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. *hb0975* HOUSE BILL 975 J1, J2 2lr2220 CF SB 696 By: Delegates Charles, Howell, Jalisi, and Proctor Proctor, Bagnall, Belcastro, Bhandari, Carr, Chisholm, Cullison, Hill, Johnson, Kaiser, Kelly, Kerr, Kipke, Krebs, Landis, R. Lewis, Morgan, Pena–Melnyk, Pendergrass, Reilly, Rosenberg, Saab, Sample–Hughes, Szeliga, and K. Young Introduced and read first time: February 10, 2022 Assigned to: Health and Government Operations Committee Report: Favorable with amendments House action: Adopted Read second time: March 30, 2022 CHAPTER ______ AN ACT concerning 1 Maryland Loan Assistance Repayment for Nurses and Nursing Workers Support 2 Staff – Program Establishment and Funding 3 FOR the purpose of establishing the Maryland Loan Assistance Repayment Program or for 4 Nurses and Nursing Workers Support Staff to assist certain nurses and nursing 5 workers support staff with the repayment of certain education loans; establishing 6 the Maryland Loan Assistance Repayment Program Fund for Nurses and Nursing 7 Workers Support Staff; requiring the Comptroller to distribute a certain amount of 8 money of certain fees received by the State Board of Nursing to make certain grants 9 for the Program under certain circumstances in certain years; requiring the 10 Maryland Department of Health to convene a certain stakeholder workgroup for a 11 certain purpose; and generally relating to the Maryland Loan Assistance Repayment 12 Program for Nurses and Nursing Workers Support Staff. 13 BY adding to 14 Article – Health – General 15 Section 24–1801 through 24–1807 24–1806 to be under the new subtitle “Subtitle 18. 16 Maryland Loan Assistance Repayment Program for Nurses and Nursing 17 Workers Support Staff” 18 Annotated Code of Maryland 19 (2019 Replacement Volume and 2021 Supplement) 20 2 HOUSE BILL 975 BY repealing and reenacting, with amendments, 1 Article – Health Occupations 2 Section 8–206 3 Annotated Code of Maryland 4 (2021 Replacement Volume) 5 BY repealing and reenacting, without amendments, 6 Article – State Finance and Procurement 7 Section 6–226(a)(2)(i) 8 Annotated Code of Maryland 9 (2021 Replacement Volume) 10 BY repealing and reenacting, with amendments, 11 Article – State Finance and Procurement 12 Section 6–226(a)(2)(ii)144. and 145. 13 Annotated Code of Maryland 14 (2021 Replacement Volume) 15 BY adding to 16 Article – State Finance and Procurement 17 Section 6–226(a)(2)(ii)146. 18 Annotated Code of Maryland 19 (2021 Replacement Volume) 20 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21 That the Laws of Maryland read as follows: 22 Article – Health – General 23 SUBTITLE 18. MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR NURSES 24 AND NURSING WORKERS SUPPORT STAFF. 25 24–1801. 26 (A) IN THIS SUBTITLE THE FOLLOWI NG WORDS HAVE THE ME ANINGS 27 INDICATED. 28 (B) “EDUCATION LOAN ” MEANS ANY LOAN THAT IS OBTAINED FOR TUIT ION, 29 EDUCATIONAL EXPENSES , OR LIVING EXPENSES F OR STATE CERTIFICATION , 30 UNDERGRADUATE , OR GRADUATE STUDY LE ADING TO PRACTICE AS A NURSE OR 31 NURSING WORKER SUPPORT STAFF . 32 (C) “FUND” MEANS THE MARYLAND LOAN ASSISTANCE REPAYMENT 33 PROGRAM FUND FOR NURSES AND NURSING WORKERS SUPPORT STAFF. 34 (D) “NURSE” INCLUDES: 35 HOUSE BILL 975 3 (1) AN ADVANCED PRACTICE REGISTERED NURSE , AS DEFINED IN § 1 8–101(B) OF THE HEALTH OCCUPATIONS ARTICLE CERTIFIED TO PRACTIC E AS A 2 NURSE MIDWIFE OR CLI NICAL NURSE SPECIALI ST; 3 (2) A LICENSED PRACTICAL N URSE, AS DEFINED IN § 8–101(H) OF 4 THE HEALTH OCCUPATIONS ARTICLE; 5 (3) A NURSE ANESTHETIST , AS DEFINED IN § 8–101(K) OF THE 6 HEALTH OCCUPATIONS ARTICLE; 7 (4) A REGISTERED NURSE , AS DEFINED IN § 8–101(P) OF THE HEALTH 8 OCCUPATIONS ARTICLE; AND 9 (5) A REGISTERED NURSE PRA CTITIONER, AS DEFINED IN § 8–101(Q) 10 OF THE HEALTH OCCUPATIONS ARTICLE. 11 (E) “NURSING WORKER SUPPORT STAFF ” INCLUDES: 12 (1) A CERTIFIED MEDICATION TECHNICIAN, AS DEFINED IN § 13 8–6A–01(H) OF THE HEALTH OCCUPATIONS ARTICLE; 14 (2) A CERTIFIED MEDICINE A IDE, AS DEFINED IN § 8–6A–01(I) OF THE 15 HEALTH OCCUPATIONS ARTICLE; 16 (3) A CERTIFIED NURSING AS SISTANT, AS DEFINED IN § 8–6A–01(J) 17 OF THE HEALTH OCCUPATIONS ARTICLE; AND 18 (4) A GERIATRIC NURSING AS SISTANT, AS DEFINED IN § 8–6A–01(M) 19 OF THE HEALTH OCCUPATIONS ARTICLE. 20 (F) “PRIMARY CARE” INCLUDES: 21 (1) PRIMARY CARE; 22 (2) FAMILY MEDICINE ; 23 (3) INTERNAL MEDICINE; 24 (4) OBSTETRICS; 25 (5) PEDIATRICS; 26 (6) GERIATRICS; 27 4 HOUSE BILL 975 (7) EMERGENCY MEDICINE ; 1 (8) WOMEN’S HEALTH; 2 (9) PSYCHIATRY; AND 3 (10) PREVENTIVE MEDICINE . 4 (G) (F) “PROGRAM” MEANS THE MARYLAND LOAN ASSISTANCE 5 REPAYMENT PROGRAM FOR NURSES AND NURSING WORKERS SUPPORT STAFF. 6 24–1802. 7 (A) (1) THERE IS A MARYLAND LOAN ASSISTANCE REPAYMENT 8 PROGRAM FUND FOR NURSES AND NURSING WORKERS SUPPORT STAFF. 9 (2) THE FUND IS A CONTINUING, NONLAPSING FUND THAT IS NOT 10 SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 11 (3) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 12 AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 13 (4) THE FUND SHALL BE INVESTE D AND REINVE STED IN THE SAME 14 MANNER AS OTHER STATE FUNDS. 15 (5) ANY INVESTMENT EARNIN GS OF THE FUND SHALL BE PAID IN TO 16 THE FUND. 17 (B) THE FUND CONSISTS OF : 18 (1) REVENUE GENERATED THR OUGH A PERMANENT FUN DING 19 STRUCTURE RECOMMENDE D TO THE GENERAL ASSEMBLY BY A STAKEHOLDER 20 WORKGROUP CONVENED B Y THE DEPARTMENT ; 21 (2) ANY AVAILABLE FEDERAL FUNDS; AND 22 (3) INTEREST EARNINGS ; AND 23 (4) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FOR 24 THE BENEFIT OF THE FUND. 25 (C) EXPENDITURES FROM THE FUND SHALL BE MADE BY AN 26 APPROPRIATION IN THE ANNUAL STATE BUDGET OR BY AN APPROVED BUDGET 27 AMENDMENT AS PROVIDE D UNDER § 7–209 OF THE STATE FINANCE AND 28 PROCUREMENT ARTICLE. 29 HOUSE BILL 975 5 (D) THE MONEY IN THE FUND SHALL BE USED BY THE OFFICE OF THE 1 COMPTROLLER TO ADMINI STER THE PROGRAM. 2 24–1803. 3 THERE IS A MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR 4 NURSES AND NURSING WORKERS SUPPORT STAFF. 5 24–1804. 6 (A) (1) IN THIS SECTION , “ELIGIBLE FIELD OF EM PLOYMENT” MEANS 7 EMPLOYMENT BY AN ORG ANIZATION, AN INSTITUTION, AN ASSOCIATION , A SOCIETY, 8 OR A CORPORATION THA T IS EXEMPT FROM TAX ATION UNDER § 501(C)(3) OR (4) OF 9 THE INTERNAL REVENUE CODE OF 1986. 10 (2) “ELIGIBLE FIELD OF EMP LOYMENT” INCLUDES EMPLOYMENT BY 11 THE STATE OR A LOCAL GOVE RNMENT IN THE STATE. 12 (B) THE DEPARTMENT SHALL USE THE FUND TO ASSIST IN THE 13 REPAYMENT WITH THE FUNDS TRANSFERRED TO THE DEPARTMENT BY THE 14 COMPTROLLER UNDER § 8–206 OF THE HEALTH OCCUPATIONS ARTICLE OF THE 15 AMOUNT OF EDUCATION LOANS OWED BY A NURS E OR NURSING WORKER SUPPORT 16 STAFF WHO: 17 (1) PRACTICES PRIMARY CARE IN AN ELIGIBLE FIELD OF 18 EMPLOYMENT IN A GEOGRAPHIC AREA OF THE STATE THAT HAS BEEN F EDERALLY 19 DESIGNATED; OR 20 (2) MEETS ANY OTHER REQUI REMENTS ESTABLISHED BY THE 21 DEPARTMENT . 22 (C) ANY UNSPENT PORTIONS OF THE MONEY THAT IS TRANSFERRED TO THE 23 DEPARTMENT FO R USE UNDER THIS SUB TITLE FROM THE BOARD OF NURSING 24 FUND ESTABLISHED UNDE R § 8–206 OF THE HEALTH OCCUPATIONS ARTICLE MAY 25 NOT BE TRANSFERRED T O OR REVERT TO THE GENERAL FUND OF THE STATE, BUT 26 SHALL REMAIN IN THE FUND MAINTAINED BY TH E DEPARTMENT TO ADMINIS TER 27 THE PROGRAM. 28 24–1805. 29 (A) IN ADDITION TO THE AS SISTANCE PROVIDED UN DER § 24–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§ 10 24–1804(B) OF THIS SUBTITLE; 11 (2) NURSES AND NURSING WO RKERS PRACTICING PRI MARY CARE IN 12 A GEOGRAPHIC AREA WH ERE THE DEPARTMENT HAS IDENTI FIED A SHORTAGE OF 13 NURSES AND NURSING W ORKERS; AND 14 (3) NURSES AND NURSING WO RKERS PRACTICING A M EDICAL 15 SPECIALTY OTHER THAN PRIMARY CARE IN A GE OGRAPHIC AREA WHERE THE 16 DEPARTMENT HAS IDENTI FIED A SHORTAGE OF T HAT SPECIALTY. 17 24–1806. 18 THE DEPARTMENT SHALL ADOP T REGULATIONS TO CAR RY OUT THE 19 PROVISIONS OF THIS S UBTITLE, INCLUDING REGULATION S THAT: 20 (1) WITH ADVICE FROM A ST AKEHOLDER WORKGROUP CONVENED BY 21 THE DEPARTMENT , ESTABLISH PRIORITIES FOR FUNDING THE REPA YMENT OF 22 EDUCATION LOANS THRO UGH THE PROGRAM; 23 (1) (2) ESTABLISH THE MAXIMUM NUMBER OF PARTICIPAN TS IN 24 THE PROGRAM EACH YEAR IN EACH PRIORITY A REA DESCRIBED UNDER § 24–1805 25 OF THIS SUBTITLE ESTABLISHED UNDER IT EM (1) OF THIS SECTION; AND 26 (2) (3) ESTABLISH THE MINIMUM AND MAXIMUM AMOUNT O F LOAN 27 REPAYMENT ASSISTANCE AWARDED UNDER THIS S UBTITLE IN EACH PRIO RITY AREA 28 DESCRIBED UNDER § 24–1805 OF THIS SUBTITLE ESTABLISHED UNDER IT EM (1) OF 29 THIS SECTION. 30 24–1807. 24–1806. 31 HOUSE BILL 975 7 ON OR BEFORE OCTOBER 1, 2023, AND EACH OCTOBER 1 THEREAFTER , THE 1 DEPARTMENT SHALL REPO RT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH 2 § 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON: 3 (1) THE ELIGIBLE NURSES A ND NURSING WORKERS SUPPORT STAFF 4 WHO APPLIED FOR THE PROGRAM, INCLUDING INFORMATIO N ON: 5 (I) THE SPECIALTY PRACTICE OF THE NURSE OR NURS ING 6 WORKER SUPPORT STAFF ; 7 (II) THE TYPE AND LOCATION OF THE SITE IN WHICH THE 8 NURSE OR NURSING WORKER SUPPORT STAFF PROVIDED SERVICES ; AND 9 (III) THE GEOGRAPHIC AREA S ERVED BY THE NURSE O R 10 NURSING WORKER SUPPORT STAFF ; AND 11 (2) THE NURSES AND NURSIN G WORKERS SUPPORT STAFF WHO 12 PARTICIPATED IN THE PROGRAM, INCLUDING INFORMATIO N ON: 13 (I) THE AMOUNT OF ASSISTA NCE PROVIDED TO EACH 14 PARTICIPANT; 15 (II) THE SPECIALTY PRACTICE OF THE PARTICIPANT ; 16 (III) THE TYPE AND LOCATION OF THE SITE IN WHICH THE 17 PARTICIPANT PROVIDED SERVICES; AND 18 (IV) THE GEOGRAPHIC AREA S ERVED BY THE PARTICI PANT. 19 Article – Health Occupations 20 8–206. 21 (a) There is a Board of Nursing Fund. 22 (b) (1) The Board may set reasonable fees for the issuance and renewal of 23 licenses and its other services. 24 (2) The fees charged shall be set so as to produce funds to approximate the 25 cost of maintaining the Board as provided in subsection (e) of this section. 26 (3) (i) In addition to the fee set by the Board under this title for the 27 renewal of a nurse practitioner who holds an advanced practice registered nurse 28 certification, the Board shall assess a separate $15 fee for the renewal of the nurse 29 practitioner, regardless of the number of certifications held by the nurse practitioner. 30 8 HOUSE BILL 975 (ii) The Board shall pay the fee collected under subparagraph (i) of 1 this paragraph to the Nurse Practitioner Preceptorship Tax Credit Fund established under 2 § 10–739 of the Tax – General Article. 3 (c) The Board shall publish in its rules and regulations the fees that it sets. 4 (d) (1) The Board shall pay all fees collected under the provisions of this title 5 to the Comptroller of the State. 6 (2) The Comptroller shall distribute the fees received from the Board to the 7 Board of Nursing Fund. 8 (E) (1) IN EACH OF FISCAL YEA RS 2023 THROUGH 2025, IF THE 9 GOVERNOR DOES NOT INC LUDE IN THE STATE BUDGET AT LEAST $400,000 FOR THE 10 OPERATION OF THE MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR 11 NURSES AND NURSING WORKERS UNDER TITLE 24, SUBTITLE 18 OF THE HEALTH 12 – GENERAL ARTICLE, AS ADMINISTERED BY THE DEPARTMENT , THE COMPTROLLER 13 SHALL DISTRIBUTE : 14 (I) $400,000 OF THE FEES RECEIVED FROM THE BOARD TO THE 15 DEPARTMENT TO BE USED TO MAKE GRANTS UNDER THE MARYLAND LOAN 16 ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND NURSING WORKERS UNDER 17 TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL ARTICLE TO NURSES AND 18 NURSING WORKERS ENGA GED IN PRIMARY CARE WHO AGREE TO PRACTIC E FOR AT 19 LEAST 2 YEARS IN A GEOGRAPHI C AREA OF THE STATE THAT HAS BEEN D ESIGNATED 20 BY THE SECRETARY AS BEING ME DICALLY UNDERSERVED ; AND 21 (II) THE BALANCE OF THE FE ES TO THE BOARD OF NURSING 22 FUND. 23 (2) IN FISCAL YEAR 2026 AND EACH FISCAL YEAR THEREAFTER , IF 24 THE DEPARTMENT DOES NOT I MPLEMENT A PERMANENT FUNDING STRUCTURE 25 UNDER § 24–1802(B) OF THE HEALTH – GENERAL ARTICLE AND THE GOVERNOR 26 DOES NOT INCLUDE IN TH E STATE BUDGET AT LEAST $400,000 FOR THE OPERATION 27 OF THE MARYLAND LOAN ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND 28 NURSING WORKERS UNDER TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL 29 ARTICLE, AS ADMINISTERED BY T HE DEPARTMENT , THE COMPTROLLER SHALL 30 DISTRIBUTE: 31 (I) $400,000 OF THE FEES RECEIVED FROM THE BOARD TO THE 32 DEPARTMENT TO BE USED TO MAKE GRANTS UNDER THE MARYLAND LOAN 33 ASSISTANCE REPAYMENT PROGRAM FOR NURSES AND NURSING WORKERS UNDER 34 TITLE 24, SUBTITLE 18 OF THE HEALTH – GENERAL ARTICLE TO NURSES AND 35 NURSING WORKERS ENGA GED IN PRIMARY CARE WHO AGREE TO PRACTIC E FOR AT 36 HOUSE BILL 975 9 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 [(e)] (F) (1) The Board of Nursing Fund shall be used exclusively to cover the 5 actual documented direct and indirect costs of fulfilling the statutory and regulatory duties 6 of the Board as provided by the provisions of this title. 7 (2) (i) The Board of Nursing Fund is a continuing, nonlapsing fund, not 8 subject to § 7–302 of the State Finance and Procurement Article. 9 (ii) Any unspent portions of the Board of Nursing Fund may not be 10 transferred or revert to the General Fund of the State, but shall remain in the Board of 11 Nursing Fund to be used for the purposes specified in this title. 12 (3) No other State money may be used to support the Board of Nursing 13 Fund. 14 (4) AVAILABLE FEDERAL FUN DS MAY BE USED TO SU PPORT THE 15 BOARD OF NURSING FUND. 16 [(f)] (G) (1) The Chairman of the Board or the designee of the Chairman shall 17 administer the Board of Nursing Fund. 18 (2) Money in the Board of Nursing Fund may be expended only for any 19 lawful purpose authorized by the provisions of this title. 20 [(g)] (H) The Legislative Auditor shall audit the accounts and transactions of the 21 Board of Nursing Fund as provided in § 2–1220 of the State Government Article. 22 Article – State Finance and Procurement 23 6–226. 24 (a) (2) (i) Notwithstanding any other provision of law, and unless 25 inconsistent with a federal law, grant agreement, or other federal requirement or with the 26 terms of a gift or settlement agreement, net interest on all State money allocated by the 27 State Treasurer under this section to special funds or accounts, and otherwise entitled to 28 receive interest earnings, as accounted for by the Comptroller, shall accrue to the General 29 Fund of the State. 30 (ii) The provisions of subparagraph (i) of this paragraph do not apply 31 to the following funds: 32 10 HOUSE BILL 975 144. the Health Equity Resource Community Reserve Fund; 1 [and] 2 145. the Access to Counsel in Evictions Special Fund; AND 3 146. THE MARYLAND LOAN ASSISTANCE REPAYMENT 4 PROGRAM FUND FOR NURSES AND NURSING SUPPORT STAFF. 5 SECTION 2. AND BE IT FURTHER ENACTED, That: 6 (a) The Maryland Department of Health shall convene a stakeholder workgroup 7 to examine how the State can implement a program within or in addition to the Maryland 8 Loan Assistance Program Fund for Nurses and Nursing Workers Support Staff to further 9 incentivize nursing and nursing worker support staff students to practice in professional 10 shortage areas and medically underserved areas in the State. 11 (b) The workgroup shall consist of the following members: 12 (1) the Secretary of Health, or the Secretary’s designee; 13 (2) one representative of the State Board of Nursing; 14 (3) one representative of the Maryland Nurses Association; 15 (4) one representative of 1199 SEIU United Healthcare Workers East; 16 (5) one representative of the Health Facilities Association of Maryland; 17 (6) one representative of the Maryland Hospital Association; and 18 (7) one representative of the LifeSpan Network; 19 (8) one representative of Leading Age Maryland; 20 (9) one representative of AFSCME Maryland; 21 (10) one representative of the Nurse Practitioner Association of Maryland; 22 (11) one representative of the Maryland Association of County Health 23 Officers; 24 (12) one representative from a community health center; and 25 (13) any other stakeholder that the Department determines appropriate. 26 (c) The workgroup shall consult with the Department of Legislative Services 27 when developing its recommendations. 28 HOUSE BILL 975 11 (d) The workgroup shall: 1 (1) review nursing school debt experienced in the United States and in 2 Maryland; 3 (2) examine other models for nurse and nursing worker support staff 4 recruitment and retention that operate in other states, including how these models are 5 funded and how to improve the Maryland Loan Assistance Repayment Program Fund for 6 Nurses and Nursing Workers Support Staff to ensure that the Program is competitive with 7 other states; 8 (3) examine and recommend methods to incentivize nursing and nursing 9 worker support staff students to commit to practicing in medically underserved areas in 10 the State before entering an educational program or on graduation from nursing school or 11 a program focusing on training for nursing workers support staff; and 12 (4) investigate the availability of other federal grants to further expand 13 loan repayment and loan forgiveness for other nurses and nursing workers support staff in 14 Maryland; and 15 (5) make recommendations to the Department on priorities for funding the 16 repayment of education loans through the Maryland Loan Assistance Repayment Program 17 Fund for Nurses and Nursing Support Staff, including priorities relating to practice 18 settings other than an “eligible field of employment”, as defined by § 24–1804 of the Health 19 – General Article, as enacted by Section 1 of this Act. 20 (e) (1) On or before December 1, 2022, the workgroup shall submit an interim 21 report of its findings and recommendations, in accordance with § 2–1257 of the State 22 Government Article, to the General Assembly. 23 (2) On or before December 1, 2023, the workgroup shall submit a final 24 report of its findings and recommendations, including recommendations on the structure 25 of a permanent advisory council and a permanent funding structure for the Maryland Loan 26 Assistance Repayment Program Fund for Nurses and Nursing Workers Support Staff, to 27 the General Assembly in accordance with § 2–1257 of the State Government Article. 28 SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect July 29 1, 2022. 30