EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb1099*
SENATE BILL 1099
J1, E4, P1 4lr0761
By: Senators Smith, Gile, James, Rosapepe, Zucker, Salling, Muse, McKay,
Carozza, Hettleman, Jackson, Kramer, Folden, King, Guzzone, Lam,
Elfreth, Waldstreicher, and West
Introduced and read first time: February 2, 2024
Assigned to: Education, Energy, and the Environment
A BILL ENTITLED
AN ACT concerning 1
Emergency Services – Automated External Defibrillator and Naloxone 2
Co–Location Initiative – Requirements for Public Buildings 3
FOR the purpose of requiring the State Emergency Medical Services Board, in collaboration 4
with the Maryland Department of Health, to develop and implement an initiative 5
under the Public Access Automated External Defibrillator Program to require that 6
naloxone be co–located with each automated external defibrillator placed in a public 7
building; establishing a certain immunity from liability for owners and operators of 8
public buildings who provide and maintain naloxone under the initiative and for 9
individuals who administer naloxone made available under the initiative in response 10
to a known or suspected drug overdose; and generally relating to emergency services 11
and the availability of naloxone in public buildings. 12
BY repealing and reenacting, with amendments, 13
Article – Courts and Judicial Proceedings 14
Section 5–603 15
Annotated Code of Maryland 16
(2020 Replacement Volume and 2023 Supplement) 17
BY repealing and reenacting, with amendments, 18
Article – Education 19
Section 13–517 20
Annotated Code of Maryland 21
(2022 Replacement Volume and 2023 Supplement) 22
BY adding to 23
Article – Education 24
Section 13–518 25
Annotated Code of Maryland 26 2 SENATE BILL 1099
(2022 Replacement Volume and 2023 Supplement) 1
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
That the Laws of Maryland read as follows: 3
Article – Courts and Judicial Proceedings 4
5–603. 5
(a) A person described in subsection (b) of this section is not civilly liable for any 6
act or omission in giving any assistance or medical care, if: 7
(1) The act or omission is not one of gross negligence; 8
(2) The assistance or medical care is provided without fee or other 9
compensation; and 10
(3) The assistance or medical care is provided: 11
(i) At the scene of an emergency; 12
(ii) In transit to a medical facility; or 13
(iii) Through communications with personnel providing emergency 14
assistance. 15
(b) Subsection (a) of this section applies to the following: 16
(1) An individual who is licensed by this State to provide medical care; 17
(2) A member of any State, county, municipal, or volunteer fire 18
department, ambulance and rescue squad, or law enforcement agency, the National Ski 19
Patrol System, or a corporate fire department responding to a call outside of its corporate 20
premises, if the member: 21
(i) Has completed an American Red Cross course in advanced first 22
aid and has a current card showing that status; 23
(ii) Has completed an equivalent of an American Red Cross course in 24
advanced first aid, as determined by the Secretary of Health; 25
(iii) Is certified or licensed by this State as an emergency medical 26
services provider; or 27
(iv) Is administering medications or treatment approved for use in 28
response to an apparent drug overdose and the member is: 29
SENATE BILL 1099 3
1. Licensed or certified as an emergency medical services 1
provider by the State Emergency Medical Services Board and authorized to administer the 2
medications and treatment under protocols established by the State Emergency Medical 3
Services Board; 4
2. Certified to administer the medications and treatment 5
under protocols established by the Secretary of Health; or 6
3. Certified to administer the medications and treatment 7
under protocols established by the Maryland State Police Medical Director; 8
(3) A volunteer fire department or ambulance and rescue squad whose 9
members have immunity; and 10
(4) A corporation when its fire department personnel are immune under 11
item (2) of this subsection. 12
(c) (1) An individual who is not covered otherwise by this section is not civilly 13
liable for any act or omission in providing assistance or medical aid to a victim at the scene 14
of an emergency, if: 15
[(1)] (I) The assistance or aid is provided in a reasonably prudent 16
manner; 17
[(2)] (II) The assistance or aid is provided without fee or other 18
compensation; and 19
[(3)] (III) The individual relinquishes care of the victim when someone who 20
is licensed or certified by this State to provide medical care or services becomes available 21
to take responsibility. 22
(2) THE IMMUNITY FROM CIV IL LIABILITY UNDER P ARAGRAPH (1) OF 23
THIS SUBSECTION APPL IES TO AN INDIVIDUAL WHEN ADMINISTER ING NALOXONE IN 24
RESPONSE TO A KNOWN OR SUSPECTED DRUG OVERDOSE. 25
Article – Education 26
13–517. 27
(a) (1) In this section the following words have the meanings indicated. 28
(2) “Automated external defibrillator (AED)” means a medical heart 29
monitor and defibrillator device that: 30
(i) Is cleared for market by the federal Food and Drug 31
Administration; 32 4 SENATE BILL 1099
(ii) Recognizes the presence or absence of ventricular fibrillation or 1
rapid ventricular tachycardia; 2
(iii) Determines, without intervention by an operator, whether 3
defibrillation should be performed; 4
(iv) On determining that defibrillation should be performed, 5
automatically charges; and 6
(v) 1. Requires operator intervention to deliver the electrical 7
impulse; or 8
2. Automatically continues with delivery of electrical 9
impulse. 10
(3) “Certificate” means a certificate issued by the EMS Board to a 11
registered facility. 12
(4) (i) “Facility” means an agency, an association, a corporation, a firm, 13
a partnership, or any other entity. 14
(ii) “Facility” does not include a grocery store or restaurant that is 15
subject to § 21–330.3 of the Health – General Article. 16
(5) “Jurisdictional emergency medical services operational program” 17
means the institution, agency, corporation, or other entity that has been approved by the 18
EMS Board to provide oversight of emergency medical services for each of the local 19
government and State and federal emergency medical services programs. 20
(6) “Program” means the Public Access Automated External Defibrillator 21
Program. 22
(7) “Regional administrator” means the individual employed by the 23
Institute as regional administrator in each EMS region. 24
(8) “Regional council” means an EMS advisory body as created by the Code 25
of Maryland Regulations 30.05. 26
(9) “Regional council AED committee” means a committee appointed by the 27
regional council consisting of: 28
(i) The regional medical director; 29
(ii) The regional administrator; and 30
SENATE BILL 1099 5
(iii) Three or more individuals with knowledge of and expertise in 1
AEDs. 2
(10) “Registered facility” means an organization, a business association, an 3
agency, or any other entity that meets the requirements of the EMS Board for registering 4
with the Program. 5
(b) (1) There is a Public Access Automated External Defibrillator Program. 6
(2) The purpose of the Program is to [coordinate]: 7
(I) COORDINATE an effective statewide public access defibrillation 8
program; AND 9
(II) IMPLEMENT THE INITIAT IVE TO CO–LOCATE NALOXONE 10
WITH AUTOMATED EXTER NAL DEFIBRILLATORS P LACED IN PUBLIC BUILDINGS, AS 11
REQUIRED UNDER § 13–518 OF THIS SUBTITLE . 12
(3) The Program shall be administered by the EMS Board. 13
(c) The EMS Board may: 14
(1) Adopt regulations for the administration of the Program; 15
(2) Issue and renew certificates to facilities that meet the requirements of 16
this section; 17
(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered 18
facility for failure to meet the requirements of this section; 19
(4) Approve educational and training programs required under this section 20
that: 21
(i) Are conducted by any private or public entity; 22
(ii) Include training in cardiopulmonary resuscitation and 23
automated external defibrillation; and 24
(iii) May include courses from nationally recognized entities such as 25
the American Heart Association, the American Red Cross, and the National Safety Council; 26
(5) Approve the protocol for the use of an AED; and 27
(6) Delegate to the Institute any portion of its authority under this section. 28
6 SENATE BILL 1099
(d) (1) Each facility that desires to make automated external defibrillation 1
available shall possess a valid certificate from the EMS Board. 2
(2) This subsection does not apply to: 3
(i) A jurisdictional emergency medical services operational 4
program; 5
(ii) A licensed commercial ambulance service; 6
(iii) A health care facility as defined in § 19–114 of the Health – 7
General Article; or 8
(iv) A place of business for health care practitioners who are licensed 9
as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14 10
of the Health Occupations Article and are authorized to use an AED in accordance with 11
that license. 12
(e) To qualify for a certificate a facility shall: 13
(1) Comply with the written protocol approved by the EMS Board for the 14
use of an AED which includes notification of the emergency medical services system 15
through the use of the 911 universal emergency access number as soon as possible on the 16
use of an AED; 17
(2) Have established automated external defibrillator maintenance, 18
placement, operation, reporting, and quality improvement procedures as required by the 19
EMS Board; 20
(3) Maintain each AED and all related equipment and supplies in 21
accordance with the standards established by the device manufacturer and the federal Food 22
and Drug Administration; [and] 23
(4) Ensure that each individual who is expected to operate an AED for the 24
registered facility has successfully completed an educational training course and refresher 25
training as required by the EMS Board; AND 26
(5) IF THE FACILITY IS A PUBLIC BUILDING , MEET ANY 27
REQUIREMENTS ESTABLISHED UNDER § 13–518 OF THIS SUBTITLE RELATING TO 28
THE CO–LOCATION OF NALOXONE WITH EACH AED MAINTAINED IN THE FA CILITY. 29
(f) A registered facility shall report the use of an AED to the Institute for review 30
by the regional council AED committee. 31
(g) A facility that desires to establish or renew a certificate shall: 32
SENATE BILL 1099 7
(1) Submit an application on the form that the EMS Board requires; and 1
(2) Meet the requirements under this section. 2
(h) (1) The EMS Board shall issue a new or a renewed certificate to a facility 3
that meets the requirements of this section. 4
(2) Each certificate shall include: 5
(i) The type of certificate; 6
(ii) The full name and address of the facility; 7
(iii) A unique identification number; and 8
(iv) The dates of issuance and expiration of the certificate. 9
(3) A certificate is valid for 3 years. 10
(i) The EMS Board may issue a cease and desist order or obtain injunctive relief 11
if a facility makes automated external defibrillation available in violation of this section. 12
(j) (1) In addition to any other immunities available under statutory or 13
common law, a registered facility is not civilly liable for any act or omission in the provision 14
of automated external defibrillation if the registered facility: 15
(i) Has satisfied the requirements for making automated external 16
defibrillation available under this section; and 17
(ii) Possesses a valid certificate at the time of the act or omission. 18
(2) In addition to any other immunities available under statutory or 19
common law, a member of the regional council AED committee is not civilly liable for any 20
act or omission in the provision of automated external defibrillation. 21
(3) In addition to any other immunities available under statutory or 22
common law, an individual is not civilly liable for any act or omission if: 23
(i) The individual is acting in good faith while rendering automated 24
external defibrillation to a person who is a victim or reasonably believed by the individual 25
to be a victim of a sudden cardiac arrest; 26
(ii) The assistance or aid is provided in a reasonably prudent 27
manner; and 28
(iii) The automated external defibrillation is provided without fee or 29
other compensation. 30 8 SENATE BILL 1099
(4) The immunities in this subsection are not available if the conduct of the 1
registered facility or an individual amounts to gross negligence, willful or wanton 2
misconduct, or intentionally tortious conduct. 3
(5) This subsection does not affect, and may not be construed as affecting, 4
any immunities from civil or criminal liability or defenses established by any other 5
provision of the Code or by common law to which a registered facility, a member of the 6
regional council AED committee, or an individual may be entitled. 7
(k) (1) A registered facility aggrieved by a decision of the Institute acting 8
under the delegated authority of the EMS Board under this section shall be afforded an 9
opportunity for a hearing before the EMS Board. 10
(2) A registered facility aggrieved by a decision of the EMS Board under 11
this section shall be afforded an opportunity for a hearing in accordance with Title 10, 12
Subtitle 2 of the State Government Article. 13
13–518. 14
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 15
INDICATED. 16
(2) “AUTOMATE D EXTERNAL DEFIBRILL ATOR (AED)” HAS THE 17
MEANING STATED IN § 13–517 OF THIS SUBTITLE. 18
(3) “NALOXONE” MEANS THE MEDICATION APPROVED BY THE 19
FEDERAL FOOD AND DRUG ADMINISTRATION FOR TH E REVERSAL OF A KNOW N OR 20
SUSPECTED OPIOID OVE RDOSE. 21
(4) “PUBLIC BUILDING” MEANS: 22
(I) A PUBLIC MASS TRANSPOR TATION ACCOMMODATION , SUCH 23
AS A TERMINAL OR STA TION, THAT IS SUPPORTED BY PUBLIC FUNDS; 24
(II) AN IMPROVEMENT OF A P UBLIC AREA USED FOR 25
GATHERING OR AMUSEME NT, INCLUDING A PUBLIC P ARK OR RECREATION CE NTER; 26
OR 27
(III) A FACILITY THAT IS SUPPORTED BY PUBLIC FUNDS AND 28
PRIMARILY USED TO PR OVIDE SECONDARY OR H IGHER EDUCATION . 29
(B) (1) THE EMS BOARD, IN COLLABORATION WIT H THE MARYLAND 30
DEPARTMENT OF HEALTH, SHALL DEVELOP AND IMPLEMENT AN INITIAT IVE UNDER 31
THE PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM TO 32 SENATE BILL 1099 9
REQUIRE THAT NALOXONE BE CO –LOCATED WITH EACH AUTOMATED EXTERNAL 1
DEFIBRILLATOR PLACED IN A PUBLIC BUILDING . 2
(2) THE INITIATIVE DEVELOPED UNDER PARAGRAPH (1) OF THIS 3
SUBSECTION SHALL ENSURE THAT UP TO TWO DOSES OF NALOXONE ARE 4
MAINTAINED IN A LOCATION THAT: 5
(I) IS VISIBLE AND IN CLOSE PHYSICAL PROXI MITY TO THE 6
AUTOMATED EXTERNAL D EFIBRILLATOR ; AND 7
(II) HAS A LABEL THAT CLEA RLY INDICATES TO THE PUB LIC 8
THE AVAILABILITY OF NALOXONE. 9
(3) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS 10
SUBSECTION SHALL BE FUNDED IN THE SAME M ANNER AS THE PUBLIC ACCESS 11
AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM. 12
(C) (1) THE OWNER OR OPERATOR OF A PUBLIC BUILDING IS NOT CIVILLY 13
LIABLE FOR ANY ACT O R OMISSION IN THE PR OVISION AND MAINTENANCE OF 14
NALOXONE UNDER THE I NITIATIVE DEVELOPED UNDER SUBSECTION (B)(1) OF THIS 15
SECTION IF THE OWNER OR OPERATOR HAS SATI SFIED ANY REQUIREM ENTS 16
ESTABLISHED FOR PROVIDING AND MAINTAINING NALOXONE UNDER THE 17
INITIATIVE. 18
(2) AN INDIVIDUAL WHO ADMIN ISTERS NALOXONE MADE AVAILABLE 19
UNDER THE INITIATIVE DEVELOPED UNDER PARA GRAPH (1) OF THIS SUBSECTION 20
IN RESPONSE TO A KNOWN OR SUSPECTED DRUG OVERDOSE SHALL HAVE IMMUNITY 21
FROM CIVIL LIABILITY AS PROVIDED IN § 5–603 OF THE COURTS ARTICLE. 22
(D) THE EMS BOARD AND THE MARYLAND DEPARTMENT OF HEALTH 23
JOINTLY SHALL ADOPT REGULATI ONS THAT: 24
(1) ESTABLISH GUIDELINES FOR PERIODIC INSPECT IONS AND 25
MAINTENANCE OF THE NALOXONE PLACED IN PUBLIC BUI LDINGS; AND 26
(2) ASSIST THE ADMINISTRATORS O F EACH PUBLIC BUILDI NG IN 27
CARRYING OUT THE PRO VISIONS OF THIS SECT ION. 28
SECTION 2. AND BE IT FURTHER ENACTED, T hat this Act shall take effect 29
October 1, 2024. 30