<section article="ghg" article_name="Health - General" number="3-101" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="1" subtitle_name="Definitions"> <level label="a"> <text>In this title the following words have the meanings indicated.</text> </level> <level label="b"> <text>“County” does not include Baltimore City.</text> </level> <level label="c"> <text>“Health officer” does not include the Baltimore City Commissioner of Health.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-201" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="2" subtitle_name="County Boards of Health"> <level label="a"> <text>Except as provided in subsection (b) of this section, the governing body of a county is ex officio the board of health for the county.</text> </level> <level label="b"> <text>In a code county or charter county, the governing body is ex officio the board of health for the county, unless the governing body establishes a board of health.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-202" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="2" subtitle_name="County Boards of Health"> <level label="a"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, each county board of health shall exercise the duties imposed by law on a board of health.</text> </level> <level label="2"> <text>The county board of health shall exercise those duties in each municipality or special taxing district in the county unless the municipality or district has a charter provision or ordinance that:</text> <level label="i"> <text>Covers the same subject matter;</text> </level> <level label="ii"> <text>Is at least as restrictive as the provision that the county board is required to enforce; and</text> </level> <level label="iii"> <text>Includes provisions for enforcement.</text> </level> </level> </level> <level label="b"> <text>In addition to the other duties provided by law, each county board of health shall:</text> <level label="1"> <text>Meet in May and October of each year and at any other time the board considers necessary;</text> </level> <level label="2"> <text>Coordinate its activities with the Department; and</text> </level> <level label="3"> <text>Report to the Department on the sanitary conditions of the county whenever the board considers it important and necessary to do so.</text> </level> </level> <level label="c"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, each county board of health may set any fee or charge in connection with its rules and regulations.</text> </level> <level label="2"> <text>A fee or charge for a service that is provided wholly or partly with State or federal funds that the Department administers is subject to approval and modification by the Secretary.</text> </level> </level> <level label="d"> <text>In addition to the other powers provided by law and subject to the provisions of this article, each county board of health may adopt and enforce rules and regulations on any nuisance or cause of disease in the county.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-301" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>There is a health officer for each county.</text> </level> <level label="b"> <text>Subsection (a) of this section does not prevent an individual from serving as a health officer for more than 1 county.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-302" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>The health officer for a county shall be nominated by the county and appointed by the Secretary.</text> </level> <level label="b"> <level label="1"> <text>The governing body of each county shall establish, by ordinance or resolution, the process by which the county nominates an individual for health officer.</text> </level> <level label="2"> <text>If a vacancy occurs in the position of health officer for a county, the governing body shall establish a process, in consultation with the Department, for making a recommendation to the Secretary for the appointment of a health officer.</text> </level> <level label="3"> <text>The process established under paragraph (2) of this subsection shall include the requirements for recruiting, interviewing, and recommending applicants for the position of health officer.</text> </level> </level> <level label="c"> <level label="1"> <text>If the Secretary finds that a nominee meets the qualifications of this section, the Secretary shall appoint the nominee as health officer.</text> </level> <level label="2"> <text>If the Secretary finds that the nominee does not meet the qualifications of this section, the Secretary shall reject the nomination, and the county shall provide the Secretary with another nomination.</text> </level> </level> <level label="d"> <text>Each health officer:</text> <level label="1"> <text>Shall have:</text> <level label="i"> <text>A master’s degree in public health and at least 2 years’ work in the field of public health; or</text> </level> <level label="ii"> <text>At least 5 years’ work in the field of public health;</text> </level> </level> <level label="2"> <text>Shall have any other qualifications and training in the field of public health that the Secretary requires by rule or regulation; and</text> </level> <level label="3"> <text>Need not be a physician, if the health officer has a deputy who:</text> <level label="i"> <text>Is a physician; and</text> </level> <level label="ii"> <text>Meets the qualifications of this subsection.</text> </level> </level> </level> <level label="e"> <text>Before taking office, each appointee to the office of health officer shall take the oath required by Article I, § 9 of the Maryland Constitution.</text> </level> <level label="f"> <level label="1"> <text>The health officer for a county may be removed from office with the concurrence of the governing body of that county and the Secretary.</text> </level> <level label="2"> <level label="i"> <text>Any information concerning the removal of a health officer from office is confidential in accordance with Title 4 of the General Provisions Article.</text> </level> <level label="ii"> <text>Any meeting of the governing body of a county or any meeting that includes the Secretary related to the removal of a health officer from office shall be closed.</text> </level> </level> <level label="3"> <level label="i"> <text>If the Secretary and the governing body concur on the removal of a health officer, the Secretary shall provide written notification to the health officer that includes:</text> <level label="1"> <text>The basis for the removal;</text> </level> <level label="2"> <text>Documentation supporting the removal; and</text> </level> <level label="3"> <text>Notice of the opportunity to request a hearing with the Secretary within 10 days after receipt of the written notification and information on how to request the hearing.</text> </level> </level> <level label="ii"> <text>If the health officer requests a hearing with the Secretary:</text> <level label="1"> <text>The Secretary promptly shall hold a hearing, provided that the hearing may not be held sooner than 10 days or later than 30 days after the Secretary sends the health officer a notice of the removal;</text> </level> <level label="2"> <text>The health officer shall have an opportunity to be heard before the Secretary in the health officer’s defense; and</text> </level> <level label="3"> <text>The Secretary shall make a final decision not later than 10 days after the date of the hearing.</text> </level> </level> </level> <level label="4"> <text>Not later than 30 days after the Secretary makes a decision under paragraph (3) of this subsection, a health officer may request a hearing before the appropriate circuit court to ensure that the proceedings for the removal of the health officer were conducted in accordance with paragraph (3) of this subsection.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="3-303" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>If a health officer or deputy of a health officer is a physician, the health officer or deputy may practice medicine with the approval of the local governing body.</text> </level> <level label="b"> <text>The local governing body shall notify the Secretary of its approval.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-304" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>The health officer for a county is entitled to:</text> <level label="1"> <text>The salary provided in the State budget;</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget; and</text> </level> <level label="3"> <text>Any additional salary that the county provides.</text> </level> </level> <level label="b"> <text>Except as otherwise provided by law, each health officer is a special appointment in the State Personnel Management System.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-305" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <level label="1"> <text>The governing body of each county shall establish, by ordinance or resolution, the process by which the county evaluates its health officer.</text> </level> <level label="2"> <text>The Secretary shall establish, by rule or regulation, the process by which the Secretary evaluates health officers.</text> </level> </level> <level label="b"> <level label="1"> <text>At least annually, the health officer for a county shall be evaluated, in writing, by the Secretary and by the county.</text> </level> <level label="2"> <text>The Secretary and the county each shall review their respective evaluations of a health officer with the health officer.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="3-306" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>Except as provided by agreement between the Secretary and the local governing body, and in addition to the powers and duties set forth elsewhere, each health officer has the powers and duties set forth in this section.</text> </level> <level label="b"> <text>A health officer may obtain samples of food and drugs for analysis.</text> </level> <level label="c"> <level label="1"> <text>The health officer for a county is the executive officer and secretary of the county board of health.</text> </level> <level label="2"> <text>Except in Montgomery County, the health officer for a county shall appoint the staff of the county health department.</text> </level> <level label="3"> <text>The health officer for a county shall have an office at an accessible place in the county.</text> </level> <level label="4"> <level label="i"> <text>The health officer for a county shall enforce throughout the county:</text> <level label="1"> <text>Under the direction of the Secretary, the State health laws and the policies, rules, and regulations that the Secretary adopts; and</text> </level> <level label="2"> <text>Except as provided in subparagraph (ii) of this paragraph, under the direction of the county board of health, the rules and regulations that the county board of health adopts.</text> </level> </level> <level label="ii"> <text>The health officer for a county shall enforce in each municipality or special taxing district in the county the rules or regulations that the county board of health adopts unless the municipality or district has a charter provision or ordinance that:</text> <level label="1"> <text>Covers the same subject matter as the county rule or regulation;</text> </level> <level label="2"> <text>Is at least as restrictive as the county rule or regulation; and</text> </level> <level label="3"> <text>Includes provisions for enforcement.</text> </level> </level> </level> <level label="5"> <text>A health officer shall perform any investigation or other duty or function directed by the Secretary or the county board of health and submit appropriate reports to them.</text> </level> </level> <level label="d"> <level label="1"> <text>Subject to the consent of the governing body of the county and the written approval of the Secretary, a health officer for a county may enter into a contract or any other written agreement to assist or participate in the delivery of health care services with a person that is authorized to provide, finance, coordinate, facilitate, or otherwise deliver health care services in the State.</text> </level> <level label="2"> <text>If the Secretary does not respond to a request for written approval within 7 days after receiving the request, the health officer for the county may enter the contract or written agreement.</text> </level> </level> <level label="e"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, a health officer for a county and the Baltimore City Commissioner of Health may authorize the county health department to retain all collections, including any unspent balance at the end of a fiscal year, received from:</text> <level label="i"> <text>Fees authorized under this article;</text> </level> <level label="ii"> <text>Fees authorized under the Environment Article; and</text> </level> <level label="iii"> <text>Fees derived from charges authorized under Title 16, Subtitle 2 of this article.</text> </level> </level> <level label="2"> <text>The authority to retain collections under paragraph (1) of this subsection does not apply:</text> <level label="i"> <text>To license fees set by a county governing body or Baltimore City and paid to the chief financial officer of the county or Baltimore City as authorized under State law;</text> </level> <level label="ii"> <text>To fees that must be transferred to the General Fund under § 4–217(c) of this article from the fees collected for each birth certificate issued or report issued that a search was made but the requested record is not on file; or</text> </level> <level label="iii"> <text>If the retention of collections would be inconsistent with established local practice.</text> </level> </level> <level label="3"> <text>Each health officer for a county and the Baltimore City Commissioner of Health shall report annually to the Secretary on the use of collections retained under paragraph (1) of this subsection.</text> </level> </level> <level label="f"> <text>A health officer for a county may serve on the board of a hospital in the State as a representative of a local health department only if the health officer does not accept payment for the health officer’s service on the board.</text> </level> <level label="g"> <text>The Secretary may delegate duties, powers, and functions as provided in this article to a health officer for a county or other county official authorized to administer and enforce health and environmental laws.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-306.1" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>This section applies only in Howard County.</text> </level> <level label="b"> <text>The Secretary shall notify the county health officer when the Department receives an application for licensure or certification for a health facility or program that will serve 16 or more individuals.</text> </level> <level label="c"> <text>If the county health officer receives notice under subsection (b) of this section, then the county health officer shall notify the county council.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-307" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <level label="a"> <text>In the performance of official duties, a health officer may enter and inspect any private house if the health officer:</text> <level label="1"> <text>Has obtained consent to enter and inspect;</text> </level> <level label="2"> <text>Has obtained a warrant; or</text> </level> <level label="3"> <text>Does not have time or opportunity to obtain a warrant and an exceptional or emergency situation exists.</text> </level> </level> <level label="b"> <text>In the performance of official duties, a health officer may enter any place of business or employment.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-308" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <text>If a health emergency exists, the Secretary may assign temporarily a health officer to another county or Baltimore City.</text> </section> <section article="ghg" article_name="Health - General" number="3-309" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <text>Whenever necessary, the Secretary may:</text> <level label="1"> <text>Call a public conference of health officers; or</text> </level> <level label="2"> <text>Send a delegate to any conference of health officers.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-310" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="3" subtitle_name="Health Officers"> <text>Unless otherwise provided by State law or regulation, as each reference to a county health department or local health department in the Code applies to Montgomery County, the term means the Montgomery County government.</text> </section> <section article="ghg" article_name="Health - General" number="3-401" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="4" subtitle_name="Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Authorized prescriber” means a licensed registered nurse, licensed dentist, licensed physician, licensed physician’s assistant, licensed podiatrist, or other individual authorized by law to prescribe prescription or nonprescription drugs or devices.</text> </level> <level label="c"> <text>“Committee” means the Committee on Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments.</text> </level> <level label="d"> <level label="1"> <text>“Device” means an item used in the diagnosis, treatment, or prevention of disease.</text> </level> <level label="2"> <text>“Device” does not include:</text> <level label="i"> <text>Surgical or dental instruments;</text> </level> <level label="ii"> <text>Physical therapy equipment;</text> </level> <level label="iii"> <text>X–ray apparatuses; or</text> </level> <level label="iv"> <text>Component parts of or accessories for any of the items described in items (i) through (iii) of this paragraph.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>“Dispense” means a procedure that results in the receipt of a drug or device by a patient or a patient’s agent.</text> </level> <level label="2"> <text>“Dispense” includes:</text> <level label="i"> <text>Interpreting an authorized prescriber’s prescription for a drug or device;</text> </level> <level label="ii"> <text>Selecting and labeling the drug or device prescribed;</text> </level> <level label="iii"> <text>Measuring and packaging the drug or device in accordance with State and federal law; and</text> </level> <level label="iv"> <text>Documenting the transaction in the patient’s medical record.</text> </level> </level> </level> <level label="f"> <text>“Drug” means, unless the context requires otherwise, a prescription or nonprescription drug.</text> </level> <level label="g"> <text>“Formulary” means a list of drugs and devices.</text> </level> <level label="h"> <text>“Nonprescription drug” means a drug that:</text> <level label="1"> <text>May be sold without a prescription; and</text> </level> <level label="2"> <text>Is labeled for use by a consumer in accordance with State and federal law.</text> </level> </level> <level label="i"> <text>“Personally prepare and dispense” means to:</text> <level label="1"> <text>Physically prepare a prescription;</text> </level> <level label="2"> <text>Perform a final check of the prescription before dispensing it to a patient; and</text> </level> <level label="3"> <text>Not delegate any step of the dispensing process.</text> </level> </level> <level label="j"> <text>“Prescription drug” means a drug that, under § 21–220 of this article, may be dispensed only on the prescription of an authorized prescriber.</text> </level> <level label="k"> <text>“Registered nurse” means an individual who:</text> <level label="1"> <text>Is licensed by the State Board of Nursing to practice registered nursing under Title 8 of the Health Occupations Article; and</text> </level> <level label="2"> <text>Personally prepares and dispenses drugs and devices in a local health department:</text> <level label="i"> <text>In accordance with the Overdose Response Program under Title 13, Subtitle 31 of this article or the Expedited Partner Therapy Pilot Program under § 18–214.1 of this article; or</text> </level> <level label="ii"> <text>To patients in need of communicable disease, alcohol and drug abuse, family planning, or reproductive health services.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="3-402" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="4" subtitle_name="Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments"> <text>A registered nurse shall comply with:</text> <level label="1"> <text>The formulary developed and approved under § 3–403(b) of this subtitle; and</text> </level> <level label="2"> <text>The requirements of § 8–512 of the Health Occupations Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="3-403" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="4" subtitle_name="Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments"> <level label="a"> <level label="1"> <text>There is a Committee on Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments.</text> </level> <level label="2"> <text>The Committee consists of the following members:</text> <level label="i"> <text>A representative of the Department, appointed by the Department;</text> </level> <level label="ii"> <text>A representative of the State Board of Nursing, appointed by the State Board of Nursing;</text> </level> <level label="iii"> <text>A representative of the State Board of Pharmacy, appointed by the State Board of Pharmacy;</text> </level> <level label="iv"> <text>A representative of the State Board of Physicians, appointed by the State Board of Physicians;</text> </level> <level label="v"> <text>A pharmacist who practices in the State, appointed by the State Board of Pharmacy;</text> </level> <level label="vi"> <text>A registered nurse who practices in the State, appointed by the State Board of Nursing;</text> </level> <level label="vii"> <text>A representative of the Office of Controlled Substances Administration, appointed by the Office; and</text> </level> <level label="viii"> <text>A representative of a local health department, appointed by the Department.</text> </level> </level> <level label="3"> <level label="i"> <text>The term of a member is 4 years.</text> </level> <level label="ii"> <text>At the end of a term, a member continues to serve until a successor is appointed.</text> </level> </level> <level label="4"> <text>A member of the Committee:</text> <level label="i"> <text>May not receive compensation as a member of the Committee; but</text> </level> <level label="ii"> <text>Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> <level label="5"> <text>The Secretary shall designate the chair of the Committee.</text> </level> <level label="6"> <text>The Department shall provide staff for the Committee.</text> </level> </level> <level label="b"> <text>The Committee shall:</text> <level label="1"> <text>Develop and approve a formulary for use by registered nurses that includes all nonprescription contraceptive drugs and devices approved by the U.S. Food and Drug Administration for over–the–counter use; and</text> </level> <level label="2"> <text>Annually review the formulary to ensure compliance with current prescribing standards.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="3-404" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="4" subtitle_name="Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments"> <text>A local health department that employs a registered nurse shall be subject to inspection by the Department.</text> </section> <section article="ghg" article_name="Health - General" number="3-405" title_number="3" title_name="County Boards of Health; Health Officers" subtitle_number="4" subtitle_name="Registered Nurses Personally Preparing and Dispensing Drugs and Devices in Local Health Departments"> <level label="a"> <text>The Department shall establish and administer a training program for registered nurses.</text> </level> <level label="b"> <text>The training program shall be jointly developed and annually reviewed to ensure compliance with current prescribing standards by:</text> <level label="1"> <text>The Department;</text> </level> <level label="2"> <text>The State Board of Nursing; and</text> </level> <level label="3"> <text>The State Board of Pharmacy.</text> </level> </level> </section>