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.
*hb0218*
HOUSE BILL 218
J2 2lr1480
By: Delegate Kelly
Introduced and read first time: January 13, 2022
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 22, 2022
CHAPTER ______
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 except under certain circumstances; 5
altering the composition of the Board advisory committee; authorizing the Board to 6
conduct site visits of certified dialysis technician training programs; and generally 7
relating to dialysis technicians. 8
BY repealing and reenacting, with amendments, 9
Article – Health Occupations 10
Section 8–205(a)(2), 8–208(a), (j), and (m), 8–510(a); 8–6A–01, 8–6A–02(a) and (b), 11
8–6A–03(c), 8–6A–04 through 8–6A–10, 8–6A–12, 8–6A–13(a) and (b), 12
8–6A–14.1, 8–6A–15, and 8–6A–15 to be under the amended subtitle “Subtitle 13
6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication 14
Technicians”; and 8–701(h) and (i), and 8–703(a)(4) 15
Annotated Code of Maryland 16
(2021 Replacement Volume) 17
BY repealing and reenacting, without amendments, 18
Article – Health Occupations 19
Section 8–208(b)(1) and 8–6A–02(b) 20
Annotated Code of Maryland 21
(2021 Replacement Volume) 22
2 HOUSE BILL 218
BY adding to 1
Article – Health Occupations 2
Section 8–6A–02(e), 8–6A–03(c), 8–701(h), 8–703(j), 8–705(f), and 8–706(h) 3
Annotated Code of Maryland 4
(2021 Replacement Volume) 5
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That the Laws of Maryland read as follows: 7
Article – Health Occupations 8
8–205. 9
(a) In addition to the powers and duties set forth elsewhere in this title, the Board 10
has the following powers and duties: 11
(2) To set standards for the practice of registered nursing, advanced 12
practice registered nursing, licensed practical nursing, certified nursing assistants, 13
CERTIFIED DIALYSIS T ECHNICIANS, certified medication technicians, electrology, 14
direct–entry midwifery, and certified midwifery; 15
8–208. 16
(a) (1) In this section the following words have the meanings indicated. 17
(2) “Applicant” means an individual who has submitted an application to 18
the Board to be licensed as a registered nurse, licensed practical nurse, electrologist, 19
licensed direct–entry midwife, or licensed certified midwife or to be certified as an advanced 20
practice registered nurse, a nursing assistant, A DIALYSIS TECHNICIA N, or A medication 21
technician in this State. 22
(3) “Participant” means a registered nurse, an advanced practice 23
registered nurse, a licensed practical nurse, a nursing assistant, a medication technician, 24
an electrologist, a licensed direct–entry midwife, a licensed certified midwife, A CERTIFIED 25
DIALYSIS TECHNICIAN , or an applicant enrolled in the safe practice program. 26
(4) “Program” means the safe practice program. 27
(5) “Substance use disorder” means a disorder that occurs when an 28
individual exhibits a pattern of behaviors ranging from the misuse of, dependence on, or 29
addiction to drugs, alcohol, or other chemicals. 30
(b) (1) There is a Safe Practice Committee in the Board. 31
(j) In addition to the powers set forth elsewhere in this subtitle, the Committee 32
may: 33
HOUSE BILL 218 3
(1) Evaluate those registered nurses, advanced practice registered nurses, 1
licensed practical nurses, nursing assistants, medication technicians, electrologists, 2
licensed direct–entry midwives, licensed certified midwives, CERTIFIED DIALYSIS 3
TECHNICIANS, or applicants who request participation in the program according to the 4
guidelines prescribed by the Board and consider the recommendations for admission into 5
the program; 6
(2) Receive and review information concerning a participant in the 7
program; 8
(3) Consider in the case of each participant whether the participant may 9
safely continue or resume to practice or qualify for licensure or certification to practice; and 10
(4) Have meetings as necessary to consider the requests of registered 11
nurses, advanced practice registered nurses, licensed practical nurses, nursing assistants, 12
medication technicians, electrologists, licensed direct–entry midwives, licensed certified 13
midwives, CERTIFIED DIALYSIS T ECHNICIANS, or applicants to participate in the 14
program, and consider reports regarding participants. 15
(m) (1) Each licensee, certificate holder, or applicant who requests to 16
participate in the program shall agree to cooperate with the individual plan or agreement 17
designed by the Committee. 18
(2) Any failure to comply with the conditions of a plan or agreement may 19
result in the participant being expelled from the program. 20
(3) (i) The Committee shall report to the Board the name and license 21
number of a registered nurse, licensed practical nurse, electrologist, licensed direct–entry 22
midwife, or licensed certified midwife, the name and certificate number of an advanced 23
practice registered nurse, a nursing assistant, [or] A medication technician, OR A 24
CERTIFIED DIALYSIS T ECHNICIAN, or the name of an applicant who is expelled from the 25
program for failure to comply with the conditions of a plan or agreement. 26
(ii) The program shall transfer to the Board all records of any 27
participant expelled from the program. 28
(4) If a participant is expelled from the program, the Board may: 29
(i) Initiate disciplinary action in accordance with the provisions of 30
§§ 8–316 and 8–317, §§ 8–6A–10 and 8–6A–10.1, §§ 8–6B–18 and 8–6B–19, § 8–6C–20, or 31
§ 8–6D–10 of this title; and 32
(ii) Summarily suspend the license or certificate of any licensee or 33
certificate holder in accordance with Title 10, Subtitle 2 of the State Government Article. 34
8–510. 35
4 HOUSE BILL 218
(a) The Board may conduct a demonstration study to evaluate a proposed change 1
to regulations regarding nursing practices or the activities of nursing assistants, DIALYSIS 2
TECHNICIANS, or medication technicians in a practice setting. 3
Subtitle 6A. Certification of Nursing Assistants, DIALYSIS TECHNICIANS, and 4
Medication Technicians. 5
8–6A–01. 6
(a) In this subtitle the following words have the meanings indicated. 7
(b) “Applicant” means, unless the context requires otherwise: 8
(1) An individual applying for an initial certificate by examination or 9
endorsement; 10
(2) A certificate holder applying for renewal of a certificate; or 11
(3) An individual applying for reinstatement of a certificate in accordance 12
with § 8–6A–10 of this subtitle. 13
(C) (1) “APPROVED DIALYSIS TEC HNICIAN TRAINING PRO GRAM” MEANS 14
A COURSE OF TRAINING APPROVED BY THE BOARD THAT PREPARES: 15
(I) PREPARES THE APPLICANT FOR NA TIONAL CERTIFICATION 16
AND THAT MEETS ; 17
(II) MEETS THE REQUIREMENTS OF 42 C.F.R. § 494.140(E)(3); 18
AND 19
(III) MEETS THE REQUIREMENT S SET BY THE BOARD IN 20
REGULATION . 21
(2) “APPROVED DIALYSIS TEC HNICIAN TRAINING PRO GRAM” 22
INCLUDES THE COURSES REQUIRED FOR NATIONAL CERTIFICATION AS : 23
(I) A CERTIFIED CLINICAL HEMODIALYSIS TECHNICIAN BY 24
THE NEPHROLOGY NURSING CERTIFICATION COMMISSION; 25
(II) A CLINICAL NEPHROLOGY TECHNICIAN BY THE NATIONAL 26
NEPHROLOGY CERTIFICATION ORGANIZATION; OR 27
(III) A CERTIFIED HEMODIALYSIS TECHNICIAN BY THE BOARD 28
OF NEPHROLOGY EXAMINERS NURSING TECHNOLOGY . 29
HOUSE BILL 218 5
[(c)] (D) “Approved medication technician training program” means a course of 1
training approved by the Board that meets the basic medication technician core curriculum 2
and the medication technician content training specific to the setting in which the 3
medication technician will work. 4
[(d)] (E) “Approved nursing assistant training program” means a course of 5
training that meets the basic nursing assistant curriculum prescribed and approved by the 6
Board. 7
[(e)] (F) “Board” means the State Board of Nursing. 8
[(f)] (G) “Certificate” means a certificate issued by the Board to practice as a 9
certified nursing assistant, A CERTIFIED DIALYSIS TECHNICIAN, or a certified medication 10
technician in the State. 11
[(g)] (H) “Certificate holder” means a certified nursing assistant, DIALYSIS 12
TECHNICIAN, or medication technician who has: 13
(1) An active certificate; 14
(2) An inactive certificate; 15
(3) A temporary certificate; 16
(4) An expired temporary certificate; 17
(5) An expired certificate; 18
(6) A lapsed certificate; 19
(7) A suspended certificate; or 20
(8) A certificate subject to a reprimand, probation, or suspension. 21
(I) “CERTIFIED DIALYSIS TE CHNICIAN” MEANS AN INDIVIDUAL WHO: 22
(1) HAS COMPLETED A BOARD–APPROVED DIALYSIS TE CHNICIAN 23
PROGRAM; AND 24
(2) IS CERTIFIED BY THE BOARD AS A DIALYSIS T ECHNICIAN. 25
[(h)] (J) “Certified medication technician” means an individual who: 26
(1) Has completed a Board–approved medication technician training 27
program; and 28
6 HOUSE BILL 218
(2) Is certified by the Board as a medication technician. 1
[(i)] (K) “Certified medicine aide” means a certified nursing assistant who has 2
completed a Board–approved course in medication administration. 3
[(j)] (L) “Certified nursing assistant”: 4
(1) Means an individual regardless of title who routinely performs nursing 5
tasks delegated by a registered nurse or licensed practical nurse for compensation; and 6
(2) Does not include a CERTIFIED DIALYSIS T ECHNICIAN OR A certified 7
medication technician. 8
[(k)] (M) “Department” means the Maryland Department of Health. 9
[(l)] (N) “Expired certificate” means a certificate that was not renewed before 10
the expiration date of the certificate as established under § 8–6A–08(a) of this title. 11
[(m)] (O) “Geriatric nursing assistant” means a certified nursing assistant who 12
has successfully completed the requirements for geriatric nursing assistant mandated 13
under federal law and the regulations of the Board. 14
[(n)] (P) “Lapsed certificate” means a certificate that was not renewed because 15
a certificate holder failed to renew the certificate or otherwise did not meet the renewal 16
requirements of this subtitle. 17
8–6A–02. 18
(a) Except SUBJECT TO SUBSECTION (E) OF THIS SECTION AND EXCEPT as 19
otherwise provided in this subtitle, an individual shall be certified by the Board to practice 20
as a nursing assistant, DIALYSIS TECHNICIAN , or medication technician before the 21
individual may practice as a nursing assistant, DIALYSIS TECHNICIAN , or medication 22
technician in the State. 23
(b) This subtitle does not apply to an individual who: 24
(1) Practices a health occupation that the individual is authorized to 25
practice under this article; 26
(2) Provides for the gratuitous care of friends, domestic partners, or family 27
members; 28
(3) Performs nursing assistant tasks while a nursing student enrolled in 29
an accredited nursing program and practicing under the direct supervision of qualified 30
faculty or preceptors; 31
HOUSE BILL 218 7
(4) Performs nursing assistant tasks as a student while: 1
(i) Enrolled in a Board–approved nursing assistant training 2
program; and 3
(ii) Practicing under the direct supervision of qualified faculty or 4
preceptors; 5
(5) Performs medication technician tasks as a student while practicing 6
under the direct supervision of qualified faculty; or 7
(6) PERFORMS DIALYSIS TEC HNICIAN TASKS AS A S TUDENT WHILE 8
UNDER THE DIRECT SUP ERVISION OF QUALIFIED FACULTY ; OR 9
(6) (7) Works as a principal or school secretary, does not administer 10
medication as a routine part of the position, and has completed training by the delegating 11
nurse for the occasion where the individual may need to administer medication in the 12
absence of the nurse or medication technician. 13
(E) AN INDIVIDUAL SHALL B E CERTIFIED BY THE BOARD TO PRACTICE AS A 14
NURSING ASSISTANT AN D AS A DIALYSIS TECH NICIAN BEFORE THE IN DIVIDUAL MAY 15
PRACTICE AS A DIALYS IS TECHNICIAN IN A STATE–OWNED HOSPITAL OR 16
STATE–OWNED FACILITY . 17
8–6A–03. 18
(C) AN INDIVIDUAL SHALL B E CERTIFIED AS A DIA LYSIS TECHNICIAN BY 19
THE BOARD BEFORE THE INDI VIDUAL MAY: 20
(1) USE THE TITLE “CERTIFIED DIALYSIS T ECHNICIAN”; 21
(2) USE THE INITIALS “C.D.T.” AFTER THE NAME OF TH E 22
INDIVIDUAL; OR 23
(3) REPRESENT TO THE PUBL IC THAT THE INDIVIDU AL IS A 24
CERTIFIED DIALYSIS T ECHNICIAN. 25
[(c)] (D) An individual may not practice, attempt to practice, or offer to practice 26
as a CERTIFIED DIA LYSIS TECHNICIAN OR A certified medication technician without 27
certification from the Board. 28
8–6A–04. 29
8 HOUSE BILL 218
(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 T ECHNICIANS, 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 HOUSE BILL 218 9
2. AN APPROVED DIALYSIS TE CHNICIAN TRAINING 1
PROGRAM; 2
[2.] 3. An approved course in medication administration; or 3
[3.] 4. A portion of an approved nursing education program 4
that the Board determines meets the requirements of a nursing assistant training program, 5
DIALYSIS TRAINING CO URSE, or medication administration course; 6
(iii) Pay to the Board an application fee set by the Board; 7
(iv) Be of good moral character; 8
(v) Be at least 16 years old to apply for certification as a nursing 9
assistant; [and] 10
(VI) BE AT LEAST 18 YEARS OLD TO APPLY F OR CERTIFICATION 11
AS A DIALYSIS TECHNI CIAN; AND 12
[(vi)] (VII) Be at least 18 years old to apply for certification as a 13
medication technician. 14
(2) Subject to paragraph (1) of this subsection, an applicant for certification 15
as a certified nursing assistant OR DIALYSIS TECHNICI AN shall submit to the Board: 16
(i) A criminal history records check in accordance with § 8–303 of 17
this title and § 8–6A–08(k) of this subtitle; and 18
(ii) On the form required by the Board, written, verified evidence 19
that the requirement of item (i) of this paragraph is being met or has been met. 20
(3) An applicant for certification as a certified medicine aide, in addition to 21
the requirements under paragraph (1) of this subsection, shall submit an additional 22
application to that effect to the Board on the form that the Board requires. 23
(4) An applicant for a certificate may not: 24
(i) Have committed any act or omission that would be grounds for 25
discipline or denial of certification under this subtitle; and 26
(ii) Have a record of abuse, negligence, misappropriation of a 27
resident’s property, or any disciplinary action taken or pending in any other state or 28
territory of the United States against the certification of the nursing assistant or 29
medication technician in the state or territory. 30
10 HOUSE BILL 218
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
(i) Any expiration date; 31 HOUSE BILL 218 11
(ii) The type of certificate; and 1
(iii) Any specific category of nursing assistant. 2
(c) An individual who has met the requirements for a certified nursing assistant 3
shall be certified with the title of “certified nursing assistant”. 4
(d) An individual who routinely performs nursing tasks delegated by a registered 5
nurse or licensed practical nurse for compensation and has also completed a 6
Board–approved course in medication administration shall be certified with the title of 7
“certified medicine aide”. 8
(E) AN INDIVIDUAL WHO HAS MET THE REQUIREMENTS FOR A CERTIFIED 9
DIALYSIS TECHNICIAN SHALL BE CERTIFIED W ITH THE TITLE OF “CERTIFIED 10
DIALYSIS TECHNICIAN ”. 11
[(e)] (F) An individual who has met the requirements for a certified medication 12
technician shall be certified with the title of “certified medication technician”. 13
[(f)] (G) (1) The Board may issue a temporary practice certificate to an 14
applicant who: 15
(i) Has met the appropriate certification requirements of this 16
subtitle to the satisfaction of the Board; and 17
(ii) Does not have a criminal record and has not been the subject of 18
a health professional disciplinary action in this State or another jurisdiction. 19
(2) Unless the Board suspends or revokes a temporary practice certificate, 20
the temporary practice certificate expires 90 days after issuance. 21
(3) A temporary practice certificate may be extended up to an additional 90 22
days if the applicant is awaiting the completion of criminal history record information. 23
[(g)] (H) A medication technician graduate may practice for no more than 90 24
days from the date of completion of a medication technician training program without 25
certification by the Board. 26
[(h)] (I) (1) On receipt of the criminal history record information of an 27
applicant for certification as a certified nursing assistant OR DIALYSIS TECHNICI AN 28
forwarded to the Board in accordance with § 8–303 of this title, in determining whether to 29
grant a certificate, the Board shall consider: 30
(i) The age at which the crime was committed; 31
12 HOUSE BILL 218
(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
CERTIFICATE HOLDER by: 15
(i) First–class mail to the last known mailing address of the nursing 16
assistant or medication technician CERTIFICATE HOLDER ; 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 OR 25
DIALYSIS technician is required to have a criminal history records check before a certificate 26
may be renewed, the Board shall send the nursing assistant, DIALYSIS TECHNICIAN , or 27
medication OR DIALYSIS technician the documents necessary for initiating the criminal 28
history records check in conjunction with the renewal notice required under paragraph (1) 29
of this subsection. 30
HOUSE BILL 218 13
(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 EXPIRATION; 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 EXPIRATION; 17
and 18
(2) Successfully complete a Board–approved medicine aide continuing 19
education program. 20
(E) BEFORE A CERTIFICATE EXPIRES, A DIALYSIS TECHNICIA N 21
PERIODICALLY MAY REN EW IT FOR AN ADDITIO NAL TERM, IF THE CERTIFICATE 22
HOLDER: 23
(1) OTHERWISE IS ENTITLED TO BE CERTIFIED; 24
(2) SUBMITS TO THE BOARD A RENEWAL APPLI CATION ON THE FORM 25
THAT THE BOARD REQUIRES ; 26
(3) PAYS TO THE BOARD A RENEWAL FEE S ET BY THE BOARD; 27
(4) HAS COMPLETED 16 HOURS OF PRACTICE AS A DIALYSIS 28
TECHNICIAN IN THE 2–YEAR PERIOD IMMEDIAT ELY PRECEDING THE DA TE OF 29
RENEWAL; 30
14 HOUSE BILL 218
(5) HAS COMPLETED A 3–HOUR CONTINUING EDUC ATION COURSE 1
APPROVED BY THE BOARD; AND 2
(4) HAS COMPLETED : 3
(I) 1. 16 HOURS OF PRACTICE AS A DIALYSIS TECHNICIA N IN 4
THE 2–YEAR PERIOD IMMEDIATELY P RECEDING THE DATE OF EXPIRATION; AND 5
2. A 3–HOUR CONTINUING EDUC ATION COURSE 6
APPROVED BY THE BOARD; OR 7
(II) A DIALYSIS TECHNICIAN TRAINING PROGRAM APP ROVED 8
BY THE BOARD; AND 9
(6) (5) HAS AN ACTIVE NATIONA L CERTIFICATION LIST ED IN § 10
8–6A–01(C)(2) OF THIS SUBTITLE . 11
[(e)] (F) Before a certificate expires, a medication technician periodically may 12
renew it for an additional term, if the certificate holder: 13
(1) Otherwise is entitled to be certified; 14
(2) Submits to the Board a renewal application on the form that the Board 15
requires; 16
(3) Pays to the Board a renewal fee set by the Board; 17
(4) Every 2 years, provides satisfactory evidence of completion of a 18
Board–approved clinical refresher course; and 19
(5) Provides satisfactory evidence of completion of 100 hours of practice as 20
a certified medication technician within the 2–year period preceding the date of renewal. 21
[(f)] (G) The Board may grant a 30 –day extension, beyond a certificate’s 22
expiration date, to a certificate holder so that the certificate holder may renew the 23
certificate before it expires. 24
[(g)] (H) The Board shall reinstate the certificate of a certificate holder who has 25
failed to renew the certificate for any reason if the certificate holder meets the applicable 26
renewal requirements of subsections (c) through [(e)] (F) and [(k)(1)(i)2] (L)(1)(I)2 of this 27
section. 28
[(h)] (I) Subject to subsection [(i)] (J) of this section, the Board shall renew the 29
certificate of each nursing assistant, DIALYSIS TECHNICIAN , or medication technician who 30
meets the requirements of this section. 31
HOUSE BILL 218 15
[(i)] (J) (1) Within 60 days after a change has occurred, each certificate 1
holder shall notify the Board in writing of any change in a name or address. 2
(2) If the certificate holder fails to notify the Board within the time 3
required under this subsection, the Board may impose an administrative penalty of $25 on 4
the certificate holder. 5
[(j)] (K) The Board shall pay any penalty collected under this subsection to the 6
General Fund of the State. 7
[(k)] (L) (1) (i) The Board shall require criminal history records checks in 8
accordance with § 8–303 of this title on: 9
1. Selected applicants for certification as a certified nursing 10
assistant OR DIALYSIS TECHNICI AN who renew their certificates every 2 years as 11
determined by regulations adopted by the Board; and 12
2. Each former certified nursing assistant OR DIALYSIS 13
TECHNICIAN who files for reinstatement under subsection [(g)] (H) of this section after 14
failing to renew the certificate for a period of 1 year or more. 15
(ii) An additional criminal history records check shall be performed 16
every 12 years thereafter. 17
(2) On receipt of the criminal history record information of a certificate 18
holder forwarded to the Board in accordance with § 8–303 of this title, in determining 19
whether to initiate disciplinary action against the certificate holder based on the 20
information received, the Board shall consider: 21
(i) The age at which the crime was committed; 22
(ii) The circumstances surrounding the crime; 23
(iii) The length of time that has passed since the crime; 24
(iv) Subsequent work history; 25
(v) Employment and character references; and 26
(vi) Other evidence that demonstrates whether the certificate holder 27
poses a threat to the public health or safety. 28
(3) The Board may not renew a certificate without written documentation 29
that the applicant has submitted to a criminal history records check as required under § 30
8–303 of this title. 31
16 HOUSE BILL 218
[(l)] (M) (1) If an individual has been certified by the Board to practice as a 1
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State in 2
accordance with the requirements of this subtitle, the individual subsequently may be 3
certified as a nursing assistant, DIALYSIS TECHNICIAN , or medication technician on 4
inactive status. 5
(2) The Board shall place a certificate holder on inactive status and record 6
the inactive status in the Board’s database and on the Board’s website if the certificate 7
holder: 8
(i) Submits documentation of a medical condition that the Board 9
determines will prevent the certificate holder from practicing as a nursing assistant, 10
DIALYSIS TECHNICIAN , or medication technician; and 11
(ii) Completes the biennial application for inactive status and 12
submits documentation of a continuing medical condition. 13
(3) A certificate holder on inactive status may apply for reactivation of the 14
certificate if the certificate holder: 15
(i) Submits documentation satisfactory to the Board that the 16
medical condition for which the inactive status was granted no longer exists; and 17
(ii) Meets the renewal requirements of this section. 18
(4) If a certificate holder meets the requirements of paragraph (3) of this 19
subsection, the Board shall: 20
(i) Record the status of the certificate holder as active in the Board’s 21
database and on the Board’s website; and 22
(ii) Reactivate the certificate holder’s certificate to practice as a 23
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State. 24
(5) The Board may not charge a fee to place the certificate holder on or 25
remove the certificate holder from inactive status under this subsection. 26
(6) Inactive status: 27
(i) May not be considered a disciplinary action under § 8–6A–10 of 28
this subtitle; and 29
(ii) May not be reported to any certifying entity, employer, or 30
insurance company as a disciplinary action. 31
[(m)] (N) (1) The Board shall adopt regulations to specify: 32 HOUSE BILL 218 17
(i) The circumstances under which a nursing assistant, as a 1
condition of renewal, is required to complete either an approved nursing assistant training 2
program or an approved nursing assistant refresher training program; and 3
(ii) The number of didactic instruction hours and clinical training 4
hours the nursing assistant training program or nursing assistant refresher training 5
program must have to be approved. 6
(2) Regulations adopted under paragraph (1) of this subsection must be 7
consistent with federal law. 8
8–6A–09. 9
(a) The Board may impose a civil fine not exceeding $50 on a certified nursing 10
assistant, A CERTIFIED DIALYSIS TECHNICIAN, or a certified medication technician who 11
fails to renew a certificate within 30 days after its expiration date and practices as a 12
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication 13
technician during the period of expiration. 14
(b) The Board shall pay any penalty collected under this section to the General 15
Fund of the State. 16
8–6A–10. 17
(a) Subject to the hearing provisions of § 8–317 of this title and § 8–6A–10.1 of 18
this subtitle, the Board may deny a certificate or grant a certificate, including a certificate 19
subject to a reprimand, probation, or suspension, to any applicant, reprimand any 20
certificate holder, place any certificate holder on probation, or suspend or revoke the 21
certificate of a certificate holder, if the applicant or certificate holder: 22
(1) Fraudulently or deceptively obtains or attempts to obtain a certificate 23
for the applicant or for another; 24
(2) Fraudulently or deceptively uses a certificate; 25
(3) Is disciplined by a licensing, military, or disciplinary authority in this 26
State or in any other state or country or convicted or disciplined by a court in this State or 27
in any other state or country for an act that would be grounds for disciplinary action under 28
the Board’s disciplinary statutes; 29
(4) Is convicted of or pleads guilty or nolo contendere to a felony or to a 30
crime involving moral turpitude, whether or not any appeal or other proceeding is pending 31
to have the conviction or plea set aside; 32
(5) Files a false report or record of an individual under the certificate 33
holder’s care; 34 18 HOUSE BILL 218
(6) Gives any false or misleading information about a material matter in 1
an employment application; 2
(7) Fails to file or record any health record that is required by law; 3
(8) Induces another individual to fail to file or record any health record that 4
is required by law; 5
(9) Has violated any order, rule, or regulation of the Board relating to the 6
practice or certification of a nursing assistant, DIALYSIS TECHNICIAN , or medication 7
technician; 8
(10) Provides services as a nursing assistant, DIALYSIS TECHNICIAN , or 9
medication technician while: 10
(i) Under the influence of alcohol; or 11
(ii) Using any narcotic or controlled dangerous substance, as defined 12
in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic 13
amounts or without valid medical indication; 14
(11) Has a substance use disorder; 15
(12) Is addicted to, or habitually abuses, any narcotic or controlled 16
dangerous substance as defined in § 5–101 of the Criminal Law Article; 17
(13) Has acted in a manner inconsistent with the health or safety of an 18
individual under the applicant or certificate holder’s care; 19
(14) Has practiced as a nursing assistant, DIALYSIS TECHNICIAN , or 20
medication technician in a manner which fails to meet generally accepted standards for the 21
practice of a nursing assistant, DIALYSIS TECHNICIAN , or medication technician; 22
(15) Has physically, verbally, or psychologically abused, neglected, or 23
otherwise harmed an individual under the applicant or certificate holder’s care; 24
(16) Has a physical or mental condition which renders the applicant or 25
certificate holder unable to practice as a certified nursing assistant, CERTIFIED DIALYSIS 26
TECHNICIAN, or certified medication technician with reasonable skill and safety to the 27
patients and which may endanger the health or safety of individuals under the care of the 28
applicant or certificate holder; 29
(17) Has violated the confidentiality of information or knowledge as 30
prescribed by law concerning any patient; 31
HOUSE BILL 218 19
(18) Has misappropriated patient or facility property; 1
(19) Performs certified nursing assistant, CERTIFIED DIALYSIS 2
TECHNICIAN, or certified medication technician functions incompetently; 3
(20) Has violated any provision of this title or has aided or knowingly 4
permitted any individual to violate any provision of this title; 5
(21) Submits a false statement to collect a fee; 6
(22) Refuses, withholds from, denies, or discriminates against an individual 7
with regard to the provision of professional services for which the applicant or certificate 8
holder is certified and qualified to render because the individual is HIV positive; 9
(23) Except in an emergency life–threatening situation where it is not 10
feasible or practicable, fails to comply with the Centers for Disease Control and 11
Prevention’s guidelines on universal precautions; 12
(24) Fails to cooperate with a lawful investigation conducted by the Board; 13
(25) Fails to comply with instructions and directions of the supervising 14
registered nurse or licensed practical nurse; 15
(26) When holding an expired certificate or a lapsed certificate, commits any 16
act that would be grounds for disciplinary action under this section; 17
(27) Practices as a nursing assistant, DIALYSIS TECHNICIAN , or 18
medication technician before obtaining or renewing the certificate, including any time 19
period when practicing as a nursing assistant, DIALYSIS TECHNICIAN , or medication 20
technician on an expired certificate or a lapsed certificate; 21
(28) Impersonates another individual: 22
(i) Licensed under the provisions of this title; or 23
(ii) Who holds a certificate issued under the provisions of this title; 24
(29) Engages in conduct that violates the code of ethics; 25
(30) Performs activities that exceed the education and training of the 26
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication 27
technician; 28
(31) Is expelled from the safe practice program established pursuant to § 29
8–208 of this title for failure to comply with the conditions of the program; 30
20 HOUSE BILL 218
(32) Fails to submit to a criminal history records check in accordance with § 1
8–303 of this title as required under § 8–6A–05(c)(2) of this subtitle; 2
(33) Abandons a patient; or 3
(34) Is a director of nursing, or acts in the capacity of a director of nursing 4
and knowingly employs an individual who is not authorized to perform delegated nursing 5
duties under this subtitle. 6
(b) If, after a hearing under § 8–317 of this title and § 8–6A–10.1 of this subtitle, 7
the Board finds that there are grounds under subsection (a) of this section to suspend or 8
revoke a certificate to practice as a certified nursing assistant, CERTIFIED DIALYSIS 9
TECHNICIAN, or certified medication technician, to reprimand a certificate holder, or place 10
a certificate holder on probation, the Board may impose a penalty not exceeding $500 11
instead of or in addition to suspending or revoking the certificate, reprimanding the 12
certificate holder, or placing the certificate holder on probation. 13
(c) (1) If a certificate issued under this subtitle was suspended or revoked for 14
a period of more than 1 year, or if a period of more than 1 year has passed since a certificate 15
was surrendered, the Board may reinstate the certificate if the certificate holder: 16
(i) Applies to the Board for reinstatement; 17
(ii) Meets the requirements for renewal under § 8–6A–08 of this 18
subtitle; 19
(iii) Meets any other requirements for reinstatement as established 20
by the Board in regulations; and 21
(iv) Submits to a criminal history records check in accordance with § 22
8–303 of this title. 23
(2) If a certificate holder meets the requirements of paragraph (1) of this 24
subsection, the Board may: 25
(i) Reinstate the certificate; 26
(ii) Reinstate the certificate subject to terms and conditions that the 27
Board considers necessary, including a period of probation; or 28
(iii) Deny reinstatement of the certificate. 29
8–6A–12. 30
(a) Unless the Board agrees to accept the surrender of a certificate, a certified 31
nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication technician 32
may not surrender the certificate. 33 HOUSE BILL 218 21
(b) The Board may require terms and conditions on an agreement with the 1
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication 2
technician to accept surrender of the certificate. 3
(c) An agreement to accept the surrender of a certificate is a final order of the 4
Board and is a public record. 5
8–6A–13. 6
(a) The Board shall appoint an advisory committee consisting of at least [15] 17 7
members. 8
(b) Of the [15] 17 committee members: 9
(1) Six shall be nursing assistants: 10
(i) One shall be an acute care nursing assistant; 11
(ii) One shall be a home care nursing assistant; 12
(iii) One shall be a long–term care nursing assistant; 13
(iv) One shall be an adult medical day care nursing assistant; 14
(v) At least one of the nursing assistant members shall be a member 15
of a union; and 16
(vi) One shall be an independent contractor; 17
(2) Three shall be registered nurses: 18
(i) One shall be an acute care registered nurse; 19
(ii) One shall be a home care registered nurse; and 20
(iii) One shall be a long–term care registered nurse; 21
(3) [One] TWO shall be [an administrator] ADMINISTRATORS from [a] 22
licensed health care [facility] FACILITIES; 23
(4) One shall be a licensed practical nurse; 24
(5) One shall be an individual who teaches a nursing assistant course; 25
(6) One shall be a consumer member who has received care, or has a family 26
member who has received care from a nursing assistant; 27 22 HOUSE BILL 218
(7) One shall be a representative of the Department; [and] 1
(8) One shall be a certified medication technician; AND 2
(9) ONE SHALL BE A CERTIFIED DIALYSIS TECHNICIAN . 3
8–6A–14.1. 4
The Board may make survey visits from time to time, without prior notice, to all 5
Board–approved medication technician training AND DIALYSIS TECHNIC IAN TRAINING 6
programs. 7
8–6A–15. 8
(a) If, during the review of an application for certification or investigation of an 9
allegation brought against a certified nursing assistant, CERTIFIED DIALYSIS 10
TECHNICIAN, or certified medication technician under this subtitle, the Board has reason 11
to believe and objective evidence that the applicant, certified nursing assistant, CERTIFIED 12
DIALYSIS TECHNICIAN , or certified medication technician may cause harm to a person 13
affected by the practice of the applicant, certified nursing assistant, CERTIFIED DIALYSIS 14
TECHNICIAN, or certified medication technician, the Board, on its own initiative, shall 15
direct the applicant, certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or 16
certified medication technician to submit to an appropriate examination by a health care 17
provider designated by the Board. 18
(b) In return for the privilege to practice as a certified nursing assistant, 19
CERTIFIED DIALYSIS T ECHNICIAN, or certified medication technician in the State, an 20
applicant, certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified 21
medication technician is deemed to have: 22
(1) Consented to submit to an examination under this section if requested 23
by the Board in writing; and 24
(2) Waived any legal claim of privilege as to the testimony or examination 25
reports of the examining health care provider. 26
(c) The failure or refusal of an applicant, certified nursing assistant, CERTIFIED 27
DIALYSIS TECHNICIAN , or certified medication technician to submit to an examination 28
required under subsection (b) of this section is prima facie evidence of the inability of the 29
applicant, certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified 30
medication technician to competently practice as a certified nursing assistant, CERTIFIED 31
DIALYSIS TECHNICIAN , or certified medication technician, unless the Board finds that the 32
failure or refusal was beyond the control of the applicant, certified nursing assistant, 33
CERTIFIED DIALYSIS T ECHNICIAN, or certified medication technician. 34 HOUSE BILL 218 23
(d) The Board shall pay the cost of any examination made in accordance with the 1
provisions of this section. 2
8–701. 3
(H) EXCEPT AS OTHERWISE P ROVIDED IN THIS TITL E, AN INDIVIDUAL MAY 4
NOT PRACTICE , ATTEMPT TO PRACTICE , OR OFFER TO PRACTICE AS A CERTIFIED 5
DIALYSIS TECHNICIAN UNLESS LICENSED CERTIFIED BY THE BOARD TO PRACTICE 6
AS A CERTIFIED DIALY SIS TECHNICIAN. 7
[(h)] (I) An individual may not require a licensee to perform an act that is 8
beyond the licensee’s knowledge and skills. 9
[(i)] (J) An individual may not direct a licensee to delegate a nursing task to a 10
nurse when the individual reasonably believes: 11
(1) The nurse lacks the knowledge and skills to perform the nursing task; 12
or 13
(2) The patient’s condition does not allow delegation of the nursing task. 14
8–703. 15
(a) (4) Unless authorized to provide patient care as a certified nursing 16
assistant, DIALYSIS TECHNICIAN , or medication assistant under this title, an individual 17
may not represent to the public by title, by description of services, methods, or procedures, 18
or otherwise, that the individual is authorized to provide care as a certified nursing 19
assistant, DIALYSIS TECHNICIAN , or medication assistant in this State. 20
(J) UNLESS AUTHORIZED TO PRACTICE AS A CERTIF IED DIALYSIS 21
TECHNICIAN UNDER THI S TITLE, AN INDIVIDUAL MAY NO T USE THE WORDS OR 22
TERMS “DIALYSIS TECHNICIAN ” OR “CERTIFIED DIALYSIS T ECHNICIAN”, THE 23
ABBREVIATION “C.D.T.”, OR ANY OTHER TITLE , SYMBOL, ABBREVIATION , SIGN, 24
CARD, DEVICE, OR OTHER REPRESENTAT ION WITH THE INTENT TO REPRESENT 25
THAT THE INDIVIDUAL PRACTICES AS A CERTI FIED DIALYSIS TECHNICIAN. 26
8–705. 27
(F) AN INDIVIDUAL MAY NOT PRACTICE AS A CERTIF IED DIALYSIS 28
TECHNICIAN UNDER COL OR OF ANY DIPLOMA , LICENSE, RECORD, OR CERTIFICATE 29
THAT IS: 30
(1) ILLEGALLY OR FRAUDULE NTLY OBTAINED ; OR 31
24 HOUSE BILL 218
(2) SIGNED OR ISSUED UNLA WFULLY OR BY FRAUDU LENT 1
REPRESENTATION . 2
8–706. 3
(H) AN INDIVIDUAL MAY NOT KNOWINGLY EMPLOY TO PRACTICE AS A 4
CERTIFIED DIALYSIS T ECHNICIAN ANY INDIVI DUAL WHO IS NOT AUTH ORIZED TO 5
PRACTICE AS A CERTIF IED DIALYSIS TECHNIC IAN UNDER THIS TITLE . 6
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 7
1, 2022. 8
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.