In this subtitle the following words have the meanings indicated. “Catastrophic health emergency” has the meaning stated in § 14-3A-01 of the Public Safety Article. “Deadly agent” has the meaning stated in § 14-3A-01 of the Public Safety Article. “Exposure to a deadly agent” has the meaning stated in § 14-3A-01 of the Public Safety Article. “Health care facility” has the meaning stated in § 19–114(d)(1) of this article. “Health care practitioner” has the meaning stated in § 19–114(e) of this article. “Health care practitioner” includes an individual licensed or certified as an emergency medical services provider under § 13–516 of the Education Article. “Health care provider” means: A health care facility; or A health care practitioner.

Notwithstanding any other provision of law, the Secretary may exercise the authority granted in this subtitle to: Continuously evaluate and modify existing disease surveillance procedures in order to detect a catastrophic health emergency; Investigate actual or potential exposures to a deadly agent; and Treat, prevent, or reduce the spread of the disease or outbreak believed to have been caused by the exposure to a deadly agent.

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: Staff training needs; Stockpiling of equipment, medication, and supplies necessary to address a catastrophic health emergency; Treatment and decontamination protocols; The coordination of services with other public and private entities; and 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. 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. After consulting with the appropriate licensing board, the Secretary: Shall publish protocols to assist health care practitioners in developing plans to respond to a catastrophic health emergency; and May, if necessary, require health care practitioners to implement the plans developed under item (1) of this subsection. 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.

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. 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: Require a health care provider or other person to report information to the Secretary or other public official on the following: The presence of an individual or group of individuals with specified illnesses or symptoms; Diagnostic and laboratory findings relating to diseases caused by deadly agents; Statistical or utilization trends relating to potential disease outbreaks; Information needed to conduct contact tracing for exposed individuals; and Other data deemed by the Secretary to have epidemiological significance in detecting possible catastrophic health emergencies; Obtain access to information in the possession of a health care provider; 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; Require a health care provider or other person to submit reports to the Department containing information detailing the presence and use of deadly agents; Obtain access to premises in order to secure environmental samples and otherwise investigate actual or potential exposures to deadly agents; and Require a veterinarian or other person to report data relating to specified illnesses or symptoms in animal populations. The Secretary, in acquiring information under subsection (b) of this section, shall: Request and use nonidentifying information whenever possible; and Limit the use of confidential information to the extent necessary to detect and investigate actual or potential exposures to a deadly agent. 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. 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. A person may redisclose the information to another health care provider or public official provided that: The health care provider or public agency to whom the information is disclosed will maintain the confidentiality of the disclosure; and 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.

In investigating actual or potential exposures to a deadly agent, the Secretary: 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; 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 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; 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 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. The Secretary may issue an order under subsection (a) of this section: 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 As necessary to implement an order issued by the Governor under § 14-3A-02 of the Public Safety Article.

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. The directive shall specify: The identity of the individual or group of individuals subject to isolation or quarantine; The premises subject to isolation or quarantine; The date and time at which isolation or quarantine commences; The suspected deadly agent causing the outbreak or disease, if known; The basis upon which isolation or quarantine is justified; and The availability of a hearing to contest the directive. 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. 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. 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. 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. A request for a hearing may not stay or enjoin an isolation or quarantine directive. Upon receipt of a request under this subsection, the court shall conduct a hearing within 3 days from receipt of the request. 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. 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. 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. 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. An order authorizing the isolation or quarantine issued under this paragraph shall: Identify the isolated or quarantined individual or group of individuals by name or shared characteristics; Specify factual findings warranting isolation or quarantine; and Except as provided in subsubparagraph 2 of this subparagraph, be in writing and given to the individual or group of individuals. 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. An order authorizing isolation or quarantine is effective for a period not to exceed 30 days. Prior to the expiration of an order, the Secretary or designated official may move to continue isolation or quarantine for subsequent 30–day periods. The court shall base its decision on the standards provided under this paragraph. In the event that an individual cannot personally appear before the court, proceedings may be conducted: By an individual’s authorized representative; and Through any means that allow other individuals to fully participate. In any proceedings brought under this subsection, the court may order the consolidation of individual claims into group claims where: The number of individuals involved or affected is so large as to render individual participation impractical; There are questions of law or fact common to the individual claims or rights to be determined; The group claims or rights to be determined are typical of the affected individual’s claims or rights; or The entire group will be adequately represented in the consolidation. The court shall appoint counsel to represent individuals or a group of individuals who are not otherwise represented by counsel. The Supreme Court of Maryland shall develop emergency rules of procedure to facilitate the efficient adjudication of any proceedings brought under this section. 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.

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. 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. 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. 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: Placing the licensee or certificate holder on probation; Suspending or revoking the license or certificate holder; or Imposing a civil penalty not to exceed $3,000 for each offense. 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.

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. 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.