<section article="ghg" article_name="Health - General" number="20-101" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>Notwithstanding any other provision of law, a minor who is at least 17 years old, without the consent of a parent or legal guardian, may give blood to a program that:</text> <level label="1"> <text>Is voluntary;</text> </level> <level label="2"> <text>Does not pay money for the blood; and</text> </level> <level label="3"> <text>Is approved by:</text> <level label="i"> <text>The American Association of Blood Banks; or</text> </level> <level label="ii"> <text>The American Red Cross.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Notwithstanding any other provision of law, a minor who is at least 16 years old, and has obtained the consent of a parent or legal guardian, may give blood to the programs listed in subsection (a) of this section.</text> </level> <level label="2"> <text>Consent may be obtained via telephone or electronic means.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-102" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>A minor has the same capacity as an adult to consent to medical or dental treatment if the minor:</text> <level label="1"> <text>Is married;</text> </level> <level label="2"> <text>Is the parent of a child; or</text> </level> <level label="3"> <level label="i"> <text>Is living separate and apart from the minor’s parent, parents, or guardian, whether with or without consent of the minor’s parent, parents, or guardian; and</text> </level> <level label="ii"> <text>Is self–supporting, regardless of the source of the minor’s income.</text> </level> </level> </level> <level label="b"> <text>A minor has the same capacity as an adult to consent to medical treatment if, in the judgment of the attending physician, the life or health of the minor would be affected adversely by delaying treatment to obtain the consent of another individual.</text> </level> <level label="c"> <text>A minor has the same capacity as an adult to consent to:</text> <level label="1"> <text>Treatment for or advice about drug abuse;</text> </level> <level label="2"> <text>Treatment for or advice about alcoholism;</text> </level> <level label="3"> <text>Treatment for or advice about venereal disease;</text> </level> <level label="4"> <text>Treatment for or advice about pregnancy;</text> </level> <level label="5"> <text>Treatment for or advice about contraception other than sterilization;</text> </level> <level label="6"> <text>Physical examination and treatment of injuries from an alleged rape or sexual offense;</text> </level> <level label="7"> <text>Physical examination to obtain evidence of an alleged rape or sexual offense;</text> </level> <level label="8"> <text>Initial medical screening and physical examination on and after admission of the minor into a detention center; and</text> </level> <level label="9"> <text>Treatment for the prevention of human immunodeficiency virus (HIV).</text> </level> </level> <level label="c–1"> <text>The capacity of a minor to consent to treatment for drug abuse or alcoholism under subsection (c)(1) or (2) of this section does not include the capacity to refuse treatment for drug abuse or alcoholism in an inpatient or intensive outpatient alcohol or drug abuse treatment program certified under Title 8 of this article for which a parent or guardian has given consent.</text> </level> <level label="d"> <text>A minor has the same capacity as an adult to consent to psychological treatment as specified under subsection (c)(1) and (2) of this section if, in the judgment of the attending physician or a psychologist, the life or health of the minor would be affected adversely by delaying treatment to obtain the consent of another individual.</text> </level> <level label="e"> <text>A licensed health care practitioner who treats a minor is not liable for civil damages or subject to any criminal or disciplinary penalty solely because the minor did not have capacity to consent under this section.</text> </level> <level label="f"> <text>Without the consent of or over the express objection of a minor, a licensed health care practitioner may, but need not, give a parent, guardian, or custodian of the minor or the spouse of the parent information about treatment needed by the minor or provided to the minor under this section, except information about an abortion.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-103" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>In this section, “qualified provider” means a physician, nurse practitioner, nurse–midwife, licensed certified midwife, physician assistant, or any other individual:</text> <level label="1"> <text>Who is licensed, certified, or otherwise authorized by law to practice in the State; and</text> </level> <level label="2"> <text>For whom the performance of an abortion is within the scope of the individual’s license or certification.</text> </level> </level> <level label="b"> <text>Except as provided in subsections (c) and (d) of this section, a qualified provider may not perform an abortion on an unmarried minor unless the qualified provider first gives notice to a parent or guardian of the minor.</text> </level> <level label="c"> <text>The qualified provider may perform the abortion without notice to a parent or guardian if:</text> <level label="1"> <text>The minor does not live with a parent or guardian; and</text> </level> <level label="2"> <text>A reasonable effort to give notice to a parent or guardian is unsuccessful.</text> </level> </level> <level label="d"> <level label="1"> <text>The qualified provider may perform the abortion, without notice to a parent or guardian of a minor if, in the professional judgment of the qualified provider:</text> <level label="i"> <text>Notice to the parent or guardian may lead to physical or emotional abuse of the minor;</text> </level> <level label="ii"> <text>The minor is mature and capable of giving informed consent to an abortion; or</text> </level> <level label="iii"> <text>Notification would not be in the best interest of the minor.</text> </level> </level> <level label="2"> <text>The qualified provider is not liable for civil damages or subject to a criminal penalty for a decision under this subsection not to give notice.</text> </level> </level> <level label="e"> <text>The postal receipt that shows an article of mail was sent by certified mail, return receipt requested, bearing a postmark from the United States Postal Service, to the last known address of a parent or guardian and that is attached to a copy of the notice letter that was sent in that article of mail shall be conclusive evidence of notice or a reasonable effort to give notice, as the case may be.</text> </level> <level label="f"> <text>A qualified provider may not provide notice to a parent or guardian if the minor decides not to have the abortion.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-104" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>In this section, “health care provider” means an individual who is:</text> <level label="1"> <text>Licensed under the Health Occupations Article; and</text> </level> <level label="2"> <text>Acting within the scope of the individual’s license to diagnose and treat mental and emotional disorders.</text> </level> </level> <level label="b"> <level label="1"> <text>Subject to paragraph (2) of this subsection, a minor who is 12 years old or older who is determined by a health care provider to be mature and capable of giving informed consent has the same capacity as an adult to consent to consultation, diagnosis, and treatment of a mental or emotional disorder by the health care provider or a clinic.</text> </level> <level label="2"> <text>The capacity of a minor to consent to consultation, diagnosis, and treatment of a mental or emotional disorder by a health care provider or a clinic under paragraph (1) of this subsection does not include the capacity to:</text> <level label="i"> <text>Refuse consultation, diagnosis, or treatment for a mental or emotional disorder for which a parent, guardian, or custodian of the minor has given consent; or</text> </level> <level label="ii"> <text>Except as otherwise provided in this subtitle, if the minor is under the age of 16 years, consent to the use of prescription medications to treat a mental or emotional disorder.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection and subject to paragraph (3) of this subsection, without the consent of or over the express objection of a minor, the health care provider or, on advice or direction of the health care provider, a member of the medical staff of a hospital or public clinic may, but need not, give a parent, guardian, or custodian of the minor or the spouse of the parent information about treatment needed by the minor or provided to the minor under this section.</text> </level> <level label="2"> <text>Subject to paragraph (3) of this subsection, if a health care provider is on a treatment team for a minor that is headed by a physician, the physician heading the treatment team shall decide whether a parent, guardian, or custodian of the minor or the spouse of the parent should receive information about treatment needed by the minor or provided to the minor under this section.</text> </level> <level label="3"> <text>A health care provider may decide to provide information to a parent, guardian, or custodian of a minor under paragraphs (1) and (2) of this subsection unless the health care provider believes that the disclosure will lead to harm to the minor or deter the minor from seeking care.</text> </level> </level> <level label="d"> <text>Unless the parent, guardian, or custodian of a minor consents to consultation, diagnosis, or treatment of the minor, the parent, guardian, or custodian is not liable for any costs of the consultation, diagnosis, or treatment of the minor under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-105" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Informal kinship care” means a living arrangement in which a relative of a child, who is not in the care, custody, or guardianship of the local department of social services, provides for the care and custody of the child due to a serious family hardship.</text> </level> <level label="3"> <text>“Relative” means an adult related to the child by blood or marriage within the fifth degree of consanguinity.</text> </level> <level label="4"> <text>“Serious family hardship” means:</text> <level label="i"> <text>Death of a parent or legal guardian of the child;</text> </level> <level label="ii"> <text>Serious illness of a parent or legal guardian of the child;</text> </level> <level label="iii"> <text>Drug addiction of a parent or legal guardian of the child;</text> </level> <level label="iv"> <text>Incarceration of a parent or legal guardian of the child;</text> </level> <level label="v"> <text>Abandonment by a parent or legal guardian of the child; or</text> </level> <level label="vi"> <text>Assignment of a parent or legal guardian to active uniformed services duty.</text> </level> </level> </level> <level label="b"> <text>A relative providing informal kinship care for a child may consent to health care on behalf of the child if:</text> <level label="1"> <text>A court has not appointed a guardian for the child or awarded custody of the child to an individual other than the relative providing informal kinship care; and</text> </level> <level label="2"> <text>The relative verifies the informal kinship care relationship through a sworn affidavit that:</text> <level label="i"> <text>Meets the requirements of this section; and</text> </level> <level label="ii"> <text>Is filed with the Department of Human Services, Social Services Administration.</text> </level> </level> </level> <level label="c"> <text>The affidavit shall include:</text> <level label="1"> <text>The name and date of birth of the child;</text> </level> <level label="2"> <text>The name and address of the child’s parent or legal guardian;</text> </level> <level label="3"> <text>The name and address of the relative providing informal kinship care;</text> </level> <level label="4"> <text>The date the relative assumed informal kinship care;</text> </level> <level label="5"> <text>The nature of the serious family hardship and why it resulted in informal kinship care; and</text> </level> <level label="6"> <text>The kinship relation to the child of the relative providing informal kinship care.</text> </level> </level> <level label="d"> <text>The affidavit shall be in the following form:</text> <level label="1"> <text>I, the undersigned, am over eighteen (18) years of age and competent to testify to the facts and matters set forth herein.</text> </level> <level label="2"> <text>_______________ (name of child), whose date of birth is _____________, is living with me because of the following serious family hardship (check each that is applicable):</text> <text>_____ Death of father/mother/legal guardian</text> <text>_____ Serious illness of father/mother/legal guardian</text> <text>_____ Drug addiction of father/mother/legal guardian</text> <text>_____ Incarceration of father/mother/legal guardian</text> <text>_____ Abandonment by father/mother/legal guardian</text> <text>_____ Assignment of father/mother/legal guardian to active uniformed services duty</text> </level> <level label="3"> <text>The name and last known address of the child’s parent(s) or legal guardian is:</text> <text>_______________________________________</text> <text>_______________________________________</text> <text>_______________________________________</text> </level> <level label="4"> <text>My kinship relation to the child is _____________________________</text> </level> <level label="5"> <text>My address is:</text> <text>______________________________________________________</text> <text>Street Apt. No.</text> <text>______________________________________________________</text> <text>City State Zip Code</text> </level> <level label="6"> <text>I assumed informal kinship care of this child for 24 hours a day and 7 days a week on __________________ (day/month/year).</text> </level> <level label="7"> <text>The name and address of the school that the child attends is:</text> <text>______________________________________________________</text> <text>______________________________________________________</text> </level> <level label="8"> <text>I solemnly affirm under the penalties of perjury that the contents of the foregoing are true to the best of my knowledge, information, and belief.</text> <text>______________________________________</text> <text>Signature of affiant</text> <text>______________________________________</text> <text>(Day/month/year)</text> </level> </level> <level label="e"> <text>Affidavit forms that comply with subsection (d) of this section shall be made available free of charge at the offices of each county board of education and each local health department.</text> </level> <level label="f"> <text>If a change occurs in the care or in the serious family hardship of the child, the relative providing informal kinship care shall notify the Department of Human Services, Social Services Administration in writing within 30 days after the change occurs.</text> </level> <level label="g"> <text>The relative providing informal kinship care shall file an affidavit annually with the Department of Human Services, Social Services Administration for each year the child continues to live with the relative because of a serious family hardship.</text> </level> <level label="h"> <text>A copy of the affidavit shall be given to the health care provider that treats the child.</text> </level> <level label="i"> <text>The relative providing informal kinship care may apply on behalf of the child for all medical and public assistance entitlements for which the child may be eligible.</text> </level> <level label="j"> <text>An affidavit under this section does not abrogate the right of the parent or guardian of a child to consent to health care on behalf of the child in a future health care decision.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-106" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Phototherapy device” means any equipment that emits ultraviolet radiation and is used in the diagnosis or treatment of disease or injury.</text> </level> <level label="3"> <text>“Tanning device” means any equipment that emits radiation used for tanning of the skin, including sunlamps, tanning booths, or tanning beds.</text> </level> <level label="4"> <text>“Tanning facility” means any place where a tanning device is used for a fee, membership dues, or other compensation.</text> </level> </level> <level label="b"> <level label="1"> <text>This section does not apply to the use of any phototherapy device by a health care practitioner acting within the scope of the license of the health care practitioner or by order of a health care practitioner acting within the scope of the license of the health care practitioner.</text> </level> <level label="2"> <text>Paragraph (1) of this subsection may not be construed to authorize a prescription to be written for a minor for the use of a tanning device.</text> </level> </level> <level label="c"> <text>An owner, employee, or operator of a tanning facility may not allow a minor under the age of 18 years to use a tanning device.</text> </level> <level label="d"> <text>The owner, employee, or operator of a tanning facility shall:</text> <level label="1"> <text>Require appropriate documentation to verify the age of an individual before allowing the individual access to a tanning device; and</text> </level> <level label="2"> <text>Ensure that the notice developed under subsection (e) of this section is posted in a conspicuous place in the tanning facility.</text> </level> </level> <level label="e"> <text>The Department shall develop and make available to each tanning facility a notice that includes the following information:</text> <level label="1"> <text>That it is unlawful for a tanning facility owner, employee, or operator to allow a minor to use any tanning device;</text> </level> <level label="2"> <text>That a tanning facility owner, employee, or operator that violates one or more provisions of this section may be subject to a civil penalty;</text> </level> <level label="3"> <text>That an individual may report a violation of one or more provisions of this section to the local law enforcement agency; and</text> </level> <level label="4"> <text>The health risks associated with tanning, including skin cancer, premature skin aging, injuries including burns, and adverse reactions when combined with certain medications, foods, and cosmetics.</text> </level> </level> <level label="f"> <level label="1"> <text>The Secretary may impose on a person who violates this section:</text> <level label="i"> <text>For a first violation, a civil penalty not to exceed $250;</text> </level> <level label="ii"> <text>For a second violation, a civil penalty not to exceed $500; and</text> </level> <level label="iii"> <text>For each subsequent violation, a civil penalty not to exceed $1,000.</text> </level> </level> <level label="2"> <text>The Secretary may adopt regulations to implement and carry out this section.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-108" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Disabled individual” means an individual with actual or potential limitations in self-care, mobility, hygiene, vocation, family role, or coping mechanisms.</text> </level> <level label="3"> <text>“Reportable condition” means a:</text> <level label="i"> <text>Spinal cord injury;</text> </level> <level label="ii"> <text>Stroke;</text> </level> <level label="iii"> <text>Amputation; or</text> </level> <level label="iv"> <text>Head injury.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Each hospital shall report to the Department within 7 days of the occurrence of a reportable condition.</text> </level> <level label="2"> <level label="i"> <text>The report shall contain the individual’s name, age, residence, the type of disability, and any additional information that the Department requires.</text> </level> <level label="ii"> <text>The information collected under this section is confidential and not open to inspection nor considered a public record. The information shall only be used statistically for the use of the Department in the performance of its duties, except that the identities of individuals reported may be disclosed for research purposes in accordance with the criteria set forth in § 4–501(e) of the General Provisions Article.</text> </level> </level> </level> <level label="c"> <text>The report form shall be developed by the Department with input from physicians, disabled individuals, and consumer advocates. The Department shall be responsible for distributing the form to physicians and institutions.</text> </level> <level label="d"> <text>The Department shall establish a central registry to compile information about disabled individuals with reportable conditions.</text> </level> <level label="e"> <level label="1"> <text>Within 15 days of receiving a report of an individual with a reportable condition, the Department shall notify the individual or the individual’s parent or guardian of any assistance or services that may be available from the State and of the eligibility requirements for such assistance or services.</text> </level> <level label="2"> <text>Upon request, the Department shall refer the individual to appropriate divisions of the Department and other agencies, public or private, which provide rehabilitation services for persons with reportable conditions.</text> </level> <level label="3"> <text>The Department shall make each public and private health and social agency aware of the rehabilitation information provided by the Department and advise them how to contact the Department to obtain the information.</text> </level> <level label="4"> <text>All other agencies of the State shall cooperate with the Department to provide available, appropriate rehabilitation services to an individual with a reportable condition who meets the eligibility requirements for such services.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-109" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>In this section, “Alzheimer’s special care unit or program” means a secured or segregated special unit or program specifically designed for individuals with a probable or confirmed diagnosis of Alzheimer’s disease or a related disorder.</text> </level> <level label="b"> <text>An assisted living program that provides care for or offers to provide care for persons with Alzheimer’s disease or a related disorder by means of an Alzheimer’s special care unit or program, shall disclose how the form of care and treatment provided by the Alzheimer’s special care unit or program is specifically designed for the specialized care of individuals diagnosed with Alzheimer’s disease or a related disorder.</text> </level> <level label="c"> <text>At the time of licensure, an assisted living program with an Alzheimer’s special care unit or program shall send to the Department a written description of the special care unit or program.</text> </level> <level label="d"> <text>An assisted living program with an Alzheimer’s special care unit or program shall disclose the written description of the special care unit to:</text> <level label="1"> <text>Any person on request; and</text> </level> <level label="2"> <text>The family or party responsible for any resident prior to admission of the resident to the Alzheimer’s special care unit or program.</text> </level> </level> <level label="e"> <text>The description of the Alzheimer’s special care unit or program shall include:</text> <level label="1"> <text>A statement of philosophy or mission;</text> </level> <level label="2"> <text>Staff training and staff job titles;</text> </level> <level label="3"> <text>Admission procedures including screening criteria;</text> </level> <level label="4"> <text>Assessment and care planning protocol;</text> </level> <level label="5"> <text>Staffing patterns;</text> </level> <level label="6"> <text>A description of the physical environment and any unique design features appropriate to support the functioning of cognitively impaired individuals;</text> </level> <level label="7"> <text>A description of activities including frequency and type;</text> </level> <level label="8"> <text>Charges to residents for services provided by the Alzheimer’s special care unit or program;</text> </level> <level label="9"> <text>Discharge procedures;</text> </level> <level label="10"> <text>Any services, training, or other procedures that are over and above those that are provided in the existing assisted living program; and</text> </level> <level label="11"> <text>Any other information that the Department may require.</text> </level> </level> <level label="f"> <text>The Department, in consultation with the Alzheimer’s Association, the Health Facilities Association of Maryland, and Lifespan, may adopt regulations that govern the submission of disclosure materials to the Department and to consumers.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-110" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>Except as provided in subsection (b) of this section, the following are not civilly liable for taking a blood sample from an individual without consent of the individual or for testing the blood sample, if the blood is taken at the request of a police officer or a sheriff or officer in a sheriff’s office for a criminal investigation:</text> <level label="1"> <text>A licensed hospital.</text> </level> <level label="2"> <text>A physician.</text> </level> <level label="3"> <text>Any of the following who take the blood in the course of duties at a licensed hospital:</text> <level label="i"> <text>A resident.</text> </level> <level label="ii"> <text>An intern.</text> </level> <level label="iii"> <text>A registered nurse.</text> </level> <level label="iv"> <text>A health career technician.</text> </level> </level> </level> <level label="b"> <text>A person who negligently takes blood samples in a manner otherwise than according to accepted medical practices or who negligently performs tests is subject to civil liability for injury resulting from the person’s negligence.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-111" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>This section applies to the use of sperm or eggs from a donor known to the individual who intends to become a parent through the use of the sperm or eggs.</text> </level> <level label="2"> <text>This section does not apply to the use of sperm or eggs donated to a tissue bank or fertility clinic by a donor who intended to remain anonymous either indefinitely or until a child that results from the use of the sperm or eggs becomes an adult.</text> </level> </level> <level label="b"> <text>A person may not use sperm or eggs from a known donor after the donor’s death for the purpose of assisted reproduction, if:</text> <level label="1"> <text>The person knows that the known donor died and did not give consent for the posthumous use of the sperm or eggs; or</text> </level> <level label="2"> <text>The donor or the individual who intends to become a parent through the use of the sperm or eggs receives any remuneration for the donation or use of the sperm or eggs.</text> </level> </level> <level label="c"> <text>A donor’s consent to the posthumous use of the donor’s sperm or eggs given on or after October 1, 2012 is not valid unless it is:</text> <level label="1"> <text>In writing; and</text> </level> <level label="2"> <text>Signed by the donor or by some other person for the donor, in the presence of the donor, and at the express direction of the donor.</text> </level> </level> <level label="d"> <text>A person who violates this section is guilty of a misdemeanor and on conviction is subject to:</text> <level label="1"> <text>For a first offense, a fine not exceeding $1,000; and</text> </level> <level label="2"> <text>For a second or subsequent offense, a fine not exceeding $5,000.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-113" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>Before a physician treats any patient for any form of breast cancer, the physician shall educate the patient of alternative methods of treatment that may be medically practicable.</text> </level> <level label="b"> <text>The Maryland Department of Health shall:</text> <level label="1"> <text>Provide a standardized written summary in layman’s language that:</text> <level label="i"> <text>Lists all effective methods of treatment for breast cancer that may be medically practicable including surgical, radiological, chemotherapeutic, and combinations of those treatments; and</text> </level> <level label="ii"> <text>Describes the advantages, disadvantages, risks, and procedures associated with each method of treatment listed;</text> </level> </level> <level label="2"> <text>Update the standardized written summary annually; and</text> </level> <level label="3"> <text>Distribute the standardized written summary to each hospital, clinic, and physician’s office and other facility that performs treatments of breast cancer.</text> </level> </level> <level label="c"> <text>A physician satisfies the requirements of subsection (a) of this section if:</text> <level label="1"> <text>The physician provides a breast cancer patient with the standardized written summary described in subsection (b) of this section in language that the patient understands;</text> </level> <level label="2"> <text>The patient receives the standardized written summary within 5 days of the start of the treatment for breast cancer; and</text> </level> <level label="3"> <text>The patient signs a statement provided by the Maryland Department of Health acknowledging the receipt of the standardized written summary.</text> </level> </level> <level label="d"> <text>This section does not apply if the attending physician certifies that:</text> <level label="1"> <text>Treatment for breast cancer occurred within 5 days of the physician informing the patient of the diagnosis; and</text> </level> <level label="2"> <text>Treatment within this period of time was necessary to save the life of the patient.</text> </level> </level> <level label="e"> <text>A physician who violates any provision of subsection (a) of this section is subject to the provisions of § 14–404(a)(27) of the Health Occupations Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-114" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>Before a physician operates on a patient to insert a breast implant, the physician shall inform the patient of the advantages, disadvantages, and risks associated with a breast implantation.</text> </level> <level label="b"> <text>The Department shall:</text> <level label="1"> <text>Provide a standardized written summary in layman’s language that:</text> <level label="i"> <text>Contains all the information on breast implantation generally contained in the information sheet for the breast implant; and</text> </level> <level label="ii"> <text>Discloses side effects, warnings, and cautions for a breast implantation operation;</text> </level> </level> <level label="2"> <text>Update as necessary the standardized written summary; and</text> </level> <level label="3"> <text>Distribute the standardized written summary to each hospital, clinic, and physician’s office and any other facility that performs breast implantations.</text> </level> </level> <level label="c"> <text>A physician satisfies the requirements of subsection (a) of this section if:</text> <level label="1"> <text>The physician provides the breast implantation patient with the standardized written summary described in subsection (b) of this section;</text> </level> <level label="2"> <text>The patient receives the standardized written summary 5 days before the breast implantation operation; and</text> </level> <level label="3"> <text>The patient signs a statement provided by the Department acknowledging the receipt of the standardized written summary.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-115" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Center” means any facility that produces, develops, or interprets:</text> <level label="1"> <text>Screening mammograms; or</text> </level> <level label="2"> <text>Diagnostic mammograms.</text> </level> </level> <level label="ii"> <text>“Center” includes a hospital, outpatient department, medical laboratory, clinic, radiology practice, office of a health care provider, or other testing facility conducting mammography testing.</text> </level> <level label="iii"> <text>“Center” does not include a facility of the federal Department of Veterans Affairs.</text> </level> </level> <level label="3"> <text>“Dense breast tissue” means heterogeneously dense or extremely dense tissue as defined in nationally recognized guidelines or systems for breast imaging reporting of mammography screening, including the breast imaging reporting and data system of the American College of Radiology.</text> </level> <level label="4"> <text>“Mammogram” means a radiographic image produced through mammography.</text> </level> <level label="5"> <text>“Mammography testing” means the imaging of the breast with ionizing radiation.</text> </level> </level> <level label="b"> <text>On or after July 1, 1992, a person may not perform mammography testing unless:</text> <level label="1"> <text>The individual performing mammography testing is qualified under Title 14 of the Health Occupations Article; and</text> </level> <level label="2"> <text>The center where the mammography testing is performed:</text> <level label="i"> <text>Is accredited or has applied for accreditation under the American College of Radiology Screening Mammography Accreditation Program; and</text> </level> <level label="ii"> <text>Has obtained a certificate of approval from the federal Food and Drug Administration as specified in the federal Mammography Quality Standards Act of 1992.</text> </level> </level> </level> <level label="c"> <level label="1"> <level label="i"> <text>This subsection does not apply if the federal Mammography Quality Standards Act of 1992, or regulations adopted under the Act, requires a notice regarding breast density to be included in the screening results letter that is sent to a patient.</text> </level> <level label="ii"> <text>This subsection may not be construed to:</text> <level label="1"> <text>Require a notice regarding breast density to be sent to a patient that is inconsistent with the provisions of the federal Mammography Quality Standards Act of 1992, or regulations adopted under the Act; or</text> </level> <level label="2"> <text>Create a standard of care, obligation, or duty that provides a basis for a cause of action.</text> </level> </level> </level> <level label="2"> <text>Subject to paragraph (3) of this subsection, a center where mammography testing is performed shall include in a screening results letter that is sent to a patient, as required by federal law, the following notice: “This notice contains the results of your recent mammogram, including information about breast density.</text> <text>If your mammogram shows that your breast tissue is dense, you should know that dense breast tissue is a common finding and is not abnormal, with about half of women having dense or highly dense breasts. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of cancer.</text> <text>This information about the result of your mammogram is given to you to raise your awareness and to inform your conversations with your physician. Together, you can decide whether additional screening options are right for you based on your mammogram results, individual risk factors, or physical examination. A report of your results was sent to your physician.”.</text> </level> <level label="3"> <text>If the Department finds significant differences between the content of the notice that is required to be provided under paragraph (2) of this subsection and current medical evidence on breast density, the Department may adopt regulations that change the content of the notice.</text> </level> </level> <level label="d"> <level label="1"> <text>This subsection may not be construed to create a standard of care, obligation, or duty that provides a basis for a cause of action.</text> </level> <level label="2"> <text>Subject to paragraph (3) of this subsection, a center where mammography testing is performed shall include in a screening results letter that is sent to a patient, as required by federal law, the following notice:</text> <text>“This notice contains the results of your recent mammogram, including information about breast arterial calcification.</text> <text>If your mammogram shows breast arterial calcification, you should know that breast arterial calcification is a common finding. However, breast arterial calcification may be an indicator of an increased risk of cardiovascular disease. If you have breast arterial calcifications, please discuss this with your physician to assess your cardiovascular risks and determine if additional testing may be appropriate for you.</text> <text>This information about the result of your mammogram is given to you to raise your awareness and to inform your conversations with your physician. Together you can decide whether additional screening options are right for you based on your mammogram results, individual risk factors, or physical examination. A report of your results was sent to your physician.”.</text> </level> <level label="3"> <text>If the Department finds significant differences between the content of the notice that is required to be provided under paragraph (2) of this subsection and current medical evidence on breast arterial calcification, the Department may adopt regulations that change the content of the notice.</text> </level> </level> <level label="e"> <text>Notwithstanding any other provision of this title, the penalty for a violation of subsection (b) of this section may not exceed $1,000.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-116" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Biennial” means once every other year.</text> </level> <level label="3"> <text>“Clinical breast examination” means a breast examination performed by a health care professional for the purpose of detecting breast cancer.</text> </level> <level label="4"> <text>“Eligible individual” means an individual who is eligible to receive benefits under the Program in accordance with subsection (e) of this section.</text> </level> <level label="5"> <text>“Mammogram” means an X-ray examination of the breast using dedicated equipment, including X-ray tube, filter, compression device, screens, films, and cassettes, specifically for mammography that delivers an average radiation exposure of less than one rad mid-breast with two views for each breast.</text> </level> <level label="6"> <text>“Mastectomy” means the surgical removal of all or part of a breast as a result of breast cancer.</text> </level> <level label="7"> <text>“Program” means the Breast Cancer Program.</text> </level> </level> <level label="b"> <level label="1"> <text>The Department shall establish a Breast Cancer Program.</text> </level> <level label="2"> <text>The purpose of the Program is to:</text> <level label="i"> <text>Provide at least biennial screening mammograms and clinical breast examinations to low-income, underinsured and low-income, uninsured women aged 40 years to 49 years;</text> </level> <level label="ii"> <text>Provide annual screening mammograms and clinical breast examinations to low-income, underinsured and low-income, uninsured women aged 50 years and older; and</text> </level> <level label="iii"> <text>Provide diagnosis and treatment for individuals who are identified by this Program as being in need.</text> </level> </level> </level> <level label="c"> <text>Treatment provided to a Program participant who has undergone a mastectomy shall include:</text> <level label="1"> <text>Reconstruction of the breast on which the mastectomy has been performed;</text> </level> <level label="2"> <text>Surgery and reconstruction of the other breast to produce a symmetrical appearance;</text> </level> <level label="3"> <text>Prostheses; and</text> </level> <level label="4"> <text>Any physical complications related to the mastectomy.</text> </level> </level> <level label="d"> <text>The Department shall administer the Program through the local health departments using a grant program under which a local health department makes arrangements with health care facilities to provide screening mammograms and clinical breast examinations to eligible individuals.</text> </level> <level label="e"> <text>An individual is eligible for the Program if the individual:</text> <level label="1"> <text>Has a family income that does not exceed 250% of the federal poverty level; and</text> </level> <level label="2"> <text>Does not have access to health insurance coverage that covers screening mammograms and clinical breast examinations for women aged 40 years and older.</text> </level> </level> <level label="f"> <text>For each fiscal year, the Governor shall include an appropriation of general funds to the Program in an amount not less than the amount appropriated for breast cancer screening, diagnosis, and treatment in the State budget for fiscal year 1999, subject to the availability of State funds.</text> </level> <level label="g"> <text>The Department shall:</text> <level label="1"> <text>Adopt regulations necessary to implement the Program; and</text> </level> <level label="2"> <text>Work with all interested parties to assure that breast cancer screening services are available to women at least 40 years old.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-117" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Cancer research” includes research to develop and advance the understanding of cancer and the techniques and modalities effective in the prevention, cure, screening, and treatment of cancer.</text> </level> <level label="3"> <text>“Fund” means the Maryland Cancer Fund established under this section.</text> </level> <level label="4"> <text>“Income tax checkoff system” means the checkoff system established under § 2–112 of the Tax – General Article.</text> </level> </level> <level label="b"> <level label="1"> <text>There is a Maryland Cancer Fund.</text> </level> <level label="2"> <text>The net proceeds from contributions under the income tax checkoff system and any other donations to the Fund shall be credited to the Fund.</text> </level> <level label="3"> <text>The Secretary shall administer the Fund.</text> </level> <level label="4"> <text>The Fund shall be used only for cancer research, prevention, and treatment as provided in subsection (c) of this section.</text> </level> <level label="5"> <text>The Fund shall be maintained for the purposes stated in this section and unspent portions of the Fund shall remain in the Fund and may not revert to the General Fund of the State.</text> </level> <level label="6"> <text>Money expended from the Fund for cancer research, prevention, and treatment is supplemental and is not intended to take the place of funding that would otherwise be appropriated to the Department for cancer research, prevention, and treatment.</text> </level> <level label="7"> <text>All expenditures from the Fund shall be made only in accordance with an appropriation approved by the General Assembly in the annual State budget or through an approved budget amendment under §§ 7–209 and 7–210 of the State Finance and Procurement Article.</text> </level> </level> <level label="c"> <level label="1"> <text>The Secretary may distribute not more than 5% of the net proceeds of the Fund to a promotional account to be used to promote further donations to the Fund.</text> </level> <level label="2"> <text>After making the distribution allowed under paragraph (1) of this subsection, the Secretary shall use the remainder of the net proceeds of the Fund only to provide grants to eligible physicians, hospitals, laboratories, educational institutions, and other organizations and persons to conduct cancer research, prevention, and treatment.</text> </level> </level> <level label="d"> <level label="1"> <text>On or before August 31 of each year, the Secretary shall submit a report to the General Assembly, pursuant to § 2–1257 of the State Government Article, on the administration of the Maryland Cancer Fund.</text> </level> <level label="2"> <text>The report required under this subsection shall include:</text> <level label="i"> <text>The gross amount of donations to the Fund through the income tax checkoff system and otherwise;</text> </level> <level label="ii"> <text>The costs of administration by the Comptroller of the income tax checkoff system;</text> </level> <level label="iii"> <text>A description of promotional efforts undertaken with money from the Fund; and</text> </level> <level label="iv"> <text>A detailed accounting of the use of the Fund.</text> </level> </level> </level> <level label="e"> <text>The Secretary shall adopt regulations to implement a Maryland Cancer Grant Program under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-120" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Fund” means the Maryland Pediatric Cancer Fund established under this section.</text> </level> <level label="3"> <text>“Pediatric cancer research” includes research to develop and advance the understanding of pediatric cancer and the techniques and modalities effective in the prevention, cure, screening, and treatment of pediatric cancer.</text> </level> </level> <level label="b"> <level label="1"> <text>There is a Maryland Pediatric Cancer Fund.</text> </level> <level label="2"> <text>The Fund consists of:</text> <level label="i"> <text>Money appropriated in the State budget to the Fund; and</text> </level> <level label="ii"> <text>Any donations or other money from any other source accepted for the benefit of the Fund.</text> </level> </level> <level label="3"> <text>The Secretary shall administer the Fund.</text> </level> <level label="4"> <text>The Fund shall be used only for pediatric cancer research and administrative expenses as provided in subsection (c) of this section.</text> </level> <level label="5"> <text>The Fund shall be maintained for the purposes stated in this section and unspent portions of the Fund shall remain in the Fund and may not revert to the General Fund of the State.</text> </level> <level label="6"> <text>Money expended from the Fund for pediatric cancer research is supplemental and is not intended to take the place of funding that would otherwise be appropriated to the Department for pediatric cancer research.</text> </level> <level label="7"> <text>All expenditures from the Fund shall be made only in accordance with an appropriation approved by the General Assembly in the annual State budget or through an approved budget amendment under §§ 7–209 and 7–210 of the State Finance and Procurement Article.</text> </level> <level label="8"> <level label="i"> <text>For fiscal year 2023, the Governor shall include in the annual budget bill an appropriation of $5,000,000 to the Fund.</text> </level> <level label="ii"> <text>If $5,000,000 is not included in the annual budget bill for fiscal year 2023, then the Governor shall include in the annual budget bill for fiscal year 2024 an appropriation of $5,000,000 to the Fund.</text> </level> </level> </level> <level label="c"> <level label="1"> <level label="i"> <text>Each year, the Secretary may:</text> <level label="1"> <text>Distribute funds from the Fund to a promotional account to be allocated to a State–based childhood cancer organization to be used to promote further donations to the Fund and to educate the State scientific community about the opportunities for childhood cancer research through the Fund; and</text> </level> <level label="2"> <text>Use funds from the Fund to administer the Fund, including for staff and administrative costs associated with the Commission established under § 20–121 of this title.</text> </level> </level> <level label="ii"> <text>The amounts distributed and used under subparagraph (i) of this paragraph may not exceed a total of 5% of the Fund.</text> </level> </level> <level label="2"> <level label="i"> <text>After making the distribution allowed under paragraph (1) of this subsection, the Secretary shall use the remainder of the Fund only to provide grants to nonprofit hospitals, educational institutions, and other nonprofit organizations to conduct pediatric cancer research.</text> </level> <level label="ii"> <text>Money received from the grant program under this section may not be used to pay for institutional overhead expenses, organizational expenses, or charges that are not directly related to pediatric cancer research or expenses arising from community–based support services.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>On or before August 31 each year, the Secretary shall submit a report to the General Assembly, in accordance with § 2–1257 of the State Government Article, on the administration of the Fund.</text> </level> <level label="2"> <text>The report required under this subsection shall include:</text> <level label="i"> <text>A description of promotional efforts undertaken with money from the Fund; and</text> </level> <level label="ii"> <text>A detailed accounting of the use of the Fund.</text> </level> </level> </level> <level label="e"> <text>The Secretary shall adopt regulations to implement a pediatric cancer grant program under this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-121" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="1" subtitle_name="Consent Provisions"> <level label="a"> <text>In this section, “Commission” means the Pediatric Cancer Research Commission.</text> </level> <level label="b"> <text>There is a Pediatric Cancer Research Commission.</text> </level> <level label="c"> <text>The purpose of the Commission is to oversee the award of competitive grants from the Pediatric Cancer Fund, established under § 20–120 of this subtitle, to public and private entities in the State.</text> </level> <level label="d"> <text>The Commission consists of:</text> <level label="1"> <text>The Secretary of Health, or the Secretary’s designee; and</text> </level> <level label="2"> <text>The following members appointed by the Governor:</text> <level label="i"> <text>Two individuals who are adult survivors of pediatric cancer or caregivers of pediatric cancer patients, who may be identified in consultation with the American Childhood Cancer Organization;</text> </level> <level label="ii"> <text>One representative of the American Childhood Cancer Organization;</text> </level> <level label="iii"> <text>Four scientists with expertise in pediatric cancer research;</text> </level> <level label="iv"> <text>Two advanced practice registered nurses who have experience in pediatric cancer care; and</text> </level> <level label="v"> <text>Three physicians with expertise in treating pediatric cancer patients.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>The term of an appointed member is 3 years.</text> </level> <level label="2"> <text>The terms of the appointed members of the Commission are staggered as required by the terms provided for members of the Commission on October 1, 2024.</text> </level> <level label="3"> <text>If a vacancy occurs during the term of an appointed member, the Governor shall appoint a successor who shall serve until the term expires.</text> </level> <level label="4"> <text>At the end of a term, a member may continue to serve only until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="6"> <text>A member may not serve more than two consecutive full terms.</text> </level> </level> <level label="f"> <text>Each member of the Commission shall disclose to the State Ethics Commission whether the member is employed by or has a financial interest in an entity that may apply to conduct State–funded pediatric cancer research.</text> </level> <level label="g"> <level label="1"> <text>The Governor may remove a member for neglect of duty, incompetence, misconduct, malfeasance, misfeasance, nonfeasance, or any other sufficient cause.</text> </level> <level label="2"> <text>The Governor may not remove a member for political party preference.</text> </level> </level> <level label="h"> <level label="1"> <text>A majority of the full authorized membership of the Commission is a quorum.</text> </level> <level label="2"> <text>The decision of the Commission shall be by a majority of the quorum present and voting.</text> </level> </level> <level label="i"> <text>The Commission shall meet at least twice a year, at the times and places that it determines.</text> </level> <level label="j"> <text>A member of the Commission:</text> <level label="1"> <text>May not receive compensation as a member of the Commission; but</text> </level> <level label="2"> <text>Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> <level label="k"> <text>The Commission annually shall elect a chair and vice chair from among its members.</text> </level> <level label="l"> <text>The Commission shall:</text> <level label="1"> <text>Develop criteria, standards, and requirements for the review of applications for pediatric cancer research grants from the Pediatric Cancer Fund;</text> </level> <level label="2"> <text>Establish procedures and guidelines to be used in the review, evaluation, ranking, and rating of the research grant proposals;</text> </level> <level label="3"> <text>Develop criteria and a process for reviewing grant applications to ensure that each application is complete and satisfies the criteria, standards, and requirements developed by the Commission under item (1) of this subsection;</text> </level> <level label="4"> <text>Develop disclosure and recusal guidelines to be followed by members of the Commission when considering grant applications;</text> </level> <level label="5"> <text>Establish standards for the oversight of awards; and</text> </level> <level label="6"> <text>Conduct progress reviews of grant recipients.</text> </level> </level> <level label="m"> <text>The Commission may consult with experts in performing its duties.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-207" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="2" subtitle_name="Abortions; Artificial Insemination; Sterilizations"> <text>In Part II of this subtitle, “qualified provider” means an individual:</text> <level label="1"> <text>Who is licensed, certified, or otherwise authorized by law to practice in the State; and</text> </level> <level label="2"> <text>For whom the performance of an abortion is within the scope of the individual’s license or certification.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-208" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="2" subtitle_name="Abortions; Artificial Insemination; Sterilizations"> <text>An abortion must be performed by a qualified provider.</text> </section> <section article="ghg" article_name="Health - General" number="20-209" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="2" subtitle_name="Abortions; Artificial Insemination; Sterilizations"> <level label="a"> <text>In this section, “viable” means that stage when, in the best clinical judgment of the qualified provider based on the particular facts of the case before the qualified provider, there is a reasonable likelihood of the fetus’s sustained survival outside the womb.</text> </level> <level label="b"> <text>Except as otherwise provided in this subtitle, the State may not interfere with the decision of a woman to terminate a pregnancy:</text> <level label="1"> <text>Before the fetus is viable; or</text> </level> <level label="2"> <text>At any time during the woman’s pregnancy, if:</text> <level label="i"> <text>The termination procedure is necessary to protect the life or health of the woman; or</text> </level> <level label="ii"> <text>The fetus is affected by genetic defect or serious deformity or abnormality.</text> </level> </level> </level> <level label="c"> <text>The Department may adopt regulations that:</text> <level label="1"> <text>Are both necessary and the least intrusive method to protect the life or health of the woman; and</text> </level> <level label="2"> <text>Are not inconsistent with established clinical practice.</text> </level> </level> <level label="d"> <text>The qualified provider is not liable for civil damages or subject to a criminal penalty for a decision to perform an abortion under this section made in good faith and in the qualified provider’s best clinical judgment in accordance with accepted standards of clinical practice.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-214" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="2" subtitle_name="Abortions; Artificial Insemination; Sterilizations"> <level label="a"> <level label="1"> <text>A person may not be required to perform or participate in, or refer to any source for, any medical procedure that results in artificial insemination, sterilization, or termination of pregnancy.</text> </level> <level label="2"> <text>The refusal of a person to perform or participate in, or refer to a source for, these medical procedures may not be a basis for:</text> <level label="i"> <text>Civil liability to another person; or</text> </level> <level label="ii"> <text>Disciplinary or other recriminatory action against the person.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Except as provided in § 19–342.1 of this article, a licensed hospital, hospital director, or hospital governing board may not be required:</text> <level label="i"> <text>To allow, within the hospital, the performance of any medical procedure that results in artificial insemination, sterilization, or termination of pregnancy; or</text> </level> <level label="ii"> <text>To refer to any source for these medical procedures.</text> </level> </level> <level label="2"> <text>The refusal to allow or to refer to a source for these procedures may not be grounds for:</text> <level label="i"> <text>Civil liability to another person; or</text> </level> <level label="ii"> <text>Disciplinary or other recriminatory action against the person by this State or any person.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>The refusal of an individual to submit to or give consent for an abortion or sterilization may not be grounds for loss of any privileges or immunities to which the individual otherwise would be entitled.</text> </level> <level label="2"> <text>Submitting to or granting consent for an abortion or sterilization may not be a condition precedent to the receipt of any public benefits.</text> </level> </level> <level label="d"> <text>Notwithstanding any other provision of this section, a health care provider, a licensed hospital, a hospital director, or a hospital governing board is not immune from civil damages, if available at law, or from disciplinary or other recriminatory action, if the failure to refer a patient to a source for any medical procedure that results in sterilization or termination of pregnancy would reasonably be determined as:</text> <level label="1"> <text>The cause of death or serious physical injury or serious long-lasting injury to the patient; and</text> </level> <level label="2"> <text>Otherwise contrary to the standards of medical care.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-301" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>In this subtitle, “nuisance” means a condition that is dangerous to health or safety including:</text> <level label="1"> <text>An inadequately protected swimming pool;</text> </level> <level label="2"> <text>An unprotected open ditch;</text> </level> <level label="3"> <text>An unsanitary outhouse;</text> </level> <level label="4"> <text>A foul pigpen;</text> </level> <level label="5"> <text>An improperly functioning sewage system;</text> </level> <level label="6"> <text>An unkempt junkyard;</text> </level> <level label="7"> <text>An unkempt scrap metal processing facility;</text> </level> <level label="8"> <text>An excessive accumulation of trash or garbage;</text> </level> <level label="9"> <text>A dead animal;</text> </level> <level label="10"> <text>A contaminated water supply;</text> </level> <level label="11"> <text>An inadequately protected water supply;</text> </level> <level label="12"> <text>A rodent harborage;</text> </level> <level label="13"> <text>Poor housekeeping that could endanger the health of the owner, occupant, employee, or a neighbor; or</text> </level> <level label="14"> <text>Any condition that may endanger health that may be transmitted by means including:</text> <level label="i"> <text>Running streams;</text> </level> <level label="ii"> <text>Surface drainage;</text> </level> <level label="iii"> <text>Air currents;</text> </level> <level label="iv"> <text>Birds;</text> </level> <level label="v"> <text>Domestic animals; or</text> </level> <level label="vi"> <text>Human beings.</text> </level> </level> </level> <level label="b"> <text>“Nuisance” does not include:</text> <level label="1"> <text>Any condition resulting from a farm operation following generally accepted agricultural practices that are not creating a condition dangerous to health or safety; or</text> </level> <level label="2"> <text>Any condition resulting from a commercial fishing or seafood operation following generally accepted industry standards and processes that are not creating a condition dangerous to health or safety.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-301.1" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>Notwithstanding the provisions of Title 10 of the Environment Article, the Secretary is responsible for the general care of the sanitary interests of the people of the State.</text> </section> <section article="ghg" article_name="Health - General" number="20-302" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>The Secretary or a local health officer may investigate a suspected nuisance and devise means for the control of the nuisance.</text> </section> <section article="ghg" article_name="Health - General" number="20-303" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>The Secretary may adopt rules and regulations to govern the character and location of:</text> <level label="1"> <text>Plumbing;</text> </level> <level label="2"> <text>Drainage;</text> </level> <level label="3"> <text>Water supply;</text> </level> <level label="4"> <text>Offensive trades; and</text> </level> <level label="5"> <text>Disposal of any waste material, including sewage or garbage.</text> </level> </level> <level label="b"> <text>The Secretary may adopt rules and regulations to govern the sanitary condition of:</text> <level label="1"> <text>Streets;</text> </level> <level label="2"> <text>Cesspools;</text> </level> <level label="3"> <text>Outhouses; and</text> </level> <level label="4"> <text>Any sanitary feature connected with any of these.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-304" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>The Secretary may enter on and inspect any private property to determine whether a nuisance exists.</text> </section> <section article="ghg" article_name="Health - General" number="20-305" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>The Secretary or a local health officer may bring an action to enjoin any person from committing any nuisance subject to this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="20-306" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>The health officer for each county:</text> <level label="1"> <text>May investigate any suspected nuisance; and</text> </level> <level label="2"> <text>Shall investigate and report on the sanitary conditions of schools, places of business, and places of employment in the county.</text> </level> </level> <level label="b"> <level label="1"> <text>If the health officer finds that a nuisance exists, the health officer shall serve a written notice to the person who is causing the nuisance, ordering the person to abate the nuisance within a time specified in the notice.</text> </level> <level label="2"> <text>The notice shall be served:</text> <level label="i"> <text>On the person who is causing the nuisance; or</text> </level> <level label="ii"> <text>If the person who is causing the nuisance cannot be found, on the owner or occupant of the property where the nuisance exists.</text> </level> </level> </level> <level label="c"> <text>Failure to comply with the requirements of a notice served under this section is a violation of this subtitle.</text> </level> <level label="d"> <text>If a question arises between health officers as to the jurisdiction or duties of a health officer in the abatement of a nuisance, the question shall be referred to the Secretary for resolution.</text> </level> <level label="e"> <level label="1"> <text>A health officer may file a complaint in the circuit court for the county where the nuisance exists if:</text> <level label="i"> <text>The person served with the notice under this section fails to comply with the requirements of the notice; or</text> </level> <level label="ii"> <text>Although the person served with a notice under this section complies with the requirements of the notice, the nuisance is likely to recur on the same property.</text> </level> </level> <level label="2"> <text>A complaint filed under this subsection may seek a court order requiring the individual served with a notice under subsection (b) of this section to:</text> <level label="i"> <text>Comply with the requirements of the health officer’s abatement notice;</text> </level> <level label="ii"> <text>Abate the nuisance within a specified time;</text> </level> <level label="iii"> <text>Prevent the nuisance from recurring; or</text> </level> <level label="iv"> <text>Pay a fine of not more than $1,000.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-307" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>The Secretary may investigate any suspected nuisance.</text> </level> <level label="b"> <level label="1"> <text>If the Secretary finds that a nuisance exists, the Secretary shall serve a written notice to the person who is causing the nuisance, ordering the person to abate the nuisance within a time specified in the notice.</text> </level> <level label="2"> <text>The notice shall be served:</text> <level label="i"> <text>On the person who is causing the nuisance; or</text> </level> <level label="ii"> <text>If the person who is causing the nuisance cannot be found, on the owner or occupant of the property where the nuisance exists.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>The Secretary may file a complaint in the circuit court for the county where the nuisance exists if:</text> <level label="i"> <text>The person served with the notice fails to comply with the requirements of the notice; or</text> </level> <level label="ii"> <text>Although the person served complies with the requirements of the notice, the nuisance is likely to recur on the same property.</text> </level> </level> <level label="2"> <text>A complaint filed under this subsection may seek a court order requiring the person served with the notice to:</text> <level label="i"> <text>Comply with the requirements of the Secretary’s abatement notice;</text> </level> <level label="ii"> <text>Abate the nuisance within a time specified in the order;</text> </level> <level label="iii"> <text>Prevent the nuisance from recurring; or</text> </level> <level label="iv"> <text>Pay a fine of not more than $1,000.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-308" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>If, after investigation, the Secretary or a local health officer finds that a nuisance exists that presents an immediate hazard to public health, the Secretary or local health officer may summarily abate the nuisance.</text> </level> <level label="b"> <text>Before summarily abating a nuisance under this section, the Secretary or a local health officer shall:</text> <level label="1"> <text>Serve an abatement order on the owner of the property where the nuisance exists or, if the owner cannot be found, on the occupant or tenant of the property; or</text> </level> <level label="2"> <text>If the property is unoccupied and the owner cannot be found, attach an abatement order to the property where the nuisance exists.</text> </level> </level> <level label="c"> <level label="1"> <text>The abatement order shall require and state:</text> <level label="i"> <text>A time period within which the owner, occupant, or tenant of the property where the nuisance exists shall abate the nuisance; and</text> </level> <level label="ii"> <text>The work and materials necessary to abate the nuisance.</text> </level> </level> <level label="2"> <text>The time period within which to abate the nuisance may not be less than 24 hours nor more than 5 days from the date and hour that the order is served.</text> </level> </level> <level label="d"> <level label="1"> <text>If the owner, occupant, or tenant served with an abatement order fails to abate or only partially abates the nuisance within the time specified in the order, the Secretary, local health officer, or the representative of the Secretary or local health officer shall:</text> <level label="i"> <text>Enter on the property; and</text> </level> <level label="ii"> <text>At the expense of the owner, occupant, or tenant of the property, do any work and use any materials necessary to abate the nuisance.</text> </level> </level> <level label="2"> <text>The Secretary or local health officer may not expend more than $5,000 to abate the nuisance.</text> </level> </level> <level label="e"> <text>If, within 60 days after the Secretary or local health officer has completed an abatement under this section, the owner, occupant, or tenant does not pay to the Secretary or local health officer the cost of the abatement, the Secretary or local health officer shall file suit against the owner, occupant, or tenant in the District Court for the county where the nuisance was abated.</text> </level> <level label="f"> <text>A person may not:</text> <level label="1"> <text>Interfere with the Secretary, local health officer, or the representative of the Secretary or local health officer summarily abating a nuisance under this section; or</text> </level> <level label="2"> <text>Refuse to allow the Secretary, local health officer, or the representative of the Secretary or local health officer to enter on any property for the purpose of summarily abating a nuisance under this section.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-309" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>A person who fails to comply with the requirements of a notice served under § 20-306 or § 20-307 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000.</text> </section> <section article="ghg" article_name="Health - General" number="20-310" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>A person who fails to exercise due diligence under a court order to abate a condition under § 20-306 or § 20-307 of this subtitle is guilty of a misdemeanor and on conviction is subject to:</text> <level label="1"> <text>A fine not exceeding $1,000; and</text> </level> <level label="2"> <text>The cost of prosecution.</text> </level> </level> <level label="b"> <text>A person who knowingly or willfully acts contrary to a court order to abate a condition under § 20-306 or § 20-307 of this subtitle is guilty of a misdemeanor and on conviction is subject to:</text> <level label="1"> <text>A fine not exceeding $1,000; and</text> </level> <level label="2"> <text>The cost of prosecution.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-311" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>In addition to any other penalty provided by law, a person is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 30 days or both, if the person:</text> <level label="1"> <text>Interferes with the Secretary, local health officer, or the representative of the Secretary or local health officer summarily abating a nuisance under § 20-308 of this subtitle; or</text> </level> <level label="2"> <text>Refuses to allow the Secretary, local health officer, or the representative of the Secretary or local health officer to enter on any property for the purpose of summarily abating a nuisance under § 20-308 of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-312" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <level label="a"> <text>The Secretary may adopt regulations to implement the provisions of this subtitle.</text> </level> <level label="b"> <text>A person who violates any rule or regulation that the Secretary adopts under this subtitle is guilty of a misdemeanor.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-313" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>In Cecil County or Allegany County, in addition to any other penalty imposed by this subtitle, a person who refuses or neglects to comply with a notice or order to abate a nuisance by the Secretary, or by the health officer for the county where the nuisance exists, is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $100 a day for each day the violation continues.</text> </section> <section article="ghg" article_name="Health - General" number="20-314" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="3" subtitle_name="Nuisance Control"> <text>Sections 20-310 through 20-313 of this subtitle may not be construed to abrogate any equitable or legal right or remedy otherwise available under the law to abate a nuisance.</text> </section> <section article="ghg" article_name="Health - General" number="20-401" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="4" subtitle_name="Identification of Newborn Infants"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Born” means the complete expulsion or extraction of a product of human conception from the mother, regardless of the period of gestation, if, after the expulsion or extraction, it breathes or shows any other evidence of life, such as heartbeat, pulsation of the umbilical cord, or definite movement of voluntary muscle, whether or not the umbilical cord is cut or the placenta is attached.</text> </level> <level label="c"> <text>“Cord blood sampling” means:</text> <level label="1"> <text>Taking a sample of a newborn infant’s blood from the infant’s umbilical cord; or</text> </level> <level label="2"> <text>The act of producing such a sample.</text> </level> </level> <level label="d"> <text>“Footprinting” means:</text> <level label="1"> <text>An ink or other type of impression of the skin patterns located on the sole of a foot; or</text> </level> <level label="2"> <text>The act of producing such an impression.</text> </level> </level> <level label="e"> <text>“Institution” means:</text> <level label="1"> <text>A hospital or related institution as defined in § 19-301 of this article;</text> </level> <level label="2"> <text>A freestanding birthing center as defined in § 19-3B-01(f) of this article; or</text> </level> <level label="3"> <text>Any other facility that delivers an infant from its mother.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-402" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="4" subtitle_name="Identification of Newborn Infants"> <level label="a"> <text>Except as provided in subsection (b) of this section, after an infant is born in an institution and before the infant leaves the delivery room of the institution, the institution shall perform at least one of the following infant identification procedures on all newborn infants:</text> <level label="1"> <text>Cord blood sampling;</text> </level> <level label="2"> <text>Footprinting; or</text> </level> <level label="3"> <text>Any other procedure the Secretary deems equivalent and appropriate.</text> </level> </level> <level label="b"> <level label="1"> <text>An institution shall maintain the record of a newborn infant’s identification for a period of time the Secretary establishes by regulation.</text> </level> <level label="2"> <text>In establishing the regulations required under paragraph (1) of this subsection, the Secretary shall:</text> <level label="i"> <text>Consider the varying nature of infant identification procedures that may be used by an institution under this subtitle; and</text> </level> <level label="ii"> <text>Adopt appropriate time periods for each type of infant identification procedure.</text> </level> </level> </level> <level label="c"> <text>All personnel of an institution responsible for performing newborn infant identification procedures under this subtitle shall be adequately trained in all infant identification procedures used by the institution.</text> </level> <level label="d"> <text>An institution acting in good faith in accordance with the provisions of this subtitle may not be liable in any cause of action related to the failure to produce an identifiable newborn infant identification.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-601" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <text>In this subtitle, “female genital mutilation” means a procedure performed for nonmedical reasons that involves partial or total removal of or other injury to the external female genitalia, including:</text> <level label="1"> <text>A clitoridectomy or the partial or total removal of the clitoris, prepuce, or clitoral hood;</text> </level> <level label="2"> <text>Excision or the partial or total removal, with or without excision of the clitoris, of the labia minora, with or without removal of the labia majora;</text> </level> <level label="3"> <text>Infibulation or the narrowing of the vaginal opening, with or without excision of the clitoris; or</text> </level> <level label="4"> <text>Any other procedure that is harmful to the external female genitalia, including pricking, piercing, incising, scraping, or cauterizing the genital area.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-602" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <level label="a"> <text>Except as provided in § 20–603 of this subtitle, a person may not:</text> <level label="1"> <text>Knowingly perform, attempt to perform, or conspire to perform female genital mutilation on an individual who is under the age of 18 years; or</text> </level> <level label="2"> <text>Transport an individual who is under the age of 18 years out of the State for the purpose of performing or facilitating the performance of female genital mutilation on the individual.</text> </level> </level> <level label="b"> <text>Except as provided in § 20–603 of this subtitle, a parent, guardian, or other individual is guilty of female genital mutilation if the individual:</text> <level label="1"> <text>Is legally responsible and charged with the care or custody of a child under the age of 18 years; and</text> </level> <level label="2"> <text>Knowingly consents to the performance of female genital mutilation on the child.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-603" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <level label="a"> <text>A surgical operation is not a violation of this subtitle if the operation is necessary to the health of the individual on whom it is performed and is performed by a person licensed in the State as a medical practitioner.</text> </level> <level label="b"> <text>In determining whether an operation is necessary to the health of the individual, no account may be taken of the belief on the part of any individual that the operation is required as a matter of custom or ritual.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-604" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <level label="a"> <text>A person who violates the provisions of this subtitle is guilty of a felony and on conviction is subject to imprisonment not exceeding 10 years or a fine not exceeding $10,000 or both.</text> </level> <level label="b"> <text>If an individual who holds a license issued under the Health Occupations Article is convicted of, enters a plea of guilty or of nolo contendere for, or receives probation before judgment for a violation of this subtitle, the applicable health occupations board shall revoke the license of the individual.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-605" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <level label="a"> <text>A victim of female genital mutilation performed in violation of this subtitle may file an action in the circuit court in the county in which the violation occurred or the victim resides.</text> </level> <level label="b"> <text>If the court finds that a person violated this subtitle, the court may award the plaintiff:</text> <level label="1"> <text>Actual damages;</text> </level> <level label="2"> <text>Compensatory damages;</text> </level> <level label="3"> <text>Punitive damages;</text> </level> <level label="4"> <text>Reasonable attorney’s fees, court costs, and litigation expenses, including expert witness fees and expenses; and</text> </level> <level label="5"> <text>Any other appropriate relief.</text> </level> </level> <level label="c"> <text>An action brought under subsection (a) of this section shall be filed the later of:</text> <level label="1"> <text>Not more than 10 years after the date on which the violation occurred; or</text> </level> <level label="2"> <text>The date on which the victim of the violation reaches 28 years of age.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-606" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <level label="a"> <text>On or before December 1 each year, beginning in 2027, the Department, in consultation with the Social Services Administration, State and local law enforcement agencies, and other appropriate government agencies and public and private organizations, shall submit a report to the General Assembly, in accordance with § 2–1257 of the State Government Article, containing de–identified and disaggregated data on the number of:</text> <level label="1"> <text>Reports of female genital mutilation submitted in accordance with § 5–704 of the Family Law Article;</text> </level> <level label="2"> <text>Individuals prosecuted for a violation of this subtitle;</text> </level> <level label="3"> <text>Individuals convicted of a violation of this subtitle;</text> </level> <level label="4"> <text>Civil actions filed in accordance with this subtitle; and</text> </level> <level label="5"> <text>Civil actions under this subtitle in which a judgment was entered, whether by settlement or adjudication.</text> </level> </level> <level label="b"> <text>The Department shall make the report required under subsection (a) of this section available to the public.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-607" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="6" subtitle_name="Female Genital Mutilation"> <text>The Department, in collaboration with community–based organizations, shall:</text> <level label="1"> <text>Develop and publish culturally and linguistically appropriate educational materials on female genital mutilation, including:</text> <level label="i"> <text>The signs that an individual has been subjected to female genital mutilation;</text> </level> <level label="ii"> <text>The physical and mental health risks caused by female genital mutilation; and</text> </level> <level label="iii"> <text>The criminal penalties for a violation of this subtitle; and</text> </level> </level> <level label="2"> <text>Distribute the educational materials described under item (1) of this section to:</text> <level label="i"> <text>Health care providers;</text> </level> <level label="ii"> <text>Law enforcement agencies;</text> </level> <level label="iii"> <text>Schools;</text> </level> <level label="iv"> <text>The public; and</text> </level> <level label="v"> <text>Any other professional or community–based organizations that may work or interact with individuals who are at risk of female genital mutilation.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-701" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="7" subtitle_name="Injury Reports"> <level label="a"> <text>This section applies only in:</text> <level label="1"> <text>Allegany County;</text> </level> <level label="2"> <text>Anne Arundel County;</text> </level> <level label="3"> <text>Charles County;</text> </level> <level label="4"> <text>Harford County;</text> </level> <level label="5"> <text>Kent County;</text> </level> <level label="6"> <text>Montgomery County;</text> </level> <level label="7"> <text>Prince George’s County;</text> </level> <level label="8"> <text>Somerset County;</text> </level> <level label="9"> <text>Talbot County; and</text> </level> <level label="10"> <text>Wicomico County.</text> </level> </level> <level label="b"> <text>A physician, pharmacist, dentist, or nurse who treats an individual for an injury that was caused or shows evidence of having been caused by an automobile accident or a lethal weapon, or the individual in charge of a hospital that treats the injured individual, shall notify the county sheriff, the county police, or the Department of State Police of the injury as soon as practicable.</text> </level> <level label="c"> <text>A report of injury shall include:</text> <level label="1"> <text>The injured individual’s name and address, if known;</text> </level> <level label="2"> <text>A description of the injury; and</text> </level> <level label="3"> <text>Any other facts concerning the matter that might assist in detecting crime.</text> </level> </level> <level label="d"> <text>An individual who fails to make a report required by this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $25.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-702" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="7" subtitle_name="Injury Reports"> <level label="a"> <text>In this section, “moving vessel” means a vessel as defined in § 8-701 of the Natural Resources Article that:</text> <level label="1"> <text>Is in the water; and</text> </level> <level label="2"> <text>Is not anchored or tied to a fixed object.</text> </level> </level> <level label="b"> <level label="1"> <text>A physician, pharmacist, dentist, or nurse who treats an individual for an injury that was caused or shows evidence of having been caused by an accident involving a moving vessel, or the individual in charge of a hospital that treats the injured individual, shall notify the county sheriff, the county police, the Department of State Police, or the Natural Resources Police of the injury as soon as practicable.</text> </level> <level label="2"> <text>A police department notified of an accident involving a moving vessel promptly shall advise the Department of Natural Resources.</text> </level> </level> <level label="c"> <text>A report of injury shall include:</text> <level label="1"> <text>The injured individual’s name and address, if known;</text> </level> <level label="2"> <text>A description of the injury; and</text> </level> <level label="3"> <text>Any other facts concerning the matter that might assist in detecting crime.</text> </level> </level> <level label="d"> <text>An individual who fails to make a report under subsection (b)(1) of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $25.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-703" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="7" subtitle_name="Injury Reports"> <level label="a"> <text>A physician, pharmacist, dentist, or nurse who treats an individual for an injury that was caused or shows evidence of having been caused by a gunshot of any type, or the individual in charge of a hospital that treats the injured individual, shall notify the county sheriff, the county police, or the Department of State Police of the injury as soon as practicable.</text> </level> <level label="b"> <text>A report of injury shall include:</text> <level label="1"> <text>The injured individual’s name and address, if known;</text> </level> <level label="2"> <text>A description of the injury; and</text> </level> <level label="3"> <text>Any other facts concerning the matter that might assist in detecting crime.</text> </level> </level> <level label="c"> <text>A person who fails to make a report required by this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $25.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-801" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="8" subtitle_name="Breast-Feeding"> <level label="a"> <text>A mother may breast-feed her child in any public or private location in which the mother and child are authorized to be.</text> </level> <level label="b"> <text>A person may not restrict or limit the right of a mother to breast-feed her child.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-901" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="9" subtitle_name="Health Care Services Disparities Prevention"> <text>In adopting this subtitle, the General Assembly intends to encourage courses or seminars that address the identification and elimination of health care services disparities of minority populations as part of:</text> <level label="1"> <text>Curriculum courses or seminars offered or required by institutions of higher education;</text> </level> <level label="2"> <text>Continuing education requirements for health care providers; and</text> </level> <level label="3"> <text>Continuing education programs offered by hospitals for hospital staff and health care practitioners.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-902" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="9" subtitle_name="Health Care Services Disparities Prevention"> <level label="a"> <text>An institution of higher education in the State that includes in the curriculum courses necessary for the licensing of health care professionals in the State may include in the curriculum courses or offer special seminars that address the identification and elimination of health care services disparities of minority populations as reported in the findings of:</text> <level label="1"> <text>The Institute of Medicine’s report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care”; and</text> </level> <level label="2"> <text>The Surgeon General’s “Healthy People 2020” report.</text> </level> </level> <level label="b"> <text>The courses or special seminars described under subsection (a) of this section shall address, with cultural competence, sensitivity, and health literacy the issue of health care services disparities of minority populations identified by:</text> <level label="1"> <text>Race;</text> </level> <level label="2"> <text>Ethnicity;</text> </level> <level label="3"> <text>Poverty; and</text> </level> <level label="4"> <text>Gender.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-903" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="9" subtitle_name="Health Care Services Disparities Prevention"> <text>A hospital with a continuing education program may offer and require the hospital’s medical staff and health care practitioners to take a continuing medical education or continuing education unit course that addresses health care services disparities of minority populations.</text> </section> <section article="ghg" article_name="Health - General" number="20-1001" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Director” means the Director of the Office of Minority Health and Health Disparities.</text> </level> <level label="c"> <text>“Minority person” includes African Americans, Hispanics, Asian and Pacific Islanders, and American Indians statewide.</text> </level> <level label="d"> <text>“Office” means the Maryland Office of Minority Health and Health Disparities established under § 20-1002 of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1002" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <text>There is an Office of Minority Health and Health Disparities in the Department.</text> </section> <section article="ghg" article_name="Health - General" number="20-1003" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <text>The Director shall report to the Secretary.</text> </section> <section article="ghg" article_name="Health - General" number="20-1004" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <text>The Office shall:</text> <level label="1"> <text>Be an advocate for the improvement of minority health care by working with the Department on its own, or in partnership with other public and private entities to establish appropriate forums, programs, or initiatives designed to educate the public regarding minority health and health disparities issues, with an emphasis on preventive health and healthy lifestyles;</text> </level> <level label="2"> <text>Assist the Secretary in identifying, coordinating, and establishing priorities for programs, services, and resources that the State should provide for minority health and health disparities issues;</text> </level> <level label="3"> <text>Collect, classify, and analyze relevant research information and data collected or compiled by:</text> <level label="i"> <text>The Department;</text> </level> <level label="ii"> <text>The Department in collaboration with others; and</text> </level> <level label="iii"> <text>Other public and private entities;</text> </level> </level> <level label="4"> <text>Research innovative methods and obtain resources to improve existing data systems to ensure that the health information that is collected includes specific race and ethnicity identifiers;</text> </level> <level label="5"> <text>Serve as a clearinghouse and resource library for information about minority health and health disparities data, strategies, services, and programs that address minority health and health disparities issues;</text> </level> <level label="6"> <text>Develop a strategic plan to improve public services and programs targeting minorities;</text> </level> <level label="7"> <text>Obtain funding and, contingent upon funding, provide grants to community–based organizations and historically black colleges and universities to conduct special research, demonstration, and evaluation projects for targeted at–risk racial and ethnic minority populations and to support ongoing community–based programs that are designed to reduce or eliminate racial and ethnic health disparities in the State;</text> </level> <level label="8"> <text>Develop criteria for the awarding of grants for programs that are designed to improve minority health care;</text> </level> <level label="9"> <text>Review existing laws and regulations to ensure that they facilitate the provision of adequate health care to the minorities of this State;</text> </level> <level label="10"> <text>Recommend to the Secretary any additions or changes to existing laws and regulations designed to facilitate the adequate provision of health care to minorities in this State;</text> </level> <level label="11"> <text>Identify and review health promotion and disease prevention strategies relating to the leading health causes of death and disability among minority populations;</text> </level> <level label="12"> <text>Develop and implement model public and private partnerships in racial and ethnic minority communities for health awareness campaigns and to improve the access, acceptability, and use of public health services;</text> </level> <level label="13"> <text>Develop recommendations for the most effective means of providing outreach to racial and ethnic minority communities throughout the State to ensure their maximum participation in publicly funded health benefits programs;</text> </level> <level label="14"> <text>Develop a statewide plan for increasing the number of racial and ethnic minority health care professionals which includes recommendations for the financing mechanisms and recruitment strategies necessary to carry out the plan;</text> </level> <level label="15"> <text>Work collaboratively with universities and colleges of medicine, nursing, pharmacy, dentistry, social work, public health, and allied health in this State and other health care professional training programs to develop courses with cultural competency, sensitivity, and health literacy, that are designed to address the problem of racial and ethnic disparities in health care access, utilization, treatment decisions, quality, and outcomes;</text> </level> <level label="16"> <text>Work collaboratively with the Maryland Health Care Disparities Initiative, the Morgan–Hopkins Center for Health Disparities Solutions, the University of Maryland Disparity Project, the Monumental City Medical Society, faculty and researchers at historically black colleges and universities, and other existing alliances or plans, to reduce or eliminate racial and ethnic disparities in the State;</text> </level> <level label="17"> <text>Seek to establish a statewide alliance with community–based agencies and organizations, historically black colleges and universities, health care facilities, health care provider organizations, managed care organizations, and pharmaceutical manufacturers to promote the objectives of the Office;</text> </level> <level label="18"> <text>Evaluate multicultural or racial and ethnic minority health programs in other states to assess their efficacy and potential for replication in this State and make recommendations regarding the adoption of such programs, as appropriate;</text> </level> <level label="19"> <text>Apply for and accept any grant of money from the federal government, private foundations, or other sources which may be available for programs related to minority health and health disparities;</text> </level> <level label="20"> <text>Serve as the designated State agency for receipt of federal funds specifically designated for minority health and health disparities programs;</text> </level> <level label="21"> <text>Work collaboratively with the Governor’s Office of Small, Minority, and Women Business Affairs as the Office determines necessary;</text> </level> <level label="22"> <text>To the extent authorized under federal and State privacy laws, publish on its website health data that includes race and ethnicity information collected by the Office and update the data at least once every 6 months; and</text> </level> <level label="23"> <text>To the extent authorized under federal and State privacy laws, respond to requests for health data that includes race and ethnicity information within 30 days after receipt of the request.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1005" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <text>Subject to the limitations of any law that governs the activities of other units of the Executive Branch of State government, the Director shall:</text> <level label="1"> <text>Promote health and the prevention of disease among members of minority groups;</text> </level> <level label="2"> <text>Distribute grants from available federal and special funds to community–based health groups to be used to promote health and the prevention of disease among members of minority groups;</text> </level> <level label="3"> <text>Fund projects which are innovative, culturally sensitive, and specific in their approach toward reduction of the incidence and severity of those diseases or conditions which are responsible for excess morbidity and mortality in minority populations; and</text> </level> <level label="4"> <text>Meet with representatives from the Maryland Health Care Commission and the Department at least annually to:</text> <level label="i"> <text>Examine the collection of health data that includes race and ethnicity information in the State; and</text> </level> <level label="ii"> <text>Identify any changes for improving the health data that includes race and ethnicity information that is accessible by the Office.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1006" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <level label="a"> <text>On or before the 15th day of each regular session of the General Assembly, the Department shall submit an annual report on the Office of Minority Health and Health Disparities to the Governor and, subject to § 2–1257 of the State Government Article, to the General Assembly.</text> </level> <level label="b"> <text>The report shall include:</text> <level label="1"> <text>The projects and services developed and funded by the Office and the health care problems that the grant funds are intended to ameliorate;</text> </level> <level label="2"> <text>A “Health Care Disparities Policy Report Card”, developed in collaboration with the Maryland Health Care Commission, and the health occupations boards established under the Health Occupations Article, that includes:</text> <level label="i"> <text>An analysis of racial and ethnic variations in insurance coverage for low–income, nonelderly individuals;</text> </level> <level label="ii"> <text>The racial and ethnic composition of the individuals who hold a license or certificate issued by a health occupations board established under the Health Occupations Article compared to the racial and ethnic composition of the State’s population;</text> </level> <level label="iii"> <text>The racial and ethnic disparities in morbidity and mortality rates for cardiovascular disease, cancer, diabetes, HIV/AIDS, infant mortality, asthma, dementia, and other diseases identified by the Maryland Health Care Commission; and</text> </level> <level label="iv"> <text>A comparison of the information included under items (i) and (ii) of this item with previously published “Health Care Disparities Policy Report Cards” including the same information; and</text> </level> </level> <level label="3"> <text>The following information from the immediately preceding fiscal year:</text> <level label="i"> <text>The Office’s efforts to obtain funding described under § 20–1007(b) of this subtitle; and</text> </level> <level label="ii"> <text>The amount of funding from federal and special funding sources the Office received.</text> </level> </level> </level> <level label="c"> <text>The report may include any recommendations for administrative or legislative action that it deems appropriate.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1007" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="10" subtitle_name="Office of Minority Health and Health Disparities"> <level label="a"> <text>For fiscal year 2023 and each fiscal year thereafter, the Governor shall include in the annual budget bill an appropriation for the Office in an amount that is at least $1,788,314 or 0.012% of the total funds appropriated to the Department in that fiscal year, whichever is greater.</text> </level> <level label="b"> <text>It is the intent of the General Assembly that the Office supplement the funding for the Office provided under subsection (a) of this section with funding from federal and special funding sources.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1301" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Cultural and linguistic competency” means cultural and linguistic abilities that can be incorporated into therapeutic and medical evaluation and treatment, including:</text> <level label="1"> <text>Direct communication in the patient’s primary language;</text> </level> <level label="2"> <text>Understanding and applying the roles that culture, ethnicity, and race play in diagnosis, treatment, and clinical care; and</text> </level> <level label="3"> <text>Awareness of how the attitudes, values, and beliefs of health care providers and patients influence and impact professional and patient relations.</text> </level> </level> <level label="c"> <text>“Health care professional” includes a physician, nurse, dentist, social worker, psychologist, pharmacist, health educator, or other allied health professional.</text> </level> <level label="d"> <text>“Implicit bias” means a bias in judgment that results from subtle cognitive processes, including the following prejudices and stereotypes that often operate at a level below conscious awareness and without intentional control:</text> <level label="1"> <text>Prejudicial negative feelings or beliefs about a group that an individual holds without being aware of the feelings or beliefs; and</text> </level> <level label="2"> <text>Unconscious attributions of particular qualities to a member of a specific social group that are influenced by experience and based on learned associations between various qualities and social categories, including race and gender.</text> </level> </level> <level label="e"> <text>“Program” means the Cultural and Linguistic Health Care Professional Competency Program.</text> </level> <level label="f"> <text>“Structural racism” means the totality of ways in which societies foster racial discrimination by mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1302" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <level label="a"> <text>There is a Cultural and Linguistic Health Care Professional Competency Program.</text> </level> <level label="b"> <text>The purpose of the Program is to:</text> <level label="1"> <text>Provide for a voluntary program in which educational classes are offered to health care professionals to teach health care professionals:</text> <level label="i"> <text>Methods to improve the health care professionals’ cultural and linguistic competency to communicate with non–English speaking patients and patients from other cultures who are English speaking;</text> </level> <level label="ii"> <text>Cultural beliefs and practices that may impact patient health care practices and allow health care professionals to incorporate the knowledge of the beliefs and practices in the diagnosis and treatment of patients; and</text> </level> <level label="iii"> <text>Methods to enable health care professionals to increase the health literacy of their patients to improve the patient’s ability to obtain, process, and understand basic health information and services to make appropriate health care decisions;</text> </level> </level> <level label="2"> <text>Establish and provide an evidence–based implicit bias training program for health care professionals involved in the perinatal care of patients under § 20–1305 of this subtitle; and</text> </level> <level label="3"> <text>Identify and approve implicit bias and structural racism training programs for health occupation licensure and certification under § 1–225 of the Health Occupations Article.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1303" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <text>The Medical and Chirurgical Faculty of Maryland, the State Medical Society, the Maryland Nurses Association, the Maryland State Dental Association, the National Association of Social Workers – Maryland Chapter, the Maryland Clinical Social Work Coalition, the Maryland Psychological Association, the Maryland Pharmacists Association, or any other health professional association or public health entity in the State is encouraged to identify training programs, or, if feasible, to develop or collaborate in the development of training programs, that:</text> <level label="1"> <text>Address ethnic language or racial groups of interest to the health care professional members;</text> </level> <level label="2"> <text>Are based on the established knowledge of health care professionals serving target populations;</text> </level> <level label="3"> <text>Are developed in collaboration with the Office of Minority Health and Health Disparities; and</text> </level> <level label="4"> <text>Include standards that identify the degree of competency for participants to qualify for completion of a program.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1304" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <level label="a"> <text>The Maryland Department of Health shall develop a method through which the appropriate professional licensing board recognizes the training received by health care professionals under this subtitle, either through continuing education credits or otherwise.</text> </level> <level label="b"> <text>The Program shall provide a certificate of training completion for any individual who completes the training established under § 20–1305 of this subtitle, and to a facility on request.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1305" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Perinatal care” means the provision of care during pregnancy, labor, delivery, and postpartum and neonatal periods.</text> </level> <level label="3"> <text>“Perinatal care facility” includes:</text> <level label="i"> <text>A hospital, as defined in § 19–301 of this article, that provides perinatal care; and</text> </level> <level label="ii"> <text>A freestanding birthing center, as defined in § 19–3B–01 of this article.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>On or before January 1, 2021, the Program shall establish an evidence–based implicit bias training program for all health care professionals involved in the perinatal care of patients in a perinatal care facility.</text> </level> <level label="2"> <level label="i"> <text>The Program shall establish the implicit bias program required under paragraph (1) of this subsection using best practices in implicit bias training.</text> </level> <level label="ii"> <text>The implicit bias program required under paragraph (1) of this subsection may include best practices used in other states.</text> </level> </level> </level> <level label="c"> <text>On or before January 1, 2022, and once every 2 years thereafter or more frequently, as determined by the perinatal care facility, a health care professional who is an employee of, and involved in the perinatal care of patients at, a perinatal care facility shall complete the training established under subsection (b) of this section.</text> </level> <level label="d"> <text>The Program shall offer the training established under subsection (b) of this section to any health care professional involved in perinatal care of patients at a perinatal care facility who is not required to complete the training under subsection (c) of this section because the health care professional is not an employee of a perinatal care facility.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1306" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="13" subtitle_name="Cultural and Linguistic Competency of Health Care Professionals"> <level label="a"> <level label="1"> <text>The Program shall, in coordination with the Office of Minority Health and Health Disparities, identify and approve implicit bias and structural racism training programs that an individual may complete to satisfy the requirements of § 1–225 of the Health Occupations Article.</text> </level> <level label="2"> <text>The Program may approve only implicit bias and structural racism training programs under paragraph (1) of this subsection that are recognized by a health occupations board established under the Health Occupations Article or accredited by the Accreditation Council for Continuing Medical Education or the Accreditation Council for Pharmacy Education.</text> </level> </level> <level label="b"> <text>The Program shall provide a list of training programs approved under subsection (a) of this section on request.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1401" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Advisory Committee” means the Health Equity Resource Community Advisory Committee.</text> </level> <level label="c"> <text>“Commission” means the Community Health Resources Commission.</text> </level> <level label="d"> <text>“Community health worker” has the meaning stated in § 13–3701 of this article.</text> </level> <level label="e"> <text>“Federally qualified health center” has the meaning stated in § 24–1301 of this article.</text> </level> <level label="f"> <text>“Fund” means the Health Equity Resource Community Reserve Fund established under § 20–1407 of this subtitle.</text> </level> <level label="g"> <text>“Health care practitioner” means an individual or, collectively, a group of individuals working together within the same practice, each of whom is licensed, certified, or otherwise authorized by law to provide health care services under the Health Occupations Article.</text> </level> <level label="h"> <text>“Health disparity” means a particular type of health difference, such as a difference in rates of hypertension, heart disease, asthma, diabetes, substance abuse, mental health disorders, and maternal and infant mortality, that:</text> <level label="1"> <text>Is closely linked with social, economic, or environmental disadvantage; and</text> </level> <level label="2"> <text>Adversely affects groups of individuals who have systematically experienced greater obstacles to health care based on their:</text> <level label="i"> <text>Race or ethnicity;</text> </level> <level label="ii"> <text>Religion;</text> </level> <level label="iii"> <text>Socioeconomic status;</text> </level> <level label="iv"> <text>Gender, gender identity, or sexual orientation;</text> </level> <level label="v"> <text>Age;</text> </level> <level label="vi"> <text>Mental health status;</text> </level> <level label="vii"> <text>Cognitive, sensory, or physical disability;</text> </level> <level label="viii"> <text>Geographic location; or</text> </level> <level label="ix"> <text>Other characteristic historically linked to discrimination or exclusion.</text> </level> </level> </level> <level label="i"> <text>“Health Equity Resource Community” means a contiguous geographic area that:</text> <level label="1"> <text>Demonstrates measurable and documented health disparities and poor health outcomes;</text> </level> <level label="2"> <text>Is small enough to allow for the incentives offered under this subtitle to have a significant impact on improving health outcomes and reducing health disparities, including racial, ethnic, geographic, and disability related health disparities;</text> </level> <level label="3"> <text>Is designated by the Commission in accordance with the provisions of this subtitle; and</text> </level> <level label="4"> <text>Has a minimum population of 5,000 residents.</text> </level> </level> <level label="j"> <text>“Hospital” has the meaning stated in § 19–301 of this article.</text> </level> <level label="k"> <text>“Institution of higher education” has the meaning stated in § 10–101 of the Education Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1402" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <text>The purpose of establishing Health Equity Resource Communities is to target State resources to specific areas of the State to:</text> <level label="1"> <text>Reduce health disparities;</text> </level> <level label="2"> <text>Improve health outcomes;</text> </level> <level label="3"> <text>Improve access to primary care;</text> </level> <level label="4"> <text>Promote primary and secondary prevention services; and</text> </level> <level label="5"> <text>Reduce health care costs and hospital admissions and readmissions.</text> </level> </level> <level label="b"> <level label="1"> <text>The Commission may adopt regulations to carry out the provisions of this subtitle and to specify eligibility criteria and application, approval, and monitoring processes for the resources allocated under this subtitle.</text> </level> <level label="2"> <level label="i"> <text>The Office of Minority Health and Health Disparities and the Chesapeake Regional Information System for our Patients (CRISP) shall provide technical assistance to the Commission in implementing the provisions of this subtitle.</text> </level> <level label="ii"> <text>At the request of the Commission, any other unit in the Department shall provide technical assistance to the Commission in implementing the provisions of this subtitle.</text> </level> </level> </level> <level label="c"> <text>Two additional staff shall be added to the Commission to carry out the provisions of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1403" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <level label="1"> <text>On or before July 1, 2021, the Commission shall establish a Health Equity Resource Community Advisory Committee.</text> </level> <level label="2"> <text>The duties of the Advisory Committee include:</text> <level label="i"> <text>Providing initial and ongoing assistance and guidance regarding program evaluation and data collection metrics for Health Equity Resource Communities and health equity research practitioners;</text> </level> <level label="ii"> <text>Assisting the Commission in preparing the required annual report described in § 20–1408(b) of this subtitle and § 19–2112 of this article;</text> </level> <level label="iii"> <text>Proposing strategies for tax incentives and loan repayments to assist Health Equity Resource Communities in achieving their mission; and</text> </level> <level label="iv"> <text>Providing guidance, as determined by the Commission, to the Commission as necessary to implement the provisions of this subtitle.</text> </level> </level> </level> <level label="b"> <text>The Advisory Committee consists of:</text> <level label="1"> <text>The Chair of the Community Health Resources Commission or the Chair’s designee;</text> </level> <level label="2"> <text>The Director of the Office of Minority Health and Health Disparities, or the Director’s designee;</text> </level> <level label="3"> <text>Three members appointed by the Governor, including:</text> <level label="i"> <text>One individual representing the Maryland Department of Health; and</text> </level> <level label="ii"> <text>One individual with expertise in health care financing;</text> </level> </level> <level label="4"> <text>Three members appointed by the President of the Senate, including:</text> <level label="i"> <text>One individual with expertise in the social determinants of health; and</text> </level> <level label="ii"> <text>One individual who is a member of the general public residing in an area that has been or may be designated a Health Equity Resource Community; and</text> </level> </level> <level label="5"> <text>Three members appointed by the Speaker of the House, including:</text> <level label="i"> <text>One individual with expertise in health equity; and</text> </level> <level label="ii"> <text>One individual who is a member of the general public residing in an area that has been or may be designated a Health Equity Resource Community.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>Collectively, the members of the Advisory Committee shall have knowledge of the following:</text> <level label="i"> <text>Existing or potential health disparities in the State;</text> </level> <level label="ii"> <text>Groups of residents negatively affected by health disparities;</text> </level> <level label="iii"> <text>Systems, policies, and methods likely to improve health outcomes and reduce health disparities;</text> </level> <level label="iv"> <text>Effective prevention services;</text> </level> <level label="v"> <text>Health care costs, trends, and drivers;</text> </level> <level label="vi"> <text>Clinical health services research;</text> </level> <level label="vii"> <text>Consumer or patient perspectives; and</text> </level> <level label="viii"> <text>Innovative ways to address social determinants of health through the use of community health workers.</text> </level> </level> <level label="2"> <text>To the extent practicable and consistent with federal and State law, the membership of the Advisory Committee shall reflect the racial, ethnic, geographic, and gender diversity of the State.</text> </level> <level label="3"> <text>The Chair of the Maryland Community Health Resources Commission shall chair the Advisory Committee.</text> </level> </level> <level label="d"> <level label="1"> <text>The term of a member of the Advisory Committee is 4 years.</text> </level> <level label="2"> <text>The Commission shall stagger the terms of the initial appointed members.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the remainder of that term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>The Commission may remove an appointed member for incompetence, misconduct, or failure to perform the duties of the position.</text> </level> </level> <level label="e"> <text>A member of the Advisory Committee:</text> <level label="1"> <text>May not receive compensation as a member of the Advisory Committee; but</text> </level> <level label="2"> <text>Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> <level label="f"> <text>The Advisory Committee shall:</text> <level label="1"> <text>On or before January 1, 2022, hold an initial meeting; and</text> </level> <level label="2"> <text>Meet at least once every 6 months thereafter.</text> </level> </level> <level label="g"> <text>The Commission may convene working or advisory groups to facilitate the implementation of this subtitle that shall include individuals who reside in an area that has been or may be designated as a Health Equity Resource Community.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1404" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <text>For an area to receive a designation as a Health Equity Resource Community, a nonprofit community–based organization, a nonprofit hospital, an institution of higher education, a federally qualified health center, or a local government agency shall:</text> <level label="1"> <text>Apply to the Commission on behalf of the area to receive the designation; and</text> </level> <level label="2"> <text>Include federally qualified health centers or other community–based organizations to provide health or wraparound support services within the Health Equity Resource Community.</text> </level> </level> <level label="b"> <text>Subject to subsections (c) and (e) of this section, the application shall be in the form and manner and contain the information that the Commission requires.</text> </level> <level label="c"> <level label="1"> <text>The application shall contain an effective and sustainable plan to reduce health disparities, reduce costs or produce savings to the health care system, and improve health outcomes.</text> </level> <level label="2"> <text>The application shall include:</text> <level label="i"> <text>A description of how the plan will expand federally qualified health centers’ or other community–based organizations’ capacity to provide health care services or wraparound services to address social determinants of health; and</text> </level> <level label="ii"> <text>A description of how funding available under this subtitle will be used to address health disparities through evidence–based, cross–sector strategies that may include:</text> <level label="1"> <text>Building health care provider capacity;</text> </level> <level label="2"> <text>Improving health services delivery;</text> </level> <level label="3"> <text>Effectuating community improvements;</text> </level> <level label="4"> <text>Conducting outreach and education efforts;</text> </level> <level label="5"> <text>Implementing systemic strategies to improve coordination and communication across organizations that provide health care services;</text> </level> <level label="6"> <text>Supporting community leadership development efforts;</text> </level> <level label="7"> <text>Facilitating policy interventions to address upstream determinants of health; and</text> </level> <level label="8"> <text>Implementing scalable approaches to meet the nonmedical social needs of populations identified in the most recent community health needs assessment, such as unstable housing, inadequate food, or job development.</text> </level> </level> </level> </level> <level label="d"> <text>The application may include:</text> <level label="1"> <text>A proposal to use funding available under this subtitle to provide for loan repayment incentives to induce health care practitioners to practice in the area;</text> </level> <level label="2"> <text>A proposal to use innovative public health strategies to reduce health disparities in the area that may be supported by grants awarded under this subtitle, such as the use of community health workers, community health centers, federally qualified health centers, institutions of higher education, and community–based disease management activities; and</text> </level> <level label="3"> <text>A proposal to use other incentives or mechanisms to address health disparities that focus on ways to expand access to care, expand access to nonmedical interventions that promote improved health outcomes, promote hiring, and reduce costs to the health care system.</text> </level> </level> <level label="e"> <text>The application submitted in accordance with this section shall allocate sufficient funding to cover salary and benefit costs for the evaluator required under § 20–1406 of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1405" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <level label="1"> <text>On or before October 1, 2023, the Commission shall issue a request for proposals to designate areas as Health Equity Resource Communities in accordance with this subtitle.</text> </level> <level label="2"> <text>The Commission:</text> <level label="i"> <text>Shall consider geographic diversity, among other factors, when designating areas as Health Equity Resource Communities; and</text> </level> <level label="ii"> <text>May conduct outreach efforts to facilitate a geographically diverse pool of applicants, including efforts to facilitate submission of applications from rural areas.</text> </level> </level> <level label="3"> <text>After receiving all applications submitted to the Commission, the Commission shall report to the Senate Finance Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article, on the names of applicants and geographic areas in which applicants are located.</text> </level> </level> <level label="b"> <text>The Commission shall give priority to applications that demonstrate:</text> <level label="1"> <text>Support from and participation of key stakeholders in the public and private sectors, including residents of the area and local government;</text> </level> <level label="2"> <text>A plan for long–term funding and self–sustainability;</text> </level> <level label="3"> <text>Inclusion of supporting funds from the private sector;</text> </level> <level label="4"> <text>Integration with the State Health Improvement Process and the goals set out in the strategic plan of the local health improvement coalition;</text> </level> <level label="5"> <text>A plan for evaluation of the impact of designation of the proposed area as a Health Equity Resource Community and strategies for quality improvement;</text> </level> <level label="6"> <text>Other factors that the Commission determines are appropriate to demonstrate a commitment to reduce health disparities and improve health outcomes; and</text> </level> <level label="7"> <text>A previous designation as a Health Enterprise Zone or inclusion of areas previously included in a Health Enterprise Zone.</text> </level> </level> <level label="c"> <level label="1"> <text>An application for designation of an area as a Health Equity Resource Community submitted by a nonprofit community–based organization, a nonprofit hospital, an institution of higher education, a federally qualified health center, or a local government agency shall provide for the employment and supervision of employment of one full–time employee to serve as an evaluator of the operation, impact, and effectiveness of the Health Equity Resource Community designated under this subtitle.</text> </level> <level label="2"> <text>To be designated as an evaluator under this subsection, the employee must demonstrate experience in methods of qualitative and quantitative research methodology.</text> </level> <level label="3"> <text>An employee designated as an evaluator under this subsection shall coordinate with the Commission to:</text> <level label="i"> <text>Monitor the operation, effectiveness, and impact of the Health Equity Resource Community; and</text> </level> <level label="ii"> <text>Provide data, statistics, and analysis to the Commission that shall address the reporting elements specified under § 20–1408(b) of this subtitle.</text> </level> </level> </level> <level label="d"> <text>Notwithstanding the requirement to hire a full–time employee to serve as an evaluator under subsection (c) of this section, a nonprofit community–based organization, a nonprofit hospital, an institution of higher education, a federally qualified health center, or a local government agency may contract with a historically black college or university in the State to provide evaluator services.</text> </level> <level label="e"> <text>The decision of the Commission to designate an area as a Health Equity Resource Community shall be a final decision.</text> </level> <level label="f"> <text>A designation by the Commission of an area as a Health Equity Resource Community shall have a term of 5 years and may be renewed in accordance with an application approved by the Commission.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1406" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <text>Health care practitioners and community health workers that practice in a Health Equity Resource Community may receive loan repayment assistance, as provided for in the application for designation for the Health Equity Resource Community and approved by the Commission under this subtitle.</text> </level> <level label="b"> <level label="1"> <text>A health care practitioner or community health worker may apply to the Commission for a grant to defray the costs of capital or leasehold improvements to, or medical or dental equipment to be used in, a Health Equity Resource Community.</text> </level> <level label="2"> <text>To qualify for a grant under paragraph (1) of this subsection, a health care practitioner or a community health worker shall:</text> <level label="i"> <text>Own or lease the health care facility; and</text> </level> <level label="ii"> <text>Provide health care from that facility.</text> </level> </level> <level label="3"> <level label="i"> <text>A grant to defray the cost of medical or dental equipment may not exceed the lesser of $25,000 or 50% of the cost of the equipment.</text> </level> <level label="ii"> <text>Grants for capital or leasehold improvements shall be for the purposes of improving or expanding the delivery of health care in the Health Equity Resource Community.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>A nonprofit community–based organization, a nonprofit hospital, an institution of higher education, a federally qualified health center, or a local government agency that receives approval of an application submitted under § 20–1403 of this subtitle may submit an application, on its own behalf, to receive grants for capital or leasehold improvements, as determined by the Commission, for the purposes described under subsection (b)(3)(ii) of this section.</text> </level> <level label="2"> <text>Subject to § 20–1408(a)(2) of this subtitle, the term of any grant awarded to a nonprofit community–based organization, a nonprofit hospital, an institution of higher education, a federally qualified health center, or a local government agency for capital or leasehold improvements shall have a term of 5 years, and may be renewed in accordance with an application approved by the Commission.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1407" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <text>There is a Health Equity Resource Community Reserve Fund.</text> </level> <level label="b"> <text>The purpose of the Fund is to:</text> <level label="1"> <text>Support areas designated by the Commission as Health Equity Resource Communities by providing grants to community–based organizations, nonprofit hospitals, institutions of higher education, federally qualified health centers, local government agencies, health care practitioners, and community health workers to facilitate reduction of health disparities, improve health outcomes, provide drug treatment and rehabilitation, and reduce health costs and hospital admissions and readmissions in specific areas of the State; and</text> </level> <level label="2"> <text>Provide funding to supplement and not supplant existing funding for behavioral health programs that provide prevention, recovery support, and harm reduction services for individuals with substance use and mental health disorders.</text> </level> </level> <level label="c"> <text>The Commission shall administer the Fund.</text> </level> <level label="d"> <level label="1"> <text>The Fund is a special, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.</text> </level> <level label="2"> <text>Any unspent portion of the Fund may not be transferred or revert to the General Fund but shall remain in the Fund to be used for the purposes specified in this subtitle.</text> </level> <level label="3"> <text>The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.</text> </level> </level> <level label="e"> <text>The Fund consists of:</text> <level label="1"> <text>Money appropriated in the State budget to the Fund in accordance with § 31–107 of the Insurance Article;</text> </level> <level label="2"> <text>Interest earnings of the Fund; and</text> </level> <level label="3"> <text>Any other money from any other source accepted for the benefit of the Fund.</text> </level> </level> <level label="f"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, the Fund may be used only to provide funding to the Commission for the support of areas designated as Health Equity Resource Communities by providing grants to community–based organizations, nonprofit hospitals, institutions of higher education, local government agencies, health care practitioners, federally qualified health centers, and community health workers to reduce health disparities, improve health outcomes, provide addiction and mental health services, and reduce health costs and hospital admissions and readmissions.</text> </level> <level label="2"> <level label="i"> <text>The Fund may be used for the purpose of funding one full–time staff position under § 19–2112(a)(4) of this article and two full–time staff positions under § 20–1402(c) of this subtitle on the Commission.</text> </level> <level label="ii"> <text>In fiscal year 2024 and each fiscal year thereafter, the Fund may be used to pay for the costs incurred by the Chesapeake Regional Information System for our Patients (CRISP) in providing technical assistance to the Commission.</text> </level> </level> </level> <level label="g"> <level label="1"> <text>The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.</text> </level> <level label="2"> <text>Any interest earnings of the Fund shall be credited to the Fund.</text> </level> </level> <level label="h"> <text>Expenditures from the Fund may be made only in accordance with the State budget.</text> </level> <level label="i"> <text>Money expended from the Fund to support areas designated by the Commission as Health Equity Resource Communities under this subtitle is supplemental to and not intended to supplant funding that otherwise would be appropriated for those purposes.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1408" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="14" subtitle_name="Health Equity Resource Communities"> <level label="a"> <level label="1"> <text>Each nonprofit community–based organization, nonprofit hospital, institution of higher education, federally qualified health center, or local government agency that has submitted a successful application for designation of an area as a Health Equity Resource Community under § 20–1403 of this subtitle shall submit to the Commission a report that includes:</text> <level label="i"> <text>A description of progress made toward the objectives set forth in the application;</text> </level> <level label="ii"> <text>A description of objectives to be met during the immediately following year; and</text> </level> <level label="iii"> <text>Any other information as requested by the Commission.</text> </level> </level> <level label="2"> <text>The reporting required under paragraph (1) of this subsection shall be submitted periodically in accordance with a schedule determined by the Commission.</text> </level> <level label="3"> <text>The Commission may revoke a designation of an area as a Health Equity Resource Community if the nonprofit community–based organization, nonprofit hospital, institution of higher education, federally qualified health center, or local government agency that has submitted a successful application for designation of an area as a Health Equity Resource Community fails to meet the objectives provided to the Commission under subsection (a)(1) of this section for a given year.</text> </level> </level> <level label="b"> <level label="1"> <text>On or before December 15 each year, the Commission shall submit to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly a report that includes:</text> <level label="i"> <text>The number and types of incentives granted in each Health Equity Resource Community;</text> </level> <level label="ii"> <text>Evidence of the impact of the loan repayment incentives in attracting health care practitioners and community health workers to Health Equity Resource Communities;</text> </level> <level label="iii"> <text>Evidence of the impact of the incentives offered in Health Equity Resource Communities in reducing health disparities and improving health outcomes; and</text> </level> <level label="iv"> <text>Evidence of the progress in reducing health costs and hospital admissions and readmissions in Health Equity Resource Communities.</text> </level> </level> <level label="2"> <text>The report described in paragraph (1) of this subsection shall include data disaggregated by the following:</text> <level label="i"> <text>Race;</text> </level> <level label="ii"> <text>Ethnicity;</text> </level> <level label="iii"> <text>Primary language;</text> </level> <level label="iv"> <text>Gender;</text> </level> <level label="v"> <text>Socioeconomic status; and</text> </level> <level label="vi"> <text>Zip code.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1501" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="15" subtitle_name="Down Syndrome Information"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Down syndrome” means a chromosomal condition caused by an error in cell division that results in the presence of an extra whole or partial copy of chromosome 21.</text> </level> <level label="c"> <level label="1"> <text>“Health care facility” means a facility or an office where health or medical care is provided to patients by a health care provider.</text> </level> <level label="2"> <text>“Health care facility” includes a hospital and a limited service hospital.</text> </level> </level> <level label="d"> <level label="1"> <text>“Health care provider” means a person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health or medical care in the ordinary course of business or practice of a profession.</text> </level> <level label="2"> <text>“Health care provider” includes a genetic counselor.</text> </level> </level> <level label="e"> <text>“Hospital” has the meaning stated in § 19–301 of this article.</text> </level> <level label="f"> <text>“Limited service hospital” has the meaning stated in § 19–301 of this article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1502" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="15" subtitle_name="Down Syndrome Information"> <level label="a"> <text>The Department shall identify up–to–date, evidence–based, written information about Down syndrome that:</text> <level label="1"> <text>Has been reviewed by medical experts and national and local Down syndrome organizations;</text> </level> <level label="2"> <text>Is designed for use by an expectant parent who receives a prenatal test result for Down syndrome or a parent of a child who receives a diagnosis of Down syndrome;</text> </level> <level label="3"> <text>Is culturally and linguistically appropriate for potential recipients of the information; and</text> </level> <level label="4"> <text>Includes:</text> <level label="i"> <text>Information addressing physical, developmental, educational, and psychosocial outcomes, life expectancy, clinical course, and intellectual and functional development and treatment options for individuals with Down syndrome; and</text> </level> <level label="ii"> <text>Contact information for national and local Down syndrome education and support programs and services, including information hotlines, resource centers, and clearinghouses.</text> </level> </level> </level> <level label="b"> <text>The Department shall:</text> <level label="1"> <text>Provide the information identified by the Department under subsection (a) of this section to health care facilities and health care providers that provide prenatal care, postnatal care, or genetic counseling to expectant parents who receive a prenatal test result for Down syndrome and parents of a child diagnosed with Down syndrome; and</text> </level> <level label="2"> <text>Make available the information identified by the Department under subsection (a) of this section on the Department’s website.</text> </level> </level> <level label="c"> <level label="1"> <text>On receipt of a positive test result from a test for Down syndrome, a health care facility or health care provider may provide to the expectant parent who receives a prenatal test result for Down syndrome or the parent of the child diagnosed with Down syndrome the written information provided or made available by the Department under subsection (b) of this section.</text> </level> <level label="2"> <text>The information provided under this subsection shall be culturally and linguistically appropriate for the recipient of the information.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1601" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Anatomical gift” means the donation of all or part of a human body to take effect after the donor’s death for the purpose of transplantation or transfusion.</text> </level> <level label="c"> <text>“Auxiliary aids and services” includes:</text> <level label="1"> <text>Qualified interpreters or other effective methods of making aurally delivered materials available to individuals with hearing impairments;</text> </level> <level label="2"> <text>Qualified readers, taped texts, texts in accessible electronic format, or other effective methods of making visually delivered materials available to individuals with visual impairments;</text> </level> <level label="3"> <text>Supported decision–making services, including:</text> <level label="i"> <text>The use of a support individual to assist in making medical decisions, communicating information to the individual, or ascertaining an individual’s wishes;</text> </level> <level label="ii"> <text>The provision of information to a person designated by the individual consistent with the federal Health Insurance Portability and Accountability Act and other applicable laws and regulations governing the disclosure of health information; and</text> </level> <level label="iii"> <text>If an individual has a court–appointed guardian or other individual responsible for making medical decisions on behalf of the individual, any measures used to ensure that the individual is included in decisions involving the individual’s health care and that medical decisions are in accordance with the individual’s own expressed interests; and</text> </level> </level> <level label="4"> <text>Any other aid or service that is used to provide information in a format that is easily understandable and accessible to individuals with cognitive, neurological, developmental, or intellectual disabilities.</text> </level> </level> <level label="d"> <text>“Covered entity” means:</text> <level label="1"> <text>A licensed health care provider;</text> </level> <level label="2"> <text>A health care facility as defined in § 19–114 of this article;</text> </level> <level label="3"> <text>A laboratory;</text> </level> <level label="4"> <text>A State psychiatric hospital;</text> </level> <level label="5"> <text>A State residential center as defined in § 7–101 of this article;</text> </level> <level label="6"> <text>An alternative living unit as defined in § 7–101 of this article;</text> </level> <level label="7"> <text>A group home as defined in § 7–101 of this article;</text> </level> <level label="8"> <text>An institutional medical unit in a correctional facility; or</text> </level> <level label="9"> <text>Any entity responsible for potential recipients of the anatomical gift.</text> </level> </level> <level label="e"> <text>“Disability” has the meaning stated in the federal Americans with Disabilities Act.</text> </level> <level label="f"> <text>“Organ transplant” means the transplantation or transfusion of a part of a human body into the body of another individual for the purpose of treating or curing a medical condition.</text> </level> <level label="g"> <text>“Qualified individual” means an individual who:</text> <level label="1"> <text>Has a disability; and</text> </level> <level label="2"> <text>Meets the essential eligibility requirements for the receipt of an anatomical gift, with or without:</text> <level label="i"> <text>The support networks available to the individual;</text> </level> <level label="ii"> <text>The provision of auxiliary aids and services; or</text> </level> <level label="iii"> <text>Reasonable modifications to the policies or practices of a covered entity, including modifications to allow:</text> <level label="1"> <text>Communication with individuals responsible for supporting the individual with postsurgical and posttransplantation care, including medication; and</text> </level> <level label="2"> <text>The consideration of support networks available to the individual, including family, friends, and home– and community–based services funded through the Maryland Medical Assistance Program, Medicare, or another health plan in which the individual is enrolled, or any program or source of funding available to the individual, in determining whether the individual is able to comply with posttransplantation medical requirements.</text> </level> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1602" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <text>This subtitle may not be construed to require a covered entity to make a referral or recommendation for or perform a medically inappropriate organ transplant.</text> </section> <section article="ghg" article_name="Health - General" number="20-1603" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <text>The General Assembly finds that:</text> <level label="1"> <text>A mental or physical disability does not diminish an individual’s right to health care;</text> </level> <level label="2"> <text>The federal Americans with Disabilities Act prohibits discrimination against individuals with disabilities, yet many individuals with disabilities still experience discrimination in accessing critical health care services;</text> </level> <level label="3"> <text>In other states nationwide, individuals with mental and physical disabilities have historically been denied life–saving organ transplants based on assumptions that their lives are less worthy, that they are incapable of complying with posttransplantation medical requirements, or that they lack adequate support systems to ensure compliance with posttransplantation medical requirements;</text> </level> <level label="4"> <text>Although organ transplant centers must consider medical and psychosocial criteria when determining if a patient is suitable to receive an organ transplant, transplant centers that participate in Medicare, the Maryland Medical Assistance Program, and other federally funded programs are required to use patient selection criteria that result in a fair and nondiscriminatory distribution of organs; and</text> </level> <level label="5"> <text>State residents in need of organ transplants are entitled to assurances that they will not encounter discrimination on the basis of a disability.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1604" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <text>This subtitle applies to each part of the organ transplant process.</text> </section> <section article="ghg" article_name="Health - General" number="20-1605" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <level label="a"> <text>A covered entity may not solely on the basis of an individual’s disability:</text> <level label="1"> <text>Consider a qualified individual ineligible to receive an anatomical gift or organ transplant;</text> </level> <level label="2"> <text>Deny medical and other services related to organ transplantation, including evaluation, surgery, counseling, and posttransplantation treatment and services;</text> </level> <level label="3"> <text>Refuse to refer the individual to a transplant center or a related specialist for the purpose of evaluation or receipt of an organ transplant;</text> </level> <level label="4"> <text>Refuse to place a qualified individual on an organ transplant waiting list; or</text> </level> <level label="5"> <text>Place a qualified individual at a lower–priority position on an organ transplant waiting list than the position at which the qualified individual would have been placed if not for the disability.</text> </level> </level> <level label="b"> <level label="1"> <text>Subject to paragraph (2) of this subsection, a covered entity may take an individual’s disability into account when making treatment or coverage recommendations or decisions, solely to the extent that the disability has been found by a physician, following an individualized evaluation of the individual, to be medically significant to the provision of the anatomical gift.</text> </level> <level label="2"> <text>If an individual has the necessary support system to assist the individual in complying with posttransplantation medical requirements, a covered entity may not consider the individual’s inability to independently comply with the posttransplantation medical requirements to be medically significant for the purposes of paragraph (1) of this subsection.</text> </level> </level> <level label="c"> <text>A covered entity shall make reasonable modifications in policies, practices, or procedures, when the modifications are necessary to allow an individual with a disability access to services, including transplantation–related counseling, information, coverage, or treatment, unless the covered entity can demonstrate that making the modifications would fundamentally alter the nature of the services.</text> </level> <level label="d"> <text>A covered entity shall take such steps as may be necessary to ensure that an individual with a disability is not denied services, including transplantation–related counseling, information, coverage, or treatment, due to the absence of auxiliary aids and services, unless the covered entity can demonstrate that taking the steps would fundamentally alter the nature of the services being offered or would result in an undue burden.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1606" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="16" subtitle_name="Nondiscrimination in Access to Anatomical Gifts and Organ Transplantation"> <level label="a"> <text>If a covered entity violates this subtitle, the affected individual may bring an action in the appropriate circuit court for injunctive or other equitable relief.</text> </level> <level label="b"> <text>In an action brought under subsection (a) of this section, the circuit court shall:</text> <level label="1"> <text>Schedule a hearing as soon as possible; and</text> </level> <level label="2"> <text>Apply the same standards in rendering a judgment in the action as would be applied in an action brought in federal court under the federal Americans with Disabilities Act.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1701" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="17" subtitle_name="Lyme Disease Information"> <level label="a"> <text>A health care provider licensed in the State who draws the blood of a patient to perform a laboratory test for Lyme disease or a medical laboratory, as defined in § 17–201 of this article, that performs a laboratory test for the presence of Lyme disease shall provide the following written notice to the patient at the time the patient’s blood is drawn:</text> <text>“Your health care provider has ordered a laboratory test for the presence of Lyme disease for you. Current laboratory testing for Lyme disease can be problematic and standard laboratory tests often result in false negative and false positive results and, if done too early, you may not have produced enough antibodies to be considered positive because your immune response requires time to develop antibodies. If you are tested for Lyme disease and the results are negative, this does not necessarily mean you do not have Lyme disease. If you continue to experience unexplained symptoms, you should contact your health care provider and inquire about the appropriateness of retesting or initial or additional treatment.”.</text> </level> <level label="b"> <text>If the Department finds significant differences between the content of the notice required by subsection (a) of this section and current medical evidence on Lyme disease testing, the Department may adopt regulations that change the content of the notice.</text> </level> <level label="c"> <text>The Department shall provide written notice to the Senate Finance Committee and the House Health Committee before submitting any proposed regulation under subsection (b) of this section to the Maryland Register for publication.</text> </level> <level label="d"> <text>The provision by a health care provider or medical laboratory of the notice required by subsection (a) of this section may not be the sole basis for a cause of action.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1801" future_version_removed="true" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="18" subtitle_name="Maternal Mental Health"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Health care facility” means a facility or an office where health or medical care is provided to patients by a health care provider.</text> </level> <level label="ii"> <text>“Health care facility” includes a hospital and a limited service hospital.</text> </level> </level> <level label="3"> <text>“Health care provider” means a person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health or medical care in the ordinary course of business or practice of a profession.</text> </level> <level label="4"> <text>“Hospital” has the meaning stated in § 19–301 of this article.</text> </level> <level label="5"> <text>“Limited service hospital” has the meaning stated in § 19–301 of this article.</text> </level> </level> <level label="b"> <text>The Department, in consultation with stakeholders, shall identify up–to–date, evidence–based, written information about perinatal mood and anxiety disorders that:</text> <level label="1"> <text>Has been reviewed by medical experts and national and local organizations specializing in maternal mental health;</text> </level> <level label="2"> <text>Is designed for use by health care providers and pregnant and postpartum women and their families;</text> </level> <level label="3"> <text>Is culturally and linguistically appropriate for potential recipients of the information; and</text> </level> <level label="4"> <text>Includes:</text> <level label="i"> <text>Information addressing:</text> <level label="1"> <text>The signs and symptoms of perinatal mood and anxiety disorders;</text> </level> <level label="2"> <text>Perinatal medication usage;</text> </level> <level label="3"> <text>Risk factors of perinatal mood and anxiety disorders, including perinatal loss and high–risk pregnancy;</text> </level> <level label="4"> <text>How and when to screen for symptoms of perinatal mood and anxiety disorders;</text> </level> <level label="5"> <text>Brief intervention strategies; and</text> </level> <level label="6"> <text>Evidence–based psychosocial treatments; and</text> </level> </level> <level label="ii"> <text>Contact information for national and local maternal mental health programs and services.</text> </level> </level> </level> <level label="c"> <text>The Department shall:</text> <level label="1"> <text>Provide the information identified by the Department under subsection (b) of this section to health care facilities and health care providers that provide prenatal care, labor and delivery services, and postnatal care to expectant parents; and</text> </level> <level label="2"> <text>Make the information identified by the Department under subsection (b) of this section available on the Department’s website.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-1802" future_version_removed="true" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="18" subtitle_name="Maternal Mental Health"> <level label="a"> <text>The Department, in collaboration with MedChi, The Maryland State Medical Society, the Maryland Nurses Association, the Maryland Affiliate of the American College of Nurse Midwives, the Maryland Psychological Association, and any other health professional association or public health entity in the State identified by the Department, shall identify and develop training programs that improve early identification of postpartum depression and perinatal mood and anxiety disorders.</text> </level> <level label="b"> <text>The programs developed under subsection (a) of this section shall include continuing medical education programs developed by organizations that are accredited by the Accreditation Council for Continuing Medical Education.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1803" future_version_removed="true" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="18" subtitle_name="Maternal Mental Health" /> <section article="ghg" article_name="Health - General" number="20-1804" future_version_removed="true" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="18" subtitle_name="Maternal Mental Health" /> <section article="ghg" article_name="Health - General" number="20-1901" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="19" subtitle_name="Subcutaneous Implanting of Identification Device"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <level label="1"> <text>“Identification device” means an item, an application, or a product that is passively or actively capable of transmitting personal information, including devices using radio frequency technology.</text> </level> <level label="2"> <text>“Identification device” does not include an item, an application, or a product that is used in the diagnosis, monitoring, treatment, or prevention of a health condition.</text> </level> </level> <level label="c"> <text>“Personal information” includes the following data elements to the extent that the data elements are used alone or in conjunction with other information used to identify an individual:</text> <level label="1"> <text>First or last name;</text> </level> <level label="2"> <text>Address;</text> </level> <level label="3"> <text>Telephone number;</text> </level> <level label="4"> <text>E–mail, Internet Protocol, or website address;</text> </level> <level label="5"> <text>Date of birth;</text> </level> <level label="6"> <text>Driver’s license number or identification card number;</text> </level> <level label="7"> <text>Bank, credit card, or other financial account number;</text> </level> <level label="8"> <text>Any unique personal identifier contained or encoded on a health insurance, health benefit, or benefit card or record issued in conjunction with a government–supported aid program;</text> </level> <level label="9"> <text>Religion;</text> </level> <level label="10"> <text>Ethnicity or nationality;</text> </level> <level label="11"> <text>Photograph;</text> </level> <level label="12"> <text>Fingerprint or other biometric identifier;</text> </level> <level label="13"> <text>Social Security number; and</text> </level> <level label="14"> <text>Any other unique personal identifier.</text> </level> </level> <level label="d"> <text>“Require, coerce, or compel” includes the use of physical violence, threat, intimidation, retaliation, the conditioning of any private or public benefit, including employment, promotion, or other employment benefit, and any other means to cause a reasonable individual of ordinary susceptibilities to acquiesce when the individual otherwise would not.</text> </level> <level label="e"> <text>“Subcutaneous” means existing, performed, or introduced under or on the skin.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-1902" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="19" subtitle_name="Subcutaneous Implanting of Identification Device"> <level label="a"> <text>A person or an agent, a representative, or a designee of the State or a local government may not require, coerce, or compel an individual to undergo the subcutaneous implanting of an identification device.</text> </level> <level label="b"> <level label="1"> <text>An individual who is implanted with a subcutaneous identification device in violation of subsection (a) of this section may file a civil action in the circuit court in the county where the violation occurred.</text> </level> <level label="2"> <text>If the court finds that the person or agent, representative, or designee of the State or a local government violated subsection (a) of this section, the court may:</text> <level label="i"> <text>Assess against the defendant:</text> <level label="1"> <text>A civil penalty not exceeding $10,000; and</text> </level> <level label="2"> <text>An additional civil penalty not exceeding $1,000 for each day after the day of implantation that the violation continues until corrected; and</text> </level> </level> <level label="ii"> <text>Award the plaintiff:</text> <level label="1"> <text>Compensatory damages;</text> </level> <level label="2"> <text>Injunctive relief;</text> </level> <level label="3"> <text>Reasonable attorney’s fees and litigation expenses, including expert witness fees and expenses; or</text> </level> <level label="4"> <text>Any other appropriate relief.</text> </level> </level> </level> <level label="3"> <text>In addition to the damages or relief awarded under paragraph (2) of this subsection, the court may award the plaintiff punitive damages on a finding of proof of the defendant’s malice, oppression, fraud, or duress inflicted in requiring, coercing, or compelling the plaintiff to undergo the subcutaneous implanting of an identification device.</text> </level> </level> <level label="c"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, an action brought under subsection (b) of this section shall be filed within 3 years after the date on which the identification device was implanted.</text> </level> <level label="2"> <text>If a defendant induces the plaintiff to delay the filing of the action or the plaintiff delays the filing due to threats made by the defendant that caused the plaintiff duress, the defendant may not assert the limitation specified under paragraph (1) of this subsection.</text> </level> </level> <level label="d"> <text>The remedies provided by this section are in addition to any other statutory, legal, or equitable remedies that may be available and are not intended to be prerequisite to or exclusive of any other remedies.</text> </level> <level label="e"> <text>The provisions of this section shall be liberally construed in the protection of privacy and bodily integrity.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2001" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="20" subtitle_name="Facilities Providing Dialysis Treatment"> <text>In this subtitle, “health care facility” means a facility or an office where health or medical care is provided to patients by a health care provider, including:</text> <level label="1"> <text>A health care facility as defined in § 19–114(d)(1) of this article;</text> </level> <level label="2"> <text>A kidney dialysis center;</text> </level> <level label="3"> <text>A facility operated by the Department or a health officer; and</text> </level> <level label="4"> <text>The office of a health care provider.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2002" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="20" subtitle_name="Facilities Providing Dialysis Treatment"> <level label="a"> <text>A health care facility may not provide peritoneal dialysis or hemodialysis treatment services unless the individual performing the dialysis procedure has received training in the peritoneal dialysis or hemodialysis technique being performed.</text> </level> <level label="b"> <text>A person who violates subsection (a) of this section is subject to a civil penalty imposed by the Department not exceeding $5,000 for each violation.</text> </level> <level label="c"> <text>The Department shall adopt regulations to carry out this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2101" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="21" subtitle_name="Long-Term Care Planning"> <level label="a"> <text>On or before April 1, 2022, the Department shall develop and publish materials to assist Maryland residents with long–term care family planning.</text> </level> <level label="b"> <text>The materials developed under subsection (a) of this section, consistent with recommendation number 4 in the Report of the Maryland Governor’s Task Force on Long–Term Care Planning published in 2018 as required by Chapters 212 and 213 of the Acts of the General Assembly of 2017, shall:</text> <level label="1"> <text>Meet the requirements for the PLAN NOW Starter Kit described in recommendation number 4;</text> </level> <level label="2"> <text>Be consistent with the mock–up PLAN NOW Starter Kit materials detailed in recommendation number 4; and</text> </level> <level label="3"> <text>Include contact information, including websites and phone numbers, for organizations that a State resident may contact for assistance with long–term care family planning.</text> </level> </level> <level label="c"> <text>The Department shall:</text> <level label="1"> <text>Make the materials published under this section available in English, Spanish, and any other language, as the Department determines is necessary; and</text> </level> <level label="2"> <text>Ensure that the materials published under this section are understandable to individuals with limited literacy skills.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-2201" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Hub” means the Consumer Health Information Hub.</text> </level> <level label="c"> <text>“Plain language” means language that is clear, concise, well–organized, and complies with other best practices appropriate to the subject or field and intended audience.</text> </level> <level label="d"> <level label="1"> <text>“Public communication” means a document that:</text> <level label="i"> <text>Is necessary for obtaining a government benefit or service;</text> </level> <level label="ii"> <text>Provides information about a government benefit or service; or</text> </level> <level label="iii"> <text>Explains to the public how to comply with a requirement that the government administers or enforces.</text> </level> </level> <level label="2"> <text>“Public communication” includes a letter, a publication, a form, a notice, or an instruction.</text> </level> <level label="3"> <text>“Public communication” does not include a regulation.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-2202" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <text>The General Assembly finds that health literacy is:</text> <level label="1"> <text>Part of the State’s critical public health and health systems infrastructure; and</text> </level> <level label="2"> <text>An essential contributor to health equity.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2203" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <text>State and local agencies shall use plain language in public communications about health, health insurance, safety, and social services benefits.</text> </section> <section article="ghg" article_name="Health - General" number="20-2204" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <level label="a"> <text>The University of Maryland Herschel S. Horowitz Center for Health Literacy is designated as the State’s Consumer Health Information Hub.</text> </level> <level label="b"> <text>The purpose of the Hub is to promote and ensure public access to accurate, consistent, evidence–based, plain–language information in preferred languages to inform decisions about health, safety, and social services benefits.</text> </level> <level label="c"> <text>To the extent funding is available, the Hub shall:</text> <level label="1"> <text>Protect and promote public health by engaging with State and local government agencies, health systems, nonprofit and community–based organizations, and other entities to carry out the Hub’s purpose and duties under this subtitle;</text> </level> <level label="2"> <text>Establish and promote health literacy criteria, certifications, and best practices that advance the effectiveness of the State’s health care system;</text> </level> <level label="3"> <text>Identify health literacy challenges and provide recommendations to agencies and organizations on how to address the challenges, including by improving programs and materials to provide the public with access to plain–language health, safety, and social services benefits information;</text> </level> <level label="4"> <text>Monitor and report on the use of health literacy and plain–language initiatives and support public reporting of vital public health information, including health care quality reports from the Maryland Health Care Commission; and</text> </level> <level label="5"> <text>Support the identification and ongoing training of health literacy officers in State and local agencies.</text> </level> </level> <level label="d"> <text>On or before July 1 each year, beginning in 2024, the Hub shall submit a report to the Senate Finance Committee and the House Health Committee, in accordance with § 2–1257 of the State Government Article, on the implementation of this subtitle, including the status of statewide health literacy efforts and materials provided.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2205" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <level label="a"> <text>The Hub shall facilitate consistent State and local government use of health literacy and plain–language criteria, which may include by:</text> <level label="1"> <text>Identifying vendors of health information products that adopt the Hub’s health literacy criteria;</text> </level> <level label="2"> <text>Offering a health literacy review of sources of public information or public media regarding health, safety, and social services benefits information;</text> </level> <level label="3"> <text>Publishing templates that aid the development of plain–language health information materials; and</text> </level> <level label="4"> <text>Publishing templates and model language for use by State agencies and local government agencies for awarding grants and contracts to ensure that recipients:</text> <level label="i"> <text>Address health literacy issues in their proposals and workplans; and</text> </level> <level label="ii"> <text>Refrain from creating additional health literacy barriers.</text> </level> </level> </level> <level label="b"> <text>The Hub shall support workforce development, which may include by:</text> <level label="1"> <text>Offering or recommending educational sessions on health literacy for health professionals and individuals who develop health, safety, and social services benefits information for the public; and</text> </level> <level label="2"> <text>Providing educational and age–appropriate resources that teach students health literacy and health literacy skills for primary and secondary schools and institutions of higher education.</text> </level> </level> <level label="c"> <text>The Hub shall assist programs and organizations to promote community health literacy, which may include by:</text> <level label="1"> <text>Offering Hub assessments of programs and organizations to identify barriers to public access of health, safety, and social services benefits information and services; and</text> </level> <level label="2"> <text>Assisting entities with providing consumers with plain–language health information and referral and support services in a consumer’s preferred language.</text> </level> </level> <level label="d"> <text>In carrying out this section, the Hub may collaborate with entities that directly educate the public, including education institutions, libraries, and consumer referral services.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2206" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <level label="a"> <text>The Hub shall develop and publish criteria for evaluating whether media or a media campaign follows best practices for the promotion of health literacy.</text> </level> <level label="b"> <level label="1"> <text>If a person submits its media or media campaign to the Hub for review, the Hub shall use the criteria developed under subsection (a) of this section to evaluate whether the media or media campaign follows best practices for the promotion of health literacy.</text> </level> <level label="2"> <text>The Department and the Hub shall encourage persons that promote public health, health education, or health awareness to submit media for evaluation by the Hub under this section.</text> </level> </level> <level label="c"> <text>When awarding grants, the Department and local health departments shall give special consideration, in a manner determined to be appropriate by the department awarding the grant, to entities that are designated by the Hub to meet health literacy criteria under subsection (b) of this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2207" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <level label="a"> <text>Alleged compliance or noncompliance with a provision of this subtitle is not subject to judicial review.</text> </level> <level label="b"> <text>This subtitle does not create or authorize a right enforceable by administrative or judicial action.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2208" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="22" subtitle_name="Consumer Health Information"> <text>The Department shall adopt regulations to carry out this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="20-2301" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="23" subtitle_name="Plain Language Dental Information"> <level label="a"> <text>In this section, “plain language” means language that is clear, concise, and well–organized and complies with other best practices, including generally accepted guidelines regarding compliance with the federal Plain Writing Act of 2010, appropriate to the subject or field and intended audience.</text> </level> <level label="b"> <text>The Department shall:</text> <level label="1"> <text>Create and distribute to dental practices plain language materials regarding:</text> <level label="i"> <text>The importance of regular dental appointments for an individual’s overall health; and</text> </level> <level label="ii"> <text>Various dental procedures, as determined by the Department; and</text> </level> </level> <level label="2"> <text>Encourage dentists and dental hygienists to distribute the plain language materials created in accordance with item (1) of this subsection to their patients.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-2401" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <text>In this subtitle, “Commission” means the Maryland Emergency Department Wait Time Reduction Commission. </text> </section> <section article="ghg" article_name="Health - General" number="20-2402" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <level label="a"> <level label="1"> <text>There is a Maryland Emergency Department Wait Time Reduction Commission.</text> </level> <level label="2"> <text>The purpose of the Commission is to address factors throughout the health care system that contribute to increased emergency department wait times.</text> </level> </level> <level label="b"> <text>The Commission consists of the following members:</text> <level label="1"> <text>The Secretary, or the Secretary’s designee;</text> </level> <level label="2"> <text>The Executive Director of the Maryland Institute for Emergency Medical Services Systems, or the Executive Director’s designee;</text> </level> <level label="3"> <text>The Executive Director of the Health Services Cost Review Commission, or the Executive Director’s designee;</text> </level> <level label="4"> <text>The Executive Director of the Maryland Health Care Commission, or the Executive Director’s designee; and</text> </level> <level label="5"> <text>The following members, appointed by the Secretary:</text> <level label="i"> <text>Two individuals who have operations leadership responsibilities over a hospital emergency department in the State, including one emergency department physician;</text> </level> <level label="ii"> <text>One individual with professional experience in an emergency department who is not a physician or an advanced practice provider, such as a nurse or care manager;</text> </level> <level label="iii"> <text>One representative of a local emergency medical service;</text> </level> <level label="iv"> <text>One representative of a managed care plan with experience in care management or care coordination;</text> </level> <level label="v"> <text>One representative of an advanced primary care practice;</text> </level> <level label="vi"> <text>One representative of the Maryland Hospital Association;</text> </level> <level label="vii"> <text>One representative of a patient advocacy organization; and</text> </level> <level label="viii"> <text>One representative of a behavioral health provider.</text> </level> </level> </level> <level label="c"> <text>The Secretary of Health and the Executive Director of the Health Services Cost Review Commission shall cochair the Commission.</text> </level> <level label="d"> <text>The Health Services Cost Review Commission shall provide staff for the Commission.</text> </level> <level label="e"> <text>A member of the Commission:</text> <level label="1"> <text>May not receive compensation as a member of the Commission; but</text> </level> <level label="2"> <text>Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-2403" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <text>The Commission shall develop strategies and initiatives to recommend to State and local agencies, hospitals, and health care providers to reduce emergency department wait times, including:</text> <level label="1"> <text>Initiatives that:</text> <level label="i"> <text>Ensure that patients are seen in the most appropriate setting to reduce unnecessary use of emergency departments;</text> </level> <level label="ii"> <text>Improve hospital efficiency, including by increasing emergency department and inpatient throughput; and</text> </level> <level label="iii"> <text>Improve postdischarge resources to facilitate timely emergency department and inpatient discharges;</text> </level> </level> <level label="2"> <text>By identifying and recommending improvements for the collection and submission of data that is necessary to monitor and reduce emergency department wait times;</text> </level> <level label="3"> <text>By making recommendations to State and local agencies, hospitals, and health care providers; and</text> </level> <level label="4"> <text>By facilitating the sharing of best practices for reducing emergency department wait times.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2404" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <text>In carrying out its duties, the Commission may:</text> <level label="1"> <text>Recommend that State and local agencies, hospitals, and health care providers implement the strategies and initiatives developed under § 20–2403 of this subtitle;</text> </level> <level label="2"> <text>Request interviews with State and local officials;</text> </level> <level label="3"> <text>Request data from:</text> <level label="i"> <text>The Department;</text> </level> <level label="ii"> <text>The Maryland Institute for Emergency Medical Services Systems;</text> </level> <level label="iii"> <text>The Health Services Cost Review Commission;</text> </level> <level label="iv"> <text>The Maryland Health Care Commission;</text> </level> <level label="v"> <text>The State–designated health information exchange;</text> </level> <level label="vi"> <text>Hospitals in the State;</text> </level> <level label="vii"> <text>Other providers of health care services; and</text> </level> <level label="viii"> <text>Payors for health care services; and</text> </level> </level> <level label="4"> <text>Create advisory workgroups that do not include members of the Commission.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2405" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <level label="a"> <text>Except as provided in subsection (b) of this section, an entity that receives a request for data under § 20–2404 of this subtitle shall:</text> <level label="1"> <text>For data that does not contain personally identifiable information, promptly transmit the data to the staff of the Commission provided by the Health Services Cost Review Commission; and</text> </level> <level label="2"> <text>For data that contains personally identifiable information:</text> <level label="i"> <text>Promptly enter into an appropriate data sharing and use agreement with the Health Services Cost Review Commission; and</text> </level> <level label="ii"> <text>On the approval of an appropriate agreement by the parties, promptly transmit the data, through a secure and encrypted manner, to the staff of the Commission provided by the Health Services Cost Review Commission.</text> </level> </level> </level> <level label="b"> <text>If an entity that receives a data request under § 20–2404 of this subtitle is prohibited from sharing the data under federal law, the Commission may not require the submission of the data.</text> </level> <level label="c"> <text>The Commission may use personally identifiable information requested under § 20–2404 of this subtitle only for the purpose of meeting the requirements of § 20–2403 of this subtitle and completing the reports required under § 20–2406 of this subtitle.</text> </level> <level label="d"> <text>Personally identifiable information submitted under subsection (a)(2) of this section may not be shared with:</text> <level label="1"> <text>A member of the Commission who is not an employee of the Health Services Cost Review Commission; or</text> </level> <level label="2"> <text>Any other person that is not a party to the data sharing and use agreement for the information.</text> </level> </level> <level label="e"> <text>Commission staff shall:</text> <level label="1"> <text>Analyze personally identifiable information shared with the Commission staff; and</text> </level> <level label="2"> <text>Share the findings of the analysis with the members of the Commission in a manner that does not reveal personally identifiable information.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="20-2406" effective_note="EFFECTIVE UNTIL JUNE 30, 2027 PER CHAPTER 844 OF 2024" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="24" subtitle_name="Maryland Emergency Department Wait Time Reduction Commission"> <text>On or before November 1 each year, beginning in 2025, the Commission shall submit to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly a report on its activities and its findings and recommendations, including an update on the development, implementation, and impact of the recommended policies and programs developed to improve emergency department wait times.</text> </section> <section article="ghg" article_name="Health - General" number="20-2501" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="25"> <text>In this subtitle: </text> <level label="1"> <text>“Caregiver” means an individual who provides care, supervision, or assistance to another individual due to the individual’s age, disability, chronic illness, cognitive impairment, or other functional limitation;</text> </level> <level label="2"> <text>“Caregiver” includes:</text> <level label="i"> <text>A parent or guardian of a child with a disability, chronic illness, cognitive impairment, or other functional limitation;</text> </level> <level label="ii"> <text>An individual caring for an adult family member or loved one with a disability, chronic illness, cognitive impairment, or other functional limitation; and</text> </level> <level label="iii"> <text>A minor or dependent providing care to a parent, grandparent, or other adult due to the age, disability, chronic illness, cognitive impairment, or other functional limitation of the parent, grandparent, or other adult; and</text> </level> </level> <level label="3"> <text>“Caregiver” does not include a parent or guardian providing care, supervision, or assistance to a child that does not have a disability, chronic illness, cognitive impairment, or other functional limitation.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2502" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="25"> <level label="a"> <text>The Department shall develop and maintain a centralized caregiver resource webpage for caregivers in the State.</text> </level> <level label="b"> <text>The caregiver resource webpage shall:</text> <level label="1"> <text>Be posted in a conspicuous location on the Department’s website; and</text> </level> <level label="2"> <text>Provide plain–language, easily accessible information to support all types of caregivers at different stages of caregiving.</text> </level> </level> <level label="c"> <text>The caregiver resource webpage shall include information and links to resources related to:</text> <level label="1"> <text>Caregiving for:</text> <level label="i"> <text>Children with disabilities and special health care needs, including educational and school–based supports;</text> </level> <level label="ii"> <text>Adults with disabilities, chronic illness, or behavioral health needs; and</text> </level> <level label="iii"> <text>Older adults, including individuals with dementia or cognitive impairment;</text> </level> </level> <level label="2"> <text>Caregiver health, wellness, and respite resources;</text> </level> <level label="3"> <text>State and local programs that may provide financial assistance, training, or support to caregivers;</text> </level> <level label="4"> <text>Safety planning, including wandering and elopement risks; and</text> </level> <level label="5"> <text>Privacy, data minimization, and data security considerations when technology is used to support caregiving or safety.</text> </level> </level> <level label="d"> <text>In developing the webpage under subsection (a) of this section, the Department shall coordinate with:</text> <level label="1"> <text>The State Department of Education;</text> </level> <level label="2"> <text>The Department of Aging;</text> </level> <level label="3"> <text>The Developmental Disabilities Administration; and</text> </level> <level label="4"> <text>Any other relevant State or local agencies.</text> </level> </level> <level label="e"> <text>The Department shall review and update the webpage as necessary, but not less than annually.</text> </level> </section> <section article="ghg" article_name="Health - General" number="20-2503" title_number="20" title_name="Miscellaneous Health Provisions" subtitle_number="25"> <text>This subtitle may not be construed to require the Department, any State or local agency, or any other person described, listed, or linked to on the caregivers resource webpage to provide or fund a specific service, device, resource, or program described, listed, or linked to on the caregivers resource webpage.</text> </section>