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.
*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 West, Augustine, Brooks, Feldman, Hester,
Kagan, Lewis Young, and Simonaire
Introduced and read first time: February 2, 2024
Assigned to: Education, Energy, and the Environment
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 3, 2024
CHAPTER ______
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; requiring that the initiative be funded using 11
available funds from the Opioid Restitution Fund; and generally relating to 12
emergency services and the availability of naloxone in public buildings. 13
BY repealing and reenacting, with amendments, 14
Article – Courts and Judicial Proceedings 15
Section 5–603 16
Annotated Code of Maryland 17
(2020 Replacement Volume and 2023 Supplement) 18
BY repealing and reenacting, with amendments, 19
Article – Education 20 2 SENATE BILL 1099
Section 13–517 1
Annotated Code of Maryland 2
(2022 Replacement Volume and 2023 Supplement) 3
BY adding to 4
Article – Education 5
Section 13–518 6
Annotated Code of Maryland 7
(2022 Replacement Volume and 2023 Supplement) 8
BY repealing and reenacting, without amendments, 9
Article – State Finance and Procurement 10
Section 7–331(a) 11
Annotated Code of Maryland 12
(2021 Replacement Volume and 2023 Supplement) 13
BY repealing and reenacting, with amendments, 14
Article – State Finance and Procurement 15
Section 7–331(f)(1)(i) 16
Annotated Code of Maryland 17
(2021 Replacement Volume and 2023 Supplement) 18
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 19
That the Laws of Maryland read as follows: 20
Article – Courts and Judicial Proceedings 21
5–603. 22
(a) A person described in subsection (b) of this section is not civilly liable for any 23
act or omission in giving any assistance or medical care, if: 24
(1) The act or omission is not one of gross negligence; 25
(2) The assistance or medical care is provided without fee or other 26
compensation; and 27
(3) The assistance or medical care is provided: 28
(i) At the scene of an emergency; 29
(ii) In transit to a medical facility; or 30
(iii) Through communications with personnel providing emergency 31
assistance. 32
(b) Subsection (a) of this section applies to the following: 33 SENATE BILL 1099 3
(1) An individual who is licensed by this State to provide medical care; 1
(2) A member of any State, county, municipal, or volunteer fire 2
department, ambulance and rescue squad, or law enforcement agency, the National Ski 3
Patrol System, or a corporate fire department responding to a call outside of its corporate 4
premises, if the member: 5
(i) Has completed an American Red Cross course in advanced first 6
aid and has a current card showing that status; 7
(ii) Has completed an equivalent of an American Red Cross course in 8
advanced first aid, as determined by the Secretary of Health; 9
(iii) Is certified or licensed by this State as an emergency medical 10
services provider; or 11
(iv) Is administering medications or treatment approved for use in 12
response to an apparent drug overdose and the member is: 13
1. Licensed or certified as an emergency medical services 14
provider by the State Emergency Medical Services Board and authorized to administer the 15
medications and treatment under protocols established by the State Emergency Medical 16
Services Board; 17
2. Certified to administer the medications and treatment 18
under protocols established by the Secretary of Health; or 19
3. Certified to administer the medications and treatment 20
under protocols established by the Maryland State Police Medical Director; 21
(3) A volunteer fire department or ambulance and rescue squad whose 22
members have immunity; and 23
(4) A corporation when its fire department personnel are immune under 24
item (2) of this subsection. 25
(c) (1) An individual who is not covered otherwise by this section is not civilly 26
liable for any act or omission in providing assistance or medical aid to a victim at the scene 27
of an emergency, if: 28
[(1)] (I) The assistance or aid is provided in a reasonably prudent 29
manner; 30
[(2)] (II) The assistance or aid is provided without fee or other 31
compensation; and 32
4 SENATE BILL 1099
[(3)] (III) The individual relinquishes care of the victim when someone who 1
is licensed or certified by this State to provide medical care or services becomes available 2
to take responsibility. 3
(2) THE IMMUNITY FROM CIV IL LIABILITY UNDER P ARAGRAPH (1) OF 4
THIS SUBSECTION APPL IES TO AN INDIVIDUAL WHEN ADMINISTERING N ALOXONE IN 5
RESPONSE TO A KNOWN OR SUSPECTED DRUG OV ERDOSE. 6
Article – Education 7
13–517. 8
(a) (1) In this section the following words have the meanings indicated. 9
(2) “Automated external defibrillator (AED)” means a medical heart 10
monitor and defibrillator device that: 11
(i) Is cleared for market by the federal Food and Drug 12
Administration; 13
(ii) Recognizes the presence or absence of ventricular fibrillation or 14
rapid ventricular tachycardia; 15
(iii) Determines, without intervention by an operator, whether 16
defibrillation should be performed; 17
(iv) On determining that defibrillation should be performed, 18
automatically charges; and 19
(v) 1. Requires operator intervention to deliver the electrical 20
impulse; or 21
2. Automatically continues with delivery of electrical 22
impulse. 23
(3) “Certificate” means a certificate issued by the EMS Board to a 24
registered facility. 25
(4) (i) “Facility” means an agency, an association, a corporation, a firm, 26
a partnership, or any other entity. 27
(ii) “Facility” does not include a grocery store or restaurant that is 28
subject to § 21–330.3 of the Health – General Article. 29
(5) “Jurisdictional emergency medical services operational program” 30
means the institution, agency, corporation, or other entity that has been approved by the 31 SENATE BILL 1099 5
EMS Board to provide oversight of emergency medical services for each of the local 1
government and State and federal emergency medical services programs. 2
(6) “Program” means the Public Access Automated External Defibrillator 3
Program. 4
(7) “Regional administrator” means the individual employed by the 5
Institute as regional administrator in each EMS region. 6
(8) “Regional council” means an EMS advisory body as created by the Code 7
of Maryland Regulations 30.05. 8
(9) “Regional council AED committee” means a committee appointed by the 9
regional council consisting of: 10
(i) The regional medical director; 11
(ii) The regional administrator; and 12
(iii) Three or more individuals with knowledge of and expertise in 13
AEDs. 14
(10) “Registered facility” means an organization, a business association, an 15
agency, or any other entity that meets the requirements of the EMS Board for registering 16
with the Program. 17
(b) (1) There is a Public Access Automated External Defibrillator Program. 18
(2) The purpose of the Program is to [coordinate]: 19
(I) COORDINATE an effective statewide public access defibrillation 20
program; AND 21
(II) IMPLEMENT THE INITIAT IVE TO CO–LOCATE NALOXONE 22
WITH AUTOMATED EXTER NAL DEFIBRILLATORS P LACED IN PUBLIC BUIL DINGS, AS 23
REQUIRED UNDER § 13–518 OF THIS SUBTITLE . 24
(3) The Program shall be administered by the EMS Board. 25
(c) The EMS Board may: 26
(1) Adopt regulations for the administration of the Program; 27
(2) Issue and renew certificates to facilities that meet the requirements of 28
this section; 29
6 SENATE BILL 1099
(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered 1
facility for failure to meet the requirements of this section; 2
(4) Approve educational and training programs required under this section 3
that: 4
(i) Are conducted by any private or public entity; 5
(ii) Include training in cardiopulmonary resuscitation and 6
automated external defibrillation; and 7
(iii) May include courses from nationally recognized entities such as 8
the American Heart Association, the American Red Cross, and the National Safety Council; 9
(5) Approve the protocol for the use of an AED; and 10
(6) Delegate to the Institute any portion of its authority under this section. 11
(d) (1) Each facility that desires to make automated external defibrillation 12
available shall possess a valid certificate from the EMS Board. 13
(2) This subsection does not apply to: 14
(i) A jurisdictional emergency medical services operational 15
program; 16
(ii) A licensed commercial ambulance service; 17
(iii) A health care facility as defined in § 19–114 of the Health – 18
General Article; or 19
(iv) A place of business for health care practitioners who are licensed 20
as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14 21
of the Health Occupations Article and are authorized to use an AED in accordance with 22
that license. 23
(e) To qualify for a certificate a facility shall: 24
(1) Comply with the written protocol approved by the EMS Board for the 25
use of an AED which includes notification of the emergency medical services system 26
through the use of the 911 universal emergency access number as soon as possible on the 27
use of an AED; 28
(2) Have established automated external defibrillator maintenance, 29
placement, operation, reporting, and quality improvement procedures as required by the 30
EMS Board; 31
SENATE BILL 1099 7
(3) Maintain each AED and all related equipment an d supplies in 1
accordance with the standards established by the device manufacturer and the federal Food 2
and Drug Administration; [and] 3
(4) Ensure that each individual who is expected to operate an AED for the 4
registered facility has successfully completed an educational training course and refresher 5
training as required by the EMS Board; AND 6
(5) IF THE FACILITY IS A PUBLIC BUILDING , MEET ANY 7
REQUIREMENTS ESTABLI SHED UNDER § 13–518 OF THIS SUBTITLE REL ATING TO 8
THE CO–LOCATION OF NALOXONE WITH EACH AED MAINTAINED IN THE FA CILITY. 9
(f) A registered facility shall report the use of an AED to the Institute for review 10
by the regional council AED committee. 11
(g) A facility that desires to establish or renew a certificate shall: 12
(1) Submit an application on the form that the EMS Board requires; and 13
(2) Meet the requirements under this section. 14
(h) (1) The EMS Board shall issue a new or a renewed certificate to a facility 15
that meets the requirements of this section. 16
(2) Each certificate shall include: 17
(i) The type of certificate; 18
(ii) The full name and address of the facility; 19
(iii) A unique identification number; and 20
(iv) The dates of issuance and expiration of the certificate. 21
(3) A certificate is valid for 3 years. 22
(i) The EMS Board may issue a cease and desist order or obtain injunctive relief 23
if a facility makes automated external defibrillation available in violation of this section. 24
(j) (1) In addition to any other immunities available under statutory or 25
common law, a registered facility is not civilly liable for any act or omission in the provision 26
of automated external defibrillation if the registered facility: 27
(i) Has satisfied the requirements for making automated external 28
defibrillation available under this section; and 29
(ii) Possesses a valid certificate at the time of the act or omission. 30 8 SENATE BILL 1099
(2) In addition to any other immunities available under statutory or 1
common law, a member of the regional council AED committee is not civilly liable for any 2
act or omission in the provision of automated external defibrillation. 3
(3) In addition to any other immunities available under statutory or 4
common law, an individual is not civilly liable for any act or omission if: 5
(i) The individual is acting in good faith while rendering automated 6
external defibrillation to a person who is a victim or reasonably believed by the individual 7
to be a victim of a sudden cardiac arrest; 8
(ii) The assistance or aid is provided in a reasonably prudent 9
manner; and 10
(iii) The automated external defibrillation is provided without fee or 11
other compensation. 12
(4) The immunities in this subsection are not available if the conduct of the 13
registered facility or an individual amounts to gross negligence, willful or wanton 14
misconduct, or intentionally tortious conduct. 15
(5) This subsection does not affect, and may not be construed as affecting, 16
any immunities from civil or criminal liability or defenses established by any other 17
provision of the Code or by common law to which a registered facility, a member of the 18
regional council AED committee, or an individual may be entitled. 19
(k) (1) A registered facility aggrieved by a decision of the Institute acting 20
under the delegated authority of the EMS Board under this section shall be afforded an 21
opportunity for a hearing before the EMS Board. 22
(2) A registered facility aggrieved by a decision of the EMS Board under 23
this section shall be afforded an opportunity for a hearing in accordance with Title 10, 24
Subtitle 2 of the State Government Article. 25
13–518. 26
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 27
INDICATED. 28
(2) “AUTOMATED EXTERNAL DE FIBRILLATOR (AED)” HAS THE 29
MEANING STATED IN § 13–517 OF THIS SUBTITLE. 30
(3) “NALOXONE” MEANS THE MEDICATION APPROVED BY THE 31
FEDERAL FOOD AND DRUG ADMINISTRATION FOR COMMUNITY USE FOR THE 32
REVERSAL OF A KNOWN OR SUSPECTED OPIOID OVERDOSE. 33 SENATE BILL 1099 9
(4) “PUBLIC BUILDING ” MEANS: 1
(I) A PUBLIC MASS TRANSPOR TATION ACCOMMODATION , SUCH 2
AS A TERMINAL OR STA TION, THAT IS SUPPORTED BY PUBLIC FUNDS; 3
(II) AN IMPROVEMENT OF A P UBLIC AREA USED FOR 4
GATHERING OR AMUSEME NT, INCLUDING A PUBLIC P ARK OR RECREATION CE NTER; 5
OR 6
(III) A FACILITY THAT IS SUP PORTED BY PUBLIC FUN DS AND 7
PRIMARILY USED TO PR OVIDE SECONDARY OR H IGHER EDUCATION . 8
(B) (1) THE EMS BOARD, IN COLLABORATION WIT H THE MARYLAND 9
DEPARTMENT OF HEALTH, SHALL DEVELOP AND IM PLEMENT AN INITIATIV E UNDER 10
THE PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM TO 11
REQUIRE THAT NALOXON E BE CO–LOCATED WITH EACH AU TOMATED EXTERNAL 12
DEFIBRILLATOR PLACED IN A PUB LIC BUILDING. 13
(2) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS 14
SUBSECTION SHALL ENS URE THAT UP TO TWO D OSES OF NALOXONE ARE 15
MAINTAINED IN A LOCA TION THAT: 16
(I) IS VISIBLE AND IN CLO SE PHYSICAL PROXIMIT Y TO THE 17
AUTOMATED EX TERNAL DEFIBRILLATOR ; AND 18
(II) HAS A LABEL THAT CLEA RLY INDICATES TO THE PUBLIC 19
THE AVAILABILITY OF NALOXONE. 20
(3) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS 21
SUBSECTION SHALL BE FUNDED IN THE SAME MANNER A S THE PUBLIC ACCESS 22
AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM USING AVAILABLE FUND S 23
FROM THE OPIOID RESTITUTION FUND. 24
(C) (1) THE OWNER OR OPERATOR OF A PUBLIC BUILDING IS NOT CIVILLY 25
LIABLE FOR ANY ACT O R OMISSION IN THE PR OVISION AND MAINTENA NCE OF 26
NALOXONE UNDER THE I NITIATIVE DEVELOPED UNDER SUBS ECTION (B)(1) OF THIS 27
SECTION IF THE OWNER OR OPERATOR HAS SATI SFIED ANY REQUIREMEN TS 28
ESTABLISHED FOR PROV IDING AND MAINTAININ G NALOXONE UNDER THE 29
INITIATIVE. 30
(2) AN INDIVIDUAL WHO ADM INISTERS NALOXONE MA DE AVAILABLE 31
UNDER THE INITIA TIVE DEVELOPED UNDER PARAGRAPH (1) OF THIS SUBSECTION 32 10 SENATE BILL 1099
IN RESPONSE TO A KNO WN OR SUSPECTED DRUG OVERDOSE SHALL HAVE IMMUNITY 1
FROM CIVIL LIABILITY AS PROVIDED IN § 5–603 OF THE COURTS ARTICLE. 2
(D) THE EMS BOARD AND THE MARYLAND DEPARTMENT OF HEALTH 3
JOINTLY SHALL ADOPT REGULATI ONS THAT: 4
(1) ESTABLISH GUIDELINES FOR PERIODIC INSPECT IONS AND 5
MAINTENANCE OF THE N ALOXONE PLACED IN PU BLIC BUILDINGS; AND 6
(2) ASSIST THE ADMINISTRA TORS OF EACH PUBLIC BUILDING IN 7
CARRYING OUT THE PRO VISIONS OF THIS SECT ION. 8
Article – State Finance and Procurement 9
7–331. 10
(a) In this section, “Fund” means the Opioid Restitution Fund. 11
(f) The Fund may be used only to provide funds for: 12
(1) programs, services, supports, and resources for evidence–based 13
substance use disorder prevention, treatment, recovery, or harm reduction that have the 14
purpose of: 15
(i) improving access to medications proven to prevent or reverse an 16
overdose, INCLUDING BY SUPPORT ING THE INITIATIVE T O CO–LOCATE NALOXONE 17
WITH AUTOMATED EXTER NAL DEFIBRILLATORS PLACE D IN PUBLIC BUILDING S 18
UNDER § 13–518 OF THE EDUCATION ARTICLE; 19
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
October 1, 2024. 21
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.