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.
*hb0497*
HOUSE BILL 497
J1 3lr0419
CF SB 498
By: Delegates Jacobs, Arentz, and Ghrist
Introduced and read first time: January 30, 2023
Assigned to: Health and Government Operations
Committee Report: Favorable
House action: Adopted
Read second time: March 1, 2023
CHAPTER ______
AN ACT concerning 1
Rural Health Collaborative Pilot Repeal and Mid Shore Health Improvement 2
Coalition Funding 3
FOR the purpose of repealing the provisions of law establishing and governing the Rural 4
Health Collaborative Pilot; requiring the Governor to provide an appropriation in 5
the State budget in certain fiscal years to fund the operations of the Mid Shore 6
Health Improvement Coalition; and generally relating to the Rural Health 7
Collaborative Pilot and the Mid Shore Health Improvement Coalition. 8
BY repealing 9
Article – Health – General 10
Section 2–901 through 2–908 and the subtitle “Subtitle 9. Rural Health 11
Collaborative Pilot” 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2022 Supplement) 14
BY adding to 15
Article – Health – General 16
Section 24–2201 to be under the new subtitle “Subtitle 22. Mid Shore Health 17
Improvement Coalition Funding” 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2022 Supplement) 20
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
That the Laws of Maryland read as follows: 22 2 HOUSE BILL 497
Article – Health – General 1
[Subtitle 9. Rural Health Collaborative Pilot.] 2
[2–901. 3
(a) In this subtitle the following words have the meanings indicated. 4
(b) “Collaborative” means the Rural Health Collaborative Pilot established under 5
§ 2–902 of this subtitle. 6
(c) “Executive Committee” means the Executive Committee of the Rural Health 7
Collaborative Pilot. 8
(d) “Mid–shore region” includes Caroline County, Dorchester County, Kent 9
County, Queen Anne’s County, and Talbot County. 10
(e) “Primary care provider” includes a primary care physician, a physician 11
assistant, and a nurse practitioner. 12
(f) “Rural Health Complex” means a community–based ambulatory care setting 13
or inpatient care setting that integrates primary care and other health care services 14
determined to be essential by the Collaborative with input by the community, and 15
determined to be sustainable by the Collaborative.] 16
[2–902. 17
(a) There is a Rural Health Collaborative Pilot within the mid–shore region. 18
(b) The Collaborative is an independent unit in the Department. 19
(c) The Collaborative shall have a minimum of 29 members but may not exceed 20
35 members. 21
(d) The Collaborative shall include the following members: 22
(1) The Executive Committee; and 23
(2) The following members appointed by the Secretary: 24
(i) One representative from a local department of social services in 25
the mid–shore region; 26
(ii) One representative from a local management board in the 27
mid–shore region; 28
HOUSE BILL 497 3
(iii) One representative from a department of emergency services in 1
the mid–shore region; 2
(iv) One representative from a local agency on aging in the mid–shore 3
region; 4
(v) One representative from a local board of education in the 5
mid–shore region; 6
(vi) One health care consumer from each county in the mid–shore 7
region; 8
(vii) One health care provider from each county in the mid–shore 9
region; and 10
(viii) Two representatives from primary transportation providers in 11
the mid–shore region. 12
(e) The purposes of the Collaborative are to: 13
(1) Lead a regional partnership in building a rural health system that 14
enhances access to and utilization of health care services designed to meet the triple aim 15
of: 16
(i) Providing health care; 17
(ii) Alignment with the State’s Medicare waiver; and 18
(iii) Improving population health; 19
(2) Mediate disputes between stakeholders; 20
(3) Assist in collaboration among health care service providers in the 21
mid–shore region; 22
(4) Increase the awareness among county officials and residents regarding 23
the health status, health needs, and available resources in the mid–shore region; and 24
(5) Enhance rural economic development in the mid–shore region.] 25
[2–903. 26
This subtitle does not affect the authority of the Secretary, the Maryland Health 27
Care Commission, or the Health Services Cost Review Commission to regulate a health 28
care facility, a health care institution, a health care service, or a health care program under 29
this article.] 30
4 HOUSE BILL 497
[2–904. 1
(a) There is a Rural Health Care Collaborative Executive Committee. 2
(b) The Executive Committee consists of the following members: 3
(1) The health officers from Caroline County, Dorchester County, Kent 4
County, Queen Anne’s County, and Talbot County; 5
(2) The Chief Executive Officer of: 6
(i) University of Maryland Shore Regional Health; and 7
(ii) The Anne Arundel Medical Center; 8
(3) The Chief Executive Officer of a federally qualified health center that 9
serves the mid–shore region; and 10
(4) The following members appointed by the Secretary: 11
(i) One primary care provider who practices in the mid–shore 12
region; 13
(ii) One specialty care physician who practices in the mid–shore 14
region; 15
(iii) One behavioral health provider who practices in the mid–shore 16
region; and 17
(iv) One health care consumer residing in the mid–shore region. 18
(c) The Executive Committee shall: 19
(1) Provide general direction to the Collaborative; and 20
(2) Make operating decisions on projects approved by the Collaborative.] 21
[2–905. 22
(a) (1) With the approval of the Secretary, the Executive Committee shall 23
appoint an Executive Director of the Collaborative. 24
(2) The Executive Director shall serve at the pleasure of the Executive 25
Committee. 26
(3) In accordance with the State budget, the Executive Committee shall 27
determine the appropriate compensation for the Executive Director. 28 HOUSE BILL 497 5
(b) Under the direction of the Executive Committee, the Executive Director shall: 1
(1) Be the chief administrative officer of the Collaborative; 2
(2) Direct, administer, and manage the operations of the Collaborative; and 3
(3) Perform all duties necessary to comply with and carry out the 4
provisions of this subtitle. 5
(c) In accordance with the State budget, the Executive Director may employ and 6
retain a staff for the Collaborative. 7
(d) The Executive Director shall determine the classification, grade, and 8
compensation of those positions designated under subsection (c) of this section: 9
(1) In consultation with the Secretary of Budget and Management; 10
(2) With the approval of the Executive Committee; and 11
(3) In accordance with the State pay plan.] 12
[2–906. 13
(a) In addition to the powers set forth elsewhere in this subtitle, the Collaborative 14
may: 15
(1) Adopt bylaws, rules, and policies; 16
(2) Adopt regulations to carry out this subtitle; 17
(3) Maintain an office at the place designated by the Collaborative; 18
(4) Apply for and receive grants, contracts, or other public or private 19
funding; 20
(5) Issue and award contracts and grants; and 21
(6) Do all things necessary or convenient to carry out the powers granted 22
by this subtitle. 23
(b) To carry out the purposes of this subtitle, the Collaborative may create and 24
consult with ad hoc advisory committees.] 25
[2–907. 26
6 HOUSE BILL 497
For fiscal year 2019 and for each fiscal year thereafter, the Governor shall provide 1
an appropriation in the State budget adequate to fully fund the operations of the 2
Collaborative.] 3
[2–908. 4
(a) (1) The Collaborative shall direct the establishment of Rural Health 5
Complexes by: 6
(i) Assessing the needs of communities in the mid–shore region that 7
lack access to essential community–based primary care, behavioral health, specialty care, 8
or dental care services; 9
(ii) Identifying care delivery models that have the potential to reduce 10
deficits in care; and 11
(iii) Convening health and hospital systems, community 12
organizations, and local stakeholders to build consensus on the appropriate scale of a Rural 13
Health Complex. 14
(2) (i) The Secretary shall approve a Rural Health Complex: 15
1. Recommended by the Collaborative by a majority of a 16
quorum of the Collaborative present and voting; 17
2. That meets the standards and criteria established by the 18
Collaborative for a Rural Health Complex; and 19
3. If the Rural Health Complex demonstrates that it meets 20
the standards and criteria established by the Collaborative. 21
(ii) A complex that fails to meet the standards and criteria 22
established by the Collaborative shall relinquish its designation as a complex. 23
(3) On or before December 1, 2020, the Collaborative shall report to the 24
Governor and, in accordance with § 2–1257 of the State Government Article, the General 25
Assembly on the standards and criteria that a community must meet to establish a Rural 26
Health Complex before the Collaborative approves a Rural Health Complex. 27
(b) On or before December 1, 2021, and December 1 each year thereafter, the 28
Collaborative shall report to the Governor and, in accordance with § 2–1257 of the State 29
Government Article, the General Assembly on its activities regarding health care delivery 30
in the mid–shore region, including: 31
(1) The number of Rural Health Complexes approved; 32
HOUSE BILL 497 7
(2) The effect that each Rural Health Complex had on the health status of 1
the overall population and the vulnerable population in its community; and 2
(3) The effect that Rural Health Complexes have had on the available 3
community–based health care resources in communities where complexes have been 4
established.] 5
SUBTITLE 22. MID SHORE HEALTH IMPROVEMENT COALITION FUNDING. 6
24–2201. 7
FOR FISCAL YEAR 2024, AND FOR EACH FISCAL YEAR THEREAFTER , THE 8
GOVERNOR SHALL PROVID E AN APPROPRIATION I N THE STATE BUDGET TO FUND 9
THE OPERATIONS OF TH E MID SHORE HEALTH IMPROVEMENT COALITION. 10
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 11
1, 2023. 12
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.