LAWRENCE J. HOGAN, JR., Governor Ch. 681
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Chapter 681
(House Bill 218)
AN ACT concerning
Health Occupations – Nursing – Dialysis Technicians
FOR the purpose of establishing the separate category of certified dialysis technicians to
be certified by the State Board of Nursing; repealing the requirement that a dialysis
technician be a certified nursing assistant except under certain circumstances;
altering the composition of the Board advisory committee; authorizing the Board to
conduct site visits of certified dialysis technician training programs; and generally
relating to dialysis technicians.
BY repealing and reenacting, with amendments,
Article – Health Occupations
Section 8–205(a)(2), 8–208(a), (j), and (m), 8–510(a); 8–6A–01, 8–6A–02(a) and (b),
8–6A–03(c), 8–6A–04 through 8–6A–10, 8–6A–12, 8–6A–13(a) and (b),
8–6A–14.1, 8–6A–15, and 8–6A–15 to be under the amended subtitle “Subtitle
6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication
Technicians”; and 8–701(h) and (i), and 8–703(a)(4)
Annotated Code of Maryland
(2021 Replacement Volume)
BY repealing and reenacting, without amendments,
Article – Health Occupations
Section 8–208(b)(1) and 8–6A–02(b)
Annotated Code of Maryland
(2021 Replacement Volume)
BY adding to
Article – Health Occupations
Section 8–6A–02(e), 8–6A–03(c), 8–701(h), 8–703(j), 8–705(f), and 8–706(h)
Annotated Code of Maryland
(2021 Replacement Volume)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health Occupations
8–205.
(a) In addition to the powers and duties set forth elsewhere in this title, the Board
has the following powers and duties:
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(2) To set standards for the practice of registered nursing, advanced
practice registered nursing, licensed practical nursing, certified nursing assistants,
CERTIFIED DIALYSIS T ECHNICIANS, certified medication technicians, electrology,
direct–entry midwifery, and certified midwifery;
8–208.
(a) (1) In this section the following words have the meanings indicated.
(2) “Applicant” means an individual who has submitted an application to
the Board to be licensed as a registered nurse, licensed practical nurse, electrologist,
licensed direct–entry midwife, or licensed certified midwife or to be certified as an advanced
practice registered nurse, a nursing assistant, A DIALYSIS TECHNICIA N, or A medication
technician in this State.
(3) “Participant” means a registered nurse, an advanced practice
registered nurse, a licensed practical nurse, a nursing assistant, a medication technician,
an electrologist, a licensed direct–entry midwife, a licensed certified midwife, A CERTIFIED
DIALYSIS TECHNICIAN , or an applicant enrolled in the safe practice program.
(4) “Program” means the safe practice program.
(5) “Substance use disorder” means a disorder that occurs when an
individual exhibits a pattern of behaviors ranging from the misuse of, dependence on, or
addiction to drugs, alcohol, or other chemicals.
(b) (1) There is a Safe Practice Committee in the Board.
(j) In addition to the powers set forth elsewhere in this subtitle, the Committee
may:
(1) Evaluate those registered nurses, advanced practice registered nurses,
licensed practical nurses, nursing assistants, medication technicians, electrologists,
licensed direct–entry midwives, licensed certified midwives, CERTIFIED DIALYSIS
TECHNICIANS, or applicants who request participation in the program according to the
guidelines prescribed by the Board and consider the recommendations for admission into
the program;
(2) Receive and review information concerning a participant in the
program;
(3) Consider in the case of each participant whether the participant may
safely continue or resume to practice or qualify for licensure or certification to practice; and
(4) Have meetings as necessary to consider the requests of registered
nurses, advanced practice registered nurses, licensed practical nurses, nursing assistants, LAWRENCE J. HOGAN, JR., Governor Ch. 681
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medication technicians, electrologists, licensed direct–entry midwives, licensed certified
midwives, CERTIFIED DIALYSIS T ECHNICIANS, or applicants to participate in the
program, and consider reports regarding participants.
(m) (1) Each licensee, certificate holder, or applicant who requests to
participate in the program shall agree to cooperate with the individual plan or agreement
designed by the Committee.
(2) Any failure to comply with the conditions of a plan or agreement may
result in the participant being expelled from the program.
(3) (i) The Committee shall report to the Board the name and license
number of a registered nurse, licensed practical nurse, electrologist, licensed direct–entry
midwife, or licensed certified midwife, the name and certificate number of an advanced
practice registered nurse, a nursing assistant, [or] A medication technician, OR A
CERTIFIED DIALYSIS T ECHNICIAN, or the name of an applicant who is expelled from the
program for failure to comply with the conditions of a plan or agreement.
(ii) The program shall transfer to the Board all records of any
participant expelled from the program.
(4) If a participant is expelled from the program, the Board may:
(i) Initiate disciplinary action in accordance with the provisions of
§§ 8–316 and 8–317, §§ 8–6A–10 and 8–6A–10.1, §§ 8–6B–18 and 8–6B–19, § 8–6C–20, or
§ 8–6D–10 of this title; and
(ii) Summarily suspend the license or certificate of any licensee or
certificate holder in accordance with Title 10, Subtitle 2 of the State Government Article.
8–510.
(a) The Board may conduct a demonstration study to evaluate a proposed change
to regulations regarding nursing practices or the activities of nursing assistants, DIALYSIS
TECHNICIANS , or medication technicians in a practice setting.
Subtitle 6A. Certification of Nursing Assistants, DIALYSIS TECHNICIANS, and
Medication Technicians.
8–6A–01.
(a) In this subtitle the following words have the meanings indicated.
(b) “Applicant” means, unless the context requires otherwise:
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(1) An individual applying for an initial certificate by examination or
endorsement;
(2) A certificate holder applying for renewal of a certificate; or
(3) An individual applying for reinstatement of a certificate in accordance
with § 8–6A–10 of this subtitle.
(C) (1) “APPROVED DIALYSIS TEC HNICIAN TRAINING PRO GRAM” MEANS
A COURSE OF TRAINING APPROVED BY THE BOARD THAT PREPARES:
(I) PREPARES THE APPLICANT FOR NA TIONAL CERTIFICATION
AND THAT MEETS ;
(II) MEETS THE REQUIREMENTS OF 42 C.F.R. § 494.140(E)(3);
AND
(III) MEETS THE REQUIREMENT S SET BY THE BOARD IN
REGULATION .
(2) “APPROVED DIALYSIS TEC HNICIAN TRAINING PRO GRAM”
INCLUDES THE COURSES REQUIRED FOR NATIONAL CERTIFICATION AS :
(I) A CERTIFIED CLINICAL HEMODIALYSIS TECHNICIAN BY
THE NEPHROLOGY NURSING CERTIFICATION COMMISSION;
(II) A CLINICAL NEPHROLOGY TECHNICIAN BY THE NATIONAL
NEPHROLOGY CERTIFICATION ORGANIZATION ; OR
(III) A CERTIFIED HEMODIALYSIS TECHNICIAN BY THE BOARD
OF NEPHROLOGY EXAMINERS NURSING TECHNOLOGY .
[(c)] (D) “Approved medication technician training program” means a course of
training approved by the Board that meets the basic medication technician core curriculum
and the medication technician content training specific to the setting in which the
medication technician will work.
[(d)] (E) “Approved nursing assistant training program” means a course of
training that meets the basic nursing assistant curriculum prescribed and approved by the
Board.
[(e)] (F) “Board” means the State Board of Nursing.
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[(f)] (G) “Certificate” means a certificate issued by the Board to practice as a
certified nursing assistant, A CERTIFIED DIALYSIS TECHNICIAN, or a certified medication
technician in the State.
[(g)] (H) “Certificate holder” means a certified nursing assistant, DIALYSIS
TECHNICIAN, or medication technician who has:
(1) An active certificate;
(2) An inactive certificate;
(3) A temporary certificate;
(4) An expired temporary certificate;
(5) An expired certificate;
(6) A lapsed certificate;
(7) A suspended certificate; or
(8) A certificate subject to a reprimand, probation, or suspension.
(I) “CERTIFIED DIALYSIS TE CHNICIAN” MEANS AN INDIVIDUAL WHO:
(1) HAS COMPLETED A BOARD–APPROVED DIALYSIS TE CHNICIAN
PROGRAM; AND
(2) IS CERTIFIED BY THE BOARD AS A DIALYSIS T ECHNICIAN.
[(h)] (J) “Certified medication technician” means an individual who:
(1) Has completed a Board–approved medication technician training
program; and
(2) Is certified by the Board as a medication technician.
[(i)] (K) “Certified medicine aide” means a certified nursing assistant who has
completed a Board–approved course in medication administration.
[(j)] (L) “Certified nursing assistant”:
(1) Means an individual regardless of title who routinely performs nursing
tasks delegated by a registered nurse or licensed practical nurse for compensation; and
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(2) Does not include a CERTIFIED DIALYSIS T ECHNICIAN OR A certified
medication technician.
[(k)] (M) “Department” means the Maryland Department of Health.
[(l)] (N) “Expired certificate” means a certificate that was not renewed before
the expiration date of the certificate as established under § 8–6A–08(a) of this title.
[(m)] (O) “Geriatric nursing assistant” means a certified nursing assistant who
has successfully completed the requirements for geriatric nursing assistant mandated
under federal law and the regulations of the Board.
[(n)] (P) “Lapsed certificate” means a certificate that was not renewed because
a certificate holder failed to renew the certificate or otherwise did not meet the renewal
requirements of this subtitle.
8–6A–02.
(a) Except SUBJECT TO SUBSECTION (E) OF THIS SECTION AND EXCEPT as
otherwise provided in this subtitle, an individual shall be certified by the Board to practice
as a nursing assistant, DIALYSIS TECHNICIAN , or medication technician before the
individual may practice as a nursing assistant, DIALYSIS TECHNICIAN , or medication
technician in the State.
(b) This subtitle does not apply to an individual who:
(1) Practices a health occupation that the individual is authorized to
practice under this article;
(2) Provides for the gratuitous care of friends, domestic partners, or family
members;
(3) Performs nursing assistant tasks while a nursing student enrolled in
an accredited nursing program and practicing under the direct supervision of qualified
faculty or preceptors;
(4) Performs nursing assistant tasks as a student while:
(i) Enrolled in a Board–approved nursing assistant training
program; and
(ii) Practicing under the direct supervision of qualified faculty or
preceptors;
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(5) Performs medication technician tasks as a student while practicing
under the direct supervision of qualified faculty; or
(6) PERFORMS DIALYSIS TEC HNICIAN TASKS AS A S TUDENT WHILE
UNDER THE DIRECT SUP ERVISION OF QUALIFIE D FACULTY; OR
(6) (7) Works as a principal or school secretary, does not administer
medication as a routine part of the position, and has completed training by the delegating
nurse for the occasion where the individual may need to administer medication in the
absence of the nurse or medication technician.
(E) AN INDIVIDUAL SHALL B E CERTIFIED BY THE BOARD TO PRACTICE AS A
NURSING ASSISTANT AN D AS A DIALYSIS TECH NICIAN BEFORE THE IN DIVIDUAL MAY
PRACTICE AS A DIALYS IS TECHNICIAN IN A STATE–OWNED HOSPITAL OR
STATE–OWNED FACILITY.
8–6A–03.
(C) AN INDIVIDUAL SHALL B E CERTIFIED AS A DIA LYSIS TECHNICIAN BY
THE BOARD BEFORE THE INDI VIDUAL MAY:
(1) USE THE TITLE “CERTIFIED DIALYSIS T ECHNICIAN”;
(2) USE THE INITIALS “C.D.T.” AFTER THE NAME OF TH E
INDIVIDUAL; OR
(3) REPRESENT TO THE PUBL IC THAT THE INDIVIDU AL IS A
CERTIFIED DIALYSIS T ECHNICIAN.
[(c)] (D) An individual may not practice, attempt to practice, or offer to practice
as a CERTIFIED DIALYSIS T ECHNICIAN OR A certified medication technician without
certification from the Board.
8–6A–04.
(a) (1) The Board shall set reasonable fees for the issuance and renewal of
certificates and other services it provides to certified nursing assistants, CERTIFIED
DIALYSIS TECHNICIANS , and certified medication technicians.
(2) The fees charged shall be set to produce funds to approximate the cost
of maintaining the certification program and the other services provided to certified
nursing assistants, CERTIFIED DIALYSIS T ECHNICIANS, and certified medication
technicians.
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(b) (1) The Board shall pay all fees collected under the provisions of this
subtitle to the Comptroller of the State.
(2) The Comptroller shall distribute all the fees to the State Board of
Nursing Fund established under § 8–206 of this title.
8–6A–05.
(a) The Board shall adopt regulations establishing:
(1) Categories of certified nursing assistants, including geriatric nursing
assistants, home health aides, school health aides, [dialysis technicians,] individuals
working in developmental disabilities administration facilities, and medicine aides;
(2) Qualifications for each category of certified nursing assistant;
(3) QUALIFICATIONS FOR CE RTIFIED DIALYSIS TEC HNICIANS;
[(3)] (4) Qualifications for certified medication technicians; and
[(4)] (5) Standards for qualification of applicants for certification,
including the applicant’s criminal history, work record, and prohibitions against behavior
which may be potentially harmful to patients.
(b) To qualify for certification as a nursing assistant, a nursing assistant in a
specific category, A DIALYSIS TECHNICIA N, or a medication technician, an applicant shall
meet the requirements set by the Board.
(c) (1) An applicant for a certificate shall:
(i) Submit an application to the Board on the form that the Board
requires;
(ii) Provide evidence, as required by the Board, of successful
completion of:
1. An approved nursing assistant training program;
2. AN APPROVED DIALYSIS TECHNICIAN TRAINING
PROGRAM;
[2.] 3. An approved course in medication administration; or
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[3.] 4. A portion of an approved nursing education program
that the Board determines meets the requirements of a nursing assistant training program,
DIALYSIS TRAINING COURSE, or medication administration course;
(iii) Pay to the Board an application fee set by the Board;
(iv) Be of good moral character;
(v) Be at least 16 years old to apply for certification as a nursing
assistant; [and]
(VI) BE AT LEAST 18 YEARS OLD TO APPLY F OR CERTIFICATION
AS A DIALYSIS TECHNI CIAN; AND
[(vi)] (VII) Be at least 18 years old to apply for certification as a
medication technician.
(2) Subject to paragraph (1) of this subsection, an applicant for certification
as a certified nursing assistant OR DIALYSIS TECHNICI AN shall submit to the Board:
(i) A criminal history records check in accordance with § 8–303 of
this title and § 8–6A–08(k) of this subtitle; and
(ii) On the form required by the Board, written, verified evidence
that the requirement of item (i) of this paragraph is being met or has been met.
(3) An applicant for certification as a certified medicine aide, in addition to
the requirements under paragraph (1) of this subsection, shall submit an additional
application to that effect to the Board on the form that the Board requires.
(4) An applicant for a certificate may not:
(i) Have committed any act or omission that would be grounds for
discipline or denial of certification under this subtitle; and
(ii) Have a record of abuse, negligence, misappropriation of a
resident’s property, or any disciplinary action taken or pending in any other state or
territory of the United States against the certification of the nursing assistant or
medication technician in the state or territory.
8–6A–06.
Every applicant for certification by endorsement shall:
(1) Pay the required application fee;
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(2) Submit the information required by the Board in the manner and form
specified by the Board; and
(3) Submit written evidence that the applicant:
(i) Is certified to practice as a nursing assistant OR DIALYSIS
TECHNICIAN by another state or territory of the United States with requirements that are
essentially similar to the requirements for certification established in this subtitle and that
the certification is in good standing;
(ii) Has not committed any act or omission that would be grounds for
discipline or denial of certification under this subtitle;
(iii) Has successfully completed nursing assistant training OR
DIALYSIS TECHNICIAN TRAINING that meets the standards for an approved nursing
assistant training program OR DIALYSIS TECHNICI AN TRAINING PROGRAM established
under this subtitle and the standards adopted by the Board; and
(iv) Has no record of abuse, negligence, or misappropriation of a
resident’s property or any disciplinary action taken or pending in any other state or
territory of the United States against the certification of the nursing assistant OR
DIALYSIS TECHNIC IAN in the state or territory.
8–6A–07.
(a) Subject to subsection (f) of this section, the Board shall certify any applicant
who meets the requirements of this subtitle.
(b) (1) The Board shall:
(i) Issue each new certified nursing assistant , DIALYSIS
TECHNICIAN, or medication technician a certificate number and registration certificate
that indicates the initial certificate was issued by the Board; and
(ii) Electronically record each certificate in the Board’s database and
on the Board’s website.
(2) Each certificate shall include:
(i) Any expiration date;
(ii) The type of certificate; and
(iii) Any specific category of nursing assistant.
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(c) An individual who has met the requirements for a certified nursing assistant
shall be certified with the title of “certified nursing assistant”.
(d) An individual who routinely performs nursing tasks delegated by a registered
nurse or licensed practical nurse for compensation and has also completed a
Board–approved course in medication administration shall be certified with the title of
“certified medicine aide”.
(E) AN INDIVIDUAL WHO HAS MET THE REQUIREMENTS FOR A CERTIFIED
DIALYSIS TECHNICIAN SHALL BE CERTIFIED W ITH THE TITLE OF “CERTIFIED
DIALYSIS TECHNICIAN ”.
[(e)] (F) An individual who has met the requirements for a certified medication
technician shall be certified with the title of “certified medication technician”.
[(f)] (G) (1) The Board may issue a temporary practice certificate to an
applicant who:
(i) Has met the appropriate certification requirements of this
subtitle to the satisfaction of the Board; and
(ii) Does not have a criminal record and has not been the subject of
a health professional disciplinary action in this State or another jurisdiction.
(2) Unless the Board suspends or revokes a temporary practice certificate,
the temporary practice certificate expires 90 days after issuance.
(3) A temporary practice certificate may be extended up to an additional 90
days if the applicant is awaiting the completion of criminal history record information.
[(g)] (H) A medication technician graduate may practice for no more than 90
days from the date of completion of a medication technician training program without
certification by the Board.
[(h)] (I) (1) On receipt of the criminal history record information of an
applicant for certification as a certified nursing assistant OR DIALYSIS TECHNICI AN
forwarded to the Board in accordance with § 8–303 of this title, in determining whether to
grant a certificate, the Board shall consider:
(i) The age at which the crime was committed;
(ii) The circumstances surrounding the crime;
(iii) The length of time that has passed since the crime;
(iv) Subsequent work history; Ch. 681 2022 LAWS OF MARYLAND
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(v) Employment and character references; and
(vi) Other evidence that demonstrates whether the applicant poses a
threat to the public health or safety.
(2) The Board may not issue a certificate if the criminal history record
information required under § 8–303 of this title has not been received.
8–6A–08.
(a) A certificate expires on the 28th day of the birth month of the nursing
assistant, DIALYSIS TECHNICIAN , or medication technician, unless the certificate is
renewed for a 2–year term as provided in this section.
(b) (1) At least 3 months before a certificate expires, the Board shall send a
renewal notice to the nursing assistant, DIALYSIS TECHNICIAN , or medication technician
CERTIFICATE HOLDER by:
(i) First–class mail to the last known mailing address of the nursing
assistant or medication technician CERTIFICATE HOLDER ; or
(ii) Electronic means to the last known electronic address of the
certificate holder.
(2) A renewal notice shall state:
(i) The date on which the current certificate expires;
(ii) The date by which the renewal application must be received by
the Board for the renewal to be issued and mailed before the certificate expires; and
(iii) The amount of the renewal fee.
(3) If a nursing assistant, DIALYSIS TECHNICIAN , or medication OR
DIALYSIS technician is required to have a criminal history records check before a certificate
may be renewed, the Board shall send the nursing assistant, DIALYSIS TECHNICIAN , or
medication OR DIALYSIS technician the documents necessary for initiating the criminal
history records check in conjunction with the renewal notice required under paragraph (1)
of this subsection.
(c) Before a certificate expires, a nursing assistant periodically may renew it for
an additional term, if the certificate holder:
(1) Otherwise is entitled to be certified; LAWRENCE J. HOGAN, JR., Governor Ch. 681
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(2) Submits to the Board a renewal application on the form that the Board
requires;
(3) Pays to the Board a renewal fee set by the Board; and
(4) Provides satisfactory evidence of completion of:
(i) 16 hours of active nursing assistant practice within the 2–year
period immediately preceding the date of renewal EXPIRATION; or
(ii) If the nursing assistant did not complete 16 hours of active
practice as required under item (i) of this item, an approved nursing assistant training
program or an approved nursing assistant refresher training program as required in
regulations adopted by the Board in accordance with subsection (m) of this section.
(d) In addition to the requirements in subsection (c)(1), (2), and (3) of this section,
a certified medicine aide shall:
(1) Provide satisfactory evidence of completion of 100 hours of practice as
a certified medicine aide in the 2–year period preceding the date of renewal EXPIRATION;
and
(2) Successfully complete a Board–approved medicine aide continuing
education program.
(E) BEFORE A CERTIFICATE EXPIRES, A DIALYSIS TECHNICIA N
PERIODICALLY MAY REN EW IT FOR AN ADDITIO NAL TERM, IF THE CERTIFICATE
HOLDER:
(1) OTHERWISE IS ENTITLED TO BE CERTIFIED ;
(2) SUBMITS TO THE BOARD A RENEWAL APPLI CATION ON THE FORM
THAT THE BOARD REQUIRES ;
(3) PAYS TO THE BOARD A RENEWAL FEE S ET BY THE BOARD;
(4) HAS COMPLETED 16 HOURS OF PRACTICE AS A DIALYSIS
TECHNICIAN IN THE 2–YEAR PERIOD IMMEDIAT ELY PRECEDING THE DA TE OF
RENEWAL;
(5) HAS COMPLETED A 3–HOUR CONTINUING EDUC ATION COURSE
APPROVED BY THE BOARD; AND
(4) HAS COMPLETED : Ch. 681 2022 LAWS OF MARYLAND
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(I) 1. 16 HOURS OF PRACTICE AS A DIALYSIS TECHNICIA N IN
THE 2–YEAR PERIOD IMMEDIAT ELY PRECEDING THE DA TE OF EXPIRATION ; AND
2. A 3–HOUR CONTINUING EDUC ATION COURSE
APPROVED BY THE BOARD; OR
(II) A DIALYSIS TECHNICIAN TRAINING PROGRAM APP ROVED
BY THE BOARD; AND
(6) (5) HAS AN ACTIVE NATIONA L CERTIFICATION LIST ED IN §
8–6A–01(C)(2) OF THIS SUBTITLE .
[(e)] (F) Before a certificate expires, a medication technician periodically may
renew it for an additional term, if the certificate holder:
(1) Otherwise is entitled to be certified;
(2) Submits to the Board a renewal application on the form that the Board
requires;
(3) Pays to the Board a renewal fee set by the Board;
(4) Every 2 years, provides satisfactory evidence of completion of a
Board–approved clinical refresher course; and
(5) Provides satisfactory evidence of completion of 100 hours of practice as
a certified medication technician within the 2–year period preceding the date of renewal.
[(f)] (G) The Board may grant a 30 –day extension, beyond a certificate’s
expiration date, to a certificate holder so that the certificate holder may renew the
certificate before it expires.
[(g)] (H) The Board shall reinstate the certificate of a certificate holder who has
failed to renew the certificate for any reason if the certificate holder meets the applicable
renewal requirements of subsections (c) through [(e)] (F) and [(k)(1)(i)2] (L)(1)(I)2 of this
section.
[(h)] (I) Subject to subsection [(i)] (J) of this section, the Board shall renew the
certificate of each nursing assistant, DIALYSIS TECHNICIAN , or medication technician who
meets the requirements of this section.
[(i)] (J) (1) Within 60 days after a change has occurred, each certificate
holder shall notify the Board in writing of any change in a name or address.
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(2) If the certificate holder fails to notify the Board within the time
required under this subsection, the Board may impose an administrative penalty of $25 on
the certificate holder.
[(j)] (K) The Board shall pay any penalty collected under this subsection to the
General Fund of the State.
[(k)] (L) (1) (i) The Board shall require criminal history records checks in
accordance with § 8–303 of this title on:
1. Selected applicants for certification as a certified nursing
assistant OR DIALYSIS TECHNICI AN who renew their certificates every 2 years as
determined by regulations adopted by the Board; and
2. Each former certified nursing assistant OR DIALYSIS
TECHNICIAN who files for reinstatement under subsection [(g)] (H) of this section after
failing to renew the certificate for a period of 1 year or more.
(ii) An additional criminal history records check shall be performed
every 12 years thereafter.
(2) On receipt of the criminal history record information of a certificate
holder forwarded to the Board in accordance with § 8–303 of this title, in determining
whether to initiate disciplinary action against the certificate holder based on the
information received, the Board shall consider:
(i) The age at which the crime was committed;
(ii) The circumstances surrounding the crime;
(iii) The length of time that has passed since the crime;
(iv) Subsequent work history;
(v) Employment and character references; and
(vi) Other evidence that demonstrates whether the certificate holder
poses a threat to the public health or safety.
(3) The Board may not renew a certificate without written documentation
that the applicant has submitted to a criminal history records check as required under §
8–303 of this title.
[(l)] (M) (1) If an individual has been certified by the Board to practice as a
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State in
accordance with the requirements of this subtitle, the individual subsequently may be Ch. 681 2022 LAWS OF MARYLAND
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certified as a nursing assistant, DIALYSIS TECHNICIAN , or medication technician on
inactive status.
(2) The Board shall place a certificate holder on inactive status and record
the inactive status in the Board’s database and on the Board’s website if the certificate
holder:
(i) Submits documentation of a medical condition that the Board
determines will prevent the certificate holder from practicing as a nursing assistant,
DIALYSIS TECHNICIAN , or medication technician; and
(ii) Completes the biennial application for inactive status and
submits documentation of a continuing medical condition.
(3) A certificate holder on inactive status may apply for reactivation of the
certificate if the certificate holder:
(i) Submits documentation satisfactory to the Board that the
medical condition for which the inactive status was granted no longer exists; and
(ii) Meets the renewal requirements of this section.
(4) If a certificate holder meets the requirements of paragraph (3) of this
subsection, the Board shall:
(i) Record the status of the certificate holder as active in the Board’s
database and on the Board’s website; and
(ii) Reactivate the certificate holder’s certificate to practice as a
nursing assistant, DIALYSIS TECHNICIAN , or medication technician in the State.
(5) The Board may not charge a fee to place the certificate holder on or
remove the certificate holder from inactive status under this subsection.
(6) Inactive status:
(i) May not be considered a disciplinary action under § 8–6A–10 of
this subtitle; and
(ii) May not be reported to any certifying entity, employer, or
insurance company as a disciplinary action.
[(m)] (N) (1) The Board shall adopt regulations to specify:
LAWRENCE J. HOGAN, JR., Governor Ch. 681
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(i) The circumstances under which a nursing assistant, as a
condition of renewal, is required to complete either an approved nursing assistant training
program or an approved nursing assistant refresher training program; and
(ii) The number of didactic instruction hours and clinical training
hours the nursing assistant training program or nursing assistant refresher training
program must have to be approved.
(2) Regulations adopted under paragraph (1) of this subsection must be
consistent with federal law.
8–6A–09.
(a) The Board may impose a civil fine not exceeding $50 on a certified nursing
assistant, A CERTIFIED DIALYSIS TECHNICIAN, or a certified medication technician who
fails to renew a certificate within 30 days after its expiration date and practices as a
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication
technician during the period of expiration.
(b) The Board shall pay any penalty collected under this section to the General
Fund of the State.
8–6A–10.
(a) Subject to the hearing provisions of § 8–317 of this title and § 8–6A–10.1 of
this subtitle, the Board may deny a certificate or grant a certificate, including a certificate
subject to a reprimand, probation, or suspension, to any applicant, reprimand any
certificate holder, place any certificate holder on probation, or suspend or revoke the
certificate of a certificate holder, if the applicant or certificate holder:
(1) Fraudulently or deceptively obtains or attempts to obtain a certificate
for the applicant or for another;
(2) Fraudulently or deceptively uses a certificate;
(3) Is disciplined by a licensing, military, or disciplinary authority in this
State or in any other state or country or convicted or disciplined by a court in this State or
in any other state or country for an act that would be grounds for disciplinary action under
the Board’s disciplinary statutes;
(4) Is convicted of or pleads guilty or nolo contendere to a felony or to a
crime involving moral turpitude, whether or not any appeal or other proceeding is pending
to have the conviction or plea set aside;
(5) Files a false report or record of an individual under the certificate
holder’s care; Ch. 681 2022 LAWS OF MARYLAND
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(6) Gives any false or misleading information about a material matter in
an employment application;
(7) Fails to file or record any health record that is required by law;
(8) Induces another individual to fail to file or record any health record that
is required by law;
(9) Has violated any order, rule, or regulation of the Board relating to the
practice or certification of a nursing assistant, DIALYSIS TECHNICIAN , or medication
technician;
(10) Provides services as a nursing assistant, DIALYSIS TECHNICIAN , or
medication technician while:
(i) Under the influence of alcohol; or
(ii) Using any narcotic or controlled dangerous substance, as defined
in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic
amounts or without valid medical indication;
(11) Has a substance use disorder;
(12) Is addicted to, or habitually abuses, any narcotic or controlled
dangerous substance as defined in § 5–101 of the Criminal Law Article;
(13) Has acted in a manner inconsistent with the health or safety of an
individual under the applicant or certificate holder’s care;
(14) Has practiced as a nursing assistant, DIALYSIS TECHNICIAN , or
medication technician in a manner which fails to meet generally accepted standards for the
practice of a nursing assistant, DIALYSIS TECHNICIAN , or medication technician;
(15) Has physically, verbally, or psychologically abused, neglected, or
otherwise harmed an individual under the applicant or certificate holder’s care;
(16) Has a physical or mental condition which renders the applicant or
certificate holder unable to practice as a certified nursing assistant, CERTIFIED DIALYSIS
TECHNICIAN, or certified medication technician with reasonable skill and safety to the
patients and which may endanger the health or safety of individuals under the care of the
applicant or certificate holder;
(17) Has violated the confidentiality of information or knowledge as
prescribed by law concerning any patient;
LAWRENCE J. HOGAN, JR., Governor Ch. 681
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(18) Has misappropriated patient or facility property;
(19) Performs certified nursing assistant, CERTIFIED DIALYSIS
TECHNICIAN, or certified medication technician functions incompetently;
(20) Has violated any provision of this title or has aided or knowingly
permitted any individual to violate any provision of this title;
(21) Submits a false statement to collect a fee;
(22) Refuses, withholds from, denies, or discriminates against an individual
with regard to the provision of professional services for which the applicant or certificate
holder is certified and qualified to render because the individual is HIV positive;
(23) Except in an emergency life–threatening situation where it is not
feasible or practicable, fails to comply with the Centers for Disease Control and
Prevention’s guidelines on universal precautions;
(24) Fails to cooperate with a lawful investigation conducted by the Board;
(25) Fails to comply with instructions and directions of the supervising
registered nurse or licensed practical nurse;
(26) When holding an expired certificate or a lapsed certificate, commits any
act that would be grounds for disciplinary action under this section;
(27) Practices as a nursing assistant, DIALYSIS TECHNIC IAN, or
medication technician before obtaining or renewing the certificate, including any time
period when practicing as a nursing assistant, DIALYSIS TECHNICIAN , or medication
technician on an expired certificate or a lapsed certificate;
(28) Impersonates another individual:
(i) Licensed under the provisions of this title; or
(ii) Who holds a certificate issued under the provisions of this title;
(29) Engages in conduct that violates the code of ethics;
(30) Performs activities that exceed the education and training of the
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication
technician;
(31) Is expelled from the safe practice program established pursuant to §
8–208 of this title for failure to comply with the conditions of the program;
Ch. 681 2022 LAWS OF MARYLAND
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(32) Fails to submit to a criminal history records check in accordance with §
8–303 of this title as required under § 8–6A–05(c)(2) of this subtitle;
(33) Abandons a patient; or
(34) Is a director of nursing, or acts in the capacity of a director of nursing
and knowingly employs an individual who is not authorized to perform delegated nursing
duties under this subtitle.
(b) If, after a hearing under § 8–317 of this title and § 8–6A–10.1 of this subtitle,
the Board finds that there are grounds under subsection (a) of this section to suspend or
revoke a certificate to practice as a certified nursing assistant, CERTIFIED DIALYSIS
TECHNICIAN, or certified medication technician, to reprimand a certificate holder, or place
a certificate holder on probation, the Board may impose a penalty not exceeding $500
instead of or in addition to suspending or revoking the certificate, reprimanding the
certificate holder, or placing the certificate holder on probation.
(c) (1) If a certificate issued under this subtitle was suspended or revoked for
a period of more than 1 year, or if a period of more than 1 year has passed since a certificate
was surrendered, the Board may reinstate the certificate if the certificate holder:
(i) Applies to the Board for reinstatement;
(ii) Meets the requirements for renewal under § 8–6A–08 of this
subtitle;
(iii) Meets any other requirements for reinstatement as established
by the Board in regulations; and
(iv) Submits to a criminal history records check in accordance with §
8–303 of this title.
(2) If a certificate holder meets the requirements of paragraph (1) of this
subsection, the Board may:
(i) Reinstate the certificate;
(ii) Reinstate the certificate subject to terms and conditions that the
Board considers necessary, including a period of probation; or
(iii) Deny reinstatement of the certificate.
8–6A–12.
LAWRENCE J. HOGAN, JR., Governor Ch. 681
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(a) Unless the Board agrees to accept the surrender of a certificate, a certified
nursing assistant, CERTIFIED DIALYSIS TECHNICIA N, or certified medication technician
may not surrender the certificate.
(b) The Board may require terms and conditions on an agreement with the
certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified medication
technician to accept surrender of the certificate.
(c) An agreement to accept the surrender of a certificate is a final order of the
Board and is a public record.
8–6A–13.
(a) The Board shall appoint an advisory committee consisting of at least [15] 17
members.
(b) Of the [15] 17 committee members:
(1) Six shall be nursing assistants:
(i) One shall be an acute care nursing assistant;
(ii) One shall be a home care nursing assistant;
(iii) One shall be a long–term care nursing assistant;
(iv) One shall be an adult medical day care nursing assistant;
(v) At least one of the nursing assistant members shall be a member
of a union; and
(vi) One shall be an independent contractor;
(2) Three shall be registered nurses:
(i) One shall be an acute care registered nurse;
(ii) One shall be a home care registered nurse; and
(iii) One shall be a long–term care registered nurse;
(3) [One] TWO shall be [an administrator] ADMINISTRATORS from [a]
licensed health care [facility] FACILITIES;
(4) One shall be a licensed practical nurse;
Ch. 681 2022 LAWS OF MARYLAND
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(5) One shall be an individual who teaches a nursing assistant course;
(6) One shall be a consumer member who has received care, or has a family
member who has received care from a nursing assistant;
(7) One shall be a representative of the Department; [and]
(8) One shall be a certified medication technician; AND
(9) ONE SHALL BE A CERTIF IED DIALYSIS TECHNIC IAN.
8–6A–14.1.
The Board may make survey visits from time to time, without prior notice, to all
Board–approved medication technician training AND DIALYSIS TECHNIC IAN TRAINING
programs.
8–6A–15.
(a) If, during the review of an application for certification or investigation of an
allegation brought against a certified nursing assistant, CERTIFIED DIALYSIS
TECHNICIAN, or certified medication technician under this subtitle, the Board has reason
to believe and objective evidence that the applicant, certified nursing assistant, CERTIFIED
DIALYSIS TECHNICIAN , or certified medication technician may cause harm to a person
affected by the practice of the applicant, certified nursing assistant, CERTIFIED DIALYSIS
TECHNICIAN, or certified medication technician, the Board, on its own initiative, shall
direct the applicant, certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or
certified medication technician to submit to an appropriate examination by a health care
provider designated by the Board.
(b) In return for the privilege to practice as a certified nursing assistant,
CERTIFIED DIALYSIS T ECHNICIAN, or certified medication technician in the State, an
applicant, certified nursing assistant, CERTIFIED DIALYSIS T ECHNICIAN, or certified
medication technician is deemed to have:
(1) Consented to submit to an examination under this section if requested
by the Board in writing; and
(2) Waived any legal claim of privilege as to the testimony or examination
reports of the examining health care provider.
(c) The failure or refusal of an applicant, certified nursing assistant, CERTIFIED
DIALYSIS TECHNICIAN , or certified medication technician to submit to an examination
required under subsection (b) of this section is prima facie evidence of the inability of the
applicant, certified nursing assistant, CERTIFIED DIALYSI S TECHNICIAN, or certified LAWRENCE J. HOGAN, JR., Governor Ch. 681
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medication technician to competently practice as a certified nursing assistant, CERTIFIED
DIALYSIS TECHNICIAN , or certified medication technician, unless the Board finds that the
failure or refusal was beyond the control of the applicant, certified nursing assistant,
CERTIFIED DIALYSIS T ECHNICIAN, or certified medication technician.
(d) The Board shall pay the cost of any examination made in accordance with the
provisions of this section.
8–701.
(H) EXCEPT AS OTHERWISE P ROVIDED IN THIS TITLE, AN INDIVIDUAL MAY
NOT PRACTICE , ATTEMPT TO PRACTICE , OR OFFER TO PRACTICE AS A CERTIFIED
DIALYSIS TECHNICIAN UNLESS LICENSED CERTIFIED BY THE BOARD TO PRACTICE
AS A CERTIFIED DIALY SIS TECHNICIAN.
[(h)] (I) An individual may not require a licensee to perform an act that is
beyond the licensee’s knowledge and skills.
[(i)] (J) An individual may not direct a licensee to delegate a nursing task to a
nurse when the individual reasonably believes:
(1) The nurse lacks the knowledge and skills to perform the nursing task;
or
(2) The patient’s condition does not allow delegation of the nursing task.
8–703.
(a) (4) Unless authorized to provide patient care as a certified nursing
assistant, DIALYSIS TECHNICIAN , or medication assistant under this title, an individual
may not represent to the public by title, by description of services, methods, or procedures,
or otherwise, that the individual is authorized to provide care as a certified nursing
assistant, DIALYSIS TECHNICIAN , or medication assistant in this State.
(J) UNLESS AUTHORIZED TO PRACTICE AS A CERTIF IED DIALYSIS
TECHNICIAN UNDER THI S TITLE, AN INDIVIDUAL MAY NO T USE THE WORDS OR
TERMS “DIALYSIS TECHNICIAN ” OR “CERTIFIED DIALYSIS T ECHNICIAN”, THE
ABBREVIATION “C.D.T.”, OR ANY OTHER TITLE, SYMBOL, ABBREVIATION , SIGN,
CARD, DEVICE, OR OTHER REPRESENTAT ION WITH THE INTENT TO REPRESENT
THAT THE INDIVIDUAL PRACTICES AS A CERTI FIED DIALYSIS TECHNI CIAN.
8–705.
Ch. 681 2022 LAWS OF MARYLAND
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(F) AN INDIVIDUAL MAY NOT PRACTICE AS A CERTIF IED DIALYSIS
TECHNICIAN UNDER C OLOR OF ANY DIPLOMA , LICENSE, RECORD, OR CERTIFICATE
THAT IS:
(1) ILLEGALLY OR FRAUDULE NTLY OBTAINED ; OR
(2) SIGNED OR ISSUED UNLA WFULLY OR BY FRAUDUL ENT
REPRESENTATION .
8–706.
(H) AN INDIVIDUAL MAY NOT KNOWINGLY EMPLOY TO PRACTICE AS A
CERTIFIED DIALYSIS T ECHNICIAN ANY INDIVI DUAL WHO IS NOT AUTH ORIZED TO
PRACTICE AS A CERTIF IED DIALYSIS TECHNIC IAN UNDER THIS TITLE .
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take ef fect July
1, 2022.
Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.