WES MOORE, Governor Ch. 764
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Chapter 764
(Senate Bill 1099)
AN ACT concerning
Emergency Services – Automated External Defibrillator and Naloxone
Co–Location Initiative – Requirements for Public Buildings
FOR the purpose of requiring the State Emergency Medical Services Board, in collaboration
with the Maryland Department of Health, to develop and implement an initiative
under the Public Access Automated External Defibrillator Program to require that
naloxone be co–located with each automated external defibrillator placed in a public
building; establishing a certain immunity from liability for owners and operators of
public buildings who provide and maintain naloxone under the initiative and for
individuals who administer naloxone made available under the initiative in response
to a known or suspected drug overdose; requiring that the initiative be funded using
available funds from the Opioid Restitution Fund appropriated through the State
budget; and generally relating to emergency services and the availability of naloxone
in public buildings.
BY repealing and reenacting, with amendments,
Article – Courts and Judicial Proceedings
Section 5–603
Annotated Code of Maryland
(2020 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – Education
Section 13–517
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
BY adding to
Article – Education
Section 13–518
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – State Finance and Procurement
Section 7–331(a)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – State Finance and Procurement Ch. 764 2024 LAWS OF MARYLAND
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Section 7–331(f)(1)(i)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Courts and Judicial Proceedings
5–603.
(a) A person described in subsection (b) of this section is not civilly liable for any
act or omission in giving any assistance or medical care, if:
(1) The act or omission is not one of gross negligence;
(2) The assistance or medical care is provided without fee or other
compensation; and
(3) The assistance or medical care is provided:
(i) At the scene of an emergency;
(ii) In transit to a medical facility; or
(iii) Through communications with personnel providing emergency
assistance.
(b) Subsection (a) of this section applies to the following:
(1) An individual who is licensed by this State to provide medical care;
(2) A member of any State, county, municipal, or volunteer fire
department, ambulance and rescue squad, or law enforcement agency, the National Ski
Patrol System, or a corporate fire department responding to a call outside of its corporate
premises, if the member:
(i) Has completed an American Red Cross course in advanced first
aid and has a current card showing that status;
(ii) Has completed an equivalent of an American Red Cross course in
advanced first aid, as determined by the Secretary of Health;
(iii) Is certified or licensed by this State as an emergency medical
services provider; or
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(iv) Is administering medications or treatment approved for use in
response to an apparent drug overdose and the member is:
1. Licensed or certified as an emergency medical services
provider by the State Emergency Medical Services Board and authorized to administer the
medications and treatment under protocols established by the State Emergency Medical
Services Board;
2. Certified to administer the medications and treatment
under protocols established by the Secretary of Health; or
3. Certified to administer the medications and treatment
under protocols established by the Maryland State Police Medical Director;
(3) A volunteer fire department or ambulance and rescue squad whose
members have immunity; and
(4) A corporation when its fire department personnel are immune under
item (2) of this subsection.
(c) (1) An individual who is not covered otherwise by this section is not civilly
liable for any act or omission in providing assistance or medical aid to a victim at the scene
of an emergency, if:
[(1)] (I) The assistance or aid is provided in a reasonably prudent
manner;
[(2)] (II) The assistance or aid is provided without fee or other
compensation; and
[(3)] (III) The individual relinquishes care of the victim when someone who
is licensed or certified by this State to provide medical care or services becomes available
to take responsibility.
(2) THE IMMUNITY FROM CIV IL LIABILITY UNDER P ARAGRAPH (1) OF
THIS SUBSECTION APPLIES T O AN INDIVIDUAL WHEN ADMINISTERING NALOXO NE IN
RESPONSE TO A KNOWN OR SUSPECTED DRUG OV ERDOSE.
Article – Education
13–517.
(a) (1) In this section the following words have the meanings indicated.
(2) “Automated external defibrillator (AED)” means a medical heart
monitor and defibrillator device that: Ch. 764 2024 LAWS OF MARYLAND
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(i) Is cleared for market by the federal Food and Drug
Administration;
(ii) Recognizes the presence or absence of ventricular fibrillation or
rapid ventricular tachycardia;
(iii) Determines, without intervention by an operator, whether
defibrillation should be performed;
(iv) On determining that defibrillation should be performed,
automatically charges; and
(v) 1. Requires operator intervention to deliver the electrical
impulse; or
2. Automatically continues with delivery of electrical
impulse.
(3) “Certificate” means a certificate issued by the EMS Board to a
registered facility.
(4) (i) “Facility” means an agency, an association, a corporation, a firm,
a partnership, or any other entity.
(ii) “Facility” does not include a grocery store or restaurant that is
subject to § 21–330.3 of the Health – General Article.
(5) “Jurisdictional emergency medical services operational program”
means the institution, agency, corporation, or other entity that has been approved by the
EMS Board to provide oversight of emergency medical services for each of the local
government and State and federal emergency medical services programs.
(6) “Program” means the Public Access Automated External Defibrillator
Program.
(7) “Regional administrator” means the individual employed by the
Institute as regional administrator in each EMS region.
(8) “Regional council” means an EMS advisory body as created by the Code
of Maryland Regulations 30.05.
(9) “Regional council AED committee” means a committee appointed by the
regional council consisting of:
(i) The regional medical director; WES MOORE, Governor Ch. 764
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(ii) The regional administrator; and
(iii) Three or more individuals with knowledge of and expertise in
AEDs.
(10) “Registered facility” means an organization, a business association, an
agency, or any other entity that meets the requirements of the EMS Board for registering
with the Program.
(b) (1) There is a Public Access Automated External Defibrillator Program.
(2) The purpose of the Program is to [coordinate]:
(I) COORDINATE an effective statewide public access defibrillation
program; AND
(II) IMPLEMENT THE INITIAT IVE TO CO–LOCATE NALOXONE
WITH AUTOMATED EXTERNAL DEFIBRILLAT ORS PLACED IN PUBLIC BUILDINGS, AS
REQUIRED UNDER § 13–518 OF THIS SUBTITLE .
(3) The Program shall be administered by the EMS Board.
(c) The EMS Board may:
(1) Adopt regulations for the administration of the Program;
(2) Issue and renew certificates to facilities that meet the requirements of
this section;
(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered
facility for failure to meet the requirements of this section;
(4) Approve educational and training programs required under this section
that:
(i) Are conducted by any private or public entity;
(ii) Include training in cardiopulmonary resuscitation and
automated external defibrillation; and
(iii) May include courses from nationally recognized entities such as
the American Heart Association, the American Red Cross, and the National Safety Council;
(5) Approve the protocol for the use of an AED; and
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(6) Delegate to the Institute any portion of its authority under this section.
(d) (1) Each facility that desires to make automated external defibrillation
available shall possess a valid certificate from the EMS Board.
(2) This subsection does not apply to:
(i) A jurisdictional emergency medical services operational
program;
(ii) A licensed commercial ambulance service;
(iii) A health care facility as defined in § 19–114 of the Health –
General Article; or
(iv) A place of business for health care practitioners who are licensed
as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14
of the Health Occupations Article and are authorized to use an AED in accordance with
that license.
(e) To qualify for a certificate a facility shall:
(1) Comply with the written protocol approved by the EMS Board for the
use of an AED which includes notification of the emergency medical services system
through the use of the 911 universal emergency access number as soon as possible on the
use of an AED;
(2) Have established automated external d efibrillator maintenance,
placement, operation, reporting, and quality improvement procedures as required by the
EMS Board;
(3) Maintain each AED and all related equipment and supplies in
accordance with the standards established by the device manufacturer and the federal Food
and Drug Administration; [and]
(4) Ensure that each individual who is expected to operate an AED for the
registered facility has successfully completed an educational training course and refresher
training as required by the EMS Board; AND
(5) IF THE FACILITY IS A PUBLIC BUILDING , MEET ANY
REQUIREMENTS ESTABLI SHED UNDER § 13–518 OF THIS SUBTITLE REL ATING TO
THE CO–LOCATION OF NALOXONE WITH EACH AED MAINTAINED IN THE FA CILITY.
(f) A registered facility shall report the use of an AED to the Institute for review
by the regional council AED committee.
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(g) A facility that desires to establish or renew a certificate shall:
(1) Submit an application on the form that the EMS Board requires; and
(2) Meet the requirements under this section.
(h) (1) The EMS Board shall issue a new or a renewed certificate to a facility
that meets the requirements of this section.
(2) Each certificate shall include:
(i) The type of certificate;
(ii) The full name and address of the facility;
(iii) A unique identification number; and
(iv) The dates of issuance and expiration of the certificate.
(3) A certificate is valid for 3 years.
(i) The EMS Board may issue a cease and desist order or obtain injunctive relief
if a facility makes automated external defibrillation available in violation of this section.
(j) (1) In addition to any other immunities available under statutory or
common law, a registered facility is not civilly liable for any act or omission in the provision
of automated external defibrillation if the registered facility:
(i) Has satisfied the requirements for making automated external
defibrillation available under this section; and
(ii) Possesses a valid certificate at the time of the act or omission.
(2) In addition to any other immunities available under statutory or
common law, a member of the regional council AED committee is not civilly liable for any
act or omission in the provision of automated external defibrillation.
(3) In addition to any other immunities available under statutory or
common law, an individual is not civilly liable for any act or omission if:
(i) The individual is acting in good faith while rendering automated
external defibrillation to a person who is a victim or reasonably believed by the individual
to be a victim of a sudden cardiac arrest;
(ii) The assistance or aid is provided in a reasonably prudent
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(iii) The automated external defibrillation is provided without fee or
other compensation.
(4) The immunities in this subsection are not available if the conduct of the
registered facility or an individual amounts to gross negligence, willful or wanton
misconduct, or intentionally tortious conduct.
(5) This subsection does not affect, and may not be construed as affecting,
any immunities from civil or criminal liability or defenses established by any other
provision of the Code or by common law to which a registered facility, a member of the
regional council AED committee, or an individual may be entitled.
(k) (1) A registered facility aggrieved by a decision of the Institute acting
under the delegated authority of the EMS Board under this section shall be afforded an
opportunity for a hearing before the EMS Board.
(2) A registered facility aggrieved by a decision of the EMS Board under
this section shall be afforded an opportunity for a hearing in accordance with Title 10,
Subtitle 2 of the State Government Article.
13–518.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) “AUTOMATED EXTERNAL DE FIBRILLATOR (AED)” HAS THE
MEANING STATED IN § 13–517 OF THIS SUBTITLE.
(3) “NALOXONE” MEANS THE MEDICATION APPROVED BY THE
FEDERAL FOOD AND DRUG ADMINISTRATION FOR COMMUNITY USE FOR THE
REVERSAL OF A KNOWN OR SUSPECTED OPIOID OVERDO SE.
(4) “PUBLIC BUILDING ” MEANS:
(I) A PUBLIC MASS TRANSPOR TATION ACCOMMODATION , SUCH
AS A TERMINAL OR STA TION, THAT IS SUPPORTED BY PUBLIC FUNDS;
(II) AN IMPROVEMENT OF A P UBLIC AREA USED FOR
GATHERING OR AMUSEME NT, INCLUDING A PUBLIC P ARK OR RECREATION CE NTER;
OR
(III) A FACILITY THAT IS SUP PORTED BY PUBLIC FUN DS AND
PRIMARILY USED TO PR OVIDE SECONDARY OR H IGHER EDUCATION .
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(B) (1) THE EMS BOARD, IN COLLABORATION WIT H THE MARYLAND
DEPARTMENT OF HEALTH, SHALL DEVELOP AND IMPLEMENT A N INITIATIVE UNDER
THE PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM TO
REQUIRE THAT NALOXON E BE CO–LOCATED WITH EACH AU TOMATED EXTERNAL
DEFIBRILLATOR PLACED IN A PUBLIC BUILDING .
(2) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS
SUBSECTION SHALL ENS URE THAT UP TO TWO D OSES OF NALOXONE ARE
MAINTAINED IN A LOCA TION THAT:
(I) IS VISIBLE AND IN CLO SE PHYSICAL PROXIMIT Y TO THE
AUTOMATED EXTERNAL D EFIBRILLATOR ; AND
(II) HAS A LABEL THAT CLEA RLY INDICATES TO THE PUBLIC
THE AVAILABILITY OF NALOXONE.
(3) THE INITIATIVE DEVELO PED UNDER PARAGRAPH (1) OF THIS
SUBSECTION SHALL BE FUNDED IN THE SAME MANNER A S THE PUBLIC ACCESS
AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM USING AVAILABLE FUNDS
FROM THE OPIOID RESTITUTION FUND APPROPRIATED THROUGH THE STATE
BUDGET.
(C) (1) THE OWNER OR OPERATOR OF A PUBLIC BUILDING IS NOT CIVILLY
LIABLE FOR ANY ACT O R OMISSION IN THE PR OVISION AND MAINTENA NCE OF
NALOXONE UNDER THE I NITIATIVE DEVELOPED UNDER SUBSECTION (B)(1) OF THIS
SECTION IF THE OWNER OR OPERATOR HAS SATI SFIED ANY REQUIREMEN TS
ESTABLISHED FOR PROV IDING AND MAINTAININ G NALOXONE UNDER THE
INITIATIVE.
(2) AN INDIVIDUAL WHO ADM INISTERS NALOXONE MA DE AVAILABLE
UNDER THE INITIATIVE DEVELOPED UNDER PARA GRAPH (1) OF THIS SUBSECTION
IN RESPONSE TO A KNO WN OR SUSPECTED DRUG OVERDOSE SHALL HAVE IMMUNITY
FROM CIVIL LIABILITY AS PROVIDED IN § 5–603 OF THE COURTS ARTICLE.
(D) THE EMS BOARD AND THE MARYLAND DEPARTMENT OF HEALTH
JOINTLY SHALL ADOPT REGULATIONS THAT :
(1) ESTABLISH GUIDELINES FOR PERIODIC INSPECTIONS AND
MAINTENANCE OF THE N ALOXONE PLACED IN PU BLIC BUILDINGS; AND
(2) ASSIST THE ADMINISTRA TORS OF EACH PUBLIC BUILDING IN
CARRYING OUT THE PRO VISIONS OF THIS SECT ION; AND
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(3) ESTABLISH INITIAL PRI ORITIZATION OF THE P UBLIC BUILDINGS
ELIGIBLE TO RECEIVE FUNDING UNDER THIS S ECTION WITH A GOAL O F
CO–LOCATION OF NALOXONE WITH EACH AUTOMATED EXTERNAL DEFIBRILLAT OR
LOCATED IN A PUBLIC BUILDING BY OCTOBER 1, 2027.
Article – State Finance and Procurement
7–331.
(a) In this section, “Fund” means the Opioid Restitution Fund.
(f) The Fund may be used only to provide funds for:
(1) programs, services, supports, and resources for evidence–based
substance use disorder prevention, treatment, recovery, or harm reduction that have the
purpose of:
(i) improving access to medications proven to prevent or reverse an
overdose, INCLUDING BY SUPPORT ING THE INITIATIVE T O CO–LOCATE NALOXONE
WITH AUTOMATED EXTER NAL DEFIBRILLATORS P LACED IN PUBLIC BUILDINGS
UNDER § 13–518 OF THE EDUCATION ARTICLE;
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2024.
Approved by the Governor, May 16, 2024.