EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1084*
HOUSE BILL 1084
J1, J3, J2 EMERGENCY BILL 2lr1575
CF SB 840
By: Delegate Pena–Melnyk
Introduced and read first time: February 10, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
COVID–19 Response Act of 2022 2
FOR the purpose of establishing and altering certain requirements related to COVID–19, 3
including requirements related to planning by institutions of higher education, home 4
health agencies, nursing homes, and assisted living programs, the provision of 5
coverage by the Maryland Medical Assistance Program, the Maryland MyIR Mobile 6
immunization record service, and reporting by the Maryland Department of Health; 7
establishing that certain urgent care centers are not subject to the rate–setting 8
jurisdiction of the Health Services Cost Review Commission; requiring the State 9
Board of Nursing to establish an apprentice geriatric nursing assistant program; 10
altering the authority of pharmacists to refill prescriptions, administer certain 11
vaccines, and delegate certain functions to pharmacy technicians; and generally 12
relating to public health, the provision of health care services, and responding to 13
COVID–19 in the State. 14
BY repealing and reenacting, with amendments, 15
Article – Education 16
Section 11–1702(a) 17
Annotated Code of Maryland 18
(2018 Replacement Volume and 2021 Supplement) 19
(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 20
Special Session) 21
BY repealing and reenacting, without amendments, 22
Article – Health – General 23
Section 15–103(a)(1) 24
Annotated Code of Maryland 25
(2019 Replacement Volume and 2021 Supplement) 26
BY repealing and reenacting, with amendments, 27
Article – Health – General 28 2 HOUSE BILL 1084
Section 15–103(a)(2)(xvi) and (xvii) 1
Annotated Code of Maryland 2
(2019 Replacement Volume and 2021 Supplement) 3
BY adding to 4
Article – Health – General 5
Section 15–103(a)(2)(xviii), 18–9A–02(g), 18–9A–03(d), 18–9A–03.1, 18–9A–03.2, 6
18–9A–05, and 19–211.1 7
Annotated Code of Maryland 8
(2019 Replacement Volume and 2021 Supplement) 9
BY repealing and reenacting, without amendments, 10
Article – Health – General 11
Section 18–9A–02(a) and (b), 18–9A–03(a), and 18–9A–04(a) and (b) 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2021 Supplement) 14
(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 15
Special Session) 16
BY repealing and reenacting, with amendments, 17
Article – Health – General 18
Section 18–9A–04(c), 19–411(b), 19–14C–02(a), and 19–1815(b) 19
Annotated Code of Maryland 20
(2019 Replacement Volume and 2021 Supplement) 21
(As enacted by Chapters 29 and 31 of the Acts of the General Assembly of the 2021 22
Special Session) 23
BY repealing and reenacting, without amendments, 24
Article – Health Occupations 25
Section 8–6A–05(a) 26
Annotated Code of Maryland 27
(2021 Replacement Volume) 28
BY adding to 29
Article – Health Occupations 30
Section 8–6A–05(d) 31
Annotated Code of Maryland 32
(2021 Replacement Volume) 33
BY repealing and reenacting, with amendments, 34
Article – Health Occupations 35
Section 12–101(g) and (i), 12–506, 12–508, and 12–6B–06 36
Annotated Code of Maryland 37
(2021 Replacement Volume) 38
BY repealing and reenacting, with amendments, 39
Chapter 29 of the Acts of the General Assembly of the 2021 Special Session 40 HOUSE BILL 1084 3
Section 5 1
BY repealing and reenacting, with amendments, 2
Chapter 31 of the Acts of the General Assembly of the 2021 Special Session 3
Section 5 4
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5
That the Laws of Maryland read as follows: 6
Article – Education 7
11–1702. 8
(a) For calendar [year] YEARS 2021, 2022, AND 2023, an institution of higher 9
education that has residence halls for students shall establish a COVID–19 security plan 10
that includes both screening and testing procedures that will keep students, faculty, and 11
staff safe while on campus for face–to–face instruction during the pandemic. 12
Article – Health – General 13
15–103. 14
(a) (1) The Secretary shall administer the Maryland Medical Assistance 15
Program. 16
(2) The Program: 17
(xvi) Beginning on January 1, 2021, shall provide, subject to the 18
limitations of the State budget and § 15–855(b)(2) of the Insurance Article, and as permitted 19
by federal law, services for pediatric autoimmune neuropsychiatric disorders associated 20
with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, 21
including the use of intravenous immunoglobulin therapy, for eligible Program recipients, 22
if pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections 23
and pediatric acute onset neuropsychiatric syndrome are coded for billing and diagnosis 24
purposes in accordance with § 15–855(d) of the Insurance Article; [and] 25
(xvii) Beginning on January 1, 2022, may not include, subject to federal 26
approval and limitations of the State budget, a frequency limitation on covered dental 27
prophylaxis care or oral health exams that requires the dental prophylaxis care or oral 28
health exams to be provided at an interval greater than 120 days within a plan year; AND 29
(XVIII) SHALL PROVIDE COVERAG E FOR COVID–19 TESTS 30
AND RELATED SERVICES FOR THE ADMINISTRATI ON OF COVID–19 TESTS TO 31
UNINSURED INDIVIDUAL S, AS AUTHORIZED BY THE FEDERAL FAMILIES FIRST 32
CORONAVIRUS RESPONSE ACT AND THE CORONAVIRUS AID, RELIEF, AND 33
ECONOMIC SECURITY (CARES) ACT. 34 4 HOUSE BILL 1084
18–9A–02. 1
(a) On or before June 1, 2021, the Department, in collaboration with local health 2
departments in the State and the Maryland State Department of Education, shall adopt 3
and implement a 2–year plan to respond to the outbreak of COVID–19. 4
(b) The plan required under this section shall: 5
(1) Include measures to enhance public health efforts at the State and local 6
level to monitor, prevent, and mitigate the spread of COVID–19; 7
(2) (i) Assess the COVID–19 public and private testing infrastructure 8
in place both statewide and in each local jurisdiction; 9
(ii) Identify and address the unmet needs for COVID–19 testing 10
statewide and in each local jurisdiction, including the number and location of public and 11
private testing providers required to ensure access to testing on demand for all residents of 12
the State; 13
(iii) Establish specific monthly goals for COVID–19 testing statewide 14
and in each local jurisdiction to ensure access to testing for all residents of the State, 15
including: 16
1. A goal to achieve the capacity to perform the surveillance 17
testing required to safely reopen and keep open schools, institutions of higher education, 18
workplaces, and other community facilities in the State while minimizing the community 19
spread of COVID–19 in calendar years 2021, and 2022, through a network of public and 20
private testing providers; and 21
2. For each local jurisdiction, a goal to establish the required 22
number of public or private COVID–19 testing locations to achieve the surveillance testing 23
goal described in item 1 of this item; and 24
(iv) Estimate the funding required to implement the surveillance 25
testing goal described in item (iii)1 of this item and the extent to which federal funding 26
already received by the State in fiscal year 2021, and federal funding that is provided to 27
the State and received after March 1, 2021, can be used to cover the cost required to achieve 28
that goal; 29
(3) (i) Assess the contact tracing infrastructure in place for COVID–19 30
both statewide and in each local jurisdiction; 31
(ii) Determine the optimal number of contact tracing, case 32
management, care resource coordination, and other personnel per 100,000 residents needed 33
in each jurisdiction to effectively monitor, prevent, and mitigate the spread of COVID–19; 34
HOUSE BILL 1084 5
(iii) Identify and address the unmet needs for COVID–19 contact 1
tracing and related outbreak prevention and mitigation efforts both statewide and in each 2
local jurisdiction; and 3
(iv) 1. Establish goals for identifying, locating, and testing 4
individuals who have been in close contact with individuals who test positive for 5
COVID–19 that are in alignment with Centers for Disease Control and Prevention guidance 6
for effective contact tracing programs; and 7
2. Include a mechanism for monitoring performance of 8
contact tracing and testing of contacts both statewide and for each local jurisdiction; 9
(4) Require the Department to assist local jurisdictions that adopt 10
strategies to: 11
(i) Accelerate access to and the use of at–home collection and 12
point–of–care tests for COVID–19; and 13
(ii) Incentivize and encourage pharmacies and health care providers, 14
including primary care providers, to provide COVID–19 testing; and 15
(5) Allow each local jurisdiction to establish and implement a program for 16
COVID–19 contact tracing that is independent from the contact tracing program performed 17
by the State or the entity with whom the State has contracted to perform contact tracing 18
for the State. 19
(G) ON OR BEFORE JUNE 1, 2022, THE DEPARTMEN T, IN COLLABORATION 20
WITH LOCAL HEALTH DE PARTMENTS IN THE STATE AND THE STATE DEPARTMENT 21
OF EDUCATION, SHALL DEVELOP AND SU BMIT TO THE GENERAL ASSEMBLY, IN 22
ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, AN UPDATE TO 23
THE PLAN REQUIRED UN DER THIS SECTION THAT INCLUDES : 24
(1) SUBJECT TO ITEMS (2) THROUGH (5) OF THIS SUBSECTION , THE 25
INFORMATION DESCRIBE D IN SUBSECTION (B) FOR CALENDAR YEARS 2022, AND 26
2023; 27
(2) (I) SPECIFIC MONTHLY GOAL S STATEWIDE AND IN E ACH LOCAL 28
JURISDICTION TO ACHI EVE THE CAPAC ITY TO PERFORM DIAGN OSTIC TESTING AND 29
SCREENING TESTING RE QUIRED TO SAFELY REO PEN AND KEEP OPEN SC HOOLS, 30
INSTITUTIONS OF HIGH ER EDUCATION , WORKPLACES , AND OTHER COMMUNITY 31
FACILITIES IN THE STATE WHILE MINIMIZIN G THE COMMUNITY SPRE AD OF 32
COVID–19 IN CALENDAR YEARS 2022, AND 2023, THROUGH A NETWORK OF PUBLIC 33
AND PRIVATE TESTING PROVIDERS; 34
(II) MONTHLY GOALS TO ESTA BLISH THE REQUIRED N UMBER 35 6 HOUSE BILL 1084
OF PUBLIC OR PRIVATE COVID–19 TESTING LOCATIONS TO ACHIEVE THE TESTING 1
GOALS DESCRIBED IN I TEM (I) OF THIS ITEM; AND 2
(III) AN ESTIMATE OF THE FU NDING REQUIRED TO IM PLEMENT 3
THE TESTING GOALS DE SCRIBED IN ITEMS (I) AND (II) OF THIS ITEM AND TO THE 4
EXTENT TO WHICH FEDE RAL FUNDING ALREADY RECEIVED BY THE STATE IN FISCAL 5
YEAR 2022, AND FEDERAL FUNDING THAT IS PROVIDED TO THE STATE AND 6
RECEIVED IN SUBSEQUE NT FISCAL YEARS , CAN BE USED TO COVER THE COST 7
REQUIRED TO ACHIEVE THESE GOALS; 8
(3) A REQUIREMENT THAT THE DEPARTMENT KEEP TRACK OF THE 9
QUANTITY OF COVID–19 TESTS THAT IT WILL H AVE AVAILABLE FOR DI STRIBUTION 10
AND WHEN T HE TESTS WILL BE AVA ILABLE FOR DISTRIBUT ION; 11
(4) A METHOD FOR RESIDENTS OF THE STATE TO SELF –REPORT 12
POSITIVE COVID–19 TEST RESULTS TO THE DEPARTMENT ; AND 13
(5) FOR CALENDAR YEARS 2022, AND 2023, THE OPTIMAL NUMBER 14
OF CONTACT TRACING , CASE MANAGEMENT , CARE RESOURCE COORDIN ATION, AND 15
OTHER PERSONNEL PER 100,000 RESIDENTS NEEDED IN EACH JURISDICTION 16
DURING PERIODS OF SU RGES AND NONSURGES O F COVID–19 CASES IN THE STATE. 17
18–9A–03. 18
(a) (1) On or before June 1, 2021, the Department, with input from subject 19
matter experts and other relevant stakeholders, shall develop and submit to the General 20
Assembly a comprehensive plan for vaccinating residents of the State against COVID–19. 21
(2) The plan required under paragraph (1) of this subsection shall include: 22
(i) Detailed information on: 23
1. The categories of residents of the State who will receive 24
priority access to vaccines for COVID–19; 25
2. The timeline for providing vaccines for COVID–19 to 26
residents in each of the priority categories and to members of the general public who are 27
not included in priority categories; and 28
3. Target metrics for vaccinating residents in each of the 29
priority categories and for members of the general public who are not included in priority 30
categories; 31
(ii) A dedication of time and resources to target vaccine distribution 32
and vaccine safety outreach efforts to communities that have been disproportionately 33 HOUSE BILL 1084 7
impacted by COVID–19 infection, morbidity, and mortality; 1
(iii) A vaccine distribution strategy that allocates resources and 2
vaccines across all partners and vaccination sites in an equitable manner that ensures that 3
the vaccine allocation by jurisdiction accounts for the disproportionate impact of the 4
COVID–19 pandemic on underserved and minority communities; and 5
(iv) A strategy for outreach and distribution of vaccines to 6
individuals who are not receiving the vaccine, due to either lack of access or vaccine 7
hesitancy. 8
(D) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL DEVE LOP AND 9
SUBMIT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH § 2–1257 OF THE 10
STATE GOVERNMENT ARTICLE, AN UPDATE TO THE PLA N REQUIRED UNDER THI S 11
SECTION THAT INCLUDE S: 12
(1) SUBJECT TO ITEMS (2) THROUGH (5) OF THIS SUBSECTION , THE 13
INFORMATION DESCRIBE D IN SUBSECTION (A) OF THIS SECTION FOR CALENDAR 14
YEARS 2022 AND 2023; 15
(2) A REQUIREMENT THAT THE DEPARTMENT KEEP TRACK OF THE 16
QUANTITY OF COVID–19 VACCINES IT WILL HAV E AVAILABLE FOR 17
ADMINISTRATION AND W HEN THE VACCINES WIL L BE AVAILABLE FOR 18
ADMINISTRATION ; 19
(3) RECOMMENDATIONS FO R APPROACHES THE MARYLAND 20
MEDICAL ASSISTANCE PROGRAM CAN TAKE TO I NCENTIVIZE: 21
(I) HEALTH CARE PROVIDER VACCINATION EFFORTS ; 22
(II) VACCINATION AMONG MARYLAND MEDICAL ASSISTANCE 23
PROGRAM RECIPIENTS ; AND 24
(III) MANAGED CARE ORGANIZA TIONS TO DEVELOP AND MEET 25
VACCINATION TARGETS ; 26
(4) MEASURES TO INCREASE VACCINATION RATES AM ONG THE 27
UNVACCINATED ; AND 28
(5) A STRATEGY TO INCENTIV IZE ELIGIBLE INDIVID UALS TO 29
RECEIVE: 30
(I) A THIRD COVID–19 VACCINE DOSE ; AND 31
8 HOUSE BILL 1084
(II) ANY FUTURE VACCINES R ECOMMENDED B Y THE CENTERS 1
FOR DISEASE CONTROL AND PREVENTION. 2
18–9A–03.1. 3
(A) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT , WITH INPUT FROM 4
SUBJECT MATTER EXPER TS AND OTHER RELEVAN T STAKEHOLDERS , SHALL 5
DEVELOP A COMPREHENS IVE PLAN FOR TREATIN G RESIDENTS OF THE STATE WHO 6
HAVE COVID–19. 7
(B) THE PLAN REQUIRED UND ER THIS SECTION SHAL L: 8
(1) (I) IDENTIFY EFFECTIVE TR EATMENTS FOR TREATIN G 9
COVID–19; AND 10
(II) ASSESS THE EFFECTIVEN ESS OF MONOCLONAL AN TIBODIES 11
AND ORALLY ADMINISTE RED ANTIVIRAL MEDICA TIONS IN TREATING COVID–19; 12
AND 13
(2) (I) RECOMMEND THE EFFICIE NT AND EFFECTIVE 14
DISTRIBUTION OF COVID–19 TREATMENTS TO ENSURE THAT THERE IS ACCESS TO 15
TREATMENT FOR RESIDE NTS OF THE STATE WHO HAVE COVID–19; AND 16
(II) CONSIDER THE AT –HOME DISTRIBUTION OF COVID–19 17
TREATMEN TS. 18
(C) THE PLAN REQUIRED UND ER THIS SECTION SHAL L ADDRESS THE 19
DISPROPORTIONATE IMP ACT OF THE COVID–19 PANDEMIC ON UNDERSER VED AND 20
MINORITY COMMUNITIES IN THE STATE. 21
(D) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL SUBM IT THE 22
PLAN REQUIRED UNDER THIS SECTION TO THE GENERAL ASSEMBLY, IN 23
ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE. 24
18–9A–03.2. 25
AFTER SUBMITTING THE COVID–19 PLANS TO THE GENERAL ASSEMBLY AS 26
REQUIRED UNDER §§ 18–9A–02 THROUGH 18–9A–03.1 OF THIS SUBTITLE , THE 27
DEPARTMENT SHA LL PROVIDE MONTHLY P ROGRESS REPORTS TO T HE GENERAL 28
ASSEMBLY FOR THE DURA TION OF CALENDAR YEA R 2022 AND CALENDAR YEAR 29
2023 ON: 30
(1) THE IMPLEMENTATION OF THE COVID–19 PLANS REQUIRED 31 HOUSE BILL 1084 9
UNDER §§ 18–9A–02 THROUGH 18–9A–03.1 OF THIS SUBTITLE; AND 1
(2) THE NUMBER OF COVID–19 TESTS, VACCINES, AND TREATMENTS 2
IT HAS AT ITS DISPOS AL. 3
18–9A–04. 4
(a) The Department shall convene a Maryland Public Health Modernization 5
Workgroup. 6
(b) The Workgroup shall include representatives of the Department, local health 7
departments, subject matter experts, and any other relevant stakeholders. 8
(c) The Workgroup shall: 9
(1) Assess the current public health infrastructure and resources in the 10
State; 11
(2) Make recommendations for how to establish a modern and effective 12
public health system with a capacity to: 13
(i) Monitor, prevent, control, and mitigate the spread of infectious 14
disease; and 15
(ii) Achieve State Health Improvement Process goals; 16
(3) Make recommendations regarding the establishment of a Maryland 17
Public Health Job Corps to respond to the outbreak of COVID–19 or similar outbreaks; and 18
(4) Consider, where appropriate, the use of federal funds to implement any 19
recommendations made under this subsection, INCLUDING FROM AMERICORPS AND ITS 20
GRANT PROGRAM FOR ELIGIBLE ORGANIZ ATIONS TO ENGAGE AMERICORPS 21
MEMBERS IN SPECIFIED PRACTICES TO RESPOND TO PUBLIC HEALTH NEE DS. 22
18–9A–05. 23
(A) IN THIS SECTION , “MARYLAND MYIR MOBILE” MEANS THE STATE 24
IMMUNIZATION RECORD SERVICE THAT PROVIDE S AN INDIVIDUAL WITH : 25
(1) ACCESS TO THE INDIVID UAL’S OFFICIAL STATE IMMUNIZATION 26
RECORDS; AND 27
(2) THE ABILITY TO VOLUNT ARILY AND SECURELY D ISPLAY ON AND 28
TRANSMIT THROUGH A M OBILE DEVICE PROOF O F THE INDIVIDUAL ’S VACCINATION 29
FOR COVID–19 USING A SMART HEALTH CARD QR CODE. 30 10 HOUSE BILL 1084
(B) ON OR BEFORE JUNE 1, 2022, THE DEPARTMENT SHALL ENSU RE THAT 1
MARYLAND MYIR MOBILE HAS A DESIGN T HAT: 2
(1) ENABLES ITS VOLUNTARY USE AS A VACCINE PAS SPORT FOR 3
INDIVIDUALS WHO SEEK TO DISPLAY PROOF OF THE INDIVIDUAL ’S COVID–19 4
VACCINATION STATUS O N A MOBILE DEVICE TO ACCESS VEN UES WHERE PROOF OF 5
COVID–19 VACCINATION IS REQUI RED FOR ENTRY ; 6
(2) USES A MOBILE APPLICA TION THAT IS COMPATI BLE WITH ALL 7
MOBILE DEVICES IN WI DESPREAD USE , INCLUDING IOS AND ANDROID COMPATIBLE 8
APPLICATIONS; 9
(3) IS ABLE TO AUTOMATI CALLY DISPLAY A SMART HEALTH CARD 10
QR CODE IN A WALLET FUN CTION ON ANY MOBILE DEVICE THAT HAS THAT 11
FUNCTION; 12
(4) HAS A SMART HEALTH CARD QR CODE THAT IS VERIFIE D AS 13
VALID UNDER COMMONTRUST NETWORK REQUIREMENTS FOR MULTISTATE 14
FUNCTIONALITY ; 15
(5) IS COMPATIBLE WITH MULTINAT IONAL VACCINE PASSPO RT 16
PLATFORMS ; 17
(6) DISPLAYS INFORMATION IN SPANISH AND OTHER LAN GUAGES 18
COMMONLY USED IN THE STATE, AS DETERMINED BY THE DEPARTMENT ; AND 19
(7) ENABLES ITS USE BY IN DIVIDUALS WITH DISAB ILITIES. 20
(C) THE DEPARTMENT SHALL DEVELOP AND IM PLEMENT AN OUTREACH 21
AND MARKETING PLAN T O RAISE AWARENESS OF MARYLAND MYIR MOBILE AS A 22
VOLUNTARY VACCINE PA SSPORT TECHNOLOGY TH AT MAY BE USED FOR V ERIFYING 23
PROOF OF COVID–19 VACCINATION STATUS B Y INDIVIDUALS, BUSINESSES, AND 24
OTHER PUBLI C AND PRIVATE ENTITI ES IN THE STATE. 25
19–211.1. 26
(A) IN THIS SECTION , “HOSPITAL–ADJACENT URGENT CARE CENTER” 27
MEANS ANY CENTER , SERVICE, OFFICE FACILITY, OR OTHER ENTITY THAT : 28
(1) OPERATES FOR THE PURP OSE OF PROVIDING URG ENT CARE AND 29
OTHER BASIC HEALTH CARE SERVICES , INCLUDING DIAGNOSTIC , TREATMENT , 30
CONSULTATIVE , REFERRAL, AND PREVENTIVE SERVI CES; AND 31 HOUSE BILL 1084 11
(2) IS LOCATED ADJACENT T O A FACILITY THAT PR OVIDES HOSPITAL 1
SERVICES SUBJECT TO THE RATE–SETTING JURISDICTION OF THE COMMISSION. 2
(B) A HOSPITAL–ADJACENT URGENT CARE CEN TER: 3
(1) IS NOT SUBJECT TO THE RATE–SETTING JURISDICTION OF THE 4
COMMISSION; AND 5
(2) MAY SET RATES AND REC EIVE REIMBURSEMENT F OR HEALTH 6
CARE SERVICES PROVID ED AT THE CENTER ON AN UNREGULATED BASIS . 7
19–411. 8
(b) For calendar years 2021 [and 2022], 2022, AND 2023, a home health agency 9
shall adopt and implement a COVID–19 infection control and prevention plan for patients 10
and staff who provide home health care services to patients of the home health agency. 11
19–14C–02. 12
(a) For calendar years 2021 [and 2022], 2022, AND 2023, a nursing home shall 13
adopt and implement a COVID–19 testing plan for residents of the nursing home and staff 14
who provide services to residents of the nursing home. 15
19–1815. 16
(b) For calendar years 2021 [and 2022], 2022, AND 2023, an assisted living 17
program shall adopt and implement a COVID–19 testing plan for residents of the assisted 18
living program and staff who provide services to residents of the assisted living program. 19
Article – Health Occupations 20
8–6A–05. 21
(a) The Board shall adopt regulations establishing: 22
(1) Categories of certified nursing assistants, including geriatric nursing 23
assistants, home health aides, school health aides, dialysis technicians, individuals 24
working in developmental disabilities administration facilities, and medicine aides; 25
(2) Qualifications for each category of certified nursing assistant; 26
(3) Qualifications for certified medication technicians; and 27
(4) Standards for qualification of applicants for certification, including the 28
applicant’s criminal history, work record, and prohibitions against behavior which may be 29 12 HOUSE BILL 1084
potentially harmful to patients. 1
(D) (1) IN THIS SUBSECTION , “COVID–19 PUBLIC HEALTH EMERGE NCY” 2
MEANS THE FEDERAL PU BLIC HEALTH EMERGENCY DEC LARED DURING THE 3
COVID–19 PANDEMIC THAT INCLUD ED A WAIVER OF FEDER AL NURSE AIDE 4
TRAINING AND CERTIFI CATION REQUIREMENTS ISSUED BY THE U.S. SECRETARY OF 5
HEALTH AND HUMAN SERVICES. 6
(2) THE BOARD SHALL ESTABLISH AND IMPLEMENT AN APP RENTICE 7
GERIATRIC NURSING AS SISTANT PROGRAM TO P ROVIDE FOR THE CERTI FICATION 8
OF GERIATRIC NURSING ASSISTANTS WHO HAVE WORKED OR ARE WORKIN G AS 9
TEMPORARY NURSING AS SISTANTS AND MEET TH E REQUIREMENTS UNDER THIS 10
SUBSECTION. 11
(3) THE PROGRAM REQUIRED UNDER THIS SUBSECTION SHALL 12
PROVIDE FOR THE CERT IFICATION OF A GERIA TRIC NURSING ASSISTA NT WHO: 13
(I) 1. WORKED FULL – OR PART–TIME AS A TEMPORARY 14
NURSING ASSISTANT FO R AT LEAST 6 MONTHS DURING THE COVID–19 PUBLIC 15
HEALTH EMERGENCY ; 16
2. COMPLETES TRAINING AN D C OMPETENCY 17
REQUIREMENTS THROUGH WORK AS A TEMPORARY NURSING ASSISTANT UN DER A 18
DESIGNATION AS AN AP PRENTICE NURSING ASS ISTANT IN ACCORDANCE WITH 19
FEDERAL NURSE AIDE TRAINING AND COMPETENCY EVALUATION PROGRAM 20
REQUIREMENTS ; AND 21
3. PASSES THE STATE COMPETEN CY EXAMINATION ; OR 22
(II) DID NOT WORK DURING T HE COVID–19 PUBLIC HEALTH 23
EMERGENCY , BUT COMPLETES A NURS ING ASSISTANT APPREN TICESHIP PATHWAY 24
THAT: 25
1. ALLOWS PARTICIPANTS T O WORK AS A TEMPORAR Y 26
NURSING ASSISTANT FO R 4 MONTHS; 27
2. REQUIRES THE RE CEIPT OF A TOTAL OF 40 HOURS OF 28
CLASSROOM AND CLINIC AL TRAINING IN ACCOR DANCE WITH FEDERAL NURSE AIDE 29
TRAINING AND COMPETENCY EVALUATION PROGRAM REQUIREMENTS ; AND 30
3. REQUIRES PASSAGE OF T HE STATE’S COMPETENCY 31
EXAMINATION . 32
HOUSE BILL 1084 13
(4) THE BOARD SHALL ADOPT REGULATIONS TO CARRY OUT THE 1
PROVISIONS OF THIS S UBSECTION. 2
12–101. 3
(g) (1) “Delegated pharmacy act” means an activity that constitutes the 4
practice of pharmacy delegated by a licensed pharmacist under this title and regulations 5
adopted by the Board. 6
(2) “Delegated pharmacy act” does not include: 7
(i) An act within the parameters of a therapy management contract 8
as provided under Subtitle 6A of this title; 9
[(ii) The administration of an influenza vaccination in accordance 10
with § 12–508 of this title;] 11
[(iii)] (II) The delegation of a pharmacy act by a registered 12
pharmacy technician, pharmacy student, or pharmacy technician trainee; 13
[(iv)] (III) A pharmacy activity performed by a pharmacy student in 14
accordance with § 12–301(b) of this title; 15
[(v)] (IV) A pharmacy activity performed by an applicant for a 16
license to practice pharmacy in accordance with regulations adopted by the Board; or 17
[(vi)] (V) The performance of other functions prohibited in 18
regulations adopted by the Board. 19
(i) (1) “Direct supervision” means [that a licensed pharmacist is physically 20
available, notwithstanding appropriate breaks, on–site and in the prescription area or in 21
an area where pharmacy services are provided to supervise the practice of pharmacy and 22
delegated pharmacy acts] SUPERVISION BY A LIC ENSED PHARMACIST WHO : 23
(I) IS READILY AND IMMEDI ATELY AVAILABLE AT A LL TIMES 24
THE DELEGATED TASKS ARE BEING PERFORMED ; 25
(II) IS AWARE OF THE DELEG ATED TASKS BEING PER FORMED; 26
AND 27
(III) PROVIDES PERSONAL ASSISTANCE, DIRECTION, AND 28
APPROVAL THROUGHOUT THE TIME THE DELEGAT ED TASKS ARE BEING 29
PERFORMED . 30
(2) “DIRECT SUPERVISION ” INCLUDES SUPERVISION OF A PHARMACY 31 14 HOUSE BILL 1084
TECHNICIAN THROUGH T ECHNOLOGICAL MEANS . 1
12–506. 2
(a) A pharmacist may refill a prescription for a drug or device for which the refill 3
has not been authorized if: 4
(1) The pharmacist: 5
(i) Attempts to obtain an authorization from the authorized 6
prescriber; and 7
(ii) Is not able readily to obtain the authorization; 8
(2) The refill of the prescription is not for a controlled dangerous substance; 9
(3) The drug or device is essential to the maintenance of [life] PATIENT 10
WELL–BEING; 11
(4) (i) The drug or device is essential to the continuation of therapy [in 12
chronic conditions]; and 13
(ii) In the pharmacist’s professional judgment, the interruption of 14
the therapy reasonably might produce an undesirable health consequence, be detrimental 15
to the patient’s welfare, or cause physical or mental discomfort; 16
(5) The pharmacist: 17
(i) Enters on the back of the prescription or on another appropriate 18
uniformly maintained, readily retrievable record, such as a medication record, the date and 19
the quantity of the drug or device dispensed; and 20
(ii) Signs or initials the record; and 21
(6) The pharmacist notifies the authorized prescriber of the refill of the 22
prescription within 72 hours of dispensing the drug or device. 23
(b) If a pharmacist refills a prescription under subsection (a) of this section, the 24
pharmacist may provide only [1] ONE refill of the prescription and the refill quantity 25
dispensed shall be in conformity with the prescriber’s directions for use and may not exceed 26
a [14–day] 30–DAY supply or unit of use. 27
(c) If the federal or a state government declares a state of emergency, a 28
pharmacist working in Maryland may refill a prescription for a drug for which the refill 29
has not been authorized if: 30
HOUSE BILL 1084 15
(1) As a result of the emergency, the pharmacist is unable to obtain an 1
authorization from the authorized prescriber; 2
(2) The refill of the prescription is not for a controlled dangerous substance; 3
(3) The quantity dispensed does not exceed a [30–day] 90–DAY supply or 4
unit of use; and 5
(4) The pharmacist notifies the authorized prescriber of the refill of the 6
prescription within 7 days of dispensing the drug. 7
12–508. 8
[(a) (1) Subject to subsection (c) of this section, a pharmacist may administer 9
an influenza vaccination to an individual who is at least 9 years old, in accordance with 10
regulations adopted by the Board, in consultation with the Department. 11
(2) Subject to subsection (c) of this section, a pharmacist may administer a 12
vaccination that is listed in the Centers for Disease Control and Prevention’s Recommended 13
Immunization Schedule to an individual who: 14
(i) Is at least 11 years old but under the age of 18 years; and 15
(ii) Has a prescription from an authorized prescriber. 16
(3) (i) Subject to subparagraph (ii) of this paragraph, a pharmacist may 17
administer to an adult a vaccination that is: 18
1. Listed in the Centers for Disease Control and Prevention’s 19
Recommended Immunization Schedule; or 20
2. Recommended in the Centers for Disease Control and 21
Prevention’s Health Information for International Travel. 22
(ii) A pharmacist shall administer a vaccination under 23
subparagraph (i) of this paragraph under a written protocol that: 24
1. Is vaccine specific; and 25
2. Meets criteria established by the Department, in 26
consultation with the Board, the Board of Physicians, and the Board of Nursing, in 27
regulation. 28
(4) A pharmacist shall: 29
(i) Report all vaccinations administered by the pharmacist to the 30
ImmuNet Program established under § 18–109 of the Health – General Article; 31 16 HOUSE BILL 1084
(ii) If the vaccination has been administered in accordance with a 1
prescription, document at least one effort to inform the individual’s authorized prescriber 2
that the vaccination has been administered; and 3
(iii) For a vaccination administered under paragraph (2) or (3) of this 4
subsection, if the authorized prescriber is not the individual’s primary care provider or if 5
the vaccination has not been administered in accordance with a prescription, document at 6
least one effort to inform the individual’s primary care provider or other usual source of 7
care that the vaccination has been administered. 8
(b) The Board shall: 9
(1) Set reasonable fees for the administration of vaccinations under this 10
section; and 11
(2) Adopt regulations that require a pharmacist to submit a registration 12
form to the Board that includes verification that the pharmacist: 13
(i) Has successfully completed a certification course approved by the 14
Board that included instruction in the guidelines and recommendations of the Centers for 15
Disease Control and Prevention regarding vaccinations; and 16
(ii) Is certified in basic cardiopulmonary resuscitation and obtained 17
the certification through in–person classroom instruction.] 18
[(c)] (A) [From July 1, 2021, to June 30, 2023, inclusive, a] A pharmacist may 19
ORDER AND administer a vaccine to an individual who is at least 3 years old [but under 20
the age of 18 years] if: 21
(1) The vaccine is approved by the U.S. Food and Drug Administration; 22
(2) The vaccination is ordered and administered in accordance with the 23
Centers for Disease Control and Prevention’s Advisory Committee on Immunization 24
Practices immunization schedules; 25
(3) The pharmacist has completed a practical training program of at least 26
20 hours that is approved by the Accreditation Council for Pharmacy Education and 27
includes: 28
(i) Hands–on injection techniques; 29
(ii) Clinical evaluation of indications and contraindications of 30
vaccines; and 31
(iii) The recognition and treatment of emergency reactions to 32
vaccines; 33 HOUSE BILL 1084 17
(4) The pharmacist has a current certificate in basic cardiopulmonary 1
resuscitation; 2
(5) The pharmacist has completed a minimum of 2 hours of continuing 3
pharmaceutical education related to immunizations that is approved by the Accreditation 4
Council for Pharmacy Education as part of the license renewal requirements under § 5
12–309 of this title; 6
(6) The pharmacist complies with the FOLLOWING record–keeping and 7
reporting requirements [in subsection (a)(4) of this section] and the corresponding 8
regulations: 9
(I) REPORT ALL VACCINATIO NS ADMINISTERED TO T HE 10
IMMUNET PROGRAM E STABLISHED UNDER § 18–109 OF THE HEALTH – GENERAL 11
ARTICLE; 12
(II) IF THE VACCINATION HA S BEEN ADMINISTERED IN 13
ACCORDANCE WITH A PR ESCRIPTION, DOCUMENT AT LEAST ON E EFFORT TO 14
INFORM THE INDIVIDUA L’S AUTHORIZED PRESCRI BER THAT THE VACCINA TION HAS 15
BEEN ADMINISTERED; AND 16
(III) FOR A VACCINATION IN WHICH THE AUTHORIZED 17
PRESCRIBER IS NOT TH E INDIVIDUAL’S PRIMARY CARE PROVI DER OR IF THE 18
VACCINATION HAS NOT BEEN ADMINISTERED IN ACCORDANCE WITH A 19
PRESCRIPTION , DOCUMENT AT LEAST ON E EFFORT TO INFORM T HE INDIVIDUAL’S 20
PRIMARY CARE PROVIDE R OR OTHER USUAL SOU RCE OF CARE THAT THE 21
VACCINATION HAS BEEN ADMINISTERED ; and 22
(7) The pharmacist informs each child vaccination patient and adult 23
caregiver who is accompanying the child of the importance of well–child visits with a 24
pediatric primary care provider and refers the patient to a pediatric primary care provider 25
when appropriate. 26
(B) A PHARMACIST MAY DELEG ATE THE ADMINISTRATI ON OF A VACCINE 27
UNDER SUBSECTION (A) OF THIS SECTION TO A PHARMACY TECHNICIAN IF THE 28
PHARMACY TECHNICIAN HAS CO MPLETED A PRACTICAL TRAINING PROGRAM OF AT 29
LEAST 6 HOURS THAT IS APPROV ED BY THE ACCREDITAT ION COUNCIL FOR 30
PHARMACY EDUCATION A ND INCLUDES: 31
(1) HANDS–ON INJECTION TECHNIQ UES; AND 32
(2) THE RECOGNITION AND T REATMENT OF EMERGENC Y REACTIONS 33
TO VACCINES. 34 18 HOUSE BILL 1084
12–6B–06. 1
(a) Registration authorizes a registered pharmacist technician to perform 2
delegated pharmacy acts as defined in § 12–101 of this title while the registration is 3
effective. 4
(b) A registered pharmacy technician or a pharmacy technician trainee may not: 5
(1) Act within the parameters of a therapy management contract as 6
provided under Subtitle 6A of this title; 7
[(2) Administer an influenza vaccination in accordance with § 12–508 of this 8
title;] 9
[(3)] (2) Delegate a pharmacy act that was delegated to the registered 10
pharmacy technician or individual engaging in a Board approved technician training 11
program; or 12
[(4)] (3) Perform other functions prohibited by regulations adopted by the 13
Board. 14
Chapter 29 of the Acts of the 2021 Special Session 15
SECTION 5. AND BE IT FURTHER ENACTED, That this Act is an emergency 16
measure, is necessary for the immediate preservation of the public health or safety, has 17
been passed by a yea and nay vote supported by three–fifths of all the members elected to 18
each of the two Houses of the General Assembly, and shall take effect from the date it is 19
enacted. Section 2 of this Act shall remain effective through December 31, [2022] 2023, 20
and, at the end of December 31, [2022] 2023, Section 2 of this Act, with no further action 21
required by the General Assembly, shall be abrogated and of no further force and effect. 22
Chapter 31 of the Acts of the 2021 Special Session 23
SECTION 5. AND BE IT FURTHER ENACTED, That this Act is an emergency 24
measure, is necessary for the immediate preservation of the public health or safety, has 25
been passed by a yea and nay vote supported by three–fifths of all the members elected to 26
each of the two House of the General Assembly, and shall take effect from the date it is 27
enacted. Section 2 of this Act shall remain effective through December 31, [2022] 2023, 28
and, at the end of December 31, [2022] 2023, Section 2 of this Act, with no further action 29
required by the General Assembly, shall be abrogated and of no further force and effect. 30
SECTION 2. AND BE IT FURTHER ENACTED, That the Maryland Department of 31
Health shall: 32
(1) (i) conduct a study on the use of digital learning programs for 33 HOUSE BILL 1084 19
education and training requirements for health care practitioners in the State applying for 1
a license, certification, registration, or permit or the renewal of a license or permit; 2
(ii) in conjunction with the Maryland Department of Labor, study 3
multiyear approaches to reducing the workforce shortage in health care in the State; 4
(iii) with participation from the Office of Health Care Quality and the 5
State Board of Nursing, collaborate with other State agencies, including the State 6
Department of Education, health care industry and association stakeholders, community 7
colleges, higher education institutions, and high schools, to develop explicit workforce 8
career paths from high school and higher education apprenticeships to higher education 9
enrollment for entry into a health care field; and 10
(iv) on or before December 31, 2022, report to the General Assembly, 11
in accordance with § 2–1257 of the State Government Article, on the findings of the studies 12
and development of career paths required under this item; and 13
(2) on or before December 31, 2022, submit an update to the report required 14
under Section 2 of Chapter 798 of the Acts of the General Assembly of 2018, relating to 15
reimbursement rates and costs of certain home– and community–based services to the 16
General Assembly, in accordance with § 2–1257 of the State Government Article. 17
SECTION 3. AND BE IT FURTHER ENACTED, That this Act is an emergency 18
measure, is necessary for the immediate perseveration of the public health or safety, has 19
been passed by a yea and nay vote supported by three–fifths of all the members elected to 20
each of the two Houses of the General Assembly, and shall take effect from the date it is 21
enacted. 22