WES MOORE, Governor Ch. 223
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Chapter 223
(Senate Bill 960)
AN ACT concerning
State Board of Nursing – Sunset Extension, Licensure Exceptions, and Board
Operations and Membership
FOR the purpose of continuing the State Board of Nursing in accordance with the
provisions of the Maryland Program Evaluation Act (sunset law) by extending to a
certain date the termination provisions relating to the statutory and regulatory
authority of the Board; altering the exceptions to the registered nursing and licensed
practical nurse licensure requirements; providing that, for a certain period of time,
the Secretary of Health, rather than the Board, has authority over the infrastructure
operations of the Board, including the authority to employ staff for the Board and
set compensation for certain employees as determined in consultation with the
Secretary of Budget and Management; prohibiting the Board of Nursing Fund from
being used to pay for infrastructure operations for a certain period of time; altering
certain qualifications for the executive director of the Board after the authority of
the Secretary of Health over the Board’s infrastructure operations is terminated;
requiring the Board to hire a certain consultant to conduct an independent
evaluation of the Board; requiring that the terms of certain members of the Board
end on certain dates; and generally relating to the State Board of Nursing.
BY repealing and reenacting, with amendments,
Article – Health Occupations
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,
and 8–802
Annotated Code of Maryland
(2021 Replacement Volume and 2022 Supplement)
BY repealing and reenacting, without amendments,
Article – Health Occupations
Section 8–206(a) and 8–301(a) and (b)
Annotated Code of Maryland
(2021 Replacement Volume and 2022 Supplement)
BY repealing
Article – Health Occupations
Section 8–204(d)
Annotated Code of Maryland
(2021 Replacement Volume and 2022 Supplement)
BY adding to
Article – Health Occupations
Section 8–204(d) Ch. 223 2023 LAWS OF MARYLAND
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Annotated Code of Maryland
(2021 Replacement Volume and 2022 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health Occupations
8–205.
(a) In addition to the powers and duties set forth elsewhere in this title, the Board
has the following powers and duties:
(8) To submit to the Governor, the Secretary, and, in accordance with §
2–1257 of the State Government Article, the General Assembly, an annual report that
includes:
(i) The following data calculated on a fiscal year basis:
1. The number of initial and renewal licenses and certificates
issued;
2. The number of positive and negative criminal history
records checks results received;
3. The number of individuals denied initial or renewal
licensure or certification due to positive criminal history records checks results;
4. The number of individuals denied licensure or certification
due to reasons other than a positive criminal history records check;
5. The number of new complaints received;
6. The number of complaints carried over from year to year;
7. The most common grounds for complaints; [and]
8. The number and types of disciplinary actions taken by the
Board; and
9. ANY ADDITIONAL AGGREG ATE DATA, IDENTIFIED BY
THE BOARD IN CONSULTATION WITH STAKEHOLDERS , DETERMINED TO BE
NECESSARY TO FACILIT ATE WORKFORCE AND HE ALTH PLANNING PURPOS ES THAT
DOES NOT REFERENCE A NY INDIVIDUAL’S NAME OR OTHER PERS ONAL IDENTIFIER ;
AND
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(ii) By analyzing information gathered from renewal applications
submitted under § 8–312 of this title, an evaluation of the State’s nursing workforce by
certification level, region, and type of workplace, including hospitals and home health
workers;
8–301.
(a) Except as otherwise provided in this title, an individual shall be licensed by
the Board before the individual may practice registered nursing in this State.
(b) Except as otherwise provided in this title, an individual shall be licensed by
the Board before the individual may practice licensed practical nursing in this State.
(c) [This] SUBSECTIONS (A) AND (B) OF THIS section [does] DO not apply to:
(1) A student enrolled in an approved education program while practicing
registered nursing or licensed practical nursing in that program;
(2) An individual employed by the federal government to practice
registered nursing or licensed practical nursing while practicing within the scope of that
employment, if the individual is authorized by any state to practice registered nursing or
licensed practical nursing;
(3) An individual permitted to practice registered nursing or licensed
practical nursing under rules and regulations adopted by the Board, if the individual:
(i) Otherwise has qualified to practice registered nursing or licensed
practical nursing in any other state or country and is in this State temporarily; or
(ii) Has an application for a license pending before the Board:
1. But has not taken the examination required under this
title;
2. Has taken an examination under this title, but the results
of the examination are not yet known; [or]
3. Has taken and passed an examination under this title, but
is waiting for the completion of the criminal history records check; OR
4. HAS TAKEN AND FAILED AN EXAMINATION REQUI RED
UNDER THIS TITLE BUT HAS NOT FAILED THE E XAMINATION MORE THAN ONE TIME
WITHIN THE 120–DAY PERIOD IMMEDIATE LY PRECEDING FOLLOWING THE
SUBMISSION OF THE AP PLICATION TO THE BOARD;
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(4) An individual who provides gratuitous care for friends, domestic
partners, or family members; or
(5) An individual who responds to a disaster situation in this State to
practice registered nursing or licensed practical nursing, if:
(i) The individual has an active unencumbered license to practice
registered nursing or licensed practical nursing in another state and the individual is
assigned by:
1. The American Red Cross; or
2. A member of the Maryland Emergency Management
Assistance Compact under § 14–803 of the Public Safety Article;
(ii) The Governor has declared a State of Emergency by Executive
Order or proclamation in accordance with § 3–401 of the State Government Article; and
(iii) The individual reports to the designated staging area in
accordance with § 14–803(2)(b)(5)(iv) of the Public Safety Article.
8–6B–30.
Subject to the evaluation and reestablishment provisions of the Maryland Program
Evaluation Act, and subject to the termination of this title under § 8–802 of this title, this
subtitle and all rules and regulations adopted under this subtitle shall terminate and be of
no effect after July 1, [2023] 2025.
8–6C–26.
Subject to the evaluation and reestablishment provisions of the Maryland Program
Evaluation Act, and subject to the termination of this subtitle under § 8–802 of this title,
this subtitle and all regulations adopted under this subtitle shall terminate and be of no
effect after July 1, [2023] 2025.
8–802.
Subject to the evaluation and reestablishment provisions of the Program Evaluation
Act, the provisions of this title and of any rule or regulation adopted under this title shall
terminate and be of no effect after July 1, [2023] 2025.
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
as follows:
Article – Health Occupations
WES MOORE, Governor Ch. 223
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1–203.
(b) (1) (I) IN THIS SUBSECTION , “INFRASTRUCTURE OPERA TIONS”
MEANS THE ADMINISTRA TIVE ACTIVITIES OF A BOARD OR COMMISSION
ESTABLISHED UNDER TH IS ARTICLE, INCLUDING TOOLS AND RESOURCES FOR THE
USE AND SUPPORT OF D ELIBERATIVE ACTIONS .
(II) “INFRASTRUCTURE OPERAT IONS” DOES NOT INCLUDE
LICENSING:
1. POLICY OR REGULATORY DECISIONS OF THE BOA RD
OR COMMISSION ; OR
2. LICENSING, INVESTIGATION , OR DISCIPLINARY
ACTIVITIES.
(2) [The] EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS
SUBSECTION, THE power of the Secretary to transfer staff or functions of units in the
Department does not apply to any staff of a board or commission, established under this
article, or to any functions that pertain to licensing, disciplinary, or enforcement authority,
or to any other authority specifically delegated by law to a board or commission.
(3) THE SECRETARY HAS AUTHORI TY OVER THE INFR ASTRUCTURE
OPERATIONS OF THE STATE BOARD OF NURSING ESTABLISHED U NDER TITLE 8 OF
THIS ARTICLE.
8–204.
[(d) The Board may:
(1) Employ a staff in accordance with the State budget;
(2) Define the duties of its staff; and
(3) Employ:
(i) An executive director who shall be a registered nurse with a
minimum of a master’s degree in nursing or the equivalent, in the judgment of the Board,
in professional education and administrative experience; and
(ii) A deputy director who shall assume the duties and authority of
the executive director in the absence of the executive director.]
(D) (1) (I) THE SECRETARY MAY EMPLOY A STAFF FOR THE BOARD IN
ACCORDANCE WITH THE STATE BUDGET . Ch. 223 2023 LAWS OF MARYLAND
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(II) THE SECRETARY MAY DESIGNA TE ONE OF THE STAFF WHO
IS A REGISTERED NURSE AS AN EXECUTIVE DIRE CTOR.
(2) THE SECRETARY MAY SET THE COMPENSATION OF AN E MPLOYEE
OF THE BOARD IN A POSITION T HAT:
(I) IS UNIQUE TO THE BOARD;
(II) REQUIRES SPECIFIC SKI LLS OR EXPERIENCE TO PERFORM
THE DUTIES OF THE PO SITION; AND
(III) DOES NOT REQUIRE THE EMPLOYEE TO PERFORM
FUNCTIONS THAT ARE C OMPARABLE TO FUNCTIO NS PERFORMED IN OTHE R UNITS
OF THE EXECUTIVE BRANCH OF STATE GOVERNMENT .
(3) THE SECRETARY OF BUDGET AND MANAGEMENT , IN
CONSULTATION WITH TH E SECRETARY, SHALL DETE RMINE THE POSITIONS FOR
WHICH THE SECRETARY MAY SET COM PENSATION UNDER PARA GRAPH (2) OF THIS
SUBSECTION.
8–206.
(a) There is a Board of Nursing Fund.
(e) (1) (I) The Board of Nursing Fund shall be used exclusively to cover the
actual documented direct and indirect costs of fulfilling the statutory and regulatory duties
of the Board as provided by the provisions of this title.
(II) THE BOARD OF NURSING FUND MAY NOT BE USED TO PAY
FOR INFRASTRUCTURE O PERATIONS, AS DEFINED IN § 1–203(B) OF THIS ARTICLE.
SECTION 3. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
as follows:
Article – Health Occupations
8–204.
(d) The Board may:
(3) Employ:
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(i) An executive director [who shall be a registered nurse with a
minimum of a master’s degree in nursing or the equivalent, in the judgment of the Board,
in professional education and administrative experience]; and
(ii) A deputy director who shall assume the duties and authority of
the executive director in the absence of the executive director.
SECTION 4. 3. AND BE IT FURTHER ENACTED, That:
(a) In this section, “Board” means the State Board of Nursing.
(b) Subject to subsection (c) of this section, the Board shall hire an external
consultant approved by the Secretary of Health to conduct an independent evaluation of
the Board to develop an action plan to implement the recommendations identified in the
report the Board submitted as required by the Fiscal 2022 Joint Chairmen’s Report.
(c) The action plan required under subsection (b) of this section shall be developed
in partnership with the Department of Budget and Management, the Maryland
Department of Health, and the Department of Information Technology, and shall include:
(1) a gap analysis to address the Board’s immediate infrastructure needs
and to identify resources needed for the Board’s long–term sustainability and a plan to fill
all Board staff vacancies and process personnel actions;
(2) the identification of new workflows to reduce the time to fill Board staff
vacancies;
(3) an evaluation of the qualifications necessary to serve as Executive
Director of the Board, including a recommendation on whether to repeal the requirement
that the Executive Director be a registered nurse;
(3) (4) a plan to hire additional nurse and nonnurse investigators to ensure
timely processing of complaints submitted to the Board;
(4) (5) an update of the organizational structure of the Board to make
leadership more effective and the provision of the new organizational chart to Board staff
and members and the Maryland Department of Health;
(5) (6) a plan to create and staff a new Office of Compliance to implement
relevant recommendations to ensure ongoing adherence to State and national standards;
(6) (7) a plan to create and staff a Communications Department within the
Operations Division to relieve operational staff of duties related to constituent
communication and provide responsive service, improve public perception of the Board, and
upgrade social media interaction;
Ch. 223 2023 LAWS OF MARYLAND
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(7) (8) strategic goals established in collaboration with the Board President
and Executive Director; and
(8) (9) a review of the Board’s fee structure and rates and a comparison of the
fees and rates with neighboring states.
(d) Notwithstanding any other provision of law, the Board may use funds from
the Board of Nursing Fund to cover the cost of the independent evaluation required under
subsection (b) of this section.
(e) (1) On or before September 1, 2023, the external consultant hired under
this section shall report its findings and the action plan developed under this section to the
Senate Finance Committee and the House Health and Government Operations Committee
in accordance with § 2–1257 of the State Government Article.
(2) The report submitted under paragraph (1) of this subsection may serve
as the basis for additional recommendations made by the Office of Program Evaluation and
Government Accountability as part of the performance evaluation of the Board directed by
the Executive Director of the Department of Legislative Services on January 3, 2023.
(f) On or before December 1, 2023, the Board shall report to the Governor and, in
accordance with § 2–1257 of the State Government Article, the Senate Finance Committee
and the House Health and Government Operations Committee on average processing times
for fiscal year 2023 for:
(1) issuing initial licenses, certifications, and renewals, as measured from
the date the applicant passed the NCLEX, if applicable, or from the date the initial
application was submitted, as opposed to the date the completed application was submitted;
(2) the issuance of authorization to test; and
(3) the approval of proposed nursing curriculum revisions, new nursing
education programs, new certified nursing assistant education programs, new faculty, and
new clinical sites.
SECTION 5. 4. AND BE IT FURTHER ENACTED, That:
(a) The terms of the members of the State Board of Nursing who are in office on
the effective date of this Act shall end as follows:
(1) the terms of five seven members shall end on July May 1, 2023; and
(2) the terms of five seven members shall end on October November 1,
2023; and.
(3) the terms of four members shall end on January 1, 2024. WES MOORE, Governor Ch. 223
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(b) (1) Subject to the provisions of § 8–202 of the Health Occupations Article,
a member of the Board whose term ends under subsection (a) of this section may apply for
reappointment.
(2) The appointment of a member under § 8–202(b)(8) of the Health
Occupations Article who is appointed by the Governor is subject to the advice and consent
of the Senate during the legislative session immediately following the date of appointment.
(3) (i) Except as provided in subparagraph (ii) of this paragraph, a
member of the Board who was appointed to fill a vacancy created under subsection (a) of
this section shall serve for the remainder of the term.
(ii) If a member who applies for reappointment under paragraph (1)
of this subsection is reappointed, the member shall be considered appointed on the date of
the member’s initial appointment and is subject to the requirements of § 8–202(i) of the
Health Occupations Article.
SECTION 6. AND BE IT FURTHER ENAC TED, That Section 3 of this Act shall take
effect July 1, 2025.
SECTION 7. 5. AND BE IT FURTHER ENACTED, That , except as provided in
Section 6 of this Act, this Act is an emergency measure, is necessary for the immediate
preservation of the public health or safety, has been passed by a yea and nay vote supported
by three–fifths of all the members elected to each of the two Houses of the General
Assembly, and shall take effect from the date it is enacted. Section 2 of this Act shall remain
effective through June 30, 2025, and, at the end of June 30, 2025, Section 2 of this Act, with
no further action required by the General Assembly, shall be abrogated and of no further
force and effect.
Approved by the Governor, April 24, 2023.