EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
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SENATE BILL 407
J1, J2 EMERGENCY BILL 2lr0152
CF HB 407
By: The President (By Request – Administration) and Senators Bailey, Carozza,
Cassilly, Corderman, Eckardt, Edwards, Elfreth, Gallion, Hershey, Hough,
Jennings, Ready, Salling, Simonaire, and West
Introduced and read first time: January 24, 2022
Assigned to: Finance and Education, Health, and Environmental Affairs
A BILL ENTITLED
AN ACT concerning 1
Health Occupations – Health Care Staffing Shortage Emergency – Declaration 2
and Licensing and Practice Requirements 3
(Health Care Heroes Act of 2022) 4
FOR the purpose of authorizing the Secretary of Health to declare a health care staffing 5
shortage emergency in the State; requiring each health occupations board to 6
establish processes for the issuance of initial licenses, temporary licenses, and 7
temporary practice letters on an expedited basis during a health care staffing 8
shortage emergency; providing that certain health care practitioners qualify for 9
initial or temporary health occupation licenses or temporary practice letters or to be 10
practicing a certain health occupation at a health care facility without a license or 11
temporary practice letter under certain circumstances; and generally relating to a 12
health care staffing shortage emergency and health occupational licensing and 13
practice. 14
BY adding to 15
Article – Health – General 16
Section 2–109 17
Annotated Code of Maryland 18
(2019 Replacement Volume and 2021 Supplement) 19
BY adding to 20
Article – Health Occupations 21
Section 1–227 22
Annotated Code of Maryland 23
(2021 Replacement Volume) 24
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 25
That the Laws of Maryland read as follows: 26 2 SENATE BILL 407
Article – Health – General 1
2–109. 2
(A) IN THIS SECTION, “HEALTH CARE FACILITY ” MEANS: 3
(1) A HOSPITAL AS DEFINED IN § 19–301 OF THIS ARTICLE; 4
(2) A HEALTH MAINTENANCE O RGANIZATION AS DEFIN ED IN § 5
19–701(G) OF THIS ARTICLE; 6
(3) A FREESTANDING AMBULAT ORY CARE FACILITY AS DEFINED IN § 7
19–3B–01 OF THIS ARTICLE; 8
(4) AN ASSISTED LIVING FA CILITY AS DEFINED IN § 19–1801 OF THIS 9
ARTICLE; 10
(5) A LABORATORY AS DEFINE D IN § 17–201 OF THIS ARTICLE; 11
(6) A HOME HEALTH AGENCY A S DEFINED IN § 19–401 OF THIS 12
ARTICLE; 13
(7) A RESIDENTIAL TREATMEN T CENTER AS DEFINED IN § 19–301 OF 14
THIS ARTICLE; 15
(8) A COMPREHENSIVE REHABI LITATION FACILITY AS DEFINED IN § 16
19–1201 OF THIS ARTICLE; 17
(9) A FORENSIC LABORATORY AS DEFINED IN § 17–2A–01 OF THIS 18
ARTICLE; 19
(10) A SUBSTANCE–RELATED DISORDER PRO GRAM AS DEFINED IN § 20
7.5–101 OF THIS ARTICLE; 21
(11) A MENTAL HEALTH PROGRA M AS DEFINED IN § 7.5–101 OF THIS 22
ARTICLE; 23
(12) A NURSING HOME AS DEFI NED IN § 19–401 OF THIS ARTICLE; 24
(13) A PHARMACY; OR 25
(14) ANY OTHER FACILITY AS DETERMINED BY THE SECRETARY. 26
SENATE BILL 407 3
(B) IF THE SECRETARY FINDS THAT AN EMERGENCY HAS DEV ELOPED 1
REGARDING THE ABILITY OF HEALTH CARE FACILITI ES IN THE STATE TO 2
APPROPRIATELY RESPON D TO THE CLINICAL NE EDS OF PATIENT S BECAUSE OF 3
INSUFFICIENT STAFF AND THAT THE STAFFING SHORTAGE ENDANGERS THE PUBLIC 4
HEALTH IN THE STATE, THE SECRETARY MAY DECLAR E A HEALTH CARE STAFFING 5
SHORTAGE EMERGENCY . 6
(C) THE SECRETARY SHALL ESTABLISH THE CRITERIA FOR DETERMIN ING 7
THE EMERGENCY CONDITIONS THAT WOULD REQUIRE THE DECLARATION OF A 8
HEALTH CARE STAFFING SHORTAGE EMERGENCY . 9
(D) THE CRITERIA ESTABLISHED UNDER SU BSECTION (C) OF THIS SECTION 10
SHALL INCLUDE CONSIDERATION OF THE FOLLOWING FACTOR S: 11
(1) STAFFED BED OCCUPANCY RATE; 12
(2) STAFF VACANCY RATE FO R THE SPECIFIC CATEGORY OF HEALTH 13
CARE PRACTITIONER INCLUDED IN THE STAF FING SHORTAGE ; 14
(3) AVERAGE EMERGENCY DEP ARTMENT WAIT TIMES ; 15
(4) DURATION OF VACANCY R ATE FOR THE SPECIFIC CATEGORY OF 16
HEALTH CARE PRACTITI ONER INCLUDED IN TH E STAFFING SHORTAGE ; 17
(5) AVERAGE STAFF VACANCY RATE FOR THE IMMEDIATELY 18
PRECEDING 12 MONTHS FOR THE SPECI FIC CATEGORY OF HEALTH CARE 19
PRACTITIONER INCLUDED IN THE STAF FING SHORTAGE ; AND 20
(6) ANY OTHER FACTOR DETERMINED RELEVANT BY THE 21
SECRETARY. 22
(E) ON THE DECLARATION OF A HEALTH CARE STAFFING SHORTA GE 23
EMERGENCY , THE SECRETARY MAY DIRECT THE HEALTH OCCUPATIONS BOARDS 24
THAT REGULATE THE CATEGORIES OF HEALTH CARE PRACTITI ONERS INCLUDED IN 25
THE IDENTIFIED STAFF ING SHORTAGE TO IMPLEMENT THE EXPEDITED LICENSING 26
PROCESSES UNDER § 1–227 OF THE HEALTH OCCUPATIONS ARTICLE. 27
(F) A DECLARED HEALTH CARE STAFFING SHORTAGE EMERGENCY MAY NOT 28
EXCEED 180 DAYS. 29
(G) THE SECRETARY SHALL ADOPT REGULATIONS TO CARRY OUT THIS 30
SECTION. 31
4 SENATE BILL 407
Article – Health Occupations 1
1–227. 2
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 3
INDICATED. 4
(2) “HEALTH OCCUPATION LICENSE” MEANS A LICENSE OR 5
CERTIFICATE ISSUED B Y A HEALTH OCCUPATIO NS BOARD TO PRACTICE A HEALTH 6
OCCUPATION IN THE STATE. 7
(3) “INACTIVE LICENSEE” MEANS A LICENSEE WHO HOLDS A HEALTH 8
OCCUPATION LICENSE ISSUED BY A HEALTH O CCUPATIONS BOARD THAT HAS BEEN 9
PLACED ON INACTIVE S TATUS WITHIN THE PAST 8 YEARS. 10
(4) “NURSING GRADUATE” MEANS AN INDIVIDUAL WHO HAS 11
SATISFACTORILY COMPLETED ALL THE REQUIREMENTS FOR A D IPLOMA OR DEGREE 12
FROM: 13
(I) A REGISTERED NURSING E DUCATION PROGRAM APP ROVED 14
BY THE STATE BOARD OF NURSING; OR 15
(II) AN OUT–OF–STATE NURSING EDUCAT ION PROGRAM 16
DETERMINED TO BE EQU IVALENT TO A PROGRAM UNDER I TEM (I) OF THIS 17
PARAGRAPH BY THE STATE BOARD OF NURSING. 18
(5) “RETIRED HEALTH CARE P RACTITIONER” MEANS AN INDIVIDUAL 19
WHO HELD A VALID HEALTH OCCUPATION LICENSE ISSUED BY A HEALTH 20
OCCUPATIONS BOARD WITHIN THE PAST 8 YEARS THAT IS NOT ACTIVE A ND HAS NOT 21
BEEN PLACED ON INACTIVE STATUS . 22
(6) “TEMPORARY HEALTH OCCUPATION LICENSE” AND “TEMPORARY 23
PRACTICE LETTER ” MEANS A HEALTH OCCUPATION LICENSE OR PRACTICE LETTER 24
ISSUED BY A HEALTH O CCUPATIONS BOARD AUT HORIZING THE HOLDER TO 25
PRACTICE A SPECIFIED HEALTH OCCUPATION IN THE STATE FOR A TEMPORARY 26
PERIOD OF TIME. 27
(B) EACH HEALTH OCCUPATIO NS BOARD SHALL ESTABLISH PROCESSES 28
FOR THE ISSUANCE OF A N INITIAL HEALTH OCCUPATION LI CENSE, A TEMPORARY 29
HEALTH OCCUPATION LI CENSE, AND A TEMPORARY PRACTICE L ETTER ON AN 30
EXPEDITED BASIS DURI NG A HEALTH CARE STAFF ING SHORTAGE EMERGENCY 31
DECLARED BY THE SECRETARY UNDER § 2–109 OF THE HEALTH – GENERAL 32
ARTICLE. 33
SENATE BILL 407 5
(C) THE FOLLOWING INDIVID UALS QUALIFY FO R A HEALTH OCCUPATION 1
LICENSE ISSUED ON AN EXPEDIT ED BASIS UNDER SUBSE CTION (B) OF THIS SECTION 2
DURING A HEALTH CARE STAFF ING SHORTAGE EMERGENCY : 3
(1) AN APPLICANT FOR AN I NITIAL HEALTH OCCUPA TION LICENSE; 4
(2) AN INDIVIDUAL WHO HOL DS A VALID, UNEXPIRED HEALTH 5
OCCUPATION LICENSE ISSUED IN ANOTHER ST ATE; 6
(3) AN INACTIVE LICENSEE ; 7
(4) A RETIRED HEALTH CARE PRACTITIONER ; AND 8
(5) A NURSING GRADUATE . 9
(D) (1) TO APPLY FOR A N INITIAL HEALTH OCC UPATION LICENSE , A 10
TEMPORARY HEALTH OCC UPATION LICENSE , OR A TEMPORARY PRACT ICE LETTER 11
UNDER SUBSECTION (B) OF THIS SECTION, AN APPLICANT SHALL S UBMIT TO THE 12
APPROPRIATE HEALTH O CCUPATIONS BOARD : 13
(I) AN APPLICATION; 14
(II) ANY DOCUMENTATION REQUIRED BY THE BOARD; 15
(III) IF A CRIMINAL HISTORY RECORDS C HECK IS REQUIRED BY 16
THE BOARD FOR LICENS URE, PROOF OF APPLICATION FOR A CRIMINAL HISTO RY 17
RECORDS CHECK ; 18
(IV) ANY APPLICATION FEE ; AND 19
(V) ANY OTHER INFORMATION REQUIRED BY THE BOARD. 20
(2) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION , A 21
HEALTH OCCUPATIONS B OARD SHALL PROCESS A ND ISSUE A LICENSE O R 22
TEMPORARY PRACTICE L ETTER TO AN APPLICAN T WHO MEETS THE REQU IREMENTS 23
OF THIS SUBSECTION USING THE EXPEDITED PROCESS ESTABLISHED UNDER 24
SUBSECTION (B) OF THIS SECTION. 25
(3) A HEALTH OCCUPATIONS B OARD MAY NOT ISSUE A LICENSE OR 26
TEMPORARY PRACTICE L ETTER UNDER THIS SEC TION IF THE ISSUANCE OF THE 27
LICENSE OR TEMPORARY PRACTICE LETTER WOUL D POSE A RISK TO PUB LIC 28
HEALTH, WELFARE, OR SAFETY. 29
6 SENATE BILL 407
(E) (1) A TEMPORARY HEALTH OCC UPATION LICENSE OR TEMPORARY 1
PRACTICE LETTER ISSU ED UNDER THIS SECTIO N AUTHORIZES THE HEA LTH CARE 2
PRACTITIONER TO PRACTICE THE SPECIFIED HEALTH OCCUPATION FO R A LIMITED 3
PERIOD OF TIME , AS DETERMINED BY THE HEALTH OCCUPATIONS BOARD AND 4
SUBJECT TO THE DURAT ION OF THE HEALTH CARE STAFFING SHORTAGE 5
EMERGENCY . 6
(2) A HEALTH OCCUPATION LI CENSE ISSUED UNDER T HIS SECTION 7
AUTHORIZES THE LICEN SEE TO PRACTICE THE SPECIFIED HEALTH OCCUPATION 8
FOR A LIMITED PERIOD OF TIME, AS DETERMINED BY THE HE ALTH OCCUPATIONS 9
BOARD, WHILE THE LICENSEE C OMPLETES ADDITIONAL REQUIREMENTS FOR 10
LICENSURE IN THE STATE, IF REQUIRED. 11
(F) (1) DURING A HEALTH CARE STAFFING SHORTAGE EM ERGENCY, A 12
HEALTH CARE PRACTITI ONER MAY PRACTICE THE SPECIFIED HEALTH OCCUPATION 13
THAT IS INCLUDED IN THE STAFFING SHORTAGE IN A HEALTH CARE FACILITY IN THE 14
STATE WITHOUT FIRST OBTAIN ING A LICENSE OR PRA CTICE LETTER FROM TH E 15
RELEVANT HEALTH OCCU PATIONS BOARD ONLY IN ACCORDANCE W ITH THE 16
REQUIREMENTS OF THIS SUBSECTION. 17
(2) A HEALTH CARE PRACTITI ONER WHO HOLDS A VALID , UNEXPIRED 18
HEALTH OCCUPATION LI CENSE ISSUED IN ANOT HER STATE MAY PRACTI CE THE 19
SPECIFIED HEALTH OCC UPATION IN A HEALTH CARE FAC ILITY UNDER PARAGRAP H 20
(1) OF THIS SUBSECTION I F: 21
(I) DOING SO IS NECESSARY TO ALLOW T HE HEALTH CARE 22
FACILITY TO MEET REQ UIRED STAFFING RATIO S OR OTHERWISE ENSUR E THE 23
CONTINUED AND SAFE D ELIVERY OF HEALTH CA RE SERVICES TO PATIENTS IN THE 24
FACILITY; 25
(II) THE HEALTH CARE PRACT ITIONER REASONABLY BELIEVES 26
A TEMPORARY HEALTH OCCUPATION LICENSE OR TEMPORARY PRACTIC E LETTER 27
COULD NOT BE OBTAINE D IN SUFFICIENT TIME T O MEET THE IMMINENT NEEDS OF 28
THE HEALTH CARE FACI LITY; AND 29
(III) THE HEALTH CARE PRACTITI ONER SUBMITS AN 30
APPLICATION FOR A TEMPORARY HEALTH OCCUPATION LICENSE OR TEMPORARY 31
PRACTICE LETTER WITHIN 10 DAYS OF THE DAY THE HEALT H CARE PRACTITIONER 32
BEGINS WORKING AT A HEALTH CARE FACILITY. 33
(3) AN INACTIVE LICENSEE OR A RETIRED HEALTH CARE 34
PRACTITIONER MAY PRACTICE A SPECIFIED HEALTH O CCUPATION IN A HEALTH 35
CARE FACILITY UNDER PARAGRAPH (1) OF THIS SUBSECTION I F: 36 SENATE BILL 407 7
(I) QUALIFIED SUPERVISORY PERSONNE L AT THE HEALTH 1
CARE FACILITY REASON ABLY CONCLUDE THAT T HE INACTIVE LICENSEE OR 2
RETIRED HEALTH CARE PRACTITIONER CAN COM PETENTLY PRACTICE THE HEALT H 3
OCCUPATION ; 4
(II) DOING SO IS NECESSARY TO A LLOW THE HEALTH CARE 5
FACILITY TO MEET REQ UIRED STAFFING RATIO S OR OTHERWISE ENSUR E THE 6
CONTINUED AND SAFE D ELIVERY OF HEALTH CA RE SERVICES TO PATIENTS IN THE 7
FACILITY; 8
(III) THE HEALTH CARE PRACTITI ONER REASONABLY BELIEVES 9
THE INACTIVE LICENSE COULD NOT BE REACTIVATED OR A TEMPORARY HEALTH 10
OCCUPATION LICENSE O R TEMPORARY PRACTICE LETTER COULD NOT BE OBTAINE D 11
IN SUFFICIENT TIME T O MEET THE IMMINENT NEEDS OF THE HEALTH CARE 12
FACILITY; AND 13
(IV) THE INACTIVE LICENSEE OR RETIRED HEALTH CARE 14
PRACTITIONER SUBMITS AN APPLICATION TO TH E HEALTH OCCUPATION S BOARD 15
WITHIN 10 DAYS OF THE DAY THE HEALTH CARE PRACTITI ONER BEGINS WORKING 16
AT A HEALTH CARE FAC ILITY: 17
1. TO REACTIVATE AN INAC TIVE LICENSE; OR 18
2. FOR A TEMPORARY HEALTH OCC UPATION LICENSE 19
OR TEMPORARY PRACTIC E LETTER. 20
(4) A NURSING GRADUATE MAY PRACTICE REGISTERED NURSING , AS 21
DEFINED IN § 8–101(O) OF THIS ARTICLE , IN A HEALTH CARE FACILITY UNDER 22
PARAGRAPH (1) OF THIS SUBSECTION IF: 23
(I) DOING SO IS NECESSARY TO ALLOW THE HEALTH CARE 24
FACILITY TO MEET REQUIRED STA FFING RATIOS OR OTHE RWISE ENSURE THE 25
CONTINUED AND SAFE D ELIVERY OF HEALTH CA RE SERVICES TO PATIENTS IN THE 26
FACILITY; 27
(II) QUALIFIED SUPERVISORY PERSONNE L AT THE HEALTH 28
CARE FACILITY: 29
1. REASONABLY CONCLUDE T HAT THE NURSING 30
GRADUATE CAN COMPETENTLY PRACTICE REGISTERED NURSING; AND 31
8 SENATE BILL 407
2. ACTIVELY S UPERVISE THE NURSING GRADUATE 1
WHILE PRACTICING REGISTERE D NURSING AT THE HEA LTH CARE FACILITY ; AND 2
(III) THE NURSING GRADUATE SUBMITS AN APPLICATION TO 3
THE STATE BOARD OF NURSING WITHIN 10 DAYS OF THE DAY THE NURSING 4
GRADUATE BEGINS WORKING AT THE HEALTH CARE FACILITY . 5
SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 6
measure, is necessary for the immediate preservation of the public health or safety, has 7
been passed by a yea and nay vote supported by three–fifths of all the members elected to 8
each of the two Houses of the General Assembly, and shall take effect from the date it is 9
enacted. 10