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. The report shall: Contain the information and be in a format specified or approved by the Secretary; and Be transmitted as directed by the Secretary. 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: Confidential; Not medical records under Title 4, Subtitle 3 of this article; Not open to public inspection; and Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record. This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed. 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. 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. 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: The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease.

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. The report shall: Be on the form that the Secretary provides; Identify the disease; State the name, age, race, sex, and residence address of the individual; State the pregnancy status of the individual, if applicable; and Be signed by the health care provider. A health care provider shall submit a report as described in subsection (b) of this section to the Secretary within 48 hours of: The birth of an infant whose mother has tested positive for HIV; and A pregnant woman testing positive for HIV, for the purpose of intervention. 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. All health care provider reports required under this section are: Confidential and subject to Title 4, Subtitle 1 of this article; and 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. 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. 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.

In this section, “institution” includes: A hospital; and A lodging facility. 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. The report shall: Contain the information and be in a format specified or approved by the Secretary; and Be transmitted as directed by the Secretary. 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: Confidential; Not medical records under Title 4, Subtitle 3 of this article; Not open to public inspection; and Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record. This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed. 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. 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. 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: The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease.

In this section, “institution” includes: A hospital; A nursing home; A hospice facility; A medical clinic in a correctional facility; An inpatient psychiatric facility; and An inpatient drug rehabilitation facility. 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. The report shall: Be on the form that the Secretary provides; Identify the disease; State the name, age, race, sex, and residence address of the individual with the disease; State the pregnancy status of the individual, if applicable; State the name of the administrative head of the institution; and State the address of the institution. All institution reports required under this section are: Confidential and subject to Title 4, Subtitle 1 of this article; and 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. 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. 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.

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: The patient is a resident of the other state; The Department determines that the agency will preserve the confidentiality of the information; and The other state has authority to provide equivalent information on Maryland residents to this State.

In this section the following words have the meanings indicated. “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: Reasonably obtained patient demographic information, including risk factors; Relevant information on the: Initial histologically precise diagnosis; Initial treatment; Extent of the disease by the end of the first hospitalization; and 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 Facility and other provider identification information. “Central nervous system tumor” means, irrespective of histologic type or behavior, a primary tumor in the following sites: The brain; The caudea equina; A cranial nerve; The craniopharyngeal duct; The meninges; The pineal gland; The pituitary gland; or The spinal cord. “Central nervous system tumor” includes a primary intracranial tumor. “Freestanding ambulatory care facility” has the meaning stated in § 19–3B–01 of this article. 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: Submit a cancer report to the Secretary, on the form that the Secretary provides or in a computerized file; Make available to the Secretary, or an agent of the Secretary, at the facility the information necessary to compile a cancer report; or 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 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. 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. Information obtained under this subsection shall be confidential and subject to Title 4, Subtitle 1 of this article. 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. 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. 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. 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.

In this section, “clinical material” means: An organism isolated from a clinical specimen; Material derived or prepared from a clinical specimen in which evidence of a communicable disease has been identified or detected; or 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: A patient specimen; Microbial genetic material; or Other laboratory material. 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. 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. 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. A director of a medical laboratory shall submit clinical material to the Secretary as directed by the Secretary. 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: At least 1 positive test result is reported; and The health officer has approved the reporting of less than all test results. 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. The report shall: Contain the information and be in a format specified or approved by the Secretary; and Be transmitted as directed by the Secretary. 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. A health officer shall inform the Secretary of each laboratory examination report received under subsection (b)(1) of this section. 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. 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. 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: Confidential; Not medical records under Title 4, Subtitle 3 of this article; Not open to public inspection; and Not discoverable or admissible in evidence in any civil or criminal matter except in accordance with a court order sealing the court record. This subsection does not apply to reports, information, and records otherwise available to the public or required to be publicly disclosed. 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. 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: The agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and The disclosure is necessary to protect the public health or to prevent the spread of an infectious or contagious disease. 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. 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. The Secretary shall adopt regulations that designate the diseases or conditions that are reportable by a director of a medical laboratory under this section.

In this section the following words have the meanings indicated. “Birth defect” means an abnormality of the structure or a function of the human body present at birth that may result in: A physical or mental disability; or Death. “Health care provider” has the meaning stated in § 4–301 of this article. 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. 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. 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. A health care provider shall allow the Department to inspect and obtain the following medical information regarding a child with a birth defect: The medical records of: A child through the child’s second year of life; and A child’s mother regarding the mother’s pregnancy with the child; Records of any laboratory tests relating to a child’s birth defect; and Any other medical information relating to a child’s birth defect. The hospital shall disclose the identity of the child with a birth defect to the Secretary so that the Secretary may: Use the information to protect the public health; or 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. 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. 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. The Department shall keep any medical information obtained under this section confidential. Medical information requested under this section shall be only as intrusive as necessary and used for the purpose of: Assuring the quality of the data reported; Providing information or services to a child’s family; Conducting an epidemiological investigation related to a birth defect; or Conducting the Department’s research into the causes of birth defects. 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. A health care provider who discloses medical records to the Department under this section: Is not liable in any suit for civil damages for the disclosure of the medical records; Is not subject to disciplinary action by any licensing or disciplining authority for disclosure of confidential information; and May not be subject to any criminal penalties. 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. While conducting research using human subjects under this section, the Department shall comply with the requirements for the protection of human subjects under: Title 13, Subtitle 20 of this article; and 42 U.S.C. § 289. The Department shall assure that information is prepared and periodically updated on: Birth defects; and Public and private services for children with birth defects. The Secretary shall appoint a committee to determine the information required under paragraph (1) of this subsection. The committee shall consist of: Physicians; Educators; Social service specialists; Representatives of the Department; Representatives of the Department of Human Services; Representatives of the State Department of Education; and Parents or guardians of children with birth defects. 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. 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. The letter shall offer information about the birth defect and available services with emphasis on needs identified after discharge from the hospital. 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. 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.

In this section the following words have the meanings indicated. “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. “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: Reasonably obtained patient demographic information, including name and risk factors; Relevant information on the: Initial diagnosis; Treatment and referral; and Clinical condition; and Facility and other provider identification information. “Report” means: A laboratory examination report for HIV or CD 4+ count as required by § 18–205 of this subtitle; A report for HIV or AIDS as required by § 18–201.1, § 18–202, or § 18–202.1 of this subtitle; or An HIV/AIDS case report. 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. A report or information assembled or obtained under this section: Is confidential and subject to Title 4, Subtitle 1 of this article; and 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. 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. 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.

When a health officer has reason to believe that a disease that endangers public health exists within the county, the health officer shall: Report immediately to the appropriate county board of health; and With the approval of the board: Investigate the suspected disease; and Act properly to prevent the spread of the disease. 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. 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. A county board of health shall pay the necessary and legitimate expenses that a health officer incurs under this subsection. When a health officer is notified of an infectious or contagious disease within the county, the health officer: Shall act immediately to prevent the spread of the disease; Within 24 hours after receiving notice of the disease, shall give the Secretary all information obtained on the disease; and Shall cooperate with the Secretary to prevent the spread of the disease. 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. If a health officer is unsure whether a disease is infectious or contagious, the health officer shall notify the Secretary.

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.

To prevent the spread of an infectious or contagious disease that endangers public health, a health officer may have: Any part of a house disinfected if the house has been exposed to the disease; and Any article in the house disinfected or destroyed if the article has been exposed to the disease. The county where the house is located shall: Incur the expense of disinfecting the house; and Reasonably compensate a person who suffers damage from the exercise of a power granted by this section, if the person is not at fault.

A health officer may have an individual moved to a suitable place for the reception of the sick if: A physician certifies that the individual has an infectious disease that endangers public health; The individual: Is staying in a room occupied by more than 1 family; Is on board a vessel; or Otherwise does not have proper housing; and The administrative head of the place for the reception of the sick consents to the move. The city or county where the infected individual is found shall pay for the cost of moving the individual. A person may not willfully disobey an order or obstruct the carrying out of an order of the health officer to move an individual.

The health officer shall keep a record of each report that is submitted to the health officer under § 18-201 of this subtitle. The record shall: Be on the form that the Secretary provides; State the date of the report; State the name of the physician who submits the report; State the disease identified in the report; State the name and residence address of the patient named in the report; and State the actions taken to prevent the spread of the disease.

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: Quarantine a vessel that is entering the waters of the State; Prohibit or restrict contact between the State and the place affected by the disease; and Take other actions that appear to the Governor to be necessary to carry out this section.

In this section the following words have the meanings indicated. “Contagious disease or virus” means: Human immunodeficiency virus (HIV); Meningococcal meningitis; Tuberculosis; Mononucleosis; Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G; Diphtheria; Plague; Hemorrhagic fevers; or Rabies. “Correctional institution” means a place of detention or correctional confinement operated by or for the State or a local government. “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. “Correctional officer” includes any sheriff, warden, superintendent, or any other person having an equivalent title. “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: The Department of State Police; The Baltimore City Police Department; The police department, bureau, or force of any county; The police department, bureau, or force of any incorporated city or town; The office of the sheriff of any county; 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; 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; The law enforcement officers of the Department of Natural Resources; The Field Enforcement Bureau of the Comptroller’s Office; The Field Enforcement Division of the Alcohol, Tobacco, and Cannabis Commission; The Crofton Police Department; The Intelligence and Investigative Division of the Department of Public Safety and Correctional Services; or The Ocean Pines Police Department. “Medical care facility” means a hospital as defined in § 19–301 of this article or a health care facility of a correctional institution. 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. 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. 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. The notification required under subsection (b), (c), or (d) of this section shall: Be made within 48 hours, or sooner, of confirmation of the patient’s diagnosis; Include subsequent written confirmation of possible exposure to the contagious disease or virus; Be conducted in a manner that will protect the confidentiality of the patient; and 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. The written confirmation required under subsection (e)(2) of this section shall constitute compliance with this section. 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. 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. 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: 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 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. 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: The routes of transmission of HIV and hepatitis B virus; and 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 The current Centers for Disease Control and Prevention guidelines for preventing prehospital exposure to HIV and hepatitis B while rendering emergency medical care. 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. 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. On request, copies of the procedures developed in this subsection shall be made available to employees, employee unions, volunteer associations, and the Secretary. A person under this section may not refuse to treat or transport an individual because the individual is HIV positive.

In this section the following words have the meanings indicated. “Body fluids” means: Any fluid containing visible blood, semen, or vaginal secretions; or Cerebral spinal fluid, synovial, or amniotic fluid. “Body fluid” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus. “Contact exposure” means as between a patient and a sworn member of the State Fire Marshal’s office: Percutaneous contact with blood or body fluids; Mucocutaneous contact with blood or body fluids; Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or Intact skin contact with large amounts of blood or body fluids for a prolonged period. “Contagious disease or virus” means: Human immunodeficiency virus (HIV); Meningococcal meningitis; Tuberculosis; Mononucleosis; Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G; Diphtheria; Plague; Hemorrhagic fevers; or Rabies. “Medical care facility” means a hospital as defined in § 19–301 of this article or a health care facility of a correctional institution. 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. The notification required under subsection (b) of this section shall: Be made within 48 hours of confirmation of the patient’s diagnosis; Include subsequent written confirmation of possible contact exposure to the contagious disease or virus; Be conducted in a manner that will protect the confidentiality of the patient; and 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. The written confirmation required under subsection (c)(2) of this section shall constitute compliance with this section. 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. 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. 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: 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 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. 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: The routes of transmission of HIV and hepatitis B virus; and The routes by which a sworn member of the State Fire Marshal’s office may be exposed to HIV and hepatitis B virus; and The current Centers for Disease Control and Prevention guidelines for preventing prehospital exposure to HIV and hepatitis B while rendering emergency medical care. 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. The State Fire Marshal’s office shall develop written procedures for the implementation of this section. On request, copies of the procedures developed under this subsection shall be made available to employees, employee unions, volunteer associations, and the Secretary. A person under this section may not refuse to treat or transport an individual because the individual is HIV positive.

In this section the following words have the meanings indicated. “Body fluids” means: Any fluid containing visible blood, semen, or vaginal secretions; or Cerebral spinal fluid, synovial, or amniotic fluid. “Body fluids” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus. “Contact exposure” means as between a decedent and a first responder: Percutaneous contact with blood or body fluids; Mucocutaneous contact with blood or body fluids; Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or Intact skin contact with large amounts of blood or body fluids for a prolonged period. “Contagious disease or virus” means: Human immunodeficiency virus (HIV); Meningococcal meningitis; Tuberculosis; Mononucleosis; Any form of viral hepatitis, including but not limited to hepatitis A, B, C, D, E, F, and G; Diphtheria; Plague; Hemorrhagic fevers; or Rabies. “Correctional institution” means a place of detention or correctional confinement operated by or for the State or a local government. “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. “Correctional officer” includes any sheriff, warden, superintendent, or other individual having the equivalent title. “First responder” means a: Firefighter; Emergency medical technician; Rescue squad member; Law enforcement officer; Correctional officer; or Sworn member of the State Fire Marshal’s office. “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: The Department of State Police; The Baltimore City Police Department; The police department, bureau, or force of any county; The police department, bureau, or force of any incorporated city or town; The office of the sheriff of any county; 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; 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; The law enforcement officers of the Department of Natural Resources; The Field Enforcement Bureau of the Comptroller’s Office; The Intelligence and Investigative Division of the Department of Public Safety and Correctional Services; or The Maryland Capitol Police of the Department of General Services. “Medical care facility” means a hospital, or a health care facility of a correctional institution. “Physician performing a postmortem examination” means any of the following persons who perform a postmortem examination on a decedent: The Chief Medical Examiner; or The Chief Medical Examiner’s designee. 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. The notification required under subsection (b) of this section shall: 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; Include subsequent written confirmation of possible contact exposure to the contagious disease or virus; Be conducted in a manner that will protect the confidentiality of the deceased person; and To the extent possible, be conducted in a manner that will protect the confidentiality of the first responder. The written confirmation required under subsection (c)(2) of this section shall constitute compliance with this section. 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. 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: 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 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. 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. 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. 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.

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. There is a Statewide Advisory Commission on Immunizations. The following members shall serve without term limits: The State Superintendent of Schools or the State Superintendent’s designee with knowledge of the immunizations required of children entering schools; One local health officer; One representative from the Department’s Vaccines for Children Program; and The Maryland State Epidemiologist. The following members are subject to term limits: One representative from a public health consumer advocacy group; One nurse practitioner; One representative from a health insurance carrier; One consumer; One pharmacist; One physician member of MedChi, The Maryland State Medical Society; Two physician members of the Maryland Chapter of the American Academy of Pediatrics with experience in private practice and infectious diseases; One physician member of the Maryland Academy of Family Physicians; One school–based health care provider member of the Maryland Assembly on School–Based Health Care; One school nurse member of the Maryland Association of School Health Nurses or the Maryland Nurses Association; One physician member of the American College of Physicians – Internal Medicine Society of Maryland; One physician assistant member of the Maryland Academy of Physician Assistants; and Up to three additional members selected by the Secretary. 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. The Secretary, in consultation with MedChi, The Maryland State Medical Society, shall appoint the chair of the Commission. The chair of the Commission shall: Establish subcommittees to facilitate the work of the Commission; and Appoint subcommittee chairs from among the Commission members. This subsection applies only to members who are subject to term limits. The term of an appointed member is 4 years. Subject to paragraph (5) of this subsection, a member may serve two consecutive terms. At the end of a term, a member continues to serve until a successor is appointed and qualifies. A member who serves two consecutive full 4–year terms may not be reappointed for 4 years after the completion of those terms. 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. If a vacancy for an appointed member of the Commission occurs, the Secretary shall promptly appoint a successor. 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. The Department shall provide the staffing for the Commission. The Commission shall: Determine where community vaccine shortages exist and which vaccines are in short supply; Develop a recommendation for a plan to effectuate the equitable distribution of vaccines; Review: Potential provider reimbursement barriers to increasing immunizations; The relative effectiveness of outreach programs that educate the public about the benefits of immunizations; Potential cost–shifting of immunization expenses for privately insured patients who receive immunizations at local health departments; and Potential administrative burdens associated with State purchasing of vaccines; 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 Study and make recommendations about other related issues as determined by the Commission, including: Immunizations required of children entering schools; 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; 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; Elimination of any vaccine distribution disparities; A public education campaign in the event of a vaccine shortage or public health emergency involving immunizations; and The availability and affordability of adult, adolescent, and childhood vaccines. The Commission may recommend to the Department that information on vaccine safety be communicated to health care providers. 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.

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: Contain and stop the further spread of the infection; and Reduce the likelihood of reinfection in the diagnosed patient. 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: A physician licensed under Title 14 of the Health Occupations Article; 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; 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; A registered nurse employed by a local health department who complies with: The formulary developed and approved under § 3–403(b) of this article; and The requirements established under § 8–512 of the Health Occupations Article; and A certified midwife licensed under Title 8, Subtitle 6D of the Health Occupations Article. 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. 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. The Secretary shall adopt regulations to implement the requirements of this section in public and private health care settings in the State.

In this section, “public institution of higher education” means: A public senior higher education institution, as defined in § 10–101 of the Education Article; and A community college. A public institution of higher education does not include an institution without residential housing or a health center. 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. 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. The outbreak response plan required under subsection (b) of this section shall be customized to the public institution of higher education and include: A process for expediently notifying students, families of students, faculty, and staff of: The outbreak of a contagious disease; Subpopulations that are at high risk of severe complications from the contagious disease; Guidance on how students, families of students, faculty, and staff can take reasonable protective measures; and Information on the availability of laboratory testing for students, faculty, and staff; Processes for implementing evidence–based outbreak response measures; 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; A process for reporting an outbreak of a contagious disease at the public institution of higher education to: The Department; The local health department; Campus health providers; Local community health providers; and Regional hospitals; and Any other measure required by the Department.

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. 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. 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. 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. 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. 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: A fine not exceeding $100,000, imprisonment for not more than 5 years, or both; and 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. This subsection does not apply to an officer or employee of a governmental unit that is conducting a criminal investigation. A health care provider or any other person who knowingly violates subsection (e) or (f) of this section is liable for actual damages. 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.

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.

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.

In this part, “animal” means any nonhuman living creature, whether native to Maryland or not, which is: Wild by nature; and Endowed with sensation and power of voluntary motion.

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. This section does not apply to: Domestic cats; Domestic dogs; Domestic ferrets; Animals used for agricultural purposes; Animals used for scientific purposes; Animals used for educational purposes; Animals used for public exhibitions; or Any animal that the Secretary determines is not a threat to human health and safety. 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.

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.

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.

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. 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.