EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0042*
HOUSE BILL 42
J1, C2, D4 4lr0164
(PRE–FILED) CF SB 220
By: Chair, Health and Government Operations Committee (By Request –
Departmental – Health)
Requested: September 13, 2023
Introduced and read first time: January 10, 2024
Assigned to: Health and Government Operations
Committee Report: Favorable
House action: Adopted
Read second time: February 13, 2024
CHAPTER ______
AN ACT concerning 1
Public Health – Public Health Services and Protections – Revisions 2
FOR the purpose of repealing the exceptions that allow the sale, distribution, or purchase 3
of tobacco products, tobacco paraphernalia, and electronic smoking devices to or for 4
certain individuals who are active duty members of the military; authorizing the 5
Maryland Department of Health to reallocate from one county to another county 6
certain projected unspent grant funding relating to cancer to address certain funding 7
needs; altering the duties of the State Council on Child Abuse and Neglect; repealing 8
the requirement that the Secretary of Health appoint and convene an expert panel 9
on child abuse and neglect relating to research and data collection on a yearly basis; 10
transferring responsibility for the payment of certain emergency medical treatment 11
charges in cases of child abuse and neglect from the Department to the Governor’s 12
Office of Crime Prevention, Youth, and Victim Services; and generally relating to 13
public health services and protections. 14
BY repealing and reenacting, with amendments, 15
Article – Business Regulation 16
Section 16–209(c), 16.5–214.1, and 16.7–204.1 17
Annotated Code of Maryland 18
(2015 Replacement Volume and 2023 Supplement) 19
BY repealing and reenacting, with amendments, 20
Article – Criminal Law 21 2 HOUSE BILL 42
Section 10–107(b), (c), and (d) 1
Annotated Code of Maryland 2
(2021 Replacement Volume and 2023 Supplement) 3
BY repealing and reenacting, with amendments, 4
Article – Family Law 5
Section 5–712(e), 5–7A–06, and 5–7A–09 6
Annotated Code of Maryland 7
(2019 Replacement Volume and 2023 Supplement) 8
BY repealing and reenacting, without amendments, 9
Article – Family Law 10
Section 5–7A–01(a) 11
Annotated Code of Maryland 12
(2019 Replacement Volume and 2023 Supplement) 13
BY repealing 14
Article – Health – General 15
Section 13–1013(d) and 13–2205 16
Annotated Code of Maryland 17
(2023 Replacement Volume) 18
BY repealing and reenacting, with amendments, 19
Article – Health – General 20
Section 13–1013(e), (f), and (g), 24–305(b) and (d), and 24–307(a), (d), and (f) 21
Annotated Code of Maryland 22
(2023 Replacement Volume) 23
BY adding to 24
Article – Health – General 25
Section 13–1108(f) 26
Annotated Code of Maryland 27
(2023 Replacement Volume) 28
BY repealing and reenacting, with amendments, 29
Article – Local Government 30
Section 1–1203 31
Annotated Code of Maryland 32
(2013 Volume and 2023 Supplement) 33
Preamble 34
WHEREAS, The minimum age in all states for the sale of tobacco products was 35
raised from 18 to 21 years effective December 20, 2019, under 21 U.S.C. § 387f(d)(5); and 36
HOUSE BILL 42 3
WHEREAS, State statutory provisions maintain exceptions for active duty military 1
personnel between the ages of 18 and 21 years of age to purchase tobacco products, which 2
has caused confusion among Maryland tobacco product sellers; and 3
WHEREAS, Distribution of funds for the Local Public Health Cancer Grant for 4
cancer prevention, education, screening, and treatment are made in accordance with the 5
formula established in § 13–1108(b) of the Health – General Article, and funds cannot be 6
redistributed between eligible counties during the fiscal year if distribution does not align 7
with the fiscal needs of counties; and 8
WHEREAS, Reporting on Enforcement Strategies for Distribution of Tobacco 9
Products to Minors under § 24–307(f) of the Health – General Article contains references 10
to sections of the Criminal Law Article repealed by the enactment of Chapter 396 of the 11
Acts of the General Assembly of 2019; and 12
WHEREAS, Reporting requirements of the Cigarette Restitution Fund’s 13
Counter–Marketing Component under § 13–1013(d) of the Health – General Article are 14
duplicative of reporting requirements of the Cigarette Restitution Fund’s Annual 15
Accomplishments and Outcomes Report under § 7 –317 of the State Finance and 16
Procurement Article; and 17
WHEREAS, Section 13–2205 of the Health – General Article, establishing an expert 18
panel on child abuse and neglect, can be repealed without reducing the amount or quality 19
of information provided to the General Assembly as the expert panel has completed its work 20
and the efforts and reporting requirements of the expert panel can be assumed by the State 21
Council on Child Abuse and Neglect established under § 5–7A–01 of the Family Law 22
Article; and 23
WHEREAS, The Maryland Department of Health currently is named as the payor 24
of last resort and given authority to adopt regulations for payments for emergency medical 25
treatment to children in cases of child abuse and neglect under § 5–712(e) of the Family 26
Law Article; and 27
WHEREAS, The Governor’s Office of Crime Prevention, Youth, and Victim Services 28
has taken over the responsibility as the payor of last resort for the payments for emergency 29
medical treatment; now, therefore, 30
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 31
That the Laws of Maryland read as follows: 32
Article – Business Regulation 33
16–209. 34
(c) (1) A licensee shall post a sign in a location that is clearly visible to the 35
consumer that states: 36
4 HOUSE BILL 42
“No person under the age of 21 may be sold tobacco [products without military 1
identification”] PRODUCTS”. 2
(2) The sign required under this subsection shall be written in letters at 3
least one–half inch high. 4
16.5–214.1. 5
(a) A licensed other tobacco products retailer shall post a sign in a location that 6
is clearly visible to the consumer that states: 7
“No person under the age of 21 may be sold tobacco [products without military 8
identification”] PRODUCTS”. 9
(b) The sign required under this section shall be written in letters at least 10
one–half inch high. 11
16.7–204.1. 12
(a) A retail licensee shall post a sign in a location that is clearly visible to the 13
consumer that states: 14
“No person under the age of 21 may be sold tobacco [products without military 15
identification”] PRODUCTS”. 16
(b) The sign required under this section shall be written in letters at least 17
one–half inch high. 18
Article – Criminal Law 19
10–107. 20
(b) (1) This subsection does not apply to the distribution of a tobacco product 21
or tobacco paraphernalia to[: 22
(i)] an individual under the age of 21 years who is acting solely as 23
the agent of the individual’s employer if the employer distributes tobacco products or 24
tobacco paraphernalia for commercial purposes[; or 25
(ii) a purchaser or recipient who: 26
1. is at least 18 years of age; 27
2. is an active duty member of the military; and 28
3. presents a valid military identification]. 29 HOUSE BILL 42 5
(2) A person who distributes tobacco products for commercial purposes, 1
including a person licensed under Title 16, Title 16.5, Title 16.7, or Title 16.9 of the 2
Business Regulation Article, may not distribute to an individual under the age of 21 years: 3
(i) a tobacco product; 4
(ii) tobacco paraphernalia; or 5
(iii) a coupon redeemable for a tobacco product. 6
(c) A person not described in subsection (b)(2) of this section may not: 7
(1) purchase for or sell a tobacco product to an individual under the age of 8
21 years[,unless the individual: 9
(i) is at least 18 years of age; 10
(ii) is an active duty member of the military; and 11
(iii) presents a valid military identification]; or 12
(2) distribute tobacco paraphernalia to an individual under the age of 21 13
years[, unless the individual: 14
(i) is at least 18 years of age; 15
(ii) is an active duty member of the military; and 16
(iii) presents a valid military identification]. 17
(d) In a prosecution for a violation of this section, it is a defense that the defendant 18
examined the purchaser’s or recipient’s driver’s license or other valid identification issued 19
by a government unit that positively identified the purchaser or recipient as at least 21 20
years of age [or as at least 18 years of age and an active duty member of the military]. 21
Article – Family Law 22
5–712. 23
(e) (1) In accordance with regulations adopted by the [Secretary of Health] 24
EXECUTIVE DIRECTOR OF THE GOVERNOR’S OFFICE OF CRIME PREVENTION, 25
YOUTH, AND VICTIM SERVICES, the [Maryland Department of Health] GOVERNOR’S 26
OFFICE OF CRIME PREVENTION, YOUTH, AND VICTIM SERVICES shall pay for 27
emergency medical treatment charges that are incurred on behalf of a child who is 28
examined or treated under this section. 29 6 HOUSE BILL 42
(2) The child’s parent or guardian is liable to the [Maryland Department 1
of Health] GOVERNOR’S OFFICE OF CRIME PREVENTION, YOUTH, AND VICTIM 2
SERVICES for the payments and shall take any steps necessary to secure health benefits 3
available for the child from a public or private benefit program. 4
(3) The local department shall: 5
(i) immediately determine whether a child treated or examined 6
under this section is eligible for medical assistance payments; and 7
(ii) secure medical assistance benefits for any eligible child 8
examined or treated under this section. 9
5–7A–01. 10
(a) There is a State Council on Child Abuse and Neglect. 11
5–7A–06. 12
(a) In addition to any duties set forth elsewhere, the Council shall, by examining 13
the policies and procedures of State and local agencies and specific cases that the Council 14
considers necessary to perform its duties under this section, evaluate the extent to which 15
State and local agencies are effectively discharging their child protection responsibilities in 16
accordance with: 17
(1) the State plan under 42 U.S.C. § 5106a(b); 18
(2) the child protection standards set forth in 42 U.S.C. § 5106a(b); and 19
(3) any other criteria that the Council considers important to ensure the 20
protection of children, including: 21
(i) a review of the extent to which the State child protective services 22
system is coordinated with the foster care and adoption program established under Part E 23
of Title IV of the Social Security Act; and 24
(ii) a review of child fatalities and near fatalities. 25
(b) The Council may request that a local citizens review panel established under 26
§ 5–539.2 of this title conduct a review under this section and report its findings to the 27
Council. 28
(c) The Council shall coordinate its activities under this section with the State 29
Citizens Review Board for Children, local citizens review panels, [and] the child fatality 30 HOUSE BILL 42 7
review teams, AND THE CHILD ABUSE MEDICAL PROVIDERS (MARYLAND CHAMP) 1
INITIATIVE in order to avoid unnecessary duplication of effort. 2
(d) The chairperson of the Council may designate members of the Children’s 3
Justice Act Committee as special members of the Council for the purpose of carrying out 4
the duties set forth in this section. 5
5–7A–09. 6
(a) The Council shall report and make recommendations annually to the 7
Governor and the General Assembly on: 8
(1) ACTIVITIES OF THE MARYLAND CHAMP INITIATIVE 9
ESTABLISHED UNDER TITLE 13, SUBTITLE 22 OF THE HEALTH – GENERAL ARTICLE, 10
INCLUDING DATA COLLECT ED ON CHILD ABUSE AN D NEGLECT DIAGNOSES AND 11
TREATMENT ; AND 12
(2) matters relating to the prevention, detection, prosecution, and 13
treatment of child abuse and neglect, including policy and training needs that require the 14
attention and action of the Governor or the General Assembly. 15
(b) The Council shall annually prepare and make available to the public a report 16
containing a summary of its activities under § 5–7A–05 of this subtitle. 17
Article – Health – General 18
13–1013. 19
[(d) Subject to subsection (c)(2) of this section, before spending any funds allocated 20
in the State budget to the Counter–Marketing and Media Component and no later than 21
January 1, 2001, the Department shall submit a report to the Governor and, subject to § 22
2–1257 of the State Government Article, the General Assembly that: 23
(1) Identifies the goals of the Counter–Marketing and Media Component 24
and the target dates for meeting these goals; 25
(2) Describes the various elements of the Counter–Marketing and Media 26
Component and how the Department plans to implement the Component; and 27
(3) Identifies the different target audiences of the Counter–Marketing and 28
Media Component.] 29
[(e)] (D) (1) The Department may contract with a higher education 30
institution or private entity to implement any part of the Counter–Marketing and Media 31
Component. 32
8 HOUSE BILL 42
(2) If the Department determines that any part of the Counter–Marketing 1
and Media Component should be implemented by a higher education institution or private 2
entity, the Department shall issue a request for proposal to select the entity that will 3
implement that part of the Component. 4
(3) At a minimum, the request for proposal shall: 5
(i) State with specificity the goals of the Counter–Marketing and 6
Media Component; 7
(ii) State with specificity the objectives and performance criteria 8
that will be used to measure the success of the program to which the request for proposal 9
relates; and 10
(iii) Require that the response to the request for proposal include a 11
plan to reach the targeted audiences identified by the Department. 12
(4) If the Department issues a request for proposal to select an entity to 13
implement any part of the Counter–Marketing and Media Component, the Department 14
shall use the criteria established in § 13–1003(e)(5) of this subtitle as a guide in 15
administering the request for proposal process. 16
[(f)] (E) To the extent practicable, the Department shall take steps to maximize 17
the cost effectiveness of the Counter–Marketing and Media Component, including: 18
(1) Using advertisements and other communications and public relations 19
products and services that have been developed by and shown to be effective in other states; 20
(2) Subject to subsection [(g)] (F) of this section, using money that is 21
allocated to the Counter–Marketing and Media Component to obtain money from the 22
federal government, the National Public Education Fund, or any other entity; and 23
(3) Coordinating the purchase of broadcast time with other states. 24
[(g)] (F) The Department may not accept money from the federal government, 25
the National Public Education Fund, or any other entity if the Department is required to 26
accept, as a condition of receiving the money, restrictions on the content of advertisements, 27
communications, or other public relations products or services that are funded with money 28
from the Cigarette Restitution Fund if the restrictions are inconsistent with the purposes 29
of this subtitle. 30
13–1108. 31
(F) THE DEPARTMENT MAY REALLO CATE PROJECTED UNSPE NT FUNDS 32
AWARDED TO A COUNTY TO ANOTHER COUNTY AS NEEDED DURING THE FI SCAL YEAR 33 HOUSE BILL 42 9
IN ORDER TO ADDRESS ANY UNMET COUNTY FUN DING NEEDS AS DETERM INED 1
UNDER § 13–1107 OF THIS SUBTITLE. 2
[13–2205. 3
(a) The Secretary shall appoint and convene an expert panel on child abuse and 4
neglect relating to research and data collection at least one time each year. 5
(b) The panel shall assist the Secretary in: 6
(1) Reviewing the appropriateness of current procedural terminology 7
(CPT) codes and billing protocols for services provided regarding child abuse and neglect; 8
and 9
(2) Determining how diagnosis and treatment data may be preserved to 10
provide statistics on the extent of child abuse and neglect in the State, including through 11
the creation of a special billing code. 12
(c) The panel shall meet at least one time each year with representatives from 13
each emergency room, child advocacy center, and any other facility that provides expert 14
child abuse and neglect care, as defined in § 5–712 of the Family Law Article, to provide 15
training in current procedural terminology (CPT) codes and billing protocols. 16
(d) On or before December 1 of each year, the panel shall submit a report, in 17
accordance with § 2–1257 of the State Government Article, to the General Assembly on the 18
data collected on child abuse and neglect diagnosis and treatment and the activities of the 19
Initiative.] 20
24–305. 21
(b) (1) Except as provided in paragraph (2) of this subsection, a person may 22
not sell, distribute, or offer for sale to an individual under the age of 21 years an electronic 23
smoking device, as defined in § 16.7–101(c) of the Business Regulation Article. 24
(2) This subsection does not apply to[: 25
(i) An] AN electronic smoking device that contains or delivers 26
nicotine intended for human consumption if the device has been approved by the United 27
States Food and Drug Administration for sale as a tobacco cessation product and is being 28
marketed and sold solely for this purpose[; or 29
(ii) A purchaser or recipient who: 30
1. Is at least 18 years of age; 31
2. Is an active duty member of the military; and 32 10 HOUSE BILL 42
3. Presents a valid military identification]. 1
(d) In a prosecution for a violation of this section, it is a defense that the defendant 2
examined the purchaser’s or recipient’s driver’s license or other valid identification issued 3
by a government unit that positively identified the purchaser or recipient as at least 21 4
years of age [or as at least 18 years of age and an active duty member of the military]. 5
24–307. 6
(a) (1) This section does not apply to the distribution of a coupon that is 7
redeemable for a tobacco product if the coupon is: 8
(i) Contained in a newspaper, a magazine, or any other type of 9
publication in which the coupon is incidental to the primary purpose of the publication; or 10
(ii) Sent through the mail. 11
(2) This section does not apply to the distribution of a tobacco product or 12
tobacco paraphernalia to[: 13
(i) An] AN individual under the age of 21 years who is acting solely 14
as the agent of the individual’s employer if the employer distributes tobacco products or 15
tobacco paraphernalia for commercial purposes[; or 16
(ii) A purchaser or recipient who: 17
1. Is at least 18 years of age; 18
2. Is an active duty member of the military; and 19
3. Presents a valid military identification]. 20
(d) In a prosecution for a violation of subsection (b) of this section, it is a defense 21
that the defendant examined the purchaser’s or recipient’s driver’s license or other valid 22
identification issued by a governmental unit that positively identified the purchaser or 23
recipient as at least 21 years old [or as at least 18 years of age and an active duty member 24
of the military]. 25
(f) (1) The Maryland Department of Health, in collaboration and consultation 26
with the Office of the Comptroller, the Executive Director of the Alcohol [and], Tobacco, 27
AND CANNABIS Commission, local health departments, and local law enforcement 28
agencies, shall develop ongoing strategies for enforcement of [§§ 10–107 and 10–108] § 29
10–107 of the Criminal Law Article. 30
HOUSE BILL 42 11
(2) On or before October 1 each year, the Department shall report to the 1
General Assembly, in accordance with § 2–1257 of the State Government Article, on: 2
(i) The development of enforcement strategies required under 3
paragraph (1) of this subsection; and 4
(ii) Training and assistance to tobacco retailers to improve 5
compliance with § 10–107 of the Criminal Law Article. 6
Article – Local Government 7
1–1203. 8
(a) This section applies only in: 9
(1) Carroll County; 10
(2) Cecil County; 11
(3) Garrett County; and 12
(4) St. Mary’s County. 13
(b) Subsection (c)(3) of this section does not apply to the distribution of a coupon 14
that is redeemable for a tobacco product if the coupon: 15
(1) is contained in a newspaper, magazine, or other type of publication and 16
the coupon is incidental to the primary purpose of the publication; or 17
(2) is sent through the mail. 18
(c) A person may not: 19
(1) distribute a tobacco product to an individual under the age of 21 years, 20
unless[: 21
(i)] the individual is acting solely as the agent of the individual’s 22
employer who is engaged in the business of distributing tobacco products; [or 23
(ii) the individual: 24
1. is at least 18 years of age; 25
2. is an active duty member of the military; and 26
3. presents a valid military identification;] 27
12 HOUSE BILL 42
(2) distribute cigarette rolling papers to an individual under the age of 21 1
years[, unless the individual: 2
(i) is at least 18 years of age; 3
(ii) is an active duty member of the military; and 4
(iii) presents a valid military identification]; or 5
(3) distribute to an individual under the age of 21 years a coupon 6
redeemable for a tobacco product[, unless the individual: 7
(i) is at least 18 years of age; 8
(ii) is an active duty member of the military; and 9
(iii) presents a valid military identification]. 10
(d) A person has not violated this section if: 11
(1) the person examined the driver’s license or other valid 12
government–issued identification presented by the recipient of a tobacco product, cigarette 13
rolling paper, or coupon redeemable for a tobacco product; and 14
(2) the license or other identification positively identified the recipient as 15
being at least 21 years old [or as being at least 18 years of age and an active duty member 16
of the military]. 17
(e) (1) In Carroll County and St. Mary’s County, a person who violates this 18
section commits a civil infraction and is subject to a civil penalty of: 19
(i) $300 for the first violation; and 20
(ii) $500 for any subsequent violation within 24 months after the 21
previous citation. 22
(2) In Cecil County, a person who violates this section commits a civil 23
infraction and is subject to a civil penalty of: 24
(i) $300 for the first violation; 25
(ii) $500 for a second violation; and 26
(iii) $750 for any subsequent violation. 27
HOUSE BILL 42 13
(3) In Garrett County, a person who violates this section commits a civil 1
infraction and is subject to a civil penalty not exceeding $300. 2
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
October 1, 2024. 4
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.