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.
*hb0048*
HOUSE BILL 48
J1 2lr1289
HB 209/21 – HGO (PRE–FILED) CF SB 94
By: Delegate Belcastro
Requested: November 1, 2021
Introduced and read first time: January 12, 2022
Assigned to: Health and Government Operations
Committee Report: Favorable
House action: Adopted
Read second time: February 25, 2022
CHAPTER ______
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 2 HOUSE BILL 48
Article – Health Occupations 1
Section 1–401(a)(1) and (3), (b), and (c) 2
Annotated Code of Maryland 3
(2021 Replacement Volume) 4
Preamble 5
WHEREAS, The Maryland Governor’s Commission on Suicide Prevention declared 6
that suicide deaths are a serious public health issue and have a tremendous family and 7
societal impact; and 8
WHEREAS, Veterans account for 18% of all suicide deaths in this State, as reported 9
by the National Violent Death Reporting System in 2013–2014; and 10
WHEREAS, The number of recorded suicide deaths in Maryland increased from 474 11
to 650 between 2000 and 2018, representing a 37% increase; and 12
WHEREAS, Across all ages, one–half of all persons who die by suicide in this State 13
experienced mental health problems; and 14
WHEREAS, Every year in this State, an average of 530 persons die by suicide; and 15
WHEREAS, More persons die by suicide in this State than die by homicide; and 16
WHEREAS, Suicide deaths are significantly underestimated and inadequately 17
documented, thus preventing efforts to identify and reduce or eliminate such deaths; and 18
WHEREAS, No process exists in this State for the confidential identification, 19
investigation, or dissemination of findings regarding suicide deaths; and 20
WHEREAS, Goal number one in the Maryland Center for Preventive Health 21
Services and the Partnership for a Safer Maryland’s Strategic Plan is to expand and refine 22
the current surveillance efforts to assess injury risks, inform intervention development, 23
and evaluate the impacts of injury prevention initiatives; and 24
WHEREAS, The U.S. National Strategy for Suicide Prevention, as issued by the U.S. 25
Office of the Surgeon General, recommends that suicide deaths be investigated through 26
state–based suicide mortality reviews to institute the systemic changes needed to decrease 27
suicide mortality; and 28
WHEREAS, There is a need to establish a statewide program to review suicide 29
deaths among persons in this State and to develop strategies for the prevention of suicide 30
deaths in this State; now, therefore, 31
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 32
That the Laws of Maryland read as follows: 33
HOUSE BILL 48 3
Article – Courts and Judicial Proceedings 1
5–637. 2
(a) In this section, “medical review committee” has the meaning stated in § 1–401 3
of the Health Occupations Article. 4
(b) A person who acts in good faith and within the scope of the jurisdiction of a 5
medical review committee is not civilly liable for any action as a member of the medical 6
review committee or for giving information to, participating in, or contributing to the 7
function of the medical review committee. 8
Article – Health – General 9
SUBTITLE 10. MARYLAND SUICIDE FATALITY REVIEW COMMITTEE. 10
5–1001. 11
IN THIS SUBTITLE, “STATE TEAM” MEANS THE MARYLAND SUICIDE FATALITY 12
REVIEW COMMITTEE. 13
5–1002. 14
(A) THERE IS A MARYLAND SUICIDE FATALITY REVIEW COMMITTEE, ALSO 15
REFERRED TO AS THE STATE TEAM. 16
(B) THE PURPOSE OF THE STATE TEAM IS TO IDEN TIFY AND ADDRESS THE 17
FACTORS CONTRIBUTING TO SUICIDE DEATHS AN D FACILITATE SYSTEM CHANGES IN 18
THE STATE TO PREVENT SUICIDE DEATHS . 19
(C) (1) THE STATE TEAM SHALL INCL UDE THE FOLLOWING ME MBERS, 20
WHO SHALL SERVE ON A N EX OFFICIO BASIS: 21
(I) THE SECRETARY, OR THE SECRETARY’S DESIGNEE; 22
(II) THE DEPUTY SECRETARY OF THE BEHAVIORAL HEALTH 23
ADMINISTRATION , OR THE DEPUTY SECRETARY’S DESIGNEE; AND 24
(III) THE CHAIR OF THE GOVERNOR’S COMMISSION ON SUICIDE 25
PREVENTION. 26
(2) THE SECRETARY MAY INCLUDE IN THE STATE TEAM THE CHIEF 27
MEDICAL EXAMINER, OR THE CHIEF MEDICAL EXAMINER’S DESIGNEE. 28
(3) THE SECRETARY MAY INCLUDE THE FOLLOWING MEMBERS IN 29 4 HOUSE BILL 48
THE STATE TEAM, AS DESIGNATED BY THE SECRETARY: 1
(I) A SUICIDOLOGIST OR AN ACADEMIC WITH A SPEC IALTY IN 2
THE STUDY AND PREVEN TION OF SUICIDE; 3
(II) ONE REPRESENTATIVE OF HEALTH CARE PROVIDER S; 4
(III) ONE REPRESENTATIVE OF AN ORGANIZATION HAVING 5
EXPERTISE IN SUICIDE PREVENTION ; 6
(IV) ONE REPRESENTATIVE OF AN ORGANIZATION HAVI NG 7
EXPERTISE IN THE TRE ATMENT AND PREVENTIO N OF SUBSTANCE ABUSE ; 8
(V) ONE REPRESENTATIVE OF AN ORGANIZATION THAT 9
ADVOCATES FOR INDIVI DUALS WITH MENTAL ILLNESS; 10
(VI) ONE REPRESENTATIVE OF LAW ENFORCEMENT OR 11
CORRECTIONAL SERVICE S; AND 12
(VII) ANY ADDITIONAL MEMBER S DETERMINED TO BE 13
NECESSARY BY THE SECRETARY TO CARRY OU T THE PURPOSE OF THI S SUBTITLE, 14
WHICH MAY INCLUDE RE PRESENTATIVES FROM R ELEVANT DISCIPLINES AND 15
RELEVANT COMMUNITY –BASED ORGANIZATIONS . 16
(D) THE STATE TEAM SHALL ELEC T THE CHAIR OF THE STATE TEAM BY A 17
MAJORITY VOTE . 18
(E) THE DEPARTMENT SHALL PROV IDE STAFF FOR THE STATE TEAM. 19
(F) ALL MEMBERS OF THE STATE TEAM SHALL BE V OTING MEMBERS. 20
(G) (1) EACH MEMBER DESIGNATE D UNDER SUBSECTION (C)(3) OF THIS 21
SECTION SHALL SERVE ON THE STATE TEAM FOR A TERM OF 3 YEARS AND MAY BE 22
REAPPOINTED . 23
(2) AT THE END OF A TERM , A MEMBER DESIGNATED UNDER 24
SUBSECTION (C)(3) OF THIS SECTION CONT INUES TO SERVE UNTIL A SUC CESSOR IS 25
APPOINTED. 26
(3) ALL VACANCIES SHALL B E FILLED BY THE DESI GNATING 27
AUTHORITY IN ACCORDA NCE WITH THIS SECTIO N. 28
(H) A MEMBER OF THE STATE TEAM: 29
HOUSE BILL 48 5
(1) MAY NOT RECEIVE COMPE NSATION FOR SERVICE ON THE STATE 1
TEAM; BUT 2
(2) IS ENTITLED TO REIMBURS EMENT FOR EXPENSES U NDER THE 3
STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET . 4
(I) TO THE EXTENT THAT FU NDS ARE AVAILABLE , THE STATE TEAM MAY 5
HIRE STAFF OR CONSUL TANTS TO ASSIST THE STATE TEAM IN CARRYIN G OUT ITS 6
DUTIES. 7
5–1003. 8
(A) THE STATE TEAM SHALL : 9
(1) MEET AT LEAST QUARTER LY TO REVIEW SUICIDE DEATHS, 10
CONSISTENT WITH THE REQUIREMENTS OF THIS SUBTITLE; 11
(2) MAKE DETERMINATIONS R EGARDING: 12
(I) THE FOLLOWING ISSUES RELATED TO INDIVIDUA LS AT RISK 13
FOR SUICIDE: 14
1. TRENDS; 15
2. RISK FACTORS; 16
3. CURRENT BEST PRACTICE S IN SUICIDE PREVENT ION; 17
4. LAPSES IN SYSTEMIC RE SPONSES; AND 18
5. BARRIERS TO SAFETY AN D WELL–BEING; AND 19
(II) STRATEGIES FOR THE PR EVENTION OF SUICIDE DEATHS; 20
(3) REPORT AT LEAST ANNUA LLY TO THE GOVERNOR AND , IN 21
ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL 22
ASSEMBLY ON: 23
(I) THE STATE TEAM’S ACTIVITIES; AND 24
(II) THE STATE TEAM’S RECOMMENDATIONS ON : 25
1. CHANGING ANY LAW OR P OLICY IN A MANNER THAT 26
WOULD PROMOTE THE PR EVENTION OF SUICIDE DEATHS; AND 27
6 HOUSE BILL 48
2. IMPROVING THE AVAILAB ILITY OF SOURCES OF 1
INFORMATION RELATING TO THE INVESTIGATION OF REPORTED SUICIDE 2
FATALITIES; 3
(4) UNDERTAKE ANNUAL STAT ISTICAL STUDIES OF : 4
(I) THE INCIDENTS AND CAUSES OF SUICIDE MORTALITY IN 5
THE STATE; AND 6
(II) TRENDS AND PATTERNS O F SUICIDE DEATHS IN THE STATE; 7
AND 8
(5) DISSEMINATE FINDINGS AND RECOMMENDATIONS BASED ON THE 9
STUDIES CONDUCTED UN DER ITEM (4) OF THIS SUBSECTION T O POLICYMAKERS , 10
HEALTH CARE PROVIDERS , HEALTH CARE FACILITI ES, AND THE PUBLIC . 11
(B) THE STATE TEAM MAY PERIOD ICALLY MAKE AVAILABL E, IN A GENERAL 12
MANNER THAT DOES NOT REVEAL CONFIDENTIAL INFORMATION ABOUT IN DIVIDUAL 13
CASES, ONLY THE AGGREGATE F INDINGS OF THE STATE TEAM’S REVIEWS AND THEIR 14
RECOMMENDATIONS FOR PREVENTIVE ACTIONS . 15
5–1004. 16
A PERSON SHALL HAVE TH E IMMUNITY FROM LIAB ILITY UNDER § 5–637 OF 17
THE COURTS ARTICLE FOR ANY ACTIO N AS A MEMBER OF THE STATE TEAM OR FOR 18
GIVING INFORMATION T O, PARTICIPATING IN , OR CONTRIB UTING TO THE FUNCTIO N 19
OF THE STATE TEAM. 20
5–1005. 21
(A) THE STATE TEAM IS A PUBLI C HEALTH AUTHORITY , AS DEFINED IN 45 22
C.F.R. § 164.501, CONDUCTING PUBLIC HE ALTH ACTIVITIES IN A CCORDANCE WITH 23
THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT. 24
(B) ON REQUEST OF THE CHA IR OF THE STATE TEAM AND AS NEC ESSARY TO 25
CARRY OUT THE STATE TEAM’S PURPOSE AND DUTIES , A HEALTH CARE PROVID ER 26
OR A STATE OR LOCAL GOVERN MENT AGENCY IMMEDIAT ELY SHALL PROVIDE TO 27
THE STATE TEAM ANY RECORD S OF THE HEALTH CARE PROVIDER OR STATE OR 28
LOCAL GOVERNMENT AGE NCY NECESSARY TO COM PLETE THE REVIEW OF A 29
SPECIFIC FATALITY , INCLUDING: 30
(1) HOSPITAL RECORDS ; 31
(2) OUTPATIENT CLINIC , HEALTH CARE PROVIDER , AND 32 HOUSE BILL 48 7
LABORATORY RECORDS ; 1
(3) POLICE INVESTIGATION DATA; 2
(4) MEDICAL EXAMINER INVESTIGATI VE DATA; 3
(5) CAUSE–OF–DEATH INFORMATION IN VITAL RECORDS ; 4
(6) SOCIAL SERVICES RECOR DS; AND 5
(7) OTHER RECORDS FROM STATE OFFICES , AGENCIES, AND 6
DEPARTMENTS . 7
(C) THE STATE TEAM MAY REQUES T THAT A PERSON WITH DIRECT 8
KNOWLEDGE OF CIRCUMSTANCES SURROU NDING A FATALITY PRO VIDE THE STATE 9
TEAM WITH INFORMATIO N NECESSARY TO COMPL ETE THE REVIEW OF TH E 10
PARTICULAR FATALITY , INCLUDING INFORMATIO N FROM: 11
(1) A HEALTH CARE PROVIDER OR STAFF INVOLVED IN THE CARE OF 12
THE DECEDENT ; AND 13
(2) THE PERSON WHO FIRST RESPONDED TO A REPOR T CONCERNING 14
THE DECEDENT . 15
(D) THE STATE TEAM: 16
(1) MAY SHARE INFORMATION WITH OTHER PUBLIC HE ALTH 17
AUTHORITIES OR THEIR DESIGNEES AS THE STATE TEAM DETERMINES NECESSARY 18
TO CARRY OUT THE PUR POSES OF THIS SUBTIT LE; AND 19
(2) SHALL COORDINATE WITH THE STATE’S CHILD FATALITY 20
REVIEW AND DRUG OVERDOSE FATALITY REVIEW TEAMS TO SHARE AND RECEIVE 21
INFORMATION RELEVANT TO THE STATE TEAM ’S FINDINGS AND TO EN SURE 22
EFFICIENCY IN THE WO RK OF THE TEAMS . 23
(E) (1) EXCEPT AS PROVID ED IN PARAGRAPH (2) OF THIS SUBSECTION , 24
ALL INFORMATION AND RECORDS ACQUIRED BY THE STATE TEAM IN THE EXE RCISE 25
OF ITS DUTIES: 26
(I) SHALL BE CONFIDENTIAL ; 27
(II) SHALL BE EXEMPT FROM DISCLOSURE UNDER THE PUBLIC 28
INFORMATION ACT; AND 29
8 HOUSE BILL 48
(III) MAY NOT BE SUBJECT TO DISCOVERY OR INTRODUCTION 1
INTO EVIDENCE IN ANY PROCEEDINGS . 2
(2) INFORMATION MAY BE DI SCLOSED AS NECESSARY AND IN A 3
MANNER CONSISTENT WI TH THIS SUBTITLE TO CARRY OUT THE PURPOS ES OF THIS 4
SUBTITLE. 5
(F) MENTAL HEALTH RECORDS ARE SUBJECT TO TH E ADDITIONAL 6
LIMITATIONS UNDER § 4–307 OF THIS ARTICLE FOR DISCLOSURE OF A MEDI CAL 7
RECORD DEVELOPED PRI MARILY IN CONNECTION WITH THE PROVISION O F MENTAL 8
HEALTH SERVICES . 9
5–1006. 10
(A) MEETINGS OF THE STATE TEAM SHALL BE C LOSED TO THE PUBLIC AND 11
ARE NOT SUBJECT TO THE OPEN MEETINGS ACT. 12
(B) A MEMBER OF THE STATE TEAM OR ATTENDE E OF A STATE TEAM 13
MEETING MAY NOT : 14
(1) RELEASE TO THE PUBLIC OR THE NEWS MEDIA IN FORMATION 15
DISCUSSED AT MEETING S; OR 16
(2) EXCEPT AS PROVIDED IN § 5–1007 OF THIS SUBTITLE , TESTIFY IN 17
ANY PROCEEDING ABOUT DETAILS OF A STATE TEAM MEETING , INCLUDING ANY 18
INFORMATION PRESENTE D AT THE MEETING , OR ABOUT OPINIONS FO RMED BY THE 19
INDIVIDUAL BECAUSE O F THE MEETING. 20
(C) EACH MEMBER OF THE STATE TEAM AND ANY AT TENDEE OF A MEETING 21
OF THE STATE TEAM SHALL SIGN A STATEMENT INDICATI NG AN UNDERSTANDING 22
OF AND ADHERENCE TO THE STATE TEAM’S CONFIDENTIALITY RE QUIREMENTS , 23
INCLUDING ANY POTENT IAL CIVIL OR CRIMINA L CONSEQUENCES FOR A BREACH OF 24
CONFIDENTIALITY UNDE R THIS SECTION. 25
5–1007. 26
THIS SUBTITLE MAY NOT BE CONST RUED TO PROHIBIT A P ERSON FROM : 27
(1) TESTIFYING IN A CIVIL OR CRIMINAL ACTION A BOUT MATTERS 28
THAT OCCURRED IN A STATE TEAM MEETING IF THE TESTIMONY WILL B E BASED ON 29
THE PERSON’S INDEPENDENT KNOWLE DGE; OR 30
(2) INVESTIGATING OR REVI EWING A SUICIDE DEATH U NDER ANY 31
OTHER PROVISION OF L AW. 32 HOUSE BILL 48 9
5–1008. 1
THE DEPARTMENT MAY ADOPT REGULATIONS TO CARRY OUT THIS SUBTITLE , 2
INCLUDING REGULATION S ON: 3
(1) THE PROCEDURES BY WHI CH HEALTH CARE PROVI DERS, HEALTH 4
CARE FACILITIES, AND OTHER PERSONS IDENTIFY AND REPORT SUICIDE DEATHS TO 5
THE DEPARTMENT OR AS DIRE CTED BY THE DEPARTMENT ; 6
(2) THE PROTOCOLS , PROCEDURES , METHODS, MANNER, AND 7
EXTENT OF ALL INVEST IGATIONS AND REVIEWS BY THE STATE TEAM; AND 8
(3) THE MANNER IN AND EXT ENT TO WHICH INFORMA TION SHALL BE 9
DISSEMINATED UNDER T HIS SUBTITLE. 10
5–1009. 11
THIS SUBTITLE MAY BE CITED AS THE MARYLAND SUICIDE MORTALITY 12
REVIEW AND PREVENTION ACT. 13
Article – Health Occupations 14
1–401. 15
(a) (1) In this section the following words have the meanings indicated. 16
(3) “Medical review committee” means a committee or board that: 17
(i) Is within one of the categories described in subsection (b) of this 18
section; and 19
(ii) Performs functions that include at least one of the functions 20
listed in subsection (c) of this section. 21
(b) For purposes of this section, a medical review committee is: 22
(1) A regulatory board or agency established by State or federal law to 23
license, certify, or discipline any provider of health care; 24
(2) A committee of the Maryland State Medical Society or any of its 25
component societies or a committee of any other professional society or association 26
composed of providers of health care; 27
(3) A committee appointed by or established in the Department or a local 28
health department for review purposes; 29 10 HOUSE BILL 48
(4) A committee appointed by or established in the Maryland Institute for 1
Emergency Medical Services Systems; 2
(5) A committee of the medical staff or other committee, including any risk 3
management, credentialing, or utilization review committee established in accordance with 4
§ 19–319 of the Health – General Article, of a hospital, related institution, or alternative 5
health care system, if the governing board of the hospital, related institution, or alternative 6
health care system forms and approves the committee or approves the written bylaws under 7
which the committee operates; 8
(6) A committee or individual designated by the holder of a pharmacy 9
permit, as defined in § 12–101 of this article, that performs the functions listed in 10
subsection (c) of this section, as part of a pharmacy’s ongoing quality assurance program; 11
(7) Any person, including a professional standard review organization, who 12
contracts with an agency of this State or of the federal government to perform any of the 13
functions listed in subsection (c) of this section; 14
(8) Any person who contracts with a provider of health care to perform any 15
of those functions listed in subsection (c) of this section that are limited to the review of 16
services provided by the provider of health care; 17
(9) An organization, established by the Maryland Hospital Association, 18
Inc. and the Maryland State Medical Society, that contracts with a hospital, related 19
institution, or alternative delivery system to: 20
(i) Assist in performing the functions listed in subsection (c) of this 21
section; or 22
(ii) Assist a hospital in meeting the requirements of § 19–319(e) of 23
the Health – General Article; 24
(10) A committee appointed by or established in an accredited health 25
occupations school; 26
(11) An organization described under § 14–501 of this article that contracts 27
with a hospital, related institution, or health maintenance organization to: 28
(i) Assist in performing the functions listed in subsection (c) of this 29
section; or 30
(ii) Assist a health maintenance organization in meeting the 31
requirements of Title 19, Subtitle 7 of the Health – General Article, the National Committee 32
for Quality Assurance (NCQA), or any other applicable credentialing law or regulation; 33
(12) An accrediting organization as defined in § 14–501 of this article; 34 HOUSE BILL 48 11
(13) A Mortality and Quality Review Committee established under § 5–802 1
of the Health – General Article or a Morbidity, Mortality, and Quality Review Committee 2
established under § 18–107 of the Health – General Article; 3
(14) A center designated by the Maryland Health Care Commission as the 4
Maryland Patient Safety Center that performs the functions listed in subsection (c)(1) of 5
this section; or 6
(15) The Maryland Health Care Commission or its staff, when performing 7
the functions listed in subsection (c) of this section, provided that the data or medical 8
information under review is furnished to the Maryland Health Care Commission by 9
another medical review committee. 10
(c) For purposes of this section, a medical review committee: 11
(1) Evaluates and seeks to improve the quality of health care provided by 12
providers of health care; 13
(2) Evaluates the need for and the level of performance of health care 14
provided by providers of health care; 15
(3) Evaluates the qualifications, competence, and performance of providers 16
of health care; or 17
(4) Evaluates and acts on matters that relate to the discipline of any 18
provider of health care. 19
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall be construed to 20
apply only prospectively to deaths that occur after the effective date of this Act and may 21
not be applied or interpreted to have any effect on or application to any deaths that occurred 22
before the effective date of this Act. 23
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 24
October 1, 2022. 25