<section article="ghg" article_name="Health - General" number="18-101" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <text>The Secretary shall investigate:</text> <level label="1"> <text>The causes of disease and, particularly, the causes of epidemics;</text> </level> <level label="2"> <text>The causes of mortality; and</text> </level> <level label="3"> <text>The influence of locality, employment, habit, and other conditions on health.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-102" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall adopt rules and regulations necessary to prevent:</text> <level label="1"> <text>The introduction of an infectious or contagious disease into this State or other disease that endangers public health in this State; or</text> </level> <level label="2"> <text>The spread of an infectious or contagious disease or other disease that endangers public health in this State.</text> </level> </level> <level label="b"> <text>When the Secretary has reason to believe that an infectious or contagious disease or other disease that endangers public health exists within the State, the Secretary shall:</text> <level label="1"> <text>Investigate the suspected disease; and</text> </level> <level label="2"> <text>Act properly to prevent the spread of the disease.</text> </level> </level> <level label="c"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, an individual enrolled in an institution of higher education who resides in on-campus student housing shall be vaccinated against meningococcal disease.</text> </level> <level label="2"> <text>An individual is exempt from the vaccination requirement in paragraph (1) of this subsection if:</text> <level label="i"> <text>The institution of higher education provides detailed information on the risks associated with meningococcal disease and the availability and effectiveness of any vaccine to:</text> <level label="1"> <text>The individual, if the individual is 18 years of age or older; or</text> </level> <level label="2"> <text>The individual’s parent or guardian, if the individual is a minor; and</text> </level> </level> <level label="ii"> <level label="1"> <text>The individual is 18 years of age or older and the individual signs a written waiver in a form approved by the Secretary stating that the individual has received and reviewed the information provided and has chosen not to be vaccinated against meningococcal disease; or</text> </level> <level label="2"> <text>The individual is a minor and the individual’s parent or guardian signs a written waiver in a form approved by the Secretary stating that the parent or guardian has received and reviewed the information provided and has chosen to not have the individual vaccinated against meningococcal disease.</text> </level> </level> </level> <level label="3"> <text>Nothing in this subsection shall be construed to require any institution of higher education to provide or pay for vaccinations against meningococcal disease.</text> </level> <level label="4"> <text>The Secretary, in consultation with the Maryland Higher Education Commission, shall adopt regulations necessary to implement this subsection.</text> </level> </level> <level label="d"> <text>The Secretary may enter on and inspect private property to determine the presence, cause, and source of an infectious or contagious disease or other disease that endangers public health in this State.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-103" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall:</text> <level label="1"> <text>Obtain accurate and complete reports on communicable diseases in this State;</text> </level> <level label="2"> <text>Determine the prevalence of each communicable disease; and</text> </level> <level label="3"> <text>Devise means to control communicable diseases.</text> </level> </level> <level label="b"> <text>The Secretary shall publish monthly a communicable disease bulletin for health officers and other related health professionals.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-104" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall investigate, if feasible, means to prevent, treat, and cure cancer.</text> </level> <level label="b"> <text>The Secretary may adopt procedures to obtain information about cancers that are caused by carcinogens and about the incidence of these cancers.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-105" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <text>The Secretary may adopt procedures to obtain information about diseases that are caused by toxic substances and about the incidence of these diseases.</text> </section> <section article="ghg" article_name="Health - General" number="18-106" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall establish and administer a Lead Poisoning Screening Program that will assure the appropriate screening of children in Maryland for lead poisoning.</text> </level> <level label="b"> <text>The Lead Poisoning Screening Program shall:</text> <level label="1"> <text>Encourage continuity of care with the child’s continuing care health care provider;</text> </level> <level label="2"> <text>Promote timely, appropriate screening of children at risk of being poisoned by lead;</text> </level> <level label="3"> <text>Utilize all of the payment mechanisms available to cover lead poisoning screening, including:</text> <level label="i"> <text>Third party payments from insurers;</text> </level> <level label="ii"> <text>The Medical Assistance Program;</text> </level> <level label="iii"> <text>Primary care medical assistance programs established under waiver from the federal government;</text> </level> <level label="iv"> <text>Health maintenance organizations;</text> </level> <level label="v"> <text>Federally qualified and Maryland qualified community health centers; and</text> </level> <level label="vi"> <text>Any other Medicaid reimbursement or waiver to which the State may be entitled under this section;</text> </level> </level> <level label="4"> <text>Target children under 6 years of age;</text> </level> <level label="5"> <text>Provide lead poisoning screening on a sliding fee scale at sites designated by local health departments for children unable to afford lead poisoning screening; and</text> </level> <level label="6"> <text>Employ an initial questionnaire to assess children’s exposure to potential lead hazards, except that children residing in at risk areas identified under subsection (c) of this section shall be screened by a blood test for lead poisoning.</text> </level> </level> <level label="c"> <text>The Secretary shall target efforts to promote and to provide blood tests for lead poisoning in at risk areas, as identified by:</text> <level label="1"> <text>Census tract and zip code information noting areas with large concentrations of pre-1978 housing; and</text> </level> <level label="2"> <text>Highest rates of lead poisoning as evidenced by information provided to and by the Childhood Lead Registry established and maintained by the Department of the Environment.</text> </level> </level> <level label="d"> <text>The Secretary shall require providers caring for children in areas designated as at risk for lead poisoning, as determined under subsection (c) of this section, to administer a blood test for lead poisoning of children:</text> <level label="1"> <text>Within the time frame specified in regulations adopted by the Department; or</text> </level> <level label="2"> <text>In accordance with the guidelines of the Centers for Disease Control and Prevention for children over age 24 months who have not received a blood test for lead poisoning.</text> </level> </level> <level label="e"> <text>The Secretary may include information on blood testing for lead poisoning collected under this section, § 7-403 of the Education Article, and §§ 6-303 and 6-304 of the Environment Article on any immunization registry developed by the Department.</text> </level> <level label="f"> <level label="1"> <text>Subject to paragraph (2) of this subsection, this section does not require blood testing of a child whose parent or guardian, in accordance with regulations adopted by the Secretary, objects to the testing on the ground that it conflicts with the parent’s or guardian’s bona fide religious beliefs and practices.</text> </level> <level label="2"> <text>Paragraph (1) of this subsection does not apply if the responses of the child’s parent or guardian on a questionnaire furnished by the Secretary and administered by a pediatrician indicate that the child is at high risk for lead poisoning.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-107" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall:</text> <level label="1"> <text>Devise and institute means to prevent and control morbidity and mortality associated with:</text> <level label="i"> <text>Pregnancy;</text> </level> <level label="ii"> <text>Childbirth;</text> </level> <level label="iii"> <text>Infancy; and</text> </level> <level label="iv"> <text>Early childhood; and</text> </level> </level> <level label="2"> <text>Promote the welfare and hygiene of maternity and infancy.</text> </level> </level> <level label="b"> <level label="1"> <text>The Secretary shall establish a Morbidity, Mortality, and Quality Review Committee in the Department.</text> </level> <level label="2"> <text>The Committee shall:</text> <level label="i"> <text>Conduct confidential and anonymous case reviews of morbidity and mortality associated with pregnancy, childbirth, infancy, and early childhood; and</text> </level> <level label="ii"> <text>Develop and implement interventions to improve the system of care for pregnancy, childbirth, infancy, and early childhood based on the findings from case reviews conducted under item (i) of this paragraph.</text> </level> </level> <level label="3"> <level label="i"> <text>The Secretary shall adopt regulations to implement the requirements of this section.</text> </level> <level label="ii"> <text>The regulations shall include:</text> <level label="1"> <text>The types of case reviews conducted by the Committee;</text> </level> <level label="2"> <text>The confidentiality of case reviews;</text> </level> <level label="3"> <text>A description of the types of records and information needed by the Committee to conduct the case reviews under this section; and</text> </level> <level label="4"> <text>The process for obtaining records, including patient medical records, and any other necessary information in accordance with § 4–305(b) of this article.</text> </level> </level> </level> </level> <level label="c"> <text>This section does not enable the Secretary:</text> <level label="1"> <text>To take charge of a child if the parent, guardian, or other person who has custody of the child objects; or</text> </level> <level label="2"> <text>To treat the child for a disease without the consent of the parent, guardian, or other person who has custody of the child.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-108" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Food instrument” means a voucher, check, coupon, or other document that is used by a participant to obtain supplemental foods.</text> </level> <level label="3"> <text>“Local agency” means a public or private, nonprofit health or human service agency that:</text> <level label="i"> <text>Provides health services either directly or through contract; and</text> </level> <level label="ii"> <text>By written agreement with the State agency, provides Program services in a designated area.</text> </level> </level> <level label="4"> <text>“Participant” means an individual who is receiving supplemental foods or food instruments under the Program and includes:</text> <level label="i"> <text>Pregnant women;</text> </level> <level label="ii"> <text>Breast–feeding women up to 1 year postpartum who are breast–feeding their infants;</text> </level> <level label="iii"> <text>Postpartum women up to 6 months after termination of pregnancy;</text> </level> <level label="iv"> <text>Infants under 1 year of age; and</text> </level> <level label="v"> <text>Children who are at least 1 year old but under the age of 5 years.</text> </level> </level> <level label="5"> <text>“Program” means the Special Supplemental Food Program for Women, Infants, and Children authorized by § 17 of the Child Nutrition Act of 1966, as amended.</text> </level> <level label="6"> <text>“Supplemental foods” means those foods containing nutrients determined to be beneficial for pregnant, breast–feeding, and postpartum women, infants, and children, as prescribed by the Secretary of the U.S. Department of Agriculture.</text> </level> </level> <level label="b"> <level label="1"> <text>Except as otherwise provided in this subsection, a local agency shall include in its proposed written agreement the option to require a participant in the Program to report monthly, bimonthly, or trimonthly to a designated site at designated times to receive food instruments prepared for that participant and to acknowledge receipt of the instruments.</text> </level> <level label="2"> <text>Food instruments may be mailed or otherwise delivered to participants by a local agency only if approved by the Department on the basis of hardships which may be encountered by the target population of the local agency, such as seasonally inclement weather.</text> </level> <level label="3"> <level label="i"> <text>On presentation by the participant of a written request, including justification, a local agency may mail or otherwise deliver food instruments to an individual on the basis of the difficulty of the participant and the participant’s proxies in obtaining the food instruments.</text> </level> <level label="ii"> <text>The justification may include:</text> <level label="1"> <text>Illness;</text> </level> <level label="2"> <text>Imminent childbirth;</text> </level> <level label="3"> <text>Difficulty of access to the local agency; or</text> </level> <level label="4"> <text>Handicapping condition.</text> </level> </level> </level> <level label="4"> <level label="i"> <text>The Secretary shall institute at least one pilot program in a local subdivision or part of a subdivision utilizing a credit card system along with or in place of a food instrument system.</text> </level> <level label="ii"> <text>Implementation must take place within a reasonable period of time from the date of enactment of this section, unless such a pilot program is found to be inconsistent with subsection (d) of this section and a waiver is not granted.</text> </level> </level> </level> <level label="c"> <text>The Department shall maximize distribution of administrative funds to local agencies in a manner that assures equity among the local agencies.</text> </level> <level label="d"> <text>The provisions of this section are effective only to the extent that they are not inconsistent with applicable federal law or regulations.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-109" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Authorized user” means:</text> <level label="i"> <text>A child care facility;</text> </level> <level label="ii"> <text>A health care provider;</text> </level> <level label="iii"> <text>A health insurer;</text> </level> <level label="iv"> <text>A health maintenance organization;</text> </level> <level label="v"> <text>An institution of higher learning;</text> </level> <level label="vi"> <text>A local health department;</text> </level> <level label="vii"> <text>A long–term care facility;</text> </level> <level label="viii"> <text>A managed care organization;</text> </level> <level label="ix"> <text>A nonprofit health service plan;</text> </level> <level label="x"> <text>A patient;</text> </level> <level label="xi"> <text>A school;</text> </level> <level label="xii"> <text>A school–based health center;</text> </level> <level label="xiii"> <text>In the case of a minor child, a parent or guardian; and</text> </level> <level label="xiv"> <text>Any other user designated by the Secretary.</text> </level> </level> <level label="3"> <text>“Health care provider” means a licensed health care practitioner authorized under the Health Occupations Article to administer vaccines in the State.</text> </level> <level label="4"> <text>“ImmuNet” means a computerized information and reminder system to:</text> <level label="i"> <text>Improve the timely and appropriate delivery of immunizations;</text> </level> <level label="ii"> <text>Provide a coordinated network for reminder notices when immunizations are due;</text> </level> <level label="iii"> <text>Provide and collect information to be shared by authorized users; and</text> </level> <level label="iv"> <text>Provide a quality indicator for the insurers’ health care provider practices and public health purposes.</text> </level> </level> <level label="5"> <text>“Immunization” means the process by which an individual becomes protected against a disease including, as the result of having a disease, receiving a vaccination, or receiving preformed antibodies.</text> </level> <level label="6"> <text>“Refusal to permit” means the right of an individual or the parent or guardian of a minor to prevent disclosure to authorized users of individual identifiable information that was reported to ImmuNet.</text> </level> <level label="7"> <text>“Vaccination” means the administration of a killed or weakened infectious organism to prevent disease caused by that organism.</text> </level> <level label="8"> <text>“Vaccine” means a substance that:</text> <level label="i"> <text>May be administered by injection, mouth, or aerosol; and</text> </level> <level label="ii"> <text>Produces immunity that protects the body from a disease.</text> </level> </level> </level> <level label="b"> <text>There is an ImmuNet program in the Department.</text> </level> <level label="c"> <text>Subject to subsection (d) of this section, an authorized user may use the information in ImmuNet for the following purposes:</text> <level label="1"> <text>To provide coordinated immunization services, including sending reminder notices to individuals who need immunizations;</text> </level> <level label="2"> <text>To obtain an individual immunization history;</text> </level> <level label="3"> <text>To identify geographic areas or population groups that are underimmunized;</text> </level> <level label="4"> <text>To compile aggregate data and distribute statistical reports on the status of immunizations in geographic areas and population groups;</text> </level> <level label="5"> <text>To assist in the management of State and local immunization programs;</text> </level> <level label="6"> <text>To monitor the safety of vaccines;</text> </level> <level label="7"> <text>To assess compliance with immunization requirements by monitoring admissions to schools, institutions of higher learning, and child care facilities; and</text> </level> <level label="8"> <text>For any other purpose that the Secretary deems necessary to prevent the spread of communicable diseases.</text> </level> </level> <level label="d"> <level label="1"> <text>An individual, or the parent or guardian of a minor child who has received a vaccination, may refuse to permit disclosure of confidential information collected by ImmuNet, to an authorized user.</text> </level> <level label="2"> <text>If the individual or the parent or guardian of a minor child does not want the release of the individual’s or child’s confidential information, the individual or the parent or guardian of a minor child shall complete a “refusal to permit” form, provided by the Department, to be returned to the Department.</text> </level> <level label="3"> <text>The Secretary shall make available “refusal to permit” forms to each health care provider who gives vaccinations.</text> </level> <level label="4"> <text>The Department shall:</text> <level label="i"> <text>Develop brochures about ImmuNet that:</text> <level label="1"> <text>Describe the benefits of ImmuNet for authorized users;</text> </level> <level label="2"> <text>Describe privacy protections in ImmuNet;</text> </level> <level label="3"> <text>Notify an individual of the right to refuse to permit disclosure to an authorized user;</text> </level> <level label="4"> <text>Notify an individual that the individual may correct any inaccurate information;</text> </level> <level label="5"> <text>Provide a list of addresses where an individual may obtain a form to request the correction or removal of inaccurate information from ImmuNet;</text> </level> <level label="6"> <text>Explain the right of an individual who has received a vaccination to have the individual’s personal information kept confidential;</text> </level> <level label="7"> <text>Describe the kind of information collected and retained by ImmuNet about an individual who receives a vaccination;</text> </level> <level label="8"> <text>Describe who has access to the information in ImmuNet; and</text> </level> <level label="9"> <text>Describe how the information is used by ImmuNet; and</text> </level> </level> <level label="ii"> <text>Make the brochure available to each health care provider who administers vaccines.</text> </level> </level> <level label="5"> <text>Prior to administering vaccines to a newborn child, each birth hospital or birthing center shall distribute the form and the brochure described in paragraphs (2) and (4) of this subsection to the parent of a newborn child.</text> </level> <level label="6"> <text>A health care provider who administers a vaccine, or the agent of the health care provider, shall:</text> <level label="i"> <text>Provide the individual with a copy of the form and the brochure described in paragraphs (2) and (4) of this subsection;</text> </level> <level label="ii"> <text>Notify the individual or the parent or guardian of a minor of the right to refuse to disclose to ImmuNet; and</text> </level> <level label="iii"> <text>Report to ImmuNet all vaccines administered.</text> </level> </level> </level> <level label="e"> <text>Subject to the provisions of subsection (d) of this section, information for ImmuNet may be obtained from:</text> <level label="1"> <text>Any records owned or controlled by the Department, including Medicaid records, clinic records, and vital records;</text> </level> <level label="2"> <text>Any authorized user; and</text> </level> <level label="3"> <text>Any other source of information authorized by the Secretary for use.</text> </level> </level> <level label="f"> <text>Authorized users may not use the information in ImmuNet:</text> <level label="1"> <text>To release or disclose information in ImmuNet that an individual has refused to disclose;</text> </level> <level label="2"> <text>To solicit new patients or clients; or</text> </level> <level label="3"> <text>For any other purpose unless authorized by the Secretary.</text> </level> </level> <level label="g"> <level label="1"> <text>A local health department may operate a local immunization system.</text> </level> <level label="2"> <text>A local health department operating a local immunization system shall be subject to the provisions of subsections (c) through (f) of this section.</text> </level> <level label="3"> <text>A local health department is required to submit information maintained in a local immunization system to ImmuNet in accordance with regulations adopted by the Secretary.</text> </level> </level> <level label="h"> <text>An authorized user who in good faith discloses or does not disclose information to ImmuNet is not liable in any cause of action arising from the disclosure or nondisclosure of that information.</text> </level> <level label="i"> <text>An authorized user, including an officer or employee of a governmental unit, who knowingly and willfully violates subsection (f) of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 for the first offense and not exceeding $5,000 for each subsequent offense.</text> </level> <level label="j"> <text>If the confidentiality of records of Maryland citizens is protected, the Secretary may enter into collaborative agreements with other states for the purpose of sharing information about immunizations.</text> </level> <level label="k"> <text>The Secretary shall adopt regulations to implement this section, including regulations specifying:</text> <level label="1"> <text>The type and kind of information to be collected;</text> </level> <level label="2"> <text>Procedures for protecting the confidentiality of information in ImmuNet;</text> </level> <level label="3"> <text>The permissible use of information compiled by ImmuNet; and</text> </level> <level label="4"> <text>Standards for maintaining security and reliability of collected information in the system.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-110" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <text>The Department, in partnership with the Department of Aging, the Virginia I. Jones Alzheimer’s Disease and Related Dementias Council, and the Greater Maryland Chapter of the Alzheimer’s Association, shall incorporate information into relevant public health outreach programs administered by the Department to:</text> <level label="1"> <text>Educate health care providers regarding:</text> <level label="i"> <text>The importance of early detection and timely diagnosis of cognitive impairment;</text> </level> <level label="ii"> <text>Validated assessment tools for the detection and diagnosis of cognitive impairment;</text> </level> <level label="iii"> <text>The value of a Medicare annual wellness visit or other annual physical for an individual at least 65 years old for cognitive health;</text> </level> <level label="iv"> <text>The Medicare care planning billing code for individuals with cognitive impairment; and</text> </level> <level label="v"> <text>Treatments approved by the Food and Drug Administration for Alzheimer’s disease and related dementias, including relevant information on treatment use and outcomes; and</text> </level> </level> <level label="2"> <text>Increase public understanding and awareness of:</text> <level label="i"> <text>The early warning signs of Alzheimer’s disease and related dementias;</text> </level> <level label="ii"> <text>The value of early detection, diagnosis, and treatment of Alzheimer’s disease and related dementias;</text> </level> <level label="iii"> <text>How to reduce the risk of cognitive decline, particularly among individuals in Black and Latino communities who are at greater risk of developing Alzheimer’s disease and related dementias; and</text> </level> <level label="iv"> <text>Treatments approved by the U.S. Food and Drug Administration for Alzheimer’s disease and related dementias and relevant information on treatment use and outcomes, including information related to treatment outcomes based on biological sex.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-111" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Department, in collaboration with the State–designated health information exchange, shall establish and maintain a publicly accessible website that includes in a downloadable format the following information:</text> <level label="1"> <text>The prevalence of Alzheimer’s disease and related dementias in the State;</text> </level> <level label="2"> <text>The hospitalization rate related to Alzheimer’s disease and related dementias; and</text> </level> <level label="3"> <text>To the extent possible, the prevalence and hospitalization rate of Alzheimer’s disease and related dementias disaggregated based on:</text> <level label="i"> <text>Age, including age of diagnosis;</text> </level> <level label="ii"> <text>Sex;</text> </level> <level label="iii"> <text>Race;</text> </level> <level label="iv"> <text>Ethnicity;</text> </level> <level label="v"> <text>Number of cases by county;</text> </level> <level label="vi"> <text>Co–occurrence of Down Syndrome (Trisomy–21); and</text> </level> <level label="vii"> <text>Type of dementia.</text> </level> </level> </level> <level label="b"> <text>The website required under subsection (a) of this section shall:</text> <level label="1"> <text>Include the data available for the immediately preceding 5–year period ending September 30, 2025; and</text> </level> <level label="2"> <text>Be updated on or before January 1 each year, beginning in 2027, to include any newly available data.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-112" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary"> <level label="a"> <text>The Secretary shall issue recommendations for immunizations, screenings, and preventive services for infants, children, and adults that follow the generally accepted consensus within the scientific community and sound clinical guidance as specified in subsection (b) of this section and subject to subsection (c) of this section.</text> </level> <level label="b"> <text>The recommendations shall:</text> <level label="1"> <text>Be made in accordance with the applicable recommendations of the following authoritative medical organizations:</text> <level label="i"> <text>The American Academy of Pediatrics;</text> </level> <level label="ii"> <text>The American College of Obstetricians and Gynecologists; or</text> </level> <level label="iii"> <text>The American Academy of Family Physicians; and</text> </level> </level> <level label="2"> <text>Take into consideration the applicable guidance of:</text> <level label="i"> <text>The Maryland Statewide Advisory Commission on Immunizations;</text> </level> <level label="ii"> <text>The U.S. Department of Health And Human Services, including the Health Resources and Services Administration;</text> </level> <level label="iii"> <text>The U.S. Centers for Disease Control and Prevention, including the Advisory Committee on Immunization Practices;</text> </level> <level label="iv"> <text>The U.S. Food and Drug Administration, including the Vaccines and Related Biological Products Advisory Committee; and</text> </level> <level label="v"> <text>The U.S. Preventive Services Task Force.</text> </level> </level> </level> <level label="c"> <text>Before adopting a recommendation for a preventive service that is not an immunization and has not received a recommendation from the U.S. Department of Health and Human Services or an A or B rating from the U.S. Preventive Services Task Force, the Secretary shall:</text> <level label="1"> <text>Hold a notice and comment period of at least 30 days;</text> </level> <level label="2"> <text>Obtain an analysis from the Maryland Health Care Commission on the service that meets the requirements of § 15–1501 of the Insurance Article; and</text> </level> <level label="3"> <text>Cite the applicable recommendations of the authoritative medical organizations on which a recommendation would be based.</text> </level> </level> <level label="d"> <text>The Secretary shall:</text> <level label="1"> <text>Publish recommendations issued under this section on the Department’s website; and</text> </level> <level label="2"> <text>Distribute the recommendations issued under this section to licensed health professionals in the State and to the Maryland Insurance Administration.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-201" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>A physician with reason to suspect that a patient under the physician’s care has a condition or an infectious or contagious disease, except human immunodeficiency virus or acquired immunodeficiency syndrome, that endangers public health and that has been designated by the Secretary as reportable shall submit immediately a report to the health officer for the county where the physician cares for that patient.</text> </level> <level label="b"> <text>The report shall:</text> <level label="1"> <text>Contain the information and be in a format specified or approved by the Secretary; and</text> </level> <level label="2"> <text>Be transmitted as directed by the Secretary.</text> </level> </level> <level label="c"> <level label="1"> <text>Except as provided in paragraphs (2) through (5) of this subsection, all reports and all information collected in connection with a report from a health care provider, the subject of the report, or other individuals who might be affected by the condition or disease in the report are:</text> <level label="i"> <text>Confidential;</text> </level> <level label="ii"> <text>Not medical records under Title 4, Subtitle 3 of this article;</text> </level> <level label="iii"> <text>Not open to public inspection; and</text> </level> <level label="iv"> <text>Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record.</text> </level> </level> <level label="2"> <text>This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed.</text> </level> <level label="3"> <text>The Secretary may prepare and disseminate nonindividually identifiable information about one or more cases of a condition or disease based on any report received under this section, for any purpose consistent with the Secretary’s lawful duties as authorized by an act of the Maryland General Assembly.</text> </level> <level label="4"> <text>This subsection does not apply to or restrict the use or publication of any statistics, information, or other material that summarizes or refers to confidential records in the aggregate, without disclosing the identity of any individual who is the subject of the confidential record.</text> </level> <level label="5"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties as authorized by an act of the Maryland General Assembly or the United States Congress where the Secretary determines that:</text> <level label="i"> <text>The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and</text> </level> <level label="ii"> <text>The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-201.1" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>A health care provider who has diagnosed an individual under the health care provider’s care with HIV infection or acquired immunodeficiency syndrome according to the current definition published in the Morbidity and Mortality Weekly Report by the Centers for Disease Control and Prevention of the Department of Health and Human Services shall submit immediately a report to the health officer for the county where the health care provider cares for that individual.</text> </level> <level label="b"> <text>The report shall:</text> <level label="1"> <text>Be on the form that the Secretary provides;</text> </level> <level label="2"> <text>Identify the disease;</text> </level> <level label="3"> <text>State the name, age, race, sex, and residence address of the individual;</text> </level> <level label="4"> <text>State the pregnancy status of the individual, if applicable; and</text> </level> <level label="5"> <text>Be signed by the health care provider.</text> </level> </level> <level label="c"> <level label="1"> <text>A health care provider shall submit a report as described in subsection (b) of this section to the Secretary within 48 hours of:</text> <level label="i"> <text>The birth of an infant whose mother has tested positive for HIV; and</text> </level> <level label="ii"> <text>A pregnant woman testing positive for HIV, for the purpose of intervention.</text> </level> </level> <level label="2"> <text>If a newborn infant does not become HIV positive after 18 months from the infant’s date of birth, the Secretary shall have the newborn infant’s name removed from the HIV registry.</text> </level> </level> <level label="d"> <level label="1"> <text>All health care provider reports required under this section are:</text> <level label="i"> <text>Confidential and subject to Title 4, Subtitle 1 of this article; and</text> </level> <level label="ii"> <text>Not medical records under Title 4, Subtitle 3 of this article, but are subject to the confidentiality requirements of Title 4, Subtitle 1 of this article.</text> </level> </level> <level label="2"> <text>The reports and any proceedings, records, or files relating to the reports required under this section are not discoverable and are not admissible in evidence in any criminal, civil, or administrative action.</text> </level> <level label="3"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties pursuant to State or federal law where the Secretary determines the agency to whom the information is disclosed will maintain the confidentiality of the disclosure.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-202" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>In this section, “institution” includes:</text> <level label="1"> <text>A hospital; and</text> </level> <level label="2"> <text>A lodging facility.</text> </level> </level> <level label="b"> <text>When the administrative head of an institution has reason to believe that an individual on the premises of the institution has a condition or an infectious or contagious disease, except human immunodeficiency virus or acquired immunodeficiency syndrome, that has been designated by the Secretary as reportable, the administrative head immediately shall submit a report to the health officer for the county where the institution is located.</text> </level> <level label="c"> <text>The report shall:</text> <level label="1"> <text>Contain the information and be in a format specified or approved by the Secretary; and</text> </level> <level label="2"> <text>Be transmitted as directed by the Secretary.</text> </level> </level> <level label="d"> <level label="1"> <text>Except as provided in paragraphs (2) through (5) of this subsection, all reports and all information collected in connection with a report from a health care provider, the subject of the report, or other individuals who might be affected by the condition or disease in the report are:</text> <level label="i"> <text>Confidential;</text> </level> <level label="ii"> <text>Not medical records under Title 4, Subtitle 3 of this article;</text> </level> <level label="iii"> <text>Not open to public inspection; and</text> </level> <level label="iv"> <text>Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record.</text> </level> </level> <level label="2"> <text>This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed.</text> </level> <level label="3"> <text>This subsection does not apply to or restrict the use or publication of any statistics, information, or other material that summarizes or refers to confidential records in the aggregate, without disclosing the identity of any individual who is the subject of the confidential record.</text> </level> <level label="4"> <text>The Secretary may prepare and disseminate nonindividually identifiable information about one or more cases of a condition or a disease based on any report received under this section, for any purpose consistent with the Secretary’s lawful duties as authorized by an act of the Maryland General Assembly.</text> </level> <level label="5"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties as authorized by an act of the Maryland General Assembly or the United States Congress where the Secretary determines that:</text> <level label="i"> <text>The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and</text> </level> <level label="ii"> <text>The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-202.1" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>In this section, “institution” includes:</text> <level label="1"> <text>A hospital;</text> </level> <level label="2"> <text>A nursing home;</text> </level> <level label="3"> <text>A hospice facility;</text> </level> <level label="4"> <text>A medical clinic in a correctional facility;</text> </level> <level label="5"> <text>An inpatient psychiatric facility; and</text> </level> <level label="6"> <text>An inpatient drug rehabilitation facility.</text> </level> </level> <level label="b"> <text>When an institution has an individual in the care of the institution with a diagnosis of HIV or acquired immunodeficiency syndrome according to the current definition published in the Morbidity and Mortality Weekly Report by the Centers for Disease Control and Prevention, a clinical or infection control practitioner shall submit a report within 48 hours to the health officer for the county where the institution is located.</text> </level> <level label="c"> <text>The report shall:</text> <level label="1"> <text>Be on the form that the Secretary provides;</text> </level> <level label="2"> <text>Identify the disease;</text> </level> <level label="3"> <text>State the name, age, race, sex, and residence address of the individual with the disease;</text> </level> <level label="4"> <text>State the pregnancy status of the individual, if applicable;</text> </level> <level label="5"> <text>State the name of the administrative head of the institution; and</text> </level> <level label="6"> <text>State the address of the institution.</text> </level> </level> <level label="d"> <level label="1"> <text>All institution reports required under this section are:</text> <level label="i"> <text>Confidential and subject to Title 4, Subtitle 1 of this article; and</text> </level> <level label="ii"> <text>Not medical records under Title 4, Subtitle 3 of this article, but are subject to the confidentiality requirements of Title 4, Subtitle 1 of this article.</text> </level> </level> <level label="2"> <text>The reports and any proceedings, records, or files relating to the reports required under this section are not discoverable and are not admissible in evidence in any criminal, civil, or administrative action.</text> </level> <level label="3"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties in accordance with State or federal law where the Secretary determines the agency to whom the information is disclosed will maintain the confidentiality of the disclosure.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-203" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>Notwithstanding any other provision of law, the Department may provide patient-identifying information for patients treated in this State for cancer to a cancer control agency in another state if:</text> <level label="1"> <text>The patient is a resident of the other state;</text> </level> <level label="2"> <text>The Department determines that the agency will preserve the confidentiality of the information; and</text> </level> <level label="3"> <text>The other state has authority to provide equivalent information on Maryland residents to this State.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-204" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Cancer report” means a 1–time abstract of the medical record of a patient diagnosed or treated for cancer or a central nervous system tumor which contains:</text> <level label="i"> <text>Reasonably obtained patient demographic information, including risk factors;</text> </level> <level label="ii"> <text>Relevant information on the:</text> <level label="1"> <text>Initial histologically precise diagnosis;</text> </level> <level label="2"> <text>Initial treatment;</text> </level> <level label="3"> <text>Extent of the disease by the end of the first hospitalization; and</text> </level> <level label="4"> <text>Extent of the disease within 2 months of diagnosis if the information is available to the reporting facility and the reporting facility has a tumor registry; and</text> </level> </level> <level label="iii"> <text>Facility and other provider identification information.</text> </level> </level> <level label="3"> <level label="i"> <text>“Central nervous system tumor” means, irrespective of histologic type or behavior, a primary tumor in the following sites:</text> <level label="1"> <text>The brain;</text> </level> <level label="2"> <text>The caudea equina;</text> </level> <level label="3"> <text>A cranial nerve;</text> </level> <level label="4"> <text>The craniopharyngeal duct;</text> </level> <level label="5"> <text>The meninges;</text> </level> <level label="6"> <text>The pineal gland;</text> </level> <level label="7"> <text>The pituitary gland; or</text> </level> <level label="8"> <text>The spinal cord.</text> </level> </level> <level label="ii"> <text>“Central nervous system tumor” includes a primary intracranial tumor.</text> </level> </level> <level label="4"> <text>“Freestanding ambulatory care facility” has the meaning stated in § 19–3B–01 of this article.</text> </level> </level> <level label="b"> <level label="1"> <text>Each hospital that has care of a patient with cancer or a central nervous system tumor, each freestanding laboratory, freestanding ambulatory care facility, or therapeutic radiological center that has care of or has diagnosed cancer or a central nervous system tumor for a nonhospitalized patient, and each physician who has care of or has diagnosed cancer or a central nervous system tumor for a nonhospitalized patient not otherwise reported shall:</text> <level label="i"> <level label="1"> <text>Submit a cancer report to the Secretary, on the form that the Secretary provides or in a computerized file;</text> </level> <level label="2"> <text>Make available to the Secretary, or an agent of the Secretary, at the facility the information necessary to compile a cancer report; or</text> </level> <level label="3"> <text>Enter into an agreement with a hospital or other facility or agency that agrees to report to the Maryland Cancer Registry to act as the reporting source for a cancer or central nervous system tumor patient who has been referred to or from that facility, or reported to that agency with regard to cancer or central nervous system tumor screening, diagnosis, or treatment; and</text> </level> </level> <level label="ii"> <text>Effective July 1, 1993, submit a cancer report in a computerized file on a quarterly basis to the Secretary, or an agent of the Secretary, for all patients initially diagnosed, treated, or admitted to a facility for cancer or a central nervous system tumor during that calendar quarter.</text> </level> </level> <level label="2"> <text>To assure compliance with this section, the Secretary, or an agent of the Secretary, may inspect upon reasonable notice a representative sample of the medical records of patients diagnosed, treated, or admitted for cancer or a central nervous system tumor at the facility.</text> </level> <level label="3"> <level label="i"> <text>Information obtained under this subsection shall be confidential and subject to Title 4, Subtitle 1 of this article.</text> </level> <level label="ii"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties pursuant to State or federal law where the Secretary determines that the agency to whom the information is disclosed will maintain the confidentiality of the disclosure.</text> </level> <level label="iii"> <text>A cancer report is not a medical record under Title 4, Subtitle 3 of this article, but is subject to the confidentiality requirements of Title 4, Subtitle 1 of this article.</text> </level> </level> <level label="4"> <text>Each hospital, freestanding laboratory, freestanding ambulatory care facility, therapeutic radiological center, or physician who in good faith submits a cancer report to the Secretary is not liable in any cause of action arising from the submission of the report.</text> </level> <level label="5"> <text>The Secretary, after consultation with the Cancer Registry Advisory Committee, the Maryland Hospital Association, and representatives of freestanding laboratories and therapeutic radiological centers, shall adopt regulations to implement the requirements of this section.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-205" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>In this section, “clinical material” means:</text> <level label="1"> <text>An organism isolated from a clinical specimen;</text> </level> <level label="2"> <text>Material derived or prepared from a clinical specimen in which evidence of a communicable disease has been identified or detected; or</text> </level> <level label="3"> <text>If the organism or material described in subparagraph (i) or (ii) of this paragraph is not available, material from an individual that has already been obtained by the medical laboratory, in the following order of preference:</text> <level label="i"> <text>A patient specimen;</text> </level> <level label="ii"> <text>Microbial genetic material; or</text> </level> <level label="iii"> <text>Other laboratory material.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Except for the director of the State’s public health laboratory system, the director of a medical laboratory located in this State shall submit a report to the health officer for the county where the laboratory is located after an examination of a human specimen shows evidence of any infectious or contagious disease or condition that has been designated by the Secretary as reportable.</text> </level> <level label="2"> <text>The director of the State’s public health laboratory system shall submit a report to the Secretary if an examination of a human specimen shows evidence of any infectious or contagious disease or condition that has been designated by the Secretary as reportable.</text> </level> <level label="3"> <text>The director of a medical laboratory located outside of this State that performs a medical laboratory test on a human specimen acquired from a person in this State shall submit a report to the Secretary after an examination of that specimen shows evidence of any infectious or contagious disease or condition that has been designated by the Secretary as reportable.</text> </level> <level label="4"> <text>A director of a medical laboratory shall submit clinical material to the Secretary as directed by the Secretary.</text> </level> </level> <level label="c"> <level label="1"> <text>When more than 1 specimen is taken from a patient during 1 disease episode, the director of the medical laboratory need not report every test result of a specimen that shows evidence of the same disease in that patient if:</text> <level label="i"> <text>At least 1 positive test result is reported; and</text> </level> <level label="ii"> <text>The health officer has approved the reporting of less than all test results.</text> </level> </level> <level label="2"> <text>The director of the medical laboratory need not report vibriosis, noncholera, if the disease is found in a specimen obtained from the patient’s teeth, gingival tissues, or oral mucosa.</text> </level> </level> <level label="d"> <text>The report shall:</text> <level label="1"> <text>Contain the information and be in a format specified or approved by the Secretary; and</text> </level> <level label="2"> <text>Be transmitted as directed by the Secretary.</text> </level> </level> <level label="e"> <text>This section does not relieve a person of the duty to report under § 18–201, § 18–201.1, § 18–202, or § 18–202.1 of this subtitle.</text> </level> <level label="f"> <level label="1"> <text>A health officer shall inform the Secretary of each laboratory examination report received under subsection (b)(1) of this section.</text> </level> <level label="2"> <text>The Secretary shall inform the health officer of the jurisdiction where the patient resides of a laboratory examination report received under this section from a medical laboratory located outside this State.</text> </level> </level> <level label="g"> <text>The Secretary, a health officer, or an agent of the Secretary or health officer may discuss a laboratory report with the attending physician or another health care provider caring for a patient, but, if the physician or another health care provider caring for a patient is not reasonably available, may communicate with a patient directly in a manner prescribed by the Secretary.</text> </level> <level label="h"> <level label="1"> <text>Except as provided in paragraphs (2) through (5) of this subsection, all reports and all information collected in connection with a report from a health care provider, the subject of the report, or other individuals who might be affected by the condition or disease in the report are:</text> <level label="i"> <text>Confidential;</text> </level> <level label="ii"> <text>Not medical records under Title 4, Subtitle 3 of this article;</text> </level> <level label="iii"> <text>Not open to public inspection; and</text> </level> <level label="iv"> <text>Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record.</text> </level> </level> <level label="2"> <text>This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed.</text> </level> <level label="3"> <text>The Secretary may prepare and disseminate nonindividually identifiable information about one or more cases of a condition or a disease based on any report made under this section, for any purpose consistent with the Secretary’s lawful duties as authorized by an act of the Maryland General Assembly.</text> </level> <level label="4"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties as authorized by an act of the Maryland General Assembly or the United States Congress where the Secretary determines that:</text> <level label="i"> <text>The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and</text> </level> <level label="ii"> <text>The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease.</text> </level> </level> <level label="5"> <text>This subsection does not apply to or restrict the use or publication of any statistics, information, or other material that summarizes or refers to confidential records in the aggregate, without disclosing the identity of any individual who is the subject of the confidential record.</text> </level> </level> <level label="i"> <text>To assure compliance with this section, the Secretary, a health officer, or an agent of the Secretary or health officer may inspect pertinent laboratory records.</text> </level> <level label="j"> <text>The Secretary shall adopt regulations that designate the diseases or conditions that are reportable by a director of a medical laboratory under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-206" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Birth defect” means an abnormality of the structure or a function of the human body present at birth that may result in:</text> <level label="i"> <text>A physical or mental disability; or</text> </level> <level label="ii"> <text>Death.</text> </level> </level> <level label="3"> <text>“Health care provider” has the meaning stated in § 4–301 of this article.</text> </level> </level> <level label="b"> <level label="1"> <text>A hospital shall make a report on each child who is live–born or stillborn in the hospital and has a birth defect. If a child is born outside the hospital, the person filling out the birth certificate shall make a report under this section.</text> </level> <level label="2"> <text>The Secretary shall appoint a committee of physicians, hospital representatives, epidemiologists, parents or guardians of children with birth defects, and officials from the Department to determine the information required under paragraph (1) of this subsection.</text> </level> <level label="3"> <text>The hospital shall submit the reports required under paragraph (1) of this subsection to the Department within 1 month after the date of release of the child’s mother from the hospital.</text> </level> </level> <level label="c"> <text>A health care provider shall allow the Department to inspect and obtain the following medical information regarding a child with a birth defect:</text> <level label="1"> <text>The medical records of:</text> <level label="i"> <text>A child through the child’s second year of life; and</text> </level> <level label="ii"> <text>A child’s mother regarding the mother’s pregnancy with the child;</text> </level> </level> <level label="2"> <text>Records of any laboratory tests relating to a child’s birth defect; and</text> </level> <level label="3"> <text>Any other medical information relating to a child’s birth defect.</text> </level> </level> <level label="d"> <level label="1"> <text>The hospital shall disclose the identity of the child with a birth defect to the Secretary so that the Secretary may:</text> <level label="i"> <text>Use the information to protect the public health; or</text> </level> <level label="ii"> <text>Provide the parents or guardians of the child with information on birth defects and public and private services available in accordance with subsection (g)(1) and (4) of this section.</text> </level> </level> <level label="2"> <text>If the Department shows a need for the individual identity of children without birth defects to conduct an investigation that aids in the protection of the public health, the hospital shall obtain the written consent of the parent or guardian of the child to disclose the child’s name to the Secretary.</text> </level> <level label="3"> <text>The Secretary shall assure that the identity of a child under this section may not be released outside the Department without the written consent of the parent or guardian of the child.</text> </level> </level> <level label="e"> <level label="1"> <text>The Department shall keep any medical information obtained under this section confidential.</text> </level> <level label="2"> <text>Medical information requested under this section shall be only as intrusive as necessary and used for the purpose of:</text> <level label="i"> <text>Assuring the quality of the data reported;</text> </level> <level label="ii"> <text>Providing information or services to a child’s family;</text> </level> <level label="iii"> <text>Conducting an epidemiological investigation related to a birth defect; or</text> </level> <level label="iv"> <text>Conducting the Department’s research into the causes of birth defects.</text> </level> </level> <level label="3"> <level label="i"> <text>The release of medical information obtained in accordance with this section to the Department is not a violation of the confidential relationship between a health care provider and a patient.</text> </level> <level label="ii"> <text>A health care provider who discloses medical records to the Department under this section:</text> <level label="1"> <text>Is not liable in any suit for civil damages for the disclosure of the medical records;</text> </level> <level label="2"> <text>Is not subject to disciplinary action by any licensing or disciplining authority for disclosure of confidential information; and</text> </level> <level label="3"> <text>May not be subject to any criminal penalties.</text> </level> </level> </level> <level label="4"> <text>The medical information obtained by the Department under this section is not subject to subpoena, discovery, or introduction into evidence in any administrative, civil, or criminal proceeding.</text> </level> </level> <level label="f"> <text>While conducting research using human subjects under this section, the Department shall comply with the requirements for the protection of human subjects under:</text> <level label="1"> <text>Title 13, Subtitle 20 of this article; and</text> </level> <level label="2"> <text>42 U.S.C. § 289.</text> </level> </level> <level label="g"> <level label="1"> <text>The Department shall assure that information is prepared and periodically updated on:</text> <level label="i"> <text>Birth defects; and</text> </level> <level label="ii"> <text>Public and private services for children with birth defects.</text> </level> </level> <level label="2"> <level label="i"> <text>The Secretary shall appoint a committee to determine the information required under paragraph (1) of this subsection.</text> </level> <level label="ii"> <text>The committee shall consist of:</text> <level label="1"> <text>Physicians;</text> </level> <level label="2"> <text>Educators;</text> </level> <level label="3"> <text>Social service specialists;</text> </level> <level label="4"> <text>Representatives of the Department;</text> </level> <level label="5"> <text>Representatives of the Department of Human Services;</text> </level> <level label="6"> <text>Representatives of the State Department of Education; and</text> </level> <level label="7"> <text>Parents or guardians of children with birth defects.</text> </level> </level> </level> <level label="3"> <text>The information provided under this subsection shall be distributed to each hospital and made available to parents or guardians of children with birth defects by the child’s physician before the child is discharged from the hospital and with an explanation, to the extent possible, of the birth defect to the parents or guardians.</text> </level> <level label="4"> <level label="i"> <text>The Secretary shall send a letter to the parent or guardian of each child reported under this section with a birth defect before the child is 6 months old.</text> </level> <level label="ii"> <text>The letter shall offer information about the birth defect and available services with emphasis on needs identified after discharge from the hospital.</text> </level> <level label="iii"> <text>Before sending a letter to a parent or guardian, the Secretary shall implement appropriate procedures to assure that a letter is not sent to a parent or guardian of a child who has died.</text> </level> </level> </level> <level label="h"> <text>The Department and the Department of the Environment shall jointly develop procedures to monitor the data on birth defect trends which may be caused by environmental hazards.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-207" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Designated anonymous HIV test site” means an HIV counseling and testing site approved by the Maryland Department of Health as a site where a patient may have an anonymous HIV test.</text> </level> <level label="3"> <text>“HIV/AIDS case report” means an abstract of the medical record of a patient diagnosed with human immunodeficiency virus or acquired immunodeficiency syndrome which contains:</text> <level label="i"> <text>Reasonably obtained patient demographic information, including name and risk factors;</text> </level> <level label="ii"> <text>Relevant information on the:</text> <level label="1"> <text>Initial diagnosis;</text> </level> <level label="2"> <text>Treatment and referral; and</text> </level> <level label="3"> <text>Clinical condition; and</text> </level> </level> <level label="iii"> <text>Facility and other provider identification information.</text> </level> </level> <level label="4"> <text>“Report” means:</text> <level label="i"> <text>A laboratory examination report for HIV or CD 4+ count as required by § 18–205 of this subtitle;</text> </level> <level label="ii"> <text>A report for HIV or AIDS as required by § 18–201.1, § 18–202, or § 18–202.1 of this subtitle; or</text> </level> <level label="iii"> <text>An HIV/AIDS case report.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Except for a designated anonymous HIV test site, a facility or office that orders a test for HIV and receives a test result that documents the presence of HIV as defined by the CDC laboratory criteria shall, upon the Secretary’s request, make available to the Secretary, or an agent of the Secretary, the information necessary to compile an HIV/AIDS case report.</text> </level> <level label="2"> <text>A report or information assembled or obtained under this section:</text> <level label="i"> <text>Is confidential and subject to Title 4, Subtitle 1 of this article; and</text> </level> <level label="ii"> <text>Is not a medical record under Title 4, Subtitle 3 of this article, but is subject to the confidentiality requirements of Title 4, Subtitle 1 of this article.</text> </level> </level> <level label="3"> <text>This subsection does not apply to a disclosure by the Secretary to another governmental agency performing its lawful duties pursuant to State or federal law where the Secretary determines that the agency to which the information is disclosed will maintain the confidentiality of the disclosure.</text> </level> <level label="4"> <text>The report and any proceedings, records, or files relating to the reports required under this section are not discoverable and are not admissible in evidence in any civil action.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-208" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>When a health officer has reason to believe that a disease that endangers public health exists within the county, the health officer shall:</text> <level label="i"> <text>Report immediately to the appropriate county board of health; and</text> </level> <level label="ii"> <text>With the approval of the board:</text> <level label="1"> <text>Investigate the suspected disease; and</text> </level> <level label="2"> <text>Act properly to prevent the spread of the disease.</text> </level> </level> </level> <level label="2"> <level label="i"> <text>Except in Baltimore City, the attending physician of an individual who has the disease may act properly to prevent the spread of the disease and does not need the approval of the county board of health to act.</text> </level> <level label="ii"> <text>A physician may act under this paragraph only until the health officer completes the investigation under paragraph (1) of this subsection or, if sooner, until the emergency ends.</text> </level> </level> <level label="3"> <text>A county board of health shall pay the necessary and legitimate expenses that a health officer incurs under this subsection.</text> </level> </level> <level label="b"> <text>When a health officer is notified of an infectious or contagious disease within the county, the health officer:</text> <level label="1"> <text>Shall act immediately to prevent the spread of the disease;</text> </level> <level label="2"> <text>Within 24 hours after receiving notice of the disease, shall give the Secretary all information obtained on the disease; and</text> </level> <level label="3"> <text>Shall cooperate with the Secretary to prevent the spread of the disease.</text> </level> </level> <level label="c"> <level label="1"> <text>When a health officer knows of any unusual disease or mortality in the county or a contiguous county, the health officer promptly shall give the Secretary notice of the disease or mortality.</text> </level> <level label="2"> <text>If a health officer is unsure whether a disease is infectious or contagious, the health officer shall notify the Secretary.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-209" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>When a health officer receives notice of an infectious or contagious disease that affects or is likely to endanger the health of school children within the county, the health officer immediately shall give written notice to the county board of education.</text> </section> <section article="ghg" article_name="Health - General" number="18-210" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>To prevent the spread of an infectious or contagious disease that endangers public health, a health officer may have:</text> <level label="1"> <text>Any part of a house disinfected if the house has been exposed to the disease; and</text> </level> <level label="2"> <text>Any article in the house disinfected or destroyed if the article has been exposed to the disease.</text> </level> </level> <level label="b"> <text>The county where the house is located shall:</text> <level label="1"> <text>Incur the expense of disinfecting the house; and</text> </level> <level label="2"> <text>Reasonably compensate a person who suffers damage from the exercise of a power granted by this section, if the person is not at fault.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-211" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>A health officer may have an individual moved to a suitable place for the reception of the sick if:</text> <level label="1"> <text>A physician certifies that the individual has an infectious disease that endangers public health;</text> </level> <level label="2"> <text>The individual:</text> <level label="i"> <text>Is staying in a room occupied by more than 1 family;</text> </level> <level label="ii"> <text>Is on board a vessel; or</text> </level> <level label="iii"> <text>Otherwise does not have proper housing; and</text> </level> </level> <level label="3"> <text>The administrative head of the place for the reception of the sick consents to the move.</text> </level> </level> <level label="b"> <text>The city or county where the infected individual is found shall pay for the cost of moving the individual.</text> </level> <level label="c"> <text>A person may not willfully disobey an order or obstruct the carrying out of an order of the health officer to move an individual.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-212" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>The health officer shall keep a record of each report that is submitted to the health officer under § 18-201 of this subtitle.</text> </level> <level label="b"> <text>The record shall:</text> <level label="1"> <text>Be on the form that the Secretary provides;</text> </level> <level label="2"> <text>State the date of the report;</text> </level> <level label="3"> <text>State the name of the physician who submits the report;</text> </level> <level label="4"> <text>State the disease identified in the report;</text> </level> <level label="5"> <text>State the name and residence address of the patient named in the report; and</text> </level> <level label="6"> <text>State the actions taken to prevent the spread of the disease.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-212.1" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>If the Governor has strong grounds to believe that there is a danger of a malignant and contagious disease being introduced into the State, the Governor may:</text> <level label="1"> <text>Quarantine a vessel that is entering the waters of the State;</text> </level> <level label="2"> <text>Prohibit or restrict contact between the State and the place affected by the disease; and</text> </level> <level label="3"> <text>Take other actions that appear to the Governor to be necessary to carry out this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-213" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Contagious disease or virus” means:</text> <level label="i"> <text>Human immunodeficiency virus (HIV);</text> </level> <level label="ii"> <text>Meningococcal meningitis;</text> </level> <level label="iii"> <text>Tuberculosis;</text> </level> <level label="iv"> <text>Mononucleosis;</text> </level> <level label="v"> <text>Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G;</text> </level> <level label="vi"> <text>Diphtheria;</text> </level> <level label="vii"> <text>Plague;</text> </level> <level label="viii"> <text>Hemorrhagic fevers; or</text> </level> <level label="ix"> <text>Rabies.</text> </level> </level> <level label="3"> <text>“Correctional institution” means a place of detention or correctional confinement operated by or for the State or a local government.</text> </level> <level label="4"> <level label="i"> <text>“Correctional officer” means a member of a correctional unit who is charged with and actually performs those duties that relate to the investigation, care, custody, control, or supervision of persons confined to places of incarceration.</text> </level> <level label="ii"> <text>“Correctional officer” includes any sheriff, warden, superintendent, or any other person having an equivalent title.</text> </level> </level> <level label="5"> <text>“Law enforcement officer” means any person who, in an official capacity, is authorized by law to make arrests and who is a member of one of the following law enforcement agencies:</text> <level label="i"> <text>The Department of State Police;</text> </level> <level label="ii"> <text>The Baltimore City Police Department;</text> </level> <level label="iii"> <text>The police department, bureau, or force of any county;</text> </level> <level label="iv"> <text>The police department, bureau, or force of any incorporated city or town;</text> </level> <level label="v"> <text>The office of the sheriff of any county;</text> </level> <level label="vi"> <text>The police department, bureau, or force of any bicounty agency or constituent institution of the University System of Maryland, Morgan State University, St. Mary’s College, or of any institution under the jurisdiction of the Maryland Higher Education Commission;</text> </level> <level label="vii"> <text>The Maryland Transit Administration police force of the Department of Transportation, the Maryland Transportation Authority Police Force, and the Maryland Port Administration police force of the Department of Transportation;</text> </level> <level label="viii"> <text>The law enforcement officers of the Department of Natural Resources;</text> </level> <level label="ix"> <text>The Field Enforcement Bureau of the Comptroller’s Office;</text> </level> <level label="x"> <text>The Field Enforcement Division of the Alcohol, Tobacco, and Cannabis Commission;</text> </level> <level label="xi"> <text>The Crofton Police Department;</text> </level> <level label="xii"> <text>The Intelligence and Investigative Division of the Department of Public Safety and Correctional Services; or</text> </level> <level label="xiii"> <text>The Ocean Pines Police Department.</text> </level> </level> <level label="6"> <text>“Medical care facility” means a hospital as defined in § 19–301 of this article or a health care facility of a correctional institution.</text> </level> </level> <level label="b"> <text>While treating or transporting an ill or injured patient to a medical care facility or while acting in the performance of duty, if a paid or volunteer firefighter, emergency medical technician, or rescue squad member comes into contact with a patient who is subsequently diagnosed as having a contagious disease or virus, as a result of information obtained in conjunction with the services provided during the visit to the facility, the attending physician, medical examiner, a designee of the medical care facility who receives the patient, the Chief Medical Examiner, or the Chief Medical Examiner’s designee shall notify the firefighter, emergency medical technician, or rescue squad member, and the employer or employer’s designee of the individual’s possible exposure to the contagious disease or virus.</text> </level> <level label="c"> <text>If, while treating or transporting an ill or injured patient to a medical care facility or while acting in the performance of duty, a law enforcement officer comes into contact with a patient who is subsequently diagnosed, as a result of information obtained in conjunction with the services provided during the visit to the facility, as having a contagious disease or virus, the attending physician, medical examiner, a designee of the medical care facility who receives the patient, the Chief Medical Examiner or the Chief Medical Examiner’s designee shall notify the law enforcement officer and the officer’s employer or employer’s designee of the officer’s possible exposure to the contagious disease or virus.</text> </level> <level label="d"> <text>If, while treating or transporting an ill or injured incarcerated individual to a medical care facility or while acting in the performance of duty, a correctional officer comes into contact with an incarcerated individual who is subsequently diagnosed, as a result of information obtained in conjunction with the services provided during the visit to the facility, as having a contagious disease or virus, the attending physician, medical examiner, a designee of the medical care facility that receives the incarcerated individual, the Chief Medical Examiner, or the Chief Medical Examiner’s designee shall notify the correctional officer and the correctional officer’s correctional institution or the correctional institution’s designee of the officer’s possible exposure to the contagious disease or virus.</text> </level> <level label="e"> <text>The notification required under subsection (b), (c), or (d) of this section shall:</text> <level label="1"> <text>Be made within 48 hours, or sooner, of confirmation of the patient’s diagnosis;</text> </level> <level label="2"> <text>Include subsequent written confirmation of possible exposure to the contagious disease or virus;</text> </level> <level label="3"> <text>Be conducted in a manner that will protect the confidentiality of the patient; and</text> </level> <level label="4"> <text>To the extent possible, be conducted in a manner that will protect the confidentiality of the firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer.</text> </level> </level> <level label="f"> <text>The written confirmation required under subsection (e)(2) of this section shall constitute compliance with this section.</text> </level> <level label="g"> <text>Each medical care facility shall develop written procedures for the implementation of this section, and, upon request, make copies available to the local fire authority, the local fire authority’s designee, the local law enforcement authority, the local law enforcement authority’s designee, the correctional officer, or the correctional institution’s designee having jurisdiction.</text> </level> <level label="h"> <text>A medical care facility, physician, Chief Medical Examiner, or the Chief Medical Examiner’s designee acting in good faith to provide notification in accordance with this section may not be liable in any cause of action related to the breach of patient confidentiality.</text> </level> <level label="i"> <text>A medical care facility, physician, Chief Medical Examiner, or the Chief Medical Examiner’s designee acting in good faith to provide notification in accordance with this section may not be liable in any cause of action for:</text> <level label="1"> <text>The failure to give the required notice, if the firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer fails to properly initiate the notification procedures developed by the health care facility under subsection (g) of this section; or</text> </level> <level label="2"> <text>The failure of the employer or employer’s designee to subsequently notify the firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer of the possible exposure to a contagious disease or virus.</text> </level> </level> <level label="j"> <text>A firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer shall receive from their employers or local governmental bodies, at the expense of the employer or local governmental body, as part of their training, education on:</text> <level label="1"> <level label="i"> <text>The routes of transmission of HIV and hepatitis B virus; and</text> </level> <level label="ii"> <text>The routes by which a firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer may be exposed to HIV and hepatitis B virus; and</text> </level> </level> <level label="2"> <text>The current Centers for Disease Control and Prevention guidelines for preventing prehospital exposure to HIV and hepatitis B while rendering emergency medical care.</text> </level> </level> <level label="k"> <text>A firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer shall receive from their employers, associations, or local governmental bodies, at the employers’, associations’, or local governmental bodies’ expense, equipment recommended by the Centers for Disease Control and Prevention to protect a firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer from exposure to HIV and hepatitis B while rendering emergency medical care.</text> </level> <level label="l"> <level label="1"> <text>The fire department, law enforcement agency, and all other agencies or organizations employing a firefighter, emergency medical technician, rescue squad member, law enforcement officer, or correctional officer shall develop written procedures for the implementation of this section.</text> </level> <level label="2"> <text>On request, copies of the procedures developed in this subsection shall be made available to employees, employee unions, volunteer associations, and the Secretary.</text> </level> </level> <level label="m"> <text>A person under this section may not refuse to treat or transport an individual because the individual is HIV positive.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-213.1" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Body fluids” means:</text> <level label="1"> <text>Any fluid containing visible blood, semen, or vaginal secretions; or</text> </level> <level label="2"> <text>Cerebral spinal fluid, synovial, or amniotic fluid.</text> </level> </level> <level label="ii"> <text>“Body fluid” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus.</text> </level> </level> <level label="3"> <text>“Contact exposure” means as between a patient and a sworn member of the State Fire Marshal’s office:</text> <level label="i"> <text>Percutaneous contact with blood or body fluids;</text> </level> <level label="ii"> <text>Mucocutaneous contact with blood or body fluids;</text> </level> <level label="iii"> <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or</text> </level> <level label="iv"> <text>Intact skin contact with large amounts of blood or body fluids for a prolonged period.</text> </level> </level> <level label="4"> <text>“Contagious disease or virus” means:</text> <level label="i"> <text>Human immunodeficiency virus (HIV);</text> </level> <level label="ii"> <text>Meningococcal meningitis;</text> </level> <level label="iii"> <text>Tuberculosis;</text> </level> <level label="iv"> <text>Mononucleosis;</text> </level> <level label="v"> <text>Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G;</text> </level> <level label="vi"> <text>Diphtheria;</text> </level> <level label="vii"> <text>Plague;</text> </level> <level label="viii"> <text>Hemorrhagic fevers; or</text> </level> <level label="ix"> <text>Rabies.</text> </level> </level> <level label="5"> <text>“Medical care facility” means a hospital as defined in § 19–301 of this article or a health care facility of a correctional institution.</text> </level> </level> <level label="b"> <text>If, while treating or transporting an ill or injured patient to a medical care facility or while acting in the performance of duty, a sworn member of the State Fire Marshal’s office comes into contact exposure with a patient who is subsequently diagnosed, as a result of information obtained in conjunction with the services provided during the visit to the facility, as having a contagious disease or virus, the attending physician, medical examiner, a designee of the medical care facility who receives the patient, the Chief Medical Examiner, or the Chief Medical Examiner’s designee shall notify the sworn member of the State Fire Marshal’s office and the State Fire Marshal or the State Fire Marshal’s designee of the officer’s possible contact exposure to the contagious disease or virus.</text> </level> <level label="c"> <text>The notification required under subsection (b) of this section shall:</text> <level label="1"> <text>Be made within 48 hours of confirmation of the patient’s diagnosis;</text> </level> <level label="2"> <text>Include subsequent written confirmation of possible contact exposure to the contagious disease or virus;</text> </level> <level label="3"> <text>Be conducted in a manner that will protect the confidentiality of the patient; and</text> </level> <level label="4"> <text>To the extent possible, be conducted in a manner that will protect the confidentiality of the sworn member of the State Fire Marshal’s office.</text> </level> </level> <level label="d"> <text>The written confirmation required under subsection (c)(2) of this section shall constitute compliance with this section.</text> </level> <level label="e"> <text>Each medical care facility shall develop written procedures for the implementation of this section, and upon request, make copies available to the State Fire Marshal’s office.</text> </level> <level label="f"> <text>A medical care facility, physician, Chief Medical Examiner, or the Chief Medical Examiner’s designee acting in good faith to provide notification in accordance with this section may not be liable in any cause of action related to the breach of patient confidentiality.</text> </level> <level label="g"> <text>A medical care facility, physician, Chief Medical Examiner, or the Chief Medical Examiner’s designee acting in good faith to provide notification in accordance with this section may not be liable in any cause of action for:</text> <level label="1"> <text>The failure to give the required notice, if the sworn member of the State Fire Marshal’s office fails to properly initiate the notification procedures developed by the health care facility under subsection (e) of this section; or</text> </level> <level label="2"> <text>The failure of the State Fire Marshal or the State Fire Marshal’s designee to subsequently notify the sworn member of the State Fire Marshal’s office of the possible contact exposure to a contagious disease or virus.</text> </level> </level> <level label="h"> <text>A sworn member of the State Fire Marshal’s office shall receive from the State Fire Marshal’s office, at the expense of the State Fire Marshal’s office, as part of the member’s training, education on:</text> <level label="1"> <level label="i"> <text>The routes of transmission of HIV and hepatitis B virus; and</text> </level> <level label="ii"> <text>The routes by which a sworn member of the State Fire Marshal’s office may be exposed to HIV and hepatitis B virus; and</text> </level> </level> <level label="2"> <text>The current Centers for Disease Control and Prevention guidelines for preventing prehospital exposure to HIV and hepatitis B while rendering emergency medical care.</text> </level> </level> <level label="i"> <text>A sworn member of the State Fire Marshal’s office shall receive from the State Fire Marshal’s office, at the State Fire Marshal’s expense, equipment recommended by the Centers for Disease Control and Prevention to protect a sworn member of the State Fire Marshal’s office from exposure to HIV and hepatitis B while rendering emergency medical care.</text> </level> <level label="j"> <level label="1"> <text>The State Fire Marshal’s office shall develop written procedures for the implementation of this section.</text> </level> <level label="2"> <text>On request, copies of the procedures developed under this subsection shall be made available to employees, employee unions, volunteer associations, and the Secretary.</text> </level> </level> <level label="k"> <text>A person under this section may not refuse to treat or transport an individual because the individual is HIV positive.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-213.2" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Body fluids” means:</text> <level label="1"> <text>Any fluid containing visible blood, semen, or vaginal secretions; or</text> </level> <level label="2"> <text>Cerebral spinal fluid, synovial, or amniotic fluid.</text> </level> </level> <level label="ii"> <text>“Body fluids” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus.</text> </level> </level> <level label="3"> <text>“Contact exposure” means as between a decedent and a first responder:</text> <level label="i"> <text>Percutaneous contact with blood or body fluids;</text> </level> <level label="ii"> <text>Mucocutaneous contact with blood or body fluids;</text> </level> <level label="iii"> <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or</text> </level> <level label="iv"> <text>Intact skin contact with large amounts of blood or body fluids for a prolonged period.</text> </level> </level> <level label="4"> <text>“Contagious disease or virus” means:</text> <level label="i"> <text>Human immunodeficiency virus (HIV);</text> </level> <level label="ii"> <text>Meningococcal meningitis;</text> </level> <level label="iii"> <text>Tuberculosis;</text> </level> <level label="iv"> <text>Mononucleosis;</text> </level> <level label="v"> <text>Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G;</text> </level> <level label="vi"> <text>Diphtheria;</text> </level> <level label="vii"> <text>Plague;</text> </level> <level label="viii"> <text>Hemorrhagic fevers; or</text> </level> <level label="ix"> <text>Rabies.</text> </level> </level> <level label="5"> <text>“Correctional institution” means a place of detention or correctional confinement operated by or for the State or a local government.</text> </level> <level label="6"> <level label="i"> <text>“Correctional officer” means a member of a correctional unit who is charged with and actually performs those duties that relate to the investigation, care, custody, control, or supervision of individuals confined to places of incarceration.</text> </level> <level label="ii"> <text>“Correctional officer” includes any sheriff, warden, superintendent, or other individual having the equivalent title.</text> </level> </level> <level label="7"> <text>“First responder” means a:</text> <level label="i"> <text>Firefighter;</text> </level> <level label="ii"> <text>Emergency medical technician;</text> </level> <level label="iii"> <text>Rescue squad member;</text> </level> <level label="iv"> <text>Law enforcement officer;</text> </level> <level label="v"> <text>Correctional officer; or</text> </level> <level label="vi"> <text>Sworn member of the State Fire Marshal’s office.</text> </level> </level> <level label="8"> <text>“Law enforcement officer” means any individual who, in an official capacity, is authorized by law to make arrests and who is a member of one of the following law enforcement agencies:</text> <level label="i"> <text>The Department of State Police;</text> </level> <level label="ii"> <text>The Baltimore City Police Department;</text> </level> <level label="iii"> <text>The police department, bureau, or force of any county;</text> </level> <level label="iv"> <text>The police department, bureau, or force of any incorporated city or town;</text> </level> <level label="v"> <text>The office of the sheriff of any county;</text> </level> <level label="vi"> <text>The police department, bureau, or force of any bicounty agency or constituent institution of the University System of Maryland, Morgan State University, St. Mary’s College, or of any institution under the jurisdiction of the Maryland Higher Education Commission;</text> </level> <level label="vii"> <text>The Maryland Aviation Administration police force of the Department of Transportation, the Maryland Transit Administration police force of the Department of Transportation, the Maryland Transportation Authority police force, and the Maryland Port Administration police force of the Department of Transportation;</text> </level> <level label="viii"> <text>The law enforcement officers of the Department of Natural Resources;</text> </level> <level label="ix"> <text>The Field Enforcement Bureau of the Comptroller’s Office;</text> </level> <level label="x"> <text>The Intelligence and Investigative Division of the Department of Public Safety and Correctional Services; or</text> </level> <level label="xi"> <text>The Maryland Capitol Police of the Department of General Services.</text> </level> </level> <level label="9"> <text>“Medical care facility” means a hospital, or a health care facility of a correctional institution.</text> </level> <level label="10"> <text>“Physician performing a postmortem examination” means any of the following persons who perform a postmortem examination on a decedent:</text> <level label="i"> <text>The Chief Medical Examiner; or</text> </level> <level label="ii"> <text>The Chief Medical Examiner’s designee.</text> </level> </level> </level> <level label="b"> <text>If, while transporting a person to a medical care facility or while acting in the performance of duty, a first responder comes into contact exposure while treating or transporting a person who dies at the scene or while being transported and who is subsequently determined, as a result of information obtained in conjunction with a postmortem examination by the Chief Medical Examiner or a designee of the Chief Medical Examiner to have had a contagious disease or virus at the time of death, the physician performing the postmortem examination shall notify the first responder and the first responder’s employer or the employer’s designee of the first responder’s possible contact exposure to the contagious disease or virus.</text> </level> <level label="c"> <text>The notification required under subsection (b) of this section shall:</text> <level label="1"> <text>Be made within 48 hours of confirmation of the determination that the deceased person had a contagious disease or virus at the time of death;</text> </level> <level label="2"> <text>Include subsequent written confirmation of possible contact exposure to the contagious disease or virus;</text> </level> <level label="3"> <text>Be conducted in a manner that will protect the confidentiality of the deceased person; and</text> </level> <level label="4"> <text>To the extent possible, be conducted in a manner that will protect the confidentiality of the first responder.</text> </level> </level> <level label="d"> <text>The written confirmation required under subsection (c)(2) of this section shall constitute compliance with this section.</text> </level> <level label="e"> <text>A medical care facility or physician performing a postmortem examination acting in good faith to provide notification in accordance with this section is not liable in any cause of action related to a breach of patient confidentiality.</text> </level> <level label="f"> <text>A medical care facility or physician performing a postmortem examination acting in good faith to provide notification in accordance with this section is not liable in any cause of action for:</text> <level label="1"> <text>The failure to give the required notice if the first responder fails to properly initiate the notification procedures developed by the medical care facility and the Chief Medical Examiner under subsection (g) of this section; or</text> </level> <level label="2"> <text>The failure of the employer or the employer’s designee to subsequently notify the first responder of the possible contact exposure to a contagious disease or virus.</text> </level> </level> <level label="g"> <level label="1"> <text>The State Fire Marshal, the Chief Medical Examiner, and each fire department, rescue squad company, medical care facility, correctional institution, and law enforcement agency in the State shall develop written procedures for the implementation of this section.</text> </level> <level label="2"> <text>On request, the State Fire Marshal and each fire department, rescue squad company, medical care facility, correctional institution, and law enforcement agency shall make copies of the procedures developed in this subtitle available to employees, employee unions, volunteer associations, and the Secretary.</text> </level> </level> <level label="h"> <text>A person covered under subsection (a)(5), (6), (7), (8), (9), and (10) of this section may not refuse to treat or transport a deceased person because the deceased person was HIV positive at the time of death.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-214" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>In this section, “vaccine” means a product intended to elicit, in humans, active or passive immunity against an infectious agent or product of an infectious agent.</text> </level> <level label="b"> <text>There is a Statewide Advisory Commission on Immunizations.</text> </level> <level label="c"> <text>The following members shall serve without term limits:</text> <level label="1"> <text>The State Superintendent of Schools or the State Superintendent’s designee with knowledge of the immunizations required of children entering schools;</text> </level> <level label="2"> <text>One local health officer;</text> </level> <level label="3"> <text>One representative from the Department’s Vaccines for Children Program; and</text> </level> <level label="4"> <text>The Maryland State Epidemiologist.</text> </level> </level> <level label="d"> <text>The following members are subject to term limits:</text> <level label="1"> <text>One representative from a public health consumer advocacy group;</text> </level> <level label="2"> <text>One nurse practitioner;</text> </level> <level label="3"> <text>One representative from a health insurance carrier;</text> </level> <level label="4"> <text>One consumer;</text> </level> <level label="5"> <text>One pharmacist;</text> </level> <level label="6"> <text>One physician member of MedChi, The Maryland State Medical Society;</text> </level> <level label="7"> <text>Two physician members of the Maryland Chapter of the American Academy of Pediatrics with experience in private practice and infectious diseases;</text> </level> <level label="8"> <text>One physician member of the Maryland Academy of Family Physicians;</text> </level> <level label="9"> <text>One school–based health care provider member of the Maryland Assembly on School–Based Health Care;</text> </level> <level label="10"> <text>One school nurse member of the Maryland Association of School Health Nurses or the Maryland Nurses Association;</text> </level> <level label="11"> <text>One physician member of the American College of Physicians – Internal Medicine Society of Maryland;</text> </level> <level label="12"> <text>One physician assistant member of the Maryland Academy of Physician Assistants; and</text> </level> <level label="13"> <text>Up to three additional members selected by the Secretary.</text> </level> </level> <level label="e"> <text>Except for the members listed in subsection (c)(1), (2), and (4) of this section, the Secretary shall appoint the membership of the Commission, based on the recommendation of the appropriate medical society or agency.</text> </level> <level label="f"> <level label="1"> <text>The Secretary, in consultation with MedChi, The Maryland State Medical Society, shall appoint the chair of the Commission.</text> </level> <level label="2"> <text>The chair of the Commission shall:</text> <level label="i"> <text>Establish subcommittees to facilitate the work of the Commission; and</text> </level> <level label="ii"> <text>Appoint subcommittee chairs from among the Commission members.</text> </level> </level> </level> <level label="g"> <level label="1"> <text>This subsection applies only to members who are subject to term limits.</text> </level> <level label="2"> <text>The term of an appointed member is 4 years.</text> </level> <level label="3"> <text>Subject to paragraph (5) of this subsection, a member may serve two consecutive terms.</text> </level> <level label="4"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member who serves two consecutive full 4–year terms may not be reappointed for 4 years after the completion of those terms.</text> </level> <level label="6"> <text>The terms of the members of the Commission are staggered as required by the terms provided for the members of the Commission on June 1, 2010.</text> </level> </level> <level label="h"> <text>If a vacancy for an appointed member of the Commission occurs, the Secretary shall promptly appoint a successor.</text> </level> <level label="i"> <text>A member of the Commission may not receive compensation but is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> <level label="j"> <text>The Department shall provide the staffing for the Commission.</text> </level> <level label="k"> <text>The Commission shall:</text> <level label="1"> <text>Determine where community vaccine shortages exist and which vaccines are in short supply;</text> </level> <level label="2"> <text>Develop a recommendation for a plan to effectuate the equitable distribution of vaccines;</text> </level> <level label="3"> <text>Review:</text> <level label="i"> <text>Potential provider reimbursement barriers to increasing immunizations;</text> </level> <level label="ii"> <text>The relative effectiveness of outreach programs that educate the public about the benefits of immunizations;</text> </level> <level label="iii"> <text>Potential cost–shifting of immunization expenses for privately insured patients who receive immunizations at local health departments; and</text> </level> <level label="iv"> <text>Potential administrative burdens associated with State purchasing of vaccines;</text> </level> </level> <level label="4"> <text>Based on the review required under item (3) of this subsection, make recommendations on how to increase immunizations, including catch–up immunizations, among adults, adolescents, and children who are recommended to receive immunizations; and</text> </level> <level label="5"> <text>Study and make recommendations about other related issues as determined by the Commission, including:</text> <level label="i"> <text>Immunizations required of children entering schools;</text> </level> <level label="ii"> <text>All available options for the purchasing of vaccines, including the development of a Universal Vaccine Purchasing System, or a similar program to increase access to necessary vaccines, for the State;</text> </level> <level label="iii"> <text>An update on the status of the use of thimerosal in vaccines, including the availability and affordability of thimerosal–free vaccines, and any other issue related to the use of thimerosal in vaccines that is identified by the Commission;</text> </level> <level label="iv"> <text>Elimination of any vaccine distribution disparities;</text> </level> <level label="v"> <text>A public education campaign in the event of a vaccine shortage or public health emergency involving immunizations; and</text> </level> <level label="vi"> <text>The availability and affordability of adult, adolescent, and childhood vaccines.</text> </level> </level> </level> <level label="l"> <text>The Commission may recommend to the Department that information on vaccine safety be communicated to health care providers.</text> </level> <level label="m"> <text>On or before December 15 of each year, the Commission shall submit a report on its findings and recommendations to the Governor and, in accordance with § 2–1257 of the State Government Article, to the Senate Finance Committee and the House Health and Government Operations Committee.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-214.1" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>The purpose of expedited partner therapy is to provide antibiotic therapy to any partner of a patient diagnosed with an infection transmitted through sexual activity identified in subsection (b) of this section in order to:</text> <level label="1"> <text>Contain and stop the further spread of the infection; and</text> </level> <level label="2"> <text>Reduce the likelihood of reinfection in the diagnosed patient.</text> </level> </level> <level label="b"> <text>Notwithstanding any other provision of law, the following health care providers may prescribe, dispense, or otherwise provide antibiotic therapy to a sexual partner of a patient diagnosed with chlamydia, gonorrhea, trichomoniasis, or bacterial vaginosis without making a personal physical assessment of the patient’s partner:</text> <level label="1"> <text>A physician licensed under Title 14 of the Health Occupations Article;</text> </level> <level label="2"> <text>An advanced practice registered nurse with prescriptive authority licensed under Title 8 of the Health Occupations Article acting in accordance with § 8–508 of the Health Occupations Article;</text> </level> <level label="3"> <text>An authorized physician assistant licensed under Title 15 of the Health Occupations Article acting in accordance with § 15–302.2 of the Health Occupations Article;</text> </level> <level label="4"> <text>A registered nurse employed by a local health department who complies with:</text> <level label="i"> <text>The formulary developed and approved under § 3–403(b) of this article; and</text> </level> <level label="ii"> <text>The requirements established under § 8–512 of the Health Occupations Article; and</text> </level> </level> <level label="5"> <text>A certified midwife licensed under Title 8, Subtitle 6D of the Health Occupations Article.</text> </level> </level> <level label="c"> <text>This section may not be construed to otherwise expand the prescribing or dispensing authority of an advanced practice registered nurse with prescriptive authority or a physician assistant.</text> </level> <level label="d"> <text>Notwithstanding any other provision of law, a pharmacist licensed under Title 12 of the Health Occupations Article may dispense antibiotic therapy prescribed in accordance with subsection (b) of this section.</text> </level> <level label="e"> <text>The Secretary shall adopt regulations to implement the requirements of this section in public and private health care settings in the State.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-214.2" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <level label="1"> <text>In this section, “public institution of higher education” means:</text> <level label="i"> <text>A public senior higher education institution, as defined in § 10–101 of the Education Article; and</text> </level> <level label="ii"> <text>A community college.</text> </level> </level> <level label="2"> <text>A public institution of higher education does not include an institution without residential housing or a health center.</text> </level> </level> <level label="b"> <level label="1"> <text>On or before August 1 each year, beginning in 2021, each public institution of higher education shall submit an outbreak response plan to the Department.</text> </level> <level label="2"> <text>If there is an outbreak of a contagious disease at a public institution of higher education, the public institution of higher education shall implement the outbreak response plan required under paragraph (1) of this subsection.</text> </level> </level> <level label="c"> <text>The outbreak response plan required under subsection (b) of this section shall be customized to the public institution of higher education and include:</text> <level label="1"> <text>A process for expediently notifying students, families of students, faculty, and staff of:</text> <level label="i"> <text>The outbreak of a contagious disease;</text> </level> <level label="ii"> <text>Subpopulations that are at high risk of severe complications from the contagious disease;</text> </level> <level label="iii"> <text>Guidance on how students, families of students, faculty, and staff can take reasonable protective measures; and</text> </level> <level label="iv"> <text>Information on the availability of laboratory testing for students, faculty, and staff;</text> </level> </level> <level label="2"> <text>Processes for implementing evidence–based outbreak response measures;</text> </level> <level label="3"> <text>The provision of staff to successfully implement the outbreak response plan during an outbreak of a contagious disease at the public institution of higher education;</text> </level> <level label="4"> <text>A process for reporting an outbreak of a contagious disease at the public institution of higher education to:</text> <level label="i"> <text>The Department;</text> </level> <level label="ii"> <text>The local health department;</text> </level> <level label="iii"> <text>Campus health providers;</text> </level> <level label="iv"> <text>Local community health providers; and</text> </level> <level label="v"> <text>Regional hospitals; and</text> </level> </level> <level label="5"> <text>Any other measure required by the Department.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-215" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>In addition to any other penalty provided by law, a physician who fails to submit the report required under § 18–204 of this subtitle, on conviction, is subject to a fine not exceeding $10.</text> </level> <level label="b"> <text>A person who violates any provision of § 18–202 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $50.</text> </level> <level label="c"> <text>In addition to any other penalty provided by law, a physician who fails to submit the report required under § 18–201 of this subtitle, on conviction, is subject to a fine not exceeding $100.</text> </level> <level label="d"> <text>A person who violates any provision of § 18–205 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500.</text> </level> <level label="e"> <text>A health care provider or any other person, including an officer or employee of a governmental unit, who knowingly and willfully discloses personal identifying health information acquired for the purposes of HIV and AIDS reporting under § 18–201.1, § 18–202.1, § 18–205, or § 18–207 of this subtitle to any person who is not authorized to receive personal identifying health information under this subtitle or otherwise in violation of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $2,000 for the first offense and not exceeding $10,000 for each subsequent conviction for a violation of any provision of this subtitle.</text> </level> <level label="f"> <level label="1"> <text>A health care provider or any other person, including an officer or employee of a governmental unit, who knowingly and willfully requests or obtains information on HIV and AIDS developed under § 18–201.1, § 18–202.1, § 18–205, or § 18–207 of this subtitle under false pretenses or through deception, on conviction is subject to:</text> <level label="i"> <text>A fine not exceeding $100,000, imprisonment for not more than 5 years, or both; and</text> </level> <level label="ii"> <text>If the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, a fine not exceeding $250,000, imprisonment for not more than 10 years, or both.</text> </level> </level> <level label="2"> <text>This subsection does not apply to an officer or employee of a governmental unit that is conducting a criminal investigation.</text> </level> </level> <level label="g"> <text>A health care provider or any other person who knowingly violates subsection (e) or (f) of this section is liable for actual damages.</text> </level> <level label="h"> <text>A physician, laboratory, or institution as defined in § 18–202.1 of this subtitle that in good faith submits a report or otherwise discloses information in accordance with this subtitle is not liable in any action arising from the disclosure of the information.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-216" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>A person who violates any provision of § 18-211(c) of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $200 or imprisonment not exceeding 6 months.</text> </section> <section article="ghg" article_name="Health - General" number="18-217" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>The General Assembly finds and declares that it is in the public interest to ensure the public health, safety, and welfare by strictly regulating in this State the importation, transportation, sale, transfer, breeding, raising, keeping, and possession of certain animals which pose a possibility of the introduction of a disease or pest harmful to humans, or endangers the physical safety of human beings.</text> </section> <section article="ghg" article_name="Health - General" number="18-218" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>In this part, “animal” means any nonhuman living creature, whether native to Maryland or not, which is:</text> <level label="1"> <text>Wild by nature; and</text> </level> <level label="2"> <text>Endowed with sensation and power of voluntary motion.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-219" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>The Secretary may prohibit the importation, selling, trading, purchasing, bartering, breeding, raising, keeping, or possession of any animals found to be dangerous to human health and safety.</text> </level> <level label="b"> <text>This section does not apply to:</text> <level label="1"> <text>Domestic cats;</text> </level> <level label="2"> <text>Domestic dogs;</text> </level> <level label="3"> <text>Domestic ferrets;</text> </level> <level label="4"> <text>Animals used for agricultural purposes;</text> </level> <level label="5"> <text>Animals used for scientific purposes;</text> </level> <level label="6"> <text>Animals used for educational purposes;</text> </level> <level label="7"> <text>Animals used for public exhibitions; or</text> </level> <level label="8"> <text>Any animal that the Secretary determines is not a threat to human health and safety.</text> </level> </level> <level label="c"> <text>This section may not be construed to prohibit the breeding, raising, keeping, or possession of turtles by a person who has obtained a permit under Title 10, Subtitle 9 of the Natural Resources Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-220" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>Nothing in this part prevents or prohibits any county, municipal corporation, or Baltimore City from imposing stricter possession requirements or banning possession of certain animals.</text> </section> <section article="ghg" article_name="Health - General" number="18-221" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <text>When prohibiting animals that may also be harmful to indigenous wildlife or agricultural animals under § 18-219 of this subtitle, the Secretary shall coordinate with the Departments of Natural Resources and Agriculture.</text> </section> <section article="ghg" article_name="Health - General" number="18-222" title_number="18" title_name="Disease Prevention" subtitle_number="2" subtitle_name="Reports; Preventive Actions"> <level label="a"> <text>Any person who imports, transports, sells, transfers, breeds, raises, keeps, or possesses any animal which is prohibited under § 18-219 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500, or imprisonment not exceeding 1 year, or both.</text> </level> <level label="b"> <text>Any animal, whose possession or keeping is prohibited under § 18-219 of this subtitle shall be considered a nuisance and a contraband, and is subject to seizure by any authorized law-enforcement officer.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-301" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>Except for a physician or a dentist, a person may not:</text> <level label="1"> <text>Treat or prescribe a treatment for cancer; or</text> </level> <level label="2"> <text>Represent to the public that the person can cure, treat, or prescribe a treatment for cancer.</text> </level> </level> <level label="b"> <text>A person may not sell, offer to sell, or give away a drug, medicine, or device that the manufacturer or seller represents as a cancer cure unless a physician or dentist prescribes the drug, medicine, or device.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-303" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>The Secretary shall establish and promote a statewide public information campaign on diethylstilbestrol (DES).</text> </level> <level label="2"> <text>The public information campaign shall:</text> <level label="i"> <text>Try to reach each individual who has been exposed to diethylstilbestrol and each offspring of those individuals, to encourage the individuals and offspring to seek medical care for the prevention or treatment of cancer that results from the exposure to diethylstilbestrol; and</text> </level> <level label="ii"> <text>Include any other matter that the Secretary considers appropriate.</text> </level> </level> </level> <level label="b"> <text>The Secretary shall expand existing cancer screening programs to detect any cancer or other abnormal condition that results from exposure to diethylstilbestrol, including breast, cervical, testicular, or vaginal cancer or vaginal adenosis.</text> </level> <level label="c"> <text>The Secretary shall establish a program to train physicians, physician’s assistants, and nurses in:</text> <level label="1"> <text>Identifying individuals who have been exposed to diethylstilbestrol;</text> </level> <level label="2"> <text>Diagnosing and treating any cancer or other abnormal condition that results from the exposure; and</text> </level> <level label="3"> <text>Preventing exposure to diethylstilbestrol.</text> </level> </level> <level label="d"> <text>To carry out this section, the Secretary:</text> <level label="1"> <text>On request, shall receive the help of or information from any agency of this State or of a political subdivision; and</text> </level> <level label="2"> <text>May contract for any necessary services.</text> </level> </level> <level label="e"> <level label="1"> <text>The Secretary may set a sliding fee schedule for services provided under this section.</text> </level> <level label="2"> <text>This State shall reimburse a provider of screening and diagnosis under this section in the amount that the screening and diagnosis exceeds the total of the fee charged for the service and of all third party payments for the service.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-304" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>A person who violates any provision of § 18-301 or § 18-302 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 5 years or both.</text> </section> <section article="ghg" article_name="Health - General" number="18-307" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>This section does not apply to a woman who objects to a standard serological syphilis test because the test is against the religious beliefs and practices of the woman.</text> </level> <level label="b"> <level label="1"> <text>The health care provider attending a woman for pregnancy shall submit to a medical laboratory:</text> <level label="i"> <text>A blood sample taken from the woman at the time that the health care provider first examines the woman;</text> </level> <level label="ii"> <text>A blood sample taken from the woman in the third trimester at:</text> <level label="1"> <text>The prenatal visit at 28 weeks of gestation; or</text> </level> <level label="2"> <text>The first prenatal visit after 28 weeks of gestation; and</text> </level> </level> <level label="iii"> <level label="1"> <text>A blood sample taken from the woman who delivers a live born infant at the time of delivery; or</text> </level> <level label="2"> <text>A blood sample taken from the woman who delivers a stillborn infant:</text> </level> <level label="A"> <text>At 20 weeks of gestation or later; or</text> </level> <level label="B"> <text>Weighing at least 500 grams.</text> </level> </level> </level> <level label="2"> <text>The medical laboratory to which a blood sample is submitted shall do a standard serological syphilis test that is approved by the Department.</text> </level> </level> <level label="c"> <text>A hospital shall determine the syphilis serologic status of the mother before discharging the newborn for the purposes of neonatal evaluation and treatment.</text> </level> <level label="d"> <text>The Department may adopt rules, regulations, and standards under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-308" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>Immediately after the birth of a child, the attending physician or attending nurse midwife shall use in the eyes of the child a prophylactic, approved by the Department, against gonococcal ophthalmia neonatorum.</text> </level> <level label="b"> <text>If, within 2 weeks after the birth of a child, an eye of the child becomes inflamed or swollen:</text> <level label="1"> <text>The attending physician shall test to determine if gonococcal ophthalmia neonatorum is the cause of the inflammation or swelling; or</text> </level> <level label="2"> <text>If there is no attending physician, any other individual who has care of the child shall report the condition immediately to a physician or to the health officer for the county where the child is located, so that testing may be done.</text> </level> </level> <level label="c"> <text>Within 48 hours after a physician knows that a child under the physician’s care has gonococcal ophthalmia neonatorum, the physician shall submit a report to the Department.</text> </level> <level label="d"> <text>An individual other than a physician may not treat the inflammation or swelling.</text> </level> <level label="e"> <text>A person who violates any provision of subsection (b)(2) or (d) of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $100 or imprisonment not exceeding 6 months or both.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-309" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>To the extent that funds are available for this purpose, the Secretary, in collaboration with other State agencies, shall establish and promote a statewide public information, awareness, and education campaign on Fetal Alcohol Syndrome and other effects of prenatal alcohol exposure.</text> </level> <level label="2"> <text>The campaign shall:</text> <level label="i"> <text>Reach out to the general public and specific populations determined to be at high risk for contracting Fetal Alcohol Syndrome;</text> </level> <level label="ii"> <text>Disseminate the information about Fetal Alcohol Syndrome through written materials, television, radio, posters, or any other medium the Secretary considers appropriate and effective for conveying the information;</text> </level> <level label="iii"> <text>Distribute informational materials free of charge to prenatal clinics and to establishments that serve alcoholic beverages; and</text> </level> <level label="iv"> <text>Include any other matter that the Secretary considers appropriate.</text> </level> </level> </level> <level label="b"> <text>To carry out this section, the Secretary:</text> <level label="1"> <text>On request, shall receive aid or information from any agency of this State, or from a political subdivision;</text> </level> <level label="2"> <text>May request the services of interested advocacy groups; and</text> </level> <level label="3"> <text>May contract for any necessary services.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-312" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>In Part III of this subtitle, “public health veterinarian” means the veterinarian whom the Secretary designates as responsible for the veterinary public health program of the Department.</text> </section> <section article="ghg" article_name="Health - General" number="18-313" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>The Secretary of Health shall provide a statewide system:</text> <level label="1"> <text>To control rabies;</text> </level> <level label="2"> <text>To grant authority to the public health veterinarian and the local health officer in matters pertaining to the disposition of animals that bite or otherwise expose rabies to an individual;</text> </level> <level label="3"> <text>To assist local political subdivisions regarding the laboratory testing of rabid animals;</text> </level> <level label="4"> <text>To treat each individual who is exposed or suspected of having been exposed to rabies;</text> </level> <level label="5"> <text>To distribute, in accordance with the conditions set by the Secretary of Agriculture, the biological products that are needed to prevent and treat rabies; and</text> </level> <level label="6"> <text>To allow a veterinary technician, as defined in § 2–301 of the Agriculture Article, or other clinical staff who work in or for an animal shelter, as defined in § 2–1701 of the Agriculture Article, or an animal control facility, as defined in § 2–305 of the Agriculture Article, to administer rabies vaccines if:</text> <level label="i"> <text>The animal shelter or animal control facility is licensed to administer drugs under § 2–305 of the Agriculture Article;</text> </level> <level label="ii"> <text>The animal being vaccinated is under the custody or control of an animal shelter or animal control facility;</text> </level> <level label="iii"> <text>The veterinary practitioner who signs the rabies vaccination certificate has ensured that the individual administering the rabies vaccine was appropriately trained on administering rabies vaccines, including proper storage, handling, administration, and management of adverse reactions; and</text> </level> <level label="iv"> <text>The individual administering the vaccine is identified on the rabies vaccination certificate.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-314" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>The Department shall provide preexposure immunization, without charge, to any individual who provides rabies control services at the request of the Department.</text> </section> <section article="ghg" article_name="Health - General" number="18-315" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>With the county health department for each county, the Department shall provide for an antirabies clinic in the county.</text> </level> <level label="b"> <text>Each clinic shall be staffed by a graduate veterinarian.</text> </level> <level label="c"> <text>The clinic for a county shall be offered on or before June 30 of each year, on the date and at the location that the Department and the health department for the county determine.</text> </level> <level label="d"> <text>Each county health department may charge fees that are set so as to produce funds to cover the cost of material and services that the clinic provides.</text> </level> <level label="e"> <text>The public health veterinarian shall set the vaccination procedures to be used at the clinics.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-316" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, an individual immediately shall report to the local police or sheriff if the individual:</text> <level label="i"> <text>Knows that a dog, cat, or other warm blooded animal has bitten, scratched, or otherwise exposed an individual to a possible rabies infection; or</text> </level> <level label="ii"> <text>Suspects that an animal has rabies.</text> </level> </level> <level label="2"> <text>In Frederick County, the individual shall report to the animal control center of Frederick County.</text> </level> </level> <level label="b"> <text>On receipt of a report under this section, the police, sheriff, or animal control center staff shall:</text> <level label="1"> <text>Notify the health officer for the county where the report is made; and</text> </level> <level label="2"> <text>Enforce all orders of the health officer and the public health veterinarian.</text> </level> </level> <level label="c"> <text>If the public health veterinarian or the local health officer issues an order to surrender an animal that is suspected of having rabies, a person may not hide or secret the animal:</text> <level label="1"> <text>In the custody of the person; or</text> </level> <level label="2"> <text>In the custody or with the cooperation of any other person.</text> </level> </level> <level label="d"> <text>A person who fails or refuses to comply with any provision of this section or any order issued under this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-317" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>The Department shall pay the cost of any antirabies treatment that an individual requires, if the individual is unable to pay for the treatment.</text> </section> <section article="ghg" article_name="Health - General" number="18-318" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>Each person who owns or keeps a dog, cat, or ferret that is 4 months old or older shall have the dog, cat, or ferret vaccinated adequately against rabies.</text> </level> <level label="b"> <level label="1"> <text>A county may not register or license a dog, cat, or ferret unless the person who owns or keeps the dog, cat, or ferret submits, with the application for registration or license, proof that the dog, cat, or ferret has been vaccinated adequately against rabies.</text> </level> <level label="2"> <text>The public health veterinarian shall determine the proof of vaccination that is acceptable.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-319" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>A licensed veterinarian who vaccinates a dog, cat, or ferret against rabies:</text> <level label="1"> <text>May select the vaccine to be used;</text> </level> <level label="2"> <text>Shall administer the vaccine in a manner that is consistent with the recommendations of the National Association of State Public Health Veterinarians;</text> </level> <level label="3"> <text>Shall issue to the owner of the dog, cat, or ferret a vaccination certificate, on the form that the Department approves; and</text> </level> <level label="4"> <text>Shall keep a record of the vaccination for a period of 5 years.</text> </level> </level> <level label="b"> <text>The information in the rabies vaccination record that a licensed veterinarian keeps may not be used:</text> <level label="1"> <text>To license the dog, cat, or ferret; or</text> </level> <level label="2"> <text>To tax the owner of the dog, cat, or ferret.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-320" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>Except as provided in subsection (e) of this section, an apparently healthy dog, cat, or ferret that has been adequately vaccinated against rabies in accordance with § 18-318 of this subtitle or any other animal that bites a human or otherwise exposes a human to rabies shall be quarantined as provided in subsection (b) of this section.</text> </level> <level label="b"> <text>An animal under quarantine shall be quarantined in a place, which may include the residence of the owner, in the manner designated by the local health officer or the public health veterinarian for a suitable period as determined by the health officer or the public health veterinarian.</text> </level> <level label="c"> <level label="1"> <text>At any time during the quarantine period, the public health veterinarian or local health officer may order the owner of a biting animal to have the animal monitored for rabies by a licensed veterinarian.</text> </level> <level label="2"> <text>The owner of the animal shall pay for the cost of any examination or other associated cost.</text> </level> </level> <level label="d"> <text>An animal under quarantine may not be moved from the place of quarantine without the written permission of the local health officer or public health veterinarian.</text> </level> <level label="e"> <text>The public health veterinarian or local health officer or the designee of the public health veterinarian or local health officer may order the immediate and humane destruction of a biting animal for rabies testing if:</text> <level label="1"> <text>It is necessary to preserve human health;</text> </level> <level label="2"> <text>A licensed veterinarian determines that a quarantined animal is inhumanely suffering; or</text> </level> <level label="3"> <text>The animal is considered wild and is not claimed by an owner within 24 hours.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-322" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>The Secretary shall keep a register of each individual who has tuberculosis.</text> </level> <level label="b"> <text>The Secretary:</text> <level label="1"> <text>Shall have exclusive control of the register; and</text> </level> <level label="2"> <text>May not disclose information in the register about any individual to any person who is not authorized by law to have the information.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-323" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>The Secretary shall provide printed instructions and any supplies that the Secretary considers necessary to prevent and control the spread of tuberculosis, on the request of any health officer or any physician attending an individual who has tuberculosis.</text> </section> <section article="ghg" article_name="Health - General" number="18-324" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>The Secretary or a health officer may have an individual examined, if the Secretary or the health officer knows or is notified in writing by a physician that the individual is suspected of having tuberculosis.</text> </level> <level label="b"> <level label="1"> <text>If, after the examination, the Secretary or the health officer finds that the individual has tuberculosis and that the condition of the individual endangers, or may endanger, the public health of the community, the Secretary or the health officer may order the individual to receive appropriate medical care.</text> </level> <level label="2"> <text>If the individual fails to comply with the order, the Secretary or the health officer may order the individual to be placed in any of the following types of medical quarantine in order to protect the public health:</text> <level label="i"> <text>Medical isolation at home;</text> </level> <level label="ii"> <text>Domiciliary care, nursing home care, or hospital care; or</text> </level> <level label="iii"> <text>Other medically appropriate living arrangement.</text> </level> </level> <level label="3"> <text>The order of the Secretary or the health officer may also contain such other conditions as the Secretary or the health officer believes are necessary to protect either the health of the infected individual or the public health.</text> </level> </level> <level label="c"> <text>The Secretary or a health officer may not require an individual to have a physical examination, other than a chest X–ray and to render sputum samples. The Secretary or a health officer may not restrict the right of the individual to select a treatment method, if the individual:</text> <level label="1"> <text>In good faith relies on spiritual means through prayer for healing; and</text> </level> <level label="2"> <text>Complies with the laws, rules, and regulations that relate to sanitation for and quarantine of infectious, contagious, and communicable diseases.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-325" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>An individual may not refuse to comply with the placement ordered under § 18-324 of this subtitle.</text> </level> <level label="b"> <text>While an individual is in any placement for tuberculosis treatment, the individual may not:</text> <level label="1"> <text>Behave in a disorderly manner; or</text> </level> <level label="2"> <text>Leave the placement before being discharged properly.</text> </level> </level> <level label="c"> <text>An individual who violates any provision of this section is guilty of a misdemeanor and on conviction shall be imprisoned in a penal institution with facilities for tuberculosis treatment until the Secretary or the Health Department of Baltimore City finds that the condition of the individual no longer endangers the health of the community, or the Secretary obtains a court order that states that the individual:</text> <level label="1"> <text>Is to be moved to a specified less restrictive setting for continuation of treatment;</text> </level> <level label="2"> <text>Must comply with the treatment until the Secretary determines the treatment has been completed;</text> </level> <level label="3"> <text>May not behave in a disorderly manner or leave the placement until the Secretary determines that the individual has completed the treatment; and</text> </level> <level label="4"> <text>Following a hearing, will be reimprisoned until the Secretary determines that the individual has completed the treatment, if the individual does not comply with the terms of the order.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-333" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>The Secretary shall establish and promote a statewide public information program on acquired immune deficiency syndrome (AIDS).</text> </level> <level label="2"> <text>The public information program shall:</text> <level label="i"> <text>Attempt to reach individuals at risk for contracting AIDS;</text> </level> <level label="ii"> <text>Encourage those individuals at risk for contracting AIDS to take the necessary precautions to prevent transmission of the HTLV-III virus; and</text> </level> <level label="iii"> <text>Include any other aspects that the Secretary considers appropriate.</text> </level> </level> </level> <level label="b"> <text>The Secretary shall establish a program to train physicians, physician’s assistants, nurses, and other health professionals in:</text> <level label="1"> <text>Diagnosing and treating AIDS or other conditions associated with AIDS; and</text> </level> <level label="2"> <text>Methods to prevent the transmission of the HTLV-III virus.</text> </level> </level> <level label="c"> <text>To carry out this section, the Secretary:</text> <level label="1"> <text>On request, shall receive the help of or information from any agency of this State or of a political subdivision; and</text> </level> <level label="2"> <text>May contract for any necessary services.</text> </level> </level> <level label="d"> <text>The Secretary may set a sliding fee schedule for services provided under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-334" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome.</text> </level> <level label="3"> <text>“Institution” means:</text> <level label="i"> <text>An ambulatory surgical facility or center, as defined in § 19-114 of this article;</text> </level> <level label="ii"> <text>A health maintenance organization, as defined in § 19-701 of this article;</text> </level> <level label="iii"> <text>A hospital or related institution, as defined in § 19-301 of this article;</text> </level> <level label="iv"> <text>A tissue bank; or</text> </level> <level label="v"> <text>The office of 1 or more physicians.</text> </level> </level> <level label="4"> <text>“Laboratory” means a public laboratory, medical laboratory, or medical test unit as those terms are defined in Title 17 of this article.</text> </level> <level label="5"> <text>“Physician” means a person licensed to practice under Title 14 of the Health Occupations Article.</text> </level> <level label="6"> <level label="i"> <text>“Tissue bank” means an establishment that obtains, stores, processes, distributes, or sells human blood or other human tissue for use in the human body.</text> </level> <level label="ii"> <text>“Tissue bank” includes a blood bank or sperm bank.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Subject to the provisions of paragraph (2) of this subsection, an institution that obtains or processes semen, blood, or tissue shall obtain and send a blood sample from each potential donor of semen, blood, or tissue to a laboratory approved by the Department to test for HIV antibodies.</text> </level> <level label="2"> <text>Before obtaining a blood sample from a potential semen, blood, or tissue donor the institution shall:</text> <level label="i"> <text>Inform the potential donor, in layman’s terms, that a blood sample of the donor will be tested for HIV antibodies and if the donor’s blood sample tests positive for HIV antibodies the result will be reported to the Department; and</text> </level> <level label="ii"> <text>Obtain written consent from the potential donor on a form provided by the Department for the administration of the HIV antibody tests and for the disclosure of a positive test result to the Department.</text> </level> </level> </level> <level label="c"> <text>An institution that obtains a positive HIV antibody test result under subsection (b) of this section shall:</text> <level label="1"> <text>Notify the potential donor from whom the blood sample was obtained of the positive result;</text> </level> <level label="2"> <text>Inform the individual of available counseling; and</text> </level> <level label="3"> <text>Report the result to the Department on the form the Department provides.</text> </level> </level> <level label="d"> <text>A test result reported by an institution under subsection (c) of this section may not contain any information that identifies the subject of the test.</text> </level> <level label="e"> <text>An institution may not use a semen, blood, or tissue specimen from a donor with a positive HIV antibody test result obtained under the provisions of this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-335" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <text>To properly ensure the quality and effectiveness of condoms sold by means of a vending machine or other automatic devices, the Secretary shall adopt regulations:</text> <level label="1"> <text>To protect the health, welfare, and safety of the public; and</text> </level> <level label="2"> <text>To provide for the enforcement of this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-336" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Health care facility” has the same meaning stated in § 18–338.2 of this subtitle.</text> </level> <level label="3"> <text>“Health care provider” means a physician, nurse, or designee of a health care facility.</text> </level> <level label="4"> <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome.</text> </level> </level> <level label="b"> <level label="1"> <text>Except as provided in Title 11, Subtitle 1, Part II of the Criminal Procedure Article or § 18–338.3 of this subtitle, before obtaining a fluid or tissue sample from the body of an individual for the purpose of testing the fluid or tissue for the presence of HIV infection, a health care provider shall:</text> <level label="i"> <text>Inform the individual verbally or in writing that HIV testing will be performed on a specimen obtained from the individual unless the individual refuses HIV testing;</text> </level> <level label="ii"> <text>Provide the individual verbal or written information or show a video that includes an explanation of HIV infection and the meaning of positive and negative test results;</text> </level> <level label="iii"> <text>Offer the individual an opportunity to ask questions and decline HIV testing; and</text> </level> <level label="iv"> <text>If the individual refuses HIV testing, document in the medical record the individual’s decision.</text> </level> </level> <level label="2"> <level label="i"> <text>Consent for HIV testing shall be included in a patient’s general informed consent for medical care in the same category as other screening and diagnostic tests.</text> </level> <level label="ii"> <text>Except as otherwise provided in this section, a health care provider may not be required to obtain consent for HIV testing using a separate consent form.</text> </level> </level> <level label="3"> <text>A health care provider shall make available to individuals for whom HIV testing is performed easily understood informational materials in the languages of the commonly encountered populations of the health care provider.</text> </level> </level> <level label="c"> <text>Subject to subsection (b) of this section, a health care provider shall obtain a fluid or tissue sample for the purpose of testing the fluid or tissue for the presence of HIV infection from:</text> <level label="1"> <text>A pregnant woman during delivery; and</text> </level> <level label="2"> <text>A newborn when the pregnant woman’s HIV status is unknown.</text> </level> </level> <level label="d"> <level label="1"> <text>If the HIV test is ordered at a location that is not a health care facility, informed consent shall be in writing and signed by the individual on an informed consent for HIV testing document that is approved by the Department.</text> </level> <level label="2"> <text>The informed consent for HIV testing document shall be distinct and separate from all other consent forms.</text> </level> <level label="3"> <text>A patient identifying number obtained from an anonymous and confidential test site which is approved by the Department may be evidence of a patient’s informed consent in lieu of a patient’s signature.</text> </level> </level> <level label="e"> <text>An individual’s refusal to undergo an HIV test or a positive test result may not be used as the sole basis by an institution or laboratory to deny services or treatment.</text> </level> <level label="f"> <text>If the individual is unable to give informed consent, substitute consent may be given under § 5–605 of this article.</text> </level> <level label="g"> <text>A health care provider who obtains a result from an HIV test conducted in accordance with the provisions of subsection (b) of this section shall:</text> <level label="1"> <text>Notify the individual from whom the fluid or tissue sample was obtained of the result; and</text> </level> <level label="2"> <text>If the test is positive:</text> <level label="i"> <text>Provide a referral for treatment and supportive services;</text> </level> <level label="ii"> <text>Counsel the individual to inform all sexual and needle–sharing partners of the individual’s positive HIV status;</text> </level> <level label="iii"> <text>Offer to assist in notifying the individual’s sexual and needle–sharing partners or refer the individual to the local health officer to assist the individual with notifying the individual’s sexual and needle–sharing partners; and</text> </level> <level label="iv"> <text>If necessary, take action appropriate to comply with § 18–337 of this subtitle.</text> </level> </level> </level> <level label="h"> <text>Local health officers shall make available to health care providers in their jurisdiction information on referral resources for an individual with an HIV positive status, including counseling, testing, needs assessment, treatment, and support services.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-337" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <text>In this section, “health care provider” means a physician, a physician’s designee, or a designee of a health care facility licensed or otherwise authorized to provide health care services.</text> </level> <level label="b"> <text>If an individual informed of the individual’s HIV positive status under § 18-336 of this subtitle refuses to notify the individual’s sexual and needle-sharing partners, the individual’s physician may inform the local health officer and/or the individual’s sexual and needle-sharing partners of:</text> <level label="1"> <text>The individual’s identity; and</text> </level> <level label="2"> <text>The circumstances giving rise to the notification.</text> </level> </level> <level label="c"> <text>When the local health officer is notified, the health officer shall enforce the provisions of §§ 18-208 through 18-213.1 of this title:</text> <level label="1"> <text>Within a reasonable time; and</text> </level> <level label="2"> <text>To the extent feasible.</text> </level> </level> <level label="d"> <text>Each local health officer shall refer the infected individual and any known sexual or needle-sharing partners of the individual to appropriate services for the care, support, and treatment for HIV infected individuals.</text> </level> <level label="e"> <text>A physician acting in good faith to provide notification in accordance with this section may not be held liable in any cause of action related to a breach of patient confidentiality.</text> </level> <level label="f"> <text>A physician acting in good faith may not be held liable in any cause of action for choosing not to disclose information related to a positive test result for the presence of human immunodeficiency virus to an individual’s sexual and needle-sharing partners.</text> </level> <level label="g"> <text>A hospital or any other health care provider acting in good faith pursuant to a physician’s order to perform or interpret a test for the presence of HIV may not be held liable in any cause of action related to:</text> <level label="1"> <text>A breach of patient confidentiality; or</text> </level> <level label="2"> <text>A physician’s decision to disclose or not to disclose information related to a positive test result to a local health officer and/or an individual’s sexual and needle-sharing partners.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-338" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Correctional employee” means:</text> <level label="i"> <text>A person who is employed by a correctional institution; or</text> </level> <level label="ii"> <text>A person who performs duties in a correctional institution by virtue of federal, State, or local government employment.</text> </level> </level> <level label="3"> <text>“Correctional institution” means a place of detention or correctional confinement operated by or for the State or a local government.</text> </level> <level label="4"> <text>“Court” means a district or circuit court of the State.</text> </level> <level label="5"> <text>“Exposure” means, as between a correctional employee and an incarcerated individual:</text> <level label="i"> <text>Percutaneous contact with blood, semen, or blood contaminated fluids;</text> </level> <level label="ii"> <text>Mucocutaneous contact with blood, semen, or blood contaminated fluids;</text> </level> <level label="iii"> <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood, semen, or blood contaminated fluids; and</text> </level> <level label="iv"> <text>Intact skin contact with large amounts of blood, semen, or blood contaminated fluids for a prolonged period.</text> </level> </level> <level label="6"> <text>“Health care provider” means:</text> <level label="i"> <text>Any person, including a physician or hospital, who is licensed or otherwise authorized in this State to provide health care services and is under contract with or operated by the correctional facility; or</text> </level> <level label="ii"> <text>An employee’s private physician.</text> </level> </level> </level> <level label="b"> <text>An incarcerated individual shall furnish to the correctional institution a blood sample or buccal (cheek) swab to be tested for the presence of human immunodeficiency virus (HIV) when:</text> <level label="1"> <text>There has been an exposure involving the incarcerated individual;</text> </level> <level label="2"> <text>The exposure occurred in connection with the incarcerated individual’s violation of institutional regulations;</text> </level> <level label="3"> <text>The incarcerated individual has been found guilty of the violation of institutional regulations described in paragraph (2) of this subsection;</text> </level> <level label="4"> <text>The correctional employee involved in the exposure has given written notice of the exposure to the managing official of the correctional institution, or the official’s designee; and</text> </level> <level label="5"> <text>The exposure is confirmed by a health care provider.</text> </level> </level> <level label="c"> <text>The correctional institution shall collect the blood sample from the incarcerated individual, and shall have the sample tested for human immunodeficiency virus (HIV) by a test and test procedure approved by the Department.</text> </level> <level label="d"> <level label="1"> <text>If the incarcerated individual refuses to furnish to the correctional institution a blood sample or buccal (cheek) swab to be tested for the presence of human immunodeficiency virus (HIV) as required under subsection (b) of this section, a court may order the incarcerated individual to furnish the blood sample or buccal (cheek) swab if:</text> <level label="i"> <text>The correctional employee involved in the exposure or the correctional employee’s representative requests the testing in writing to the State’s Attorney in the county where the exposure occurred; and</text> </level> <level label="ii"> <text>The court finds probable cause to believe that the exposure occurred.</text> </level> </level> <level label="2"> <text>Before ordering a test under paragraph (1) of this subsection and subject to the provisions of paragraph (6) of this subsection, the court shall hold a hearing at which the correctional employee or the correctional employee’s representative and the incarcerated individual or the incarcerated individual’s representative have the right to be present.</text> </level> <level label="3"> <text>The correctional employee or the correctional employee’s representative and the incarcerated individual or the incarcerated individual’s representative shall be notified of:</text> <level label="i"> <text>The date, time, and location of the hearing; and</text> </level> <level label="ii"> <text>Their right to be present at the hearing.</text> </level> </level> <level label="4"> <text>During the hearing, the court may admit into evidence only affidavits, counter–affidavits, and medical records that:</text> <level label="i"> <text>Relate to the material facts of the case; and</text> </level> <level label="ii"> <text>Support or rebut a finding of probable cause to issue a court order.</text> </level> </level> <level label="5"> <text>The written request of the correctional employee or the correctional employee’s representative shall be:</text> <level label="i"> <text>Filed by the State’s Attorney with the court; and</text> </level> <level label="ii"> <text>Sealed by the court.</text> </level> </level> <level label="6"> <text>Except for good cause, the court shall:</text> <level label="i"> <text>Hold the hearing within 15 days after the State’s Attorney’s presentment to the court of the written request of the correctional employee or the correctional employee’s representative; and</text> </level> <level label="ii"> <text>Issue an order granting or denying the request within 3 days after the conclusion of the hearing.</text> </level> </level> </level> <level label="e"> <text>The correctional employee shall be notified of the results of the test for the presence of human immunodeficiency virus (HIV) conducted under the provisions of this section.</text> </level> <level label="f"> <text>The notification required under subsection (e) of this section shall:</text> <level label="1"> <text>Be made within 48 hours of confirmation of the incarcerated individual’s diagnosis;</text> </level> <level label="2"> <text>Include subsequent written confirmation of the possible exposure to human immunodeficiency virus (HIV); and</text> </level> <level label="3"> <text>To the extent possible, be made in a manner that will protect the confidentiality of the correctional employee and the incarcerated individual.</text> </level> </level> <level label="g"> <text>If the results of the blood sample test are positive for the presence of human immunodeficiency virus (HIV), then the correctional employee and the incarcerated individual shall be provided appropriate counseling.</text> </level> <level label="h"> <text>All correctional institutions shall develop written procedures to carry out the provisions of this section.</text> </level> <level label="i"> <text>A health care provider acting in good faith to provide notification in accordance with this section may not be held liable in any cause of action related to a breach of patient confidentiality.</text> </level> <level label="j"> <text>A health care provider acting in good faith to provide notification in accordance with this section may not be held liable in any cause of action for:</text> <level label="1"> <text>The failure to give the required notice, if the correctional employee fails to properly initiate the notification procedures developed by the correctional institution under subsection (h) of this section; or</text> </level> <level label="2"> <text>The failure of the managing official of the correctional institution within which the correctional employee is employed to subsequently notify the correctional employee of the possible exposure to human immunodeficiency virus (HIV).</text> </level> </level> <level label="k"> <text>A health care provider may not be held liable in any cause of action related to obtaining a blood sample or performing and interpreting an approved HIV test without the incarcerated individual’s informed consent.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-338.1" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Body fluids” means:</text> <level label="1"> <text>Any fluid containing visible blood, semen, or vaginal secretions; or</text> </level> <level label="2"> <text>Cerebrospinal fluid, synovial, or amniotic fluid.</text> </level> </level> <level label="ii"> <text>“Body fluid” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus.</text> </level> </level> <level label="3"> <text>“Exposure” means as between a patient and a health care provider:</text> <level label="i"> <text>Percutaneous contact with blood or body fluids;</text> </level> <level label="ii"> <text>Mucocutaneous contact with blood or body fluids;</text> </level> <level label="iii"> <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or</text> </level> <level label="iv"> <text>Intact skin contact with large amounts of blood or body fluids for a prolonged period.</text> </level> </level> <level label="4"> <text>“Health care facility” means a facility or office where health or medical care is provided to patients by a health care provider, including:</text> <level label="i"> <text>A health care facility as defined in § 19–114(d)(1) of this article;</text> </level> <level label="ii"> <text>A facility operated by the Department or a health officer;</text> </level> <level label="iii"> <text>The office of a health care provider; or</text> </level> <level label="iv"> <text>A medical laboratory.</text> </level> </level> <level label="5"> <level label="i"> <text>“Health care provider” means a person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health or medical care in:</text> <level label="1"> <text>The ordinary course of business or practice of a profession; or</text> </level> <level label="2"> <text>In an approved education or training program.</text> </level> </level> <level label="ii"> <text>“Health care provider” includes any agent or employee of a health care facility.</text> </level> <level label="iii"> <text>“Health care provider” does not include any individual who is eligible to receive notification under the provisions of § 18–213 of this title, including any law enforcement officer or any member of any fire department, ambulance company, or rescue squad.</text> </level> </level> <level label="6"> <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome.</text> </level> </level> <level label="b"> <text>Except as provided in § 18–338.3 of this subtitle, a physician, nurse, or designee of a health care facility shall, at the request of an exposed health care provider, seek the informed consent of a patient to test a blood sample of the patient for the presence of HIV when:</text> <level label="1"> <text>There has been an exposure between the patient and the health care provider;</text> </level> <level label="2"> <text>The health care provider involved in the exposure has given prompt written notice of the exposure, in accordance with the standards of the health care facility, to the chief executive officer or the chief executive officer’s designee of the health care facility where the exposure occurred;</text> </level> <level label="3"> <text>The exposure occurred based on the judgment of a physician who is not the health care provider involved in the exposure; and</text> </level> <level label="4"> <text>The health care provider involved in the exposure has given informed consent and has submitted a blood sample to be tested for the presence of HIV in accordance with the provisions of subsection (d) of this section.</text> </level> </level> <level label="c"> <text>If, by virtue of the physical or mental condition of a patient, a physician, nurse, or designee of a health care facility is unable to obtain the informed consent of the patient to test a blood sample of the patient for the presence of HIV in accordance with subsection (b) of this section, the physician, nurse, or designee of the health care facility shall seek the consent of any person who has authority to consent to medical care for the patient as provided under § 5–605 of this article or as otherwise authorized by law.</text> </level> <level label="d"> <text>If the patient’s informed consent has been obtained in accordance with subsection (b) of this section or substitute consent has been obtained in accordance with subsection (c) of this section and the other requirements of subsection (b) of this section have been satisfied, a physician or the physician’s designee shall:</text> <level label="1"> <text>Collect the blood sample from the patient and health care provider involved in the exposure; and</text> </level> <level label="2"> <text>Have the blood samples tested for the presence of HIV using a test procedure approved by the Department.</text> </level> </level> <level label="e"> <text>When a physician obtains the results of a test for the presence of HIV that was conducted in accordance with the provisions of subsection (d) of this section, the physician or a designee of the health care facility shall directly notify the health care provider and the patient of the results of the patient’s HIV test.</text> </level> <level label="f"> <text>The notification required under subsection (e) of this section shall:</text> <level label="1"> <text>Be made within 48 hours of confirmation of the results of the patient’s HIV test;</text> </level> <level label="2"> <text>Include subsequent written confirmation of the possible exposure to HIV; and</text> </level> <level label="3"> <text>To the extent possible, be made in a manner that will protect the confidentiality of the health care provider and the patient.</text> </level> </level> <level label="g"> <text>If the results of a test for the presence of HIV that was conducted in accordance with the provisions of subsection (d) of this section are positive, a physician or the physician’s designee shall provide or arrange for the provision of appropriate counseling to the health care provider and the patient.</text> </level> <level label="h"> <level label="1"> <text>Notwithstanding the provisions of Title 4, Subtitle 3 of this article, the records, including any physician order for an HIV test or the results of an HIV test performed on a blood sample of a patient or a health care provider in accordance with the provisions of this section, may not be documented in the medical record of the patient or health care provider.</text> </level> <level label="2"> <text>The health care facility shall maintain a separate confidential record or incident report for all HIV tests performed on a blood sample of a patient or health care provider in accordance with the provisions of this section.</text> </level> <level label="3"> <text>The health care facility shall adopt procedures for the confidential testing of blood samples obtained in accordance with the provisions of this section.</text> </level> <level label="4"> <text>Except as provided in paragraph (5) of this subsection, the records, including any physician order for an HIV test or the results, of any HIV test performed on a blood sample of a patient or health care provider in accordance with the provisions of this section are:</text> <level label="i"> <text>Confidential; and</text> </level> <level label="ii"> <text>Not discoverable or admissible in evidence in any criminal, civil, or administrative action.</text> </level> </level> <level label="5"> <text>If the identity of the patient or any other information that could be readily associated with the identity of the patient is not disclosed, the results of an HIV test performed on a patient or health care provider in accordance with the provisions of this section may be introduced into evidence in any criminal, civil, or administrative action including the adjudication of a workers’ compensation claim.</text> </level> </level> <level label="i"> <text>The costs incurred in performing an HIV test on a patient or health care provider in accordance with the provisions of this section shall be paid by the health care facility.</text> </level> <level label="j"> <text>All health care facilities shall develop written procedures to implement the provisions of this section.</text> </level> <level label="k"> <text>A health care provider or health care facility acting in good faith to provide notification or maintain the confidentiality of the results of a test for the presence of HIV in accordance with the provisions of this section may not be held liable in any cause of action related to a breach of patient or health care provider confidentiality.</text> </level> <level label="l"> <text>The Medical and Chirurgical Faculty of the State of Maryland in consultation with the Centers for Disease Control and Prevention, the Maryland Hospital Association, and the Maryland Department of Health shall develop a practice protocol for physicians who are infected with HIV.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-338.2" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Health care facility” means a facility or office where health or medical care is provided to patients by a health care provider, including:</text> <level label="i"> <text>A hospital as defined in § 19–301 of this article;</text> </level> <level label="ii"> <text>A facility operated by the Department or a health officer; and</text> </level> <level label="iii"> <text>The office of a health care provider.</text> </level> </level> <level label="3"> <text>“Health care provider” means a physician, nurse, licensed direct–entry midwife, or designee of a health care facility.</text> </level> <level label="4"> <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome (AIDS).</text> </level> <level label="5"> <text>“Prenatal care” means obstetric and gynecologic services performed as part of a prenatal care program, including:</text> <level label="i"> <text>Screening;</text> </level> <level label="ii"> <text>Physical examination;</text> </level> <level label="iii"> <text>Laboratory and diagnostic testing procedures and interpretation; and</text> </level> <level label="iv"> <text>Counseling.</text> </level> </level> </level> <level label="b"> <text>The Department, in consultation with stakeholders, shall adopt regulations establishing requirements for prenatal HIV testing.</text> </level> <level label="c"> <level label="1"> <text>A health care provider who provides prenatal medical care shall</text> <text>follow the requirements for prenatal HIV testing that are adopted by the Department.</text> </level> <level label="2"> <text>The Department shall provide the requirements established under subsection (b) of this section to:</text> <level label="i"> <text>Hospitals that offer obstetric services;</text> </level> <level label="ii"> <text>The American College of Obstetricians and Gynecologists;</text> </level> <level label="iii"> <text>The American College of Nurse Midwives; and</text> </level> <level label="iv"> <text>The Association of Independent Midwives of Maryland.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>Except as otherwise provided in paragraph (2) of this subsection, the record of an HIV test performed under this section is confidential and not discoverable or admissible in evidence in any criminal, civil, or administrative action.</text> </level> <level label="2"> <text>Provided that the identity or any other information that could readily be associated with the identity of the pregnant woman is not disclosed, the results of an HIV test performed under this section may be introduced into evidence in any criminal, civil, or administrative action, including the adjudication of a workers’ compensation claim.</text> </level> </level> <level label="e"> <text>A health care provider may not be subject to disciplinary action by the professional licensing board that licenses the health care provider for following the requirements for prenatal HIV testing established by the Department.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-338.3" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Body fluids” means:</text> <level label="1"> <text>Any fluid containing visible blood, semen, or vaginal secretions; or</text> </level> <level label="2"> <text>Cerebrospinal fluid, synovial fluid, or amniotic fluid.</text> </level> </level> <level label="ii"> <text>“Body fluids” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus.</text> </level> </level> <level label="3"> <text>“Exposure” means:</text> <level label="i"> <text>Percutaneous contact with blood or body fluids;</text> </level> <level label="ii"> <text>Mucocutaneous contact with blood or body fluids;</text> </level> <level label="iii"> <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or</text> </level> <level label="iv"> <text>Intact skin contact with large amounts of blood or body fluids for a prolonged period.</text> </level> </level> <level label="4"> <text>“First responder” means an individual who:</text> <level label="i"> <text>Is licensed or certified under § 13–516 of the Education Article; and</text> </level> <level label="ii"> <text>Provides services to an individual before the individual is admitted to a hospital.</text> </level> </level> <level label="5"> <level label="i"> <text>“Health care provider” means an individual who is licensed, certified, or otherwise authorized under the Health Occupations Article or this article to provide health or medical care in:</text> <level label="1"> <text>The ordinary course of business or practice of a profession; or</text> </level> <level label="2"> <text>An approved education or training program.</text> </level> </level> <level label="ii"> <text>“Health care provider” includes any agent or employee of a hospital.</text> </level> <level label="iii"> <text>“Health care provider” does not include an individual who is eligible to receive notification under the provisions of § 18–213 of this title, including any law enforcement officer or any member of any fire department, ambulance company, or rescue squad.</text> </level> </level> <level label="6"> <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome.</text> </level> <level label="7"> <text>“Hospital” has the meaning stated in § 19–301 of this article.</text> </level> <level label="8"> <text>“Public safety worker” means:</text> <level label="i"> <text>A career or volunteer member of a fire, rescue, or emergency medical services department, company, squad, or auxiliary;</text> </level> <level label="ii"> <text>A law enforcement officer;</text> </level> <level label="iii"> <text>The State Fire Marshal or a sworn member of the State Fire Marshal’s office; or</text> </level> <level label="iv"> <text>A forensic scientist who works under the direction of a law enforcement agency.</text> </level> </level> </level> <level label="b"> <text>Notwithstanding the provisions of § 18–338.1 of this subtitle, the designated infectious disease/communicable disease officer of a hospital shall order a test for the presence of antibodies to the human immunodeficiency virus (HIV) under subsection (d) of this section when:</text> <level label="1"> <text>There has been an exposure in a hospital between a patient and a health care provider, an exposure between a patient and a first responder, or an exposure between a patient and a public safety worker before admission of the patient to a hospital, that, in accordance with the Centers for Disease Control and Prevention recommendations, would warrant recommending or offering chemoprophylaxis treatment for the health care provider, first responder, or public safety worker;</text> </level> <level label="2"> <level label="i"> <text>Informed consent, or substitute consent as required under § 18–338.1(c) of this subtitle, of the patient to test a blood sample of the patient for the presence of HIV was sought and the patient was unavailable or unable to consent; or</text> </level> <level label="ii"> <text>Informed consent, or substitute consent as required under § 18–338.1(c) of this subtitle, of the patient to test a blood sample already obtained from the patient for the presence of HIV was sought, the patient refused, and the patient was informed of the provisions of this subsection;</text> </level> </level> <level label="3"> <level label="i"> <text>In accordance with hospital procedures, the health care provider involved in the exposure has given prompt notice of the exposure to the designated hospital infectious disease/communicable disease officer where the exposure occurred; or</text> </level> <level label="ii"> <level label="1"> <level label="A"> <text>The first responder involved in the exposure has given prompt notice to the medical director with jurisdiction over the first responder; or</text> </level> </level> <level label="B"> <text>The public safety worker involved in the exposure has given prompt notice to the medical director with jurisdiction over the public safety worker; and</text> </level> <level label="2"> <text>The medical director has given prompt notice to the designated hospital infectious disease/communicable disease officer where the patient is admitted;</text> </level> </level> </level> <level label="4"> <text>The health care provider, first responder, or public safety worker involved in the exposure has given informed consent and has submitted a blood sample to be tested for the presence of HIV; and</text> </level> <level label="5"> <text>The designated hospital infectious disease/communicable disease officer has made a determination, in accordance with the Centers for Disease Control and Prevention recommendations, that the testing of blood samples or other body fluids of the patient for the presence of antibodies to the human immunodeficiency virus (HIV) would be helpful in managing the risk of disease and health outcome of the health care provider, first responder, or public safety worker.</text> </level> </level> <level label="c"> <text>If there has been an exposure between a first responder and an individual or a public safety worker and an individual before the admission of the individual to a hospital:</text> <level label="1"> <text>The first responder or public safety worker shall give notice to the first responder’s or public safety worker’s medical director in accordance with subsection (b)(3)(ii)1 of this section;</text> </level> <level label="2"> <text>The medical director shall act as an intermediary at all times between the first responder or public safety worker and the designated hospital infectious disease/communicable disease officer; and</text> </level> <level label="3"> <text>The medical director and the designated hospital infectious disease/communicable disease officer shall ensure that all communications and information related to the exposure of the first responder or public safety worker are confidential.</text> </level> </level> <level label="d"> <text>If the requirements of subsections (b) and (c) of this section are satisfied, the designated hospital infectious disease/communicable disease officer shall order tests to be conducted for the presence of antibodies to the human immunodeficiency virus (HIV) using a test procedure approved by the Department on:</text> <level label="1"> <text>Blood samples already obtained from the patient; or</text> </level> <level label="2"> <text>Blood samples or other body fluids collected for the purpose of HIV testing under this section.</text> </level> </level> <level label="e"> <text>When the designated hospital infectious disease/communicable disease officer obtains the results of an HIV test conducted in accordance with the provisions of subsection (d) of this section, the designated hospital infectious disease/communicable disease officer shall attempt to directly notify the patient of the results of the HIV test and, to the extent possible, in a manner that will protect the confidentiality of the health care provider, the first responder, or the public safety worker and the patient.</text> </level> <level label="f"> <text>If the results of an HIV test conducted in accordance with the provisions of subsection (d) of this section are positive, the designated hospital infectious disease/communicable disease officer shall provide or arrange for the provision of appropriate counseling and treatment recommendations to the health care provider, first responder, or public safety worker and the patient.</text> </level> <level label="g"> <level label="1"> <text>Notwithstanding the provisions of Title 4, Subtitle 3 of this article, the medical records, including any physician order for an HIV test or the results of an HIV test conducted under this section, may not be documented in the medical record of the patient, health care provider, first responder, or public safety worker.</text> </level> <level label="2"> <text>The hospital where the exposure occurred shall maintain a separate confidential record or incident report for all HIV tests conducted under this section.</text> </level> <level label="3"> <text>Each hospital shall adopt procedures for the confidential HIV testing of blood samples or other body fluids used or collected for purposes of this section.</text> </level> <level label="4"> <text>Except as provided in paragraph (5) of this subsection, the medical records, including any physician order for an HIV test or the results of any HIV test conducted under this section, are:</text> <level label="i"> <text>Confidential; and</text> </level> <level label="ii"> <text>Not discoverable or admissible in evidence in any criminal, civil, or administrative action.</text> </level> </level> <level label="5"> <text>If the identity of the patient or any other information that could be readily associated with the identity of the patient is not disclosed, the results of an HIV test conducted on a patient for purposes of this section may be introduced into evidence in any criminal, civil, or administrative action including the adjudication of a workers’ compensation claim.</text> </level> </level> <level label="h"> <text>The costs incurred in performing an HIV test on a patient in accordance with the provisions of this section shall be paid by the hospital.</text> </level> <level label="i"> <text>Each hospital shall develop written procedures to implement the provisions of this section.</text> </level> <level label="j"> <text>A health care provider, first responder, public safety worker, or hospital or designee of a hospital acting in good faith to provide notification or maintain the confidentiality of the results of a test conducted under this section may not be held liable in any cause of action related to a breach of patient, health care provider, first responder, or public safety worker confidentiality.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-401" title_number="18" title_name="Disease Prevention" subtitle_number="4"> <level label="a"> <text>A person lawfully administering a drug or vaccine shall have the immunity from liability described under § 5-629(b) of the Courts and Judicial Proceedings Article.</text> </level> <level label="b"> <text>If the Secretary or a designee of the Secretary finds that a proposed immunization project would conform to good medical and public health practice and gives written approval for the project to be administered in this State, a physician, nurse, or other person participating in the project shall have the immunity from liability described under § 5-629(c) of the Courts and Judicial Proceedings Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-402" title_number="18" title_name="Disease Prevention" subtitle_number="4"> <text>A legally authorized person who obtains, processes, stores, distributes, or uses whole human blood, tissue, organs, or bones or any substance derived from human blood, tissue, organs, or bones shall have the immunity from liability described under § 5-630 of the Courts and Judicial Proceedings Article.</text> </section> <section article="ghg" article_name="Health - General" number="18-403" title_number="18" title_name="Disease Prevention" subtitle_number="4"> <level label="a"> <text>Unless the Secretary declares an emergency or disease epidemic, the Department may not require the immunization of an individual if:</text> <level label="1"> <text>The individual objects to immunization because it conflicts with the individual’s bona fide religious beliefs and practices; or</text> </level> <level label="2"> <text>The individual is a minor and the individual’s parent or guardian objects to immunization because it conflicts with the parent or guardian’s bona fide religious beliefs and practices.</text> </level> </level> <level label="b"> <text>The Secretary shall adopt rules and regulations for religious exemptions under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-404" title_number="18" title_name="Disease Prevention" subtitle_number="4"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Employee” means an individual employed full–time or part–time directly, through contract with another entity, or as an independent contractor, by a related institution.</text> </level> <level label="3"> <text>“Medically contraindicated” means that a medical treatment is potentially detrimental to the health of the individual intended to be treated.</text> </level> <level label="4"> <text>“Related institution” has the meaning provided under § 19–301 of this article.</text> </level> </level> <level label="b"> <level label="1"> <text>Subject to subsection (e) of this section, each related institution in the State shall immunize residents against the influenza virus and pneumococcal disease.</text> </level> <level label="2"> <text>Subject to subsection (e) of this section, each related institution in the State shall immunize employees against the influenza virus.</text> </level> <level label="3"> <text>Before an immunization under this section is administered, the related institution shall obtain written consent to administer the immunization from:</text> <level label="i"> <text>The resident or employee receiving the immunization; or</text> </level> <level label="ii"> <text>The legal guardian of the resident receiving the immunization.</text> </level> </level> </level> <level label="c"> <text>Each related institution shall conduct the immunizations required under subsection (b) of this section:</text> <level label="1"> <text>In accordance with the recommendations established by the Advisory Committee on Immunization Process of the United States Centers for Disease Control and Prevention that are in effect at the time the related institution conducts the immunizations; and</text> </level> <level label="2"> <text>By December 1 of each year that the immunization is required.</text> </level> </level> <level label="d"> <text>A related institution that accepts an individual as a new resident or accepts an individual as a new employee after December 1 but before April 1 shall:</text> <level label="1"> <text>Determine the individual’s status for immunization as required under subsection (b) of this section; and</text> </level> <level label="2"> <text>If necessary, provide or arrange for an immunization as required under subsection (b) of this section.</text> </level> </level> <level label="e"> <text>A resident or employee is not required to receive a vaccine under this section if:</text> <level label="1"> <text>The vaccine is medically contraindicated for the resident or employee;</text> </level> <level label="2"> <text>The vaccine is against the resident’s or employee’s religious beliefs; or</text> </level> <level label="3"> <text>After being fully informed by the related institution of the health risks associated with not receiving a vaccine, the resident or employee refuses the vaccine.</text> </level> </level> <level label="f"> <level label="1"> <level label="i"> <text>Each related institution shall document the annual immunization against influenza virus and immunization against pneumococcal disease received by each resident in the resident’s medical record.</text> </level> <level label="ii"> <text>Each related institution shall document the annual immunization against influenza virus received by each employee in the employee’s personnel file.</text> </level> </level> <level label="2"> <text>If a resident or employee refuses to be immunized as required under subsection (b) of this section, the related institution shall document the refusal and the reason for the refusal.</text> </level> </level> <level label="g"> <text>Each related institution shall:</text> <level label="1"> <text>Notify each prospective resident and each prospective employee of the immunization requirements of this section and request that the resident or employee agree to be immunized in accordance with subsection (b)(3) of this section; and</text> </level> <level label="2"> <text>Make available to all residents and employees of the related institution educational and informational materials relating to immunization against influenza virus and immunization against pneumococcal disease.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-4A-01" title_number="18" title_name="Disease Prevention" subtitle_number="4A" subtitle_name="Consent to Immunization of Minors"> <text>In this subtitle, “parent” means:</text> <level label="1"> <text>A natural or adoptive parent of a minor;</text> </level> <level label="2"> <text>A guardian of a minor; or</text> </level> <level label="3"> <text>Any other person who, under court order, is authorized to give consent for a minor.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-4A-02" title_number="18" title_name="Disease Prevention" subtitle_number="4A" subtitle_name="Consent to Immunization of Minors"> <level label="a"> <text>Subject to the provisions of this section, a parent may delegate verbally or in writing the parent’s authority to consent to the immunization of a minor to any of the following individuals, not in order of priority:</text> <level label="1"> <text>A grandparent;</text> </level> <level label="2"> <text>An adult brother or sister;</text> </level> <level label="3"> <text>An adult aunt or uncle;</text> </level> <level label="4"> <text>A stepparent; or</text> </level> <level label="5"> <text>Any other adult who has care and control of the minor.</text> </level> </level> <level label="b"> <text>If a parent verbally delegates the parent’s authority to consent to the immunization of a minor under this subtitle, the person delegated the authority shall confirm the verbal delegation in writing and the written confirmation shall be included in the minor’s medical record.</text> </level> <level label="c"> <text>A grandparent, adult brother or sister, adult aunt or uncle, or stepparent of a minor who is the primary caregiver of the minor and who may consent to the immunization of the minor under subsection (a) of this section may delegate the authority to consent to immunization of the minor to another adult in the manner permitted under subsection (b) of this section.</text> </level> <level label="d"> <text>A health care provider may rely on a notarized document from another state or country that contains substantially the same information as is required in any immunization consent regulations of the Department if the document is presented for consent by a person listed in subsection (a) of this section.</text> </level> <level label="e"> <text>A person who consents to immunization of a minor under this subtitle shall provide the health care provider with sufficient and accurate health information about the minor for whom the consent is given and, if necessary, sufficient and accurate health information about the minor’s family to enable the person providing the consent and the health care provider to determine adequately the risks and benefits inherent in the proposed immunization and determine whether the immunization is advisable.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-4A-03" title_number="18" title_name="Disease Prevention" subtitle_number="4A" subtitle_name="Consent to Immunization of Minors"> <level label="a"> <text>Subject to the provisions of this section, the following individuals, not in order of priority, may consent to the immunization of a minor if a parent is not reasonably available and the authority to consent is not denied under subsection (b) or (c) of this section:</text> <level label="1"> <text>A grandparent;</text> </level> <level label="2"> <text>An adult brother or sister;</text> </level> <level label="3"> <text>An adult aunt or uncle;</text> </level> <level label="4"> <text>A stepparent;</text> </level> <level label="5"> <text>Any other adult who has care and control of the minor;</text> </level> <level label="6"> <text>A court that has jurisdiction of a suit affecting the parent-child relationship of which the minor is the subject;</text> </level> <level label="7"> <text>An adult who has care and control of the minor under an order of a court or by commitment by a court to the care of an agency of the State or county if the adult reasonably believes the minor needs immunization; or</text> </level> <level label="8"> <text>For minors in its care and custody, the Department of Juvenile Services.</text> </level> </level> <level label="b"> <text>A person may not consent to the immunization of a minor under subsection (a) of this section if:</text> <level label="1"> <text>The person has actual knowledge that the parent has expressly refused to give consent to the immunization; or</text> </level> <level label="2"> <text>The parent has told the person that the person may not consent to the immunization of the minor or, in the case of a written authorization, has withdrawn the authorization in writing.</text> </level> </level> <level label="c"> <text>When a parent has been contacted and requested to consent to the immunization of a minor, the Department of Juvenile Services may consent to the immunization of a minor in its care and custody if the parent:</text> <level label="1"> <text>Has not acted on the request; and</text> </level> <level label="2"> <text>Has not expressly denied to the Department of Juvenile Services the authority to consent to the immunization of the minor.</text> </level> </level> <level label="d"> <text>For purposes of this section, a person is not reasonably available if:</text> <level label="1"> <text>The location of the person is unknown;</text> </level> <level label="2"> <level label="i"> <text>A reasonable effort made by a person listed in subsection (a) of this section to locate and communicate with the parent for the purpose of obtaining consent has failed; and</text> </level> <level label="ii"> <text>Not more than 90 days have passed since the date that the effort was made; or</text> </level> </level> <level label="3"> <text>The parent has been contacted by a person listed in subsection (a) of this section and requested to consent to the immunization of the minor, and the parent:</text> <level label="i"> <text>Has not acted on the request; and</text> </level> <level label="ii"> <text>Has not expressly denied authority to the person listed in subsection (a) of this section to consent to immunization of the minor.</text> </level> </level> </level> <level label="e"> <text>A person authorized to consent to the immunization of a minor under this section shall confirm that the parent is not reasonably available in writing and the written confirmation shall be included in the minor’s medical record.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-4A-04" title_number="18" title_name="Disease Prevention" subtitle_number="4A" subtitle_name="Consent to Immunization of Minors"> <text>The responsibility of a health care provider to provide information to a person consenting to the immunization of a minor under § 18-4A-02 or § 18-4A-03 of this subtitle is the same as the health care provider’s responsibility to a parent.</text> </section> <section article="ghg" article_name="Health - General" number="18-4A-05" title_number="18" title_name="Disease Prevention" subtitle_number="4A" subtitle_name="Consent to Immunization of Minors"> <level label="a"> <text>In the absence of willful misconduct or gross negligence, a health care provider who accepts the health history and other information given by a person who is delegated the authority to consent to the immunization of a minor under § 18-4A-02 or § 18-4A-03 of this subtitle is not liable for an adverse reaction related to an immunization of the minor resulting from factual errors in the health history or information given by the person to the health care provider.</text> </level> <level label="b"> <text>Except for acts of willful misconduct or gross negligence, a person who consents to the immunization of a minor under § 18-4A-02 or § 18-4A-03 of this subtitle, a health care provider licensed to practice in the State, or a medical facility is not liable for damages arising from an immunization administered to a minor as authorized under § 18-4A-02 or § 18-4A-03 of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-501" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <text>The intent of this subtitle is:</text> <level label="1"> <text>To educate parents and physicians regarding homozygous sickle cell anemia;</text> </level> <level label="2"> <text>To monitor each affected infant’s health in that regard; and</text> </level> <level label="3"> <text>To provide resources for detecting sickle cell disease and supporting individuals with sickle cell disease.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-502" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>After securing the written approval of one of the parents or guardian of an infant at risk, the person in charge of the institution in which the infant is born, or the person who is required to prepare and register the certificate of birth for an infant born outside an institution, shall have administered a test for sickle cell anemia to the infant at risk.</text> </level> <level label="b"> <text>In addition to testing, the Department shall undertake a prenatal education program for pregnant females in the population group at risk on the subject of sickle cell anemia and related diseases.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-503" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>On determination of the presence of sickle cell anemia, the Department shall:</text> <level label="1"> <text>Notify in writing:</text> <level label="i"> <text>The physician of record or the institution at which the child is born; and</text> </level> <level label="ii"> <text>The parents or guardian of the infant;</text> </level> </level> <level label="2"> <text>Provide the parents or guardian of the infant and the physician of record with educational materials; and</text> </level> <level label="3"> <text>Offer referral for genetic counseling.</text> </level> </level> <level label="b"> <text>Within 2 months after a positive finding of sickle cell anemia, a confirmatory test shall be administered and the results of this test shall be reported to the Department.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-504" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>The Department and all persons shall maintain and treat all information derived from testing as confidential medical records as provided in § 13-109 of this article.</text> </level> <level label="b"> <text>Notwithstanding any other provision to the contrary, the Department may disclose confidential information, obtained pursuant to this title, to the Department of the Environment, as determined to be appropriate and necessary by the Secretary and consistent with the statutory responsibilities vested in the Secretary of the Environment.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-505" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>The Department shall designate any type of blood test for sickle cell anemia to be administered under this subtitle.</text> </level> <level label="b"> <text>The blood shall be tested only by a licensed laboratory that periodically undergoes standard proficiency testing for quality assurance.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-506" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>In this section, “Steering Committee” means the Statewide Steering Committee on Sickle Cell Disease.</text> </level> <level label="b"> <text>There is a Statewide Steering Committee on Sickle Cell Disease.</text> </level> <level label="c"> <text>The Steering Committee shall include representatives from:</text> <level label="1"> <text>Local and national groups that advocate for individuals with sickle cell disease;</text> </level> <level label="2"> <text>Interest and support groups for individuals with sickle cell disease;</text> </level> <level label="3"> <text>Community and consumer groups;</text> </level> <level label="4"> <text>Academic and private clinical settings with knowledge and experience caring for adults with sickle cell disease;</text> </level> <level label="5"> <text>Area hospitals caring for individuals with sickle cell disease; and</text> </level> <level label="6"> <text>Pediatric clinics that care for children with sickle cell disease.</text> </level> </level> <level label="d"> <text>The Steering Committee shall:</text> <level label="1"> <text>Establish institution and community partnerships;</text> </level> <level label="2"> <text>Establish a statewide network of stakeholders who care for individuals with sickle cell disease;</text> </level> <level label="3"> <text>Educate individuals with sickle cell disease, the public, and health care providers about the State options for care of sickle cell disease; and</text> </level> <level label="4"> <text>Identify funding sources for implementing or supporting the actions, studies, policies, regulations, or laws recommended by the Steering Committee, including funding from:</text> <level label="i"> <text>State, federal, and local government sources; and</text> </level> <level label="ii"> <text>Private sources.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-507" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>The Department may, in consultation with the Statewide Steering Committee on Sickle Cell Disease, provide services relating to sickle cell disease, including:</text> <level label="1"> <text>Educational programs on sickle cell disease for individuals affected by the disease, including:</text> <level label="i"> <text>Individuals with sickle cell disease;</text> </level> <level label="ii"> <text>Families of individuals with sickle cell disease;</text> </level> <level label="iii"> <text>Caregivers of individuals with sickle cell disease;</text> </level> <level label="iv"> <text>Employees at primary and secondary schools; and</text> </level> <level label="v"> <text>Health care providers;</text> </level> </level> <level label="2"> <text>Social services support to individuals with sickle cell disease, including support from social workers and community health workers to provide information on services that may be available to the individual;</text> </level> <level label="3"> <text>Testing;</text> </level> <level label="4"> <text>Genetic counseling;</text> </level> <level label="5"> <text>Assistance with any available reimbursement for medical expenses related to sickle cell disease;</text> </level> <level label="6"> <text>Education and counseling services after the receipt of sickle cell trait test results from the State’s Newborn Screening Program; and</text> </level> <level label="7"> <text>Any other programs or services that are necessary to decrease the use of acute care services by individuals who have sickle cell disease.</text> </level> </level> <level label="b"> <text>The Department shall provide the services in subsection (a) of this section through community–based organizations to the extent practicable.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-508" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <level label="a"> <text>The Department, in consultation with the Statewide Steering Committee on Sickle Cell Disease, shall establish and implement a system of providing information on the sickle cell trait or the thalassemia trait to:</text> <level label="1"> <text>An individual who has the sickle cell trait or the thalassemia trait, including as determined through a newborn screening under § 18–502 of this subtitle; and</text> </level> <level label="2"> <text>If the individual is a minor, the individual’s family.</text> </level> </level> <level label="b"> <text>The Department shall include the following in the information provided under subsection (a) of this section:</text> <level label="1"> <text>How the sickle cell trait or the thalassemia trait impacts the health of an individual with the trait; and</text> </level> <level label="2"> <text>How the sickle cell trait or the thalassemia trait is passed from a parent to a child.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-509" title_number="18" title_name="Disease Prevention" subtitle_number="5" subtitle_name="Sickle Cell Anemia"> <text>The Department shall maintain in a conspicuous location on its website a list of resources for health care practitioners to use to improve their understanding and clinical treatment of individuals with sickle cell disease or the sickle cell trait, including information on the health impacts of carrying the sickle cell trait.</text> </section> <section article="ghg" article_name="Health - General" number="18-601" title_number="18" title_name="Disease Prevention" subtitle_number="6" subtitle_name="Prohibited Acts; Penalties"> <level label="a"> <text>An individual who has an infectious disease that endangers public health may not willfully:</text> <level label="1"> <text>Be in a public place without taking proper precautions against exposing other individuals to the disease; or</text> </level> <level label="2"> <text>Transfer to another individual any article that has been exposed to the disease without thoroughly disinfecting the article.</text> </level> </level> <level label="b"> <text>A person who violates any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500 or imprisonment not exceeding 1 year or both.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-602" title_number="18" title_name="Disease Prevention" subtitle_number="6" subtitle_name="Prohibited Acts; Penalties"> <level label="a"> <text>A person may not:</text> <level label="1"> <text>Willfully or knowingly take an individual who has an infectious disease that endangers public health to the home of another individual;</text> </level> <level label="2"> <text>Carelessly expose an individual to another who has an infectious disease that endangers public health; or</text> </level> <level label="3"> <text>Permit a child who has an infectious disease that endangers public health to be in a public place while in charge of the child.</text> </level> </level> <level label="b"> <text>A person who violates any provision of this section is subject to a fine not exceeding $100.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-604" title_number="18" title_name="Disease Prevention" subtitle_number="6" subtitle_name="Prohibited Acts; Penalties"> <text>A person who violates any rule or regulation that the Secretary adopts under § 18-102 of this title is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500.</text> </section> <section article="ghg" article_name="Health - General" number="18-701" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Advisory Council” means the Advisory Council to the Center for the Study of the Health Effects of Fire.</text> </level> <level label="c"> <text>“Center” means the Center for the Study of the Health Effects of Fire.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-702" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>There is a Center for the Study of the Health Effects of Fire.</text> </section> <section article="ghg" article_name="Health - General" number="18-703" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <level label="a"> <text>The Chief Medical Examiner is the Director of the Center.</text> </level> <level label="b"> <text>The Chief Medical Examiner shall employ a staff for the Center in accordance with the State budget.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-704" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>The Center shall:</text> <level label="1"> <text>Study the long and short term health effects of exposure to fire;</text> </level> <level label="2"> <text>Gather and analyze information concerning the morbidity and mortality of fire-related injury or death;</text> </level> <level label="3"> <text>Establish and maintain a registry of individuals who suffer fire-related injury or death;</text> </level> <level label="4"> <text>Establish a computerized data base concerning injuries and health effects of fire;</text> </level> <level label="5"> <text>Be a common repository for information routinely collected concerning fires;</text> </level> <level label="6"> <text>Communicate with national data bases of scientific literature in toxicology, chemistry, epidemiology, and other related scientific disciplines;</text> </level> <level label="7"> <text>Establish and maintain communication and collaboration with existing agencies, such as the National Institute of Standards and Technology, involved in programs related to the health effects of fire;</text> </level> <level label="8"> <text>Encourage and facilitate interest in fire-related issues at the educational institutions located in the State;</text> </level> <level label="9"> <text>In accordance with the State budget, provide funding for pilot studies addressing issues or factors affecting injuries or health effects of fire;</text> </level> <level label="10"> <text>Apply for federal or private research grants to investigate issues relating to the health effects of fire;</text> </level> <level label="11"> <text>Solicit and follow the recommendations of the Advisory Council concerning future activities or projects of the Center; and</text> </level> <level label="12"> <text>Provide staff support to the Advisory Council, as needed.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-705" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>Information collected by the Center and intended for use in a research project or study is:</text> <level label="1"> <text>Confidential; and</text> </level> <level label="2"> <text>Not discoverable or admissible in evidence in a civil or criminal action to determine:</text> <level label="i"> <text>Cause of death; or</text> </level> <level label="ii"> <text>Liability for injury or death.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-706" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>There is an Advisory Council to the Center for the Study of the Health Effects of Fire.</text> </section> <section article="ghg" article_name="Health - General" number="18-707" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <level label="a"> <level label="1"> <text>The Advisory Council consists of 7 members.</text> </level> <level label="2"> <level label="i"> <text>The Secretary shall appoint the members from a list submitted to the Secretary by:</text> <level label="1"> <text>Appropriate academic or research facilities having expertise in this area;</text> </level> <level label="2"> <text>The Chief Medical Examiner; and</text> </level> <level label="3"> <text>The Secretary of the Department of the Environment.</text> </level> </level> <level label="ii"> <text>The number of names on the list shall be 3 times the number of vacancies.</text> </level> </level> </level> <level label="b"> <text>Each member shall be an individual with demonstrated scientific and technical expertise in the field of toxicology, epidemiology, or occupational medicine.</text> </level> <level label="c"> <level label="1"> <text>The term of a member is 5 years.</text> </level> <level label="2"> <text>The terms of members are staggered as required by the terms provided for members of the Council on July 1, 1988.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> </level> <level label="d"> <text>The Secretary may remove a member for incompetence or misconduct.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-708" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <level label="a"> <text>From among its members, the Advisory Council shall elect a chairperson.</text> </level> <level label="b"> <text>The manner of election of the chairperson shall be as the Advisory Council determines.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-709" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <level label="a"> <text>The Advisory Council shall determine the times and places of its meetings.</text> </level> <level label="b"> <text>A member of the Advisory Council:</text> <level label="1"> <text>May not receive compensation; but</text> </level> <level label="2"> <text>Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-710" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>The Advisory Council shall:</text> <level label="1"> <text>Review the work of the Center;</text> </level> <level label="2"> <text>Advise the Director of the Center concerning the scientific evaluation of the information collected by the Center; and</text> </level> <level label="3"> <text>Assist the Center in setting priorities concerning issues to be researched.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-711" title_number="18" title_name="Disease Prevention" subtitle_number="7" subtitle_name="Center for the Study of the Health Effects of Fire"> <text>The Secretary, in consultation with the State Postmortem Examiners Commission, may adopt regulations to carry out the provisions of this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="18-801" title_number="18" title_name="Disease Prevention" subtitle_number="8" subtitle_name="Oral Health Program"> <text>The Secretary shall establish and promote the Oral Health Program to prevent and detect oral cancer in the State, with a primary focus of meeting the needs of high-risk underserved populations, with the intent to reduce oral cancer mortality.</text> </section> <section article="ghg" article_name="Health - General" number="18-802" title_number="18" title_name="Disease Prevention" subtitle_number="8" subtitle_name="Oral Health Program"> <level label="a"> <text>In consultation with dental care providers, the Secretary shall develop and implement ongoing oral cancer educational programs in the State:</text> <level label="1"> <text>To train health care providers to screen and properly refer patients with oral cancers; and</text> </level> <level label="2"> <text>To promote smoking cessation with a primary focus of meeting the needs of high-risk underserved populations.</text> </level> </level> <level label="b"> <text>The programs developed and implemented under subsection (a) of this section shall address:</text> <level label="1"> <text>The risk factors that lead to oral cancer;</text> </level> <level label="2"> <text>The signs and symptoms of oral cancer;</text> </level> <level label="3"> <text>The high-risk behaviors that may lead to oral cancer; and</text> </level> <level label="4"> <text>The accessibility of screening to detect oral cancer.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-901" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Catastrophic health emergency” has the meaning stated in § 14-3A-01 of the Public Safety Article.</text> </level> <level label="c"> <text>“Deadly agent” has the meaning stated in § 14-3A-01 of the Public Safety Article.</text> </level> <level label="d"> <text>“Exposure to a deadly agent” has the meaning stated in § 14-3A-01 of the Public Safety Article.</text> </level> <level label="e"> <text>“Health care facility” has the meaning stated in § 19–114(d)(1) of this article.</text> </level> <level label="f"> <level label="1"> <text>“Health care practitioner” has the meaning stated in § 19–114(e) of this article.</text> </level> <level label="2"> <text>“Health care practitioner” includes an individual licensed or certified as an emergency medical services provider under § 13–516 of the Education Article.</text> </level> </level> <level label="g"> <text>“Health care provider” means:</text> <level label="1"> <text>A health care facility; or</text> </level> <level label="2"> <text>A health care practitioner.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-902" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <text>Notwithstanding any other provision of law, the Secretary may exercise the authority granted in this subtitle to:</text> <level label="1"> <text>Continuously evaluate and modify existing disease surveillance procedures in order to detect a catastrophic health emergency;</text> </level> <level label="2"> <text>Investigate actual or potential exposures to a deadly agent; and</text> </level> <level label="3"> <text>Treat, prevent, or reduce the spread of the disease or outbreak believed to have been caused by the exposure to a deadly agent.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-903" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <level label="1"> <text>In accordance with procedures to be adopted by the Department, the Secretary, in consultation with health care facilities, may require health care facilities to develop and implement contingency plans addressing:</text> <level label="i"> <text>Staff training needs;</text> </level> <level label="ii"> <text>Stockpiling of equipment, medication, and supplies necessary to address a catastrophic health emergency;</text> </level> <level label="iii"> <text>Treatment and decontamination protocols;</text> </level> <level label="iv"> <text>The coordination of services with other public and private entities; and</text> </level> <level label="v"> <text>Any other area that the Secretary determines is necessary to assist in the early detection and treatment of an individual exposed to a deadly agent.</text> </level> </level> <level label="2"> <text>To the extent feasible, the procedures to be adopted by the Department under paragraph (1) of this subsection shall be consistent with accreditation requirements of the Joint Commission on Accreditation of Healthcare Organizations.</text> </level> </level> <level label="b"> <text>After consulting with the appropriate licensing board, the Secretary:</text> <level label="1"> <text>Shall publish protocols to assist health care practitioners in developing plans to respond to a catastrophic health emergency; and</text> </level> <level label="2"> <text>May, if necessary, require health care practitioners to implement the plans developed under item (1) of this subsection.</text> </level> </level> <level label="c"> <text>The Secretary shall coordinate with the health occupations boards to develop a process to license, certify, or credential both licensed health care practitioners and out–of–state health care practitioners who may be needed to respond to a catastrophic health emergency.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-904" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <text>In this section, “information” means medical, epidemiological, or other data concerning a specific individual or a group of individuals, regardless of whether the information is otherwise deemed confidential under Title 4 of this article or as otherwise provided under law.</text> </level> <level label="b"> <text>In order to maintain an effective disease surveillance system for detecting whether individuals have been exposed to a deadly agent, the Secretary may by order, directive, or regulation:</text> <level label="1"> <text>Require a health care provider or other person to report information to the Secretary or other public official on the following:</text> <level label="i"> <text>The presence of an individual or group of individuals with specified illnesses or symptoms;</text> </level> <level label="ii"> <text>Diagnostic and laboratory findings relating to diseases caused by deadly agents;</text> </level> <level label="iii"> <text>Statistical or utilization trends relating to potential disease outbreaks;</text> </level> <level label="iv"> <text>Information needed to conduct contact tracing for exposed individuals; and</text> </level> <level label="v"> <text>Other data deemed by the Secretary to have epidemiological significance in detecting possible catastrophic health emergencies;</text> </level> </level> <level label="2"> <text>Obtain access to information in the possession of a health care provider;</text> </level> <level label="3"> <text>Require or authorize a health care provider to disclose information to an agency of the federal, State, or local government or another health care provider;</text> </level> <level label="4"> <text>Require a health care provider or other person to submit reports to the Department containing information detailing the presence and use of deadly agents;</text> </level> <level label="5"> <text>Obtain access to premises in order to secure environmental samples and otherwise investigate actual or potential exposures to deadly agents; and</text> </level> <level label="6"> <text>Require a veterinarian or other person to report data relating to specified illnesses or symptoms in animal populations.</text> </level> </level> <level label="c"> <text>The Secretary, in acquiring information under subsection (b) of this section, shall:</text> <level label="1"> <text>Request and use nonidentifying information whenever possible; and</text> </level> <level label="2"> <text>Limit the use of confidential information to the extent necessary to detect and investigate actual or potential exposures to a deadly agent.</text> </level> </level> <level label="d"> <level label="1"> <text>Any information that the Secretary receives under subsection (b) of this section is confidential and may be used or disclosed only in accordance with this section.</text> </level> <level label="2"> <text>If the information requested in subsection (b) of this section is otherwise confidential under Title 4 of this article or as otherwise provided under law, the Secretary or person that receives the information may not redisclose the information except as provided in paragraph (3) of this subsection.</text> </level> <level label="3"> <text>A person may redisclose the information to another health care provider or public official provided that:</text> <level label="i"> <text>The health care provider or public agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and</text> </level> <level label="ii"> <text>The Secretary determines the disclosure is necessary to treat, prevent, or reduce the spread of the disease or outbreak believed to have been caused by the exposure to a deadly agent.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-905" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <text>In investigating actual or potential exposures to a deadly agent, the Secretary:</text> <level label="1"> <level label="i"> <text>May issue an order requiring individuals whom the Secretary has reason to believe have been exposed to a deadly agent to seek appropriate and necessary evaluation and treatment;</text> </level> <level label="ii"> <text>When the Secretary determines that it is medically necessary and reasonable to prevent or reduce the spread of the disease or outbreak believed to have been caused by the exposure to a deadly agent, may order an individual or group of individuals to go to and remain in places of isolation or quarantine until the Secretary determines that the individual no longer poses a substantial risk of transmitting the disease or condition to the public; and</text> </level> <level label="iii"> <text>If a competent individual over the age of 18 refuses vaccination, medical examination, treatment, or testing under this paragraph, may require the individual to go to and remain in places of isolation or quarantine until the Secretary determines that the individual no longer poses a substantial risk of transmitting the disease or condition to the public;</text> </level> </level> <level label="2"> <text>May coordinate and direct the efforts of any health officer or health commissioner of any subdivision in seeking to detect or respond to threats posed by a deadly agent; and</text> </level> <level label="3"> <text>May order any sheriff, deputy sheriff, or other law enforcement officer of the State or any subdivision to assist in the execution or enforcement of any order issued under this subtitle.</text> </level> </level> <level label="b"> <text>The Secretary may issue an order under subsection (a) of this section:</text> <level label="1"> <text>If, prior to the issuance of a proclamation under § 14-3A-02 of the Public Safety Article, the Secretary determines that the disease or outbreak can be medically contained by the Department and appropriate health care providers; and</text> </level> <level label="2"> <text>As necessary to implement an order issued by the Governor under § 14-3A-02 of the Public Safety Article.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-906" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <level label="1"> <text>If the Secretary requires an individual or a group of individuals to go to and remain in places of isolation or quarantine under § 18–905 of this subtitle, the Secretary shall issue a directive to the individual or group of individuals.</text> </level> <level label="2"> <text>The directive shall specify:</text> <level label="i"> <text>The identity of the individual or group of individuals subject to isolation or quarantine;</text> </level> <level label="ii"> <text>The premises subject to isolation or quarantine;</text> </level> <level label="iii"> <text>The date and time at which isolation or quarantine commences;</text> </level> <level label="iv"> <text>The suspected deadly agent causing the outbreak or disease, if known;</text> </level> <level label="v"> <text>The basis upon which isolation or quarantine is justified; and</text> </level> <level label="vi"> <text>The availability of a hearing to contest the directive.</text> </level> </level> <level label="3"> <level label="i"> <text>Except as provided in subparagraph (ii) of this paragraph, the directive shall be in writing and given to the individual or group of individuals prior to the individual or group of individuals being required to go to and remain in places of isolation and quarantine.</text> </level> <level label="ii"> <level label="1"> <text>If the Secretary determines that the notice required under subparagraph (i) of this paragraph is impractical because of the number of individuals or geographical areas affected, the Secretary shall ensure that the affected individuals are fully informed of the directive using the best possible means available.</text> </level> <level label="2"> <text>If the directive applies to a group of individuals and it is impractical to provide written individual copies under subparagraph (i) of this paragraph, the written directive may be posted in a conspicuous place in the isolation or quarantine premises.</text> </level> </level> </level> </level> <level label="b"> <level label="1"> <text>An individual or group of individuals isolated or quarantined under subsection (a) of this section may request a hearing in circuit court contesting the isolation or quarantine.</text> </level> <level label="2"> <text>A request for a hearing may not stay or enjoin an isolation or quarantine directive.</text> </level> <level label="3"> <text>Upon receipt of a request under this subsection, the court shall conduct a hearing within 3 days from receipt of the request.</text> </level> <level label="4"> <level label="i"> <text>In any proceedings brought for relief under this subsection, the court may extend the time for a hearing upon a showing by the Secretary or other designated official that extraordinary circumstances exist that justify the extension.</text> </level> <level label="ii"> <text>In granting or denying an extension, the court shall consider the rights of the affected individual, the protection of the public health, the severity of the catastrophic health emergency, and the availability, if necessary, of witnesses and evidence.</text> </level> </level> <level label="5"> <level label="i"> <level label="1"> <text>The court shall grant the request for relief unless the court determines that the isolation or quarantine directive is necessary and reasonable to prevent or reduce the spread of the disease or outbreak believed to have been caused by the exposure to a deadly agent.</text> </level> <level label="2"> <text>If feasible, in making a determination under this subparagraph, the court may consider the means of transmission, the degree of contagion, and, to the extent possible, the degree of public exposure to the disease.</text> </level> </level> <level label="ii"> <level label="1"> <text>An order authorizing the isolation or quarantine issued under this paragraph shall:</text> </level> <level label="A"> <text>Identify the isolated or quarantined individual or group of individuals by name or shared characteristics;</text> </level> <level label="B"> <text>Specify factual findings warranting isolation or quarantine; and</text> </level> <level label="C"> <text>Except as provided in subsubparagraph 2 of this subparagraph, be in writing and given to the individual or group of individuals.</text> </level> <level label="2"> <text>If the court determines that the notice required in subsubparagraph 1C of this subparagraph is impractical because of the number of individuals or geographical areas affected, the court shall ensure that the affected individuals are fully informed of the order using the best possible means available.</text> </level> </level> <level label="iii"> <text>An order authorizing isolation or quarantine is effective for a period not to exceed 30 days.</text> </level> <level label="iv"> <level label="1"> <text>Prior to the expiration of an order, the Secretary or designated official may move to continue isolation or quarantine for subsequent 30–day periods.</text> </level> <level label="2"> <text>The court shall base its decision on the standards provided under this paragraph.</text> </level> </level> </level> <level label="6"> <text>In the event that an individual cannot personally appear before the court, proceedings may be conducted:</text> <level label="i"> <text>By an individual’s authorized representative; and</text> </level> <level label="ii"> <text>Through any means that allow other individuals to fully participate.</text> </level> </level> <level label="7"> <text>In any proceedings brought under this subsection, the court may order the consolidation of individual claims into group claims where:</text> <level label="i"> <text>The number of individuals involved or affected is so large as to render individual participation impractical;</text> </level> <level label="ii"> <text>There are questions of law or fact common to the individual claims or rights to be determined;</text> </level> <level label="iii"> <text>The group claims or rights to be determined are typical of the affected individual’s claims or rights; or</text> </level> <level label="iv"> <text>The entire group will be adequately represented in the consolidation.</text> </level> </level> </level> <level label="c"> <text>The court shall appoint counsel to represent individuals or a group of individuals who are not otherwise represented by counsel.</text> </level> <level label="d"> <text>The Supreme Court of Maryland shall develop emergency rules of procedure to facilitate the efficient adjudication of any proceedings brought under this section.</text> </level> <level label="e"> <text>It shall be unlawful for any public or private employer to discharge an employee who is under an order of isolation or quarantine or because of such an order.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-907" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <level label="1"> <text>A person may not knowingly and willfully fail to comply with any order, regulation, or directive issued in accordance with § 18-905 of this subtitle.</text> </level> <level label="2"> <text>A person who violates paragraph (1) of this subsection is guilty of a misdemeanor and on conviction is subject to imprisonment not exceeding 1 year or a fine not exceeding $3,000 or both.</text> </level> </level> <level label="b"> <text>If a health care facility fails to comply with an order, regulation, or directive issued under § 18-903 or § 18-904 of this subtitle, the Secretary may impose a civil penalty not to exceed $3,000 for each offense.</text> </level> <level label="c"> <text>If a health care practitioner fails to comply with an order, regulation, or directive issued under § 18-903 or § 18-904 of this subtitle, the Secretary may request the appropriate licensing board to take disciplinary action against the health care practitioner, including:</text> <level label="1"> <text>Placing the licensee or certificate holder on probation;</text> </level> <level label="2"> <text>Suspending or revoking the license or certificate holder; or</text> </level> <level label="3"> <text>Imposing a civil penalty not to exceed $3,000 for each offense.</text> </level> </level> <level label="d"> <text>A health care provider acting in good faith and in accordance with a catastrophic health emergency disease surveillance and response program is immune from civil or criminal liability related to those actions, unless the health care provider acts with willful misconduct.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-908" title_number="18" title_name="Disease Prevention" subtitle_number="9" subtitle_name="Catastrophic Health Emergency Disease Surveillance and Response Program"> <level label="a"> <text>On or before December 31, 2002, the Secretary shall submit a report to the Governor and to the General Assembly in accordance with § 2–1257 of the State Government Article regarding any plans, procedures, or protocols developed under this subtitle or any recommendations for additional legislation that may be necessary to respond to a catastrophic health emergency.</text> </level> <level label="b"> <text>The Secretary shall update the report required under subsection (a) of this section every 3 years or when any plan, procedure, or protocol developed under this subtitle or any other provision of this subtitle is used in order to detect a catastrophic health emergency.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-9A-01" title_number="18" title_name="Disease Prevention" subtitle_number="9A" subtitle_name="Covid–19 Testing, Contact Tracing, and Vaccination Act"> <level label="a"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="b"> <text>“COVID–19” means, interchangeably and collectively, the coronavirus known as COVID–19 or 2019–nCoV and the SARS–CoV–2 virus.</text> </level> <level label="c"> <text>“COVID–19 test” means an in vitro diagnostic test for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, as described in § 3201 of the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-9A-02" title_number="18" title_name="Disease Prevention" subtitle_number="9A" subtitle_name="Covid–19 Testing, Contact Tracing, and Vaccination Act"> <level label="a"> <text>On or before June 1, 2021, the Department, in collaboration with local health departments in the State and the Maryland State Department of Education, shall adopt and implement a 2–year plan to respond to the outbreak of COVID–19.</text> </level> <level label="b"> <text>The plan required under this section shall:</text> <level label="1"> <text>Include measures to enhance public health efforts at the State and local level to monitor, prevent, and mitigate the spread of COVID–19;</text> </level> <level label="2"> <level label="i"> <text>Assess the COVID–19 public and private testing infrastructure in place both statewide and in each local jurisdiction;</text> </level> <level label="ii"> <text>Identify and address the unmet needs for COVID–19 testing statewide and in each local jurisdiction, including the number and location of public and private testing providers required to ensure access to testing on demand for all residents of the State;</text> </level> <level label="iii"> <text>Establish specific monthly goals for COVID–19 testing statewide and in each local jurisdiction to ensure access to testing for all residents of the State, including:</text> <level label="1"> <text>A goal to achieve the capacity to perform the surveillance testing required to safely reopen and keep open schools, institutions of higher education, workplaces, and other community facilities in the State while minimizing the community spread of COVID–19 in calendar years 2021 and 2022 through a network of public and private testing providers; and</text> </level> <level label="2"> <text>For each local jurisdiction, a goal to establish the required number of public or private COVID–19 testing locations to achieve the surveillance testing goal described in item 1 of this item; and</text> </level> </level> <level label="iv"> <text>Estimate the funding required to implement the surveillance testing goal described in item (iii)1 of this item and the extent to which federal funding already received by the State in fiscal year 2021 and federal funding that is provided to the State and received after March 1, 2021, can be used to cover the cost required to achieve that goal;</text> </level> </level> <level label="3"> <level label="i"> <text>Assess the contact tracing infrastructure in place for COVID–19 both statewide and in each local jurisdiction;</text> </level> <level label="ii"> <text>Determine the optimal number of contact tracing, case management, care resource coordination, and other personnel per 100,000 residents needed in each jurisdiction to effectively monitor, prevent, and mitigate the spread of COVID–19;</text> </level> <level label="iii"> <text>Identify and address the unmet needs for COVID–19 contact tracing and related outbreak prevention and mitigation efforts both statewide and in each local jurisdiction; and</text> </level> <level label="iv"> <level label="1"> <text>Establish goals for identifying, locating, and testing individuals who have been in close contact with individuals who test positive for COVID–19 that are in alignment with Centers for Disease Control and Prevention guidance for effective contact tracing programs; and</text> </level> <level label="2"> <text>Include a mechanism for monitoring performance of contact tracing and testing of contacts both statewide and for each local jurisdiction;</text> </level> </level> </level> <level label="4"> <text>Require the Department to assist local jurisdictions that adopt strategies to:</text> <level label="i"> <text>Accelerate access to and the use of at–home collection and point–of–care tests for COVID–19; and</text> </level> <level label="ii"> <text>Incentivize and encourage pharmacies and health care providers, including primary care providers, to provide COVID–19 testing; and</text> </level> </level> <level label="5"> <text>Allow each local jurisdiction to establish and implement a program for COVID–19 contact tracing that is independent from the contact tracing program performed by the State or the entity with whom the State has contracted to perform contact tracing for the State.</text> </level> </level> <level label="c"> <text>The plan required under this section shall have a design that addresses the disproportionate impact of the COVID–19 pandemic on underserved and minority communities in the State.</text> </level> <level label="d"> <text>On or before June 1, 2021, the Department shall submit the plan required under this section to the General Assembly, in accordance with § 2–1257 of the State Government Article.</text> </level> <level label="e"> <level label="1"> <level label="i"> <text>For fiscal years 2021 and 2022, the Department shall provide $25,000,000 each year in grants to local jurisdictions to expand capacity for COVID–19 testing and contact tracing, or for any other public health purpose related to COVID–19 response for which federal funding is authorized.</text> </level> <level label="ii"> <text>Grant funding provided for COVID–19 response under subparagraph (i) of this paragraph shall be divided between local jurisdictions in proportion to their respective populations.</text> </level> <level label="iii"> <text>The Department shall provide additional grant funding to a local jurisdiction to supplement the grant funding allocated to the local jurisdiction under subparagraphs (i) and (ii) of this paragraph if the Department determines that the initial allocation of grant funding is not sufficient to meet the COVID–19 testing and contact tracing needs of the local jurisdiction.</text> </level> <level label="iv"> <text>A local jurisdiction may use grant funding provided under this subsection to expand COVID–19 testing capacity through direct testing efforts by the health department of the local jurisdiction or by contracting with other entities to provide testing.</text> </level> </level> <level label="2"> <level label="i"> <text>For fiscal years 2021 and 2022 and in addition to any funding provided under paragraph (1) of this subsection, the Department shall provide funding to local jurisdictions that elect to establish and implement a program for COVID–19 contact tracing that is independent from the contact tracing program performed by the State or the entity with whom the State has contracted to perform contact tracing for the State.</text> </level> <level label="ii"> <text>The amount of funding provided to a local jurisdiction for COVID–19 contact tracing under subparagraph (i) of this paragraph shall be equivalent to the cost per case amount provided to the entity with whom the State has contracted to perform contact tracing for the State.</text> </level> </level> <level label="3"> <level label="i"> <text>For fiscal years 2021 and 2022, the Department shall provide $15,000,000 each year in grants to local jurisdictions to vaccinate residents of the local jurisdiction against COVID–19.</text> </level> <level label="ii"> <text>Grant funding provided for COVID–19 vaccination under this subsection shall be divided between local jurisdictions in proportion to their respective populations.</text> </level> <level label="iii"> <text>The Department shall provide additional grant funding to a local jurisdiction to supplement the grant funding allocated to the local jurisdiction under subparagraphs (i) and (ii) of this paragraph if the Department determines that the initial allocation of grant funding is not sufficient to meet the COVID–19 vaccination needs of the local jurisdiction.</text> </level> </level> <level label="4"> <text>The Department may use only federal funding allocated to the State under the Coronavirus Response and Relief Supplemental Appropriations Act and any other federal legislation enacted in calendar years 2020 through 2022 to provide funding required under this section.</text> </level> </level> <level label="f"> <level label="1"> <text>To the extent practicable, the Department shall provide up to $9,000,000 in fiscal year 2021 and $36,000,000 in fiscal year 2022 in grant funding to assisted living programs and home health agencies in calendar year 2021 to cover the cost of COVID–19 testing for residents, patients, and staff.</text> </level> <level label="2"> <text>The Department may use only federal funding allocated to the State under the Coronavirus Response and Relief Supplemental Appropriations Act and any other federal legislation enacted in calendar years 2020 through 2022 to provide funding required under this subsection.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-9A-03" title_number="18" title_name="Disease Prevention" subtitle_number="9A" subtitle_name="Covid–19 Testing, Contact Tracing, and Vaccination Act"> <level label="a"> <level label="1"> <text>On or before June 1, 2021, the Department, with input from subject matter experts and other relevant stakeholders, shall develop and submit to the General Assembly a comprehensive plan for vaccinating residents of the State against COVID–19.</text> </level> <level label="2"> <text>The plan required under paragraph (1) of this subsection shall include:</text> <level label="i"> <text>Detailed information on:</text> <level label="1"> <text>The categories of residents of the State who will receive priority access to vaccines for COVID–19;</text> </level> <level label="2"> <text>The timeline for providing vaccines for COVID–19 to residents in each of the priority categories and to members of the general public who are not included in priority categories; and</text> </level> <level label="3"> <text>Target metrics for vaccinating residents in each of the priority categories and for members of the general public who are not included in priority categories;</text> </level> </level> <level label="ii"> <text>A dedication of time and resources to target vaccine distribution and vaccine safety outreach efforts to communities that have been disproportionately impacted by COVID–19 infection, morbidity, and mortality;</text> </level> <level label="iii"> <text>A vaccine distribution strategy that allocates resources and vaccines across all partners and vaccination sites in an equitable manner that ensures that the vaccine allocation by jurisdiction accounts for the disproportionate impact of the COVID–19 pandemic on underserved and minority communities; and</text> </level> <level label="iv"> <text>A strategy for outreach and distribution of vaccines to individuals who are not receiving the vaccine, due to either lack of access or vaccine hesitancy.</text> </level> </level> </level> <level label="b"> <text>After submitting the COVID–19 vaccine plan to the General Assembly as required under subsection (a) of this section, the Department shall provide weekly progress reports on implementation of the COVID–19 vaccine plan to the General Assembly for the duration of calendar year 2021.</text> </level> <level label="c"> <text>The COVID–19 vaccine plan and progress reports required under this section shall be submitted to the General Assembly in accordance with § 2–1257 of the State Government Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-9A-04" title_number="18" title_name="Disease Prevention" subtitle_number="9A" subtitle_name="Covid–19 Testing, Contact Tracing, and Vaccination Act"> <level label="a"> <text>The Department shall convene a Maryland Public Health Modernization Workgroup.</text> </level> <level label="b"> <text>The Workgroup shall include representatives of the Department, local health departments, subject matter experts, and any other relevant stakeholders.</text> </level> <level label="c"> <text>The Workgroup shall:</text> <level label="1"> <text>Assess the current public health infrastructure and resources in the State;</text> </level> <level label="2"> <text>Make recommendations for how to establish a modern and effective public health system with a capacity to:</text> <level label="i"> <text>Monitor, prevent, control, and mitigate the spread of infectious disease; and</text> </level> <level label="ii"> <text>Achieve State Health Improvement Process goals;</text> </level> </level> <level label="3"> <text>Make recommendations regarding the establishment of a Maryland Public Health Job Corps to respond to the outbreak of COVID–19 or similar outbreaks; and</text> </level> <level label="4"> <text>Consider, where appropriate, the use of federal funds to implement any recommendations made under this subsection.</text> </level> </level> <level label="d"> <text>On or before December 1, 2021, the Department shall submit a report to the General Assembly, in accordance with § 2–1257 of the State Government Article, that includes the findings and recommendations of the Workgroup established under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-1001" title_number="18" title_name="Disease Prevention" subtitle_number="10" subtitle_name="Hepatitis C Virus"> <text>As funds are available, the Department shall:</text> <level label="1"> <text>Conduct a needs assessment to determine the incidence of the hepatitis B virus and hepatitis C virus in the State;</text> </level> <level label="2"> <text>Initiate a statewide public awareness campaign targeting vulnerable populations and health care providers in the State to urge hepatitis B virus and hepatitis C virus education and testing;</text> </level> <level label="3"> <text>Coordinate with other units of State government, including the Department of Public Safety and Correctional Services and the Veterans’ Administration, to activate a hepatitis C virus plan for the education, testing, and treatment of the populations within the jurisdiction of the units;</text> </level> <level label="4"> <text>Solicit funding from the private sector and units of federal, State, and local government for hepatitis B virus and hepatitis C virus outreach;</text> </level> <level label="5"> <text>Provide funding for hepatitis C virus pilot programs, which may include programs in methadone clinics or programs for the Department of Correctional Services population;</text> </level> <level label="6"> <text>Review and recommend initiatives to promote advocacy, education, physician outreach, and awareness of the hepatitis B virus and hepatitis C virus;</text> </level> <level label="7"> <text>Assess the feasibility of creating a Hepatitis C Virus Administration in the Department and examine methods to maximize existing resources to raise awareness of the hepatitis C virus;</text> </level> <level label="8"> <text>Implement the 2005 Report of the Hepatitis C Advisory Council;</text> </level> <level label="9"> <text>Coordinate with the Maryland Office of Minority Health and Health Disparities to develop a hepatitis B virus plan and a hepatitis C virus plan for the education, testing, and treatment of high risk populations and ethnic and racial populations who are affected disproportionately by the hepatitis B and hepatitis C viruses, including the Asian population and African immigrants;</text> </level> <level label="10"> <text>Develop a plan to increase the availability of hepatitis B virus vaccinations in the State, in accordance with recommendations from the Centers for Disease Control and Prevention;</text> </level> <level label="11"> <text>Develop recommendations to improve the awareness and the affordability of medications for treating the hepatitis C virus; and</text> </level> <level label="12"> <text>Collaborate with the Maryland Insurance Administration to make recommendations regarding insurance coverage for the treatment of the hepatitis C virus.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-1101" title_number="18" title_name="Disease Prevention" subtitle_number="11" subtitle_name="Academic Health Center Immunotherapy Research Fund"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Fund” means the Academic Health Center Immunotherapy Research Fund.</text> </level> <level label="c"> <text>“Statewide academic health center” means:</text> <level label="1"> <text>The University of Maryland Medical System Corporation, the University of Maryland Medical School, and the University of Maryland, Baltimore Campus; or</text> </level> <level label="2"> <text>The Johns Hopkins University and the Johns Hopkins Health Systems.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="18-1102" title_number="18" title_name="Disease Prevention" subtitle_number="11" subtitle_name="Academic Health Center Immunotherapy Research Fund"> <level label="a"> <text>There is an Academic Health Center Immunotherapy Research Fund.</text> </level> <level label="b"> <text>The purpose of the Fund is to provide matching grants to statewide academic health centers for immunotherapy research.</text> </level> <level label="c"> <text>The Secretary shall administer the Fund.</text> </level> <level label="d"> <level label="1"> <text>The Fund is a special, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.</text> </level> <level label="2"> <text>The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.</text> </level> </level> <level label="e"> <text>The Fund consists of:</text> <level label="1"> <text>Money appropriated in the State budget to the Fund; and</text> </level> <level label="2"> <text>Any other money from any other source accepted for the benefit of the Fund.</text> </level> </level> <level label="f"> <level label="1"> <text>The Fund may be used only for immunotherapy research.</text> </level> <level label="2"> <text>To qualify for a grant from the Fund, a statewide academic health center must dedicate funding from other sources to be used for the purpose described under subsection (b) of this section.</text> </level> <level label="3"> <text>The amount of a grant awarded from the Fund may not exceed the amount of funding dedicated by the statewide academic health center under paragraph (2) of this subsection.</text> </level> </level> <level label="g"> <level label="1"> <text>The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.</text> </level> <level label="2"> <text>Any interest earnings of the Fund shall be credited to the General Fund of the State.</text> </level> </level> <level label="h"> <text>Expenditures from the Fund may be made only in accordance with the State budget.</text> </level> <level label="i"> <text>Money expended from the Fund is supplemental to and is not intended to take the place of funding that otherwise would be appropriated to a statewide academic health center.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-1201" title_number="18" title_name="Disease Prevention" subtitle_number="12" subtitle_name="Parkinson's Disease"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Advisory Committee” means the Parkinson’s Disease Registry Advisory Committee.</text> </level> <level label="c"> <text>“Parkinson’s disease” means a chronic and progressive disorder resulting from deficiency of the neurotransmitter dopamine as the consequence of specific degenerative changes in the area of the brain called the basal ganglia, characterized by tremors at rest, slow movements, muscle rigidity, stooped posture, and unsteady or shuffling gait.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-1202" title_number="18" title_name="Disease Prevention" subtitle_number="12" subtitle_name="Parkinson's Disease"> <text>There is a Parkinson’s Disease Registry Advisory Committee in the Department.</text> </section> <section article="ghg" article_name="Health - General" number="18-1203" title_number="18" title_name="Disease Prevention" subtitle_number="12" subtitle_name="Parkinson's Disease"> <level label="a"> <text>The Advisory Committee shall:</text> <level label="1"> <text>Assist in the development and implementation of a State Parkinson’s Disease Registry;</text> </level> <level label="2"> <text>Determine what data shall be collected and be stored in a State Parkinson’s Disease Registry and the methods to ensure the privacy and confidentiality of data collected and stored in the registry;</text> </level> <level label="3"> <text>Advise the Department on Parkinson’s disease and maintaining a State Parkinson’s Disease Registry; and</text> </level> <level label="4"> <text>Consult with entities that may be able to collect data and work in partnership with the federal Centers for Disease Control and Prevention to aid the federal Centers for Disease Control and Prevention in creating a national Parkinson’s Disease Registry.</text> </level> </level> <level label="b"> <text>Entities that may be consulted under subsection (a)(4) of this section include:</text> <level label="1"> <text>The State–designated health information exchange;</text> </level> <level label="2"> <text>Nonprofit organizations; and</text> </level> <level label="3"> <text>Colleges or universities.</text> </level> </level> <level label="c"> <level label="1"> <text>The Secretary shall appoint individuals to serve on the Advisory Committee, including:</text> <level label="i"> <text>A neurologist;</text> </level> <level label="ii"> <text>A movement disorder specialist;</text> </level> <level label="iii"> <text>A primary care provider;</text> </level> <level label="iv"> <text>A physician informaticist;</text> </level> <level label="v"> <text>A patient with Parkinson’s disease;</text> </level> <level label="vi"> <text>A public health professional;</text> </level> <level label="vii"> <text>A population health researcher familiar with disease registries;</text> </level> <level label="viii"> <text>A Parkinson’s disease researcher; and</text> </level> <level label="ix"> <text>Any other individuals the Secretary determines are necessary.</text> </level> </level> <level label="2"> <text>The Secretary shall establish:</text> <level label="i"> <text>The duration of term limits for members of the Advisory Committee;</text> </level> <level label="ii"> <text>Rules and procedures for conducting business of the Advisory Committee; and</text> </level> <level label="iii"> <text>Any other rules necessary for the Advisory Committee to function effectively.</text> </level> </level> </level> <level label="d"> <text>Beginning July 1, 2023, the Advisory Committee shall meet at least quarterly.</text> </level> </section> <section article="ghg" article_name="Health - General" number="18-1204" title_number="18" title_name="Disease Prevention" subtitle_number="12" subtitle_name="Parkinson's Disease"> <level label="a"> <text>The Department, in collaboration with the State–designated health information exchange, shall establish and maintain a publicly accessible website that has the following information in a downloadable format:</text> <level label="1"> <text>The incidence of Parkinson’s disease in the State; and</text> </level> <level label="2"> <text>To the extent possible, the incidence of Parkinson’s disease disaggregated based on:</text> <level label="i"> <text>Age, including age of diagnosis;</text> </level> <level label="ii"> <text>Gender;</text> </level> <level label="iii"> <text>Sex;</text> </level> <level label="iv"> <text>Race;</text> </level> <level label="v"> <text>Ethnicity; and</text> </level> <level label="vi"> <text>Cases by county.</text> </level> </level> </level> <level label="b"> <text>The website required under subsection (a) of this section shall:</text> <level label="1"> <text>Include the data available for the 5–year period ending on September 30, 2023; and</text> </level> <level label="2"> <text>Be updated on or before January 1 each year, to include any newly available data.</text> </level> </level> </section>