<?xml version='1.0' encoding='utf-8'?>
<subtitle article="ghg" title_number="13" subtitle_number="10" title_name="Miscellaneous Health Care Programs" subtitle_name="Tobacco Use Prevention and Cessation Program">
  <section article="ghg" article_name="Health - General" number="13-1001" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>In this subtitle the following words have the meanings indicated.</text>
    </level>
    <level label="b">
      <text>“Administrative Component” means the component of the Program that is established under § 13-1014 of this subtitle.</text>
    </level>
    <level label="c">
      <text>“Baseline Tobacco Study” means the study that is conducted under § 13-1003 of this subtitle.</text>
    </level>
    <level label="d">
      <text>“Cigarette Restitution Fund” means the fund that is established under § 7-317 of the State Finance and Procurement Article.</text>
    </level>
    <level label="e">
      <text>“Community Health Coalition” means a coalition established under § 13-1008(b)(1) of this subtitle.</text>
    </level>
    <level label="f">
      <text>“Comprehensive Plan for Tobacco Use Prevention and Cessation” means a plan that is developed under § 13-1008(b)(2) of this subtitle.</text>
    </level>
    <level label="g">
      <text>“Counter-Marketing and Media Component” means the component of the Program that is established under § 13-1013 of this subtitle.</text>
    </level>
    <level label="h">
      <text>“County” includes Baltimore City.</text>
    </level>
    <level label="i">
      <text>“Local health officer” means:</text>
      <level label="1">
        <text>The head of a county health department; or</text>
      </level>
      <level label="2">
        <text>A person designated by the Department under § 13-1008(g) of this subtitle.</text>
      </level>
    </level>
    <level label="j">
      <text>“Local Public Health Component” means the component of the Program that is established under § 13-1006 of this subtitle.</text>
    </level>
    <level label="k">
      <text>“Local Public Health Tobacco Grant” means a grant distributed by the Department to a county under §§ 13-1006 through 13-1012 of this subtitle.</text>
    </level>
    <level label="l">
      <text>“Maryland Adolescent Survey” means the Maryland Adolescent Survey that is administered by the Maryland State Department of Education.</text>
    </level>
    <level label="m">
      <text>“Master Settlement Agreement” means the Master Settlement Agreement executed by the State and participating tobacco manufacturers.</text>
    </level>
    <level label="n">
      <text>“Minority individual” means a woman or an individual of African American, Hispanic, Native American, or Asian descent.</text>
    </level>
    <level label="o">
      <text>“National Public Education Fund” means the National Public Education Fund that was established under the Master Settlement Agreement.</text>
    </level>
    <level label="p">
      <text>“Program” means the Tobacco Use Prevention and Cessation Program established under § 13-1002 of this subtitle.</text>
    </level>
    <level label="q">
      <text>“Statewide Public Health Component” means the component of the Program that is established under § 13-1005 of this subtitle.</text>
    </level>
    <level label="r">
      <text>“Surveillance and Evaluation Component” means the component of the Program that is established under § 13-1003 of this subtitle.</text>
    </level>
    <level label="s">
      <level label="1">
        <text>“Targeted minority population” means a minority population to which the tobacco industry disproportionately marketed tobacco products.</text>
      </level>
      <level label="2">
        <text>“Targeted minority population” includes:</text>
        <level label="i">
          <text>Women; and</text>
        </level>
        <level label="ii">
          <text>Individuals of African American, Hispanic, Native American, and Asian descent.</text>
        </level>
      </level>
    </level>
    <level label="t">
      <text>“Task Force Report” means the report entitled “Making Maryland the Tobacco Free State” that was issued in December 1999 by the Governor’s Task Force to End Smoking in Maryland.</text>
    </level>
    <level label="u">
      <level label="1">
        <text>“Tobacco product” means any product that is:</text>
        <level label="i">
          <text>Intended for human inhalation, absorption, ingestion, smoking, heating, chewing, dissolving, or any other manner of consumption that is made of, derived from, or contains:</text>
          <level label="1">
            <text>Tobacco; or</text>
          </level>
          <level label="2">
            <text>Nicotine; or</text>
          </level>
        </level>
        <level label="ii">
          <text>An accessory or component used in any manner of consumption of a product described in item (i) of this paragraph.</text>
        </level>
      </level>
      <level label="2">
        <text>“Tobacco product” includes:</text>
        <level label="i">
          <text>Cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, and snus;</text>
        </level>
        <level label="ii">
          <text>Electronic smoking devices; and</text>
        </level>
        <level label="iii">
          <text>Filters, rolling papers, pipes, and liquids used in electronic smoking devices regardless of nicotine content.</text>
        </level>
      </level>
      <level label="3">
        <text>“Tobacco product” does not include a drug, device, or combination product authorized for sale by the U.S. Food and Drug Administration under the Federal Food, Drug, and Cosmetic Act.</text>
      </level>
    </level>
    <level label="v">
      <text>“Uninsured individual” means an individual:</text>
      <level label="1">
        <text>For whom the appropriate treatment is not covered by private health insurance, Medicaid, Medicare, or the Maryland Children’s Health Program; and</text>
      </level>
      <level label="2">
        <text>Who the Department determines does not have the financial means to pay for appropriate treatment.</text>
      </level>
    </level>
    <level label="w">
      <text>“Youth Tobacco Survey” means the Youth Tobacco Survey developed by the Centers for Disease Control and Prevention and administered by the Department with the assistance of the Maryland State Department of Education.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1002" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is a Tobacco Use Prevention and Cessation Program in the Department.</text>
    </level>
    <level label="b">
      <text>The purpose of the Program is to coordinate the State’s use of the Cigarette Restitution Fund to address issues relating to tobacco use prevention and cessation so as to create a lasting legacy of public health initiatives that result in a reduction of tobacco use in the State and otherwise benefit the health and welfare of the State’s residents.</text>
    </level>
    <level label="c">
      <text>The Program consists of:</text>
      <level label="1">
        <text>A Surveillance and Evaluation Component;</text>
      </level>
      <level label="2">
        <text>A Statewide Public Health Component;</text>
      </level>
      <level label="3">
        <text>A Counter–Marketing and Media Component;</text>
      </level>
      <level label="4">
        <text>A Local Public Health Component; and</text>
      </level>
      <level label="5">
        <text>An Administrative Component.</text>
      </level>
    </level>
    <level label="d">
      <level label="1">
        <text>The Program shall be funded as provided in the State budget with money from the Cigarette Restitution Fund.</text>
      </level>
      <level label="2">
        <text>The Legislative Auditor is authorized to audit the appropriations and expenditures made for the purpose of implementing the Program, including the use of any funds received by a person under any component of this Program.</text>
      </level>
    </level>
    <level label="e">
      <level label="1">
        <text>The annual budget bill shall specify the amount of funding that is allocated to each component of the Program.</text>
      </level>
      <level label="2">
        <text>Except as provided in paragraph (3) of this subsection, money that is allocated to a component of the Program in the State budget:</text>
        <level label="i">
          <text>May only be expended for the purpose for which it is appropriated; and</text>
        </level>
        <level label="ii">
          <text>May not be transferred to any other component of the Program, any other program in the Department, or any other unit of State government.</text>
        </level>
      </level>
      <level label="3">
        <level label="i">
          <text>Except as provided in subparagraph (ii) of this paragraph, the Department may transfer a maximum of 10% of the total amount of money that is allocated to the Program in the State budget among components of the Program if the transfer is specifically authorized in the annual budget bill as enacted.</text>
        </level>
        <level label="ii">
          <text>The Department may not transfer money to the Administrative Component from any other component of the Program.</text>
        </level>
        <level label="iii">
          <text>If the Department transfers any money among the components of the Program as authorized under subparagraph (i) of this paragraph, the Department shall report the transfer to the Senate Budget and Taxation Committee, Senate Finance Committee, House Appropriations Committee, and House Health Committee within 60 days of the transfer.</text>
        </level>
        <level label="iv">
          <text>The Department may transfer money that is allocated to a component of the Program in the State budget to another program in the Department, or another unit of State government if the transfer is specifically authorized by:</text>
          <level label="1">
            <text>A provision of this subtitle; or</text>
          </level>
          <level label="2">
            <text>A provision of the annual budget bill as enacted that relates specifically to the transfer of funds from that component.</text>
          </level>
        </level>
      </level>
    </level>
    <level label="f">
      <level label="1">
        <text>Money that is allocated to a component of the Program in the State budget that remains unspent and unobligated at the end of the applicable fiscal year shall revert to the Cigarette Restitution Fund.</text>
      </level>
      <level label="2">
        <text>Money that reverts to the Cigarette Restitution Fund under paragraph (1) of this subsection shall be used to fund the Program in the fiscal year to which the next annual budget bill relates.</text>
      </level>
      <level label="3">
        <text>The Governor shall include in the next annual budget bill an appropriation for the Program that is at least equal to the amount of money that reverted to the Cigarette Restitution Fund under paragraph (1) of this subsection.</text>
      </level>
    </level>
    <level label="g">
      <text>No later than January 31 of each year, the Department shall report to the Governor and, subject to § 2–1257 of the State Government Article, the Senate Budget and Taxation Committee, Senate Finance Committee, House Appropriations Committee, and House Health Committee:</text>
      <level label="1">
        <text>The amount of money that was allocated to each component of the Program during:</text>
        <level label="i">
          <text>The prior fiscal year that remained unspent and unobligated at the end of that year; and</text>
        </level>
        <level label="ii">
          <text>The current fiscal year that remained unspent and unobligated as of December 31 of the preceding calendar year; and</text>
        </level>
      </level>
      <level label="2">
        <text>The amount of money that was distributed to a county as a Local Public Health Tobacco Grant during:</text>
        <level label="i">
          <text>The prior fiscal year that remained unspent and unobligated at the end of that year; and</text>
        </level>
        <level label="ii">
          <text>The current fiscal year that remained unspent and unobligated as of December 31 of the preceding calendar year.</text>
        </level>
      </level>
    </level>
    <level label="h">
      <text>The Department shall adopt regulations that establish the criteria that the Department will use to determine whether, for the purpose of qualifying as an uninsured individual under § 13–1001(v) of this subtitle, an individual has the financial means to pay for appropriate treatment.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1003" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is a Surveillance and Evaluation Component in the Program.</text>
    </level>
    <level label="b">
      <text>The purposes of the Surveillance and Evaluation Component are to:</text>
      <level label="1">
        <text>Collect, analyze, and monitor data relating to tobacco use and tobacco use prevention and cessation in the State;</text>
      </level>
      <level label="2">
        <text>Measure and evaluate the results of the Program, including the results of each component of the Program;</text>
      </level>
      <level label="3">
        <text>Conduct a Baseline Tobacco Study, as provided under subsections (c) through (e) of this section; and</text>
      </level>
      <level label="4">
        <text>Conduct a Tobacco Study, as provided under § 13–1004 of this subtitle.</text>
      </level>
    </level>
    <level label="c">
      <level label="1">
        <text>To initiate the Surveillance and Evaluation Component, the Department shall conduct a comprehensive statewide Baseline Tobacco Study as provided under this section.</text>
      </level>
      <level label="2">
        <text>The Baseline Tobacco Study shall measure:</text>
        <level label="i">
          <text>The number and percentage of individuals attending middle school or high school who smoke or otherwise use tobacco products, both statewide and in each county;</text>
        </level>
        <level label="ii">
          <text>The number and percentage of minority individuals attending middle school or high school who smoke or otherwise use tobacco products, both statewide and in each county;</text>
        </level>
        <level label="iii">
          <text>The number and percentage of individuals who smoke or otherwise use tobacco products, both statewide and in each county;</text>
        </level>
        <level label="iv">
          <text>The number and percentage of minority individuals who smoke or otherwise use tobacco products, both statewide and in each county;</text>
        </level>
        <level label="v">
          <text>The number and percentage of pregnant women who smoke or otherwise use tobacco products, both statewide and in each county;</text>
        </level>
        <level label="vi">
          <text>The number and percentage of households with individuals attending middle school or high school in which at least one household member who is at least 18 years old smokes tobacco products, both statewide and in each county;</text>
        </level>
        <level label="vii">
          <text>The number and percentage of individuals who, within an established amount of time before the start of the Baseline Tobacco Study, started to smoke or otherwise use tobacco products;</text>
        </level>
        <level label="viii">
          <text>The number and percentage of individuals who smoke or otherwise use tobacco on a regular basis and who, within an established amount of time before the start of the Baseline Tobacco Study, voluntarily stopped smoking or otherwise using tobacco products for a significant amount of time, as determined by the Department, both statewide and in each county; and</text>
        </level>
        <level label="ix">
          <text>Any other factor that the Department determines to be important for measuring tobacco use or evaluating whether the Program meets its objectives.</text>
        </level>
      </level>
    </level>
    <level label="d">
      <level label="1">
        <text>In conducting the Baseline Tobacco Study, the Department may consider any data collected after March 1, 2000, through the administration of the Maryland Adolescent Survey or the Youth Tobacco Survey.</text>
      </level>
      <level label="2">
        <text>The Maryland State Department of Education, county boards of education, and each school selected to participate in the Maryland Adolescent Survey or the Youth Tobacco Survey shall cooperate with the Department in administering the surveys.</text>
      </level>
      <level label="3">
        <level label="i">
          <text>Subject to subparagraph (ii) of this paragraph, the Maryland State Department of Education may not discontinue administration of the Maryland Adolescent Survey until after it has submitted a report to the Governor and, subject to § 2–1257 of the State Government Article, the General Assembly that states the reason for discontinuing the survey.</text>
        </level>
        <level label="ii">
          <text>If the Maryland State Department of Education submits a report as provided under subparagraph (i) of this paragraph, it may discontinue the Maryland Adolescent Survey in the first school year that begins after the report has been submitted.</text>
        </level>
      </level>
    </level>
    <level label="e">
      <level label="1">
        <text>Subject to paragraphs (2) through (4) of this subsection, the Department shall contract with a higher education institution or private entity to conduct the Baseline Tobacco Study.</text>
      </level>
      <level label="2">
        <text>The Department shall issue a request for proposal to select the entity that will conduct the Baseline Tobacco Study.</text>
      </level>
      <level label="3">
        <text>The request for proposal shall require that any methodology or model that is used by the entity to conduct the Baseline Tobacco Study, any data collected under the Study, and any electronic files, codes, and definitions relating to the Study be provided to the State for use in subsequent studies, regardless of whether the subsequent studies are conducted by the same entity.</text>
      </level>
      <level label="4">
        <text>The Department may contract with an entity to conduct the Baseline Tobacco Study and one or more biennial tobacco studies as required under § 13–1004 of this subtitle.</text>
      </level>
      <level label="5">
        <level label="i">
          <text>The Department shall use the criteria established in subparagraph (ii) of this paragraph as a guide in administering the request for proposal process for the Baseline Tobacco Study.</text>
        </level>
        <level label="ii">
          <text>The Department shall give preference to an entity that:</text>
          <level label="1">
            <text>Is a Maryland–based vendor;</text>
          </level>
          <level label="2">
            <text>Has previous work experience relating to tobacco or health activities;</text>
          </level>
          <level label="3">
            <text>Has previous work experience relating to youth and adolescents;</text>
          </level>
          <level label="4">
            <text>Demonstrates a capability for innovative activities and use of state–of–the–art technologies;</text>
          </level>
          <level label="5">
            <text>Has demonstrated the ability to provide culturally–specific and effective services to targeted minority populations;</text>
          </level>
          <level label="6">
            <text>Has previous work experience with the public sector;</text>
          </level>
          <level label="7">
            <text>Demonstrates performance in the specific content area for at least 3 years;</text>
          </level>
          <level label="8">
            <text>Has previous work experience with rural or urban communities;</text>
          </level>
          <level label="9">
            <text>Will maximize the use of State funds through the use of preexisting materials, funding partnerships, and resource matching; and</text>
          </level>
          <level label="10">
            <text>Has no history of working for the tobacco industry.</text>
          </level>
        </level>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1004" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>Beginning in fiscal year 2007 and in every second year thereafter, the Department shall conduct a Tobacco Study which shall measure the same factors that are set forth in § 13–1003(c) of this subtitle and use the same methodology or model that was used for the Baseline Tobacco Study.</text>
    </level>
    <level label="b">
      <text>To carry out the evaluation and surveillance functions of this subtitle, the Department may conduct any other tobacco study measuring the factors set forth in § 13–1003(c) of this subtitle and using a methodology or model that is consistent with but need not be identical to that used to conduct the Baseline Tobacco Study.</text>
    </level>
    <level label="c">
      <level label="1">
        <text>Subject to paragraphs (2) through (4) of this subsection, the Department shall contract with a higher education institution or private entity to conduct the Biennial Tobacco Study.</text>
      </level>
      <level label="2">
        <text>The Department shall issue a request for proposal to select the entity that will conduct the Biennial Tobacco Study.</text>
      </level>
      <level label="3">
        <text>The Department may contract with an entity to conduct one or more biennial tobacco studies.</text>
      </level>
      <level label="4">
        <text>The Department shall use the criteria established in § 13–1003(e)(5) of this subtitle as a guide in administering the request for proposal process.</text>
      </level>
    </level>
    <level label="d">
      <text>On or before May 31 of each even–numbered fiscal year, beginning in fiscal year 2008, the Department shall submit a report to the Governor and, subject to § 2–1257 of the State Government Article, the General Assembly on:</text>
      <level label="1">
        <text>The results of the Biennial Tobacco Study; and</text>
      </level>
      <level label="2">
        <text>Beginning in fiscal year 2024, a State– and county–level data summary and trends report on data collected under § 7–420 of the Education Article.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1005" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is a Statewide Public Health Component in the Program.</text>
    </level>
    <level label="b">
      <text>The purpose of the Statewide Public Health Component is to maximize the effectiveness of the anti-tobacco initiatives in the State by authorizing the Department to take steps to ensure that the Program is implemented in a coordinated and integrated manner throughout the State.</text>
    </level>
    <level label="c">
      <text>Subject to subsections (d) and (e) of this section and as necessary to ensure a coordinated and integrated statewide effort to implement tobacco use prevention and cessation programs, the Department may develop and implement statewide anti-tobacco initiatives that are consistent with the findings and recommendations of the Task Force Report and the recommendations of the Centers for Disease Control and Prevention regarding best practices for comprehensive tobacco control programs as they relate to statewide programs, including programs that support the implementation of the Local Public Health Component.</text>
    </level>
    <level label="d">
      <level label="1">
        <text>To implement this section, the Department may issue a request for proposal, distribute a grant, or enter into a contract.</text>
      </level>
      <level label="2">
        <text>The request for proposal, grant, or contract shall state with specificity the objectives and performance criteria that will be used to measure the success of the Program to which the request for proposal, grant, or contract relates.</text>
      </level>
      <level label="3">
        <text>If the Department issues a request for proposal to select an entity to implement an initiative under this section, the Department shall use the criteria established in § 13-1003(e)(5) of this subtitle as a guide in administering the request for proposal process.</text>
      </level>
    </level>
    <level label="e">
      <level label="1">
        <text>Except as provided under paragraph (2) of this subsection, the Department may not spend any of the money that is allocated to the Statewide Public Health Component in the State budget until after the Baseline Tobacco Study is completed.</text>
      </level>
      <level label="2">
        <level label="i">
          <text>Subject to subparagraph (ii) of this paragraph and before the Baseline Tobacco Study is completed, the Department may use money that is allocated to the Statewide Public Health Component in the State budget for fiscal year 2001 to distribute grants that will be used to provide outreach and start-up technical assistance to communities for the purpose of organizing participation in community health coalitions.</text>
        </level>
        <level label="ii">
          <text>The Department shall use at least $750,000 of the money that is allocated to the Statewide Public Health Component in the State budget for fiscal year 2001 to provide outreach and start-up technical assistance to African American communities in the State for the purpose of organizing participation in community health coalitions that are formed under § 13-1008(b), § 13-1109(c), or § 13-1115(b) of this title.</text>
        </level>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1006" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is a Local Public Health Component in the Program.</text>
    </level>
    <level label="b">
      <text>The purpose of the Local Public Health Component is to maximize the effectiveness of anti-tobacco initiatives in the State by authorizing local health coalitions to develop and implement tobacco use prevention and cessation programs in coordination with the Department.</text>
    </level>
    <level label="c">
      <text>Subject to §§ 13-1007 through 13-1012 of this subtitle, the Department may distribute grants to counties for tobacco use prevention and cessation programs, including:</text>
      <level label="1">
        <text>Community-based programs;</text>
      </level>
      <level label="2">
        <text>School-based programs which may include tobacco use prevention and cessation components of school-based health care services and programs established under §§ 7-401 and 7-415 of the Education Article; and</text>
      </level>
      <level label="3">
        <text>Programs relating to enforcement of tobacco control laws.</text>
      </level>
    </level>
    <level label="d">
      <level label="1">
        <text>Except as provided under paragraph (2) of this subsection, the Department may not spend any funds that are allocated to the Local Public Health Component in the State budget until after the Baseline Tobacco Study has been completed.</text>
      </level>
      <level label="2">
        <text>Before the Baseline Tobacco Study is completed, the Department may distribute a planning grant of not more than $10,000 to each local health department.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1007" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>After the Baseline Tobacco Study has been completed and before soliciting applications for Local Public Health Tobacco Grants, the Department, in consultation with the local health departments, shall:</text>
      <level label="1">
        <text>Establish short–term and long–term tobacco use prevention and cessation goals for each county;</text>
      </level>
      <level label="2">
        <text>Establish other requirements for each county that the Department determines to be necessary to meet the goals established under paragraph (1) of this subsection; and</text>
      </level>
      <level label="3">
        <text>Provide for the distribution of Local Public Health Tobacco Grants to eligible counties based on the formula established under subsection (b) of this section.</text>
      </level>
    </level>
    <level label="b">
      <text>Subject to subsections (c) through (e) of this section and §§ 13–1008 through 13–1012 of this subtitle, the Department shall distribute a Local Public Health Tobacco Grant to each county that is equal to the sum of:</text>
      <level label="1">
        <text>A base amount of funding as determined by the Department for each county and Baltimore City;</text>
      </level>
      <level label="2">
        <text>The product of:</text>
        <level label="i">
          <text>One–half of the amount remaining from the allocation to the Local Public Health Component in the State budget after the base amount under item (1) of this subsection is distributed to each county and Baltimore City; and</text>
        </level>
        <level label="ii">
          <text>The number of individuals in the county attending middle school or high school who smoke or otherwise use tobacco products divided by the number of individuals in the State attending middle school or high school who smoke or otherwise use tobacco products; and</text>
        </level>
      </level>
      <level label="3">
        <text>The product of:</text>
        <level label="i">
          <text>One–half of the amount remaining from the allocation to the Local Public Health Component in the State budget after the base amount under item (1) of this subsection is distributed to each county and Baltimore City; and</text>
        </level>
        <level label="ii">
          <text>The number of individuals in the county who smoke or otherwise use tobacco products divided by the number of individuals in the State who smoke or otherwise use tobacco products.</text>
        </level>
      </level>
    </level>
    <level label="c">
      <text>Beginning in fiscal year 2005, the calculations of the numbers of individuals smoking or using tobacco products required in subsection (b)(2)(ii) and (3)(ii) of this section shall be based on the most recent data averaged over a multiyear period as determined by the Department.</text>
    </level>
    <level label="d">
      <text>The allocation formula calculated in accordance with subsection (b) of this section for fiscal year 2005 shall remain in effect for the following 3 years and thereafter shall be recalculated every 4th year in accordance with the provisions of this section.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1008" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <level label="1">
        <text>Subject to the other provisions of this section, a local health officer may apply to the Department for a Local Public Health Tobacco Grant.</text>
      </level>
      <level label="2">
        <text>The amount of the Local Public Health Tobacco Grant shall be determined by the Department using the formula established under § 13–1007 of this subtitle.</text>
      </level>
    </level>
    <level label="b">
      <text>Before applying for a Local Public Health Tobacco Grant, a local health officer shall:</text>
      <level label="1">
        <text>Establish a Community Health Coalition, as provided under § 13–1010 of this subtitle, or identify another coalition approved by the Department; and</text>
      </level>
      <level label="2">
        <text>With the assistance of the coalition established or identified under item (1) of this subsection:</text>
        <level label="i">
          <text>Identify all existing tobacco use prevention and cessation programs in the county that are publicly funded;</text>
        </level>
        <level label="ii">
          <text>Evaluate the effectiveness of the publicly funded programs identified under item (i) of this paragraph; and</text>
        </level>
        <level label="iii">
          <text>Develop a Comprehensive Plan for Tobacco Use Prevention and Cessation that outlines a strategy for meeting the tobacco use prevention and cessation goals and requirements established for the county under § 13–1007 of this subtitle.</text>
        </level>
      </level>
    </level>
    <level label="c">
      <text>A Comprehensive Plan for Tobacco Use Prevention and Cessation shall:</text>
      <level label="1">
        <text>Include a list of the members of the coalition established or identified under subsection (b)(1) of this section and their organizational affiliations;</text>
      </level>
      <level label="2">
        <text>Include an evaluation of any county program funded with a Local Public Health Tobacco Grant in the prior year;</text>
      </level>
      <level label="3">
        <text>Each year, after the first year of funding, demonstrate that progress has been made toward meeting the tobacco use prevention and cessation goals established for the county under § 13–1007 of this subtitle;</text>
      </level>
      <level label="4">
        <text>Include a budget plan that provides specific levels of funding for each initiative described in the Plan and an explanation as to how each initiative is expected to help meet the tobacco use prevention and cessation goals and requirements established for the county under § 13–1007 of this subtitle;</text>
      </level>
      <level label="5">
        <text>Demonstrate that the county has met the base–year funding requirement established under § 13–1011 of this subtitle;</text>
      </level>
      <level label="6">
        <text>Each year, after the first year of funding, identify all persons who received money under a Local Public Health Tobacco Grant in the prior year and state the amount of money that was received by each person under the grant;</text>
      </level>
      <level label="7">
        <text>Each year, after the first year of funding, state the amount of money that was received by a county under a Local Public Health Tobacco Grant in the prior fiscal year that remained unspent and unobligated at the end of that year;</text>
      </level>
      <level label="8">
        <text>Describe how the Plan will help to reduce tobacco use among women, minority individuals, and individuals attending middle school or high school, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report;</text>
      </level>
      <level label="9">
        <text>Describe how the Plan will help to increase availability of and access to cessation programs for uninsured individuals and medically underserved populations, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report;</text>
      </level>
      <level label="10">
        <text>Allocate resources in a manner that is consistent with:</text>
        <level label="i">
          <text>The needs of different populations in the county, including targeted minority populations, as identified in the Baseline Tobacco Study and annual tobacco studies; and</text>
        </level>
        <level label="ii">
          <text>The recommendations of the Centers for Disease Control and Prevention regarding best practices for a comprehensive tobacco control program; and</text>
        </level>
      </level>
      <level label="11">
        <text>Contain any data or other information required by the Department.</text>
      </level>
    </level>
    <level label="d">
      <text>If a Comprehensive Plan for Tobacco Use Prevention and Cessation does not allocate resources in a manner that is consistent with the recommendations of the Centers for Disease Control and Prevention regarding best practices for a comprehensive tobacco control program, the Plan shall:</text>
      <level label="1">
        <text>State the reason for not allocating resources in this manner; and</text>
      </level>
      <level label="2">
        <text>Identify the extent to which other resources assist the county in meeting this requirement.</text>
      </level>
    </level>
    <level label="e">
      <text>A local health officer who seeks to obtain a Local Public Health Tobacco Grant shall apply to the Department by submitting a copy of the county’s Comprehensive Plan for Tobacco Use Prevention and Cessation for approval.</text>
    </level>
    <level label="f">
      <text>Each year, a local health officer, in consultation with the coalition established or identified under subsection (b)(1) of this section, shall update the Comprehensive Plan for Tobacco Use Prevention and Cessation.</text>
    </level>
    <level label="g">
      <level label="1">
        <text>The Department may designate a person other than the head of a county health department to coordinate a county’s tobacco use prevention and cessation efforts if:</text>
        <level label="i">
          <text>The county health department is unwilling to coordinate these efforts;</text>
        </level>
        <level label="ii">
          <text>The county health department has been unsuccessful in implementing tobacco use prevention and cessation initiatives that satisfy performance standards established by the Department; or</text>
        </level>
        <level label="iii">
          <text>The county health department lacks sufficient staff or resources to coordinate these efforts.</text>
        </level>
      </level>
      <level label="2">
        <text>Subject to paragraph (3) of this subsection, the Department shall establish procedures for making a designation under this subsection.</text>
      </level>
      <level label="3">
        <text>If the Department determines that it is necessary to designate a person other than the local health officer to coordinate a county’s tobacco use prevention and cessation efforts, the Department may designate the Department as the entity that will coordinate the county’s efforts.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1009" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>The local health officers of two or more counties may join together as a region to apply for a Local Public Health Tobacco Grant.</text>
    </level>
    <level label="b">
      <text>The amount of the Local Public Health Tobacco Grant that is distributed to a region under subsection (a) of this section shall be equal to the sum of the Local Public Health Tobacco Grants that otherwise would have been distributed to each county under § 13–1007 of this subtitle.</text>
    </level>
    <level label="c">
      <text>If the local health officers of two or more counties join together as a region to apply for a Local Public Health Tobacco Grant, the local health officers shall act jointly to:</text>
      <level label="1">
        <text>Develop a Comprehensive Plan for Tobacco Use Prevention and Cessation, as required under § 13–1008 of this subtitle;</text>
      </level>
      <level label="2">
        <text>Establish a Community Health Coalition, as required under § 13–1008 of this subtitle, or identify another coalition approved by the Department;</text>
      </level>
      <level label="3">
        <text>Demonstrate that the base–year funding requirement of § 13–1011 of this subtitle has been met; and</text>
      </level>
      <level label="4">
        <text>Otherwise satisfy the requirements of §§ 13–1006 through 13–1012 of this subtitle.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1010" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>The membership of a Community Health Coalition established under § 13-1008(b) of this subtitle shall:</text>
      <level label="1">
        <text>Reflect the demographics of the county; and</text>
      </level>
      <level label="2">
        <text>Include representatives of community-based groups, including minority, rural, and medically underserved populations, that, taken together, are familiar with all of the different communities and cultures in the county.</text>
      </level>
    </level>
    <level label="b">
      <text>The membership of a Community Health Coalition established under § 13–1008(b) of this subtitle may include:</text>
      <level label="1">
        <text>Representatives of:</text>
        <level label="i">
          <text>A local management board established under Title 8, Subtitle 3 of the Human Services Article;</text>
        </level>
        <level label="ii">
          <text>The local public school system;</text>
        </level>
        <level label="iii">
          <text>Local hospitals, clinics, physicians, and other health care providers;</text>
        </level>
        <level label="iv">
          <text>Local law enforcement;</text>
        </level>
        <level label="v">
          <text>Local businesses;</text>
        </level>
        <level label="vi">
          <text>Local religious organizations;</text>
        </level>
        <level label="vii">
          <text>Local media;</text>
        </level>
        <level label="viii">
          <text>Institutions of higher education; and</text>
        </level>
        <level label="ix">
          <text>Hospitals and other entities located outside the county that could enhance the county’s tobacco use prevention and cessation efforts; and</text>
        </level>
      </level>
      <level label="2">
        <text>Any other person that the local health officer believes would help the county meet the tobacco use prevention and cessation goals and requirements established for the county under § 13–1007 of this subtitle.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1011" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <level label="1">
        <text>Before receiving a Local Public Health Tobacco Grant, a local health officer shall submit to the Department an inventory of all publicly funded tobacco use prevention and cessation programs in the county that were identified under § 13-1008(b)(2) of this subtitle.</text>
      </level>
      <level label="2">
        <text>The inventory shall specify the amount of county funds that are being spent on each of the programs included in the inventory.</text>
      </level>
    </level>
    <level label="b">
      <text>The level of funding specified under subsection (a)(2) of this section shall be the county’s base-year funding for tobacco use prevention and cessation programs.</text>
    </level>
    <level label="c">
      <text>A Local Public Health Tobacco Grant may not be used to supplant a county’s base-year funding for tobacco use prevention and cessation programs.</text>
    </level>
    <level label="d">
      <text>The Department may not distribute a Local Public Health Tobacco Grant to a county unless the Department determines that the county will spend, in the applicable fiscal year, at least its base-year funding for tobacco use prevention and cessation programs.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1012" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>The Department shall review a Comprehensive Plan for Tobacco Use Prevention and Cessation submitted under § 13-1008(d) of this subtitle and determine whether:</text>
      <level label="1">
        <text>The Plan addresses the goals and requirements established for the county under § 13-1007 of this subtitle;</text>
      </level>
      <level label="2">
        <text>The Plan allocates resources in a manner that is consistent with the needs of the different populations in the county, including targeted minority populations, as identified in the Baseline Tobacco Study and biennial tobacco studies;</text>
      </level>
      <level label="3">
        <text>The Plan allocates resources in a manner that is consistent with the recommendations of the Centers for Disease Control and Prevention regarding best practices for a comprehensive tobacco control program or states a reason for not meeting this requirement and identifies other resources that, taken together, meet this requirement; and</text>
      </level>
      <level label="4">
        <text>The local health officer has complied with the other requirements of §§ 13-1007 through 13-1011 of this subtitle.</text>
      </level>
    </level>
    <level label="b">
      <text>The Department may not distribute a county’s share of money for a Local Public Health Tobacco Grant, as provided under § 13-1007 of this subtitle, if the Department determines that the requirements of subsection (a) of this section have not been met.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1013" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is a Counter–Marketing and Media Component in the Program.</text>
    </level>
    <level label="b">
      <text>The purpose of the Counter–Marketing and Media Component is to coordinate a statewide counter–marketing and media campaign to counter tobacco advertisements and discourage the use of tobacco products.</text>
    </level>
    <level label="c">
      <level label="1">
        <text>Except as provided in paragraph (2) of this subsection, the Department may not spend any money that is allocated to the Counter–Marketing and Media Component in the State budget until after the Baseline Tobacco Study is completed.</text>
      </level>
      <level label="2">
        <text>Before the Baseline Tobacco Study is completed, the Department may spend money that is allocated to the Counter–Marketing and Media Component in the State budget to conduct formative research relating to the Counter–Marketing and Media Component.</text>
      </level>
    </level>
    <level label="d">
      <level label="1">
        <text>The Department may contract with a higher education institution or private entity to implement any part of the Counter–Marketing and Media Component.</text>
      </level>
      <level label="2">
        <text>If the Department determines that any part of the Counter–Marketing and Media Component should be implemented by a higher education institution or private entity, the Department shall issue a request for proposal to select the entity that will implement that part of the Component.</text>
      </level>
      <level label="3">
        <text>At a minimum, the request for proposal shall:</text>
        <level label="i">
          <text>State with specificity the goals of the Counter–Marketing and Media Component;</text>
        </level>
        <level label="ii">
          <text>State with specificity the objectives and performance criteria that will be used to measure the success of the program to which the request for proposal relates; and</text>
        </level>
        <level label="iii">
          <text>Require that the response to the request for proposal include a plan to reach the targeted audiences identified by the Department.</text>
        </level>
      </level>
      <level label="4">
        <text>If the Department issues a request for proposal to select an entity to implement any part of the Counter–Marketing and Media Component, the Department shall use the criteria established in § 13–1003(e)(5) of this subtitle as a guide in administering the request for proposal process.</text>
      </level>
    </level>
    <level label="e">
      <text>To the extent practicable, the Department shall take steps to maximize the cost effectiveness of the Counter–Marketing and Media Component, including:</text>
      <level label="1">
        <text>Using advertisements and other communications and public relations products and services that have been developed by and shown to be effective in other states;</text>
      </level>
      <level label="2">
        <text>Subject to subsection (f) of this section, using money that is allocated to the Counter–Marketing and Media Component to obtain money from the federal government, the National Public Education Fund, or any other entity; and</text>
      </level>
      <level label="3">
        <text>Coordinating the purchase of broadcast time with other states.</text>
      </level>
    </level>
    <level label="f">
      <text>The Department may not accept money from the federal government, the National Public Education Fund, or any other entity if the Department is required to accept, as a condition of receiving the money, restrictions on the content of advertisements, communications, or other public relations products or services that are funded with money from the Cigarette Restitution Fund if the restrictions are inconsistent with the purposes of this subtitle.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1014" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>There is an Administrative Component in the Program.</text>
    </level>
    <level label="b">
      <text>The purpose of the Administrative Component is to provide the necessary administrative structure in the Department for effective management of the Program.</text>
    </level>
    <level label="c">
      <text>Funds that are allocated to the Administrative Component in the State budget shall be used to cover administrative costs incurred by the Department in administering the Program.</text>
    </level>
    <level label="d">
      <text>Unless otherwise specified in the annual budget bill as enacted, the amount of funds that are allocated to the Administrative Component in the State budget may not exceed 7% of the total amount that is allocated to the Program in the State budget.</text>
    </level>
    <level label="e">
      <text>A county that receives funds under a Local Public Health Tobacco Grant, a person who receives funds under a Local Public Health Tobacco Grant, and any other person who receives funds under any component of the Program may not use more than 7% of the funds to cover administrative costs.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="13-1015" title_number="13" title_name="Miscellaneous Health Care Programs" subtitle_number="10" subtitle_name="Tobacco Use Prevention and Cessation Program">
    <level label="a">
      <text>For fiscal year 2011 and fiscal year 2012, the Governor shall include at least $6,000,000 in the annual budget in appropriations for activities aimed at reducing tobacco use in Maryland as recommended by the Centers for Disease Control and Prevention, including:</text>
      <level label="1">
        <text>Media campaigns aimed at reducing smoking initiation and encouraging smokers to quit smoking;</text>
      </level>
      <level label="2">
        <text>Media campaigns educating the public about the dangers of secondhand smoke exposure;</text>
      </level>
      <level label="3">
        <text>Enforcement of existing laws banning the sale or distribution of tobacco products to individuals under the age of 21 years;</text>
      </level>
      <level label="4">
        <text>Promotion and implementation of smoking cessation programs; and</text>
      </level>
      <level label="5">
        <text>Implementation of school–based tobacco education programs.</text>
      </level>
    </level>
    <level label="b">
      <level label="1">
        <text>For fiscal years 2013 through 2021, the Governor shall include at least $10,000,000 in the annual budget in appropriations for the purposes described in subsection (a) of this section.</text>
      </level>
      <level label="2">
        <text>For fiscal years 2022 through 2026, the Governor shall include at least $18,250,000 in the annual budget in appropriations for the purposes described in subsection (a) of this section.</text>
      </level>
      <level label="3">
        <text>For fiscal year 2027 and each fiscal year thereafter, the Governor shall include at least $17,520,000 in the annual budget in appropriations for the purposes described in subsection (a) of this section.</text>
      </level>
    </level>
  </section>
</subtitle>