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. *sb0555* SENATE BILL 555 K3 3lr0134 CF HB 549 By: The President (By Request – Administration) and Senators Waldstreicher, Augustine, Benson, Carter, Ellis, Hettleman, Jackson, Kagan, King, Kramer, Lam, McCray, Muse, Rosapepe, Smith, Sydnor, M. Washington, and Watson Introduced and read first time: February 6, 2023 Assigned to: Finance and Budget and Taxation Committee Report: Favorable with amendments Senate action: Adopted Read second time: March 8, 2023 CHAPTER ______ AN ACT concerning 1 Fair Wage Act of 2023 2 FOR the purpose of increasing the State minimum wage rate in effect for certain periods of 3 time; increasing, except under certain circumstances, the State minimum wage rate 4 in effect for certain periods of time based on annual growth in a certain consumer 5 price index; altering repealing the authority of the Board of Public Works to 6 temporarily suspend an increase in the minimum wage rate; repealing the 7 requirement that the Governor’s budgets for certain fiscal years include certain 8 provider rate increases; and generally relating to the State minimum wage rate. 9 BY repealing and reenacting, with amendments, 10 Article – Health – General 11 Section 7–307, 16–201.3, and 16–201.4 12 Annotated Code of Maryland 13 (2019 Replacement Volume and 2022 Supplement) 14 BY repealing and reenacting, with amendments, 15 Article – Labor and Employment 16 Section 3–413 and 3–413.1 17 Annotated Code of Maryland 18 (2016 Replacement Volume and 2022 Supplement) 19 BY repealing 20 2 SENATE BILL 555 Article – Labor and Employment 1 Section 3–413.1 2 Annotated Code of Maryland 3 (2016 Replacement Volume and 2022 Supplement) 4 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5 That the Laws of Maryland read as follows: 6 Article – Health – General 7 7–307. 8 (a) (1) In this section the following words have the meanings indicated. 9 (2) “Community direct service worker” means an employee of a community 10 provider that provides treatment or services to developmentally disabled individuals. 11 (3) “Community provider” means a community–based agency or program 12 funded by the Administration to serve individuals with developmental disabilities. 13 (4) “Rate” means the reimbursement rate paid by the Department to a 14 community provider from the State General Fund, Maryland Medical Assistance Program 15 funds, other State or federal funds, or a combination of funds. 16 (b) Notwithstanding the provisions of this title or any other provision of law, the 17 Department shall reimburse community providers as provided in this section. 18 (c) Subject to subsection (d) of this section, the Department shall increase the rate 19 of reimbursement for community service providers each fiscal year by the amount of rate 20 increase included in the State budget for that fiscal year. 21 (d) (1) The Governor’s proposed budget for fiscal year 2019 shall include a 22 3.5% rate increase for community service providers over the funding provided in the 23 legislative appropriation for Object 08 Contractual Services in Program M00M01.02 24 Community Services for fiscal year 2018. 25 (2) The Governor’s proposed budget for fiscal year 2021 shall include a 4% 26 rate increase for community service providers over the funding provided in the legislative 27 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 28 Services for fiscal year 2020. 29 (3) The Governor’s proposed budget for fiscal year 2022 shall include a 4% 30 rate increase for community service providers over the funding provided in the legislative 31 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 32 Services for fiscal year 2021. 33 SENATE BILL 555 3 (4) The Governor’s proposed budget for fiscal year 2023 shall include a 4% 1 rate increase for community service providers over the funding provided in the legislative 2 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 3 Services for fiscal year 2022. 4 (5) The Governor’s proposed budget for fiscal year 2024 shall include a 4% 5 rate increase for community service providers over the funding provided in the legislative 6 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 7 Services for fiscal year 2023. 8 [(6) The Governor’s proposed budget for fiscal year 2025 shall include a 4% 9 rate increase for community service providers over the funding provided in the legislative 10 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 11 Services for fiscal year 2024. 12 (7) The Governor’s proposed budget for fiscal year 2026 shall include a 4% 13 rate increase for community service providers over the funding provided in the legislative 14 appropriation for Object 08 Contractual Services in Program M00M01.02 Community 15 Services for fiscal year 2025.] 16 (e) The Governor’s proposed budget for fiscal year 2016 and thereafter for 17 community service providers shall be presented in the same manner, including object and 18 program information, as provided for in the fiscal year 2015 budget. 19 (f) A portion of the funds in subsection (e) of this section may be allocated to 20 address the impact of an increase in the State minimum wage on wages and benefits of 21 direct support workers employed by community providers licensed by the Developmental 22 Disabilities Administration. 23 16–201.3. 24 (a) (1) In this section the following words have the meanings indicated. 25 (2) “Community provider” means a community–based agency or program 26 funded by the Behavioral Health Administration or the Medical Care Programs 27 Administration to serve individuals with mental disorders, substance–related disorders, or 28 a combination of these disorders. 29 (3) “Rate” means the reimbursement rate paid by the Department to a 30 community provider from the State General Fund, Maryland Medical Assistance Program 31 funds, other State or federal funds, or a combination of these funds. 32 (b) This section does not apply to reimbursement for any service provided by a 33 community provider whose rates are regulated by the Health Services Cost Review 34 Commission. 35 4 SENATE BILL 555 (c) It is the intent of the General Assembly that a substantial portion of the rate 1 adjustment provided under subsection (d) of this section be used to: 2 (1) Compensate direct care staff and licensed clinicians employed by 3 community providers; and 4 (2) Improve the quality of programming provided by community providers. 5 (d) (1) The Governor’s proposed budget for fiscal year 2019 and fiscal year 6 2020 shall include a 3.5% rate increase for community providers over the funding provided 7 in the legislative appropriation for the immediately preceding fiscal year for each of the 8 following: 9 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 10 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 11 (ii) Object 08 Contractual Services in Prog ram M00L01.02 12 Community Services – Behavioral Health Administration; and 13 (iii) Object 08 Contractual Services in Program M00L01.03 14 Community Services for Medicaid State Fund Recipients – Behavioral Health 15 Administration. 16 (2) The Governor’s proposed budget for fiscal year 2021 shall include a 4% 17 rate increase for community providers over the funding provided in the legislative 18 appropriation for the immediately preceding fiscal year for each of the following: 19 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 20 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 21 (ii) Object 08 Contractual Services in Program M00L01.02 22 Community Services – Behavioral Health Administration; and 23 (iii) Object 08 Contractual Services in Program M00L01.03 24 Community Services for Medicaid State Fund Recipients – Behavioral Health 25 Administration. 26 (3) The Governor’s proposed budget for fiscal year 2022 shall include a 27 3.5% rate increase for community providers over the funding provided in the legislative 28 appropriation for the immediately preceding fiscal year for each of the following: 29 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 30 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 31 (ii) Object 08 Contractual Services in Program M00L01.02 32 Community Services – Behavioral Health Administration; and 33 SENATE BILL 555 5 (iii) Object 08 Contractual Services in Program M00L01.03 1 Community Services for Medicaid State Fund Recipients – Behavioral Health 2 Administration. 3 (4) The Governor’s proposed budget for fiscal year 2023 shall include a 4 3.25% rate increase for community providers over the funding provided in the legislative 5 appropriation for the immediately preceding fiscal year for each of the following: 6 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 7 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 8 (ii) Object 08 Contractual Services in Program M00L01.02 9 Community Services – Behavioral Health Administration; and 10 (iii) Object 08 Contractual Services in Program M00L01.03 11 Community Services for Medicaid State Fund Recipients – Behavioral Health 12 Administration. 13 (5) The Governor’s proposed budget for fiscal year 2024 shall include a 3% 14 rate increase for community providers over the funding provided in the legislative 15 appropriation for the immediately preceding fiscal year for each of the following: 16 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 17 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 18 (ii) Object 08 Contractual Services in Program M00L01.02 19 Community Services – Behavioral Health Administration; and 20 (iii) Object 08 Contractual Services in Program M00L01.03 21 Community Services for Medicaid State Fund Recipients – Behavioral Health 22 Administration. 23 (6) [The Governor’s proposed budget for fiscal year 2025 shall include a 4% 24 rate increase for community providers over the funding provided in the legislative 25 appropriation for the immediately preceding fiscal year for each of the following: 26 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 27 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 28 (ii) Object 08 Contractual Services in Program M00L01.02 29 Community Services – Behavioral Health Administration; and 30 (iii) Object 08 Contractual Services in Program M00L01.03 31 Community Services for Medicaid State Fund Recipients – Behavioral Health 32 Administration. 33 6 SENATE BILL 555 (7) The Governor’s proposed budget for fiscal year 2026 shall include a 4% 1 rate increase for community providers over the funding provided in the legislative 2 appropriation for the immediately preceding fiscal year for each of the following: 3 (i) Object 08 Contractual Services in Program M00Q01.10 Medicaid 4 Behavioral Health Provider Reimbursement – Medical Care Programs Administration; 5 (ii) Object 08 Contractual Services in Program M00L01.02 6 Community Services – Behavioral Health Administration; and 7 (iii) Object 08 Contractual Services in Program M00L01.03 8 Community Services for Medicaid State Fund Recipients – Behavioral Health 9 Administration. 10 (8)] The Governor’s proposed budget for fiscal year 2019 and each fiscal year 11 thereafter for community providers shall be presented in the same manner, including object 12 and program information, as in the fiscal year 2018 budget. 13 (e) (1) The Behavioral Health Administration and the Medical Care Programs 14 Administration jointly shall: 15 (i) Conduct an independent cost–driven, rate–setting study to set 16 community provider rates for community–based behavioral health services that includes a 17 rate analysis and an impact study that considers the actual cost of providing 18 community–based behavioral health services; 19 (ii) Develop and implement a payment system incorporating the 20 findings of the rate–setting study conducted under item (i) of this paragraph, including 21 projected costs of implementation and recommendations to address any potential shortfall 22 in funding; and 23 (iii) Consult with stakeholders, including community providers and 24 individuals receiving services, in conducting the rate–setting study and developing the 25 payment system required by this paragraph. 26 (2) The Administration, on or before September 30, 2019, shall complete 27 the study required under paragraph (1)(i) of this subsection. 28 (3) The Administration shall adopt regulations to implement the payment 29 system required by paragraph (1) of this subsection. 30 (f) If services of community providers are provided through managed care 31 organizations, the managed care organizations shall: 32 (1) Pay the rate in effect during the immediately preceding fiscal year for 33 the first fiscal year the managed care organizations provide the services; and 34 SENATE BILL 555 7 (2) Adjust the rate for community providers each fiscal year by at least the 1 same amount that otherwise would have been required under subsection (d) of this section. 2 (g) Increased funding provided under subsection (d) of this section may be used 3 only to increase the rates paid to: 4 (1) Community providers accredited by a State–approved accrediting body 5 and licensed by the State; and 6 (2) Health care providers who are acting within the scopes of practice of 7 the health care providers’ licenses or certificates as specified under the Health Occupations 8 Article. 9 (h) (1) On or before December 1, 2018, the Department shall submit an interim 10 report to the Governor and, in accordance with § 2–1257 of the State Government Article, 11 the General Assembly on the delivery system through which community–based behavioral 12 health services should be provided and any preliminary recommendations regarding the 13 payment system required under this section. 14 (2) On or before December 1, 2019, and on or before December 1 each year 15 thereafter, the Department shall submit a report to the Governor and, in accordance with 16 § 2–1257 of the State Government Article, the General Assembly on the impact of the rate 17 adjustments and the payment system required under this section on community providers, 18 including the impact on: 19 (i) The wages and salaries paid and the benefits provided to direct 20 care staff and licensed clinicians employed by community providers; 21 (ii) The tenure and turnover of direct care staff and licensed 22 clinicians employed by community providers; and 23 (iii) The ability of community providers to recruit qualified direct 24 care staff and licensed clinicians. 25 (3) The Department may require a community provider to submit, in the 26 form and manner required by the Department, information that the Department considers 27 necessary for completion of the report required under paragraph (2) of this subsection. 28 16–201.4. 29 (a) (1) In this section the following words have the meanings indicated. 30 (2) “Provider” means a provider of: 31 (i) Nursing home services; 32 (ii) Medical day care services; 33 8 SENATE BILL 555 (iii) Private duty nursing services; 1 (iv) Personal care services; 2 (v) Home– and community–based services; and 3 (vi) Services provided through the Community First Choice program. 4 (3) “Rate” means the reimbursement rate paid by the Department to 5 providers of nursing home, medical day care, private duty nursing, personal care, and 6 home– and community–based services and services provided through the Community First 7 Choice program from the State General Fund, Maryland Medical Assistance Program 8 funds, other State or federal funds, or a combination of these funds. 9 (b) (1) The Governor’s proposed budget for fiscal year 2021 shall include a 4% 10 rate increase for providers over the funding provided in the legislative appropriation for 11 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 12 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 13 Maryland Children’s Health Program – Medical Care Programs Administration. 14 (2) The Governor’s proposed budget for fiscal year 2022 shall include a 4% 15 rate increase for providers over the funding provided in the legislative appropriation for 16 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 17 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 18 Maryland Children’s Health Program – Medical Care Programs Administration. 19 (3) The Governor’s proposed budget for fiscal year 2023 shall include a 4% 20 rate increase for providers over the funding provided in the legislative appropriation for 21 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 22 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 23 Maryland Children’s Health Program – Medical Care Programs Administration. 24 (4) The Governor’s proposed budget for fiscal year 2024 shall include a 4% 25 rate increase for providers over the funding provided in the legislative appropriation for 26 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 27 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 28 Maryland Children’s Health Program – Medical Care Programs Administration. 29 (5) [The Governor’s proposed budget for fiscal year 2025 shall include a 4% 30 rate increase for providers over the funding provided in the legislative appropriation for 31 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 32 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 33 Maryland Children’s Health Program – Medical Care Programs Administration. 34 (6) The Governor’s proposed budget for fiscal year 2026 shall include a 4% 35 rate increase for providers over the funding provided in the legislative appropriation for 36 SENATE BILL 555 9 the immediately preceding fiscal year in Program M00Q01.03 Medical Care Provider 1 Reimbursements – Medical Care Programs Administration and Program M00Q01.07 2 Maryland Children’s Health Program – Medical Care Programs Administration. 3 (7)] The Governor’s proposed budget for fiscal year 2021 and each fiscal year 4 thereafter shall be presented in the same manner, including object and program 5 information, as in the fiscal year 2020 budget. 6 Article – Labor and Employment 7 3–413. 8 (a) (1) In this section the following words have the meanings indicated. 9 (2) “CONSUMER PRICE INDEX” MEANS THE CONSUMER PRICE INDEX 10 FOR ALL URBAN CONSUMERS FOR THE WASHINGTON–ARLINGTON–ALEXANDRIA, 11 DC–VA–MD–WV METROPOLITAN AREA OR A SUCCESSOR METROPOL ITAN AREA 12 INDEX PUBLISHED BY THE FEDERAL BUREAU OF LABOR STATISTICS. 13 (3) (2) “Employer” includes a governmental unit. 14 [(3)] (4) “Small employer” means an employer that employs 14 or fewer 15 employees. 16 (b) Except as provided in subsection (d) of this section and §§ 3–413.1 and 3–414 17 of this subtitle, each employer shall pay: 18 (1) to each employee who is subject to both the federal Act and this subtitle, 19 at least the greater of: 20 (i) the minimum wage for that employee under the federal Act; or 21 (ii) the State minimum wage set under subsection (c) of this section; 22 and 23 (2) to each other employee who is subject to this subtitle, at least the 24 greater of: 25 (i) the highest minimum wage under the federal Act; or 26 (ii) the State minimum wage set under subsection (c) of this section. 27 (c) (1) Subject to § 3–413.1 of this subtitle and except as provided in paragraph 28 (2) of this subsection, the State minimum wage rate is: 29 (i) [for the 12–month period beginning July 1, 2017, $9.25 per hour; 30 10 SENATE BILL 555 (ii) for the 18–month period beginning July 1, 2018, $10.10 per hour; 1 (iii) for the 12–month period beginning January 1, 2020, $11.00 per 2 hour; 3 (iv) for the 12–month period beginning January 1, 2021, $11.75 per 4 hour; 5 (v) for the 12–month period beginning January 1, 2022, $12.50 per 6 hour; 7 (vi)] for the [12 month] 9–MONTH period beginning January 1, 2023, 8 $13.25 per hour; AND 9 [(vii) for the 12–month period beginning January 1, 2024, $14.00 per 10 hour; and 11 (viii)] (II) FOR THE 21–MONTH PERIOD beginning [January 1, 12 2025] OCTOBER 1, 2023 JANUARY 1, 2024, $15.00 per hour; AND 13 (III) FOR THE 12–MONTH PERIOD BEGINNI NG JULY 1, 2025, AND 14 EACH SUBSEQUENT 12–MONTH PERIOD , THE RATE DETERMINED BY THE 15 COMMISSIONER UNDER PA RAGRAPH (2)(II) OF THIS SUBSECTION . 16 (2) (I) EXCEPT AS PROVIDED IN SUBPARAGRAPH (III) OF THIS 17 PARAGRAPH , FOR THE 12–MONTH PERIOD BEGINNI NG JULY 1, 2025, AND EACH 18 SUBSEQUENT 12–MONTH PERIOD , THE STATE MINIMUM WAGE RA TE SHALL BE 19 INCREASED BY THE AMO UNT, ROUNDED TO THE NEARE ST 5 CENTS, THAT EQUALS 20 THE PRODUCT OF : 21 1. THE STATE MINIMUM WAGE RA TE IN EFFECT FOR THE 22 IMMEDIATELY PRECEDIN G 12–MONTH PERIOD ; AND 23 2. THE LESSER OF: 24 A. THE AVERAGE PERCENTA GE GROWTH IN THE 25 CONSUMER PRICE INDEX FOR THE IMMEDIA TELY PRECEDING 12–MONTH PERIOD , 26 AS DETERMINED BY THE COMMISSIONER UNDER SU BPARAGRAPH (II)1 OF THIS 27 PARAGRAPH ; OR 28 B. 5%. 29 (II) BEGINNING MARCH 1, 2025, AND EACH MARCH 1 30 THEREAFTER , THE COMMISSIONER SHALL DE TERMINE AND ANNOUNCE : 31 SENATE BILL 555 11 1. THE AVERAGE PERCENTA GE GROWTH, IF ANY, IN THE 1 CONSUMER PRICE INDEX BASED ON THE IM MEDIATELY PRECEDING 12–MONTH 2 PERIOD FOR WHICH DAT A ARE AVAILABLE ON MARCH 1; AND 3 2. THE STATE MINIMUM WAGE RA TE EFFECTIVE FOR 4 THE 12–MONTH PERIOD BEGINNI NG THE FOLLOWING JULY 1. 5 (III) IF THE COMMISSIONER DETERMI NES THAT THERE IS A 6 DECLINE OR NO GROWTH IN THE CONSUMER PRICE INDEX, THE STATE MINIMUM 7 WAGE RATE SHALL REMA IN THE SAME AS THE R ATE THAT WAS IN EFFE CT FOR THE 8 IMMEDIATELY PRECEDIN G 12–MONTH PERIOD . 9 [(2)] (3) Subject to § 3–413.1 of this subtitle, the State minimum wage 10 rate for a small employer is: 11 (i) [for the 18–month period beginning July 1, 2018, $10.10 per 12 hour; 13 (ii) for the 12–month period beginning January 1, 2020, $11.00 per 14 hour; 15 (iii) for the 12–month period beginning January 1, 2021, $11.60 per 16 hour; 17 (iv) for the 12–month period beginning January 1, 2022, $12.20 per 18 hour; 19 (v)] for the [12–month] 9–MONTH period beginning January 1, 2023, 20 $12.80 per hour; AND 21 [(vi) for the 12–month period beginning January 1, 2024, $13.40 per 22 hour; 23 (vii) for the 12–month period beginning January 1, 2025, $14.00 per 24 hour; 25 (viii) for the 6–month period beginning January 1, 2026, $14.60 per 26 hour; and 27 (ix)] (II) FOR THE 21–MONTH PERIOD beginning [July 1, 2026] 28 OCTOBER 1, 2023 JANUARY 1, 2024, $15.00 per hour; AND 29 12 SENATE BILL 555 (III) FOR THE 12–MONTH PERIOD BEGINNI NG JULY 1, 2025, AND 1 EACH SUBSEQUENT 12–MONTH PERIOD , EQUIVALENT TO THE STATE MINIMUM 2 WAGE RATE UNDER PARA GRAPH (1)(III) OF THIS SUBSECTION . 3 (d) An employer may pay an employee a wage that equals a rate of 85% of the 4 State minimum wage established under this section if the employee is under the age of 18 5 years. 6 3–413.1. 7 (a) In this section, “Board” means the Board of Public Works. 8 (b) [(1)] Subject to subsection (d) of this section [and except as provided in 9 paragraph (2) of this subsection], on or before [October 1, 2020] MARCH 1, 2025, and 10 [October] MARCH 1 each year thereafter [until October 1, 2024], the Board shall 11 determine whether the seasonally adjusted total employment from the Current 12 Employment Statistics series as reported by the U.S. Bureau of Labor Statistics for the 13 most recent 6–month period is negative as compared with the immediately preceding 14 6–month period. 15 [(2) The Board is not required to make a determination under paragraph 16 (1) of this subsection if the Board has previously temporarily suspended an increase to the 17 minimum wage rate specified under § 3–413(c) of this subtitle.] 18 (c) (1) Subject to subsection (d) of this section, the Board may temporarily 19 suspend an increase to the minimum wage rate specified under § 3–413(c) of this subtitle 20 if the Board determined under subsection [(b)(1)] (B) of this section that the seasonally 21 adjusted total employment is negative. 22 (2) If the seasonally adjusted total employment is negative, the Board may 23 consider the performance of State revenues in the previous 6 months, as reported by the 24 Office of the Comptroller, in determining whether to temporarily suspend an increase to 25 the minimum wage rate specified under § 3–413(c) of this subtitle. 26 (d) [The Board may temporarily suspend an increase to the minimum wage rate 27 under subsection (c)(1) of this section only one time. 28 (e)] If the Board temporarily suspends an increase to the minimum wage rate 29 specified under § 3–413(c) of this subtitle: 30 (1) the minimum wage rate in effect for the period beginning the following 31 [January] JULY 1 shall remain the same as the rate that was in effect for the immediately 32 preceding 12–month period; 33 (2) the remaining minimum wage rates specified in § 3–413 of this subtitle 34 shall take effect 1 year later than the date specified; AND 35 SENATE BILL 555 13 (3) the Board shall notify the Commissioner that the minimum wage rate 1 increase for the period beginning the following [January] JULY 1 is suspended for 1 year[; 2 and 3 (4) a rate increase under §§ 7–307, 16–201.3, and 16–201.4 of the Health – 4 General Article for the immediately following fiscal year may not go into effect]. 5 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 6 1, 2023. 7 Approved: ________________________________________________________________________________ Governor. ________________________________________________________________________________ President of the Senate. ________________________________________________________________________________ Speaker of the House of Delegates.