EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0048*
HOUSE BILL 48
J1 2lr1289
HB 209/21 – HGO (PRE–FILED) CF 2lr1194
By: Delegate Belcastro
Requested: November 1, 2021
Introduced and read first time: January 12, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Public Health – Maryland Suicide Fatality Review Committee 2
FOR the purpose of establishing the Maryland Suicide Fatality Review Committee; 3
providing that a person has immunity from liability for certain actions related to the 4
Committee; providing for the sharing of information with and confidentiality of 5
information obtained by the Committee; exempting Committee meetings from the 6
Open Meetings Act; prohibiting certain persons from testifying in any proceeding 7
about details of a Committee meeting; and generally relating to the Maryland 8
Suicide Fatality Review Committee. 9
BY repealing and reenacting, without amendments, 10
Article – Courts and Judicial Proceedings 11
Section 5–637 12
Annotated Code of Maryland 13
(2020 Replacement Volume and 2021 Supplement) 14
BY adding to 15
Article – Health – General 16
Section 5–1001 through 5–1009 to be under the new subtitle “Subtitle 10. Maryland 17
Suicide Fatality Review Committee” 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2021 Supplement) 20
BY repealing and reenacting, without amendments, 21
Article – Health Occupations 22
Section 1–401(a)(1) and (3), (b), and (c) 23
Annotated Code of Maryland 24
(2021 Replacement Volume) 25
Preamble 26 2 HOUSE BILL 48
WHEREAS, The Maryland Governor’s Commission on Suicide Prevention declared 1
that suicide deaths are a serious public health issue and have a tremendous family and 2
societal impact; and 3
WHEREAS, Veterans account for 18% of all suicide deaths in this State, as reported 4
by the National Violent Death Reporting System in 2013–2014; and 5
WHEREAS, The number of recorded suicide deaths in Maryland increased from 474 6
to 650 between 2000 and 2018, representing a 37% increase; and 7
WHEREAS, Across all ages, one–half of all persons who die by suicide in this State 8
experienced mental health problems; and 9
WHEREAS, Every year in this State, an average of 530 persons die by suicide; and 10
WHEREAS, More persons die by suicide in this State than die by homicide; and 11
WHEREAS, Suicide deaths are significantly underestimated and inadequately 12
documented, thus preventing efforts to identify and reduce or eliminate such deaths; and 13
WHEREAS, No process exists in this State for the confidential identification, 14
investigation, or dissemination of findings regarding suicide deaths; and 15
WHEREAS, Goal number one in the Maryland Center for Preventive Health 16
Services and the Partnership for a Safer Maryland’s Strategic Plan is to expand and refine 17
the current surveillance efforts to assess injury risks, inform intervention development, 18
and evaluate the impacts of injury prevention initiatives; and 19
WHEREAS, The U.S. National Strategy for Suicide Prevention, as issued by the U.S. 20
Office of the Surgeon General, recommends that suicide deaths be investigated through 21
state–based suicide mortality reviews to institute the systemic changes needed to decrease 22
suicide mortality; and 23
WHEREAS, There is a need to establish a statewide program to review suicide 24
deaths among persons in this State and to develop strategies for the prevention of suicide 25
deaths in this State; now, therefore, 26
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 27
That the Laws of Maryland read as follows: 28
Article – Courts and Judicial Proceedings 29
5–637. 30
(a) In this section, “medical review committee” has the meaning stated in § 1–401 31
of the Health Occupations Article. 32 HOUSE BILL 48 3
(b) A person who acts in good faith and within the scope of the jurisdiction of a 1
medical review committee is not civilly liable for any action as a member of the medical 2
review committee or for giving information to, participating in, or contributing to the 3
function of the medical review committee. 4
Article – Health – General 5
SUBTITLE 10. MARYLAND SUICIDE FATALITY REVIEW COMMITTEE. 6
5–1001. 7
IN THIS SUBTITLE, “STATE TEAM” MEANS THE MARYLAND SUICIDE FATALITY 8
REVIEW COMMITTEE. 9
5–1002. 10
(A) THERE IS A MARYLAND SUICIDE FATALITY REVIEW COMMITTEE, ALSO 11
REFERRED TO AS THE STATE TEAM. 12
(B) THE PURPOSE OF THE STATE TEAM IS TO IDENTIFY AND A DDRESS THE 13
FACTORS CONTRIBUTING TO SUICIDE DEATHS AN D FACILITATE SYSTEM CHANGES IN 14
THE STATE TO PREVENT SUIC IDE DEATHS. 15
(C) (1) THE STATE TEAM SHALL INCL UDE THE FOLLOWING ME MBERS, 16
WHO SHALL SERVE ON A N EX OFFICIO BASIS: 17
(I) THE SECRETARY, OR THE SECRETARY’S DESIGNEE; 18
(II) THE DEPUTY SECRETARY OF THE BEHAVIORAL HEALTH 19
ADMINISTRATION , OR THE DEPUTY SECRETARY’S DESIGNEE; AND 20
(III) THE CHAIR OF THE GOVERNOR’S COMMISSION ON SUICIDE 21
PREVENTION. 22
(2) THE SECRETARY MAY INCLUDE IN THE STATE TEAM THE CHIEF 23
MEDICAL EXAMINER, OR THE CHIEF MEDICAL EXAMINER’S DESIGNEE. 24
(3) THE SECRETARY MAY INCLUDE THE FOLLOWING MEMBER S IN 25
THE STATE TEAM, AS DESIGNATED BY THE SECRETARY: 26
(I) A SUICIDOLOGIST OR AN ACADEMIC WITH A SPEC IALTY IN 27
THE STUDY AND PREVENTION OF SUICIDE; 28
(II) ONE REPRESENTATIVE OF HEALTH CARE PROVIDER S; 29 4 HOUSE BILL 48
(III) ONE REPRESENTATIVE OF AN ORGANIZATION HAVI NG 1
EXPERTISE IN SUICIDE PREVENTION ; 2
(IV) ONE REPRESENTATIVE OF AN ORGANIZATION HAVI NG 3
EXPERTISE IN THE TRE ATMENT AND PREVENTION OF SU BSTANCE ABUSE ; 4
(V) ONE REPRESENTATIVE OF AN ORGANIZATION THAT 5
ADVOCATES FOR INDIVI DUALS WITH MENTAL IL LNESS; 6
(VI) ONE REPRESENTATIVE OF LAW ENFORCEMENT OR 7
CORRECTIONAL SERVICE S; AND 8
(VII) ANY ADDITIONAL MEMBER S DETERMINED T O BE 9
NECESSARY BY THE SECRETARY TO CARRY OU T THE PURPOSE OF THI S SUBTITLE, 10
WHICH MAY INCLUDE RE PRESENTATIVES FROM R ELEVANT DISCIPLINES AND 11
RELEVANT COMMUNITY –BASED ORGANIZATIONS . 12
(D) THE STATE TEAM SHALL ELEC T THE CHAIR OF THE STATE TEAM BY A 13
MAJORITY VO TE. 14
(E) THE DEPARTMENT SHALL PROV IDE STAFF FOR THE STATE TEAM. 15
(F) ALL MEMBERS OF THE STATE TEAM SHALL BE V OTING MEMBERS . 16
(G) (1) EACH MEMBER DESIGNATE D UNDER SUBSECTION (C)(3) OF THIS 17
SECTION SHALL SERVE ON THE STATE TEAM FOR A TERM OF 3 YEARS AND MAY BE 18
REAPPOINTED . 19
(2) AT THE END OF A TERM , A MEMBER DESIGNATED UNDER 20
SUBSECTION (C)(3) OF THIS SECTION CONT INUES TO SERVE UNTIL A SUCCESSOR IS 21
APPOINTED. 22
(3) ALL VACANCIES SHALL B E FILLED BY THE DESI GNATING 23
AUTHORITY IN ACCORDA NCE WITH THIS SECTIO N. 24
(H) A MEMBER OF THE STATE TEAM: 25
(1) MAY NOT RECEIVE COMPE NSATION FOR SERVICE ON THE STATE 26
TEAM; BUT 27
(2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE 28
STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET . 29
HOUSE BILL 48 5
(I) TO THE EXTENT THAT FUNDS ARE AVAIL ABLE, THE STATE TEAM MAY 1
HIRE STAFF OR CONSUL TANTS TO ASSIST THE STATE TEAM IN CARRYIN G OUT ITS 2
DUTIES. 3
5–1003. 4
(A) THE STATE TEAM SHALL : 5
(1) MEET AT LEAST QUARTER LY TO REVIEW SUICIDE DEATHS, 6
CONSISTENT WITH THE REQUIREMENTS OF TH IS SUBTITLE; 7
(2) MAKE DETERMINATIONS R EGARDING: 8
(I) THE FOLLOWING ISSUES RELATED TO INDIVIDUA LS AT RISK 9
FOR SUICIDE: 10
1. TRENDS; 11
2. RISK FACTORS; 12
3. CURRENT BEST PRACTICE S IN SUICIDE PREVENT ION; 13
4. LAPSES IN SYSTEMIC RE SPONSES; AND 14
5. BARRIERS TO SAFETY AN D WELL–BEING; AND 15
(II) STRATEGIES FOR THE PR EVENTION OF SUICIDE DEATHS; 16
(3) REPORT AT LEAST ANNUA LLY TO THE GOVERNOR AND , IN 17
ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL 18
ASSEMBLY ON: 19
(I) THE STATE TEAM’S ACTIVITIES; AND 20
(II) THE STATE TEAM’S RECOMMENDATIONS ON : 21
1. CHANGING ANY LAW OR P OLICY IN A MANNER TH AT 22
WOULD PROMOTE THE PR EVENTION OF SUICIDE DEATHS; AND 23
2. IMPROVING THE AVAILAB ILITY OF SOURCES OF 24
INFORMATION RELATING TO THE INVESTIGATION OF REPORTED SUICIDE 25
FATALITIES; 26
(4) UNDERTAKE ANNUAL STAT ISTICAL STUDIES OF : 27
6 HOUSE BILL 48
(I) THE INCIDENTS AND CAU SES OF SUICIDE MORTA LITY IN 1
THE STATE; AND 2
(II) TRENDS AND PATTERNS O F SUICIDE DEATHS IN THE STATE; 3
AND 4
(5) DISSEMINATE F INDINGS AND RECOMMEN DATIONS BASED ON THE 5
STUDIES CONDUCTED UN DER ITEM (4) OF THIS SUBSECTION T O POLICYMAKERS , 6
HEALTH CARE PROVIDER S, HEALTH CARE FACILITI ES, AND THE PUBLIC . 7
(B) THE STATE TEAM MAY PERIOD ICALLY MAKE AVAILABL E, IN A GENERAL 8
MANNER THAT DOE S NOT REVEAL CONFIDE NTIAL INFORMATION AB OUT INDIVIDUAL 9
CASES, ONLY THE AGGREGATE F INDINGS OF THE STATE TEAM’S REVIEWS AND THEIR 10
RECOMMENDATIONS FOR PREVENTIVE ACTIONS . 11
5–1004. 12
A PERSON SHALL HAVE TH E IMMUNITY FROM LIAB ILITY UNDER § 5–637 OF 13
THE COURTS ARTICLE FOR ANY ACTIO N AS A MEMBER OF THE STATE TEAM OR FOR 14
GIVING INFORMATION T O, PARTICIPATING IN , OR CONTRIBUTING TO T HE FUNCTION 15
OF THE STATE TEAM. 16
5–1005. 17
(A) THE STATE TEAM IS A PUBLI C HEALTH AUTHORITY , AS DEFINED IN 45 18
C.F.R. § 164.501, CONDUCTING PUBLIC HE ALTH ACTIVITIES IN A CCORDANCE WITH 19
THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT. 20
(B) ON REQUEST OF THE CHA IR OF THE STATE TEAM AND AS NEC ESSARY TO 21
CARRY OUT THE STATE TEAM’S PURPOSE AND DUTIES , A HEALTH CARE PROVID ER 22
OR A STATE OR LOCAL GOVERN MENT AGENCY IMMEDIAT ELY SHALL PROVIDE TO 23
THE STATE TEAM ANY RECORD S OF THE HEALTH CARE PROVIDER OR STATE OR 24
LOCAL GOVERNMENT AGE NCY NECESSARY TO COM PLETE THE REVIEW OF A 25
SPECIFIC FATALITY , INCLUDING: 26
(1) HOSPITAL RECORDS ; 27
(2) OUTPATIENT CLINIC , HEALTH CARE PROVIDER , AND 28
LABORATORY RECORDS ; 29
(3) POLICE INVESTIGATION DATA; 30
(4) MEDICAL EXAMINER INVE STIGATIVE DATA; 31
HOUSE BILL 48 7
(5) CAUSE–OF–DEATH INFORMATION IN VITAL RECORDS ; 1
(6) SOCIAL SERVICES RECOR DS; AND 2
(7) OTHER RECORDS FROM STATE OFFICES , AGENCIES, AND 3
DEPARTMENTS . 4
(C) THE STATE TEAM MAY REQUES T THAT A PERSON WITH DIRECT 5
KNOWLEDGE OF CIRCUMS TANCES SURROUNDING A FATALITY PROVIDE THE STATE 6
TEAM WITH INFORMATIO N NECESSARY TO COMPL ETE THE REVIEW OF TH E 7
PARTICULAR FATALITY , INCLUDING INFORMATIO N FROM: 8
(1) A HEALTH CARE PROVIDER OR STAFF INVOLVED IN THE CARE OF 9
THE DECEDENT ; AND 10
(2) THE PERSON WHO FIRST RESPONDED TO A REPOR T CONCERNING 11
THE DECEDENT . 12
(D) THE STATE TEAM: 13
(1) MAY SHARE INFORMATION WITH OTHER PUBLIC HEALTH 14
AUTHORITIES OR THEIR DESIGNEES AS THE STATE TEAM DETERMINES NECESSARY 15
TO CARRY OUT THE PUR POSES OF THIS SUBTIT LE; AND 16
(2) SHALL COORDINATE WITH THE STATE’S CHILD FATALITY 17
REVIEW AND DRUG OVERDOSE FATALITY REVIEW TEAMS TO SHARE AND RECEIVE 18
INFORMATION RELEVANT TO THE STATE TEAM ’S FINDINGS AND TO EN SURE 19
EFFICIENCY IN THE WO RK OF THE TEAMS . 20
(E) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 21
ALL INFORMATION AND RECORDS ACQUIRED BY THE STATE TEAM IN THE EXE RCISE 22
OF ITS DUTIES: 23
(I) SHALL BE CONFIDENTIAL ; 24
(II) SHALL BE EXEMPT FROM DISCLOSURE UNDER THE PUBLIC 25
INFORMATION ACT; AND 26
(III) MAY NOT BE SUBJECT TO DISCOVERY OR INTRODU CTION 27
INTO EVIDENCE IN ANY PROCEEDINGS . 28
(2) INFORMATION MAY BE DI SCLOSED AS NECESSARY AND IN A 29
MANNER CONSISTENT WITH THIS SUBTITLE TO CARRY OU T THE PURPOSES OF TH IS 30
SUBTITLE. 31 8 HOUSE BILL 48
(F) MENTAL HEALTH RECORDS ARE SUBJECT TO THE A DDITIONAL 1
LIMITATIONS UNDER § 4–307 OF THIS ARTICLE FOR DISCLOSURE OF A MEDI CAL 2
RECORD DEVELOPED PRI MARILY IN CONNECTION WITH THE PRO VISION OF MENTAL 3
HEALTH SERVICES . 4
5–1006. 5
(A) MEETINGS OF THE STATE TEAM SHALL BE C LOSED TO THE PUBLIC AND 6
ARE NOT SUBJECT TO T HE OPEN MEETINGS ACT. 7
(B) A MEMBER OF THE STATE TEAM OR ATTENDE E OF A STATE TEAM 8
MEETING MAY NOT : 9
(1) RELEASE TO THE PUBLIC OR THE NEWS MEDIA IN FORMATION 10
DISCUSSED AT MEETING S; OR 11
(2) EXCEPT AS PROVIDED IN § 5–1007 OF THIS SUBTITLE , TESTIFY IN 12
ANY PROCEEDING ABOUT DETAILS OF A STATE TEAM MEETING , INCLUDING ANY 13
INFORMATION PRESENTE D AT THE MEETING , OR ABOUT OPINIONS FORMED BY THE 14
INDIVIDUAL BECAUSE O F THE MEETING. 15
(C) EACH MEMBER OF THE STATE TEAM AND ANY AT TENDEE OF A MEETING 16
OF THE STATE TEAM SHALL SIGN A STATEMENT INDICATI NG AN UNDERSTANDING 17
OF AND ADHERENCE TO THE STATE TEAM’S CONFIDENTIALITY RE QUIREMENTS , 18
INCLUDING ANY POTENT IAL CIVIL OR CRIMINA L CONSEQUENCES FOR A BREACH OF 19
CONFIDENTIALITY UNDE R THIS SECTION. 20
5–1007. 21
THIS SUBTITLE MAY NOT BE CONSTRUED TO PROH IBIT A PERSON FROM : 22
(1) TESTIFYING IN A CIVIL OR CRIMINAL ACTION A BOUT MATTERS 23
THAT OCCURRED IN A STATE TEAM MEETING IF THE TESTIMONY WILL B E BASED ON 24
THE PERSON’S INDEPENDENT KNOWLE DGE; OR 25
(2) INVESTIGATING OR REVI EWING A SUICIDE DEAT H UNDER ANY 26
OTHER PROVISION OF L AW. 27
5–1008. 28
THE DEPARTMENT MAY ADOPT REGULATIONS TO CARRY OUT THIS SUBTITLE , 29
INCLUDING REGULATION S ON: 30
HOUSE BILL 48 9
(1) THE PROCEDURES BY WHI CH HEALTH CARE PROVIDERS , HEALTH 1
CARE FACILITIES, AND OTHER PERSONS ID ENTIFY AND REPORT SU ICIDE DEATHS TO 2
THE DEPARTMENT OR AS DIRE CTED BY THE DEPARTMENT ; 3
(2) THE PROTOCOLS , PROCEDURES , METHODS, MANNER, AND 4
EXTENT OF ALL INVEST IGATIONS AND REVIEWS BY THE STATE TEAM; AND 5
(3) THE MANNER IN AND EXT ENT TO WHICH INFORMA TION SHALL BE 6
DISSEMINATED UNDER T HIS SUBTITLE. 7
5–1009. 8
THIS SUBTITLE MAY BE CITED AS THE MARYLAND SUICIDE MORTALITY 9
REVIEW AND PREVENTION ACT. 10
Article – Health Occupations 11
1–401. 12
(a) (1) In this section the following words have the meanings indicated. 13
(3) “Medical review committee” means a committee or board that: 14
(i) Is within one of the categories described in subsection (b) of this 15
section; and 16
(ii) Performs functions that include at least one of the functions 17
listed in subsection (c) of this section. 18
(b) For purposes of this section, a medical review committee is: 19
(1) A regulatory board or agency established by State or federal law to 20
license, certify, or discipline any provider of health care; 21
(2) A committee of the Maryland State Medical Society or any of its 22
component societies or a committee of any other professional society or association 23
composed of providers of health care; 24
(3) A committee appointed by or established in the Department or a local 25
health department for review purposes; 26
(4) A committee appointed by or established in the Maryland Institute for 27
Emergency Medical Services Systems; 28
(5) A committee of the medical staff or other committee, including any risk 29
management, credentialing, or utilization review committee established in accordance with 30 10 HOUSE BILL 48
§ 19–319 of the Health – General Article, of a hospital, related institution, or alternative 1
health care system, if the governing board of the hospital, related institution, or alternative 2
health care system forms and approves the committee or approves the written bylaws under 3
which the committee operates; 4
(6) A committee or individual designated by the holder of a pharmacy 5
permit, as defined in § 12–101 of this article, that performs the functions listed in 6
subsection (c) of this section, as part of a pharmacy’s ongoing quality assurance program; 7
(7) Any person, including a professional standard review organization, who 8
contracts with an agency of this State or of the federal government to perform any of the 9
functions listed in subsection (c) of this section; 10
(8) Any person who contracts with a provider of health care to perform any 11
of those functions listed in subsection (c) of this section that are limited to the review of 12
services provided by the provider of health care; 13
(9) An organization, established by the Maryland Hospital Association, 14
Inc. and the Maryland State Medical Society, that contracts with a hospital, related 15
institution, or alternative delivery system to: 16
(i) Assist in performing the functions listed in subsection (c) of this 17
section; or 18
(ii) Assist a hospital in meeting the requirements of § 19–319(e) of 19
the Health – General Article; 20
(10) A committee appointed by or established in an accredited health 21
occupations school; 22
(11) An organization described under § 14–501 of this article that contracts 23
with a hospital, related institution, or health maintenance organization to: 24
(i) Assist in performing the functions listed in subsection (c) of this 25
section; or 26
(ii) Assist a health maintenance organization in meeting the 27
requirements of Title 19, Subtitle 7 of the Health – General Article, the National Committee 28
for Quality Assurance (NCQA), or any other applicable credentialing law or regulation; 29
(12) An accrediting organization as defined in § 14–501 of this article; 30
(13) A Mortality and Quality Review Committee established under § 5–802 31
of the Health – General Article or a Morbidity, Mortality, and Quality Review Committee 32
established under § 18–107 of the Health – General Article; 33
(14) A center designated by the Maryland Health Care Commission as the 34 HOUSE BILL 48 11
Maryland Patient Safety Center that performs the functions listed in subsection (c)(1) of 1
this section; or 2
(15) The Maryland Health Care Commission or its staff, when performing 3
the functions listed in subsection (c) of this section, provided that the data or medical 4
information under review is furnished to the Maryland Health Care Commission by 5
another medical review committee. 6
(c) For purposes of this section, a medical review committee: 7
(1) Evaluates and seeks to improve the quality of health care provided by 8
providers of health care; 9
(2) Evaluates the need for and the level of performance of health care 10
provided by providers of health care; 11
(3) Evaluates the qualifications, competence, and performance of providers 12
of health care; or 13
(4) Evaluates and acts on matters that relate to the discipline of any 14
provider of health care. 15
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall be construed to 16
apply only prospectively to deaths that occur after the effective date of this Act and may 17
not be applied or interpreted to have any effect on or application to any deaths that occurred 18
before the effective date of this Act. 19
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
October 1, 2022. 21