MD
Maryland Senate Bill SB498

Maryland 2023 Regular Session

Maryland Senate Bill SB498 Compare Versions

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1- WES MOORE, Governor Ch. 36
21
3-– 1 –
4-Chapter 36
5-(Senate Bill 498)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LAW.
4+ [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.
8+ *sb0498*
89
9-Rural Health Collaborative Pilot Repeal and Mid Shore Health Improvement
10-Coalition Funding
10+SENATE BILL 498
11+J1 3lr0418
12+ CF HB 497
13+By: Senators Hershey and Mautz
14+Introduced and read first time: February 3, 2023
15+Assigned to: Finance
16+Committee Report: Favorable
17+Senate action: Adopted
18+Read second time: March 3, 2023
1119
12-FOR the purpose of repealing the provisions of law establishing and governing the Rural
13-Health Collaborative Pilot; requiring the Governor to provide an appropriation in
14-the State budget in certain fiscal years to fund the operations of the Mid Shore
15-Health Improvement Coalition; and generally relating to the Rural Health
16-Collaborative Pilot and the Mid Shore Health Improvement Coalition.
20+CHAPTER ______
1721
18-BY repealing
19- Article – Health – General
20-Section 2–901 through 2–908 and the subtitle “Subtitle 9. Rural Health
21-Collaborative Pilot”
22- Annotated Code of Maryland
23- (2019 Replacement Volume and 2022 Supplement)
22+AN ACT concerning 1
2423
25-BY adding to
26- Article – Health – General
27-Section 24–2201 to be under the new subtitle “Subtitle 22. Mid Shore Health
28-Improvement Coalition Funding”
29- Annotated Code of Maryland
30- (2019 Replacement Volume and 2022 Supplement)
24+Rural Health Collaborative Pilot Repeal and Mid Shore Health Improvement 2
25+Coalition Funding 3
3126
32- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
33-That the Laws of Maryland read as follows:
27+FOR the purpose of repealing the provisions of law establishing and governing the Rural 4
28+Health Collaborative Pilot; requiring the Governor to provide an appropriation in 5
29+the State budget in certain fiscal years to fund the operations of the Mid Shore 6
30+Health Improvement Coalition; and generally relating to the Rural Health 7
31+Collaborative Pilot and the Mid Shore Health Improvement Coalition. 8
3432
35-Article – Health – General
33+BY repealing 9
34+ Article – Health – General 10
35+Section 2–901 through 2–908 and the subtitle “Subtitle 9. Rural Health 11
36+Collaborative Pilot” 12
37+ Annotated Code of Maryland 13
38+ (2019 Replacement Volume and 2022 Supplement) 14
3639
37-[Subtitle 9. Rural Health Collaborative Pilot.]
40+BY adding to 15
41+ Article – Health – General 16
42+Section 24–2201 to be under the new subtitle “Subtitle 22. Mid Shore Health 17
43+Improvement Coalition Funding” 18
44+ Annotated Code of Maryland 19
45+ (2019 Replacement Volume and 2022 Supplement) 20
3846
39-[2–901.
47+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
48+That the Laws of Maryland read as follows: 22 2 SENATE BILL 498
4049
41- (a) In this subtitle the following words have the meanings indicated.
4250
43- (b) “Collaborative” means the Rural Health Collaborative Pilot established under
44-§ 2–902 of this subtitle.
4551
46- (c) “Executive Committee” means the Executive Committee of the Rural Health
47-Collaborative Pilot.
48- Ch. 36 2023 LAWS OF MARYLAND
52+Article – Health – General 1
4953
50-– 2 –
51- (d) “Mid–shore region” includes Caroline County, Dorchester County, Kent
52-County, Queen Anne’s County, and Talbot County.
54+[Subtitle 9. Rural Health Collaborative Pilot.] 2
5355
54- (e) “Primary care provider” includes a primary care physician, a physician
55-assistant, and a nurse practitioner.
56+[2–901. 3
5657
57- (f) “Rural Health Complex” means a community–based ambulatory care setting
58-or inpatient care setting that integrates primary care and other health care services
59-determined to be essential by the Collaborative with input by the community, and
60-determined to be sustainable by the Collaborative.]
58+ (a) In this subtitle the following words have the meanings indicated. 4
6159
62-[2–902.
60+ (b) “Collaborative” means the Rural Health Collaborative Pilot established under 5
61+§ 2–902 of this subtitle. 6
6362
64- (a) There is a Rural Health Collaborative Pilot within the mid–shore region.
63+ (c) “Executive Committee” means the Executive Committee of the Rural Health 7
64+Collaborative Pilot. 8
6565
66- (b) The Collaborative is an independent unit in the Department.
66+ (d) “Mid–shore region” includes Caroline County, Dorchester County, Kent 9
67+County, Queen Anne’s County, and Talbot County. 10
6768
68- (c) The Collaborative shall have a minimum of 29 members but may not exceed
69-35 members.
69+ (e) “Primary care provider” includes a primary care physician, a physician 11
70+assistant, and a nurse practitioner. 12
7071
71- (d) The Collaborative shall include the following members:
72+ (f) “Rural Health Complex” means a community–based ambulatory care setting 13
73+or inpatient care setting that integrates primary care and other health care services 14
74+determined to be essential by the Collaborative with input by the community, and 15
75+determined to be sustainable by the Collaborative.] 16
7276
73- (1) The Executive Committee; and
77+[2–902. 17
7478
75- (2) The following members appointed by the Secretary:
79+ (a) There is a Rural Health Collaborative Pilot within the mid–shore region. 18
7680
77- (i) One representative from a local department of social services in
78-the mid–shore region;
81+ (b) The Collaborative is an independent unit in the Department. 19
7982
80- (ii) One representative from a local management board in the
81-mid–shore region;
83+ (c) The Collaborative shall have a minimum of 29 members but may not exceed 20
84+35 members. 21
8285
83- (iii) One representative from a department of emergency services in
84-the mid–shore region;
86+ (d) The Collaborative shall include the following members: 22
8587
86- (iv) One representative from a local agency on aging in the mid–shore
87-region;
88+ (1) The Executive Committee; and 23
8889
89- (v) One representative from a local board of education in the
90-mid–shore region;
90+ (2) The following members appointed by the Secretary: 24
9191
92- (vi) One health care consumer from each county in the mid–shore
93-region;
92+ (i) One representative from a local department of social services in 25
93+the mid–shore region; 26
9494
95- (vii) One health care provider from each county in the mid–shore
96-region; and WES MOORE, Governor Ch. 36
95+ (ii) One representative from a local management board in the 27
96+mid–shore region; 28
97+ SENATE BILL 498 3
9798
98-– 3 –
9999
100- (viii) Two representatives from primary transportation providers in
101-the mid–shore region.
100+ (iii) One representative from a department of emergency services in 1
101+the mid–shore region; 2
102102
103- (e) The purposes of the Collaborative are to:
103+ (iv) One representative from a local agency on aging in the mid–shore 3
104+region; 4
104105
105- (1) Lead a regional partnership in building a rural health system that
106-enhances access to and utilization of health care services designed to meet the triple aim
107-of:
106+ (v) One representative from a local board of education in the 5
107+mid–shore region; 6
108108
109- (i) Providing health care;
109+ (vi) One health care consumer from each county in the mid–shore 7
110+region; 8
110111
111- (ii) Alignment with the State’s Medicare waiver; and
112+ (vii) One health care provider from each county in the mid–shore 9
113+region; and 10
112114
113- (iii) Improving population health;
115+ (viii) Two representatives from primary transportation providers in 11
116+the mid–shore region. 12
114117
115- (2) Mediate disputes between stakeholders;
118+ (e) The purposes of the Collaborative are to: 13
116119
117- (3) Assist in collaboration among health care service providers in the
118-mid–shore region;
120+ (1) Lead a regional partnership in building a rural health system that 14
121+enhances access to and utilization of health care services designed to meet the triple aim 15
122+of: 16
119123
120- (4) Increase the awareness among county officials and residents regarding
121-the health status, health needs, and available resources in the mid–shore region; and
124+ (i) Providing health care; 17
122125
123- (5) Enhance rural economic development in the mid–shore region.]
126+ (ii) Alignment with the State’s Medicare waiver; and 18
124127
125-[2–903.
128+ (iii) Improving population health; 19
126129
127- This subtitle does not affect the authority of the Secretary, the Maryland Health
128-Care Commission, or the Health Services Cost Review Commission to regulate a health
129-care facility, a health care institution, a health care service, or a health care program under
130-this article.]
130+ (2) Mediate disputes between stakeholders; 20
131131
132-[2–904.
132+ (3) Assist in collaboration among health care service providers in the 21
133+mid–shore region; 22
133134
134- (a) There is a Rural Health Care Collaborative Executive Committee.
135+ (4) Increase the awareness among county officials and residents regarding 23
136+the health status, health needs, and available resources in the mid–shore region; and 24
135137
136- (b) The Executive Committee consists of the following members:
138+ (5) Enhance rural economic development in the mid–shore region.] 25
137139
138- (1) The health officers from Caroline County, Dorchester County, Kent
139-County, Queen Anne’s County, and Talbot County;
140+[2–903. 26
140141
141- (2) The Chief Executive Officer of:
142+ This subtitle does not affect the authority of the Secretary, the Maryland Health 27
143+Care Commission, or the Health Services Cost Review Commission to regulate a health 28
144+care facility, a health care institution, a health care service, or a health care program under 29
145+this article.] 30
146+ 4 SENATE BILL 498
142147
143- (i) University of Maryland Shore Regional Health; and
144- Ch. 36 2023 LAWS OF MARYLAND
145148
146-– 4 –
147- (ii) The Anne Arundel Medical Center;
149+[2–904. 1
148150
149- (3) The Chief Executive Officer of a federally qualified health center that
150-serves the mid–shore region; and
151+ (a) There is a Rural Health Care Collaborative Executive Committee. 2
151152
152- (4) The following members appointed by the Secretary:
153+ (b) The Executive Committee consists of the following members: 3
153154
154- (i) One primary care provider who practices in the mid–shore
155-region;
155+ (1) The health officers from Caroline County, Dorchester County, Kent 4
156+County, Queen Anne’s County, and Talbot County; 5
156157
157- (ii) One specialty care physician who practices in the mid–shore
158-region;
158+ (2) The Chief Executive Officer of: 6
159159
160- (iii) One behavioral health provider who practices in the mid–shore
161-region; and
160+ (i) University of Maryland Shore Regional Health; and 7
162161
163- (iv) One health care consumer residing in the mid–shore region.
162+ (ii) The Anne Arundel Medical Center; 8
164163
165- (c) The Executive Committee shall:
164+ (3) The Chief Executive Officer of a federally qualified health center that 9
165+serves the mid–shore region; and 10
166166
167- (1) Provide general direction to the Collaborative; and
167+ (4) The following members appointed by the Secretary: 11
168168
169- (2) Make operating decisions on projects approved by the Collaborative.]
169+ (i) One primary care provider who practices in the mid–shore 12
170+region; 13
170171
171-[2–905.
172+ (ii) One specialty care physician who practices in the mid–shore 14
173+region; 15
172174
173- (a) (1) With the approval of the Secretary, the Executive Committee shall
174-appoint an Executive Director of the Collaborative.
175+ (iii) One behavioral health provider who practices in the mid–shore 16
176+region; and 17
175177
176- (2) The Executive Director shall serve at the pleasure of the Executive
177-Committee.
178+ (iv) One health care consumer residing in the mid–shore region. 18
178179
179- (3) In accordance with the State budget, the Executive Committee shall
180-determine the appropriate compensation for the Executive Director.
180+ (c) The Executive Committee shall: 19
181181
182- (b) Under the direction of the Executive Committee, the Executive Director shall:
182+ (1) Provide general direction to the Collaborative; and 20
183183
184- (1) Be the chief administrative officer of the Collaborative;
184+ (2) Make operating decisions on projects approved by the Collaborative.] 21
185185
186- (2) Direct, administer, and manage the operations of the Collaborative; and
186+[2–905. 22
187187
188- (3) Perform all duties necessary to comply with and carry out the
189-provisions of this subtitle.
188+ (a) (1) With the approval of the Secretary, the Executive Committee shall 23
189+appoint an Executive Director of the Collaborative. 24
190190
191- (c) In accordance with the State budget, the Executive Director may employ and
192-retain a staff for the Collaborative. WES MOORE, Governor Ch. 36
191+ (2) The Executive Director shall serve at the pleasure of the Executive 25
192+Committee. 26
193193
194-– 5 –
194+ (3) In accordance with the State budget, the Executive Committee shall 27
195+determine the appropriate compensation for the Executive Director. 28 SENATE BILL 498 5
195196
196- (d) The Executive Director shall determine the classification, grade, and
197-compensation of those positions designated under subsection (c) of this section:
198197
199- (1) In consultation with the Secretary of Budget and Management;
200198
201- (2) With the approval of the Executive Committee; and
199+ (b) Under the direction of the Executive Committee, the Executive Director shall: 1
202200
203- (3) In accordance with the State pay plan.]
201+ (1) Be the chief administrative officer of the Collaborative; 2
204202
205-[2–906.
203+ (2) Direct, administer, and manage the operations of the Collaborative; and 3
206204
207- (a) In addition to the powers set forth elsewhere in this subtitle, the Collaborative
208-may:
205+ (3) Perform all duties necessary to comply with and carry out the 4
206+provisions of this subtitle. 5
209207
210- (1) Adopt bylaws, rules, and policies;
208+ (c) In accordance with the State budget, the Executive Director may employ and 6
209+retain a staff for the Collaborative. 7
211210
212- (2) Adopt regulations to carry out this subtitle;
211+ (d) The Executive Director shall determine the classification, grade, and 8
212+compensation of those positions designated under subsection (c) of this section: 9
213213
214- (3) Maintain an office at the place designated by the Collaborative;
214+ (1) In consultation with the Secretary of Budget and Management; 10
215215
216- (4) Apply for and receive grants, contracts, or other public or private
217-funding;
216+ (2) With the approval of the Executive Committee; and 11
218217
219- (5) Issue and award contracts and grants; and
218+ (3) In accordance with the State pay plan.] 12
220219
221- (6) Do all things necessary or convenient to carry out the powers granted
222-by this subtitle.
220+[2–906. 13
223221
224- (b) To carry out the purposes of this subtitle, the Collaborative may create and
225-consult with ad hoc advisory committees.]
222+ (a) In addition to the powers set forth elsewhere in this subtitle, the Collaborative 14
223+may: 15
226224
227-[2–907.
225+ (1) Adopt bylaws, rules, and policies; 16
228226
229- For fiscal year 2019 and for each fiscal year thereafter, the Governor shall provide
230-an appropriation in the State budget adequate to fully fund the operations of the
231-Collaborative.]
227+ (2) Adopt regulations to carry out this subtitle; 17
232228
233-[2–908.
229+ (3) Maintain an office at the place designated by the Collaborative; 18
234230
235- (a) (1) The Collaborative shall direct the establishment of Rural Health
236-Complexes by:
231+ (4) Apply for and receive grants, contracts, or other public or private 19
232+funding; 20
237233
238- (i) Assessing the needs of communities in the mid–shore region that
239-lack access to essential community–based primary care, behavioral health, specialty care,
240-or dental care services; Ch. 36 2023 LAWS OF MARYLAND
234+ (5) Issue and award contracts and grants; and 21
241235
242-– 6 –
236+ (6) Do all things necessary or convenient to carry out the powers granted 22
237+by this subtitle. 23
243238
244- (ii) Identifying care delivery models that have the potential to reduce
245-deficits in care; and
239+ (b) To carry out the purposes of this subtitle, the Collaborative may create and 24
240+consult with ad hoc advisory committees.] 25
246241
247- (iii) Convening health and hos pital systems, community
248-organizations, and local stakeholders to build consensus on the appropriate scale of a Rural
249-Health Complex.
242+[2–907. 26
243+ 6 SENATE BILL 498
250244
251- (2) (i) The Secretary shall approve a Rural Health Complex:
252245
253- 1. Recommended by the Collaborative by a majority of a
254-quorum of the Collaborative present and voting;
246+ For fiscal year 2019 and for each fiscal year thereafter, the Governor shall provide 1
247+an appropriation in the State budget adequate to fully fund the operations of the 2
248+Collaborative.] 3
255249
256- 2. That meets the standards and criteria established by the
257-Collaborative for a Rural Health Complex; and
250+[2–908. 4
258251
259- 3. If the Rural Health Complex demonstrates that it meets
260-the standards and criteria established by the Collaborative.
252+ (a) (1) The Collaborative shall direct the establishment of Rural Health 5
253+Complexes by: 6
261254
262- (ii) A complex that fails to meet the standards and criteria
263-established by the Collaborative shall relinquish its designation as a complex.
255+ (i) Assessing the needs of communities in the mid–shore region that 7
256+lack access to essential community–based primary care, behavioral health, specialty care, 8
257+or dental care services; 9
264258
265- (3) On or before December 1, 2020, the Collaborative shall report to the
266-Governor and, in accordance with § 2–1257 of the State Government Article, the General
267-Assembly on the standards and criteria that a community must meet to establish a Rural
268-Health Complex before the Collaborative approves a Rural Health Complex.
259+ (ii) Identifying care delivery models that have the potential to reduce 10
260+deficits in care; and 11
269261
270- (b) On or before December 1, 2021, and December 1 each year thereafter, the
271-Collaborative shall report to the Governor and, in accordance with § 2–1257 of the State
272-Government Article, the General Assembly on its activities regarding health care delivery
273-in the mid–shore region, including:
262+ (iii) Convening health and hospital systems, community 12
263+organizations, and local stakeholders to build consensus on the appropriate scale of a Rural 13
264+Health Complex. 14
274265
275- (1) The number of Rural Health Complexes approved;
266+ (2) (i) The Secretary shall approve a Rural Health Complex: 15
276267
277- (2) The effect that each Rural Health Complex had on the health status of
278-the overall population and the vulnerable population in its community; and
268+ 1. Recommended by the Collaborative by a majority of a 16
269+quorum of the Collaborative present and voting; 17
279270
280- (3) The effect that Rural Health Complexes have had on the available
281-community–based health care resources in communities where complexes have been
282-established.]
271+ 2. That meets the standards and criteria established by the 18
272+Collaborative for a Rural Health Complex; and 19
283273
284-SUBTITLE 22. MID SHORE HEALTH IMPROVEMENT COALITION FUNDING.
274+ 3. If the Rural Health Complex demonstrates that it meets 20
275+the standards and criteria established by the Collaborative. 21
285276
286-24–2201.
287- WES MOORE, Governor Ch. 36
277+ (ii) A complex that fails to meet the standards and criteria 22
278+established by the Collaborative shall relinquish its designation as a complex. 23
288279
289-– 7 –
290- FOR FISCAL YEAR 2024, AND FOR EACH FISCAL YEAR THEREAFTER , THE
291-GOVERNOR SHALL PROVID E AN APPROPRIATION I N THE STATE BUDGE T TO FUND
292-THE OPERATIONS OF TH E MID SHORE HEALTH IMPROVEMENT COALITION.
280+ (3) On or before December 1, 2020, the Collaborative shall report to the 24
281+Governor and, in accordance with § 2–1257 of the State Government Article, the General 25
282+Assembly on the standards and criteria that a community must meet to establish a Rural 26
283+Health Complex before the Collaborative approves a Rural Health Complex. 27
293284
294- SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July
295-1, 2023.
285+ (b) On or before December 1, 2021, and December 1 each year thereafter, the 28
286+Collaborative shall report to the Governor and, in accordance with § 2–1257 of the State 29
287+Government Article, the General Assembly on its activities regarding health care delivery 30
288+in the mid–shore region, including: 31
296289
297-Approved by the Governor, April 11, 2023.
290+ (1) The number of Rural Health Complexes approved; 32
291+ SENATE BILL 498 7
292+
293+
294+ (2) The effect that each Rural Health Complex had on the health status of 1
295+the overall population and the vulnerable population in its community; and 2
296+
297+ (3) The effect that Rural Health Complexes have had on the available 3
298+community–based health care resources in communities where complexes have been 4
299+established.] 5
300+
301+SUBTITLE 22. MID SHORE HEALTH IMPROVEMENT COALITION FUNDING. 6
302+
303+24–2201. 7
304+
305+ FOR FISCAL YEAR 2024, AND FOR EACH FISCAL YEAR THEREAFTER , THE 8
306+GOVERNOR SHALL PROVID E AN APPROPRIATION I N THE STATE BUDGE T TO FUND 9
307+THE OPERATIONS OF TH E MID SHORE HEALTH IMPROVEMENT COALITION. 10
308+
309+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 11
310+1, 2023. 12
311+
312+
313+
314+Approved:
315+________________________________________________________________________________
316+ Governor.
317+________________________________________________________________________________
318+ President of the Senate.
319+________________________________________________________________________________
320+ Speaker of the House of Delegates.