EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. [Brackets] indicate matter deleted from existing law. Underlining indicates amendments to bill. Strike out indicates matter stricken from the bill by amendment or deleted from the law by amendment. Italics indicate opposite chamber/conference committee amendments. *hb1208* HOUSE BILL 1208 J2, Q3 (2lr0907) ENROLLED BILL — Health and Government Operations/Budget and Taxation and Education, Health, and Environmental Affairs — Introduced by Delegate Kelly Delegates Kelly, Bagnall, Belcastro, Bhandari, Carr, Chisholm, Cullison, Hill, Johnson, Kaiser, Kerr, Kipke, Landis, R. Lewis, Morgan, Pena –Melnyk, Pendergrass, Reilly, Rosenberg, Saab, Sample–Hughes, Szeliga, and K. Young Read and Examined by Proofreaders: _______________________________________________ Proofreader. _______________________________________________ Proofreader. Sealed with the Great Seal and presented to the Governor, for his approval this _______ day of _______________ at ________________________ o’clock, ________M. ______________________________________________ Speaker. CHAPTER ______ AN ACT concerning 1 Health Occupations – Health Care Workforce Expansion 2 FOR the purpose of establishing requirements on the State Board of Nursing related to the 3 expansion of the workforce in nursing–related fields; establishing a State income tax 4 credit for certain licensed practical nurses, nurse practitioners advanced practice 5 registered nurses, and registered nurses; establishing the Licensed Practical Nurse 6 and Registered Nurse Preceptorship Tax Credit Fund as a special, nonlapsing fund; 7 requiring the Maryland Department of Health to work with the Division of 8 Workforce Development and Adult Learning in the Maryland Department of Labor 9 to convene a stakeholder workgroup to study expanding the State apprenticeship 10 programs to the health care workforce; requiring the Maryland Department of 11 2 HOUSE BILL 1208 Health to convene a workgroup to study how the State can implement a certain loan 1 repayment assistance program; and generally relating to expansion of the health 2 care workforce in the State. 3 BY repealing and reenacting, with amendments, 4 Article – Health Occupations 5 Section 8–205, 8–312(c), and 8–6A–05(b) 8–6A–05(a) and (b) 6 Annotated Code of Maryland 7 (2021 Replacement Volume) 8 BY adding to 9 Article – Health Occupations 10 Section 8–205.2 and 8–514 8–6A–14(g) 11 Annotated Code of Maryland 12 (2021 Replacement Volume) 13 BY adding to 14 Article – Tax – General 15 Section 10–739.1 16 Annotated Code of Maryland 17 (2016 Replacement Volume and 2021 Supplement) 18 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 19 That the Laws of Maryland read as follows: 20 Article – Health Occupations 21 8–205. 22 (a) In addition to the powers and duties set forth elsewhere in this title, the Board 23 has the following powers and duties: 24 (1) To adopt rules and regulations to carry out the provisions of this title; 25 (2) To set standards for the practice of registered nursing, advanced 26 practice registered nursing, licensed practical nursing, certified nursing assistants, 27 certified medication technicians, electrology, direct–entry midwifery, and certified 28 midwifery; 29 (3) To adopt rules and regulations for the performance of delegated medical 30 functions that are recognized jointly by the State Board of Physicians and the State Board 31 of Nursing, under § 14–306(d) of this article; 32 (4) To adopt rules and regulations for the performance of additional 33 nursing acts that: 34 HOUSE BILL 1208 3 (i) May be performed under any condition authorized by the Board, 1 including emergencies; and 2 (ii) Require education and clinical experience; 3 (5) To adopt rules and regulations for registered nurses to perform 4 independent nursing functions that: 5 (i) Require formal education and clinical experience; and 6 (ii) May be performed under any condition authorized by the Board, 7 including emergencies; 8 (6) To adopt rules and regulations for licensed practical nurses to perform 9 additional acts in the practice of registered nursing that: 10 (i) Require formal education and clinical experience; 11 (ii) May be performed under any condition authorized by the Board, 12 including emergencies; and 13 (iii) Are recognized by the Nursing Board as proper for licensed 14 practical nurses to perform; 15 (7) TO ADOPT RULES AND RE GULATIONS FOR CLINIC AL EXTERN 16 CERTIFICATES AUTHORI ZED UNDER § 8–514 OF THIS TITLE; 17 [(7)] (8) To keep a record of its proceedings; 18 [(8)] (9) To submit to the Governor, the Secretary, and, in accordance 19 with § 2–1257 of the State Government Article, the General Assembly, an annual report 20 that includes [the]: 21 (I) THE following data calculated on a fiscal year basis: 22 [(i)] 1. The number of initial and renewal licenses and certificates 23 issued; 24 [(ii)] 2. The number of positive and negative criminal history 25 records checks results received; 26 [(iii)] 3. The number of individuals denied initial or renewal 27 licensure or certification due to positive criminal history records checks results; 28 [(iv)] 4. The number of individuals denied licensure or certification 29 due to reasons other than a positive criminal history records check; 30 4 HOUSE BILL 1208 [(v)] 5. The number of new complaints received; 1 [(vi)] 6. The number of complaints carried over from year to year; 2 [(vii)] 7. The most common grounds for complaints; and 3 [(viii)] 8. The number and types of disciplinary actions taken 4 by the Board; AND 5 (II) BY ANALYZING INFORMAT ION GATHERED FROM RE NEWAL 6 APPLICATIONS SUBMITT ED UNDER § 8–312 OF THIS TITLE, AN EVALUATION OF THE 7 STATE’S NURSING WORKFORCE BY CERTIFICATION LEV EL, REGION, AND TYPE OF 8 WORKPLACE , INCLUDING HOSPITALS AND HOME HEALTH WORK ERS; 9 [(9)] (10) To enforce the employment record requirements of this title; 10 [(10)] (11) To keep separate lists, which lists are open to reasonable public 11 inspection, of all: 12 (i) Registered nurses licensed under this title; 13 (ii) Licensed practical nurses licensed under this title; 14 (iii) Nurse midwives certified under this title; 15 (iv) Nurse practitioners certified under this title; 16 (v) Nurse anesthetists certified under this title; 17 (vi) Clinical nurse specialists certified under this title; 18 (vii) Certified medication technicians certified under this title; 19 (viii) Electrologists licensed under this title; 20 (ix) Direct–entry midwives licensed under this title; 21 (x) Certified midwives licensed under this title; and 22 (xi) Other licensees with a nursing specialty that is certified under 23 this title; 24 [(11)] (12) To collect any funds of the Board; 25 HOUSE BILL 1208 5 [(12)] (13) To report any alleged violation of this title to the State’s Attorney 1 of the county where the alleged violation occurred; 2 [(13)] (14) In accordance with the State budget, to incur any necessary 3 expense for prosecution of an alleged violation of this title; 4 [(14)] (15) On receipt of a written and signed complaint, including a referral 5 from the Commissioner of Labor and Industry, conduct an unannounced inspection of the 6 office of a nurse in independent practice, other than an office of a nurse in independent 7 practice in a hospital, related institution, freestanding medical facility, or a freestanding 8 birthing center, to determine compliance at that office with the Centers for Disease Control 9 and Prevention’s guidelines on universal precautions; 10 [(15)] (16) To maintain a nurse aide registry that complies with federal law; 11 [(16)] (17) To appoint standing and ad hoc committees from among Board 12 members as necessary; and 13 [(17)] (18) To delegate to the executive director of the Board the authority 14 to discharge Board duties deemed appropriate and necessary by the Board and to hold the 15 executive director accountable to the Board. 16 (b) With regard to any list kept by the Board under subsection [(a)(10)] (A)(11) 17 of this section, upon written request from an individual licensee the Board shall delete that 18 individual’s name from any licensee list purchased from the Board. 19 (c) (1) The Board is the only unit of the Department that is responsible for 20 adopting rules and regulations to determine: 21 (i) Individuals to whom any act of the practice of registered nursing 22 and licensed practical nursing may be delegated; and 23 (ii) The acts that may be delegated safely. 24 (2) The Department shall retain its authority to require training for 25 nonlicensed patient care personnel under § 19–308.1 of the Health – General Article. 26 8–205.2. 27 THE BOARD SHALL: 28 (1) CREATE AND IMPLEMENT A MARKETING PLAN TO ATTRACT 29 INDIVIDUALS TO SEEK LICENSURE AND CERTIF ICATION UNDER THIS T ITLE; AND 30 6 HOUSE BILL 1208 (2) CREATE AND MAINTAIN O N ITS PUBLICLY ACCES SIBLE WEBSITE A 1 SINGLE LOCATION THAT HAS INFORMATION FOR INDIVIDUALS SEEKING LICENSURE 2 OR CERTIFICATION UND ER THIS TITLE ON: 3 (I) PATHWAYS TO LICENSURE OR CERTIFICATION ; 4 (II) FUNDING AND FINANCING OPTIONS TO PAY FOR R EQUIRED 5 EDUCATION AND TRAINI NG; AND 6 (III) ACCREDITED SCHOOLS AN D TRAINING PROGRAMS . 7 8–312. 8 (c) Before a license expires, the licensee periodically may renew it for an 9 additional term, if the licensee: 10 (1) Otherwise is entitled to be licensed; 11 (2) Pays to the Board: 12 (i) A renewal fee set by the Board; or 13 (ii) A renewal fee that is set by the Board if the licensee certifies to 14 the Board that the licensee provides professional services only as a volunteer; and 15 (3) Submits to the Board by paper application or electronic means: 16 (i) A renewal application on the form that the Board requires THAT 17 INCLUDES WORKFORCE D ATA INFOR MATION NECESSARY FOR THE REPORT 18 REQUIRED UNDER § 8–205(A) OF THIS TITLE; and 19 (ii) Satisfactory evidence of completion of: 20 1. 1,000 hours of active nursing practice within the 5–year 21 period immediately preceding the date of renewal; 22 2. A course of instruction, commonly known as a refresher 23 course, approved by the Board; 24 3. A preceptorship program provided by an employer and 25 approved by the Board; or 26 4. A minimum number of continuing education units as 27 required by regulations adopted by the Board. 28 8–514. 29 HOUSE BILL 1208 7 (A) IN THIS SECTION , “CLINICAL EXTERN ” MEANS A STUDENT AT A N 1 ACCREDITED SCHOOL OF NURSING APPROVED BY THE BOARD WHO HAS BEEN 2 CERTIFIED BY THE BOARD TO AUGMENT THE HEALTH SERVICES WORK FORCE. 3 (B) THE BOARD SHALL ISSUE A C LINICAL EXTERN CERTIFICATE T O A 4 NURSING STUDENT WHO : 5 (1) SUBMITS TO THE BOARD: 6 (I) AN APPLICATION ON THE FORM REQUIRED BY THE BOARD; 7 AND 8 (II) A SUPERVISOR AGREEMENT SIGNED BY THE APPLIC ANT’S 9 PROPOSED LICENSEE SU PERVISOR; 10 (2) HAS MET THE EDUCATION AL CRITERIA ESTABLISHED BY THE 11 BOARD; AND 12 (3) MEETS ANY OTHER CRITE RIA ESTABLISHED BY T HE BOARD FOR 13 CERTIFICATION AS A C LINICAL EXTERN . 14 (C) A CLINICAL EXTERN MAY : 15 (1) PRACTICE AT A HOSPITA L OR AUXILIARY TREAT MENT SITE 16 APPROVED BY THE BOARD; 17 (2) PERFORM HEALTH CARE S ERVICES APPROVED BY THE BOARD 18 ONLY UNDER THE DIREC T SUPERVISION OF THE LICENSEE SUPERVISOR APPROVED 19 BY THE BOARD; AND 20 (3) PROVIDE HEALTH CARE S ERVICES IN ACCORDANC E WITH THE 21 CLINICAL EXTERN ’S TRAINING AND TO TH E EXTENT OF THE CLIN ICAL EXTERN’S 22 COMPETENCY AS DETERM INED BY THE CLINICAL EXTERN’S LICENSEE SUPERVISO R. 23 (D) THE BOARD SHALL ADOPT REG ULATIONS NECESSARY T O CARRY OUT 24 THIS SECTION. 25 8–6A–05. 26 (a) The Board shall adopt regulations establishing: 27 (1) Categories of certified nursing assistants, including geriatric nursing 28 assistants, home health aides, school health aides, dialysis technicians, individuals 29 working in developmental disabilities administration facilities, and medicine aides; 30 8 HOUSE BILL 1208 (2) Qualifications for each category of certified nursing assistant; 1 (3) Qualifications for certified medication technicians; [and] 2 (4) Standards for qualification of applicants for certification, including the 3 applicant’s criminal history, work record, and prohibitions against behavior which may be 4 potentially harmful to patients; AND 5 (5) STANDARDS FOR THE ONL INE PROVISION OF ALL ASPECTS OF 6 DIDACTIC INSTRUCTION IN A NURSING ASSISTANT TRAINING PROGRAM THA T MEETS 7 THE REQUIREMENTS EST ABLISHED BY THE BOARD. 8 (b) (1) To qualify for certification as a nursing assistant, a nursing assistant 9 in a specific category, or a medication technician, an applicant shall meet the requirements 10 set by the Board. 11 (2) REQUIREMENTS SET BY T HE BOARD UNDER PARAGRAPH (1) OF 12 THIS SUBSECTION REGARDING QUALIFICAT IONS FOR CERTIFICATI ON AS A 13 GERIATRIC NURSING ASSISTANT SH ALL INCLUDE PROVISIO NS TO ALLOW AN 14 INDIVIDUAL WHO HAS B EEN PRACTICING AS A TEMPORARY NURSING ASSISTANT 15 WITHOUT CERTIFICATIO N BY THE BOARD, IN ACCORDANCE WITH T HE WAIVER OF 16 THE REQUIREMENTS OF 42 C.F.R. § 483.35(D) ISSUED BY THE CENTERS FOR 17 MEDICARE AND MEDICAID SERVICES ON MARCH 6, 2020, TO APPLY ON–THE–JOB 18 EXPERIENCE AS A NURS ING ASSISTANT TOWARD THE TOTAL NUMBER OF TRAINING 19 HOURS REQUIRED FOR C ERTIFICATION AS A GERIATRIC NURSI NG ASSISTANT. 20 8–6A–14. 21 (G) THE BOARD SHALL APPROVE T HE USE OF A NURSING ASSISTANT 22 TRAINING SITE BY A N URSING ASSISTANT TRA INING PROGRAM WITHIN 14 45 DAYS 23 AFTER THE NURSING AS SISTANT TRAINING PRO GRAM APPLIES FOR APP ROVAL IF 24 THE NURSING ASSISTAN T TRAINING PROGRAM HAD PREVIOUS LY BEEN APPROVED 25 TO USE THE TRAINING SITE BY THE BOARD. 26 SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 27 as follows: 28 Article – Tax – General 29 10–739.1. 30 (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEAN INGS 31 INDICATED. 32 HOUSE BILL 1208 9 (2) “ADVANCED PRACTICE REG ISTERED NURSE ” HAS THE SAME 1 MEANING STATED IN § 8–101 OF THE HEALTH OCCUPATIONS ARTICLE. 2 (3) “DEPARTMENT ” MEANS THE MARYLAND DEPARTMENT OF 3 HEALTH. 4 (3) (4) “LICENSED PRACTICAL NU RSE” HAS THE MEANING STAT ED 5 IN § 8–101 OF THE HEALTH OCCUPATIONS ARTICLE. 6 (4) “NURSE PRACTITIONER ” HAS THE MEANING STAT ED IN § 8–101 7 OF THE HEALTH OCCUPATIONS ARTICLE. 8 (5) “PRECEPTORSHIP PROGRAM ” MEANS AN ORGANIZED S YSTEM OF 9 CLINICAL EXPERIENCE THAT, FOR THE PURPOSE OF A TTAINING SPECIFIED 10 LEARNING OBJECTIVES , PAIRS A LICENSED PRA CTICAL NURSE OR REGI STERED 11 NURSE STUDENT ENROLL ED IN A NURSING EDUC ATION PROGRAM THAT I S 12 RECOGNIZED BY THE STATE BOARD OF NURSING WITH A LICENS ED PRACTICAL 13 NURSE, NURSE PRACTITIONER ADVANCED PRACTICE REGISTERED NURSE , OR 14 REGISTERED NURSE WHO MEETS THE QUALIFICAT IONS AS A PRECEPTOR . 15 (6) “REGISTERED NURSE ” HAS THE MEANING STAT ED IN § 8–101 OF 16 THE HEALTH OCCUPATIONS ARTICLE. 17 (B) (1) SUBJECT TO THE LIMITA TIONS OF THIS SECTIO N, A LICENSED 18 PRACTICAL NUR SE, NURSE PRACTITIONER ADVANCED PRACTICE RE GISTERED 19 NURSE, OR REGISTERED NURSE MAY CLAIM A CREDIT A GAINST THE STATE INCOME 20 TAX IN THE AMOUNT ST ATED ON THE TAX CRED IT CERTIFICATE ISSUE D UNDER 21 SUBSECTION (C) OF THIS SECTION FOR THE TAXABLE YEAR IN WHICH THE LICENSED 22 PRACTICAL NURSE , NURSE PRACTITIONER ADVANCED PRACTICE RE GISTERED 23 NURSE, OR REGISTERED NURSE SERVED WITHOUT COMPE NSATION AS A PRECEPT OR 24 IN A PRECEPTORSHIP P ROGRAM APPROVED BY T HE STATE BOARD OF NURSING AND 25 WORKED: 26 (I) A MINIMUM OF THREE R OTATIONS, EACH CONSISTING OF A T 27 LEAST 100 HOURS OF COMMUNITY –BASED CLINICAL TRAIN ING; AND 28 (II) IN AN AREA OF THE STATE IDENTIFIED AS H AVING A 29 HEALTH CARE WORKFORC E SHORTAGE BY THE DEPARTMENT , IN CONSULTATION 30 WITH THE GOVERNOR’S WORKFORCE DEVELOPMENT BOARD. 31 (2) (I) THE TOTAL AMOUNT OF T HE CREDIT ALLOWED UN DER THIS 32 SECTION FOR ANY TAXA BLE YEAR MAY NOT EXC EED THE STATE INCOME TAX 33 IMPOSED FOR THAT TAX ABLE YEAR. 34 10 HOUSE BILL 1208 (II) ANY UNUSED AMOUNT OF THE CREDIT FOR ANY T AXABLE 1 YEAR MAY NOT BE CARR IED OVER TO ANY OTHE R TAXABLE YEAR. 2 (C) (1) ON APPLICATION BY A L ICENSED PRACTICAL NU RSE, NURSE 3 PRACTITIONER ADVANCED PRACTICE RE GISTERED NURSE , OR REGISTERED NURSE , 4 THE DEPARTMENT SHALL ISSU E A CREDIT CERTIFICA TE IN THE AMOUNT OF $1,000 5 FOR EACH STUDENT ROT ATION OF THE MINIMUM NUMBER OF HOURS REQU IRED 6 UNDER SUBSECTION (B)(1)(I) OF THIS SECTION FOR WHICH THE LICENSED 7 PRACTICAL NURSE , NURSE PRACTI TIONER ADVANCED PRACTICE RE GISTERED 8 NURSE, OR REGISTERED NURSE SERVED AS A PRECEPTO R WITHOUT 9 COMPENSATION . 10 (2) THE APPLICATION SHALL CONTAIN: 11 (I) THE NAME OF THE APPL ICANT; 12 (II) INFORMATION IDENTIFY ING THE PRECEPTORSHI P IN 13 WHICH THE APPLICANT PARTICIPATED ; 14 (III) THE NUMBER AND NAMES OF THE STUDENTS FOR WHOM 15 THE INDIVIDUAL SERVE D AS A PRECEPTOR WIT HOUT COMPENSATION ; AND 16 (IV) ANY OTHER INFORMATIO N THAT THE DEPARTMENT 17 REQUIRES. 18 (3) FOR ANY TAXABLE YEAR , THE AMOUNT OF TAX CR EDIT STATED IN 19 THE TAX CREDIT CERTI FICATE MAY NOT EXCEE D $10,000. 20 (4) THE DEPARTMENT SHALL : 21 (I) APPROVE ALL APPLICAT IONS THAT QUALIFY FO R A TAX 22 CREDIT CERTIFICATE U NDER THIS SUBSECTION ON A FIRST–COME, FIRST–SERVED 23 BASIS; AND 24 (II) NOTIFY A TAXPAYER WI THIN 45 DAYS OF RECEIPT OF T HE 25 TAXPAYER’S APPLICATION OF ITS APPROVAL OR DENIAL . 26 (5) (I) FOR EACH TAXABLE YEAR , THE TOTAL AMOUNT OF TAX 27 CREDIT CERTIFICATES THAT MAY BE ISSUED B Y THE DEPARTMENT UNDER THIS 28 SECTION MAY NOT EXCE ED THE LESSER OF : 29 1. THE TOTAL FUNDS IN THE LICENSED PRACTICAL 30 NURSE AND REGISTERED NURSE PRECEPTORSHIP TAX CREDIT FUND FOR THAT 31 YEAR; OR 32 HOUSE BILL 1208 11 2. $100,000. 1 (II) IF THE AGGREGATE AMOU NT OF TAX CREDIT CER TIFICATES 2 ISSUED UNDER THIS SE CTION DURING A TAXAB LE YEAR TOTALS LESS THAN THE 3 AMOUNT AUTHORIZED UNDE R THIS PARAGRAPH , ANY EXCESS AMOUNT MA Y BE 4 ISSUED UNDER TAX CRE DIT CERTIFICATES IN THE NEXT TAXABLE YEA R. 5 (D) (1) IN THIS SECTION , “FUND” MEANS THE LICENSED PRACTICAL 6 NURSE AND REGISTERED NURSE PRECEPTORSHIP TAX CREDIT FUND 7 ESTABLISHE D UNDER PARAGRAPH (2) OF THIS SUBSECTION . 8 (2) THERE IS A LICENSED PRACTICAL NURSE AND REGISTERED 9 NURSE PRECEPTORSHIP TAX CREDIT FUND. 10 (3) THE DEPARTMENT SHALL ADMI NISTER THE FUND. 11 (4) THE PURPOSE OF THE FUND IS TO OFFSET THE COSTS OF THE TAX 12 CREDIT AVAILABLE UND ER THIS SECTION. 13 (5) THE FUND IS A SPECIAL , NONLAPSING FUND THAT IS NOT 14 SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 15 (6) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 16 AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 17 (7) THE FUND CONSISTS OF : 18 (I) FEDERAL FUNDING PROV IDED UNDER: 19 1. THE FEDERAL CORONAVIRUS AID, RELIEF, AND 20 ECONOMIC SECURITY ACT; 21 2. THE FEDERAL CONSOLIDATED APPROPRIATIONS 22 ACT, 2021; OR 23 3. ANY OTHER FEDERAL COVID–19 PANDEMIC RELIEF 24 FUNDING; 25 (II) MONEY APPROPRIATED I N THE STATE BUDGET TO THE 26 FUND; AND 27 (III) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED 28 FOR THE BENEFIT OF T HE FUND. 29 12 HOUSE BILL 1208 (8) THE MONEY IN THE FUND SHALL BE INVESTE D AND REINVESTED 1 BY THE STATE TREASURER, AND INTEREST AND EAR NINGS SHALL BE CREDI TED TO 2 THE GENERAL FUND OF THE STATE. 3 (9) (I) EXCEPT AS OTHERWISE P ROVIDED IN THIS PARA GRAPH, 4 MONEY CREDITED OR AP PROPRIATED TO THE FUND SHALL REMAIN IN THE FUND. 5 (II) 1. WITHIN 15 DAYS AFTER THE END O F EACH CALENDAR 6 QUARTER, THE DEPARTMENT SHALL NOTI FY THE COMPTROLLER AS TO EAC H 7 CREDIT CERTIFICATE I SSUED DURING THE QUA RTER. 8 2. ON NOTIFICATION THAT A CREDIT CERTIFICATE HAS 9 BEEN ISSUED BY THE DEPARTMENT , THE COMPTROLLER SHALL TRA NSFER AN 10 AMOUNT EQUAL TO THE CREDIT AMOUNT ST ATED IN THE TAX CRED IT CERTIFICATE 11 FROM THE FUND TO THE GENERAL FUND OF THE STATE. 12 (E) ON OR BEFORE JANUARY 31 EACH TAXABLE YEAR , THE DEPARTMENT 13 SHALL: 14 (1) REPORT TO THE COMPTROLLER ON THE TA X CREDIT 15 CERTIFICATES ISSUED UNDER THIS SECTION DURING THE P RIOR TAXABLE YEAR ; 16 AND 17 (2) REPORT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH § 18 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON THE UTILIZATION O F THE 19 CREDIT ESTABLISHED U NDER THIS SECTION . 20 (F) THE DEPARTMENT , IN CONSULTATION WITH THE GOVERNOR’S 21 WORKFORCE DEVELOPMENT BOARD, SHALL ADOPT REGULATI ONS TO CARRY OUT 22 THE PROVISIONS OF TH IS SECTION, INCLUDING THE CRITER IA AND PROCEDURES 23 FOR APPLICATION FOR , APPROVAL OF , AND MONITORING ELIGI BILITY FOR THE TAX 24 CREDIT AUTHORIZED UN DER THIS SECTION . 25 SECTION 3. AND BE IT FURTHER ENACTED, That: 26 (a) The Maryland Department of Health shall work with the Division of 27 Workforce Development and Adult Learning in the Maryland Department of Labor to 28 convene a stakeholder workgroup to: 29 (1) study expanding the State apprenticeship programs to the health care 30 workforce; and 31 (2) make recommendations on: 32 HOUSE BILL 1208 13 (i) health care fields that could be best served by introducing a 1 health care apprenticeship program, including health–related fields that do not require 2 licensure or certification under the Health Occupations Article; 3 (ii) options to provide incentives to experienced health care 4 practitioners to work with health care apprentices; 5 (iii) safeguards needed to ensure the safety of the public when 6 receiving health care services from health care apprentices; and 7 (iv) funding needed to support a health care apprenticeship program; 8 and 9 (v) nomenclature to describe apprenticeship programs for health 10 care apprentices. 11 (b) On or before December 1, 2022, the Maryland Department of Health shall 12 report the findings and recommendations of the workgroup to the Senate Education, 13 Health, and Environmental Affairs Committee and the House Health and Government 14 Operations Committee, in accordance with § 2–1257 of the State Government Article. 15 SECTION 4. AND BE IT FURTHER ENACTED, That: 16 (a) The Maryland Department of Health shall convene a stakeholder workgroup 17 to examine how the State can implement a loan repayment assistance program for nurses 18 and other health practitioners regulated by the State Board of Nursing to further 19 incentivize the health practitioners to practice in professional shortage areas and medically 20 underserved areas in the State. 21 (b) The workgroup shall consist of the following members: 22 (1) the Secretary of Health, or the Secretary’s designee; 23 (2) one representative of the State Board of Nursing, designated by the 24 Executive Director of the Board; 25 (3) one representative of the Maryland Nurses Association, designated by 26 the President of the Association; 27 (4) one representative of 1199 SEIU United Healthcare Workers East, 28 designated by the President of the union; 29 (5) one representative of the Health Facilities Association of Maryland, 30 designated by the President of the Association; 31 (6) one representative of the Maryland Hospital Association, designated by 32 the President of the Association; 33 14 HOUSE BILL 1208 (7) one representative of the LifeSpan Network, designated by the 1 President of the Network; and 2 (8) one representative of Leading Age Maryland, designated by the 3 President of the union. 4 (c) The workgroup shall consult with the Department of Legislative Services 5 when developing its recommendations. 6 (d) The workgroup shall: 7 (1) review nursing school debt experienced in the United States and in 8 Maryland; 9 (2) examine other models for recruitment and retention of nurses and other 10 health care practitioners regulated by the State Board of Nursing that operate in other 11 states, including how these models are funded and how a loan repayment assistance 12 program for the health care practitioners could be competitive with other states; 13 (3) examine and recommend methods to incentivize nursing and nursing 14 worker students to commit to practicing in medically underserved areas in the State before 15 entering an educational program or on graduation from nursing school or a program 16 focusing on training for health care practitioners regulated by the State Board of Nursing; 17 and 18 (4) investigate the availability of federal grants to further expand loan 19 repayment and loan forgiveness for nurses and other health care practitioners regulated 20 by the State Board of Nursing in Maryland. 21 (e) (1) On or before December 1, 2022, the workgroup shall submit an interim 22 report of its findings and recommendations to the General Assembly in accordance with § 23 2–1257 of the State Government Article. 24 (2) On or before December 1, 2023, the workgroup shall submit a final 25 report of its findings and recommendations, including recommendations on the structure 26 of a permanent advisory council and a permanent funding structure for a loan repayment 27 assistance program for nurses and other health care practitioners regulated by the State 28 Board of Nursing, to the General Assembly, in accordance with § 2–1257 of the State 29 Government Article. 30 SECTION 4. 5. 4. AND BE IT FURTHER ENACTED, That the State Board of 31 Nursing shall adopt the regulations required under § 8–6A–05(b)(2) of the Health 32 Occupations Article, as enacted under Section 1 of this Act, on or before December 31, 2022. 33 SECTION 5. 6. 5. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall 34 take effect June July 1, 2022, and shall be applicable to all taxable years beginning after 35 HOUSE BILL 1208 15 December 31, 2021, but before January 1, 2025. Section 2 of this Act shall remain effective 1 for a period of 3 years and, at the end of May 31 June 30, 2025, Section 2 of this Act, with 2 no further action required by the General Assembly, shall be abrogated and of no further 3 force and effect. 4 SECTION 7. 6. AND BE IT FURTHER ENACTED, That, except as provided in 5 Section 6 5 of this Act, this Act shall take effect June 1, 2022. 6 Approved: ________________________________________________________________________________ Governor. ________________________________________________________________________________ Speaker of the House of Delegates. ________________________________________________________________________________ President of the Senate.