Maryland 2024 Regular Session

Maryland House Bill HB84 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	WES MOORE, Governor Ch. 922
2	1
3		-	– 1 –
4		-	Chapter 922
5		-	(House Bill 84)
6	2
7		-	AN ACT concerning
	3	+	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
	4	+	[Brackets] indicate matter deleted from existing law.
	5	+	Underlining indicates amendments to bill.
	6	+	Strike out indicates matter stricken from the bill by amendment or deleted from the law by
	7	+	amendment.
	8	+	hb0084
8	9
9		-	Hospitals and Urgent Care Centers – Sepsis Protocol
10		-	(Lochlin’s Law)
	10	+	HOUSE BILL 84
	11	+	J3, J1 4lr0471
	12	+	(PRE–FILED) CF SB 332
	13	+	By: Delegate Kerr Delegates Kerr, Pena–Melnyk, Cullison, Alston, Bagnall,
	14	+	Bhandari, Chisholm, Hill, Hutchinson, S. Johnson, Kaiser, Kipke, R. Lewis,
	15	+	Lopez, Martinez, M. Morgan, Reilly, Rosenberg, Szeliga, Taveras, White
	16	+	Holland, and Woods
	17	+	Requested: July 27, 2023
	18	+	Introduced and read first time: January 10, 2024
	19	+	Assigned to: Health and Government Operations
	20	+	Committee Report: Favorable with amendments
	21	+	House action: Adopted
	22	+	Read second time: February 26, 2024
11	23
12		-	FOR the purpose of requiring, on or before a certain date, each hospital and urgent care
13		-	center in the State to implement a certain protocol for the early recognition and
14		-	treatment of a patient with sepsis, severe sepsis, or septic shock; requiring hospitals
15		-	and urgent care centers to require periodic training in the implementation of the
16		-	protocol for certain staff; and generally relating to sepsis protocols in hospitals and
17		-	urgent care centers.
	24	+	CHAPTER ______
18	25
19		-	BY adding to
20		-	Article – Health – General
21		-	Section 19–310.4
22		-	Annotated Code of Maryland
23		-	(2023 Replacement Volume)
	26	+	AN ACT concerning 1
24	27
25		-	~~SECTION 1.~~ ~~BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,~~
26		-	~~That the Laws of Maryland read as follows:~~
	28	+	Hospitals and Urgent Care Centers – Sepsis Protocol 2
	29	+	(Lochlin’s Law) 3
27	30
28		-	Article – Health – General
	31	+	FOR the purpose of requiring, on or before a certain date, each hospital and urgent care 4
	32	+	center in the State to implement a certain protocol for the early recognition and 5
	33	+	treatment of a patient with sepsis, severe sepsis, or septic shock; requiring hospitals 6
	34	+	and urgent care centers to require periodic training in the implementation of the 7
	35	+	protocol for certain staff; and generally relating to sepsis protocols in hospitals and 8
	36	+	urgent care centers. 9
29	37
30		-	19–310.4.
	38	+	BY adding to 10
	39	+	Article – Health – General 11
	40	+	Section 19–310.4 12
	41	+	Annotated Code of Maryland 13
	42	+	(2023 Replacement Volume) 14
31	43
32		-	(A) (1) ON SUBJECT TO PARAGRAPHS (1) AND (2) OF THIS SUBSECTION ,
33		-	ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL A ND URGENT CARE CENTE R IN
34		-	THE STATE SHALL IMPLEMENT AN EVIDENCE–BASED PROTOCOL FOR T HE EARLY
35		-	RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE SEPSIS, OR
36		-	SEPTIC SHOCK THAT IS BASED ON GENERALLY A CCEPTABLE STANDARDS OF CARE.
	44	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
	45	+	That the Laws of Maryland read as follows: 16
37	46
38		-	(2) THE EVIDENCE –BASED PROTOCOL IMPLEMENT ED FOR
39		-	HOSPITALS UNDER PARA GRAPH (1) OF THIS SUBSECTION S HALL COMPLY WITH THE
40		-	CENTERS FOR DISEASE CONTROL AND PREVENTION SEPSIS GUI DELINES.
	47	+	Article – Health – General 17
	48	+	2 HOUSE BILL 84
41	49
42		-	(3) A HOSPITAL THAT IS A S PECIALTY PSYCHIATRIC HOSPITAL SHALL
43		-	ESTABLISH A PROCESS FOR THE SCR EENING AND EARLY REC OGNITION OF A
44		-	PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK , AND PROCEDURES TO
45		-	TRANSFER THE PATIENT TO THE APPROPRIATE S ETTING.
46	50
47		-	~~(2) THE PROTOCOL SHALL : Ch~~. ~~922 2024 LAWS OF MARYLAND~~
	51	+	19–310.4. 1
48	52
49		-	– 2 –
	53	+	(A) (1) ON SUBJECT TO PARAGRAPHS (1) AND (2) OF THIS SUBSECTION , 2
	54	+	ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL AND UR GENT CARE CENTER IN 3
	55	+	THE STATE SHALL IMPLEMENT AN EVIDENCE–BASED PROTOCOL FOR T HE EARLY 4
	56	+	RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE SEP SIS, OR 5
	57	+	SEPTIC SHOCK THAT IS BASED ON GENERALLY A CCEPTABLE STANDARDS OF CARE. 6
50	58
51		-	(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION,
52		-	CARE, AND TREATMENT OF ADULTS AND CHILDREN ; AND
	59	+	(2) THE EVIDENCE –BASED PROTOCOL IMPLE MENTED FOR 7
	60	+	HOSPITALS UNDER PARA GRAPH (1) OF THIS SUBSECTION S HALL COMPLY WITH THE 8
	61	+	CENTERS FOR DISEASE CONTROL AND PREVENTION SEPSIS GUI DELINES. 9
53	62
54		-	(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHE RE AND WHEN
55		-	THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING T REATMENT
56		-	IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT.
	63	+	(3) A HOSPITAL THAT IS A S PECIALTY PSYCHIATRIC HOSPITAL SHALL 10
	64	+	ESTABLISH A PROCESS FOR THE SCREENING AN D EARLY RECOGNITION OF A 11
	65	+	PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK , AND PROCEDURES TO 12
	66	+	TRANSFER THE PATIENT TO THE APPROPRIATE S ETTING. 13
57	67
58		-	(3) THE COMPONENTS REQUIR ED UNDER PARAGR APH (2) OF THIS
59		-	SUBSECTION SHALL INC LUDE:
	68	+	(2) THE PROTOCOL SHALL : 14
60	69
61		-	(I) ~~A PROCESS FOR~~ THE ~~SCRE ENING AND EARLY RECO GNITION~~
62		-	OF ~~A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK~~ ;
	70	+	(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION, 15
	71	+	CARE, AND TREATMENT OF ADU LTS AND CHILDREN ; AND 16
63	72
64		-	(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS
65		-	APPROPRIATE FOR TREA TMENT THROUGH SEPSIS PROTOCOLS, INCLUDING
66		-	EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED FROM THE
67		-	PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATI ENT
68		-	WHO HAS CHOSEN PALLI ATIVE CARE;
	73	+	(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHE RE AND WHEN 17
	74	+	THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING T REATMENT 18
	75	+	IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT. 19
69	76
70		-	(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH E XPLICIT
71		-	PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR
72		-	NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ;
	77	+	(3) THE COMPONENTS REQUIR ED UNDER PARAGRAPH (2) OF THIS 20
	78	+	SUBSECTION SHALL INC LUDE: 21
73	79
74		-	(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID
75		-	RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR
76		-	SEVERE SEPSIS AND SEPTIC SH OCK WITH DEFINED THE RAPEUTIC GOALS FOR
77		-	CHILDREN;
	80	+	(I) A PROCESS FOR THE SCRE ENING AND EARLY RECO GNITION 22
	81	+	OF A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK ; 23
78	82
79		-	(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D
80		-	DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIMELY REEVALUA TION
81		-	TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFI ED
82		-	INFECTIOUS SOURCES ; AND
	83	+	(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS 24
	84	+	APPROPRIATE FOR TREA TMENT THROUGH SEPSIS PROTOCOLS, INCLUDING 25
	85	+	EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED FROM THE 26
	86	+	PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATIENT 27
	87	+	WHO HAS CHOSEN PALLI ATIVE CARE; 28
83	88
84		-	(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF
85		-	VASOACTIVE AGENTS .
	89	+	(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH E XPLICIT 29
	90	+	PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR 30
	91	+	NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ; 31
86	92
87		-	(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR
88		-	MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING
89		-	PROGRAM IS PRESUMED T O MEET THE REQUIREMENTS OF SUBSECTION (A) OF THIS
90		-	SECTION.
	93	+	(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID 32
	94	+	RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR 33 HOUSE BILL 84 3
91	95
92		-	(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: WES MOORE, Governor Ch. 922
93	96
94		-	– 3 –
	97	+	SEVERE SEPSIS AND SE PTIC SHOCK WITH DEFI NED THERAPEUTIC GOAL S FOR 1
	98	+	CHILDREN; 2
95	99
96		-	(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMEN TATION OF THE
97		-	SEPSIS PROTOCOL REQU IRED UNDER SUBSECTIO N (A) OF THIS SECTION FOR
98		-	PROFESSIONAL STAFF W ITH DIRECT PATIENT CARE R ESPONSIBILITIES AND , AS
99		-	APPROPRIATE , FOR STAFF WITH INDIR ECT PATIENT CARE RES PONSIBILITIES,
100		-	INCLUDING LABORATORY AND PHARMACY STAFF ; AND
	100	+	(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D 3
	101	+	DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIM ELY REEVALUATION 4
	102	+	TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFI ED 5
	103	+	INFECTIOUS SOURCES ; AND 6
101	104
102		-	(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE
103		-	HOSPITAL OR URGENT C ARE CENTER MAKES A SUBSTANTIVE CHANGE T O THE
104		-	SEPSIS PROTOCOL .
	105	+	(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF 7
	106	+	VASOACTIVE AGENTS . 8
105	107
106		-	(D) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L COLLECT AND USE
107		-	QUALITY MEASURES REL ATED TO THE RECOGNIT ION AND TREATMENT OF SEVERE
108		-	SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVEMENT .
	108	+	(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR 9
	109	+	MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING 10
	110	+	PROGRAM IS PRESUMED T O MEET THE REQUIREME NTS OF SUBSECTION (A) OF THIS 11
	111	+	SECTION. 12
109	112
110		-	(E) ON REQUEST , A HOSPITAL OR AN URGEN T CARE CENTER SHALL
111		-	PROVIDE THE PROTOCOL REQUIRED UNDER SUBSE CTION (A) OF THIS SECTION TO
112		-	THE DEPARTMENT .
	113	+	(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: 13
113	114
114		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
115		-	October 1, 2024.
	115	+	(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMENTATION OF TH E 14
	116	+	SEPSIS PROTOCOL REQU IRED UNDER SUBSECTIO N (A) OF THIS SECTION FOR 15
	117	+	PROFESSIONAL STAFF W ITH DIRECT PATIENT C ARE RESPONSIBILITIES AND, AS 16
	118	+	APPROPRIATE , FOR STAFF WITH INDIR ECT PATIENT CARE RES PONSIBILITIES, 17
	119	+	INCLUDING LABORATORY AND PHARMA CY STAFF; AND 18
116	120
117		-	Approved by the Governor, May 16, 2024.
	121	+	(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE 19
	122	+	HOSPITAL OR URGENT C ARE CENTER MAKES A S UBSTANTIVE CHANGE TO THE 20
	123	+	SEPSIS PROTOCOL . 21
	124	+
	125	+	(D) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L COLLECT AND USE 22
	126	+	QUALITY MEASURES REL ATED TO THE RE COGNITION AND TREATM ENT OF SEVERE 23
	127	+	SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVEMENT . 24
	128	+
	129	+	(E) ON REQUEST , A HOSPITAL OR AN URG ENT CARE CENTER SHAL L 25
	130	+	PROVIDE THE PROTOCOL REQUIRED UNDER SUBSE CTION (A) OF THIS SECTION TO 26
	131	+	THE DEPARTMENT . 27
	132	+
	133	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 28
	134	+	October 1, 2024. 29
	135	+