Maryland 2024 Regular Session

Maryland Senate Bill SB332 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	WES MOORE, Governor Ch. 923
2	1
3		-	– 1 –
4		-	Chapter 923
5		-	(Senate Bill 332)
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	+	sb0332
8	9
9		-	Hospitals and Urgent Care Centers – Sepsis Protocol
10		-	(Lochlin’s Law)
	10	+	SENATE BILL 332
	11	+	J3, J1 4lr1623
	12	+	CF HB 84
	13	+	By: Senators Lewis Young and Guzzone
	14	+	Introduced and read first time: January 12, 2024
	15	+	Assigned to: Finance
	16	+	Committee Report: Favorable with amendments
	17	+	Senate action: Adopted
	18	+	Read second time: February 27, 2024
11	19
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.
	20	+	CHAPTER ______
18	21
19		-	BY adding to
20		-	Article – Health – General
21		-	Section 19–310.4
22		-	Annotated Code of Maryland
23		-	(2023 Replacement Volume)
	22	+	AN ACT concerning 1
24	23
25		-	~~SECTION 1.~~ ~~BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,~~
26		-	~~That the Laws of Maryland read as follows:~~
	24	+	Hospitals and Urgent Care Centers – Sepsis Protocol 2
	25	+	(Lochlin’s Law) 3
27	26
28		-	Article – Health – General
	27	+	FOR the purpose of requiring, on or before a certain date, each hospital and urgent care 4
	28	+	center in the State to implement a certain protocol for the early recognition and 5
	29	+	treatment of a patient with sepsis, severe sepsis, or septic shock; requiring hospitals 6
	30	+	and urgent care centers to require periodic training in the implementation of the 7
	31	+	protocol for certain staff; and generally relating to sepsis protocols in hospitals and 8
	32	+	urgent care centers. 9
29	33
30		-	19–310.4.
	34	+	BY adding to 10
	35	+	Article – Health – General 11
	36	+	Section 19–310.4 12
	37	+	Annotated Code of Maryland 13
	38	+	(2023 Replacement Volume) 14
31	39
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.
	40	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
	41	+	That the Laws of Maryland read as follows: 16
37	42
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.
	43	+	Article – Health – General 17
41	44
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.
	45	+	19–310.4. 18
46	46
47		-	(2) THE PROTOCOL SHALL : Ch. 923 2024 LAWS OF MARYLAND
	47	+	(A) (1) ON SUBJECT TO PARAGRAPHS (1) AND (2) OF THIS SUBSECTION , 19
	48	+	ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL AND UR GENT CARE CENTER IN 20 2 SENATE BILL 332
48	49
49		-	– 2 –
50	50
51		-	(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION,
52		-	CARE, AND TREATMENT OF ADULTS AND CHILDREN ; AND
	51	+	THE STATE SHALL IMPLEMENT AN EVIDENCE–BASED PROTOCOL FOR T HE EARLY 1
	52	+	RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE SEPSIS, OR 2
	53	+	SEPTIC SHOCK THAT IS BASED ON GENERALLY A CCEPTABLE STANDARDS OF CARE. 3
53	54
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~~.
	55	+	(2) THE EVIDENCE –BASED PROTOCOL IMPLE MENTED FOR 4
	56	+	HOSPITALS UNDER PARA GRAPH (1) OF THIS SUBSECTION S HALL COMPLY WITH THE 5
	57	+	CENTERS FOR DISEASE CONTROL AND PREVENTION SEPSIS GUI DELINES. 6
57	58
58		-	(3) THE COMPONENTS REQUIR ED UNDER PARAGR APH (2) OF THIS
59		-	SUBSECTION SHALL INC LUDE:
	59	+	(3) A HOSPITAL THAT IS A S PECIALTY PSYCHIATRIC HOSPITAL SHALL 7
	60	+	ESTABLISH A PROC ESS FOR THE SCREENIN G AND EARLY RECOGNIT ION OF A 8
	61	+	PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK , AND PROCEDURES TO 9
	62	+	TRANSFER THE PATIENT TO THE APPROPRIATE S ETTING. 10
60	63
61		-	(I) A PROCESS FOR THE SCRE ENING AND EARLY RECO GNITION
62		-	OF A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK ;
	64	+	(2) THE PROTOCOL SHALL : 11
63	65
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;
	66	+	(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION, 12
	67	+	CARE, AND TREATMENT OF ADU LTS AND CHILDREN ; AND 13
69	68
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 ;~~
	69	+	(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHE RE AND WHEN 14
	70	+	THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING T REATMENT 15
	71	+	IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT. 16
73	72
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;
	73	+	(3) THE COMPONENTS REQUIR ED UNDER PARAGRAPH (2) OF THIS 17
	74	+	SUBSECTION SHALL INC LUDE: 18
78	75
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
	76	+	(I) A PROCESS FOR THE SCRE ENING AND EARLY RECO GNITION 19
	77	+	OF A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK ; 20
83	78
84		-	(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF
85		-	VASOACTIVE AGENTS .
	79	+	(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS 21
	80	+	APPROPRIATE FOR TREA TMENT THROUG H SEPSIS PROTOCOLS , INCLUDING 22
	81	+	EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED FROM THE 23
	82	+	PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATI ENT 24
	83	+	WHO HAS CHOSEN PALLI ATIVE CARE; 25
86	84
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.
	85	+	(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH EXPLICIT 26
	86	+	PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR 27
	87	+	NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ; 28
91	88
92		-	(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: WES MOORE, Governor Ch. 923
	89	+	(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID 29
	90	+	RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR 30
	91	+	SEVERE SEPSIS AND SEPTI C SHOCK WITH DEFINED THERAPEUTIC GOALS FO R 31
	92	+	CHILDREN; 32
	93	+	SENATE BILL 332 3
93	94
94		-	– 3 –
95	95
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
	96	+	(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D 1
	97	+	DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIMELY REEVALUA TION 2
	98	+	TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFIED 3
	99	+	INFECTIOUS SOURCES ; AND 4
101	100
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 .
	101	+	(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF 5
	102	+	VASOACTIVE AGENTS . 6
105	103
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 .
	104	+	(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR 7
	105	+	MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING 8
	106	+	PROGRAM IS PRES UMED TO MEET THE REQ UIREMENTS OF SUBSECT ION (A) OF THIS 9
	107	+	SECTION. 10
109	108
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 .
	109	+	(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: 11
113	110
114		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
115		-	October 1, 2024.
	111	+	(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMEN TATION OF THE 12
	112	+	SEPSIS PROTOCOL REQU IRED UNDER SUBSECTIO N (A) OF THIS SECTION FOR 13
	113	+	PROFESSIONAL STAFF WITH DIRECT PA TIENT CARE RESPONSIB ILITIES AND, AS 14
	114	+	APPROPRIATE , FOR STAFF WITH INDIR ECT PATIENT CARE RES PONSIBILITIES, 15
	115	+	INCLUDING LABORATORY AND PHARMACY STAFF ; AND 16
116	116
117		-	Approved by the Governor, May 16, 2024.
	117	+	(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE 17
	118	+	HOSPITAL OR URGENT C ARE CENTER MAKES A SUBSTAN TIVE CHANGE TO THE 18
	119	+	SEPSIS PROTOCOL . 19
	120	+
	121	+	(D) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L COLLECT AND USE 20
	122	+	QUALITY MEASURES REL ATED TO THE RECOGNIT ION AND TREATMENT OF SEVERE 21
	123	+	SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVEMENT . 22
	124	+
	125	+	(E) ON REQUEST, A HOSPITAL OR AN URG ENT CARE CENTER SHAL L 23
	126	+	PROVIDE THE PROTOCOL REQUIRED UNDER SUBSE CTION (A) OF THIS SECTION TO 24
	127	+	THE DEPARTMENT . 25
	128	+
	129	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 26
	130	+	October 1, 2024. 27
	131	+