The Secretary shall investigate:
The causes of disease and, particularly, the causes of epidemics;
The causes of mortality; and
The influence of locality, employment, habit, and other conditions on health.
The Secretary shall adopt rules and regulations necessary to prevent:
The introduction of an infectious or contagious disease into this State or other disease that endangers public health in this State; or
The spread of an infectious or contagious disease or other disease that endangers public health in this State.
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:
Investigate the suspected disease; and
Act properly to prevent the spread of the disease.
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.
An individual is exempt from the vaccination requirement in paragraph (1) of this subsection if:
The institution of higher education provides detailed information on the risks associated with meningococcal disease and the availability and effectiveness of any vaccine to:
The individual, if the individual is 18 years of age or older; or
The individual’s parent or guardian, if the individual is a minor; and
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
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.
Nothing in this subsection shall be construed to require any institution of higher education to provide or pay for vaccinations against meningococcal disease.
The Secretary, in consultation with the Maryland Higher Education Commission, shall adopt regulations necessary to implement this subsection.
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.
The Secretary shall:
Obtain accurate and complete reports on communicable diseases in this State;
Determine the prevalence of each communicable disease; and
Devise means to control communicable diseases.
The Secretary shall publish monthly a communicable disease bulletin for health officers and other related health professionals.
The Secretary shall investigate, if feasible, means to prevent, treat, and cure cancer.
The Secretary may adopt procedures to obtain information about cancers that are caused by carcinogens and about the incidence of these cancers.
The Secretary may adopt procedures to obtain information about diseases that are caused by toxic substances and about the incidence of these diseases.
The Secretary shall establish and administer a Lead Poisoning Screening Program that will assure the appropriate screening of children in Maryland for lead poisoning.
The Lead Poisoning Screening Program shall:
Encourage continuity of care with the child’s continuing care health care provider;
Promote timely, appropriate screening of children at risk of being poisoned by lead;
Utilize all of the payment mechanisms available to cover lead poisoning screening, including:
Third party payments from insurers;
The Medical Assistance Program;
Primary care medical assistance programs established under waiver from the federal government;
Health maintenance organizations;
Federally qualified and Maryland qualified community health centers; and
Any other Medicaid reimbursement or waiver to which the State may be entitled under this section;
Target children under 6 years of age;
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
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.
The Secretary shall target efforts to promote and to provide blood tests for lead poisoning in at risk areas, as identified by:
Census tract and zip code information noting areas with large concentrations of pre-1978 housing; and
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.
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:
Within the time frame specified in regulations adopted by the Department; or
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.
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.
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.
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.
The Secretary shall:
Devise and institute means to prevent and control morbidity and mortality associated with:
Pregnancy;
Childbirth;
Infancy; and
Early childhood; and
Promote the welfare and hygiene of maternity and infancy.
The Secretary shall establish a Morbidity, Mortality, and Quality Review Committee in the Department.
The Committee shall:
Conduct confidential and anonymous case reviews of morbidity and mortality associated with pregnancy, childbirth, infancy, and early childhood; and
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.
The Secretary shall adopt regulations to implement the requirements of this section.
The regulations shall include:
The types of case reviews conducted by the Committee;
The confidentiality of case reviews;
A description of the types of records and information needed by the Committee to conduct the case reviews under this section; and
The process for obtaining records, including patient medical records, and any other necessary information in accordance with § 4–305(b) of this article.
This section does not enable the Secretary:
To take charge of a child if the parent, guardian, or other person who has custody of the child objects; or
To treat the child for a disease without the consent of the parent, guardian, or other person who has custody of the child.
In this section the following words have the meanings indicated.
“Food instrument” means a voucher, check, coupon, or other document that is used by a participant to obtain supplemental foods.
“Local agency” means a public or private, nonprofit health or human service agency that:
Provides health services either directly or through contract; and
By written agreement with the State agency, provides Program services in a designated area.
“Participant” means an individual who is receiving supplemental foods or food instruments under the Program and includes:
Pregnant women;
Breast–feeding women up to 1 year postpartum who are breast–feeding their infants;
Postpartum women up to 6 months after termination of pregnancy;
Infants under 1 year of age; and
Children who are at least 1 year old but under the age of 5 years.
“Program” means the Special Supplemental Food Program for Women, Infants, and Children authorized by § 17 of the Child Nutrition Act of 1966, as amended.
“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.
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.
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.
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.
The justification may include:
Illness;
Imminent childbirth;
Difficulty of access to the local agency; or
Handicapping condition.
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.
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.
The Department shall maximize distribution of administrative funds to local agencies in a manner that assures equity among the local agencies.
The provisions of this section are effective only to the extent that they are not inconsistent with applicable federal law or regulations.
In this section the following words have the meanings indicated.
“Authorized user” means:
A child care facility;
A health care provider;
A health insurer;
A health maintenance organization;
An institution of higher learning;
A local health department;
A long–term care facility;
A managed care organization;
A nonprofit health service plan;
A patient;
A school;
A school–based health center;
In the case of a minor child, a parent or guardian; and
Any other user designated by the Secretary.
“Health care provider” means a licensed health care practitioner authorized under the Health Occupations Article to administer vaccines in the State.
“ImmuNet” means a computerized information and reminder system to:
Improve the timely and appropriate delivery of immunizations;
Provide a coordinated network for reminder notices when immunizations are due;
Provide and collect information to be shared by authorized users; and
Provide a quality indicator for the insurers’ health care provider practices and public health purposes.
“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.
“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.
“Vaccination” means the administration of a killed or weakened infectious organism to prevent disease caused by that organism.
“Vaccine” means a substance that:
May be administered by injection, mouth, or aerosol; and
Produces immunity that protects the body from a disease.
There is an ImmuNet program in the Department.
Subject to subsection (d) of this section, an authorized user may use the information in ImmuNet for the following purposes:
To provide coordinated immunization services, including sending reminder notices to individuals who need immunizations;
To obtain an individual immunization history;
To identify geographic areas or population groups that are underimmunized;
To compile aggregate data and distribute statistical reports on the status of immunizations in geographic areas and population groups;
To assist in the management of State and local immunization programs;
To monitor the safety of vaccines;
To assess compliance with immunization requirements by monitoring admissions to schools, institutions of higher learning, and child care facilities; and
For any other purpose that the Secretary deems necessary to prevent the spread of communicable diseases.
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.
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.
The Secretary shall make available “refusal to permit” forms to each health care provider who gives vaccinations.
The Department shall:
Develop brochures about ImmuNet that:
Describe the benefits of ImmuNet for authorized users;
Describe privacy protections in ImmuNet;
Notify an individual of the right to refuse to permit disclosure to an authorized user;
Notify an individual that the individual may correct any inaccurate information;
Provide a list of addresses where an individual may obtain a form to request the correction or removal of inaccurate information from ImmuNet;
Explain the right of an individual who has received a vaccination to have the individual’s personal information kept confidential;
Describe the kind of information collected and retained by ImmuNet about an individual who receives a vaccination;
Describe who has access to the information in ImmuNet; and
Describe how the information is used by ImmuNet; and
Make the brochure available to each health care provider who administers vaccines.
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.
A health care provider who administers a vaccine, or the agent of the health care provider, shall:
Provide the individual with a copy of the form and the brochure described in paragraphs (2) and (4) of this subsection;
Notify the individual or the parent or guardian of a minor of the right to refuse to disclose to ImmuNet; and
Report to ImmuNet all vaccines administered.
Subject to the provisions of subsection (d) of this section, information for ImmuNet may be obtained from:
Any records owned or controlled by the Department, including Medicaid records, clinic records, and vital records;
Any authorized user; and
Any other source of information authorized by the Secretary for use.
Authorized users may not use the information in ImmuNet:
To release or disclose information in ImmuNet that an individual has refused to disclose;
To solicit new patients or clients; or
For any other purpose unless authorized by the Secretary.
A local health department may operate a local immunization system.
A local health department operating a local immunization system shall be subject to the provisions of subsections (c) through (f) of this section.
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.
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.
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.
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.
The Secretary shall adopt regulations to implement this section, including regulations specifying:
The type and kind of information to be collected;
Procedures for protecting the confidentiality of information in ImmuNet;
The permissible use of information compiled by ImmuNet; and
Standards for maintaining security and reliability of collected information in the system.
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:
Educate health care providers regarding:
The importance of early detection and timely diagnosis of cognitive impairment;
Validated assessment tools for the detection and diagnosis of cognitive impairment;
The value of a Medicare annual wellness visit or other annual physical for an individual at least 65 years old for cognitive health;
The Medicare care planning billing code for individuals with cognitive impairment; and
Treatments approved by the Food and Drug Administration for Alzheimer’s disease and related dementias, including relevant information on treatment use and outcomes; and
Increase public understanding and awareness of:
The early warning signs of Alzheimer’s disease and related dementias;
The value of early detection, diagnosis, and treatment of Alzheimer’s disease and related dementias;
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
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.
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:
The prevalence of Alzheimer’s disease and related dementias in the State;
The hospitalization rate related to Alzheimer’s disease and related dementias; and
To the extent possible, the prevalence and hospitalization rate of Alzheimer’s disease and related dementias disaggregated based on:
Age, including age of diagnosis;
Sex;
Race;
Ethnicity;
Number of cases by county;
Co–occurrence of Down Syndrome (Trisomy–21); and
Type of dementia.
The website required under subsection (a) of this section shall:
Include the data available for the immediately preceding 5–year period ending September 30, 2025; and
Be updated on or before January 1 each year, beginning in 2027, to include any newly available data.
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.
The recommendations shall:
Be made in accordance with the applicable recommendations of the following authoritative medical organizations:
The American Academy of Pediatrics;
The American College of Obstetricians and Gynecologists; or
The American Academy of Family Physicians; and
Take into consideration the applicable guidance of:
The Maryland Statewide Advisory Commission on Immunizations;
The U.S. Department of Health And Human Services, including the Health Resources and Services Administration;
The U.S. Centers for Disease Control and Prevention, including the Advisory Committee on Immunization Practices;
The U.S. Food and Drug Administration, including the Vaccines and Related Biological Products Advisory Committee; and
The U.S. Preventive Services Task Force.
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:
Hold a notice and comment period of at least 30 days;
Obtain an analysis from the Maryland Health Care Commission on the service that meets the requirements of § 15–1501 of the Insurance Article; and
Cite the applicable recommendations of the authoritative medical organizations on which a recommendation would be based.
The Secretary shall:
Publish recommendations issued under this section on the Department’s website; and
Distribute the recommendations issued under this section to licensed health professionals in the State and to the Maryland Insurance Administration.