EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0674*
SENATE BILL 674
J2 3lr1468
CF HB 722
By: Senators Carozza and Klausmeier
Introduced and read first time: February 6, 2023
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Physician Assistants – Parity With Other Health Care Practitioners 2
(Physician Assistant Parity Act of 2023) 3
FOR the purpose of altering certain provisions of law to include physician assistants in the 4
health care practitioners who may take certain actions, including actions related to 5
the guardianship of disabled persons, admission of individuals to mental health 6
facilities, the Emergency and Allergy Treatment Program, the Attendant Care 7
Program, and petitions for extreme risk protective orders; requiring the Maryland 8
Department of Health to cover charges related to examinations by a physician 9
assistant for certain emergency evaluees; exempting physician assistants from the 10
Maryland Pharmacy Act; altering the membership and duties of the Statewide 11
Advisory Commission on Immunization; altering the membership of a certain 12
workgroup formed by the Maryland Health Care Commission; and generally relating 13
to physician assistants. 14
BY repealing and reenacting, with amendments, 15
Article – Correctional Services 16
Section 9–601.1(e)(1) 17
Annotated Code of Maryland 18
(2017 Replacement Volume and 2022 Supplement) 19
BY repealing and reenacting, with amendments, 20
Article – Estates and Trusts 21
Section 13–705(c)(2) 22
Annotated Code of Maryland 23
(2022 Replacement Volume and 2022 Supplement) 24
BY repealing and reenacting, with amendments, 25
Article – Health – General 26
Section 5–606, 10–601(g) and (h), 10–610(c), 10–611(b), (c), and (e), 10–615(6), 27
10–616(a)(1) and (c), 10–619, 10–620(f), 10–622(b) and (d), 10–623(a), 28 2 SENATE BILL 674
10–624(a)(1), 10–628(a)(1), 13–701, 13–705, 13–707(b)(1) and (c), 1
18–214(d)(11) and (12), 19–108.4, 19–705.1(b)(1)(vi) and (2), and 2
19–2001(a)(4) 3
Annotated Code of Maryland 4
(2019 Replacement Volume and 2022 Supplement) 5
BY repealing and reenacting, without amendments, 6
Article – Health – General 7
Section 10–601(a), 10–620(a), 18–214(b), 19–705.1(a), and 19–2001(a)(1) and (b)(1) 8
Annotated Code of Maryland 9
(2019 Replacement Volume and 2022 Supplement) 10
BY adding to 11
Article – Health – General 12
Section 10–601(g) and 18–214(d)(12) 13
Annotated Code of Maryland 14
(2019 Replacement Volume and 2022 Supplement) 15
BY repealing and reenacting, with amendments, 16
Article – Health Occupations 17
Section 4–308(k)(4)(vi) and (m)(1)(iii) and (5)(ii) and 12–102(d)(2), (e)(1)(i), (f)(1), and 18
(g) 19
Annotated Code of Maryland 20
(2021 Replacement Volume and 2022 Supplement) 21
BY repealing and reenacting, without amendments, 22
Article – Health Occupations 23
Section 4–308(m)(1)(i) 24
Annotated Code of Maryland 25
(2021 Replacement Volume and 2022 Supplement) 26
BY repealing and reenacting, with amendments, 27
Article – Human Services 28
Section 7–404(a) 29
Annotated Code of Maryland 30
(2019 Replacement Volume and 2022 Supplement) 31
BY repealing and reenacting, without amendments, 32
Article – Public Safety 33
Section 5–601(a) 34
Annotated Code of Maryland 35
(2022 Replacement Volume) 36
BY repealing and reenacting, with amendments, 37
Article – Public Safety 38
Section 5–601(e) 39
Annotated Code of Maryland 40 SENATE BILL 674 3
(2022 Replacement Volume) 1
BY repealing and reenacting, without amendments, 2
Article – State Personnel and Pensions 3
Section 9–504(a) 4
Annotated Code of Maryland 5
(2015 Replacement Volume and 2022 Supplement) 6
BY repealing and reenacting, with amendments, 7
Article – State Personnel and Pensions 8
Section 9–504(b) 9
Annotated Code of Maryland 10
(2015 Replacement Volume and 2022 Supplement) 11
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 12
That the Laws of Maryland read as follows: 13
Article – Correctional Services 14
9–601.1. 15
(e) (1) A pregnant inmate who is deemed to need infirmary care shall be 16
admitted to the infirmary on order of a primary care nurse practitioner, A PHYSICIAN 17
ASSISTANT, or AN obstetrician. 18
Article – Estates and Trusts 19
13–705. 20
(c) (2) Notwithstanding the provisions of paragraph (1) of this subsection, a 21
petition for guardianship of a disabled person shall include signed and verified certificates 22
of competency from the following health care professionals who have examined or evaluated 23
the disabled person: 24
(i) Two licensed physicians; or 25
(ii) 1. One licensed physician; and 26
2. A. One licensed psychologist; 27
B. One licensed certified social worker–clinical; [or] 28
C. One nurse practitioner; OR 29
D. ONE LICENSED PHYSICIAN ASSISTANT . 30
4 SENATE BILL 674
Article – Health – General 1
5–606. 2
(a) (1) Prior to providing, withholding, or withdrawing treatment for which 3
authorization has been obtained or will be sought under this subtitle, the attending 4
physician and a second physician [or a], nurse practitioner, OR PHYSICIAN ASSISTA NT, 5
one of whom shall have examined the patient within 2 hours before making the 6
certification, shall certify in writing that the patient is incapable of making an informed 7
decision regarding the treatment. The certification shall be based on a personal 8
examination of the patient. 9
(2) If a patient is unconscious, or unable to communicate by any means, the 10
certification of a second physician [or a], nurse practitioner, OR PHYSICIAN ASSISTA NT is 11
not required under paragraph (1) of this subsection. 12
(3) When authorization is sought for treatment of a mental illness, the 13
second physician [or the], nurse practitioner, OR PHYSICIAN ASSISTA NT may not be 14
otherwise currently involved in the treatment of the person assessed. 15
(4) The cost of an assessment to certify incapacity under this subsection 16
shall be considered for all purposes a cost of the patient’s treatment. 17
(b) A health care provider may not withhold or withdraw life –sustaining 18
procedures on the basis of an advance directive where no agent has been appointed or on 19
the basis of the authorization of a surrogate, unless: 20
(1) The patient’s attending physician and a second physician [or a], nurse 21
practitioner, OR PHYSICIAN ASSISTA NT have certified that the patient is in a terminal 22
condition or has an end–stage condition; or 23
(2) Two physicians, one of whom is a neurologist, neurosurgeon, or other 24
physician who has special expertise in the evaluation of cognitive functioning, certify that 25
the patient is in a persistent vegetative state. 26
10–601. 27
(a) In this subtitle the following words have the meanings indicated. 28
(G) “PHYSICIAN ASSISTANT ” MEANS AN INDIVIDUAL WHO IS LICENSED 29
UNDER TITLE 15 OF THE HEALTH OCCUPATIONS ARTICLE TO PRACTICE A S A 30
PHYSICIAN ASSI STANT. 31
[(g)] (H) “Psychiatric nurse practitioner” means an individual who is: 32
SENATE BILL 674 5
(1) Licensed as a registered nurse and certified as a nurse practitioner 1
under Title 8 of the Health Occupations Article; and 2
(2) Practicing in the State as a certified r egistered nurse 3
practitioner–psychiatric mental health. 4
[(h)] (I) “Psychologist” means an individual who is licensed under Title 18 of the 5
Health Occupations Article to practice psychology. 6
10–610. 7
(c) A facility may not admit an individual under this section unless: 8
(1) The individual has a mental disorder; 9
(2) The mental disorder is susceptible to care or treatment; 10
(3) The applicant understands the nature of a request for admission; and 11
(4) Assent to the admission has been given: 12
(i) By the admitting physician of the facility; or 13
(ii) For a child or adolescent unit of a State facility, by: 14
1. 1 physician and 1 psychologist; 15
2. 1 PHYSICIAN AND 1 PHYSICIAN ASSISTANT ; 16
[2.] 3. 2 physicians; 17
[3.] 4. 1 physician and 1 psychiatric nurse practitioner; 18
[4.] 5. 1 physician and 1 licensed certified social worker–clinical; 19
or 20
[5.] 6. 1 physician and 1 licensed clinical professional counselor. 21
10–611. 22
(b) A disabled person may apply for voluntary admission of the disabled person 23
if: 24
(1) The disabled person submits a formal, written application that contains 25
the disabled person’s personal information and is on the form required by the 26
Administration; and 27 6 SENATE BILL 674
(2) In accordance with subsections (c) through (e) of this section, either a 1
physician and a psychologist, two physicians, [or] a physician and a psychiatric nurse 2
practitioner, OR A PHYSICIAN AND A PHYSICIAN ASSISTANT certify that: 3
(i) The disabled person has the capacity to execute an application 4
for voluntary admission; and 5
(ii) The disabled person understands both the criteria for voluntary 6
admission set forth under this section and the procedure for requesting discharge from the 7
facility. 8
(c) (1) A certificate for voluntary admission of a disabled person under 9
subsection (b) of this section shall: 10
(i) Be based on the personal examination of the physician, 11
psychologist, [or] psychiatric nurse practitioner, OR PHYSICIAN ASSISTA NT who signs the 12
certificate; and 13
(ii) Be in the form that the Secretary of Health adopts, by rule or 14
regulation. 15
(2) The rules and regulations shall require the form to include an opinion 16
that: 17
(i) The disabled person has a mental disorder; 18
(ii) The mental disorder is susceptible to care or treatment; 19
(iii) The disabled person understands the nature of the request for 20
admission; and 21
(iv) The disabled person is able to give continuous assent to retention 22
by the facility. 23
(e) A certificate may not be used for an admission if the physician, psychologist, 24
[or] psychiatric nurse practitioner, OR PHYSICIAN ASSISTA NT who signed the certificate: 25
(1) Has a financial interest, through ownership or compensation, in a 26
proprietary facility and admission to that proprietary facility is sought for the disabled 27
person whose status is being certified; or 28
(2) Is related, by blood or marriage, to the disabled person or the guardian 29
of the person of the disabled person. 30
10–615. 31
SENATE BILL 674 7
Each application for involuntary admission to a facility or Veterans’ Administration 1
hospital under this part shall: 2
(6) Be accompanied by the certificates of: 3
(i) 1 physician and 1 psychologist; 4
(ii) 2 physicians; 5
(III) 1 PHYSICIAN AND 1 PHYSICIAN ASSISTANT; 6
[(iii)] (IV) 1 physician and 1 psychiatric nurse practitioner; 7
[(iv)] (V) 1 physician and 1 licensed certified social worker–clinical; 8
or 9
[(v)] (VI) 1 physician and 1 licensed clinical professional counselor; 10
and 11
10–616. 12
(a) (1) A certificate for involuntary admission of an individual under this part 13
shall: 14
(i) Be based on the personal examination of the physician, 15
psychologist, psychiatric nurse practitioner, PHYSICIAN ASSISTANT , licensed certified 16
social worker–clinical, or licensed clinical professional counselor who signs the certificate; 17
and 18
(ii) Be in the form that the Secretary adopts, by rule or regulation. 19
(c) A certificate may not be used for an admission if the physician, psychologist, 20
psychiatric nurse practitioner, PHYSICIAN ASSISTANT , licensed certified social 21
worker–clinical, or licensed clinical professional counselor who signed the certificate: 22
(1) Has a financial interest, through ownership or compensation, in a 23
proprietary facility and admission to that proprietary facility is sought for the individual 24
whose status is being certified; or 25
(2) Is related, by blood or marriage, to the individual or to the applicant. 26
10–619. 27
Within 12 hours of notification by a physician, licensed psychologist, psychiatric 28
nurse practitioner, PHYSICIAN ASSISTANT , licensed certified social worker–clinical, or 29
licensed clinical professional counselor who has certified an individual under this part, a 30 8 SENATE BILL 674
facility operated by the Maryland Department of Health shall receive and evaluate the 1
individual certified for involuntary admission if: 2
(1) The individual’s involuntary admission is not limited by § 10–617 of 3
this subtitle; 4
(2) An application for admission has been completed; 5
(3) A certifying physician, psychologist, psychiatric nurse practitioner, 6
PHYSICIAN ASSISTANT , licensed certified social worker–clinical, or licensed clinical 7
professional counselor is unable to place the individual in a facility not operated by the 8
Department; and 9
(4) The Department is unable to provide for the placement of the person 10
other than in a facility operated by the Department. 11
10–620. 12
(a) In Part IV of this subtitle the following words have the meanings indicated. 13
(f) (1) “Mental disorder” means the behavioral or other symptoms that 14
indicate: 15
(i) To a lay petitioner who is submitting an emergency petition, a 16
clear disturbance in the mental functioning of another individual; and 17
(ii) To the following health professionals doing an examination, at 18
least one mental disorder that is described in the version of the American Psychiatric 19
Association’s “Diagnostic and Statistical Manual – Mental Disorders” that is current at the 20
time of the examination: 21
1. Physician; 22
2. Psychologist; 23
3. Clinical social worker; 24
4. Licensed clinical professional counselor; 25
5. Clinical nurse specialist in psychiatric and mental health 26
nursing (APRN/PMH); 27
6. Psychiatric nurse practitioner (CRNP–PMH); 28
7. PHYSICIAN ASSISTANT ; or 29
[7.] 8. Licensed clinical marriage and family therapist. 30 SENATE BILL 674 9
(2) “Mental disorder” does not include intellectual disability. 1
10–622. 2
(b) (1) The petition for emergency evaluation of an individual may be made by: 3
(i) A physician, psychologist, PHYSICIAN ASSISTANT , clinical 4
social worker, licensed clinical professional counselor, clinical nurse specialist in 5
psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical 6
marriage and family therapist, or health officer or designee of a health officer who has 7
examined the individual; 8
(ii) A peace officer who personally has observed the individual or the 9
individual’s behavior; or 10
(iii) Any other interested person. 11
(2) An individual who makes a petition for emergency evaluation under 12
paragraph (1)(i) or (ii) of this subsection may base the petition on: 13
(i) The examination or observation; or 14
(ii) Other information obtained that is pertinent to the factors giving 15
rise to the petition. 16
(d) (1) A petitioner who is a physician, psychologist, PHYSICIAN ASSISTANT , 17
clinical social worker, licensed clinical professional counselor, clinical nurse specialist in 18
psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical 19
marriage and family therapist, health officer, or designee of a health officer shall give the 20
petition to a peace officer. 21
(2) The peace officer shall explain to the petitioner: 22
(i) The serious nature of the petition; and 23
(ii) The meaning and content of the petition. 24
10–623. 25
(a) If the petitioner under Part IV of this subtitle is not a physician, psychologist, 26
PHYSICIAN ASSISTANT , clinical social worker, licensed clinical professional counselor, 27
clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse 28
practitioner, licensed clinical marriage and family therapist, health officer or designee of a 29
health officer, or peace officer, the petitioner shall present the petition to the court for 30
immediate review. 31
10 SENATE BILL 674
10–624. 1
(a) (1) A peace officer shall take an emergency evaluee to the nearest 2
emergency facility if the peace officer has a petition under Part IV of this subtitle that: 3
(i) Has been endorsed by a court within the last 5 days; or 4
(ii) Is signed and submitted by a physician, psychologist, 5
PHYSICIAN ASSISTANT , clinical social worker, licensed clinical professional counselor, 6
clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse 7
practitioner, licensed clinical marriage and family therapist, health officer or designee of a 8
health officer, or peace officer. 9
10–628. 10
(a) (1) If an emergency evaluee cannot pay or does not have insurance that 11
covers the charges for emergency services, an initial consultant examination by a physician, 12
PHYSICIAN ASSISTANT , or nurse practitioner, and transportation to an emergency facility 13
and, for an involuntary admission of the emergency evaluee, to the admitting facility, the 14
Department shall pay the appropriate party the actual cost or a reasonable rate for this 15
service, whichever is lower, except that hospitals shall be paid at rates approved by the 16
Health Services Cost Review Commission. 17
13–701. 18
The Emergency and Allergy Treatment Program is a program in the Department for 19
the purpose of providing a means of authorizing certain individuals to administer 20
life–saving treatment to individuals who have severe adverse reactions to allergens or 21
insect stings when physician, PHYSICIAN ASSISTANT , registered nurse practitioner, or 22
emergency medical services are not immediately available in a youth camp. 23
13–705. 24
(a) (1) A registered nurse practitioner, PHYSICIAN ASSISTANT , or a physician 25
licensed to practice [medicine] in the State may prescribe auto–injectable epinephrine in 26
the name of a certificate holder. 27
(2) A registered nurse practitioner, a pharmacist [licensed to practice 28
pharmacy in the State], A PHYSICIAN ASSISTAN T, or a physician LICENSED TO 29
PRACTICE IN THE STATE may dispense auto–injectable epinephrine under a prescription 30
issued to a certificate holder. 31
(b) A certificate holder may: 32
(1) On presentment of a certificate, receive from any registered nurse 33
practitioner, PHYSICIAN ASSISTANT , or any physician licensed to practice [medicine] in 34 SENATE BILL 674 11
the State a prescription for auto–injectable epinephrine and the necessary paraphernalia 1
for the administration of auto–injectable epinephrine; and 2
(2) Possess and store prescribed auto–injectable epinephrine and the 3
necessary paraphernalia for the administration of auto–injectable epinephrine. 4
(c) In an emergency situation when registered nurse practitioner, physician, 5
PHYSICIAN ASSISTANT , or emergency medical services are not immediately available, a 6
certificate holder or agent may administer auto–injectable epinephrine to an individual 7
who is experiencing or believed in good faith by the certificate holder or agent to be 8
experiencing anaphylaxis. 9
13–707. 10
(b) (1) A cause of action may not arise against any physician OR PHYSICIAN 11
ASSISTANT for any act or omission when the physician OR PHYSICIAN ASSISTA NT in good 12
faith prescribes or dispenses auto–injectable epinephrine and the necessary paraphernalia 13
for the administration of auto–injectable epinephrine to a person certified by the 14
Department under this subtitle. 15
(c) This section does not affect, and may not be construed as affecting, any 16
immunities from civil liability or defenses established by any other provision of the Code or 17
by common law to which a volunteer, registered nurse practitioner, physician, PHYSICIAN 18
ASSISTANT, or pharmacist may be entitled. 19
18–214. 20
(b) There is a Statewide Advisory Commission on Immunizations. 21
(d) The following members are subject to term limits: 22
(11) One physician member of the American College of Physicians – Internal 23
Medicine Society of Maryland; [and] 24
(12) ONE PHYSICIAN ASSISTA NT MEMBER OF THE MARYLAND 25
ACADEMY OF PHYSICIAN ASSISTANTS; AND 26
[(12)] (13) Up to three additional members selected by the Secretary. 27
19–108.4. 28
(a) In this section, “primary care” means health care provided in the following 29
fields’ outpatient settings: 30
(1) Family medicine; 31
12 SENATE BILL 674
(2) General pediatrics; 1
(3) Primary care internal medicine; 2
(4) Primary care obstetrics and gynecology; 3
(5) Primary care nurse practitioner services; [and] 4
(6) PRIMARY CARE PHYSICIA N ASSISTANT SERVICES ; AND 5
[(6)] (7) Primary care midwifery. 6
(b) On or before December 1 each year, beginning in 2024, the Commission shall 7
provide a report to the Governor and, in accordance with § 2–1257 of the State Government 8
Article, the General Assembly that includes: 9
(1) An analysis of primary care investment over the immediately preceding 10
year, including data stratified by zip code and county, in relation to total health care 11
spending over the previous year; 12
(2) Ways to improve the quality of and access to primary care services, with 13
special attention to increasing health care equity, reducing health care disparities, and 14
avoiding increased costs to patients and the health care system; and 15
(3) Any findings and recommendations of the Commission. 16
(c) (1) The Commission shall form a workgroup to develop the report required 17
under subsection (b) of this section, including by interpreting the results of the required 18
analysis and making the recommendations. 19
(2) The workgroup required under this subsection shall include 20
representatives of: 21
(i) The Maryland Primary Care Program; 22
(ii) The Health Services Review Commission; 23
(iii) The Maryland Insurance Administration; 24
(iv) The Health Care Financing Division of the Maryland 25
Department of Health; 26
(v) The primary care community, including from the Maryland 27
Academy of Family Physicians, the Maryland Chapter of the America n Academy of 28
Pediatrics, the Maryland Section of the American College of Obstetricians and 29
Gynecologists, the Maryland Nurses Association, THE MARYLAND ACADEMY OF 30 SENATE BILL 674 13
PHYSICIAN ASSISTANTS, the Maryland Affiliate – American College of Nurse Midwives, 1
the Maryland Community Health System, and the MidAtlantic Association of Community 2
Health Centers; 3
(vi) Payors of primary care services, including carriers and managed 4
care organizations; 5
(vii) Health services researchers with expertise in primary care; and 6
(viii) Other interested stakeholders. 7
19–705.1. 8
(a) The Secretary shall adopt regulations that set out reasonable standards of 9
quality of care that a health maintenance organization shall provide to its members. 10
(b) (1) The standards of quality of care shall include: 11
(vi) A requirement that each member shall have an opportunity to 12
select a primary physician, A PHYSICIAN ASSISTANT , or a certified nurse practitioner from 13
among those available to the health maintenance organization; and 14
(2) This subsection may not be construed to require that a health 15
maintenance organization include certified nurse practitioners OR PHYSICIAN 16
ASSISTANTS on the health maintenance organization’s provider panel as primary care 17
providers. 18
19–2001. 19
(a) (1) In this subtitle the following words have the meanings indicated. 20
(4) (i) Except as provided in subparagraph (ii) of this paragraph, 21
“health care practitioner” means any individual licensed or certified under the Health 22
Occupations Article who: 23
1. Is a licensed practical nurse, registered nurse, or certified 24
nursing assistant; or 25
2. Practices in an allied health care field, as defined by the 26
Office in regulation. 27
(ii) “Health care practitioner” does not include: 28
1. An acupuncturist; 29
2. A dentist; 30
14 SENATE BILL 674
3. A nurse anesthetist; 1
4. A nurse midwife; 2
5. A nurse practitioner; 3
6. A pharmacist; 4
7. A physician; [or] 5
8. A PHYSICIAN ASSISTANT ; OR 6
[8.] 9. A podiatrist. 7
(b) (1) A health care staff agency shall be licensed by the Office before 8
referring health care practitioners to a health care facility to render temporary health care 9
services at a health care facility in this State. 10
Article – Health Occupations 11
4–308. 12
(k) (4) A facility in which a dental hygienist is authorized to practice under the 13
general supervision of a licensed dentist in accordance with this subsection shall ensure 14
that: 15
(vi) A dental hygienist consults with the supervising dentist or the 16
patient’s dentist and the treating physician, registered nurse practitioner, certified nurse 17
midwife, LICENSED P HYSICIAN ASSISTANT , or licensed certified midwife before 18
proceeding with treatment if there is a change in the patient’s medical condition; 19
(m) (1) (i) In this subsection the following words have the meanings 20
indicated. 21
(iii) “Clinical office” means an office of a licensed physician, 22
LICENSED PHYSICIAN A SSISTANT, CERTIFIED registered nurse practitioner, certified 23
nurse midwife, or licensed certified midwife who provides prenatal, postpartum, or primary 24
care and in which the supervising dentist and dental hygienist communicate with the 25
licensed physician, LICENSED PHYSICIAN A SSISTANT, certified registered nurse 26
practitioner, certified nurse midwife, or licensed certified midwife in providing dental 27
hygiene services to a patient. 28
(5) A dental hygienist practicing under the general supervision of a 29
licensed dentist in a facility and performing an authorized dental hygiene service for a 30
patient’s initial appointment shall: 31
SENATE BILL 674 15
(ii) Consult with the supervising dentist and the treating physician, 1
LICENSED PHYSICIAN A SSISTANT, CERTIFIED registered nurse practitioner, certified 2
nurse midwife, or licensed certified midwife before proceeding with treatment if there is a 3
change in or concerns about a patient’s medical condition; 4
12–102. 5
(d) This title does not prohibit: 6
(2) A licensed dentist, licensed physician, LICENSED PHYSICIAN 7
ASSISTANT, or licensed podiatrist from personally dispensing a drug or device sample to a 8
patient of the licensed dentist, licensed physician, LICENSED PHYSICIAN A SSISTANT, or 9
licensed podiatrist if: 10
(i) The sample complies with the labeling requirements of § 12–505 11
of this title; 12
(ii) No charge is made for the sample; and 13
(iii) The authorized prescriber enters an appropriate record in the 14
patient’s chart. 15
(e) (1) This title does not prohibit: 16
(i) A dentist, physician, LICENSED PHYSICIAN A SSISTANT, or 17
podiatrist from administering a prescription drug or device in the course of treating a 18
patient; 19
(f) (1) This title does not prohibit a dentist, physician, LICENSED PHYSICIAN 20
ASSISTANT, or podiatrist from personally dispensing a starter dosage of a prescription drug 21
or device to a patient of the dentist, physician, LICENSED PHYSICIAN A SSISTANT, or 22
podiatrist, provided that: 23
(i) The starter dosage complies with the labeling requirements of § 24
12–505 of this title; 25
(ii) No charge is made for the starter dosage; and 26
(iii) The dentist, physician, LICENSED PHYS ICIAN ASSISTANT, or 27
podiatrist enters an appropriate record on the patient’s chart. 28
(g) This title does not prohibit a dentist, physician, LICENSED PHYSICIAN 29
ASSISTANT, or podiatrist from dispensing a prescription drug or device in the course of 30
treating a patient: 31
(1) At a medical facility or clinic that is operated on a nonprofit basis; 32 16 SENATE BILL 674
(2) At a health center that operates on a campus of an institution of higher 1
education; or 2
(3) At a public health facility, a medical facility under contract with a State 3
or local health department, or a facility funded with public funds. 4
Article – Human Services 5
7–404. 6
(a) (1) The Department shall ensure that at any given time at least 50% of the 7
eligible individuals receiving financial assistance under the Program are: 8
(i) gainfully employed; 9
(ii) actively seeking employment; or 10
(iii) attending an institution of postsecondary or higher education, as 11
defined in § 10–101 of the Education Article. 12
(2) The remainder of the eligible individuals receiving financial assistance 13
under the Program shall be individuals who: 14
(i) reside in a nursing facility or similar institution licensed to 15
provide chronic or intermediate care and who will be deinstitutionalized as a result of the 16
Program; or 17
(ii) are certified by an attending physician, PHYSICIAN ASSISTANT , 18
or certified nurse practitioner as being at risk of placement in a nursing facility or similar 19
institution licensed to provide chronic or intermediate care if attendant care services are 20
not received in the community. 21
Article – Public Safety 22
5–601. 23
(a) In this subtitle the following words have the meanings indicated. 24
(e) (1) “Petitioner” means an individual who files a petition for an extreme risk 25
protective order under this subtitle. 26
(2) “Petitioner” includes: 27
(i) a physician, PHYSICIAN ASSISTANT , psychologist, clinical social 28
worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and 29 SENATE BILL 674 17
mental health nursing, psychiatric nurse practitioner, licensed clinical marriage or family 1
therapist, or health officer or designee of a health officer who has examined the individual; 2
(ii) a law enforcement officer; 3
(iii) the spouse of the respondent; 4
(iv) a cohabitant of the respondent; 5
(v) a person related to the respondent by blood, marriage, or 6
adoption; 7
(vi) an individual who has a child in common with the respondent; 8
(vii) a current dating or intimate partner of the respondent; and 9
(viii) a current or former legal guardian of the respondent. 10
Article – State Personnel and Pensions 11
9–504. 12
(a) An employee who uses sick leave for 5 or more consecutive workdays for 13
personal illness or disability or the illness or disability of a member of the employee’s 14
immediate family may not receive payment under this subtitle unless the employee gives 15
the employee’s immediate supervisor an original certificate of illness or disability. 16
(b) The certificate required under subsection (a) of this section shall be signed by 17
one of the following: 18
(1) a medical doctor who is authorized to practice medicine or surgery by 19
the state in which the doctor practices; 20
(2) if authorized to practice in a state and performing within the scope of 21
that authority: 22
(i) a chiropractor; 23
(ii) a clinical psychologist; 24
(iii) a dentist; 25
(iv) a licensed certified social worker – clinical; 26
(v) a nurse midwife; 27
(vi) a nurse practitioner; 28 18 SENATE BILL 674
(vii) an oral surgeon; 1
(viii) an optometrist; 2
(ix) a physical therapist; [or] 3
(X) A PHYSICIAN ASSI STANT; OR 4
[(x)] (XI) a podiatrist; 5
(3) an accredited Christian Science practitioner; or 6
(4) a health care provider as defined by the federal Family Medical Leave 7
Act. 8
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 9
October 1, 2023. 10