under paragraph (1) of this subsection shall include: 22
273	273
274	274	(i) Detailed information on: 23
275	275
276	276	1. The categories of residents of the State who will receive 24
277	277	priority access to vaccines for COVID–19; 25
278	278
279	279	2. The timeline for providing vaccines for COVID–19 to 26
280	280	residents in each of the priority categories and to members of the general public who are 27
281	281	not included in priority categories; and 28
282	282
283	283	3. Target metrics for vaccinating residents in each of the 29
284	284	priority categories and for members of the general public who are not included in priority 30
285	285	categories; 31
286	286
287	287	(ii) A dedication of time and resources to target vaccine distribution 32
288	288	and vaccine safety outreach efforts to communities that have been disproportionately 33 HOUSE BILL 1084 7
289	289
290	290
291	291	impacted by COVID–19 infection, morbidity, and mortality; 1
292	292
293	293	(iii) A vaccine distribution strategy that allocates resources and 2
294	294	vaccines across all partners and vaccination sites in an equitable manner that ensures that 3
295	295	the vaccine allocation by jurisdiction accounts for the disproportionate impact of the 4
296	296	COVID–19 pandemic on underserved and minority communities; and 5
297	297
298	298	(iv) A strategy for outreach and distribution of vaccines to 6
299	299	individuals who are not receiving the vaccine, due to either lack of access or vaccine 7
300	300	hesitancy. 8
301	301
302	302	(D) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL DEVE LOP AND 9
303	303	SUBMIT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH § 2–1257 OF THE 10
304	304	STATE GOVERNMENT ARTICLE, AN UPDATE TO THE PLA N REQUIRED UNDER THI S 11
305	305	SECTION THAT INCLUDE S: 12
306	306
307	307	(1) SUBJECT TO ITEMS (2) THROUGH (5) OF THIS SUBSECTION , THE 13
308	308	INFORMATION DESCRIBE D IN SUBSECTION (A) OF THIS SECTION FOR CALENDAR 14
309	309	YEARS 2022 AND 2023; 15
310	310
311	311	(2) A REQUIREMENT THAT THE DEPARTMENT KEEP TRACK OF THE 16
312	312	QUANTITY OF COVID–19 VACCINES IT WILL HAV E AVAILABLE FOR 17
313	313	ADMINISTRATION AND W HEN THE VACCINES WIL L BE AVAILABLE FOR 18
314	314	ADMINISTRATION ; 19
315	315
316	316	(3) RECOMMENDATIONS FO R APPROACHES THE MARYLAND 20
317	317	MEDICAL ASSISTANCE PROGRAM CAN TAKE TO I NCENTIVIZE: 21
318	318
319	319	(I) HEALTH CARE PROVIDER VACCINATION EFFORTS ; 22
320	320
321	321	(II) VACCINATION AMONG MARYLAND MEDICAL ASSISTANCE 23
322	322	PROGRAM RECIPIENTS ; AND 24
323	323
324	324	(III) MANAGED CARE ORGANIZA TIONS TO DEVELOP AND MEET 25
325	325	VACCINATION TARGETS ; 26
326	326
327	327	(4) MEASURES TO INCREASE VACCINATION RATES AM ONG THE 27
328	328	UNVACCINATED ; AND 28
329	329
330	330	(5) A STRATEGY TO INCENTIV IZE ELIGIBLE INDIVID UALS TO 29
331	331	RECEIVE: 30
332	332
333	333	(I) A THIRD COVID–19 VACCINE DOSE ; AND 31
334	334	8 HOUSE BILL 1084
335	335
336	336
337	337	(II) ANY FUTURE VACCINES R ECOMMENDED B Y THE CENTERS 1
338	338	FOR DISEASE CONTROL AND PREVENTION. 2
339	339
340	340	18–9A–03.1. 3
341	341
342	342	(A) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT , WITH INPUT FROM 4
343	343	SUBJECT MATTER EXPER TS AND OTHER RELEVAN T STAKEHOLDERS , SHALL 5
344	344	DEVELOP A COMPREHENS IVE PLAN FOR TREATIN G RESIDENTS OF THE STATE WHO 6
345	345	HAVE COVID–19. 7
346	346
347	347	(B) THE PLAN REQUIRED UND ER THIS SECTION SHAL L: 8
348	348
349	349	(1) (I) IDENTIFY EFFECTIVE TR EATMENTS FOR TREATIN G 9
350	350	COVID–19; AND 10
351	351
352	352	(II) ASSESS THE EFFECTIVEN ESS OF MONOCLONAL AN TIBODIES 11
353	353	AND ORALLY ADMINISTE RED ANTIVIRAL MEDICA TIONS IN TREATING COVID–19; 12
354	354	AND 13
355	355
356	356	(2) (I) RECOMMEND THE EFFICIE NT AND EFFECTIVE 14
357	357	DISTRIBUTION OF COVID–19 TREATMENTS TO ENSURE THAT THERE IS ACCESS TO 15
358	358	TREATMENT FOR RESIDE NTS OF THE STATE WHO HAVE COVID–19; AND 16
359	359
360	360	(II) CONSIDER THE AT –HOME DISTRIBUTION OF COVID–19 17
361	361	TREATMEN TS. 18
362	362
363	363	(C) THE PLAN REQUIRED UND ER THIS SECTION SHAL L ADDRESS THE 19
364	364	DISPROPORTIONATE IMP ACT OF THE COVID–19 PANDEMIC ON UNDERSER VED AND 20
365	365	MINORITY COMMUNITIES IN THE STATE. 21
366	366
367	367	(D) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL SUBM IT THE 22
368	368	PLAN REQUIRED UNDER THIS SECTION TO THE GENERAL ASSEMBLY, IN 23
369	369	ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE. 24
370	370
371	371	18–9A–03.2. 25
372	372
373	373	AFTER SUBMITTING THE COVID–19 PLANS TO THE GENERAL ASSEMBLY AS 26
374	374	REQUIRED UNDER §§ 18–9A–02 THROUGH 18–9A–03.1 OF THIS SUBTITLE , THE 27
375	375	DEPARTMENT SHA LL PROVIDE MONTHLY P ROGRESS REPORTS TO T HE GENERAL 28
376	376	ASSEMBLY FOR THE DURA TION OF CALENDAR YEA R 2022 AND CALENDAR YEAR 29
377	377	2023 ON: 30
378	378
379	379	(1) THE IMPLEMENTATION OF THE COVID–19 PLANS REQUIRED 31 HOUSE BILL 1084 9
380	380
381	381
382	382	UNDER §§ 18–9A–02 THROUGH 18–9A–03.1 OF THIS SUBTITLE; AND 1
383	383
384	384	(2) THE NUMBER OF COVID–19 TESTS, VACCINES, AND TREATMENTS 2
385	385	IT HAS AT ITS DISPOS AL. 3
386	386
387	387	18–9A–04. 4
388	388
389	389	(a) The Department shall convene a Maryland Public Health Modernization 5
390	390	Workgroup. 6
391	391
392	392	(b) The Workgroup shall include representatives of the Department, local health 7
393	393	departments, subject matter experts, and any other relevant stakeholders. 8
394	394
395	395	(c) The Workgroup shall: 9
396	396
397	397	(1) Assess the current public health infrastructure and resources in the 10
398	398	State; 11
399	399
400	400	(2) Make recommendations for how to establish a modern and effective 12
401	401	public health system with a capacity to: 13
402	402
403	403	(i) Monitor, prevent, control, and mitigate the spread of infectious 14
404	404	disease; and 15
405	405
406	406	(ii) Achieve State Health Improvement Process goals; 16
407	407
408	408	(3) Make recommendations regarding the establishment of a Maryland 17
409	409	Public Health Job Corps to respond to the outbreak of COVID–19 or similar outbreaks; and 18
410	410
411	411	(4) Consider, where appropriate, the use of federal funds to implement any 19
412	412	recommendations made under this subsection, INCLUDING FROM AMERICORPS AND ITS 20
413	413	GRANT PROGRAM FOR ELIGIBLE ORGANIZ ATIONS TO ENGAGE AMERICORPS 21
414	414	MEMBERS IN SPECIFIED PRACTICES TO RESPOND TO PUBLIC HEALTH NEE DS. 22
415	415
416	416	18–9A–05. 23
417	417
418	418	(A) IN THIS SECTION , “MARYLAND MYIR MOBILE” MEANS THE STATE 24
419	419	IMMUNIZATION RECORD SERVICE THAT PROVIDE S AN INDIVIDUAL WITH : 25
420	420
421	421	(1) ACCESS TO THE INDIVID UAL’S OFFICIAL STATE IMMUNIZATION 26
422	422	RECORDS; AND 27
423	423
424	424	(2) THE ABILITY TO VOLUNT ARILY AND SECURELY D ISPLAY ON AND 28
425	425	TRANSMIT THROUGH A M OBILE DEVICE PROOF O F THE INDIVIDUAL ’S VACCINATION 29
426	426	FOR COVID–19 USING A SMART HEALTH CARD QR CODE. 30 10 HOUSE BILL 1084
427	427
428	428
429	429
430	430	(B) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL ENSU RE THAT 1
431	431	MARYLAND MYIR MOBILE HAS A DESIGN T HAT: 2
432	432
433	433	(1) ENABLES ITS VOLUNTARY USE AS A VACCINE PAS SPORT FOR 3
434	434	INDIVIDUALS WHO SEEK TO DISPLAY PROOF OF THE INDIVIDUAL ’S COVID–19 4
435	435	VACCINATION STATUS O N A MOBILE DEVICE TO ACCESS VEN UES WHERE PROOF OF 5
436	436	COVID–19 VACCINATION IS REQUI RED FOR ENTRY ; 6
437	437
438	438	(2) USES A MOBILE APPLICA TION THAT IS COMPATI BLE WITH ALL 7
439	439	MOBILE DEVICES IN WI DESPREAD USE , INCLUDING IOS AND ANDROID COMPATIBLE 8
440	440	APPLICATIONS; 9
441	441
442	442	(3) IS ABLE TO AUTOMATI CALLY DISPLAY A SMART HEALTH CARD 10
443	443	QR CODE IN A WALLET FUN CTION ON ANY MOBILE DEVICE THAT HAS THAT 11
444	444	FUNCTION; 12
445	445
446	446	(4) HAS A SMART HEALTH CARD QR CODE THAT IS VERIFIE D AS 13
447	447	VALID UNDER COMMONTRUST NETWORK REQUIREMENTS FOR MULTISTATE 14
448	448	FUNCTIONALITY ; 15
449	449
450	450	(5) IS COMPATIBLE WITH MULTINAT IONAL VACCINE PASSPO RT 16
451	451	PLATFORMS ; 17
452	452
453	453	(6) DISPLAYS INFORMATION IN SPANISH AND OTHER LAN GUAGES 18
454	454	COMMONLY USED IN THE STATE, AS DETERMINED BY THE DEPARTMENT ; AND 19
455	455
456	456	(7) ENABLES ITS USE BY IN DIVIDUALS WITH DISAB ILITIES. 20
457	457
458	458	(C) THE DEPARTMENT SHALL DEVELOP AND IM PLEMENT AN OUTREACH 21
459	459	AND MARKETING PLAN T O RAISE AWARENESS OF MARYLAND MYIR MOBILE AS A 22
460	460	VOLUNTARY VACCINE PA SSPORT TECHNOLOGY TH AT MAY BE USED FOR V ERIFYING 23
461	461	PROOF OF COVID–19 VACCINATION STATUS B Y INDIVIDUALS, BUSINESSES, AND 24
462	462	OTHER PUBLI C AND PRIVATE ENTITI ES IN THE STATE. 25
463	463
464	464	19–211.1. 26
465	465
466	466	(A) IN THIS SECTION , “HOSPITAL–ADJACENT URGENT CARE CENTER” 27
467	467	MEANS ANY CENTER , SERVICE, OFFICE FACILITY, OR OTHER ENTITY THAT : 28
468	468
469	469	(1) OPERATES FOR THE PURP OSE OF PROVIDING URG ENT CARE AND 29
470	470	OTHER BASIC HEALTH CARE SERVICES , INCLUDING DIAGNOSTIC , TREATMENT , 30
471	471	CONSULTATIVE , REFERRAL, AND PREVENTIVE SERVI CES; AND 31 HOUSE BILL 1084 11
472	472
473	473
474	474
475	475	(2) IS LOCATED ADJACENT T O A FACILITY THAT PR OVIDES HOSPITAL 1
476	476	SERVICES SUBJECT TO THE RATE–SETTING JURISDICTION OF THE COMMISSION. 2
477	477
478	478	(B) A HOSPITAL–ADJACENT URGENT CARE CEN TER: 3
479	479
480	480	(1) IS NOT SUBJECT TO THE RATE–SETTING JURISDICTION OF THE 4
481	481	COMMISSION; AND 5
482	482
483	483	(2) MAY SET RATES AND REC EIVE REIMBURSEMENT F OR HEALTH 6
484	484	CARE SERVICES PROVID ED AT THE CENTER ON AN UNREGULATED BASIS . 7
485	485
486	486	19–411. 8
487	487
488	488	(b) For calendar years 2021 [and 2022], 2022, AND 2023, a home health agency 9
489	489	shall adopt and implement a COVID–19 infection control and prevention plan for patients 10
490	490	and staff who provide home health care services to patients of the home health agency. 11
491	491
492	492	19–14C–02. 12
493	493
494	494	(a) For calendar years 2021 [and 2022], 2022, AND 2023, a nursing home shall 13
495	495	adopt and implement a COVID–19 testing plan for residents of the nursing home and staff 14
496	496	who provide services to residents of the nursing home. 15
497	497
498	498	19–1815. 16
499	499
500	500	(b) For calendar years 2021 [and 2022], 2022, AND 2023, an assisted living 17
501	501	program shall adopt and implement a COVID–19 testing plan for residents of the assisted 18
502	502	living program and staff who provide services to residents of the assisted living program. 19
503	503
504	504	Article – Health Occupations 20
505	505
506	506	8–6A–05. 21
507	507
508	508	(a) The Board shall adopt regulations establishing: 22
509	509
510	510	(1) Categories of certified nursing assistants, including geriatric nursing 23
511	511	assistants, home health aides, school health aides, dialysis technicians, individuals 24
512	512	working in developmental disabilities administration facilities, and medicine aides; 25
513	513
514	514	(2) Qualifications for each category of certified nursing assistant; 26
515	515
516	516	(3) Qualifications for certified medication technicians; and 27
517	517
518	518	(4) Standards for qualification of applicants for certification, including the 28
519	519	applicant’s criminal history, work record, and prohibitions against behavior which may be 29 12 HOUSE BILL 1084
520	520
521	521
522	522	potentially harmful to patients. 1
523	523
524	524	(D) (1) IN THIS SUBSECTION , “COVID–19 PUBLIC HEALTH EMERGE NCY” 2
525	525	MEANS THE FEDERAL PU BLIC HEALTH EMERGENCY DEC LARED DURING THE 3
526	526	COVID–19 PANDEMIC THAT INCLUD ED A WAIVER OF FEDER AL NURSE AIDE 4
527	527	TRAINING AND CERTIFI CATION REQUIREMENTS ISSUED BY THE U.S. SECRETARY OF 5
528	528	HEALTH AND HUMAN SERVICES. 6
529	529
530	530	(2) THE BOARD SHALL ESTABLISH AND IMPLEMENT AN APP RENTICE 7
531	531	GERIATRIC NURSING AS SISTANT PROGRAM TO P ROVIDE FOR THE CERTI FICATION 8
532	532	OF GERIATRIC NURSING ASSISTANTS WHO HAVE WORKED OR ARE WORKIN G AS 9
533	533	TEMPORARY NURSING AS SISTANTS AND MEET TH E REQUIREMENTS UNDER THIS 10
534	534	SUBSECTION. 11
535	535
536	536	(3) THE PROGRAM REQUIRED UNDER THIS SUBSECTION SHALL 12
537	537	PROVIDE FOR THE CERT IFICATION OF A GERIA TRIC NURSING ASSISTA NT WHO: 13
538	538
539	539	(I) 1. WORKED FULL – OR PART–TIME AS A TEMPORARY 14
540	540	NURSING ASSISTANT FO R AT LEAST 6 MONTHS DURING THE COVID–19 PUBLIC 15
541	541	HEALTH EMERGENCY ; 16
542	542
543	543	2. COMPLETES TRAINING AN D C OMPETENCY 17
544	544	REQUIREMENTS THROUGH WORK AS A TEMPORARY NURSING ASSISTANT UN DER A 18
545	545	DESIGNATION AS AN AP PRENTICE NURSING ASS ISTANT IN ACCORDANCE WITH 19
546	546	FEDERAL NURSE AIDE TRAINING AND COMPETENCY EVALUATION PROGRAM 20
547	547	REQUIREMENTS ; AND 21
548	548
549	549	3. PASSES THE STATE COMPETEN CY EXAMINATION ; OR 22
550	550
551	551	(II) DID NOT WORK DURING T HE COVID–19 PUBLIC HEALTH 23
552	552	EMERGENCY , BUT COMPLETES A NURS ING ASSISTANT APPREN TICESHIP PATHWAY 24
553	553	THAT: 25
554	554
555	555	1. ALLOWS PARTICIPANTS T O WORK AS A TEMPORAR Y 26
556	556	NURSING ASSISTANT FO R 4 MONTHS; 27
557	557
558	558	2. REQUIRES THE RE CEIPT OF A TOTAL OF 40 HOURS OF 28
559	559	CLASSROOM AND CLINIC AL TRAINING IN ACCOR DANCE WITH FEDERAL NURSE AIDE 29
560	560	TRAINING AND COMPETENCY EVALUATION PROGRAM REQUIREMENTS ; AND 30
561	561
562	562	3. REQUIRES PASSAGE OF T HE STATE’S COMPETENCY 31
563	563	EXAMINATION . 32
564	564	HOUSE BILL 1084 13
565	565
566	566
567	567	(4) THE BOARD SHALL ADOPT REGULATIONS TO CARRY OUT THE 1
568	568	PROVISIONS OF THIS S UBSECTION. 2
569	569
570	570	12–101. 3
571	571
572	572	(g) (1) “Delegated pharmacy act” means an activity that constitutes the 4
573	573	practice of pharmacy delegated by a licensed pharmacist under this title and regulations 5
574	574	adopted by the Board. 6
575	575
576	576	(2) “Delegated pharmacy act” does not include: 7
577	577
578	578	(i) An act within the parameters of a therapy management contract 8
579	579	as provided under Subtitle 6A of this title; 9
580	580
581	581	[(ii) The administration of an influenza vaccination in accordance 10
582	582	with § 12–508 of this title;] 11
583	583
584	584	[(iii)] (II) The delegation of a pharmacy act by a registered 12
585	585	pharmacy technician, pharmacy student, or pharmacy technician trainee; 13
586	586
587	587	[(iv)] (III) A pharmacy activity performed by a pharmacy student in 14
588	588	accordance with § 12–301(b) of this title; 15
589	589
590	590	[(v)] (IV) A pharmacy activity performed by an applicant for a 16
591	591	license to practice pharmacy in accordance with regulations adopted by the Board; or 17
592	592
593	593	[(vi)] (V) The performance of other functions prohibited in 18
594	594	regulations adopted by the Board. 19
595	595
596	596	(i) (1) “Direct supervision” means [that a licensed pharmacist is physically 20
597	597	available, notwithstanding appropriate breaks, on–site and in the prescription area or in 21
598	598	an area where pharmacy services are provided to supervise the practice of pharmacy and 22
599	599	delegated pharmacy acts] SUPERVISION BY A LIC ENSED PHARMACIST WHO : 23
600	600
601	601	(I) IS READILY AND IMMEDI ATELY AVAILABLE AT A LL TIMES 24
602	602	THE DELEGATED TASKS ARE BEING PERFORMED ; 25
603	603
604	604	(II) IS AWARE OF THE DELEG ATED TASKS BEING PER FORMED; 26
605	605	AND 27
606	606
607	607	(III) PROVIDES PERSONAL ASSISTANCE, DIRECTION, AND 28
608	608	APPROVAL THROUGHOUT THE TIME THE DELEGAT ED TASKS ARE BEING 29
609	609	PERFORMED . 30
610	610
611	611	(2) “DIRECT SUPERVISION ” INCLUDES SUPERVISION OF A PHARMACY 31 14 HOUSE BILL 1084
612	612
613	613
614	614	TECHNICIAN THROUGH T ECHNOLOGICAL MEANS . 1
615	615
616	616	12–506. 2
617	617
618	618	(a) A pharmacist may refill a prescription for a drug or device for which the refill 3
619	619	has not been authorized if: 4
620	620
621	621	(1) The pharmacist: 5
622	622
623	623	(i) Attempts to obtain an authorization from the authorized 6
624	624	prescriber; and 7
625	625
626	626	(ii) Is not able readily to obtain the authorization; 8
627	627
628	628	(2) The refill of the prescription is not for a controlled dangerous substance; 9
629	629
630	630	(3) The drug or device is essential to the maintenance of [life] PATIENT 10
631	631	WELL–BEING; 11
632	632
633	633	(4) (i) The drug or device is essential to the continuation of therapy [in 12
634	634	chronic conditions]; and 13
635	635
636	636	(ii) In the pharmacist’s professional judgment, the interruption of 14
637	637	the therapy reasonably might produce an undesirable health consequence, be detrimental 15
638	638	to the patient’s welfare, or cause physical or mental discomfort; 16
639	639
640	640	(5) The pharmacist: 17
641	641
642	642	(i) Enters on the back of the prescription or on another appropriate 18
643	643	uniformly maintained, readily retrievable record, such as a medication record, the date and 19
644	644	the quantity of the drug or device dispensed; and 20
645	645
646	646	(ii) Signs or initials the record; and 21
647	647
648	648	(6) The pharmacist notifies the authorized prescriber of the refill of the 22
649	649	prescription within 72 hours of dispensing the drug or device. 23
650	650
651	651	(b) If a pharmacist refills a prescription under subsection (a) of this section, the 24
652	652	pharmacist may provide only [1] ONE refill of the prescription and the refill quantity 25
653	653	dispensed shall be in conformity with the prescriber’s directions for use and may not exceed 26
654	654	a [14–day] 30–DAY supply or unit of use. 27
655	655
656	656	(c) If the federal or a state government declares a state of emergency, a 28
657	657	pharmacist working in Maryland may refill a prescription for a drug for which the refill 29
658	658	has not been authorized if: 30
659	659	HOUSE BILL 1084 15
660	660
661	661
662	662	(1) As a result of the emergency, the pharmacist is unable to obtain an 1
663	663	authorization from the authorized prescriber; 2
664	664
665	665	(2) The refill of the prescription is not for a controlled dangerous substance; 3
666	666
667	667	(3) The quantity dispensed does not exceed a [30–day] 90–DAY supply or 4
668	668	unit of use; and 5
669	669
670	670	(4) The pharmacist notifies the authorized prescriber of the refill of the 6
671	671	prescription within 7 days of dispensing the drug. 7
672	672
673	673	12–508. 8
674	674
675	675	[(a) (1) Subject to subsection (c) of this section, a pharmacist may administer 9
676	676	an influenza vaccination to an individual who is at least 9 years old, in accordance with 10
677	677	regulations adopted by the Board, in consultation with the Department. 11
678	678
679	679	(2) Subject to subsection (c) of this section, a pharmacist may administer a 12
680	680	vaccination that is listed in the Centers for Disease Control and Prevention’s Recommended 13
681	681	Immunization Schedule to an individual who: 14
682	682
683	683	(i) Is at least 11 years old but under the age of 18 years; and 15
684	684
685	685	(ii) Has a prescription from an authorized prescriber. 16
686	686
687	687	(3) (i) Subject to subparagraph (ii) of this paragraph, a pharmacist may 17
688	688	administer to an adult a vaccination that is: 18
689	689
690	690	1. Listed in the Centers for Disease Control and Prevention’s 19
691	691	Recommended Immunization Schedule; or 20
692	692
693	693	2. Recommended in the Centers for Disease Control and 21
694	694	Prevention’s Health Information for International Travel. 22
695	695
696	696	(ii) A pharmacist shall administer a vaccination under 23
697	697	subparagraph (i) of this paragraph under a written protocol that: 24
698	698
699	699	1. Is vaccine specific; and 25
700	700
701	701	2. Meets criteria established by the Department, in 26
702	702	consultation with the Board, the Board of Physicians, and the Board of Nursing, in 27
703	703	regulation. 28
704	704
705	705	(4) A pharmacist shall: 29
706	706
707	707	(i) Report all vaccinations administered by the pharmacist to the 30
708	708	ImmuNet Program established under § 18–109 of the Health – General Article; 31 16 HOUSE BILL 1084
709	709
710	710
711	711
712	712	(ii) If the vaccination has been administered in accordance with a 1
713	713	prescription, document at least one effort to inform the individual’s authorized prescriber 2
714	714	that the vaccination has been administered; and 3
715	715
716	716	(iii) For a vaccination administered under paragraph (2) or (3) of this 4
717	717	subsection, if the authorized prescriber is not the individual’s primary care provider or if 5
718	718	the vaccination has not been administered in accordance with a prescription, document at 6
719	719	least one effort to inform the individual’s primary care provider or other usual source of 7
720	720	care that the vaccination has been administered. 8
721	721
722	722	(b) The Board shall: 9
723	723
724	724	(1) Set reasonable fees for the administration of vaccinations under this 10
725	725	section; and 11
726	726
727	727	(2) Adopt regulations that require a pharmacist to submit a registration 12
728	728	form to the Board that includes verification that the pharmacist: 13
729	729
730	730	(i) Has successfully completed a certification course approved by the 14
731	731	Board that included instruction in the guidelines and recommendations of the Centers for 15
732	732	Disease Control and Prevention regarding vaccinations; and 16
733	733
734	734	(ii) Is certified in basic cardiopulmonary resuscitation and obtained 17
735	735	the certification through in–person classroom instruction.] 18
736	736
737	737	[(c)] (A) [From July 1, 2021, to June 30, 2023, inclusive, a] A pharmacist may 19
738	738	ORDER AND administer a vaccine to an individual who is at least 3 years old [but under 20
739	739	the age of 18 years] if: 21
740	740
741	741	(1) The vaccine is approved by the U.S. Food and Drug Administration; 22
742	742
743	743	(2) The vaccination is ordered and administered in accordance with the 23
744	744	Centers for Disease Control and Prevention’s Advisory Committee on Immunization 24
745	745	Practices immunization schedules; 25
746	746
747	747	(3) The pharmacist has completed a practical training program of at least 26
748	748	20 hours that is approved by the Accreditation Council for Pharmacy Education and 27
749	749	includes: 28
750	750
751	751	(i) Hands–on injection techniques; 29
752	752
753	753	(ii) Clinical evaluation of indications and contraindications of 30
754	754	vaccines; and 31
755	755
756	756	(iii) The recognition and treatment of emergency reactions to 32
757	757	vaccines; 33 HOUSE BILL 1084 17
758	758
759	759
760	760
761	761	(4) The pharmacist has a current certificate in basic cardiopulmonary 1
762	762	resuscitation; 2
763	763
764	764	(5) The pharmacist has completed a minimum of 2 hours of continuing 3
765	765	pharmaceutical education related to immunizations that is approved by the Accreditation 4
766	766	Council for Pharmacy Education as part of the license renewal requirements under § 5
767	767	12–309 of this title; 6
768	768
769	769	(6) The pharmacist complies with the FOLLOWING record–keeping and 7
770	770	reporting requirements [in subsection (a)(4) of this section] and the corresponding 8
771	771	regulations: 9
772	772
773	773	(I) REPORT ALL VACCINATIO NS ADMINISTERED TO T HE 10
774	774	IMMUNET PROGRAM E STABLISHED UNDER § 18–109 OF THE HEALTH – GENERAL 11
775	775	ARTICLE; 12
776	776
777	777	(II) IF THE VACCINATION HA S BEEN ADMINISTERED IN 13
778	778	ACCORDANCE WITH A PR ESCRIPTION, DOCUMENT AT LEAST ON E EFFORT TO 14
779	779	INFORM THE INDIVIDUA L’S AUTHORIZED PRESCRI BER THAT THE VACCINA TION HAS 15
780	780	BEEN ADMINISTERED; AND 16
781	781
782	782	(III) FOR A VACCINATION IN WHICH THE AUTHORIZED 17
783	783	PRESCRIBER IS NOT TH E INDIVIDUAL’S PRIMARY CARE PROVI DER OR IF THE 18
784	784	VACCINATION HAS NOT BEEN ADMINISTERED IN ACCORDANCE WITH A 19
785	785	PRESCRIPTION , DOCUMENT AT LEAST ON E EFFORT TO INFORM T HE INDIVIDUAL’S 20
786	786	PRIMARY CARE PROVIDE R OR OTHER USUAL SOU RCE OF CARE THAT THE 21
787	787	VACCINATION HAS BEEN ADMINISTERED ; and 22
788	788
789	789	(7) The pharmacist informs each child vaccination patient and adult 23
790	790	caregiver who is accompanying the child of the importance of well–child visits with a 24
791	791	pediatric primary care provider and refers the patient to a pediatric primary care provider 25
792	792	when appropriate. 26
793	793
794	794	(B) A PHARMACIST MAY DELEG ATE THE ADMINISTRATI ON OF A VACCINE 27
795	795	UNDER SUBSECTION (A) OF THIS SECTION TO A PHARMACY TECHNICIAN IF THE 28
796	796	PHARMACY TECHNICIAN HAS CO MPLETED A PRACTICAL TRAINING PROGRAM OF AT 29
797	797	LEAST 6 HOURS THAT IS APPROV ED BY THE ACCREDITAT ION COUNCIL FOR 30
798	798	PHARMACY EDUCATION A ND INCLUDES: 31
799	799
800	800	(1) HANDS–ON INJECTION TECHNIQ UES; AND 32
801	801
802	802	(2) THE RECOGNITION AND T REATMENT OF EMERGENC Y REACTIONS 33
803	803	TO VACCINES. 34 18 HOUSE BILL 1084
804	804
805	805
806	806
807	807	12–6B–06. 1
808	808
809	809	(a) Registration authorizes a registered pharmacist technician to perform 2
810	810	delegated pharmacy acts as defined in § 12–101 of this title while the registration is 3
811	811	effective. 4
812	812
813	813	(b) A registered pharmacy technician or a pharmacy technician trainee may not: 5
814	814
815	815	(1) Act within the parameters of a therapy management contract as 6
816	816	provided under Subtitle 6A of this title; 7
817	817
818	818	[(2) Administer an influenza vaccination in accordance with § 12–508 of this 8
819	819	title;] 9
820	820
821	821	[(3)] (2) Delegate a pharmacy act that was delegated to the registered 10
822	822	pharmacy technician or individual engaging in a Board approved technician training 11
823	823	program; or 12
824	824
825	825	[(4)] (3) Perform other functions prohibited by regulations adopted by the 13
826	826	Board. 14
827	827
828	828	Chapter 29 of the Acts of the 2021 Special Session 15
829	829
830	830	SECTION 5. AND BE IT FURTHER ENACTED, That this Act is an emergency 16
831	831	measure, is necessary for the immediate preservation of the public health or safety, has 17
832	832	been passed by a yea and nay vote supported by three–fifths of all the members elected to 18
833	833	each of the two Houses of the General Assembly, and shall take effect from the date it is 19
834	834	enacted. Section 2 of this Act shall remain effective through December 31, [2022] 2023, 20
835	835	and, at the end of December 31, [2022] 2023, Section 2 of this Act, with no further action 21
836	836	required by the General Assembly, shall be abrogated and of no further force and effect. 22
837	837
838	838	Chapter 31 of the Acts of the 2021 Special Session 23
839	839
840	840	SECTION 5. AND BE IT FURTHER ENACTED, That this Act is an emergency 24
841	841	measure, is necessary for the immediate preservation of the public health or safety, has 25
842	842	been passed by a yea and nay vote supported by three–fifths of all the members elected to 26
843	843	each of the two House of the General Assembly, and shall take effect from the date it is 27
844	844	enacted. Section 2 of this Act shall remain effective through December 31, [2022] 2023, 28
845	845	and, at the end of December 31, [2022] 2023, Section 2 of this Act, with no further action 29
846	846	required by the General Assembly, shall be abrogated and of no further force and effect. 30
847	847
848	848	SECTION 2. AND BE IT FURTHER ENACTED, That the Maryland Department of 31
849	849	Health shall: 32
850	850
851	851	(1) (i) conduct a study on the use of digital learning programs for 33 HOUSE BILL 1084 19
852	852
853	853
854	854	education and training requirements for health care practitioners in the State applying for 1
855	855	a license, certification, registration, or permit or the renewal of a license or permit; 2
856	856
857	857	(ii) in conjunction with the Maryland Department of Labor, study 3
858	858	multiyear approaches to reducing the workforce shortage in health care in the State; 4
859	859
860	860	(iii) with participation from the Office of Health Care Quality and the 5
861	861	State Board of Nursing, collaborate with other State agencies, including the State 6
862	862	Department of Education, health care industry and association stakeholders, community 7
863	863	colleges, higher education institutions, and high schools, to develop explicit workforce 8
864	864	career paths from high school and higher education apprenticeships to higher education 9
865	865	enrollment for entry into a health care field; and 10
866	866
867	867	(iv) on or before December 31, 2022, report to the General Assembly, 11
868	868	in accordance with § 2–1257 of the State Government Article, on the findings of the studies 12
869	869	and development of career paths required under this item; and 13
870	870
871	871	(2) on or before December 31, 2022, submit an update to the report required 14
872	872	under Section 2 of Chapter 798 of the Acts of the General Assembly of 2018, relating to 15
873	873	reimbursement rates and costs of certain home– and community–based services to the 16
874	874	General Assembly, in accordance with § 2–1257 of the State Government Article. 17
875	875
876	876	SECTION 3. AND BE IT FURTHER ENACTED, That this Act is an emergency 18
877	877	measure, is necessary for the immediate perseveration of the public health or safety, has 19
878	878	been passed by a yea and nay vote supported by three–fifths of all the members elected to 20
879	879	each of the two Houses of the General Assembly, and shall take effect from the date it is 21
880	880	enacted. 22
881	881