EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0218*
HOUSE BILL 218
J2 2lr1480
By: Delegate Kelly
Introduced and read first time: January 13, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Occupations – Nursing – Dialysis Technicians 2
FOR the purpose of establishing the separate category of certified dialysis technicians to 3
be certified by the State Board of Nursing; repealing the requirement that a dialysis 4
technician be a certified nursing assistant; altering the composition of the Board 5
advisory committee; authorizing the Board to conduct site visits of certified dialysis 6
technician training programs; and generally relating to dialysis technicians. 7
BY repealing and reenacting, with amendments, 8
Article – Health Occupations 9
Section 8–208(a), (j), and (m), 8–6A–01, 8–6A–02(a), 8–6A–03(c), 8–6A–04 through 10
8–6A–10, 8–6A–12, 8–6A–13(a) and (b), 8–6A–14.1, 8–6A–15, 8–701(h) and 11
(i), and 8–703(a)(4) 12
Annotated Code of Maryland 13
(2021 Replacement Volume) 14
BY repealing and reenacting, without amendments, 15
Article – Health Occupations 16
Section 8–208(b)(1) and 8–6A–02(b) 17
Annotated Code of Maryland 18
(2021 Replacement Volume) 19
BY adding to 20
Article – Health Occupations 21
Section 8–6A–03(c), 8–701(h), 8–703(j), 8–705(f), and 8–706(h) 22
Annotated Code of Maryland 23
(2021 Replacement Volume) 24
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 25
That the Laws of Maryland read as follows: 26
2 HOUSE BILL 218
Article – Health Occupations 1
8–208. 2
(a) (1) In this section the following words have the meanings indicated. 3
(2) “Applicant” means an individual who has submitted an application to 4
the Board to be licensed as a registered nurse, licensed practical nurse, electrologist, 5
licensed direct–entry midwife, or licensed certified midwife or to be certified as an advanced 6
practice registered nurse, a nursing assistant, or medication technician in this State. 7
(3) “Participant” means a registered nurse, an advanced practice 8
registered nurse, a licensed practical nurse, a nursing assistant, a medication technician, 9
an electrologist, a licensed direct–entry midwife, a licensed certified midwife, A CERTIFIED 10
DIALYSIS TECHNICIAN , or an applicant enrolled in the safe practice program. 11
(4) “Program” means the safe practice program. 12
(5) “Substance use disorder” means a disorder that occurs when an 13
individual exhibits a pattern of behaviors ranging from the misuse of, dependence on, or 14
addiction to drugs, alcohol, or other chemicals. 15
(b) (1) There is a Safe Practice Committee in the Board. 16
(j) In addition to the powers set forth elsewhere in this subtitle, the Committee 17
may: 18
(1) Evaluate those registered nurses, advanced practice registered nurses, 19
licensed practical nurses, nursing assistants, medication technicians, electrologists, 20
licensed direct–entry midwives, licensed certified midwives, CERTIFIED DIALYSIS 21
TECHNICIANS, or applicants who request participation in the program according to the 22
guidelines prescribed by the Board and consider the recommendations for admission into 23
the program; 24
(2) Receive and review information concerning a participant in the 25
program; 26
(3) Consider in the case of each participant whether the participant may 27
safely continue or resume to practice or qualify for licensure or certification to practice; and 28
(4) Have meetings as necessary to consider the requests of registered 29
nurses, advanced practice registered nurses, licensed practical nurses, nursing assistants, 30
medication technicians, electrologists, licensed direct–entry midwives, licensed certified 31
midwives, CERTIFIED DIALYSIS T ECHNICIANS, or applicants to participate in the 32
program, and consider reports regarding participants. 33
HOUSE BILL 218 3
(m) (1) Each licensee, certificate holder, or applicant who requests to 1
participate in the program shall agree to cooperate with the individual plan or agreement 2
designed by the Committee. 3
(2) Any failure to comply with the conditions of a plan or agreement may 4
result in the participant being expelled from the program. 5
(3) (i) The Committee shall report to the Board the name and license 6
number of a registered nurse, licensed practical nurse, electrologist, licensed direct–entry 7
midwife, or licensed certified midwife, the name and certificate number of an advanced 8
practice registered nurse, a nursing assistant, [or] A medication technician, OR A 9
CERTIFIED DIALYSIS T ECHNICIAN, or the name of an applicant who is expelled from the 10
program for failure to comply with the conditions of a plan or agreement. 11
(ii) The program shall transfer to the Board all records of any 12
participant expelled from the program. 13
(4) If a participant is expelled from the program, the Board may: 14
(i) Initiate disciplinary action in accordance with the provisions of 15
§§ 8–316 and 8–317, §§ 8–6A–10 and 8–6A–10.1, §§ 8–6B–18 and 8–6B–19, § 8–6C–20, or 16
§ 8–6D–10 of this title; and 17
(ii) Summarily suspend the license or certificate of any licensee or 18
certificate holder in accordance with Title 10, Subtitle 2 of the State Government Article. 19
8–6A–01. 20
(a) In this subtitle the following words have the meanings indicated. 21
(b) “Applicant” means, unless the context requires otherwise: 22
(1) An individual applying for an initial certificate by examination or 23
endorsement; 24
(2) A certificate holder applying for renewal of a certificate; or 25
(3) An individual applying for reinstatement of a certificate in accordance 26
with § 8–6A–10 of this subtitle. 27
(C) (1) “APPROVED DIALYSIS TEC HNICIAN TRAINING PRO GRAM” MEANS 28
A COURSE OF TRAINING APPROVED BY THE BOARD THAT PREPARES THE AP PLICANT 29
FOR NATIONAL CERTIFI CATION AND THAT MEETS THE R EQUIREMENTS OF 42 C.F.R. 30
§ 494.140(E)(3). 31
4 HOUSE BILL 218
(2) “APPROVED DIALYSIS TECHNICIAN TRAINING PROGRAM” 1
INCLUDES THE COURSES REQUIRED FOR CERTIFICATION AS: 2
(I) A CERTIFIED CLINICAL HEMODIALYSIS TECHNICIAN BY 3
THE NEPHROLOGY NURSING CERTIFICATION COMMISSION; 4
(II) A CLINICAL NEPHROLOGY TECHNICIAN BY THE NATIONAL 5
NEPHROLOGY CERTIFICATION ORGANIZATION; OR 6
(III) A CERTIFIED HEMODIALYSIS TECHNICIAN BY THE BOARD 7
OF NEPHROLOGY EXAMINERS NURSING TECHNOLOGY . 8
[(c)] (D) “Approved medication technician training program” means a course of 9
training approved by the Board that meets the basic medication technician core curriculum 10
and the medication technician content training specific to the setting in which the 11
medication technician will work. 12
[(d)] (E) “Approved nursing assistant training program” means a course of 13
training that meets the basic nursing assistant curriculum prescribed and approved by the 14
Board. 15
[(e)] (F) “Board” means the State Board of Nursing. 16
[(f)] (G) “Certificate” means a certificate issued by the Board to practice as a 17
certified nursing assistant, A CERTIFIED DIALY SIS TECHNICIAN, or a certified medication 18
technician in the State. 19
[(g)] (H) “Certificate holder” means a certified nursing assistant, DIALYSIS 20
TECHNICIAN, or medication technician who has: 21
(1) An active certificate; 22
(2) An inactive certificate; 23
(3) A temporary certificate; 24
(4) An expired temporary certificate; 25
(5) An expired certificate; 26
(6) A lapsed certificate; 27
(7) A suspended certificate; or 28
(8) A certificate subject to a reprimand, probation, or suspension. 29 HOUSE BILL 218 5
(I) “CERTIFIED DIALYSIS TECHNICIAN ” MEANS AN INDIVIDUAL WHO: 1
(1) HAS COMPLETED A BOARD–APPROVED DIALYSIS TE CHNICIAN 2
PROGRAM; AND 3
(2) IS CERTIFIED BY THE BOARD AS A DIALYSIS T ECHNICIAN. 4
[(h)] (J) “Certified medication technician” means an individual who: 5
(1) Has completed a Board–approved medication technician training 6
program; and 7
(2) Is certified by the Board as a medication technician. 8
[(i)] (K) “Certified medicine aide” means a certified nursing assistant who has 9
completed a Board–approved course in medication administration. 10
[(j)] (L) “Certified nursing assistant”: 11
(1) Means an individual regardless of title who routinely performs nursing 12
tasks delegated by a registered nurse or licensed practical nurse for compensation; and 13
(2) Does not include a certified medication technician. 14
[(k)] (M) “Department” means the Maryland Department of Health. 15
[(l)] (N) “Expired certificate” means a certificate that was not renewed before 16
the expiration date of the certificate as established under § 8–6A–08(a) of this title. 17
[(m)] (O) “Geriatric nursing assistant” means a certified nursing assistant who 18
has successfully completed the requirements for geriatric nursing assistant mandated 19
under federal law and the regulations of the Board. 20
[(n)] (P) “Lapsed certificate” means a certificate that was not renewed because 21
a certificate holder failed to renew the certificate or otherwise did not meet the renewal 22
requirements of this subtitle. 23
8–6A–02. 24
(a) Except as otherwise provided in this subtitle, an individual shall be certified 25
by the Board to practice as a nursing assistant, DIALYSIS TECHNICIAN , or medication 26
technician before the individual may practice as a nursing assistant, DIALYSIS 27
TECHNICIAN, or medication technician in the State. 28
(b) This subtitle does not apply to an individual who: 29 6 HOUSE BILL 218
(1) Practices a health occupation that the individual is authorized to 1
practice under this article; 2
(2) Provides for the gratuitous care of friends, domestic partners, or family 3
members; 4
(3) Performs nursing assistant tasks while a nursing student enrolled in 5
an accredited nursing program and practicing under the direct supervision of qualified 6
faculty or preceptors; 7
(4) Performs nursing assistant tasks as a student while: 8
(i) Enrolled in a Board–approved nursing assistant training 9
program; and 10
(ii) Practicing under the direct supervision of qualified faculty or 11
preceptors; 12
(5) Performs medication technician tasks as a student while practicing 13
under the direct supervision of qualified faculty; or 14
(6) Works as a principal or school secretary, does not administer 15
medication as a routine part of the position, and has completed training by the delegating 16
nurse for the occasion where the individual may need to administer medication in the 17
absence of the nurse or medication technician. 18
8–6A–03. 19
(C) AN INDIVIDUAL SHALL B E CERTIFIED AS A DIA LYSIS TECHNICIAN BY 20
THE BOARD BEFORE THE INDI VIDUAL MAY: 21
(1) USE THE TITLE “CERTIFIED DIALYSIS T ECHNICIAN”; 22
(2) USE THE INITIALS “C.D.T.” AFTER THE NAME OF TH E 23
INDIVIDUAL; OR 24
(3) REPRESENT TO THE PUBL IC THAT THE INDIVIDU AL IS A 25
CERTIFIED DIALYSIS T ECHNICIAN. 26
[(c)] (D) An individual may not practice, attempt to practice, or offer to practice 27
as a CERTIFIED DIA LYSIS TECHNICIAN OR A certified medication technician without 28
certification from the Board. 29
8–6A–04. 30
HOUSE BILL 218 7
(a) (1) The Board shall set reasonable fees for the issuance and renewal of 1
certificates and other services it provides to certified nursing assistants, CERTIFIED 2
DIALYSIS TECHNICIANS , and certified medication technicians. 3
(2) The fees charged shall be set to produce funds to approximate the cost 4
of maintaining the certification program and the other services provided to certified 5
nursing assistants, CERTIFIED DIALYSIS TE CHNICIANS, and certified medication 6
technicians. 7
(b) (1) The Board shall pay all fees collected under the provisions of this 8
subtitle to the Comptroller of the State. 9
(2) The Comptroller shall distribute all the fees to the State Board of 10
Nursing Fund established under § 8–206 of this title. 11
8–6A–05. 12
(a) The Board shall adopt regulations establishing: 13
(1) Categories of certified nursing assistants, including geriatric nursing 14
assistants, home health aides, school health aides, [dialysis technicians,] individuals 15
working in developmental disabilities administration facilities, and medicine aides; 16
(2) Qualifications for each category of certified nursing assistant; 17
(3) QUALIFICATIONS FOR CE RTIFIED DIALYSIS TEC HNICIANS; 18
[(3)] (4) Qualifications for certified medication technicians; and 19
[(4)] (5) Standards for qualification of applicants for certification, 20
including the applicant’s criminal history, work record, and prohibitions against behavior 21
which may be potentially harmful to patients. 22
(b) To qualify for certification as a nursing assistant, a nursing assistant in a 23
specific category, A DIALYSIS TECHNICIA N, or a medication technician, an applicant shall 24
meet the requirements set by the Board. 25
(c) (1) An applicant for a certificate shall: 26
(i) Submit an application to the Board on the form that the Board 27
requires; 28
(ii) Provide evidence, as required by the Board, of successful 29
completion of: 30
1. An approved nursing assistant training program; 31 8 HOUSE BILL 218
2. AN APPROVED DIALYSIS TECHNICIAN TRAINING 1
PROGRAM; 2
[2.] 3. An approved course in medication administration; 3
or 4
[3.] 4. A portion of an approved nursing education 5
program that the Board determines meets the requirements of a nursing assistant training 6
program, DIALYSIS TRAINING CO URSE, or medication administration course; 7
(iii) Pay to the Board an application fee set by the Board; 8
(iv) Be of good moral character; 9
(v) Be at least 16 years old to apply for certification as a nursing 10
assistant; [and] 11
(VI) BE AT LEAST 18 YEARS OLD TO APPLY F OR CERTIFICATION 12
AS A DIALYSIS TECHNI CIAN; AND 13
[(vi)] (VII) Be at least 18 years old to apply for certification as a 14
medication technician. 15
(2) Subject to paragraph (1) of this subsection, an applicant for certification 16
as a certified nursing assistant shall submit to the Board: 17
(i) A criminal history records check in accordance with § 8–303 of 18
this title and § 8–6A–08(k) of this subtitle; and 19
(ii) On the form required by the Board, written, verified evidence 20
that the requirement of item (i) of this paragraph is being met or has been met. 21
(3) An applicant for certification as a certified medicine aide, in addition to 22
the requirements under paragraph (1) of this subsection, shall submit an additional 23
application to that effect to the Board on the form that the Board requires. 24
(4) An applicant for a certificate may not: 25
(i) Have committed any act or omission that would be grounds for 26
discipline or denial of certification under this subtitle; and 27
(ii) Have a record of abuse, negligence, misappropriation of a 28
resident’s property, or any disciplinary action taken or pending in any other state or 29
territory of the United States against the certification of the nursing assistant or 30
medication technician in the state or territory. 31 HOUSE BILL 218 9
8–6A–06. 1
Every applicant for certification by endorsement shall: 2
(1) Pay the required application fee; 3
(2) Submit the information required by the Board in the manner and form 4
specified by the Board; and 5
(3) Submit written evidence that the applicant: 6
(i) Is certified to practice as a nursing assistant OR DIALYSIS 7
TECHNICIAN by another state or territory of the United States with requirements that are 8
essentially similar to the requirements for certification established in this subtitle and that 9
the certification is in good standing; 10
(ii) Has not committed any act or omission that would be grounds for 11
discipline or denial of certification under this subtitle; 12
(iii) Has successfully completed nursing assistant training OR 13
DIALYSIS TECHNICIAN TRAINING that meets the standards for an approved nursing 14
assistant training program OR DIALYSIS TECHNICI AN TRAINING PROGRAM established 15
under this subtitle and the standards adopted by the Board; and 16
(iv) Has no record of abuse, negligence, or misappropriation of a 17
resident’s property or any disciplinary action taken or pending in any other state or 18
territory of the United States against the certification of the nursing assistant OR 19
DIALYSIS TECHNICIAN in the state or territory. 20
8–6A–07. 21
(a) Subject to subsection (f) of this section, the Board shall certify any applicant 22
who meets the requirements of this subtitle. 23
(b) (1) The Board shall: 24
(i) Issue each new certified nursing assistant , DIALYSIS 25
TECHNICIAN, or medication technician a certificate number and registration certificate 26
that indicates the initial certificate was issued by the Board; and 27
(ii) Electronically record each certificate in the Board’s database and 28
on the Board’s website. 29
(2) Each certificate shall include: 30
10 HOUSE BILL 218
(i) Any expiration date; 1
(ii) The type of certificate; and 2
(iii) Any specific category of nursing assistant. 3
(c) An individual who has met the requirements for a certified nursing assistant 4
shall be certified with the title of “certified nursing assistant”. 5
(d) An individual who routinely performs nursing tasks delegated by a registered 6
nurse or licensed practical nurse for compensation and has also completed a 7
Board–approved course in medication administration shall be certified with the title of 8
“certified medicine aide”. 9
(E) AN INDIVIDUAL WHO HAS MET THE REQUIREMENTS FOR A CERTIFIED 10
DIALYSIS TECHNICIAN SHALL BE CERTIFIED W ITH THE TITLE OF “CERTIFIED 11
DIALYSIS TECHNICIAN ”. 12
[(e)] (F) An individual who has met the requirements for a certified medication 13
technician shall be certified with the title of “certified medication technician”. 14
[(f)] (G) (1) The Board may issue a temporary practice certificate to an 15
applicant who: 16
(i) Has met the appropriate certification requirements of this 17
subtitle to the satisfaction of the Board; and 18
(ii) Does not have a criminal record and has not been the subject of 19
a health professional disciplinary action in this State or another jurisdiction. 20
(2) Unless the Board suspends or revokes a temporary practice certificate, 21
the temporary practice certificate expires 90 days after issuance. 22
(3) A temporary practice certificate may be extended up to an additional 90 23
days if the applicant is awaiting the completion of criminal history record information. 24
[(g)] (H) A medication technician graduate may practice for no more than 90 25
days from the date of completion of a medication technician training program without 26
certification by the Board. 27
[(h)] (I) (1) On receipt of the criminal history record information of an 28
applicant for certification as a certified nursing assistant forwarded to the Board in 29
accordance with § 8–303 of this title, in determining whether to grant a certificate, the 30
Board shall consider: 31
(i) The age at which the crime was committed; 32 HOUSE BILL 218 11
(ii) The circumstances surrounding the crime; 1
(iii) The length of time that has passed since the crime; 2
(iv) Subsequent work history; 3
(v) Employment and character references; and 4
(vi) Other evidence that demonstrates whether the applicant poses a 5
threat to the public health or safety. 6
(2) The Board may not issue a certificate if the criminal history record 7
information required under § 8–303 of this title has not been received. 8
8–6A–08. 9
(a) A certificate expires on the 28th day of the birth month of the nursing 10
assistant, DIALYSIS TECHNICIAN , or medication technician, unless the certificate is 11
renewed for a 2–year term as provided in this section. 12
(b) (1) At least 3 months before a certificate expires, the Board shall send a 13
renewal notice to the nursing assistant, DIALYSIS TECHNICIAN , or medication technician 14
by: 15
(i) First–class mail to the last known mailing address of the nursing 16
assistant or medication technician; or 17
(ii) Electronic means to the last known electronic address of the 18
certificate holder. 19
(2) A renewal notice shall state: 20
(i) The date on which the current certificate expires; 21
(ii) The date by which the renewal application must be received by 22
the Board for the renewal to be issued and mailed before the certificate expires; and 23
(iii) The amount of the renewal fee. 24
(3) If a nursing assistant, DIALYSIS TECHNICIAN , or medication 25
technician is required to have a criminal history records check before a certificate may be 26
renewed, the Board shall send the nursing assistant, DIALYSIS TECHNICIAN , or 27
medication technician the documents necessary for initiating the criminal history records 28
check in conjunction with the renewal notice required under paragraph (1) of this 29
subsection. 30
12 HOUSE BILL 218
(c) Before a certificate expires, a nursing assistant periodically may renew it for 1
an additional term, if the certificate holder: 2
(1) Otherwise is entitled to be certified; 3
(2) Submits to the Board a renewal application on the form that the Board 4
requires; 5
(3) Pays to the Board a renewal fee set by the Board; and 6
(4) Provides satisfactory evidence of completion of: 7
(i) 16 hours of active nursing assistant practice within the 2–year 8
period immediately preceding the date of renewal; or 9
(ii) If the nursing assistant did not complete 16 hours of active 10
practice as required under item (i) of this item, an approved nursing assistant training 11
program or an approved nursing assistant refresher training program as required in 12
regulations adopted by the Board in accordance with subsection (m) of this section. 13
(d) In addition to the requirements in subsection (c)(1), (2), and (3) of this section, 14
a certified medicine aide shall: 15
(1) Provide satisfactory evidence of completion of 100 hours of practice as 16
a certified medicine aide in the 2–year period preceding the date of renewal; and 17
(2) Successfully complete a Board–approved medicine aide continuing 18
education program. 19
(E) BEFORE A CERTIFICATE EXPIRES, A DIALYSIS TECHNICIA N 20
PERIODICALLY MAY REN EW IT FOR AN ADDITIO NAL TERM, IF THE CERTIFICATE 21
HOLDER: 22
(1) OTHERWISE IS ENTITLED TO BE CERTIFIED; 23
(2) SUBMITS TO THE BOARD A RENEWAL APPLI CATION ON THE FORM 24
THAT THE BOARD REQUIRES ; 25
(3) PAYS TO THE BOARD A RENEWAL FEE S ET BY THE BOARD; 26
(4) HAS COMPLETED 16 HOURS OF PRACTICE AS A DIA LYSIS 27
TECHNICIAN IN THE 2–YEAR PERIOD IMMEDIATELY PRECEDING THE DATE O F 28
RENEWAL; 29
(5) HAS COMPLETED A 3–HOUR CONTINUING EDUCATION COURSE 30
APPROVED BY THE BOARD; AND 31 HOUSE BILL 218 13
(6) HAS AN ACTIVE NATIONA L CERTIFICATION LIST ED IN § 1
8–6A–01(C)(2) OF THIS SUBTITLE. 2
[(e)] (F) Before a certificate expires, a medication technician periodically may 3
renew it for an additional term, if the certificate holder: 4
(1) Otherwise is entitled to be certified; 5
(2) Submits to the Board a renewal application on the form that the Board 6
requires; 7
(3) Pays to the Board a renewal fee set by the Board; 8
(4) Every 2 years, provides satisfactory evidence of completion of a 9
Board–approved clinical refresher course; and 10
(5) Provides satisfactory evidence of completion of 100 hours of practice as 11
a certified medication technician within the 2–year period preceding the date of renewal. 12
[(f)] (G) The Board may grant a 30 –day extension, beyond a certificate’s 13
expiration date, to a certificate holder so that the certificate holder may renew the 14
certificate before it expires. 15
[(g)] (H) The Board shall reinstate the certificate of a certificate holder who has 16
failed to renew the certificate for any reason if the certificate holder meets the applicable 17
renewal requirements of subsections (c) through [(e)] (F) and [(k)(1)(i)2] (L)(1)(I)2 of this 18
section. 19
[(h)] (I) Subject to subsection [(i)] (J) of this section, the Board shall renew the 20
certificate of each nursing assistant, DIALYSIS TECHNICIAN , or medication technician who 21
meets the requirements of this section. 22
[(i)] (J) (1) Within 60 days after a change has occurred, each certificate 23
holder shall notify the Board in writing of any change in a name or address. 24
(2) If the certificate holder fails to notify the Board within the time 25
required under this subsection, the Board may impose an administrative penalty of $25 on 26
the certificate holder. 27
[(j)] (K) The Board shall pay any penalty collected under this subsection to the 28
General Fund of the State. 29
[(k)] (L) (1) (i) The Board shall require criminal history records checks in 30
accordance with § 8–303 of this title on: 31
14 HOUSE BILL 218
1. Selected applicants for certification as a certified nursing 1
assistant who renew their certificates every 2 years as determined by regulations adopted 2
by the Board; and 3
2. Each former certified nursing assistant who files for 4
reinstatement under subsection [(g)] (H) of this section after failing to renew the certificate 5
for a period of 1 year or more. 6
(ii) An additional criminal history records check shall be performed 7
every 12 years thereafter. 8
(2) On receipt of the criminal history record information of a certificate 9
holder forwarded to the Board in accordance with § 8–303 of this title, in determining 10
whether to initiate disciplinary action against the certificate holder based on the 11
information received, the Board shall consider: 12
(i) The age at which the crime was committed; 13
(ii) The circumstances surrounding the crime; 14
(iii) The length of time that has passed since the crime; 15
(iv) Subsequent work history; 16
(v) Employment and character references; and 17
(vi) Other evidence that demonstrates whether the certificate holder 18
poses a threat to the public health or safety. 19
(3) The Board may not renew a certificate without written documentation 20
that the applicant has submitted to a criminal history records check as required under § 21
8–303 of this title. 22
[(l)] (M) (1) If an individual has been certified by the Board to practice as a 23
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State in 24
accordance with the requirements of this subtitle, the individual subsequently may be 25
certified as a nursing assistant, DIALYSIS TECHNICIAN , or medication technician on 26
inactive status. 27
(2) The Board shall place a certificate holder on inactive status and record 28
the inactive status in the Board’s database and on the Board’s website if the certificate 29
holder: 30
(i) Submits documentation of a medical condition that the Board 31
determines will prevent the certificate holder from practicing as a nursing assistant, 32
DIALYSIS TECHNICIAN , or medication technician; and 33 HOUSE BILL 218 15
(ii) Completes the biennial application for inactive status and 1
submits documentation of a continuing medical condition. 2
(3) A certificate holder on inactive status may apply for reactivation of the 3
certificate if the certificate holder: 4
(i) Submits documentation satisfactory to the Board that the 5
medical condition for which the inactive status was granted no longer exists; and 6
(ii) Meets the renewal requirements of this section. 7
(4) If a certificate holder meets the requirements of paragraph (3) of this 8
subsection, the Board shall: 9
(i) Record the status of the certificate holder as active in the Board’s 10
database and on the Board’s website; and 11
(ii) Reactivate the certificate holder’s certificate to practice as a 12
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State. 13
(5) The Board may not charge a fee to place the certificate holder on or 14
remove the certificate holder from inactive status under this subsection. 15
(6) Inactive status: 16
(i) May not be considered a disciplinary action under § 8–6A–10 of 17
this subtitle; and 18
(ii) May not be reported to any certifying entity, employer, or 19
insurance company as a disciplinary action. 20
[(m)] (N) (1) The Board shall adopt regulations to specify: 21
(i) The circumstances under which a nursing assistant, as a 22
condition of renewal, is required to complete either an approved nursing assistant training 23
program or an approved nursing assistant refresher training program; and 24
(ii) The number of didactic instruction hours and clinical training 25
hours the nursing assistant training program or nursing assistant refresher training 26
program must have to be approved. 27
(2) Regulations adopted under paragraph (1) of this subsection must be 28
consistent with federal law. 29
8–6A–09. 30
16 HOUSE BILL 218
(a) The Board may impose a civil fine not exceeding $50 on a certified nursing 1
assistant, A CERTIFIED DIALYSIS TECHNICIAN , or a certified medication technician who 2
fails to renew a certificate within 30 days after its expiration date and practices as a 3
certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified medication 4
technician during the period of expiration. 5
(b) The Board shall pay any penalty collected under this section to the General 6
Fund of the State. 7
8–6A–10. 8
(a) Subject to the hearing provisions of § 8–317 of this title and § 8–6A–10.1 of 9
this subtitle, the Board may deny a certificate or grant a certificate, including a certificate 10
subject to a reprimand, probation, or suspension, to any applicant, reprimand any 11
certificate holder, place any certificate holder on probation, or suspend or revoke the 12
certificate of a certificate holder, if the applicant or certificate holder: 13
(1) Fraudulently or deceptively obtains or attempts to obtain a certificate 14
for the applicant or for another; 15
(2) Fraudulently or deceptively uses a certificate; 16
(3) Is disciplined by a licensing, military, or disciplinary authority in this 17
State or in any other state or country or convicted or disciplined by a court in this State or 18
in any other state or country for an act that would be grounds for disciplinary action under 19
the Board’s disciplinary statutes; 20
(4) Is convicted of or pleads guilty or nolo contendere to a felony or to a 21
crime involving moral turpitude, whether or not any appeal or other proceeding is pending 22
to have the conviction or plea set aside; 23
(5) Files a false report or record of an individual under the certificate 24
holder’s care; 25
(6) Gives any false or misleading information about a material matter in 26
an employment application; 27
(7) Fails to file or record any health record that is required by law; 28
(8) Induces another individual to fail to file or record any health record that 29
is required by law; 30
(9) Has violated any order, rule, or regulation of the Board relating to the 31
practice or certification of a nursing assistant, DIALYSIS TECH NICIAN, or medication 32
technician; 33
HOUSE BILL 218 17
(10) Provides services as a nursing assistant, DIALYSIS TECHNICIAN , or 1
medication technician while: 2
(i) Under the influence of alcohol; or 3
(ii) Using any narcotic or controlled dangerous substance, as defined 4
in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic 5
amounts or without valid medical indication; 6
(11) Has a substance use disorder; 7
(12) Is addicted to, or habitually abuses, any narcotic or controlled 8
dangerous substance as defined in § 5–101 of the Criminal Law Article; 9
(13) Has acted in a manner inconsistent with the health or safety of an 10
individual under the applicant or certificate holder’s care; 11
(14) Has practiced as a nursing assistant, DIALYSIS TECHNICIAN, or 12
medication technician in a manner which fails to meet generally accepted standards for the 13
practice of a nursing assistant, DIALYSIS TECHNICIAN , or medication technician; 14
(15) Has physically, verbally, or psychologically abused, neglected, or 15
otherwise harmed an individual under the applicant or certificate holder’s care; 16
(16) Has a physical or mental condition which renders the applicant or 17
certificate holder unable to practice as a certified nursing assistant, CERTIFIED DIALYSIS 18
TECHNICIAN, or certified medication technician with reasonable skill and safety to the 19
patients and which may endanger the health or safety of individuals under the care of the 20
applicant or certificate holder; 21
(17) Has violated the confidentiality of information or knowledge as 22
prescribed by law concerning any patient; 23
(18) Has misappropriated patient or facility property; 24
(19) Performs certified nursing assistant, CERTIFIED DIALYSIS 25
TECHNICIAN, or certified medication technician functions incompetently; 26
(20) Has violated any provision of this title or has aided or knowingly 27
permitted any individual to violate any provision of this title; 28
(21) Submits a false statement to collect a fee; 29
(22) Refuses, withholds from, denies, or discriminates against an individual 30
with regard to the provision of professional services for which the applicant or certificate 31
holder is certified and qualified to render because the individual is HIV positive; 32 18 HOUSE BILL 218
(23) Except in an emergency life–threatening situation where it is not 1
feasible or practicable, fails to comply with the Centers for Disease Control and 2
Prevention’s guidelines on universal precautions; 3
(24) Fails to cooperate with a lawful investigation conducted by the Board; 4
(25) Fails to comply with instructions and directions of the supervising 5
registered nurse or licensed practical nurse; 6
(26) When holding an expired certificate or a lapsed certificate, commits any 7
act that would be grounds for disciplinary action under this section; 8
(27) Practices as a nursing assistant, DIALYSIS TECHNICIAN , or 9
medication technician before obtaining or renewing the certificate, including any time 10
period when practicing as a nursing assistant, DIALYSIS TECHNICIAN , or medication 11
technician on an expired certificate or a lapsed certificate; 12
(28) Impersonates another individual: 13
(i) Licensed under the provisions of this title; or 14
(ii) Who holds a certificate issued under the provisions of this title; 15
(29) Engages in conduct that violates the code of ethics; 16
(30) Performs activities that exceed the education and training of the 17
certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified medication 18
technician; 19
(31) Is expelled from the safe practice program established pursuant to § 20
8–208 of this title for failure to comply with the conditions of the program; 21
(32) Fails to submit to a criminal history records check in accordance with § 22
8–303 of this title as required under § 8–6A–05(c)(2) of this subtitle; 23
(33) Abandons a patient; or 24
(34) Is a director of nursing, or acts in the capacity of a director of nursing 25
and knowingly employs an individual who is not authorized to perform delegated nursing 26
duties under this subtitle. 27
(b) If, after a hearing under § 8–317 of this title and § 8–6A–10.1 of this subtitle, 28
the Board finds that there are grounds under subsection (a) of this section to suspend or 29
revoke a certificate to practice as a certified nursing assistant, CERTIFIED DIALYSIS 30
TECHNICIAN, or certified medication technician, to reprimand a certificate holder, or place 31
a certificate holder on probation, the Board may impose a penalty not exceeding $500 32 HOUSE BILL 218 19
instead of or in addition to suspending or revoking the certificate, reprimanding the 1
certificate holder, or placing the certificate holder on probation. 2
(c) (1) If a certificate issued under this subtitle was suspended or revoked for 3
a period of more than 1 year, or if a period of more than 1 year has passed since a certificate 4
was surrendered, the Board may reinstate the certificate if the certificate holder: 5
(i) Applies to the Board for reinstatement; 6
(ii) Meets the requirements for renewal under § 8–6A–08 of this 7
subtitle; 8
(iii) Meets any other requirements for reinstatement as established 9
by the Board in regulations; and 10
(iv) Submits to a criminal history records check in accordance with § 11
8–303 of this title. 12
(2) If a certificate holder meets the requirements of paragraph (1) of this 13
subsection, the Board may: 14
(i) Reinstate the certificate; 15
(ii) Reinstate the certificate subject to terms and conditions that the 16
Board considers necessary, including a period of probation; or 17
(iii) Deny reinstatement of the certificate. 18
8–6A–12. 19
(a) Unless the Board agrees to accept the surrender of a certificate, a certified 20
nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified medication technician 21
may not surrender the certificate. 22
(b) The Board may require terms and conditions on an agreement with the 23
certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified medication 24
technician to accept surrender of the certificate. 25
(c) An agreement to accept the surrender of a certificate is a final order of the 26
Board and is a public record. 27
8–6A–13. 28
(a) The Board shall appoint an advisory committee consisting of at least [15] 17 29
members. 30
(b) Of the [15] 17 committee members: 31 20 HOUSE BILL 218
(1) Six shall be nursing assistants: 1
(i) One shall be an acute care nursing assistant; 2
(ii) One shall be a home care nursing assistant; 3
(iii) One shall be a long–term care nursing assistant; 4
(iv) One shall be an adult medical day care nursing assistant; 5
(v) At least one of the nursing assistant members shall be a member 6
of a union; and 7
(vi) One shall be an independent contractor; 8
(2) Three shall be registered nurses: 9
(i) One shall be an acute care registered nurse; 10
(ii) One shall be a home care registered nurse; and 11
(iii) One shall be a long–term care registered nurse; 12
(3) [One] TWO shall be [an administrator] ADMINISTRATORS from [a] 13
licensed health care [facility] FACILITIES; 14
(4) One shall be a licensed practical nurse; 15
(5) One shall be an individual who teaches a nursing assistant course; 16
(6) One shall be a consumer member who has received care, or has a family 17
member who has received care from a nursing assistant; 18
(7) One shall be a representative of the Department; [and] 19
(8) One shall be a certified medication technician; AND 20
(9) ONE SHALL BE A CERTIF IED DIALYSIS TECHNIC IAN. 21
8–6A–14.1. 22
The Board may make survey visits from time to time, without prior notice, to all 23
Board–approved medication technician training AND DIALYSIS TECHNIC IAN TRAINING 24
programs. 25
HOUSE BILL 218 21
8–6A–15. 1
(a) If, during the review of an application for certification or investigation of an 2
allegation brought against a certified nursing assistant, CERTIFIED DIALYSIS 3
TECHNICIAN, or certified medication technician under this subtitle, the Board has reason 4
to believe and objective evidence that the applicant, certified nursing assistant, CERTIFIED 5
DIALYSIS TECHNICIAN , or certified medication technician may cause harm to a person 6
affected by the practice of the applicant, certified nursing assistant, CERTIFIED DIALYSIS 7
TECHNICIAN, or certified medication technician, the Board, on its own initiative, shall 8
direct the applicant, certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or 9
certified medication technician to submit to an appropriate examination by a health care 10
provider designated by the Board. 11
(b) In return for the privilege to practice as a certified nursing assistant, 12
CERTIFIED DIALYSIS TECHNICIAN , or certified medication technician in the State, an 13
applicant, certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified 14
medication technician is deemed to have: 15
(1) Consented to submit to an examination under this section if requested 16
by the Board in writing; and 17
(2) Waived any legal claim of privilege as to the testimony or examination 18
reports of the examining health care provider. 19
(c) The failure or refusal of an applicant, certified nursing assistant, CERTIFIED 20
DIALYSIS TECHNICIAN , or certified medication technician to submit to an examination 21
required under subsection (b) of this section is prima facie evidence of the inability of the 22
applicant, certified nursing assistant, CERTIFIED DIALYSIS TECHNICIAN , or certified 23
medication technician to competently practice as a certified nursing assistant, CERTIFIED 24
DIALYSIS TECHNICIAN , or certified medication technician, unless the Board finds that the 25
failure or refusal was beyond the control of the applicant, certified nursing assistant, 26
CERTIFIED DIALYSIS TECHNICIAN , or certified medication technician. 27
(d) The Board shall pay the cost of any examination made in accordance with the 28
provisions of this section. 29
8–701. 30
(H) EXCEPT AS OTHERWISE P ROVIDED IN THIS TITL E, AN INDIVIDUAL MAY 31
NOT PRACTICE , ATTEMPT TO PRACTICE , OR OFFER TO PRACTICE AS A CERTIFIED 32
DIALYSIS TECHNICIAN UNLESS LICENSED BY T HE BOARD TO PRACTICE AS A 33
CERTIFIED DIALYSIS TECHNICI AN. 34
[(h)] (I) An individual may not require a licensee to perform an act that is 35
beyond the licensee’s knowledge and skills. 36 22 HOUSE BILL 218
[(i)] (J) An individual may not direct a licensee to delegate a nursing task to a 1
nurse when the individual reasonably believes: 2
(1) The nurse lacks the knowledge and skills to perform the nursing task; 3
or 4
(2) The patient’s condition does not allow delegation of the nursing task. 5
8–703. 6
(a) (4) Unless authorized to provide patient care as a certified nursing 7
assistant, DIALYSIS TECHNICIA N, or medication assistant under this title, an individual 8
may not represent to the public by title, by description of services, methods, or procedures, 9
or otherwise, that the individual is authorized to provide care as a certified nursing 10
assistant, DIALYSIS TECHNICIAN, or medication assistant in this State. 11
(J) UNLESS AUTHORIZED TO PRACTICE AS A CERTIF IED DIALYSIS 12
TECHNICIAN UNDER THI S TITLE, AN INDIVIDUAL MAY NO T USE THE WORDS OR 13
TERMS “DIALYSIS TECHNICIAN ” OR “CERTIFIED DIALYSIS T ECHNICIAN”, THE 14
ABBREVIATION “C.D.T.”, OR ANY OTHER TITLE , SYMBOL, ABBREVIATION , SIGN, 15
CARD, DEVICE, OR OTHER REPRESENTAT ION WITH THE INTENT TO REPRESENT 16
THAT THE INDIVIDUAL PRACTICES AS A CERTI FIED DIALYSIS TECHNI CIAN. 17
8–705. 18
(F) AN INDIVIDUAL MAY NOT PRACTICE AS A CERTIF IED DIALYSIS 19
TECHNICIAN UNDER COL OR OF ANY DIPLOMA , LICENSE, RECORD, OR CERTIFICATE 20
THAT IS: 21
(1) ILLEGALLY OR FRAUDULE NTLY OBTAINED ; OR 22
(2) SIGNED OR ISSUED UNLA WFULLY OR BY FRAUDUL ENT 23
REPRESENTATION . 24
8–706. 25
(H) AN INDIVIDUAL MAY NOT KNOWINGLY EMPLOY TO PRACTICE AS A 26
CERTIFIED DIALYSIS T ECHNICIAN ANY INDIVI DUAL WHO IS NOT AUTH ORIZED TO 27
PRACTICE AS A CERTIF IED DIALYSIS TECHNIC IAN UNDER THIS TITLE . 28
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 29
1, 2022. 30