EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0960*
SENATE BILL 960
J2 EMERGENCY BILL 3lr2937
CF HB 611
By: Senator Kelly
Introduced and read first time: February 27, 2023
Assigned to: Rules
A BILL ENTITLED
AN ACT concerning 1
State Board of Nursing – Sunset Extension, Licensure Exceptions, and Board 2
Operations and Membership 3
FOR the purpose of continuing the State Board of Nursing in accordance with the 4
provisions of the Maryland Program Evaluation Act (sunset law) by extending to a 5
certain date the termination provisions relating to the statutory and regulatory 6
authority of the Board; altering the exceptions to the registered nursing and licensed 7
practical nurse licensure requirements; providing that, for a certain period of time, 8
the Secretary of Health, rather than the Board, has authority over the infrastructure 9
operations of the Board, including the authority to employ staff for the Board and 10
set compensation for certain employees as determined in consultation with the 11
Secretary of Budget and Management; prohibiting the Board of Nursing Fund from 12
being used to pay for infrastructure operations for a certain period of time; altering 13
certain qualifications for the executive director of the Board after the authority of 14
the Secretary of Health over the Board’s infrastructure operations is terminated; 15
requiring the Board to hire a certain consultant to conduct an independent 16
evaluation of the Board; requiring that the terms of certain members of the Board 17
end on certain dates; and generally relating to the State Board of Nursing. 18
BY repealing and reenacting, with amendments, 19
Article – Health Occupations 20
Section 1–203(b), 8–204(d)(3), 8–205(a)(8), 8–206(e)(1), 8–301(c), 8–6B–30, 8–6C–26, 21
and 8–802 22
Annotated Code of Maryland 23
(2021 Replacement Volume and 2022 Supplement) 24
BY repealing and reenacting, without amendments, 25
Article – Health Occupations 26
Section 8–206(a) and 8–301(a) and (b) 27
Annotated Code of Maryland 28
(2021 Replacement Volume and 2022 Supplement) 29 2 SENATE BILL 960
BY repealing 1
Article – Health Occupations 2
Section 8–204(d) 3
Annotated Code of Maryland 4
(2021 Replacement Volume and 2022 Supplement) 5
BY adding to 6
Article – Health Occupations 7
Section 8–204(d) 8
Annotated Code of Maryland 9
(2021 Replacement Volume and 2022 Supplement) 10
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11
That the Laws of Maryland read as follows: 12
Article – Health Occupations 13
8–205. 14
(a) In addition to the powers and duties set forth elsewhere in this title, the Board 15
has the following powers and duties: 16
(8) To submit to the Governor, the Secretary, and, in accordance with § 17
2–1257 of the State Government Article, the General Assembly, an annual report that 18
includes: 19
(i) The following data calculated on a fiscal year basis: 20
1. The number of initial and renewal licenses and certificates 21
issued; 22
2. The number of positive and negative criminal history 23
records checks results received; 24
3. The number of individuals denied initial or renewal 25
licensure or certification due to positive criminal history records checks results; 26
4. The number of individuals denied licensure or certification 27
due to reasons other than a positive criminal history records check; 28
5. The number of new complaints received; 29
6. The number of complaints carried over from year to year; 30
7. The most common grounds for complaints; [and] 31
SENATE BILL 960 3
8. The number and types of disciplinary actions taken by the 1
Board; and 2
9. ANY ADDITIONAL AGGREG ATE DATA, IDENTIFIED BY 3
THE BOARD IN CONSULTATION WITH STAKEHOLDERS , DETERMINED TO BE 4
NECESSARY TO FACILIT ATE WORKFORCE AND HE ALTH PLANNING PURPOS ES THAT 5
DOES NOT REFERENCE A NY INDIVIDUAL’S NAME OR OTHER PERS ONAL IDENTIFIER ; 6
AND 7
(ii) By analyzing information gathered from renewal applications 8
submitted under § 8–312 of this title, an evaluation of the State’s nursing workforce by 9
certification level, region, and type of workplace, including hospitals and home health 10
workers; 11
8–301. 12
(a) Except as otherwise provided in this title, an individual shall be licensed by 13
the Board before the individual may practice registered nursing in this State. 14
(b) Except as otherwise provided in this title, an individual shall be licensed by 15
the Board before the individual may practice licensed practical nursing in this State. 16
(c) [This] SUBSECTIONS (A) AND (B) OF THIS section [does] DO not apply to: 17
(1) A student enrolled in an approved education program while practicing 18
registered nursing or licensed practical nursing in that program; 19
(2) An individual employed by the federal government to practice 20
registered nursing or licensed practical nursing while practicing within the scope of that 21
employment, if the individual is authorized by any state to practice registered nursing or 22
licensed practical nursing; 23
(3) An individual permitted to practice registered nursing or licensed 24
practical nursing under rules and regulations adopted by the Board, if the individual: 25
(i) Otherwise has qualified to practice registered nursing or licensed 26
practical nursing in any other state or country and is in this State temporarily; or 27
(ii) Has an application for a license pending before the Board: 28
1. But has not taken the examination required under this 29
title; 30
2. Has taken an examination under this title, but the results 31
of the examination are not yet known; [or] 32
4 SENATE BILL 960
3. Has taken and passed an examination under this title, but 1
is waiting for the completion of the criminal history records check; OR 2
4. HAS TAKEN AND FAILED AN EXAMINATION REQUI RED 3
UNDER THIS TITLE BUT HAS NOT FAILED THE E XAMINATION MORE THAN ONE TIME 4
WITHIN THE 120–DAY PERIOD IMMEDIATE LY PRECEDING THE SUB MISSION OF THE 5
APPLICATION TO THE BOARD; 6
(4) An individual who provides gratuitous care for friends, domestic 7
partners, or family members; or 8
(5) An individual who responds to a disaster situation in this State to 9
practice registered nursing or licensed practical nursing, if: 10
(i) The individual has an active unencumbered license to practice 11
registered nursing or licensed practical nursing in another state and the individual is 12
assigned by: 13
1. The American Red Cross; or 14
2. A member of the Maryland Emergency Management 15
Assistance Compact under § 14–803 of the Public Safety Article; 16
(ii) The Governor has declared a State of Emergency by Executive 17
Order or proclamation in accordance with § 3–401 of the State Government Article; and 18
(iii) The individual reports to the designated staging area in 19
accordance with § 14–803(2)(b)(5)(iv) of the Public Safety Article. 20
8–6B–30. 21
Subject to the evaluation and reestablishment provisions of the Maryland Program 22
Evaluation Act, and subject to the termination of this title under § 8–802 of this title, this 23
subtitle and all rules and regulations adopted under this subtitle shall terminate and be of 24
no effect after July 1, [2023] 2025. 25
8–6C–26. 26
Subject to the evaluation and reestablishment provisions of the Maryland Program 27
Evaluation Act, and subject to the termination of this subtitle under § 8–802 of this title, 28
this subtitle and all regulations adopted under this subtitle shall terminate and be of no 29
effect after July 1, [2023] 2025. 30
8–802. 31
SENATE BILL 960 5
Subject to the evaluation and reestablishment provisions of the Program Evaluation 1
Act, the provisions of this title and of any rule or regulation adopted under this title shall 2
terminate and be of no effect after July 1, [2023] 2025. 3
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 4
as follows: 5
Article – Health Occupations 6
1–203. 7
(b) (1) (I) IN THIS SUBSECTION , “INFRASTRUCTURE OPERA TIONS” 8
MEANS THE ADMINISTRA TIVE ACTIVITIES OF A BOARD OR COMMISSION 9
ESTABLISHED UNDER TH IS ARTICLE, INCLUDING TOOLS AND R ESOURCES FOR THE 10
USE AND SUPPORT OF D ELIBERATIVE ACTIONS . 11
(II) “INFRASTRUCTURE OPERAT IONS” DOES NOT INCLUDE 12
LICENSING, INVESTIGATION , OR DISCIPLINARY ACTI VITIES. 13
(2) [The] EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS 14
SUBSECTION, THE power of the Secretary to transfer staff or functions of units in the 15
Department does not apply to any staff of a board or commission, established under this 16
article, or to any functions that pertain to licensing, disciplinary, or enforcement authority, 17
or to any other authority specifically delegated by law to a board or commission. 18
(3) THE SECRETARY HAS AUTHORI TY OVER THE INFRASTR UCTURE 19
OPERATIONS OF THE STATE BOARD OF NURSING ESTABLISHED U NDER TITLE 8 OF 20
THIS ARTICLE. 21
8–204. 22
[(d) The Board may: 23
(1) Employ a staff in accordance with the State budget; 24
(2) Define the duties of its staff; and 25
(3) Employ: 26
(i) An executive director who shall be a registered nurse with a 27
minimum of a master’s degree in nursing or the equivalent, in the judgment of the Board, 28
in professional education and administrative experience; and 29
(ii) A deputy director who shall assume the duties and authority of 30
the executive director in the absence of the executive director.] 31
6 SENATE BILL 960
(D) (1) (I) THE SECRETARY MAY E MPLOY A STAFF FOR TH E BOARD IN 1
ACCORDANCE WITH THE STATE BUDGET . 2
(II) THE SECRETARY MAY DESIGNATE ONE OF THE STAFF AS AN 3
EXECUTIVE DIRECTOR . 4
(2) THE SECRETARY MAY SET THE COMPENSATION OF AN E MPLOYEE 5
OF THE BOARD IN A POSITION T HAT: 6
(I) IS UNIQUE TO THE BOARD; 7
(II) REQUIRES SPECIFIC SKI LLS OR EXPERIENCE TO PERFORM 8
THE DUTIES OF THE PO SITION; AND 9
(III) DOES NOT REQUIRE THE EMPLOYEE TO PERFORM 10
FUNCTIONS THAT ARE C OMPARABLE TO FUNCTIO NS PERFORMED IN OTHE R UNITS 11
OF THE EXECUTIVE BRANCH OF STATE GOVERNMENT . 12
(3) THE SECRETARY OF BUDGET AND MANAGEMENT , IN 13
CONSULTATION WITH TH E SECRETARY, SHALL DETERMINE THE POSITIONS FOR 14
WHICH THE SECRETARY MAY SET COM PENSATION UNDER PARA GRAPH (2) OF THIS 15
SUBSECTION. 16
8–206. 17
(a) There is a Board of Nursing Fund. 18
(e) (1) (I) The Board of Nursing Fund shall be used exclusively to cover the 19
actual documented direct and indirect costs of fulfilling the statutory and regulatory duties 20
of the Board as provided by the provisions of this title. 21
(II) THE BOARD OF NURSING FUND MAY NOT BE USED TO PAY 22
FOR INFRASTRUCTURE O PERATIONS, AS DEFINED IN § 1–203(B) OF THIS ARTICLE. 23
SECTION 3. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 24
as follows: 25
Article – Health Occupations 26
8–204. 27
(d) The Board may: 28
(3) Employ: 29
SENATE BILL 960 7
(i) An executive director [who shall be a registered nurse with a 1
minimum of a master’s degree in nursing or the equivalent, in the judgment of the Board, 2
in professional education and administrative experience]; and 3
(ii) A deputy director who shall assume the duties and authority of 4
the executive director in the absence of the executive director. 5
SECTION 4. AND BE IT FURTHER ENACTED, That: 6
(a) In this section, “Board” means the State Board of Nursing. 7
(b) Subject to subsection (c) of this section, the Board shall hire an external 8
consultant to conduct an independent evaluation of the Board to develop an action plan to 9
implement the recommendations identified in the report the Board submitted as required 10
by the Fiscal 2022 Joint Chairmen’s Report. 11
(c) The action plan required under subsection (b) of this section shall be developed 12
in partnership with the Department of Budget and Management, the Maryland 13
Department of Health, and the Department of Information Technology, and shall include: 14
(1) a gap analysis to address the Board’s immediate infrastructure needs 15
and to identify resources needed for the Board’s long–term sustainability and a plan to fill 16
all Board staff vacancies and process personnel actions; 17
(2) the identification of new workflows to reduce the time to fill Board staff 18
vacancies; 19
(3) a plan to hire additional nurse and nonnurse investigators to ensure 20
timely processing of complaints submitted to the Board; 21
(4) an update of the organizational structure of the Board to make 22
leadership more effective and the provision of the new organizational chart to Board staff 23
and members and the Maryland Department of Health; 24
(5) a plan to create and staff a new Office of Compliance to implement 25
relevant recommendations to ensure ongoing adherence to State and national standards; 26
(6) a plan to create and staff a Communications Department within the 27
Operations Division to relieve operational staff of duties related to constituent 28
communication and provide responsive service, improve public perception of the Board, and 29
upgrade social media interaction; 30
(7) strategic goals established in collaboration with the Board President 31
and Executive Director; and 32
(8) a review of the Board’s fee structure and rates and a comparison of the 33
fees and rates with neighboring states. 34 8 SENATE BILL 960
(d) Notwithstanding any other provision of law, the Board may use funds from 1
the Board of Nursing Fund to cover the cost of the independent evaluation required under 2
subsection (b) of this section. 3
(e) (1) On or before September 1, 2023, the external consultant hired under 4
this section shall report its findings and the action plan developed under this section to the 5
Senate Finance Committee and the House Health and Government Operations Committee 6
in accordance with § 2–1257 of the State Government Article. 7
(2) The report submitted under paragraph (1) of this subsection may serve 8
as the basis for additional recommendations made by the Office of Program Evaluation and 9
Government Accountability as part of the performance evaluation of the Board directed by 10
the Executive Director of the Department of Legislative Services on January 3, 2023. 11
(f) On or before December 1, 2023, the Board shall report to the Governor and, in 12
accordance with § 2–1257 of the State Government Article, the Senate Finance Committee 13
and the House Health and Government Operations Committee on average processing times 14
for fiscal year 2023 for: 15
(1) issuing initial licenses, certifications, and renewals, as measured from 16
the date the applicant passed the NCLEX, if applicable, or from the date the initial 17
application was submitted, as opposed to the date the completed application was submitted; 18
(2) the issuance of authorization to test; and 19
(3) the approval of proposed nursing curriculum revisions, new nursing 20
education programs, new certified nursing assistant education programs, new faculty, and 21
new clinical sites. 22
SECTION 5. AND BE IT FURTHER ENACTED, That: 23
(a) The terms of the members of the State Board of Nursing who are in office on 24
the effective date of this Act shall end as follows: 25
(1) the terms of five members shall end on July 1, 2023; 26
(2) the terms of five members shall end on October 1, 2023; and 27
(3) the terms of four members shall end on January 1, 2024. 28
(b) (1) Subject to the provisions of § 8–202 of the Health Occupations Article, 29
a member of the Board whose term ends under subsection (a) of this section may apply for 30
reappointment. 31
SENATE BILL 960 9
(2) The appointment of a member und er § 8–202(b)(8) of the Health 1
Occupations Article who is appointed by the Governor is subject to the advice and consent 2
of the Senate during the legislative session immediately following the date of appointment. 3
(3) (i) Except as provided in subparagraph (ii) of this paragraph, a 4
member of the Board who was appointed to fill a vacancy created under subsection (a) of 5
this section shall serve for the remainder of the term. 6
(ii) If a member who applies for reappointment under paragraph (1) 7
of this subsection is reappointed, the member shall be considered appointed on the date of 8
the member’s initial appointment and is subject to the requirements of § 8–202(i) of the 9
Health Occupations Article. 10
SECTION 6. AND BE IT FURTHER ENACTED, That Section 3 of t his Act shall take 11
effect July 1, 2025. 12
SECTION 7. AND BE IT FURTHER ENACTED, That, except as provided in Section 13
6 of this Act, this Act is an emergency measure, is necessary for the immediate preservation 14
of the public health or safety, has been passed by a yea and nay vote supported by 15
three–fifths of all the members elected to each of the two Houses of the General Assembly, 16
and shall take effect from the date it is enacted. Section 2 of this Act shall remain effective 17
through June 30, 2025, and, at the end of June 30, 2025, Section 2 of this Act, with no 18
further action required by the General Assembly, shall be abrogated and of no further force 19
and effect. 20