EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0975*
HOUSE BILL 975
J1, J2 2lr2220
CF SB 696
By: Delegates Charles, Howell, Jalisi, and Proctor
Introduced and read first time: February 10, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Maryland Loan Assistance Repayment for Nurses and Nursing Workers – 2
Program Establishment and Funding 3
FOR the purpose of establishing the Maryland Loan Assistance Repayment Program or 4
Nurses and Nursing Workers to assist certain nurses and nursing workers with the 5
repayment of certain education loans; establishing the Maryland Loan Assistance 6
Repayment Program Fund for Nurses and Nursing Workers; requiring the 7
Comptroller to distribute a certain amount of money of certain fees received by the 8
State Board of Nursing to make certain grants for the Program under certain 9
circumstances in certain years; requiring the Maryland Department of Health to 10
convene a certain stakeholder workgroup for a certain purpose; and generally 11
relating to the Maryland Loan Assistance Repayment Program for Nurses and 12
Nursing Workers. 13
BY adding to 14
Article – Health – General 15
Section 24–1801 through 24–1807 to be under the new subtitle “Subtitle 18. 16
Maryland Loan Assistance Repayment Program for Nurses and Nursing 17
Workers” 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2021 Supplement) 20
BY repealing and reenacting, with amendments, 21
Article – Health Occupations 22
Section 8–206 23
Annotated Code of Maryland 24
(2021 Replacement Volume) 25
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
That the Laws of Maryland read as follows: 27
2 HOUSE BILL 975
Article – Health – General 1
SUBTITLE 18. MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR NURSES 2
AND NURSING WORKERS. 3
24–1801. 4
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 5
INDICATED. 6
(B) “EDUCATION LOAN ” MEANS ANY LOAN THAT IS OBTAINED FOR TUIT ION, 7
EDUCATIONAL EXPENSES , OR LIVING EXPENSES F OR STATE CERTIFICATION , 8
UNDERGRADUATE , OR GRADUATE STUDY LEADING TO PRACTICE AS A NURSE OR 9
NURSING WORKER . 10
(C) “FUND” MEANS THE MARYLAND LOAN ASSISTANCE REPAYMENT 11
PROGRAM FUND FOR NURSES AND NURSING WORKERS. 12
(D) “NURSE” INCLUDES: 13
(1) AN ADVANCED PRACTICE REGISTERED NURSE , AS DEFINED IN § 14
8–101(B) OF THE HEALTH OCCUPATIONS ARTICLE; 15
(2) A LICENSED PRACTICAL N URSE, AS DEFINED IN § 8–101(H) OF 16
THE HEALTH OCCUPATIONS ARTICLE; 17
(3) A NURSE ANESTHETIST , AS DEFINED IN § 8–101(K) OF THE 18
HEALTH OCCUPATIONS ARTICLE; 19
(4) A REGISTERED NURSE , AS DEFINED IN § 8–101(P) OF THE HEALTH 20
OCCUPATIONS ARTICLE; AND 21
(5) A REGISTERED NURSE PRA CTITIONER, AS DEFINED IN § 8–101(Q) 22
OF THE HEALTH OCCUPATIONS ARTICLE. 23
(E) “NURSING WORKER ” INCLUDES: 24
(1) A CERTIFIED MEDICATION TECHNICIAN, AS DEFINED IN § 25
8–6A–01(H) OF THE HEALTH OCCUPATIONS ARTICLE; 26
(2) A CERTIFIED MEDICINE A IDE, AS DEFINED IN § 8–6A–01(I) OF THE 27
HEALTH OCCUPATIONS ARTICLE; 28
HOUSE BILL 975 3
(3) A CERTIFIED NURSING AS SISTANT, AS DEFINED IN § 8–6A–01(J) 1
OF THE HEALTH OCCUPATIONS ARTICLE; AND 2
(4) A GERIATRIC NURSING A SSISTANT, AS DEFINED IN § 8–6A–01(M) 3
OF THE HEALTH OCCUPATIONS ARTICLE. 4
(F) “PRIMARY CARE” INCLUDES: 5
(1) PRIMARY CARE; 6
(2) FAMILY MEDICINE ; 7
(3) INTERNAL MEDICINE ; 8
(4) OBSTETRICS; 9
(5) PEDIATRICS; 10
(6) GERIATRICS; 11
(7) EMERGENCY MEDICINE; 12
(8) WOMEN’S HEALTH; 13
(9) PSYCHIATRY; AND 14
(10) PREVENTIVE MEDICINE . 15
(G) “PROGRAM” MEANS THE MARYLAND LOAN ASSISTANCE REPAYMENT 16
PROGRAM FOR NURSES AND NURSING WORKERS. 17
24–1802. 18
(A) (1) THERE IS A MARYLAND LOAN ASSISTANCE REPAYMENT 19
PROGRAM FUND FOR NURSES AND NURSING WORKERS. 20
(2) THE FUND IS A CONTINUING , NONLAPSING FUND THAT IS NOT 21
SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 22
(3) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 23
AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 24
4 HOUSE BILL 975
(4) THE FUND SHALL BE INVESTE D AND REINVESTED IN THE SAME 1
MANNER AS OTHER STATE FUNDS. 2
(5) ANY INVESTMENT EARNIN GS OF THE FUND SHALL BE PAID IN TO 3
THE FUND. 4
(B) THE FUND CONSISTS OF : 5
(1) REVENUE GENERATED THR OUGH A PERMANENT FUNDING 6
STRUCTURE RECOMMENDE D TO THE GENERAL ASSEMBLY BY A STAKEHO LDER 7
WORKGROUP CONVENED B Y THE DEPARTMENT ; 8
(2) ANY AVAILABLE FEDERAL FUNDS; AND 9
(3) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FOR 10
THE BENEFIT OF THE FUND. 11
(C) EXPENDITURES FROM THE FUND SHALL BE MADE BY AN 12
APPROPRIATION IN THE ANNUAL STATE BUDGET OR BY AN APPROVED BUDGET 13
AMENDMENT AS PROVIDE D UNDER § 7–209 OF THE STATE FINANCE AND 14
PROCUREMENT ARTICLE. 15
(D) THE MONEY IN THE FUND SHALL BE USED BY THE OFFICE OF THE 16
COMPTROLLER TO A DMINISTER THE PROGRAM. 17
24–1803. 18
THERE IS A MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR 19
NURSES AND NURSING WORKERS. 20
24–1804. 21
(A) (1) IN THIS SECTION , “ELIGIBLE FIELD OF EM PLOYMENT” MEANS 22
EMPLOYMENT BY AN ORG ANIZATION, AN INSTITUTION, AN ASSOCIATIO N, A SOCIETY, 23
OR A CORPORATION THA T IS EXEMPT FROM TAX ATION UNDER § 501(C)(3) OR (4) OF 24
THE INTERNAL REVENUE CODE OF 1986. 25
(2) “ELIGIBLE FIELD OF EMP LOYMENT” INCLUDES EMPLOYMENT BY 26
THE STATE OR A LOCAL GOVE RNMENT IN THE STATE. 27
(B) THE DEPARTMENT SHALL ASSI ST IN THE REPAYMENT WITH THE FUNDS 28
TRANSFERRED TO THE DEPARTMENT BY THE COMPTROLLER UNDER § 8–206 OF 29 HOUSE BILL 975 5
THE HEALTH OCCUPATIONS ARTICLE OF THE AMOUNT OF EDUCATION LOANS O WED 1
BY A NURSE OR NURSIN G WORKER WHO : 2
(1) PRACTICES PRIMARY CARE IN AN ELIGIBLE FIELD OF 3
EMPLOYMENT IN A GEOG RAPHIC AREA OF THE STATE THAT HAS BEEN F EDERALLY 4
DESIGNATED; OR 5
(2) MEETS ANY OTHER REQUI REMENTS ESTABLISHED BY THE 6
DEPARTMENT . 7
(C) ANY UNSPENT PORTIONS OF THE MONEY THAT IS TRANSFERRED TO THE 8
DEPARTMEN T FOR USE UNDER THIS SUBTITLE FROM THE BOARD OF NURSING 9
FUND ESTABLISHED UNDE R § 8―206 OF THE HEALTH OCCUPATIONS ARTICLE MAY 10
NOT BE TRANSFERRED T O OR REVERT TO THE GENERAL FUND OF THE STATE, BUT 11
SHALL REMAIN IN THE FUND MAINTAINED BY TH E DEPARTMENT TO ADMI NISTER 12
THE PROGRAM. 13
24–1805. 14
(A) IN ADDITION TO THE AS SISTANCE PROVIDED UN DER § 24–1804 OF THIS 15
SUBTITLE, THE DEPARTMENT MAY , SUBJECT TO THE AVAIL ABILITY OF MONEY IN 16
THE FUND AND SUBJECT TO A PPLICABLE REGULATION S, ASSIST IN THE REPAYM ENT 17
OF AN EDUCATIO N LOAN OWED BY A NUR SE OR NURSING WORKER WHO: 18
(1) PRACTICES A MEDICAL S PECIALTY THAT HAS BE EN IDENTIFIED 19
BY THE DEPARTMENT AS BEING I N SHORTAGE IN THE GE OGRAPHIC AREA OF THE 20
STATE WHERE THE NURSE OR NURSING WORKER PR ACTICES THAT SPECIAL TY; AND 21
(2) COMMITS TO PRACTICING IN THE AREA FOR A PE RIOD OF TIME 22
DETERMINED BY THE DEPARTMENT . 23
(B) THE DEPARTMENT SHALL PRIO RITIZE FUNDING FOR T HE REPAYMENT 24
OF EDUCATION LOANS T HROUGH THE PROGRAM IN THE FOLLOW ING ORDER: 25
(1) NURSING WORKERS WHO M EET THE REQUIREMEN TS UNDER § 26
24–1804(B) OF THIS SUBTITLE; 27
(2) NURSES AND NURSING WO RKERS PRACTICING PRI MARY CARE IN 28
A GEOGRAPHIC AREA WH ERE THE DEPARTMENT HAS IDENTI FIED A SHORTAGE OF 29
NURSES AND NURSING W ORKERS; AND 30
6 HOUSE BILL 975
(3) NURSES AND NURSING WO RKERS PRACTICING A M EDICAL 1
SPECIALTY OTHER THAN PRIMARY CARE IN A GE OGRAPHIC AREA WHERE THE 2
DEPARTMENT HAS IDENTI FIED A SHORTAGE OF T HAT SPECIALTY. 3
24–1806. 4
THE DEPARTMENT SHALL ADOP T REGULATIONS TO CAR RY OUT THE 5
PROVISIONS OF THIS S UBTITLE, INCLUDING REGULATION S THAT: 6
(1) ESTABLISH THE MAXIMUM NUMBER OF PARTICIPAN TS IN THE 7
PROGRAM EACH YEAR IN EACH PRIORITY AREA D ESCRIBED UNDER § 24–1805 OF 8
THIS SUBTITLE; AND 9
(2) ESTABLISH THE MINIMUM AND MAXIMUM AMOUNT O F LOAN 10
REPAYMENT ASSISTANCE AWARDED UNDER THIS S UBTITLE IN EACH PRI ORITY AREA 11
DESCRIBED UNDER § 24–1805 OF THIS SUBTITLE. 12
24–1807. 13
ON OR BEFORE OCTOBER 1, 2023, AND EACH OCTOBER 1 THEREAFTER , THE 14
DEPARTMENT SHALL REPO RT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH 15
§ 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON: 16
(1) THE ELIGIBLE NURSES AND NURSING WORKERS WHO APPLIED 17
FOR THE PROGRAM, INCLUDING INFORMATIO N ON: 18
(I) THE SPECIALTY OF THE NURSE OR NURSING WOR KER; 19
(II) THE TYPE AND LOCATION OF THE SITE IN WHICH THE 20
NURSE OR NURSING WOR KER PROVIDED SERVICE S; AND 21
(III) THE GEOGRAPHIC AREA S ERVED BY THE NURSE O R 22
NURSING WORKER ; AND 23
(2) THE NURSES AND NURSIN G WORKERS WHO PARTIC IPATED IN THE 24
PROGRAM, INCLUDING INFORMATIO N ON: 25
(I) THE AMOUNT OF ASSISTA NCE PROVIDED TO EACH 26
PARTICIPANT; 27
(II) THE SPECIALTY OF THE PARTICIPANT; 28
HOUSE BILL 975 7
(III) THE TYPE AND LOCATION OF THE SITE IN WHICH THE 1
PARTICIPANT PROVIDED SERVICES; AND 2
(IV) THE GEOGRAPHIC AREA S ERVED BY THE PARTICI PANT. 3
Article – Health Occupations 4
8–206. 5
(a) There is a Board of Nursing Fund. 6
(b) (1) The Board may set reasonable fees for the issuance and renewal of 7
licenses and its other services. 8
(2) The fees charged shall be set so as to produce funds to approximate the 9
cost of maintaining the Board as provided in subsection (e) of this section. 10
(3) (i) In addition to the fee set by the Board under this title for the 11
renewal of a nurse practitioner who holds an advanced practice registered nurse 12
certification, the Board shall assess a separate $15 fee for the renewal of the nurse 13
practitioner, regardless of the number of certifications held by the nurse practitioner. 14
(ii) The Board shall pay the fee collected under subparagraph (i) of 15
this paragraph to the Nurse Practitioner Preceptorship Tax Credit Fund established under 16
§ 10–739 of the Tax – General Article. 17
(c) The Board shall publish in its rules and regulations the fees that it sets. 18
(d) (1) The Board shall pay all fees collected under the provisions of this title 19
to the Comptroller of the State. 20
(2) The Comptroller shall distribute the fees received from the Board to the 21
Board of Nursing Fund. 22
(E) (1) IN EACH OF FISCAL YEA RS 2023 THROUGH 2025, IF THE 23
GOVERNOR DOES NOT INC LUDE IN THE STATE BUDGET AT LEAST $400,000 FOR THE 24
OPERATION OF THE MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR 25
NURSES AND NURSING WORKERS UNDER TITLE 24, SUBTITLE 18 OF THE HEALTH 26
– GENERAL ARTICLE, AS ADMINISTERED BY T HE DEPARTMENT , THE COMPTROLLER 27
SHALL DISTRIBUTE : 28
(I) $400,000 OF THE FEES RECEIVED FROM THE BOARD TO THE 29
DEPARTMENT TO BE USED TO MAKE GRANTS U NDER THE MARYLAND LOAN 30
ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND NURSING WORKERS UNDER 31
TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL ARTICLE TO NURSES AND 32
NURSING WORKERS ENGA GED IN PRIMARY CARE WHO AGREE TO PRACTIC E FOR AT 33 8 HOUSE BILL 975
LEAST 2 YEARS IN A GEOGRAPHI C AREA OF THE STATE THAT HAS BEEN D ESIGNATED 1
BY THE SECRETARY AS BEING ME DICALLY UNDERSERVED ; AND 2
(II) THE BALANCE OF THE FE ES TO THE BOARD OF NURSING 3
FUND. 4
(2) IN FISCAL YEAR 2026 AND EACH FISCAL YEAR THEREAFTER , IF 5
THE DEPARTMENT DOES NOT I MPLEMENT A PERMANENT FUNDING STRUCTURE 6
UNDER § 24–1802(B) OF THE HEALTH – GENERAL ARTICLE AND THE GOVERNOR 7
DOES NOT INCLUDE IN THE STATE BUDGET AT LEAST $400,000 FOR THE OPERATION 8
OF THE MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND 9
NURSING WORKERS UNDE R TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL 10
ARTICLE, AS ADMINISTERED BY T HE DEPARTMENT , THE COMPTROLLER SHALL 11
DISTRIBUTE: 12
(I) $400,000 OF THE FEES RECEIVED FROM THE BOARD TO THE 13
DEPARTMENT TO BE USED TO MAKE GRANTS UNDER THE MARYLAND LOAN 14
ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND NURSING WORKERS UNDER 15
TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL ARTICLE TO NURSES AND 16
NURSING WORKERS ENGA GED IN PRIMARY CARE WHO AGREE TO PRACTIC E FOR AT 17
LEAST 2 YEARS IN A GEOGRAPHI C AREA OF THE STATE THAT HAS BEEN DESIGNATED 18
BY THE SECRETARY AS BEING ME DICALLY UNDERSERVED ; AND 19
(II) THE BALANCE OF THE FE ES TO THE BOARD OF NURSING 20
FUND. 21
[(e)] (F) (1) The Board of Nursing Fund shall be used exclusively to cover the 22
actual documented direct and indirect costs of fulfilling the statutory and regulatory duties 23
of the Board as provided by the provisions of this title. 24
(2) (i) The Board of Nursing Fund is a continuing, nonlapsing fund, not 25
subject to § 7–302 of the State Finance and Procurement Article. 26
(ii) Any unspent portions of the Board of Nursing Fund may not be 27
transferred or revert to the General Fund of the State, but shall remain in the Board of 28
Nursing Fund to be used for the purposes specified in this title. 29
(3) No other State money may be used to support the Board of Nursing 30
Fund. 31
(4) AVAILABLE FEDERAL FUN DS MAY BE USED TO SU PPORT THE 32
BOARD OF NURSING FUND. 33
HOUSE BILL 975 9
[(f)] (G) (1) The Chairman of the Board or the designee of the Chairman shall 1
administer the Board of Nursing Fund. 2
(2) Money in the Board of Nursing Fund may be expended only for any 3
lawful purpose authorized by the provisions of this title. 4
[(g)] (H) The Legislative Auditor shall audit the accounts and transactions of the 5
Board of Nursing Fund as provided in § 2–1220 of the State Government Article. 6
SECTION 2. AND BE IT FURTHER ENACTED, That: 7
(a) The Maryland Department of Health shall convene a stakeholder workgroup 8
to examine how the State can implement a program within or in addition to the Maryland 9
Loan Assistance Program Fund for Nurses and Nursing Workers to further incentivize 10
nursing and nursing worker students to practice in professional shortage areas and 11
medically underserved areas in the State. 12
(b) The workgroup shall consist of the following members: 13
(1) the Secretary of Health, or the Secretary’s designee; 14
(2) one representative of the State Board of Nursing; 15
(3) one representative of the Maryland Nurses Association; 16
(4) one representative of 1199 SEIU United Healthcare Workers East; 17
(5) one representative of the Health Facilities Association of Maryland; 18
(6) one representative of the Maryland Hospital Association; and 19
(7) one representative of the LifeSpan Network. 20
(c) The workgroup shall consult with the Department of Legislative Services 21
when developing its recommendations. 22
(d) The workgroup shall: 23
(1) review nursing school debt experienced in the United States and in 24
Maryland; 25
(2) examine other models for nurse and nursing worker recruitment and 26
retention that operate in other states, including how these models are funded and how to 27
improve the Maryland Loan Assistance Repayment Program Fund for Nurses and Nursing 28
Workers to ensure that the Program is competitive with other states; 29
10 HOUSE BILL 975
(3) examine and recommend methods to incentivize nursing and nursing 1
worker students to commit to practicing in medically underserved areas in the State before 2
entering an educational program or on graduation from nursing school or a program 3
focusing on training for nursing workers; and 4
(4) investigate the availability of other federal grants to further expand 5
loan repayment and loan forgiveness for other nurses and nursing workers in Maryland. 6
(e) (1) On or before December 1, 2022, the workgroup shall submit an interim 7
report of its findings and recommendations, in accordance with § 2–1257 of the State 8
Government Article, to the General Assembly. 9
(2) On or before December 1, 2023, the workgroup shall submit a final 10
report of its findings and recommendations, including recommendations on the structure 11
of a permanent advisory council and a permanent funding structure for the Maryland Loan 12
Assistance Repayment Program Fund for Nurses and Nursing Workers, to the General 13
Assembly in accordance with § 2–1257 of the State Government Article. 14
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect July 15
1, 2022. 16