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Maryland House Bill HB1232

Maryland 2023 Regular Session

Maryland House Bill HB1232 Compare Versions

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33 EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW.
44 [Brackets] indicate matter deleted from existing law.
5- Underlining indicates amendments to bill.
6- Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7-amendment.
85 *hb1232*
96
107 HOUSE BILL 1232
118 J2 EMERGENCY BILL 3lr3001
129 CF SB 372
13-By: Delegate Lopez Delegates Lopez, Alston, Bagnall, Bhandari, Cullison,
14-Guzzone, S. Johnson, Kaiser, R. Lewis, Martinez, Pena–Melnyk, Rosenberg,
15-Taveras, and White
10+By: Delegate Lopez
1611 Introduced and read first time: February 13, 2023
1712 Assigned to: Rules and Executive Nominations
18-Re–referred to: Health and Government Operations, February 28, 2023
19-Committee Report: Favorable with amendments
20-House action: Adopted
21-Read second time: March 19, 2023
2213
23-CHAPTER ______
14+A BILL ENTITLED
2415
2516 AN ACT concerning 1
2617
2718 Health Occupations – Pharmacists – Administration of Vaccines 2
2819
29-FOR the purpose of authorizing a pharmacist altering the time period during which a 3
30-pharmacist is authorized to order and administer certain vaccinations to an 4
31-individual in a certain age group if certain requirements are met; altering the age of 5
32-an individual to whom a pharmacist may administer certain vaccinations; repealing 6
33-the requirement that a pharmacist administer certain vaccinations under a written 7
34-protocol; authorizing a pharmacist to administer certain vaccinations to an adult; 8
35-and generally relating to the administration of vaccinations by pharmacists. 9
20+FOR the purpose of authorizing a pharmacist to order and administer certain vaccinations 3
21+to an individual in a certain age group if certain requirements are met; altering the 4
22+age of an individual to whom a pharmacist may administer certain vaccinations; 5
23+repealing the requirement that a pharmacist administer certain vaccinations under 6
24+a written protocol; authorizing a pharmacist to administer certain vaccinations to an 7
25+adult; and generally relating to the administration of vaccinations by pharmacists. 8
3626
37-BY repealing and reenacting, with amendments, 10
38- Article – Health Occupations 11
39-Section 12–508(c) 12
40- Annotated Code of Maryland 13
41- (2021 Replacement Volume and 2022 Supplement) 14
27+BY repealing and reenacting, with amendments, 9
28+ Article – Health Occupations 10
29+Section 12–508 11
30+ Annotated Code of Maryland 12
31+ (2021 Replacement Volume and 2022 Supplement) 13
4232
43- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
44-That the Laws of Maryland read as follows: 16
33+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
34+That the Laws of Maryland read as follows: 15
4535
46-Article – Health Occupations 17
36+Article – Health Occupations 16
4737
48-12–508. 18 2 HOUSE BILL 1232
38+12–508. 17
39+
40+ (a) (1) [Subject to subsection (c) of this section, a pharmacist may administer 18
41+an influenza vaccination to an individual who is at least 9 years old, in accordance with 19
42+regulations adopted by the Board, in consultation with the Department. 20
43+
44+ (2) Subject to subsection (c) of this section, a] A pharmacist may ORDER 21
45+AND administer a vaccination [that] TO AN INDIVIDUAL WHO IS AT LEAST 3 YEARS OLD 22
46+BUT UNDER THE AGE OF 18 YEARS IF: 23
47+ 2 HOUSE BILL 1232
4948
5049
50+ (I) 1. THE VACCINE is listed in the Centers for Disease Control 1
51+and Prevention’s Recommended Immunization Schedule [to an individual who: 2
5152
52- (a) (1) [Subject to subsection (c) of this section, a pharmacist may administer 1
53-an influenza vaccination to an individual who is at least 9 years old, in accordance with 2
54-regulations adopted by the Board, in consultation with the Department. 3
53+ (i) Is at least 11 years old but under the age of 18 years; and 3
5554
56- (2) Subject to subsection (c) of this section, a] A pharmacist may ORDER 4
57-AND administer a vaccination [that] TO AN INDIVIDUAL WHO IS AT LEAST 3 YEARS OLD 5
58-BUT UNDER THE AGE OF 18 YEARS IF: 6
55+ (ii) Has a prescription from an authorized prescriber]; OR 4
5956
60- (I) 1. THE VACCINE is listed in the Centers for Disease Control 7
61-and Prevention’s Recommended Immunization Schedule [to an individual who: 8
57+ 2. THE VACCINE IS APPROV ED OR AUTHORIZED BY THE 5
58+U.S. FOOD AND DRUG ADMINISTRATION ; 6
6259
63- (i) Is at least 11 years old but under the age of 18 years; and 9
60+ (II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING 7
61+PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION 8
62+COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 9
6463
65- (ii) Has a prescription from an authorized prescriber]; OR 10
64+ 1. HANDS–ON INJECTION TECHNIQ UES; 10
6665
67- 2. THE VACCINE IS APPROV ED OR AUTHORIZED BY THE 11
68-U.S. FOOD AND DRUG ADMINISTRATION ; 12
66+ 2. CLINICAL EVALUATION O F INDICATIONS AND 11
67+CONTRAINDICATIONS OF VACCINES; AND 12
6968
70- (II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING 13
71-PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION 14
72-COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 15
69+ 3. THE RECOGNITION AND T REATMENT OF EMERGENC Y 13
70+REACTIONS TO VACCINE S; 14
7371
74- 1. HANDS–ON INJECTION TECHNIQ UES; 16
72+ (III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC 15
73+CARDIOPULMONARY RESU SCITATION; 16
7574
76- 2. CLINICAL EVALUATION O F INDICATIONS AND 17
77-CONTRAINDICATIONS OF VACCINES; AND 18
75+ (IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS 17
76+OF CONTINUING PHARMA CEUTICAL EDUCA TION RELATED TO IMMU NIZATIONS THAT 18
77+IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS 19
78+PART OF THE LICENSE RENEWAL REQUIREMENTS UNDER § 12–309 OF THIS TITLE; 20
7879
79- 3. THE RECOGNITION AND T REATMENT OF EMERGENC Y 19
80-REACTIONS TO VACCINE S; 20
80+ (V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING 21
81+AND REPORTING REQUIR EMENTS IN PARAGRAPH (3) OF THIS SUBSECTION A ND ANY 22
82+CORRESPONDING REGULA TIONS ADOPTED BY THE BOARD; AND 23
8183
82- (III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC 21
83-CARDIOPULMONARY RESU SCITATION; 22
84+ (VI) THE PHARMACIST INFORM S EACH CHILD VACCINA TION 24
85+PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE 25
86+IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRIMARY CAR E PROVIDER 26
87+AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN 27
88+APPROPRIATE . 28
8489
85- (IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS 23
86-OF CONTINUING PHARMA CEUTICAL EDUCATION R ELATED TO IMMUNIZATI ONS THAT 24
87-IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS 25
88-PART OF THE LICENSE RENEWAL RE QUIREMENTS UNDER § 12–309 OF THIS TITLE; 26
89-
90- (V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING 27
91-AND REPORTING REQUIR EMENTS IN PARAGRAPH (3) OF THIS SUBSECTION A ND ANY 28
92-CORRESPONDING REGULA TIONS ADOPTED BY THE BOARD; AND 29
93-
94- (VI) THE PHARMACIST INFORM S EACH CHILD VACCINATION 30
95-PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE 31 HOUSE BILL 1232 3
90+ [(3)] (2) [(i) Subject to subparagraph (ii) of this paragraph, a] A 29
91+pharmacist may administer to an adult a vaccination that is: 30
92+ HOUSE BILL 1232 3
9693
9794
98-IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRIMARY CA RE PROVIDER 1
99-AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN 2
100-APPROPRIATE . 3
95+ [1.] (I) Listed in the Centers for Disease Control and 1
96+Prevention’s Recommended Immunization Schedule; [or] 2
10197
102- [(3)] (2) [(i) Subject to subparagraph (ii) of this paragraph, a] A 4
103-pharmacist may administer to an adult a vaccination that is: 5
98+ [2.] (II) Recommended in the Centers for Disease Control 3
99+and Prevention’s Health Information for International Travel; OR 4
104100
105- [1.] (I) Listed in the Centers for Disease Control and 6
106-Prevention’s Recommended Immunization Schedule; [or] 7
101+ (III) APPROVED BY THE U.S. FOOD AND DRUG 5
102+ADMINISTRATION . 6
107103
108- [2.] (II) Recommended in the Centers for Disease Control 8
109-and Prevention’s Health Information for International Travel; OR 9
104+ [(ii) A pharmacist shall administer a vaccination under 7
105+subparagraph (i) of this paragraph under a written protocol that: 8
110106
111- (III) APPROVED BY THE U.S. FOOD AND DRUG 10
112-ADMINISTRATION . 11
107+ 1. Is vaccine specific; and 9
113108
114- [(ii) A pharmacist shall administer a vaccination under 12
115-subparagraph (i) of this paragraph under a written protocol that: 13
109+ 2. Meets criteria established by the Department, in 10
110+consultation with the Board, the Board of Physicians, and the Board of Nursing, in 11
111+regulation.] 12
116112
117- 1. Is vaccine specific; and 14
113+ [(4)] (3) A pharmacist shall: 13
118114
119- 2. Meets criteria established by the Department, in 15
120-consultation with the Board, the Board of Physicians, and the Board of Nursing, in 16
121-regulation.] 17
115+ (i) Report all vaccinations administered by the pharmacist to the 14
116+ImmuNet Program established under § 18–109 of the Health – General Article; 15
122117
123- [(4)] (3) A pharmacist shall: 18
118+ (ii) If the vaccination has been administered in accordance with a 16
119+prescription, document at least one effort to inform the individual’s authorized prescriber 17
120+that the vaccination has been administered; and 18
124121
125- (i) Report all vaccinations administered by the pharmacist to the 19
126-ImmuNet Program established under § 18–109 of the Health – General Article; 20
122+ (iii) [For a vaccination administered under paragraph (2) or (3)] 19
123+EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) 20
124+of this subsection, if the authorized prescriber is not the individual’s primary care provider 21
125+or if the vaccination has not been administered in accordance with a prescription, document 22
126+at least one effort to inform the individual’s primary care provider or other usual source of 23
127+care that the vaccination has been administered. 24
127128
128- (ii) If the vaccination has been administered in accordance with a 21
129-prescription, document at least one effort to inform the individual’s authorized prescriber 22
130-that the vaccination has been administered; and 23
129+ (b) The Board shall: 25
131130
132- (iii) [For a vaccination administered under paragraph (2) or (3)] 24
133-EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) 25
134-of this subsection, if the authorized prescriber is not the individual’s primary care provider 26
135-or if the vaccination has not been administered in accordance with a prescription, document 27
136-at least one effort to inform the individual’s primary care provider or other usual source of 28
137-care that the vaccination has been administered. 29
131+ (1) Set reasonable fees for the administration of vaccinations under this 26
132+section; and 27
138133
139- (b) The Board shall: 30
134+ (2) Adopt regulations that require a pharmacist to submit a registration 28
135+form to the Board that includes verification that the pharmacist: 29
140136
141- (1) Set reasonable fees for the administration of vaccinations under this 31
142-section; and 32
137+ (i) Has successfully completed a certification course approved by the 30
138+Board that included instruction in the guidelines and recommendations of the Centers for 31
139+Disease Control and Prevention regarding vaccinations; and 32
143140 4 HOUSE BILL 1232
144141
145142
146- (2) Adopt regulations that require a pharmacist to submit a registration 1
147-form to the Board that includes verification that the pharmacist: 2
143+ (ii) Is certified in basic cardiopulmonary resuscitation and obtained 1
144+the certification through in–person classroom instruction. 2
148145
149- (i) Has successfully completed a certification course approved by the 3
150-Board that included instruction in the guidelines and recommendations of the Centers for 4
151-Disease Control and Prevention regarding vaccinations; and 5
146+ [(c) From July 1, 2021, to June 30, 2023, inclusive, a pharmacist may administer 3
147+a vaccine to an individual who is at least 3 years old but under the age of 18 years if: 4
152148
153- (ii) Is certified in basic cardiopulmonary resuscitation and obtained 6
154-the certification through in–person classroom instruction. 7
149+ (1) The vaccine is approved by the U.S. Food and Drug Administration; 5
155150
156- [(c) From July 1, 2021, to June 30, 2023 JUNE 30, 2024, inclusive, a pharmacist 8
157-may administer a vaccine to an individual who is at least 3 years old but under the age of 9
158-18 years if: 10
151+ (2) The vaccination is ordered and administered in accordance with the 6
152+Centers for Disease Control and Prevention’s Advisory Committee on Immunization 7
153+Practices immunization schedules; 8
159154
160- (1) The vaccine is approved by the U.S. Food and Drug Administration; 11
155+ (3) The pharmacist has completed a practical training program of at least 9
156+20 hours that is approved by the Accreditation Council for Pharmacy Education and 10
157+includes: 11
161158
162- (2) The vaccination is ordered and administered in accordance with the 12
163-Centers for Disease Control and Prevention’s Advisory Committee on Immunization 13
164-Practices immunization schedules; 14
159+ (i) Hands–on injection techniques; 12
165160
166- (3) The pharmacist has completed a practical training program of at least 15
167-20 hours that is approved by the Accreditation Council for Pharmacy Education and 16
168-includes: 17
161+ (ii) Clinical evaluation of indications and contraindications of 13
162+vaccines; and 14
169163
170- (i) Hands–on injection techniques; 18
164+ (iii) The recognition and treatment of emergency reactions to 15
165+vaccines; 16
171166
172- (ii) Clinical evaluation of indications and contraindications of 19
173-vaccines; and 20
167+ (4) The pharmacist has a current certificate in basic cardiopulmonary 17
168+resuscitation; 18
174169
175- (iii) The recognition and treatment of emergency reactions to 21
176-vaccines; 22
170+ (5) The pharmacist has completed a minimum of 2 hours of continuing 19
171+pharmaceutical education related to immunizations that is approved by the Accreditation 20
172+Council for Pharmacy Education as part of the license renewal requirements under § 21
173+12–309 of this title; 22
177174
178- (4) The pharmacist has a current certificate in basic cardiopulmonary 23
179-resuscitation; 24
175+ (6) The pharmacist complies with the record–keeping and reporting 23
176+requirements in subsection (a)(4) of this section and the corresponding regulations; and 24
180177
181- (5) The pharmacist has completed a minimum of 2 hours of continuing 25
182-pharmaceutical education related to immunizations that is approved by the Accreditation 26
183-Council for Pharmacy Education as part of the license renewal requirements under § 27
184-12–309 of this title; 28
178+ (7) The pharmacist informs each child vaccination patient and adult 25
179+caregiver who is accompanying the child of the importance of well–child visits with a 26
180+pediatric primary care provider and refers the patient to a pediatric primary care provider 27
181+when appropriate.] 28
185182
186- (6) The pharmacist complies with the record–keeping and reporting 29
187-requirements in subsection (a)(4) of this section and the corresponding regulations; and 30
183+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 29
184+measure, is necessary for the immediate preservation of the public health or safety, has 30
185+been passed by a yea and nay vote supported by three–fifths of all the members elected to 31
186+each of the two Houses of the General Assembly, and shall take effect from the date it is 32
187+enacted. 33
188188
189- (7) The pharmacist informs each child vaccination patient and adult 31
190-caregiver who is accompanying the child of the importance of well–child visits with a 32
191-pediatric primary care provider and refers the patient to a pediatric primary care provider 33
192-when appropriate.] 34 HOUSE BILL 1232 5
193-
194-
195-
196- SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 1
197-measure, is necessary for the immediate preservation of the public health or safety, has 2
198-been passed by a yea and nay vote supported by three–fifths of all the members elected to 3
199-each of the two Houses of the General Assembly, and shall take effect from the date it is 4
200-enacted. 5
201-
202-
203-
204-
205-Approved:
206-________________________________________________________________________________
207- Governor.
208-________________________________________________________________________________
209- Speaker of the House of Delegates.
210-________________________________________________________________________________
211- President of the Senate.