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.
Italics indicate opposite chamber/conference committee amendments.
*sb1099*
SENATE BILL 1099
J1, E4, P1 (4lr0761)
ENROLLED BILL
— Education, Energy, and the Environment/Health and Government Operations —
Introduced 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
Read and Examined by Proofreaders:
_______________________________________________
Proofreader.
_______________________________________________
Proofreader.
Sealed with the Great Seal and presented to the Governor, for his approval this
_______ day of _______________ at ___________ _____________ o’clock, ________M.
______________________________________________
President.
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 appropriated through the State 12 2 SENATE BILL 1099
budget; and generally relating to emergency services and the availability of naloxone 1
in public buildings. 2
BY repealing and reenacting, with amendments, 3
Article – Courts and Judicial Proceedings 4
Section 5–603 5
Annotated Code of Maryland 6
(2020 Replacement Volume and 2023 Supplement) 7
BY repealing and reenacting, with amendments, 8
Article – Education 9
Section 13–517 10
Annotated Code of Maryland 11
(2022 Replacement Volume and 2023 Supplement) 12
BY adding to 13
Article – Education 14
Section 13–518 15
Annotated Code of Maryland 16
(2022 Replacement Volume and 2023 Supplement) 17
BY repealing and reenacting, without amendments, 18
Article – State Finance and Procurement 19
Section 7–331(a) 20
Annotated Code of Maryland 21
(2021 Replacement Volume and 2023 Supplement) 22
BY repealing and reenacting, with amendments, 23
Article – State Finance and Procurement 24
Section 7–331(f)(1)(i) 25
Annotated Code of Maryland 26
(2021 Replacement Volume and 2023 Supplement) 27
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 28
That the Laws of Maryland read as follows: 29
Article – Courts and Judicial Proceedings 30
5–603. 31
(a) A person described in subsection (b) of this section is not civilly liable for any 32
act or omission in giving any assistance or medical care, if: 33
(1) The act or omission is not one of gross negligence; 34
(2) The assistance or medical care is provided without fee or other 35
compensation; and 36 SENATE BILL 1099 3
(3) The assistance or medical care is provided: 1
(i) At the scene of an emergency; 2
(ii) In transit to a medical facility; or 3
(iii) Through communications with personnel providing emergency 4
assistance. 5
(b) Subsection (a) of this section applies to the following: 6
(1) An individual who is licensed by this State to provide medical care; 7
(2) A member of any State, county, municipal, or volunteer fire 8
department, ambulance and rescue squad, or law enforcement agency, the National Ski 9
Patrol System, or a corporate fire department responding to a call outside of its corporate 10
premises, if the member: 11
(i) Has completed an American Red Cross course in advanced first 12
aid and has a current card showing that status; 13
(ii) Has completed an equivalent of an American Red Cross course in 14
advanced first aid, as determined by the Secretary of Health; 15
(iii) Is certified or licensed by this State as an emergency medical 16
services provider; or 17
(iv) Is administering medications or treatment approved for use in 18
response to an apparent drug overdose and the member is: 19
1. Licensed or certified as an emergency medical services 20
provider by the State Emergency Medical Services Board and authorized to administer the 21
medications and treatment under protocols established by the State Emergency Medical 22
Services Board; 23
2. Certified to administer the medications and treatment 24
under protocols established by the Secretary of Health; or 25
3. Certified to administer the medications and treatment 26
under protocols established by the Maryland State Police Medical Director; 27
(3) A volunteer fire department or ambulance and rescue squad whose 28
members have immunity; and 29
(4) A corporation when its fire department personnel are immune under 30
item (2) of this subsection. 31 4 SENATE BILL 1099
(c) (1) An individual who is not covered otherwise by this section is not civilly 1
liable for any act or omission in providing assistance or medical aid to a victim at the scene 2
of an emergency, if: 3
[(1)] (I) The assistance or aid is provided in a reasonably prudent 4
manner; 5
[(2)] (II) The assistance or aid is provided without fee or other 6
compensation; and 7
[(3)] (III) The individual relinquishes care of the victim when someone who 8
is licensed or certified by this State to provide medical care or services becomes available 9
to take responsibility. 10
(2) THE IMMUNITY FROM CIV IL LIABILITY UNDER P ARAGRAPH (1) OF 11
THIS SUBSECTION APPL IES TO AN INDIVIDUAL WHEN ADMINISTERING N ALOXONE IN 12
RESPONSE TO A KNOWN OR SUSPECTED DRUG OV ERDOSE. 13
Article – Education 14
13–517. 15
(a) (1) In this section the following words have the meanings indicated. 16
(2) “Automated external defibrillator (AED)” means a medical heart 17
monitor and defibrillator device that: 18
(i) Is cleared for market by the federal Food and Drug 19
Administration; 20
(ii) Recognizes the presence or absence of ventricular fibrillation or 21
rapid ventricular tachycardia; 22
(iii) Determines, without intervention by an operator, whether 23
defibrillation should be performed; 24
(iv) On determining that defibrillation should be performed, 25
automatically charges; and 26
(v) 1. Requires operator intervention to deliver the electrical 27
impulse; or 28
2. Automatically continues with delivery of electrical 29
impulse. 30
SENATE BILL 1099 5
(3) “Certificate” means a certificate issued by the EMS Board to a 1
registered facility. 2
(4) (i) “Facility” means an agency, an association, a corporation, a firm, 3
a partnership, or any other entity. 4
(ii) “Facility” does not include a grocery store or restaurant that is 5
subject to § 21–330.3 of the Health – General Article. 6
(5) “Jurisdictional emergency medical services operational program” 7
means the institution, agency, corporation, or other entity that has been approved by the 8
EMS Board to provide oversight of emergency medical services for each of the local 9
government and State and federal emergency medical services programs. 10
(6) “Program” means the Public Access Automated External Defibrillator 11
Program. 12
(7) “Regional administrator” means the individual employed by the 13
Institute as regional administrator in each EMS region. 14
(8) “Regional council” means an EMS advisory body as created by the Code 15
of Maryland Regulations 30.05. 16
(9) “Regional council AED committee” means a committee appointed by the 17
regional council consisting of: 18
(i) The regional medical director; 19
(ii) The regional administrator; and 20
(iii) Three or more individuals with knowledge of and expertise in 21
AEDs. 22
(10) “Registered facility” means an organization, a business association, an 23
agency, or any other entity that meets the requirements of the EMS Board for registering 24
with the Program. 25
(b) (1) There is a Public Access Automated External Defibrillator Program. 26
(2) The purpose of the Program is to [coordinate]: 27
(I) COORDINATE an effective statewide public access defibrillation 28
program; AND 29
6 SENATE BILL 1099
(II) IMPLEMENT THE INITIAT IVE TO CO–LOCATE NALOXONE 1
WITH AUTOMATED EXTER NAL DEFIBRILLATORS P LACED IN PUBLIC BUIL DINGS, AS 2
REQUIRED UNDER § 13–518 OF THIS SUBTITLE . 3
(3) The Program shall be administered by the EMS Board. 4
(c) The EMS Board may: 5
(1) Adopt regulations for the administration of the Program; 6
(2) Issue and renew certificates to facilities that meet the requirements of 7
this section; 8
(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered 9
facility for failure to meet the requirements of this section; 10
(4) Approve educational and training programs required under this section 11
that: 12
(i) Are conducted by any private or public entity; 13
(ii) Include training in cardiopulmonary resuscitation and 14
automated external defibrillation; and 15
(iii) May include courses from nationally recognized entities such as 16
the American Heart Association, the American Red Cross, and the National Safety Council; 17
(5) Approve the protocol for the use of an AED; and 18
(6) Delegate to the Institute any portion of its authority under this section. 19
(d) (1) Each facility that desires to make automated external defibrillation 20
available shall possess a valid certificate from the EMS Board. 21
(2) This subsection does not apply to: 22
(i) A jurisdictional emergency medical services operational 23
program; 24
(ii) A licensed commercial ambulance service; 25
(iii) A health care facility as defined in § 19–114 of the Health – 26
General Article; or 27
(iv) A place of business for health care practitioners who are licensed 28
as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14 29 SENATE BILL 1099 7
of the Health Occupations Article and are authorized to use an AED in accordance with 1
that license. 2
(e) To qualify for a certificate a facility shall: 3
(1) Comply with the written protocol approved by the EMS Board for the 4
use of an AED which includes notification of the emergency medical services system 5
through the use of the 911 universal emergency access number as soon as possible on the 6
use of an AED; 7
(2) Have established automated external defibrillator maintenance, 8
placement, operation, reporting, and quality improvement procedures as required by the 9
EMS Board; 10
(3) Maintain each AED and all related equipment and supplies in 11
accordance with the standards established by the device manufacturer and the federal Food 12
and Drug Administration; [and] 13
(4) Ensure that each individual who is expected to operate an AED for the 14
registered facility has successfully completed an educational training course and refresher 15
training as required by the EMS Board; AND 16
(5) IF THE FACILITY IS A PUBLIC BUILDING , MEET ANY 17
REQUIREMENTS ESTABLI SHED UNDER § 13–518 OF THIS SUBTITLE REL ATING TO 18
THE CO–LOCATION OF NALOXONE WITH EACH AED MAINTAINED IN THE FAC ILITY. 19
(f) A registered facility shall report the use of an AED to the Institute for review 20
by the regional council AED committee. 21
(g) A facility that desires to establish or renew a certificate shall: 22
(1) Submit an application on the form that the EMS Board requires; and 23
(2) Meet the requirements under this section. 24
(h) (1) The EMS Board shall issue a new or a renewed certificate to a facility 25
that meets the requirements of this section. 26
(2) Each certificate shall include: 27
(i) The type of certificate; 28
(ii) The full name and address of the facility; 29
(iii) A unique identification number; and 30
8 SENATE BILL 1099
(iv) The dates of issuance and expiration of the certificate. 1
(3) A certificate is valid for 3 years. 2
(i) The EMS Board may issue a cease and desist order or obtain injunctive relief 3
if a facility makes automated external defibrillation available in violation of this section. 4
(j) (1) In addition to any other immunities available under statutory or 5
common law, a registered facility is not civilly liable for any act or omission in the provision 6
of automated external defibrillation if the registered facility: 7
(i) Has satisfied the requirements for making automated external 8
defibrillation available under this section; and 9
(ii) Possesses a valid certificate at the time of the act or omission. 10
(2) In addition to any other immunities available under statutory or 11
common law, a member of the regional council AED committee is not civilly liable for any 12
act or omission in the provision of automated external defibrillation. 13
(3) In addition to any other immunities available under statutory or 14
common law, an individual is not civilly liable for any act or omission if: 15
(i) The individual is acting in good faith while rendering automated 16
external defibrillation to a person who is a victim or reasonably believed by the individual 17
to be a victim of a sudden cardiac arrest; 18
(ii) The assistance or aid is provided in a reasonably prudent 19
manner; and 20
(iii) The automated external defibrillation is provided without fee or 21
other compensation. 22
(4) The immunities in this subsection are not available if the conduct of the 23
registered facility or an individual amounts to gross negligence, willful or wanton 24
misconduct, or intentionally tortious conduct. 25
(5) This subsection does not affect, and may not be construed as affecting, 26
any immunities from civil or criminal liability or defenses established by any other 27
provision of the Code or by common law to which a registered facility, a member of the 28
regional council AED committee, or an individual may be entitled. 29
(k) (1) A registered facility aggrieved by a decision of the Institute acting 30
under the delegated authority of the EMS Board under this section shall be afforded an 31
opportunity for a hearing before the EMS Board. 32
SENATE BILL 1099 9
(2) A registered facility aggrieved by a decision of the EMS Board under 1
this section shall be afforded an opportunity for a hearing in accordance with Title 10, 2
Subtitle 2 of the State Government Article. 3
13–518. 4
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 5
INDICATED. 6
(2) “AUTOMATED EXTERNAL DE FIBRILLATOR (AED)” HAS THE 7
MEANING STATED IN § 13–517 OF THIS SUBTITLE. 8
(3) “NALOXONE” MEANS THE MEDICATION APPROVED BY THE 9
FEDERAL FOOD AND DRUG ADMINISTRATION FOR COMMUNITY USE FOR THE 10
REVERSAL OF A KNOWN OR SUSPECTED OPIOID OVERDOSE. 11
(4) “PUBLIC BUILDING ” MEANS: 12
(I) A PUBLIC MASS TRANSPOR TATION ACCOMMODATION , SUCH 13
AS A TERMINAL OR STA TION, THAT IS SUPPORTED BY PUBLIC FUNDS; 14
(II) AN IMPROVEMENT OF A P UBLIC AREA USED FOR 15
GATHERING OR AMUSEME NT, INCLUDING A PUBLIC P ARK OR RECREATION CE NTER; 16
OR 17
(III) A FACILITY THAT IS SUP PORTED BY PUBLIC FUN DS AND 18
PRIMARILY USED TO PR OVIDE SECONDARY OR H IGHER EDUCATION . 19
(B) (1) THE EMS BOARD, IN COLLABORATION WIT H THE MARYLAND 20
DEPARTMENT OF HEALTH, SHALL DEVELOP AND IM PLEMENT AN INITIATIV E UNDER 21
THE PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM TO 22
REQUIRE THAT NALOXON E BE CO–LOCATED WITH EACH AU TOMATED EXTERNAL 23
DEFIBRILLATOR PLACED IN A PUBL IC BUILDING. 24
(2) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS 25
SUBSECTION SHALL ENS URE THAT UP TO TWO D OSES OF NALOXONE ARE 26
MAINTAINED IN A LOCA TION THAT: 27
(I) IS VISIBLE AND IN CLO SE PHYSICAL PROXIMIT Y TO THE 28
AUTOMATED EXTERNAL DEFIBRILLAT OR; AND 29
(II) HAS A LABEL THAT CLEA RLY INDICATES TO THE PUBLIC 30
THE AVAILABILITY OF NALOXONE. 31
10 SENATE BILL 1099
(3) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS 1
SUBSECTION SHALL BE FUNDED IN THE SAME MANNER A S THE PUBLIC ACCESS 2
AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM USING AVAILABLE FUNDS 3
FROM THE OPIOID RESTITUTION FUND APPROPRIATED THROUGH THE STATE 4
BUDGET. 5
(C) (1) THE OWNER OR OPERATOR OF A PUBLIC BUILDING IS NOT CIVILLY 6
LIABLE FOR ANY ACT O R OMISSION IN THE PR OVISION AND MAINTENA NCE OF 7
NALOXONE UNDER THE I NITIATIVE DEVELOPED UNDER SUBSECTION (B)(1) OF THIS 8
SECTION IF THE OWNER OR OPERATOR HAS SATI SFIED ANY REQUIREMEN TS 9
ESTABLISHED FOR PROV IDING AND MAINTAININ G NALOXONE UNDER THE 10
INITIATIVE. 11
(2) AN INDIVIDUAL WHO ADM INISTERS NALOXO NE MADE AVAILABLE 12
UNDER THE INITIATIVE DEVELOPED UNDER PARA GRAPH (1) OF THIS SUBSECTION 13
IN RESPONSE TO A KNO WN OR SUSPECTED DRUG OVERDOSE SHALL HAVE IMMUNITY 14
FROM CIVIL LIABILITY AS PROVIDED IN § 5–603 OF THE COURTS ARTICLE. 15
(D) THE EMS BOARD AND THE MARYLAND DEPARTMENT OF HEALTH 16
JOINTLY SHALL ADOPT REGULATIONS THAT : 17
(1) ESTABLISH GUIDELINES FOR PERIODIC INSPECT IONS AND 18
MAINTENANCE OF THE N ALOXONE PLACED IN PU BLIC BUILDINGS; AND 19
(2) ASSIST THE ADMINISTRA TORS OF EACH PUBLIC BUILDING IN 20
CARRYING OUT T HE PROVISIONS OF THI S SECTION; AND 21
(3) ESTABLISH INITIAL PRI ORITIZATION OF THE P UBLIC BUILDINGS 22
ELIGIBLE TO RECEIVE FUNDING UNDER THIS S ECTION WITH A GOAL O F 23
CO–LOCATION OF NALOXONE WITH EACH AUTOMATED EXTERNAL DEFIBRILLAT OR 24
LOCATED IN A PUBLIC BUILDING BY OCTOBER 1, 2027. 25
Article – State Finance and Procurement 26
7–331. 27
(a) In this section, “Fund” means the Opioid Restitution Fund. 28
(f) The Fund may be used only to provide funds for: 29
(1) programs, services, supports, and resources for evidence–based 30
substance use disorder prevention, treatment, recovery, or harm reduction that have the 31
purpose of: 32
SENATE BILL 1099 11
(i) improving access to medications proven to prevent or reverse an 1
overdose, INCLUDING BY SUPPORT ING THE INITIATIVE T O CO–LOCATE NALOXONE 2
WITH AUTOMATED EXTER NAL DEFIBRILLATORS P LACED IN PUBLIC BUIL DINGS 3
UNDER § 13–518 OF THE EDUCATION ARTICLE; 4
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 5
October 1, 2024. 6
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.