EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0474*
HOUSE BILL 474
J1, J3 5lr2341
CF SB 129
By: Delegates Bagnall, Hill, Kaiser, Kaufman, Lehman, Lopez, Martinez,
Palakovich Carr, White Holland, Wolek, and Woorman
Introduced and read first time: January 20, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Public Health – Maryland Commission on Health Equity – Advisory Committee 2
and Hospital Reporting 3
FOR the purpose of requiring the Maryland Commission on Health Equity, in coordination 4
with the Maryland Department of Health, to establish a health equity measures 5
advisory committee; requiring licensed hospitals in the State to submit a health 6
equity report annually to the Department and the health equity advisory committee; 7
and generally relating to the health equity and hospital reporting. 8
BY repealing and reenacting, with amendments, 9
Article – Health – General 10
Section 13–4301 11
Annotated Code of Maryland 12
(2023 Replacement Volume and 2024 Supplement) 13
BY repealing and reenacting, without amendments, 14
Article – Health – General 15
Section 13–4302 16
Annotated Code of Maryland 17
(2023 Replacement Volume and 2024 Supplement) 18
BY adding to 19
Article – Health – General 20
Section 13–4308 21
Annotated Code of Maryland 22
(2023 Replacement Volume and 2024 Supplement) 23
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 24
That the Laws of Maryland read as follows: 25
2 HOUSE BILL 474
Article – Health – General 1
13–4301. 2
(a) In this subtitle the following words have the meanings indicated. 3
(b) “Commission” means the Maryland Commission on Health Equity. 4
(C) “COMMITTEE” MEANS THE HEALTH EQU ITY MEASURES ADVISOR Y 5
COMMITTEE ESTABLISHE D UNDER § 13–4308(A) OF THIS SUBTITLE. 6
(D) “GEOGRAPHIC LOCATION ” MEANS AN URBAN , SUBURBAN, OR RURAL 7
AREA OF THE STATE. 8
(E) “HEALTH DISPARITY ” MEANS A DIFFERENCE I N A PARTICULAR TYPE OF 9
HEALTH OUTCOME OR OP PORTUNITY, SUCH AS A DIFFERENCE IN RATES OF 10
HYPERTENSION , HEART DISEASE , ASTHMA, DIABETES, SUBSTANCE ABUSE , MENTAL 11
HEALTH DISORDERS , AND MATERNAL AND INF ANT MORTALITY , THAT: 12
(1) IS CLOSELY LINKED WIT H SOCIAL , ECONOMIC, OR 13
ENVIRONMENTAL DISADV ANTAGE; AND 14
(2) ADVERSELY AFFECTS GRO UPS OF INDIVIDUALS W HO HAVE 15
SYSTEMATICALLY EXPER IENCED GREATER OBSTACLES TO HEALTH CARE BASED ON : 16
(I) RACE OR ETHNICITY ; 17
(II) RELIGION; 18
(III) SOCIOECONOMIC STATUS ; 19
(IV) GENDER, GENDER IDENTITY , OR SEXUAL ORIENTATIO N; 20
(V) AGE; 21
(VI) MENTAL HEALTH STATUS ; 22
(VII) COGNITIVE, SENSORY, OR PHYSICAL DISABILITY; 23
(VIII) GEOGRAPHIC LOCATION ; OR 24
(IX) ANOTHER CHARACTERISTI C HISTORICALLY LINKE D TO 25
DISCRIMINATION OR EX CLUSION. 26
HOUSE BILL 474 3
[(c)] (F) “Health equity framework” means a public health framework through 1
which policymakers and stakeholders in the public and private sectors use a collaborative 2
approach to improve health outcomes and reduce health inequities in the State by 3
incorporating health considerations into decision making across sectors and policy areas. 4
(G) “HEALTH EQUITY REPORT ” MEANS A C OMPREHENSIVE REPORT 5
ANALYZING HEALTH STA TUS AND ACCESS TO CA RE DISPARITIES IN A PATIENT 6
POPULATION , INFORMED BY NATIONAL , STATE, LOCAL, AND INTERNAL DATA AN D 7
ANY OTHER RELEVANT S OURCE. 8
(H) “HEALTH EQUITY STRATEG Y” MEANS AN EQUITY STRA TEGY CREATED 9
TO REDUCE HEALTH DISPARITIE S, PARTICULARLY IN AREA S IDENTIFIED AS HIGH 10
PRIORITIES BY NATION AL, STATE, LOCAL, AND INTERNAL DATA AN D ANY OTHER 11
RELEVANT SOURCE . 12
[(d)] (I) “Statewide health equity plan” means the equity plan required under a 13
cooperative grant funding agreement with the Center for Medicare and Medicaid 14
Innovation. 15
(J) “VULNERABLE POPULATION S” INCLUDE: 16
(1) RACIAL OR ETHNIC MINO RITIES; 17
(2) THE UNHOUSED ; 18
(3) INDIVIDUALS WITH DISA BILITIES; AND 19
(4) INDIVIDUALS THAT IDEN TIFY AS LESBIAN , GAY, BISEXUAL, 20
TRANSGENDER , OR QUEER. 21
13–4302. 22
There is a Maryland Commission on Health Equity. 23
13–4308. 24
(A) (1) THE COMMISSION SHALL , IN COORDINATION WITH THE 25
DEPARTMENT , ESTABLISH A HEALTH E QUITY MEASURES ADVIS ORY COMMITTEE TO : 26
(I) DETERMINE THE 10 WIDEST DISPARITIES I N HEALTH CARE 27
QUALITY, ACCESS, OR OUTCOMES FOR VULN ERABLE POPULATIONS ; 28
(II) REVIEW EACH HEALTH EQ UITY REPORT SUBMITTE D BY A 29
LICENSED HOSPITAL IN THE STATE; AND 30 4 HOUSE BILL 474
(III) MAKE RECOMMENDATIONS TO THE SECRETARY 1
REGARDING THE HEALTH EQUITY REPORTS. 2
(2) THE COMMITTEE SHALL I NCLUDE: 3
(I) A REPRESENTATIVE OF TH E DEPARTMENT ; AND 4
(II) THE FOLLOWING MEMBERS , APPOINTED BY THE 5
SECRETARY WITH THE AD VICE OF THE COMMISSION: 6
1. ONE ACADEMIC HEALTH C ARE QUALITY AND 7
MEASUREMENT EXPERT ; 8
2. ONE INDIVIDUAL FROM A N ASSOCIATION 9
REPRESENTING PUBLIC HOSPITALS OR HEALTH SYSTEMS; 10
3. ONE INDIVIDUAL FROM A N ASSOCIATION 11
REPRESENTING PRIVATE HOSPITALS OR HEALTH SYSTEMS; 12
4. ONE INDIVIDUAL FROM A N ORGANIZATION 13
REPRESENTING ORGANIZ ED LABOR; 14
5. ONE INDIVIDUAL FROM A N ORGANIZATION 15
REPRESENTING CONSUME RS OF HEALTH CARE SE RVICES IN THE STATE; AND 16
6. ONE INDIVIDUAL FROM A N ORGANIZATION 17
REPRESENTING VULNERA BLE POPULATIONS . 18
(B) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , ON OR 19
BEFORE OCTOBER 1 EACH YEAR, BEGINNING IN 2025, EACH LICENSED HOSPIT AL IN 20
THE STATE SHALL SUBMIT A HEALTH EQUITY REPORT TO THE DEPARTMENT AND 21
THE COMMITTEE . 22
(2) EACH HOSPITAL SYSTEM WITH MORE THAN ONE L ICENSED 23
HOSPITAL IN THE STATE SHALL SUBMIT A HEALTH EQUITY REPORT THAT I S: 24
(I) DISAGGREGATED AT THE LEVEL OF EACH INDIVI DUALLY 25
LICENSED HOSPITAL IN THE STATE THAT IS PART OF THE HOSPITAL SYSTEM ; AND 26
(II) AGGREGATED ACROSS ALL LICENSED HOSPITALS I N THE 27
HOSPITAL SYSTEM . 28
HOUSE BILL 474 5
(3) EACH LICENSED HOSPITA L SHALL PUBLISH ITS HE ALTH EQUITY 1
REPORT ON THE HOSPIT AL’S WEBSITE. 2
(4) THE DEPARTMENT SHALL PUBL ISH EACH HOSPITAL ’S HEALTH 3
EQUITY REPORT ON THE DEPARTMENT ’S WEBSITE. 4
(C) THE HEALTH EQUITY REP ORT REQUIRED UNDER S UBSECTION (B) OF 5
THIS SECTION SHALL I NCLUDE: 6
(1) AN ANALYSIS OF THE DI SPARITIES IN HEALTH STATUS AND 7
ACCESS TO CARE AT TH E HOSPITAL IN THE IM MEDIATELY PRECEDING FISCAL YEAR 8
DISAGGREGATED BY : 9
(I) AGE; 10
(II) SEX; 11
(III) RACE; 12
(IV) ETHNICITY; 13
(V) SOCIOECONOMIC STATUS ; AND 14
(VI) GEOGRAPHIC LOCATION ; AND 15
(2) A HEALTH EQUITY STRATE GY TO ACHIEVE DISPAR ITY REDUCTION 16
THAT: 17
(I) INCLUDES MEASURABLE O BJECTIVES WITH SPECI FIC 18
TIMELINES FOR IMPLEM ENTATION; 19
(II) ADDRESSES THE 10 WIDEST DISPARITIES I N HEALTH CARE 20
QUALITY, ACCESS, OR OUTCOMES FOR VULN ERABLE POPULATIONS A S DETERMINED 21
BY THE COMMITTEE UND ER SUBSECTION (A)(1)(I) OF THIS SECTION; AND 22
(III) ADDRESSES HOSPITAL PE RFORMANCE ACROSS THE 23
FOLLOWING PRIORITY A REAS: 24
1. PERSON–CENTERED CARE ; 25
2. PATIENT SAFETY; 26
3. SOCIAL DETERMINATES O F HEALTH FOR PATIENT S; 27 6 HOUSE BILL 474
4. EFFECTIVE TREATMENT ; 1
5. CARE COORDINATION ; AND 2
6. ACCESS TO CARE. 3
(D) THE DEPARTMENT MAY ADOPT REGULATIONS TO CARRY OUT THIS 4
SECTION. 5
SECTION 2. AND BE IT FURTHER ENACTED, That th is Act shall take effect July 6
1, 2025. 7