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.
*hb0084*
HOUSE BILL 84
J3, J1 4lr0471
(PRE–FILED) CF SB 332
By: Delegate Kerr Delegates Kerr, Pena–Melnyk, Cullison, Alston, Bagnall,
Bhandari, Chisholm, Hill, Hutchinson, S. Johnson, Kaiser, Kipke, R. Lewis,
Lopez, Martinez, M. Morgan, Reilly, Rosenberg, Szeliga, Taveras, White
Holland, and Woods
Requested: July 27, 2023
Introduced and read first time: January 10, 2024
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 26, 2024
CHAPTER ______
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
2 HOUSE BILL 84
19–310.4. 1
(A) (1) ON SUBJECT TO PARAGRAPHS (1) AND (2) OF THIS SUBSECTION , 2
ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL AND UR GENT CARE CENTER IN 3
THE STATE SHALL IMPLEMENT AN EVIDENCE–BASED PROTOCOL FOR T HE EARLY 4
RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE SEP SIS, OR 5
SEPTIC SHOCK THAT IS BASED ON GENERALLY A CCEPTABLE STANDARDS OF CARE. 6
(2) THE EVIDENCE –BASED PROTOCOL IMPLE MENTED FOR 7
HOSPITALS UNDER PARA GRAPH (1) OF THIS SUBSECTION S HALL COMPLY WITH THE 8
CENTERS FOR DISEASE CONTROL AND PREVENTION SEPSIS GUI DELINES. 9
(3) A HOSPITAL THAT IS A S PECIALTY PSYCHIATRIC HOSPITAL SHALL 10
ESTABLISH A PROCESS FOR THE SCREENING AN D EARLY RECOGNITION OF A 11
PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK , AND PROCEDURES TO 12
TRANSFER THE PATIENT TO THE APPROPRIATE S ETTING. 13
(2) THE PROTOCOL SHALL : 14
(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION, 15
CARE, AND TREATMENT OF ADU LTS AND CHILDREN ; AND 16
(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHE RE AND WHEN 17
THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING T REATMENT 18
IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT. 19
(3) THE COMPONENTS REQUIR ED UNDER PARAGRAPH (2) OF THIS 20
SUBSECTION SHALL INC LUDE: 21
(I) A PROCESS FOR THE SCRE ENING AND EARLY RECO GNITION 22
OF A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK ; 23
(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS 24
APPROPRIATE FOR TREA TMENT THROUGH SEPSIS PROTOCOLS, INCLUDING 25
EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED FROM THE 26
PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATIENT 27
WHO HAS CHOSEN PALLI ATIVE CARE; 28
(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH E XPLICIT 29
PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR 30
NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ; 31
(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID 32
RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR 33 HOUSE BILL 84 3
SEVERE SEPSIS AND SE PTIC SHOCK WITH DEFI NED THERAPEUTIC GOAL S FOR 1
CHILDREN; 2
(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D 3
DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIM ELY REEVALUATION 4
TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFI ED 5
INFECTIOUS SOURCES ; AND 6
(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF 7
VASOACTIVE AGENTS . 8
(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR 9
MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING 10
PROGRAM IS PRESUMED T O MEET THE REQUIREME NTS OF SUBSECTION (A) OF THIS 11
SECTION. 12
(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: 13
(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMENTATION OF TH E 14
SEPSIS PROTOCOL REQU IRED UNDER SUBSECTIO N (A) OF THIS SECTION FOR 15
PROFESSIONAL STAFF W ITH DIRECT PATIENT C ARE RESPONSIBILITIES AND, AS 16
APPROPRIATE , FOR STAFF WITH INDIR ECT PATIENT CARE RES PONSIBILITIES, 17
INCLUDING LABORATORY AND PHARMA CY STAFF; AND 18
(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE 19
HOSPITAL OR URGENT C ARE CENTER MAKES A S UBSTANTIVE CHANGE TO THE 20
SEPSIS PROTOCOL . 21
(D) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L COLLECT AND USE 22
QUALITY MEASURES REL ATED TO THE RE COGNITION AND TREATM ENT OF SEVERE 23
SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVEMENT . 24
(E) ON REQUEST , A HOSPITAL OR AN URG ENT CARE CENTER SHAL L 25
PROVIDE THE PROTOCOL REQUIRED UNDER SUBSE CTION (A) OF THIS SECTION TO 26
THE DEPARTMENT . 27
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 28
October 1, 2024. 29