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.
*sb0458*
SENATE BILL 458
J1, J2 5lr2047
CF HB 783
By: Senator Gile
Introduced and read first time: January 21, 2025
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 18, 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
(2021 Replacement Volume and 2024 Supplement) 22
2 SENATE BILL 458
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2
Article – Health – General 3
20–1301. 4
(a) In this subtitle the following words have the meanings indicated. 5
(b) “Cultural and linguistic competency” means cultural and linguistic abilities 6
that can be incorporated into therapeutic and medical evaluation and treatment, including: 7
(1) Direct communication in the patient’s primary language; 8
(2) Understanding and applying the roles that culture, ethnicity, and race 9
play in diagnosis, treatment, and clinical care; and 10
(3) Awareness of how the attitudes, values, and beliefs of health care 11
providers and patients influence and impact professional and patient relations. 12
(c) “Health care professional” includes a physician, nurse, dentist, social worker, 13
psychologist, pharmacist, health educator, or other allied health professional. 14
(d) “Implicit bias” means a bias in judgment that results from subtle cognitive 15
processes, including the following prejudices and stereotypes that often operate at a level 16
below conscious awareness and without intentional control: 17
(1) Prejudicial negative feelings or beliefs about a group that an individual 18
holds without being aware of the feelings or beliefs; and 19
(2) Unconscious attributions of particular qualities to a member of a 20
specific social group that are influenced by experience and based on learned associations 21
between various qualities and social categories, including race and gender. 22
(e) “Program” means the Cultural and Linguistic Health Care Professional 23
Competency Program. 24
(F) “STRUCTURAL RACISM ” MEANS A SYSTEM OF INHERITE D 25
INSTITUTIONAL SETTIN GS THAT PROVIDE DIFFERENTIAL OPPORTU NITIES FOR 26
HEALTH CARE , EDUCATION, HOUSING, EMPLOYMENT , AND THE ENVIRONMENT TO 27
AN INDIVIDUAL BASED ON THE INDIVIDUAL ’S RACE THE TOTALITY OF WAYS IN 28
WHICH SOCIETIES FOST ER RACIAL DISCRIMINA TION BY MUTUALLY REI NFORCING 29
SYSTEMS OF HOUSING , EDUCATION, EMPLOYMENT , EARNINGS, BENEFITS, CREDIT, 30
MEDIA, HEALTH CARE , AND CRIMINAL JUSTICE . 31
20–1302. 32 SENATE BILL 458 3
(a) There is a Cultural and Linguistic Health Care Professional Competency 1
Program. 2
(b) The purpose of the Program is to: 3
(1) Provide for a voluntary program in which educational classes are 4
offered to health care professionals to teach health care professionals: 5
(i) Methods to improve the health care professionals’ cultural and 6
linguistic competency to communicate with non–English speaking patients and patients 7
from other cultures who are English speaking; 8
(ii) Cultural beliefs and practices that may impact patient health 9
care practices and allow health care professionals to incorporate the knowledge of the 10
beliefs and practices in the diagnosis and treatment of patients; and 11
(iii) Methods to enable health care professionals to increase the 12
health literacy of their patients to improve the patient’s ability to obtain, process, and 13
understand basic health information and services to make appropriate health care 14
decisions; 15
(2) Establish and provide an evidence–based implicit bias training 16
program for health care professionals involved in the perinatal care of patients under § 17
20–1305 of this subtitle; and 18
(3) Identify and approve implicit bias AND STRUCTURAL RACIS M training 19
programs for health occupation licensure and certification under § 1–225 of the Health 20
Occupations Article. 21
20–1306. 22
(a) (1) The Program shall, in coordination with the Office of Minority Health 23
and Health Disparities, identify and approve implicit bias AND STRUCTURAL RACIS M 24
training programs that an individual may complete to satisfy the requirements of § 1–225 25
of the Health Occupations Article. 26
(2) The Program may approve only implicit bias AND STRUCTURAL 27
RACISM training programs under paragraph (1) of this subsection that are recognized by a 28
health occupations board established under the Health Occupations Article or accredited 29
by the Accreditation Council for Continuing Medical Education OR THE ACCREDITATION 30
COUNCIL FOR PHARMACY EDUCATION. 31
(b) The Program shall provide a list of training programs approved under 32
subsection (a) of this section on request. 33
4 SENATE BILL 458
Article – Health Occupations 1
1–225. 2
(a) [An] SUBJECT TO SUBSECTION (B) (C) OF THIS SECTION, AN applicant for 3
the renewal of a license or certificate issued by a health occupations board under this article 4
shall attest in the application that the applicant has completed an implicit bias AND 5
STRUCTURAL RACISM training program approved by the Cultural and Linguistic Health 6
Care Professional Competency Program under § 20–1306 of the Health – General Article. 7
(b) EACH HEALTH OCCUPATIO NS BOARD MAY ADOPT R EGULATIONS THAT 8
ALLOW AN APPLICANT S EEKING LICENSE RENEW AL TO RECEIVE CONTIN UING 9
EDUCATION CREDITS F OR COMPLETING AN IMP LICIT BIAS AND STRUC TURAL 10
RACISM TRAINING PROG RAM. 11
(C) The [requirements of] REQUIREMENT UNDER subsection (a) of this section 12
THAT AN APPLICANT AT TEST TO THE COMPLETI ON OF AN IMPLICIT BI AS AND 13
STRUCTURAL RACISM TR AINING PROGRAM shall apply only to an applicant’s first 14
license or certificate renewal after April 1, [2022] 2026. 15
SECTION 2. AND BE IT FURTHER ENACTED, That, if an applicant for the 16
renewal of a license or certificate issued by a health occupations board under the Health 17
Occupations Article is applying on or after the effective date of this Act but before April 1, 18
2026, for the applicant’s first license or certificate renewal, the applicant shall attest in the 19
application that the applicant has completed an implicit bias training program approved 20
by the Cultural and Linguistic Health Care Professional Competency Program under § 21
20–1306 of the Health – General Article. 22
SECTION 3. AND BE IT FURTHER ENACTED, That it is the intent of the General 23
Assembly that the structural racism training required under this Act be developed and 24
offered using funding from the grant provided to the Maryland Nurses Association from the 25
American Nurses Association to advance antiracism efforts. 26
SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 27
October 1, 2025. 28