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. *hb0783* HOUSE BILL 783 J1, J2 5lr2111 CF SB 458 By: Delegates Pena–Melnyk, Bagnall, Cullison, Kerr, and Rosenberg Rosenberg, Alston, Bhandari, Guzzone, Hill, S. Johnson, Kaiser, Lopez, Martinez, Taveras, White Holland, Woods, Woorman, and Ross Introduced and read first time: January 29, 2025 Assigned to: Health and Government Operations Committee Report: Favorable with amendments House action: Adopted Read second time: February 27, 2025 CHAPTER ______ AN ACT concerning 1 Health Occupations – Implicit Bias and Structural Racism Training 2 FOR the purpose of requiring applicants for renewal of certain licenses and certain 3 certificates issued by certain health occupation boards to attest that the applicant 4 completed an implicit bias and structural racism training program, rather than an 5 implicit bias training program, approved by the Cultural and Linguistic Health Care 6 Professional Competency Program; altering the implicit bias training programs that 7 the Program may approve; authorizing certain health occupations boards to adopt 8 regulations that allow applicants seeking license renewal to receive continuing 9 education credits for completing an implicit bias and structural racism training 10 program; and generally relating to implicit bias and structural racism training 11 programs. 12 BY repealing and reenacting, with amendments, 13 Article – Health – General 14 Section 20–1301, 20–1302, and 20–1306 15 Annotated Code of Maryland 16 (2023 Replacement Volume and 2024 Supplement) 17 BY repealing and reenacting, with amendments, 18 Article – Health Occupations 19 Section 1–225 20 Annotated Code of Maryland 21 2 HOUSE BILL 783 (2021 Replacement Volume and 2024 Supplement) 1 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2 That the Laws of Maryland read as follows: 3 Article – Health – General 4 20–1301. 5 (a) In this subtitle the following words have the meanings indicated. 6 (b) “Cultural and linguistic competency” means cultural and linguistic abilities 7 that can be incorporated into therapeutic and medical evaluation and treatment, including: 8 (1) Direct communication in the patient’s primary language; 9 (2) Understanding and applying the roles that culture, ethnicity, and race 10 play in diagnosis, treatment, and clinical care; and 11 (3) Awareness of how the attitudes, values, and beliefs of health care 12 providers and patients influence and impact professional and patient relations. 13 (c) “Health care professional” includes a physician, nurse, dentist, social worker, 14 psychologist, pharmacist, health educator, or other allied health professional. 15 (d) “Implicit bias” means a bias in judgment that results from subtle cognitive 16 processes, including the following prejudices and stereotypes that often operate at a level 17 below conscious awareness and without intentional control: 18 (1) Prejudicial negative feelings or beliefs about a group that an individual 19 holds without being aware of the feelings or beliefs; and 20 (2) Unconscious attributions of particular qualities to a member of a 21 specific social group that are influenced by experience and based on learned associations 22 between various qualities and social categories, including race and gender. 23 (e) “Program” means the Cultural and Linguistic Health Care Professional 24 Competency Program. 25 (F) “STRUCTURAL RACISM ” MEANS A SYSTEM OF INHERITE D 26 INSTITUTIONAL SETTIN GS THAT PROVIDE DIFFERENTIAL OPPORTU NITIES FOR 27 HEALTH CARE , EDUCATION, HOUSING, EMPLOYMENT , AND THE ENVIRONMENT TO 28 AN INDIVIDUAL BASED ON THE INDIVIDUAL ’S RACE THE TOTALITY OF WAYS IN 29 WHICH SOCIETIES FOST ER RACIAL DISCRIMINA TION BY MUTUALLY REI NFORCING 30 SYSTEMS OF HOUSING , EDUCATION, EMPLOYMENT , EARNINGS, BENEFITS, CREDIT, 31 MEDIA, HEALTH CARE , AND CRIMINAL JUSTICE . 32 HOUSE BILL 783 3 20–1302. 1 (a) There is a Cultural and Linguistic Health Care Professional Competency 2 Program. 3 (b) The purpose of the Program is to: 4 (1) Provide for a voluntary program in which educational classes are 5 offered to health care professionals to teach health care professionals: 6 (i) Methods to improve the health care professionals’ cultural and 7 linguistic competency to communicate with non–English speaking patients and patients 8 from other cultures who are English speaking; 9 (ii) Cultural beliefs and practices that may impact patient health 10 care practices and allow health care professionals to incorporate the knowledge of the 11 beliefs and practices in the diagnosis and treatment of patients; and 12 (iii) Methods to enable health care professionals to increase the 13 health literacy of their patients to improve the patient’s ability to obtain, process, and 14 understand basic health information and services to make appropriate health care 15 decisions; 16 (2) Establish and provide an evidence–based implicit bias training 17 program for health care professionals involved in the perinatal care of patients under § 18 20–1305 of this subtitle; and 19 (3) Identify and approve implicit bias AND STRUCTURAL RACIS M training 20 programs for health occupation licensure and certification under § 1–225 of the Health 21 Occupations Article. 22 20–1306. 23 (a) (1) The Program shall, in coordination with the Office of Minority Health 24 and Health Disparities, identify and approve implicit bias AND STRUCTURAL RACIS M 25 training programs that an individual may complete to satisfy the requirements of § 1–225 26 of the Health Occupations Article. 27 (2) The Program may approve only implicit bias AND STRUCTURAL 28 RACISM training programs under paragraph (1) of this subsection that are recognized by a 29 health occupations board established under the Health Occupations Article or accredited 30 by the Accreditation Council for Continuing Medical Education OR THE ACCREDITATION 31 COUNCIL FOR PHARMACY EDUCATION. 32 4 HOUSE BILL 783 (b) The Program shall provide a list of training programs approved under 1 subsection (a) of this section on request. 2 Article – Health Occupations 3 1–225. 4 (a) [An] SUBJECT TO SUBSECTION (B) (C) OF THIS SECTION, AN applicant for 5 the renewal of a license or certificate issued by a health occupations board under this article 6 shall attest in the application that the applicant has completed an implicit bias AND 7 STRUCTURAL RACISM training program approved by the Cultural and Linguistic Health 8 Care Professional Competency Program under § 20–1306 of the Health – General Article. 9 (b) EACH HEALTH OCCUPATIO NS BOARD MAY ADOPT R EGULATIONS THAT 10 ALLOW AN APPLICANT S EEKING LICENSE RENEW AL TO RECEIVE CONTIN UING 11 EDUCATION CREDITS F OR COMPLETING AN IMP LICIT BIAS AND STRUC TURAL 12 RACISM TRAINING PROG RAM. 13 (C) The [requirements of] REQUIREMENT UNDER subsection (a) of this section 14 THAT AN APPLICANT AT TEST TO THE COMPLETI ON OF AN IMPLICIT BI AS AND 15 STRUCTURAL RACISM TR AINING PROGRAM shall apply only to an applicant’s first 16 license or certificate renewal after April 1, [2022] 2026. 17 SECTION 2. AND BE IT FURTHER ENACTED, That, if an applicant for the 18 renewal of a license or certificate issued by a health occupations board under the Health 19 Occupations Article is applying on or after the effective date of this Act but before April 1, 20 2026, for the applicant’s first license or certificate renewal, the applicant shall attest in the 21 application that the applicant has completed an implicit bias training program approved 22 by the Cultural and Linguistic Health Care Professional Competency Program under § 23 20–1306 of the Health – General Article. 24 SECTION 3. AND BE IT FURTHER ENACTED, That it is the intent of the General 25 Assembly that the structural racism training required under this Act be developed and 26 offered using funding from the grant provided to the Maryland Nurses Association from the 27 American Nurses Association to advance antiracism efforts. 28 SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 29 October 1, 2025. 30