MD
Maryland Senate Bill SB772

Maryland 2023 Regular Session

Maryland Senate Bill SB772 Compare Versions

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1- WES MOORE, Governor Ch. 367
21
3-– 1 –
4-Chapter 367
5-(Senate Bill 772)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G 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+ Italics indicate opposite chamber/conference committee amendments.
9+ *sb0772*
810
9-State Board of Nursing – Peer Advisory Committees, Scopes of Practice, and
10-Licensure Requirements
11+SENATE BILL 772
12+J2 (3lr1577)
13+ENROLLED BILL
14+— Finance/Health and Government Operations —
15+Introduced by Senator Lam
1116
12-FOR the purpose of authorizing the State Board of Nursing to appoint peer advisory
13-committees to provide advice related to midwifery; authorizing licensed nurses
14-certified as nurse–midwives and licensed certified midwives to personally prepare
15-and dispense a starter dosage of certain drugs under certain circumstances;
16-authorizing licensed nurses certified as nurse–midwives and licensed certified
17-midwives to delegate certain tasks to certified medication technicians and certified
18-nursing assistants under certain circumstances; altering the exceptions to the
19-certified midwifery licensure requirement and the qualifications required for a
20-license; requiring the Maryland Department of Health, in consultation with
21-stakeholders, to develop recommendations to expand access to birthing services in
22-birthing centers; and generally relating to health care practitioners licensed by the
23-State Board of Nursing.
17+Read and Examined by Proofreaders:
2418
25-BY repealing and reenacting, without amendments,
26- Article – Health Occupations
27- Section 8–6A–01(a) and 8–6D–01(a)
28- Annotated Code of Maryland
29- (2021 Replacement Volume and 2022 Supplement)
19+_______________________________________________
20+Proofreader.
21+_______________________________________________
22+Proofreader.
3023
31-BY repealing and reenacting, with amendments,
32- Article – Health Occupations
33-Section 8–503(a), 8–508(a) and (b), 8–601, 8–6A–01(j) and (l), 8–6A–02, 8–6D–01(h),
34-8–6D–02, 8–6D–03, and 12–102(a), (c)(2)(iv) and (v), (e), (f), and (g)
35- Annotated Code of Maryland
36- (2021 Replacement Volume and 2022 Supplement)
24+Sealed with the Great Seal and presented to the Governor, for his approval this
3725
38-BY repealing and reenacting, without amendments,
39- Article – Health Occupations
40- Section 8–6A–01(a) and 8–6D–01(a)
41- Annotated Code of Maryland
42- (2021 Replacement Volume and 2022 Supplement)
26+_______ day of _______________ at _________________ _______ o’clock, ________M.
4327
44-BY adding to
45- Article – Health Occupations
46-Section 12–102(c)(2)(vi)
47- Annotated Code of Maryland
48- (2021 Replacement Volume and 2022 Supplement)
49- Ch. 367 2023 LAWS OF MARYLAND
28+______________________________________________
29+President.
5030
51-– 2 –
52- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
53-That the Laws of Maryland read as follows:
31+CHAPTER ______
5432
55-Article – Health Occupations
33+AN ACT concerning 1
5634
57-8–503.
35+State Board of Nursing – Peer Advisory Committees, Scopes of Practice, and 2
36+Licensure Requirements 3
5837
59- (a) The Board may appoint peer advisory committees to provide the Board with
60-expert advice related to the practice of nursing by advance practice nurses AND THE
61-PRACTICE OF MIDWIFER Y BY LICENSED CERTIF IED MIDWIVES.
38+FOR the purpose of authorizing the State Board of Nursing to appoint peer advisory 4
39+committees to provide advice related to midwifery; authorizing licensed nurses 5
40+certified as nurse–midwives and licensed certified midwives to personally prepare 6
41+and dispense a starter dosage of certain drugs under certain circumstances; 7
42+authorizing licensed nurses certified as nurse–midwives and licensed certified 8
43+midwives to delegate certain tasks to certified medication technicians and certified 9
44+nursing assistants under certain circumstances; altering the exceptions to the 10
45+certified midwifery licensure requirement and the qualifications required for a 11
46+license; requiring the Maryland Department of Health, in consultation with 12
47+stakeholders, to develop recommendations to expand access to birthing services in 13
48+birthing centers; and generally relating to health care practitioners licensed by the 14
49+State Board of Nursing. 15 2 SENATE BILL 772
6250
63-8–508.
6451
65- (a) (1) In this section the following words have the meanings indicated.
6652
67- (2) “MIDWIFE” MEANS A LICENSED REGISTERED NURSE CERTIFIED
68-AS A NURSE–MIDWIFE OR A LICENSED REGISTERED LICENSED CERTIFIED MIDWIFE .
53+BY repealing and reenacting, without amendments, 1
54+ Article – Health Occupations 2
55+ Section 8–6A–01(a) and 8–6D–01(a) 3
56+ Annotated Code of Maryland 4
57+ (2021 Replacement Volume and 2022 Supplement) 5
6958
70- [(2)] (3) “Nurse practitioner” means a registered nurse who is:
59+BY repealing and reenacting, with amendments, 6
60+ Article – Health Occupations 7
61+Section 8–503(a), 8–508(a) and (b), 8–601, 8–6A–01(j) and (l), 8–6A–02, 8–6D–01(h), 8
62+8–6D–02, 8–6D–03, and 12–102(a), (c)(2)(iv) and (v), (e), (f), and (g) 9
63+ Annotated Code of Maryland 10
64+ (2021 Replacement Volume and 2022 Supplement) 11
7165
72- (i) Certified as a nurse practitioner; and
66+BY repealing and reenacting, without amendments, 12
67+ Article – Health Occupations 13
68+ Section 8–6A–01(a) and 8–6D–01(a) 14
69+ Annotated Code of Maryland 15
70+ (2021 Replacement Volume and 2022 Supplement) 16
7371
74- (ii) Authorized to prescribe drugs under regulations adopted by the
75-Board.
72+BY adding to 17
73+ Article – Health Occupations 18
74+Section 12–102(c)(2)(vi) 19
75+ Annotated Code of Maryland 20
76+ (2021 Replacement Volume and 2022 Supplement) 21
7677
77- [(3) “Starter dosage” means an amount of drug sufficient to begin therapy:
78+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22
79+That the Laws of Maryland read as follows: 23
7880
79- (i) Of short duration of 72 hours or less; or
81+Article – Health Occupations 24
8082
81- (ii) Prior to obtaining a larger quantity of the drug to complete
82-therapy.]
83+8–503. 25
8384
84- (4) “Personally prepare and dispense” means that a nurse practitioner:
85+ (a) The Board may appoint peer advisory committees to provide the Board with 26
86+expert advice related to the practice of nursing by advance practice nurses AND THE 27
87+PRACTICE OF MIDWIFER Y BY LICENSED CERTIF IED MIDWIVES. 28
8588
86- (i) Is physically present on the premises where the prescription is
87-filled; and
89+8–508. 29
8890
89- (ii) Performs a final check of the prescription before it is provided to
90-the patient.
91+ (a) (1) In this section the following words have the meanings indicated. 30
9192
92- (5) “STARTER DOSAGE ” MEANS AN AMOUNT OF D RUG SUFFICIENT TO
93-BEGIN THERAPY :
93+ (2) “MIDWIFE” MEANS A LICENSED REGISTERED NURSE CERTIFIED 31
94+AS A NURSE–MIDWIFE OR A LICENSED REGISTERED LICENSED CERTIFIED MIDWIFE . 32
9495
95- (I) OF SHORT DURATION OF 72 HOURS OR LESS ; OR
96- WES MOORE, Governor Ch. 367
96+ [(2)] (3) “Nurse practitioner” means a registered nurse who is: 33
97+ SENATE BILL 772 3
9798
98-– 3 –
99- (II) PRIOR TO OBTAINING A LARGER QUANTITY OF T HE DRUG TO
100-COMPLETE THER APY.
10199
102- (b) A nurse practitioner OR MIDWIFE may personally prepare and dispense a
103-starter dosage of any drug the nurse practitioner OR MIDWIFE is authorized to prescribe
104-to a patient of the nurse practitioner OR MIDWIFE if:
100+ (i) Certified as a nurse practitioner; and 1
105101
106- (1) The starter dosage complies with the labeling requirements of § 12–505
107-of this article;
102+ (ii) Authorized to prescribe drugs under regulations adopted by the 2
103+Board. 3
108104
109- (2) No charge is made for the starter dosage; and
105+ [(3) “Starter dosage” means an amount of drug sufficient to begin therapy: 4
110106
111- (3) The nurse practitioner OR MIDWIFE enters an appropriate record in
112-the patient’s medical record.
107+ (i) Of short duration of 72 hours or less; or 5
113108
114-8–601.
109+ (ii) Prior to obtaining a larger quantity of the drug to complete 6
110+therapy.] 7
115111
116- In this subtitle:
112+ (4) “Personally prepare and dispense” means that a nurse practitioner: 8
117113
118- (1) “Practice nurse midwifery” means the management and care of
119-essentially normal newborns and of essentially normal women antepartally, intrapartally
120-and postpartally.
114+ (i) Is physically present on the premises where the prescription is 9
115+filled; and 10
121116
122- (2) “Practice nurse midwifery” includes:
117+ (ii) Performs a final check of the prescription before it is provided to 11
118+the patient. 12
123119
124- (i) Family planning and well woman reproductive care;
120+ (5) “STARTER DOSAGE ” MEANS AN AMOUNT OF D RUG SUFFICIENT TO 13
121+BEGIN THERAPY: 14
125122
126- (ii) The prescribing of substances commonly used in the practice of
127-nurse midwifery;
123+ (I) OF SHORT DURATION OF 72 HOURS OR LESS ; OR 15
128124
129- (iii) The prescribing of controlled substances on Schedules II, III, IV,
130-and V commonly used in the practice of nurse midwifery; and
125+ (II) PRIOR TO OBTAINING A LARGER QUANTITY OF T HE DRUG TO 16
126+COMPLETE THERAPY . 17
131127
132- (iv) The dispensing of the substances prescribed in accordance with
133-the provisions of [subparagraphs] ITEMS (ii) and (iii) of this paragraph in the course of
134-treating a patient [at]:
128+ (b) A nurse practitioner OR MIDWIFE may personally prepare and dispense a 18
129+starter dosage of any drug the nurse practitioner OR MIDWIFE is authorized to prescribe 19
130+to a patient of the nurse practitioner OR MIDWIFE if: 20
135131
136- 1. [A] AT A medical facility or clinic that is operated on a
137-nonprofit basis;
132+ (1) The starter dosage complies with the labeling requirements of § 12–505 21
133+of this article; 22
138134
139- 2. [A] AT A health center that operates on a campus of an
140-institution of higher education; [or]
135+ (2) No charge is made for the starter dosage; and 23
141136
142- 3. [A] AT A public health facility, a medical facility under
143-contract with a State or local health department, or a facility funded with public funds; OR Ch. 367 2023 LAWS OF MARYLAND
137+ (3) The nurse practitioner OR MIDWIFE enters an appropriate record in 24
138+the patient’s medical record. 25
144139
145-– 4 –
140+8–601. 26
146141
147- 4. WITH A STARTER DOSAGE OF A DRUG AS AUTHORI ZED
148-UNDER § 8–508 OF THIS TITLE.
142+ In this subtitle: 27
143+ 4 SENATE BILL 772
149144
150-8–6A–01.
151145
152- (a) In this subtitle the following words have the meanings indicated.
146+ (1) “Practice nurse midwifery” means the management and care of 1
147+essentially normal newborns and of essentially normal women antepartally, intrapartally 2
148+and postpartally. 3
153149
154- (j) “Certified medication technician” means an individual who:
150+ (2) “Practice nurse midwifery” includes: 4
155151
156- (1) Has completed a Board–approved medication technician training
157-program; [and]
152+ (i) Family planning and well woman reproductive care; 5
158153
159- (2) Is certified by the Board as a medication technician; AND
154+ (ii) The prescribing of substances commonly used in the practice of 6
155+nurse midwifery; 7
160156
161- (3) PERFORMS MEDICATION T ECHNICIAN TASKS SUBJECT TO
162-REGULATIONS ADOPTED BY THE BOARD, ROUTINELY PERFORMS :
157+ (iii) The prescribing of controlled substances on Schedules II, III, IV, 8
158+and V commonly used in the practice of nurse midwifery; and 9
163159
164- (I) NURSING TASKS RELATED TO THE ADMINISTRATION OF
165-MEDICATION, DELEGATED BY A REGIS TERED NURSE , LICENSED PRACTICAL N URSE,
166-OR LICENSED CERTIFIED MIDWIFE ADVANCED PRACTICE NU RSE; OR
160+ (iv) The dispensing of the substances prescribed in accordance with 10
161+the provisions of [subparagraphs] ITEMS (ii) and (iii) of this paragraph in the course of 11
162+treating a patient [at]: 12
167163
168- (II) TECHNICAL TASKS RELAT ED TO THE ADMINISTRA TION OF
169-MEDICATION DELEGATED BY A LICENSED CERTIFIED M IDWIFE.
164+ 1. [A] AT A medical facility or clinic that is operated on a 13
165+nonprofit basis; 14
170166
171- (l) “Certified nursing assistant”:
167+ 2. [A] AT A health center that operates on a campus of an 15
168+institution of higher education; [or] 16
172169
173- (1) Means an individual regardless of title who, FOR COMPENSATION
174-AND SUBJECT TO REGUL ATIONS ADOPTED BY TH E BOARD, routinely performs
175-[nursing]:
170+ 3. [A] AT A public health facility, a medical facility under 17
171+contract with a State or local health department, or a facility funded with public funds; OR 18
176172
177- (I) NURSING tasks delegated by a registered nurse or, licensed
178-practical nurse, OR ADVANCED PRACTICE REGISTERED NURSE [for compensation]; OR
173+ 4. WITH A STARTER DOSAGE OF A DRUG AS AUTHORI ZED 19
174+UNDER § 8–508 OF THIS TITLE. 20
179175
180- (II) TECHNICAL TASKS DELEG ATED BY A LICENSED C ERTIFIED
181-MIDWIFE; and
176+8–6A–01. 21
182177
183- (2) Does not include a certified dialysis technician or a certified medication
184-technician.
178+ (a) In this subtitle the following words have the meanings indicated. 22
185179
186-8–6A–02.
180+ (j) “Certified medication technician” means an individual who: 23
187181
188- (a) Subject to subsection [(e)] (F) of this section and except as otherwise provided
189-in this subtitle, an individual shall be certified by the Board to practice as a nursing WES MOORE, Governor Ch. 367
182+ (1) Has completed a Board–approved medication technician training 24
183+program; [and] 25
190184
191-– 5 –
192-assistant, dialysis technician, or medication technician before the individual may practice
193-as a nursing assistant, dialysis technician, or medication technician in the State.
185+ (2) Is certified by the Board as a medication technician; AND 26
194186
195- (b) This subtitle does not apply to an individual who:
187+ (3) PERFORMS MEDICATION T ECHNICIAN TASKS SUBJECT TO 27
188+REGULATIONS ADOPTED BY THE BOARD, ROUTINELY PERFORMS : 28
189+ SENATE BILL 772 5
196190
197- (1) Practices a health occupation that the individual is authorized to
198-practice under this article;
199191
200- (2) Provides for the gratuitous care of friends, domestic partners, or family
201-members;
192+ (I) NURSING TASKS RELATED TO THE ADMINISTRATIO N OF 1
193+MEDICATION, DELEGATED BY A REGIS TERED NURSE , LICENSED PRACTICAL N URSE, 2
194+OR LICENSED CERTIFIED MIDWIFE ADVANCED PRACTICE NU RSE; OR 3
202195
203- (3) Performs nursing assistant tasks while a nursing student enrolled in
204-an accredited nursing program and practicing under the direct supervision of qualified
205-faculty or preceptors;
196+ (II) TECHNICAL TASKS RELAT ED TO THE ADMINISTRA TION OF 4
197+MEDICATION DELEGATED BY A LICENSED CERTIF IED MIDWIFE. 5
206198
207- (4) Performs nursing assistant tasks as a student while:
199+ (l) “Certified nursing assistant”: 6
208200
209- (i) Enrolled in a Board–approved nursing assistant training
210-program; and
201+ (1) Means an individual regardless of title who, FOR COMP ENSATION 7
202+AND SUBJECT TO REGUL ATIONS ADOPTED BY TH E BOARD, routinely performs 8
203+[nursing]: 9
211204
212- (ii) Practicing under the direct supervision of qualified faculty or
213-preceptors;
205+ (I) NURSING tasks delegated by a registered nurse or, licensed 10
206+practical nurse, OR ADVANCED PRACTICE REGISTERED NURSE [for compensation]; OR 11
214207
215- (5) Performs medication technician tasks as a student while practicing
216-under the direct supervision of qualified faculty;
208+ (II) TECHNICAL TASKS DELEGATED BY A LICENSED CERTIFIED 12
209+MIDWIFE; and 13
217210
218- (6) Performs dialysis technician tasks as a student while under the direct
219-supervision of qualified faculty; or
211+ (2) Does not include a certified dialysis technician or a certified medication 14
212+technician. 15
220213
221- (7) Works as a principal or school secretary, does not administer
222-medication as a routine part of the position, and has completed training by the delegating
223-nurse for the occasion where the individual may need to administer medication in the
224-absence of the nurse or medication technician.
214+8–6A–02. 16
225215
226- (c) Nothing in this section shall preclude a registered nurse or licensed practical
227-nurse from delegating a nursing or other technical task to an unlicensed individual
228-provided that acceptance of delegated nursing or other technical tasks does not become a
229-routine part of the unlicensed individual’s job duties.
216+ (a) Subject to subsection [(e)] (F) of this section and except as otherwise provided 17
217+in this subtitle, an individual shall be certified by the Board to practice as a nursing 18
218+assistant, dialysis technician, or medication technician before the individual may practice 19
219+as a nursing assistant, dialysis technician, or medication technician in the State. 20
230220
231- (d) (1) Subject to regulations adopted by the Board under paragraph (2) of this
232-subsection, this section does not preclude an advanced practice registered nurse from
233-delegating a nursing or other technical task to an assistant if:
221+ (b) This subtitle does not apply to an individual who: 21
234222
235- (i) The assistant performs only tasks that the assistant is trained to
236-perform; and
237- Ch. 367 2023 LAWS OF MARYLAND
223+ (1) Practices a health occupation that the individual is authorized to 22
224+practice under this article; 23
238225
239-– 6 –
240- (ii) The delegating advanced practice registered nurse provides:
226+ (2) Provides for the gratuitous care of friends, domestic partners, or family 24
227+members; 25
241228
242- 1. Instruction to the assistant on the delegated task; and
229+ (3) Performs nursing assistant tasks while a nursing student enrolled in 26
230+an accredited nursing program and practicing under the direct supervision of qualified 27
231+faculty or preceptors; 28
243232
244- 2. On–site supervision of the assistant performing the
245-delegated task.
233+ (4) Performs nursing assistant tasks as a student while: 29
246234
247- (2) The Board shall adopt regulations to carry out this subsection,
248-including regulations that:
235+ (i) Enrolled in a Board–approved nursing assistant training 30
236+program; and 31
237+ 6 SENATE BILL 772
249238
250- (i) Provide for the manner in which an advanced practice registered
251-nurse delegates a nursing or other technical task to an assistant;
252239
253- (ii) Establish limitations on the authority of an advanced practice
254-registered nurse to delegate nursing or other technical tasks to an assistant; and
240+ (ii) Practicing under the direct supervision of qualified faculty or 1
241+preceptors; 2
255242
256- (iii) Otherwise clarify the scope of this subsection.
243+ (5) Performs medication technician tasks as a student while practicing 3
244+under the direct supervision of qualified faculty; 4
257245
258- (E) (1) SUBJECT TO REGULATION S ADOPTED BY THE BOARD UNDER
259-PARAGRAPH (2) OF THIS SUBSECTION , THIS SECTION DOES NO T PRECLUDE A
260-LICENSED CERTIFIED M IDWIFE FROM DELEGATI NG A TECHNICAL TASK TO AN
261-ASSISTANT IF:
246+ (6) Performs dialysis technician tasks as a student while under the direct 5
247+supervision of qualified faculty; or 6
262248
263- (I) THE ASSISTANT PERFORM S ONLY TASKS THAT TH E
264-ASSISTANT IS TRAINED TO PERFORM ; AND
249+ (7) Works as a principal or school secretary, does not administe r 7
250+medication as a routine part of the position, and has completed training by the delegating 8
251+nurse for the occasion where the individual may need to administer medication in the 9
252+absence of the nurse or medication technician. 10
265253
266- (II) THE DELEGATING LICENS ED CERTIFIED MIDWIFE
267-PROVIDES:
254+ (c) Nothing in this section shall preclude a registered nurse or licensed practical 11
255+nurse from delegating a nursing or other technical task to an unlicensed individual 12
256+provided that acceptance of delegated nursing or other technical tasks does not become a 13
257+routine part of the unlicensed individual’s job duties. 14
268258
269- 1. INSTRUCTION TO THE AS SISTANT ON THE DELEG ATED
270-TASK; AND
259+ (d) (1) Subject to regulations adopted by the Board under paragraph (2) of this 15
260+subsection, this section does not preclude an advanced practice registered nurse from 16
261+delegating a nursing or other technical task to an assistant if: 17
271262
272- 2. ON–SITE SUPERVISION OF THE ASS ISTANT
273-PERFORMING THE DELEG ATED TASK.
263+ (i) The assistant performs only tasks that the assistant is trained to 18
264+perform; and 19
274265
275- (2) THE BOARD SHALL ADOPT REG ULATIONS TO CARRY OU T THIS
276-SUBSECTION, INCLUDING REGULATION S THAT:
266+ (ii) The delegating advanced practice registered nurse provides: 20
277267
278- (I) PROVIDE FOR THE MANNE R IN WHICH A LICENSE D
279-CERTIFIED MIDWIFE DE LEGATES A TECHNICAL TASK TO AN ASSISTANT ;
268+ 1. Instruction to the assistant on the delegated task; and 21
280269
281- (II) ESTABLISH LIMITATIONS ON THE AUTHORITY OF A
282-LICENSED CERTIFIED M IDWIFE TO DELEGATE T ECHNICAL TASKS TO AN ASSISTANT;
283-AND WES MOORE, Governor Ch. 367
270+ 2. On–site supervision of the assistant performing the 22
271+delegated task. 23
284272
285-– 7 –
273+ (2) The Board shall adopt regulations to carry out this subsection, 24
274+including regulations that: 25
286275
287- (III) OTHERWISE CLARIFY THE SCOPE OF THIS SUBSEC TION.
276+ (i) Provide for the manner in which an advanced practice registered 26
277+nurse delegates a nursing or other technical task to an assistant; 27
288278
289- [(e)] (F) An individual shall be certified by the Board to practice as a nursing
290-assistant and as a dialysis technician before the individual may practice as a dialysis
291-technician in a State–owned hospital or State–owned facility.
279+ (ii) Establish limitations on the authority of an advanced practice 28
280+registered nurse to delegate nursing or other technical tasks to an assistant; and 29
292281
293-8–6D–01.
282+ (iii) Otherwise clarify the scope of this subsection. 30
294283
295- (a) In this subtitle the following words have the meanings indicated.
284+ (E) (1) SUBJECT TO REGULATIONS ADOPTED BY THE BOARD UNDER 31
285+PARAGRAPH (2) OF THIS SUBSECTION , THIS SECTION DOES NO T PRECLUDE A 32 SENATE BILL 772 7
296286
297- (h) (1) “Practice certified midwifery” means the management and care of
298-essentially normal newborns and of essentially normal women antepartally, intrapartally,
299-and postpartally.
300287
301- (2) “Practice certified midwifery” includes:
288+LICENSED CERTIFIED M IDWIFE FROM DELEGATI NG A TECHNICAL TASK TO AN 1
289+ASSISTANT IF: 2
302290
303- (i) Family planning and well woman reproductive care;
291+ (I) THE ASSISTANT PERFORM S ONLY TASKS THAT TH E 3
292+ASSISTANT IS TRAINED TO PERFORM ; AND 4
304293
305- (ii) The prescribing of substances commonly used in the practice of
306-midwifery;
294+ (II) THE DELEGATING LICENS ED CERTIFIED MIDWIFE 5
295+PROVIDES: 6
307296
308- (iii) The prescribing of Schedule II, Schedule III, Schedule IV, and
309-Schedule V controlled dangerous substances commonly used in the practice of midwifery;
310-and
297+ 1. INSTRUCTION TO THE AS SISTANT ON THE DELEG ATED 7
298+TASK; AND 8
311299
312- (iv) The dispensing of the substances prescribed in accordance with
313-the provisions of items (ii) and (iii) of this paragraph in the course of treating a patient [at]:
300+ 2. ON–SITE SUPERVISION OF THE ASSISTANT 9
301+PERFORMING THE DELEG ATED TASK. 10
314302
315- 1. [A] AT A medical facility or clinic that is operated on a
316-nonprofit basis;
303+ (2) THE BOARD SHALL ADOPT REGULATIONS TO CARRY OUT THIS 11
304+SUBSECTION, INCLUDING REGULATION S THAT: 12
317305
318- 2. [A] AT A health center that operates on a campus of an
319-institution of higher education; [or]
306+ (I) PROVIDE FOR THE MANNE R IN WHICH A LICENSE D 13
307+CERTIFIED MIDWIFE DE LEGATES A TECHNICAL TASK TO AN ASSISTANT ; 14
320308
321- 3. [A] AT A public health facility, a medical facility under
322-contract with a state or local health department, or a facility funded with public funds; OR
309+ (II) ESTABLISH LIMITATIONS ON THE AUTHORITY OF A 15
310+LICENSED CERTIFIED M IDWIFE TO DELEGATE T ECHNICAL TASKS TO AN ASSISTANT; 16
311+AND 17
323312
324- 4. WITH A STARTER DOSAGE OF A DRUG AS AUTHORI ZED
325-UNDER § 8–508 OF THIS TITLE.
313+ (III) OTHERWISE CLARIFY THE SCOPE OF THIS SUBSEC TION. 18
326314
327-8–6D–02.
315+ [(e)] (F) An individual shall be certified by the Board to practice as a nursing 19
316+assistant and as a dialysis technician before the individual may practice as a dialysis 20
317+technician in a State–owned hospital or State–owned facility. 21
328318
329- (a) Except as otherwise provided in this subtitle, an individual shall be licensed
330-by the Board before the individual may practice certified midwifery in the State.
331- Ch. 367 2023 LAWS OF MARYLAND
319+8–6D–01. 22
332320
333-– 8 –
334- (b) This section does not apply to:
321+ (a) In this subtitle the following words have the meanings indicated. 23
335322
336- (1) An individual who assists at a birth in an emergency;
323+ (h) (1) “Practice certified midwifery” means the management and care of 24
324+essentially normal newborns and of essentially normal women antepartally, intrapartally, 25
325+and postpartally. 26
337326
338- (2) An individual who is licensed as a health care practitioner whose scope
339-of practice allows the individual to practice certified midwifery; [or]
327+ (2) “Practice certified midwifery” includes: 27
340328
341- (3) A student who is practicing certified midwifery while engaged in an
342-approved clinical midwifery education experience under the supervision of a licensed
343-certified midwife or a licensed nurse certified as a nurse–midwife; OR
329+ (i) Family planning and well woman reproductive care; 28
344330
345- (4) AN INDIVIDUAL WHO HAS GRADUATED FROM AN APPROVED
346-CLINICAL A GRADUATE LEVEL ACC REDITED PROGRAM FOR MIDWIFERY EDUCATION
347-EXPERIENCE APPROVED BY ACME, AND WHO IS:
331+ (ii) The prescribing of substances commonly used in the practice of 29
332+midwifery; 30 8 SENATE BILL 772
348333
349- (I) PRACTICING CERTIFIED MIDWIFERY UNDER THE
350-SUPERVISION OF A LIC ENSED CERTIFIED MIDW IFE OR A LICENSED NU RSE
351-CERTIFIED AS A NURSE –MIDWIFE; AND
352334
353- (II) MEETS ANY OTHER REQUI REMENTS SET BY THE BOARD.
354335
355-8–6D–03.
336+ (iii) The prescribing of Schedule II, Schedule III, Schedule IV, and 1
337+Schedule V controlled dangerous substances commonly used in the practice of midwifery; 2
338+and 3
356339
357- (a) In addition to the certification and education requirements under subsection
358-(b) of this section, to qualify for a license, an applicant must:
340+ (iv) The dispensing of the substances prescribed in accordance with 4
341+the provisions of items (ii) and (iii) of this paragraph in the course of treating a patient [at]: 5
359342
360- (1) Be of good moral character; and
343+ 1. [A] AT A medical facility or clinic that is operated on a 6
344+nonprofit basis; 7
361345
362- (2) Submit to a criminal history records check in accordance with § 8–303
363-of this title.
346+ 2. [A] AT A health center that operates on a campus of an 8
347+institution of higher education; [or] 9
364348
365- (b) An applicant must:
349+ 3. [A] AT A public health facility, a medical facility under 10
350+contract with a state or local health department, or a facility funded with public funds; OR 11
366351
367- (1) Hold a current, valid certification as a certified midwife from AMCB;
352+ 4. WITH A STARTER DOSAGE OF A DRUG AS AUTHORI ZED 12
353+UNDER § 8–508 OF THIS TITLE. 13
368354
369- (2) Have graduated from a graduate –level accredited program for
370-midwifery education approved by ACME; AND
355+8–6D–02. 14
371356
372- (3) [Have completed coursework in health and sciences:
357+ (a) Except as otherwise provided in this subtitle, an individual shall be licensed 15
358+by the Board before the individual may practice certified midwifery in the State. 16
373359
374- (i) Before commencing a midwifery program described in item (2) of
375-this subsection; or
360+ (b) This section does not apply to: 17
376361
377- (ii) As part of a midwifery program described in item (2) of this
378-subsection; and WES MOORE, Governor Ch. 367
362+ (1) An individual who assists at a birth in an emergency; 18
379363
380-– 9 –
364+ (2) An individual who is licensed as a health care practitioner whose scope 19
365+of practice allows the individual to practice certified midwifery; [or] 20
381366
382- (4)] Have passed the AMCB examination.
367+ (3) A student who is practicing certified midwifery while engaged in an 21
368+approved clinical midwifery education experience under the supervision of a licensed 22
369+certified midwife or a licensed nurse certified as a nurse–midwife; OR 23
383370
384-12–102.
371+ (4) AN INDIVIDUAL WHO HAS GRADUATED FROM AN APPROVED 24
372+CLINICAL A GRADUATE LEVEL ACC REDITED PROGRAM FOR MIDWIFERY EDUCATION 25
373+EXPERIENCE APPROVED BY ACME, AND WHO IS: 26
385374
386- (a) (1) In this section the following terms have the meanings indicated.
375+ (I) PRACTICING CERTIFIED MIDWIFERY UNDER THE 27
376+SUPERVISION OF A LIC ENSED CERTIFIED MIDW IFE OR A LICENSED NU RSE 28
377+CERTIFIED AS A NURSE –MIDWIFE; AND 29
387378
388- (2) “In the public interest” means the dispensing of drugs or devices by a
389-licensed dentist, physician, NURSE OR MIDWIFE , or podiatrist to a patient when a
390-pharmacy is not conveniently available to the patient.
379+ (II) MEETS ANY OTHER REQUI REMENTS SET BY THE BOARD. 30 SENATE BILL 772 9
391380
392- (3) “NURSE OR MIDWIFE ” MEANS AN INDIVIDUAL LICENSED OR
393-CERTIFIED BY THE BOARD OF NURSING UNDER TITLE 8 OF THIS ARTICLE.
394381
395- [(3)] (4) “Personally preparing and dispensing” means that the licensed
396-dentist, physician, NURSE OR MIDWIFE , or podiatrist:
397382
398- (i) Is physically present on the premises where the prescription is
399-filled; and
383+8–6D–03. 1
400384
401- (ii) Performs a final check of the prescription before it is provided to
402-the patient.
385+ (a) In addition to the certification and education requirements under subsection 2
386+(b) of this section, to qualify for a license, an applicant must: 3
403387
404- (c) (2) This title does not prohibit:
388+ (1) Be of good moral character; and 4
405389
406- (iv) A licensed physician who complies with the requirements of item
407-(ii) of this paragraph from personally preparing and dispensing a prescription written by:
390+ (2) Submit to a criminal history records check in accordance with § 8–303 5
391+of this title. 6
408392
409- 1. A physician assistant in accordance with a delegation
410-agreement that complies with Title 15, Subtitle 3 of this article; or
393+ (b) An applicant must: 7
411394
412- 2. A nurse practitioner who is authorized to practice under
413-Title 8, Subtitle 3 of this article and is working with the physician in the same office setting;
414-[or]
395+ (1) Hold a current, valid certification as a certified midwife from AMCB; 8
415396
416- (v) A hospital–based clinic from dispensing prescriptions to its
417-patients; OR
397+ (2) Have graduated from a graduate –level accredited program for 9
398+midwifery education approved by ACME; AND 10
418399
419- (VI) AN INDIVIDUAL LICENSE D OR CERTIFIED UNDER TITLE 8
420-OF THIS ARTICLE FROM PERSONALLY PREPARING AND DISPENSING A DRU G OR
421-DEVICE AS AUTHORIZED UNDER TITLE 8 OF THIS ARTICLE .
400+ (3) [Have completed coursework in health and sciences: 11
422401
423- (e) (1) This title does not prohibit:
424- Ch. 367 2023 LAWS OF MARYLAND
402+ (i) Before commencing a midwifery program described in item (2) of 12
403+this subsection; or 13
425404
426-– 10 –
427- (i) A dentist, physician, NURSE OR MIDWIFE , or podiatrist from
428-administering a prescription drug or device in the course of treating a patient;
405+ (ii) As part of a midwifery program described in item (2) of this 14
406+subsection; and 15
429407
430- (ii) A licensed dental hygienist from administering medication under
431-§ 4–206.4 of this article; or
408+ (4)] Have passed the AMCB examination. 16
432409
433- (iii) A nurse anesthetist from administering medication under §
434-8–513 of this article.
410+12–102. 17
435411
436- (2) For the purposes of paragraph (1)(i) of this subsection, “administering”
437-means the direct introduction of a single dosage of a drug or device at a given time, whether
438-by injection or other means, and whether in liquid, tablet, capsule, or other form.
412+ (a) (1) In this section the following terms have the meanings indicated. 18
439413
440- (f) (1) This title does not prohibit a dentist, physician, NURSE OR MIDWIFE ,
441-or podiatrist from personally dispensing a starter dosage of a prescription drug or device to
442-a patient of the dentist, physician, NURSE OR MIDWIFE , or podiatrist, provided that:
414+ (2) “In the public interest” means the dispensing of drugs or devices by a 19
415+licensed dentist, physician, NURSE OR MIDWIFE , or podiatrist to a patient when a 20
416+pharmacy is not conveniently available to the patient. 21
443417
444- (i) The starter dosage complies with the labeling requirements of §
445-12–505 of this title;
418+ (3) “NURSE OR MIDWIFE ” MEANS AN INDIVIDUAL LICENSED OR 22
419+CERTIFIED BY THE BOARD OF NURSING UNDER TITLE 8 OF THIS ARTICLE. 23
446420
447- (ii) No charge is made for the starter dosage; and
421+ [(3)] (4) “Personally preparing and dispensing” means that the licensed 24
422+dentist, physician, NURSE OR MIDWIFE , or podiatrist: 25
448423
449- (iii) The dentist, physician, NURSE OR MIDWIFE , or podiatrist enters
450-an appropriate record on the patient’s chart.
424+ (i) Is physically present on the premises where the prescription is 26
425+filled; and 27
426+ 10 SENATE BILL 772
451427
452- (2) For the purposes of paragraph (1) of this subsection, “starter dosage”
453-means an amount of drug or device sufficient to begin therapy:
454428
455- (i) Of short duration of 72 hours or less; or
429+ (ii) Performs a final check of the prescription before it is provided to 1
430+the patient. 2
456431
457- (ii) Prior to obtaining a larger quantity of the drug or device to
458-complete the therapy.
432+ (c) (2) This title does not prohibit: 3
459433
460- (g) This title does not prohibit a dentist, physician, NURSE OR MIDWIFE , or
461-podiatrist from dispensing a prescription drug or device in the course of treating a patient:
434+ (iv) A licensed physician who complies with the requirements of item 4
435+(ii) of this paragraph from personally preparing and dispensing a prescription written by: 5
462436
463- (1) At a medical facility or clinic that is operated on a nonprofit basis;
437+ 1. A physician assistant in accordance with a delegation 6
438+agreement that complies with Title 15, Subtitle 3 of this article; or 7
464439
465- (2) At a health center that operates on a campus of an institution of higher
466-education; or
440+ 2. A nurse practitioner who is authorized to practice under 8
441+Title 8, Subtitle 3 of this article and is working with the physician in the same office setting; 9
442+[or] 10
467443
468- (3) At a public health facility, a medical facility under contract with a State
469-or local health department, or a facility funded with public funds.
444+ (v) A hospital–based clinic from dispensing prescriptions to its 11
445+patients; OR 12
470446
471- SECTION 2. AND BE IT FURTHER ENACTED, That, on or before December 1,
472-2023, the Maryland Department of Health, in consultation with relevant stakeholders, WES MOORE, Governor Ch. 367
447+ (VI) AN INDIVIDUAL LICENSED OR CERTIFIED UNDER TITLE 8 13
448+OF THIS ARTICLE FROM PERSONALLY PREPARING AND DISPENSING A DRU G OR 14
449+DEVICE AS AUTHORIZED UNDER TITLE 8 OF THIS ARTICLE . 15
473450
474-– 11 –
475-shall develop recommendations to expand access to birthing services in birthing centers in
476-the State and report its findings to the Senate Finance Committee and the House Health
477-and Government Operations Committee, in accordance with § 2 –1257 of the State
478-Government Article.
451+ (e) (1) This title does not prohibit: 16
479452
480- SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
481-October 1, 2023.
453+ (i) A dentist, physician, NURSE OR MIDWIFE , or podiatrist from 17
454+administering a prescription drug or device in the course of treating a patient; 18
482455
483-Approved by the Governor, May 3, 2023.
456+ (ii) A licensed dental hygienist from administering medication under 19
457+§ 4–206.4 of this article; or 20
458+
459+ (iii) A nurse anesthetist from administering medication under § 21
460+8–513 of this article. 22
461+
462+ (2) For the purposes of paragraph (1)(i) of this subsection, “administering” 23
463+means the direct introduction of a single dosage of a drug or device at a given time, whether 24
464+by injection or other means, and whether in liquid, tablet, capsule, or other form. 25
465+
466+ (f) (1) This title does not prohibit a dentist, physician, NURSE OR MIDWIFE , 26
467+or podiatrist from personally dispensing a starter dosage of a prescription drug or device to 27
468+a patient of the dentist, physician, NURSE OR MIDWIFE , or podiatrist, provided that: 28
469+
470+ (i) The starter dosage complies with the labeling requirements of § 29
471+12–505 of this title; 30
472+
473+ (ii) No charge is made for the starter dosage; and 31
474+ SENATE BILL 772 11
475+
476+
477+ (iii) The dentist, physician, NURSE OR MIDWIFE , or podiatrist enters 1
478+an appropriate record on the patient’s chart. 2
479+
480+ (2) For the purposes of paragraph (1) of this subsection, “starter dosage” 3
481+means an amount of drug or device sufficient to begin therapy: 4
482+
483+ (i) Of short duration of 72 hours or less; or 5
484+
485+ (ii) Prior to obtaining a larger quantity of the drug or device to 6
486+complete the therapy. 7
487+
488+ (g) This title does not prohibit a dentist, physician, NURSE OR MIDWIFE , or 8
489+podiatrist from dispensing a prescription drug or device in the course of treating a patient: 9
490+
491+ (1) At a medical facility or clinic that is operated on a nonprofit basis; 10
492+
493+ (2) At a health center that operates on a campus of an institution of higher 11
494+education; or 12
495+
496+ (3) At a public health facility, a medical facility under contract with a State 13
497+or local health department, or a facility funded with public funds. 14
498+
499+ SECTION 2. AND BE IT FURTHER ENACTED, That, on or before December 1, 15
500+2023, the Maryland Department of Health, in consultation with relevant stakeholders, 16
501+shall develop recommendations to expand access to birthing services in birthing centers in 17
502+the State and report its findings to the Senate Finance Committee and the House Health 18
503+and Government Operations Committee, in accordance with § 2 –1257 of the State 19
504+Government Article. 20
505+
506+ SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
507+October 1, 2023. 22
508+
509+
510+
511+
512+
513+Approved:
514+________________________________________________________________________________
515+ Governor.
516+________________________________________________________________________________
517+ President of the Senate.
518+________________________________________________________________________________
519+ Speaker of the House of Delegates.