EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0084*
HOUSE BILL 84
J3, J1 4lr0471
(PRE–FILED) CF 4lr1623
By: Delegate Kerr
Requested: July 27, 2023
Introduced and read first time: January 10, 2024
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Hospitals and Urgent Care Centers – Sepsis Protocol 2
(Lochlin’s Law) 3
FOR the purpose of requiring, on or before a certain date, each hospital and urgent care 4
center in the State to implement a certain protocol for the early recognition and 5
treatment of a patient with sepsis, severe sepsis, or septic shock; requiring hospitals 6
and urgent care centers to require periodic training in the implementation of the 7
protocol for certain staff; and generally relating to sepsis protocols in hospitals and 8
urgent care centers. 9
BY adding to 10
Article – Health – General 11
Section 19–310.4 12
Annotated Code of Maryland 13
(2023 Replacement Volume) 14
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
That the Laws of Maryland read as follows: 16
Article – Health – General 17
19–310.4. 18
(A) (1) ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL AND URGENT 19
CARE CENTER IN THE STATE SHALL IMPLEMENT AN EVIDENC E–BASED PROTOCOL 20
FOR THE EARLY RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE 21
SEPSIS, OR SEPTIC SHOCK THAT IS BASED ON GEN ERALLY ACCEPTABLE ST ANDARDS 22
OF CARE. 23
2 HOUSE BILL 84
(2) THE PROTOCOL SHALL : 1
(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION, 2
CARE, AND TREATMENT OF ADU LTS AND CHILDREN ; AND 3
(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHER E AND WHEN 4
THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING TREATMENT 5
IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT. 6
(3) THE COMPONENTS REQUIR ED UNDER PARAGRAPH (2) OF THIS 7
SUBSECTION SHALL INCLUD E: 8
(I) A PROCESS FOR THE SCRE ENING AND EARLY RECOGNITIO N 9
OF A PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK ; 10
(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS 11
APPROPRIATE FOR TREA TMENT THROUGH SEPSIS PROTOCOLS, INCLUDING 12
EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED F ROM THE 13
PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATIENT 14
WHO HAS CHOSEN PALLIATIVE CARE ; 15
(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH E XPLICIT 16
PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR 17
NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ; 18
(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID 19
RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR 20
SEVERE SEPSIS AND SE PTIC SHOCK W ITH DEFINED THERAPEU TIC GOALS FOR 21
CHILDREN; 22
(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D 23
DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIMELY REEVALUA TION 24
TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFI ED 25
INFECTIOUS SOURCES ; AND 26
(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF 27
VASOACTIVE AGENTS . 28
(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR 29
MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING 30
PROGRAM IS PRESUMED T O MEET THE REQUIREME NTS OF SUBSECTION (A) OF THIS 31
SECTION. 32
HOUSE BILL 84 3
(C) EACH HOSPITAL AND URGENT CARE CENT ER SHALL: 1
(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMEN TATION OF THE 2
SEPSIS PROTOCOL REQU IRED UNDER SUBSECTION (A) OF THIS SECTION FOR 3
PROFESSIONAL STAFF WITH DIREC T PATIENT CARE RESPO NSIBILITIES AND, AS 4
APPROPRIATE , FOR STAFF WITH INDIRECT PATIENT CARE RE SPONSIBILITIES, 5
INCLUDING LABORATORY AND PHARM ACY STAFF; AND 6
(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE 7
HOSPITAL OR URGENT CARE CENTE R MAKES A SUBSTANTIVE CHANGE TO THE 8
SEPSIS PROTOCOL . 9
(D) EACH HOSPITAL AND URGENT CARE CENT ER SHALL COLLECT AND US E 10
QUALITY MEASURES REL ATED TO THE RECOGNIT ION AND TREATMENT OF SEVERE 11
SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVE MENT. 12
(E) ON REQUEST , A HOSPITAL OR AN URGENT CARE CENTER SHALL 13
PROVIDE THE PROTOCOL REQUIRED UNDER SUBSECTION (A) OF THIS SECTION TO 14
THE DEPARTMENT . 15
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 16
October 1, 2024. 17