Health Occupations (GHO) — Title 8. Nurses
Statutes in effect as of October 1, 2026.
Subtitle 1. Definitions; General Provisions
Md. Code Ann., Health Occ. § 8-101 (2026)
Title 8. Nurses
Subtitle 1. Definitions; General Provisions
§ 8–101LinkCopy Citation
(a)
In this title the following words have the meanings indicated.
(b)
“Advanced practice registered nurse” means an individual who:
(1)
(i)
Is licensed by the Board to practice registered nursing; or
(ii)
Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and
(2)
Is certified by the Board to practice as:
(i)
A nurse practitioner;
(ii)
A nurse anesthetist;
(iii)
A nurse midwife; or
(iv)
A clinical nurse specialist.
(c)
“Applicant” means, unless the context requires otherwise:
(1)
An individual applying for an initial license by examination or endorsement;
(2)
A licensee applying for renewal of a license;
(3)
An individual applying for an initial advanced practice registered nurse certification;
(4)
A licensee applying for renewal of an advanced practice registered nurse certification; or
(5)
An individual applying for reinstatement of a license in accordance with § 8–319 of this title.
(d)
“Board” means the State Board of Nursing.
(d–1)
(1)
“Entry–level registered nursing education program” means a registered nursing education program that is the initial entry point for formal registered nursing education that, on successful completion, qualifies an individual with no prior registered nursing education to obtain licensure as a registered nurse.
(2)
“Entry–level registered nursing education program” does not include degree completion programs, including:
(i)
Associate of Applied Science Degree in Nursing to Baccalaureate of Science Degree in Nursing (AAS–BSN);
(ii)
Associate Degree in Nursing to Baccalaureate of Science Degree in Nursing (ADN–BSN);
(iii)
Associate of Applied Science Degree in Nursing to Master of Science Degree in Nursing (AAS–MSN);
(iv)
Associate Degree in Nursing to Master of Science Degree in Nursing (ADN–MSN);
(v)
Baccalaureate of Science Degree in Nursing to Master of Science Degree in Nursing (BSN–MSN);
(vi)
Baccalaureate of Science Degree in Nursing to Doctor of Philosophy (BSN–PHD);
(vii)
Baccalaureate of Science Degree in Nursing to Doctor of Education (BSN–EDD);
(viii)
Baccalaureate of Science Degree in Nursing to Doctor of Nursing Practice (BSN–DNP);
(ix)
Master of Science Degree in Nursing to Doctor of Philosophy (MSN–PHD);
(x)
Master of Science Degree in Nursing to Doctor of Education (MSN–EDD);
(xi)
Master of Science Degree in Nursing to Doctor of Nursing Practice (MSN–DNP); and
(xii)
Master of Science Degree in Nursing to Post Masters Certificate/Post Graduate Certificate.
(e)
“Expired license” means, unless the context requires otherwise, a license that was not renewed before the expiration date of the license as established under § 8–312(a) of this title.
(f)
“Lapsed license” means, unless the context requires otherwise, a license that was not renewed because a licensee failed to renew the license or otherwise did not meet the renewal requirements of this title.
(g)
“License” means, unless the context requires otherwise, a license issued by the Board to practice:
(1)
Registered nursing;
(2)
Licensed practical nursing; or
(3)
Advanced practice registered nursing.
(h)
“Licensed practical nurse” means, unless the context requires otherwise, an individual who:
(1)
Is licensed by the Board to practice licensed practical nursing; or
(2)
Has a multistate licensure privilege to practice licensed practical nursing under the Nurse Licensure Compact.
(i)
“Licensee” means, unless the context requires otherwise, a registered nurse or licensed practical nurse who has:
(1)
An active license;
(2)
An inactive license;
(3)
A temporary license;
(4)
An expired temporary license;
(5)
An expired license;
(6)
A lapsed license;
(7)
A suspended license;
(8)
A license subject to a reprimand, probation, or suspension; or
(9)
A multistate licensure privilege to practice registered nursing or licensed practical nursing under the Nurse Licensure Compact.
(j)
“Mentor” means a certified registered nurse practitioner or a licensed physician:
(1)
Who has 3 or more years of clinical practice experience; and
(2)
With whom an individual applying for certification as a certified nurse practitioner will consult and collaborate with as needed in accordance with § 8–302.1(d) of this title.
(k)
“Nurse anesthetist” means an individual who:
(1)
Is licensed by the Board to practice registered nursing; and
(2)
Is certified by the Board to practice as a nurse anesthetist.
(l)
“Practice advanced practice registered nursing” means to practice registered nursing within the scope of practice in the area of specialty for which the individual holds a certification from a nationally recognized certifying body recognized by the Board.
(m)
“Practice as a registered nurse practitioner” means to independently:
(1)
Perform an act under subsection (o) of this section;
(2)
Conduct a comprehensive physical assessment of an individual;
(3)
Establish a medical diagnosis for common chronic stable or short–term health problems;
(4)
Order, perform, and interpret laboratory tests;
(5)
Prescribe drugs as provided under § 8–508 of this title;
(6)
Perform diagnostic, therapeutic, or corrective measures;
(7)
Consult and collaborate with, or refer an individual to, an appropriate licensed physician or any other health care provider as needed; and
(8)
Provide emergency care.
(n)
“Practice licensed practical nursing” means to perform in a team relationship an act that requires specialized knowledge, judgment, and skill based on principles of biological, physiological, behavioral, or sociological science to:
(1)
Administer treatment or medication to an individual;
(2)
Aid in the rehabilitation of an individual;
(3)
Promote preventive measures in community health;
(4)
Give counsel to an individual;
(5)
Safeguard life and health;
(6)
Teach or supervise; or
(7)
Perform any additional acts authorized by the Board under § 8–205 of this title.
(o)
(1)
“Practice registered nursing” means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the biological, physiological, behavioral, or sociological sciences as the basis for assessment, nursing diagnosis, planning, implementation, and evaluation of the practice of nursing in order to:
(i)
Maintain health;
(ii)
Prevent illness; or
(iii)
Care for or rehabilitate the ill, injured, or infirm.
(2)
For these purposes, “practice registered nursing” includes:
(i)
Administration;
(ii)
Teaching;
(iii)
Counseling;
(iv)
Supervision, delegation, and evaluation of nursing practice;
(v)
Execution of therapeutic regimen, including the administration of medication and treatment;
(vi)
Independent nursing functions and delegated medical functions; and
(vii)
Performance of additional acts authorized by the Board under § 8–205 of this title.
(p)
“Registered nurse” means, unless the context requires otherwise, an individual who:
(1)
Is licensed by the Board to practice registered nursing; or
(2)
Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact.
(q)
“Registered nurse practitioner” means an individual who:
(1)
(i)
Is licensed by the Board to practice registered nursing; or
(ii)
Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and
(2)
Is certified by the Board to practice as a registered nurse practitioner.
Md. Code Ann., Health Occ. § 8-102 (2026)
Title 8. Nurses
Subtitle 1. Definitions; General Provisions
§ 8–102LinkCopy Citation
(a)
In this section, “Christian Science nurse” means an individual who is registered as a Christian Science nurse in the Christian Science Journal of the Christian Science Publishing Society.
(b)
Except as specifically provided in this title, this title does not limit the right of:
(1)
An individual to practice a health occupation that the individual is authorized to practice under this article;
(2)
A Christian Science nurse to care for an individual who is ill, injured, or infirm, if the Christian Science nurse does not administer any drug or medicine; or
(3)
An unlicensed individual to perform acts of registered nursing or acts of licensed practical nursing:
(i)
While supervised by an individual who is authorized by this State to practice registered nursing or licensed practical nursing; and
(ii)
If the unlicensed individual performs only acts that are in the area of responsibility of the supervisor and under the instruction of the supervisor.
Subtitle 2. State Board of Nursing
Md. Code Ann., Health Occ. § 8-201 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–201LinkCopy Citation
There is a State Board of Nursing in the Department.
Md. Code Ann., Health Occ. § 8-202 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–202LinkCopy Citation
(a)
(1)
The Board consists of 14 members.
(2)
Of the 14 Board members:
(i)
9 shall be registered nurses;
(ii)
1 shall be a licensed nurse who is either a licensed practical nurse, a registered nurse, or an advanced practice registered nurse;
(iii)
2 shall be licensed practical nurses; and
(iv)
2 shall be consumers.
(3)
Of the 9 registered nurse members:
(i)
2 shall be advanced practice registered nurses;
(ii)
1 shall be a baccalaureate nursing educator with, at least, a master’s degree in nursing or education;
(iii)
1 shall be an associate degree nursing educator with, at least, a master’s degree in nursing or education;
(iv)
1 shall be a practical nursing educator with, at least, a master’s degree in nursing or education;
(v)
1 shall be a nurse administrator with, at least, a master’s degree in nursing administration, business administration, business management, education, or public health;
(vi)
1 shall be a nurse clinician with at least a master’s degree in nursing or public health;
(vii)
1 shall be a currently practicing nurse, who has practiced acute care for at least 5 years, with a bachelor of science degree in nursing; and
(viii)
1 shall be a currently practicing nurse who has practiced as a delegating nurse in a supervised group living setting, as defined in COMAR 10.27.11.02(21), for at least 5 years.
(4)
Of the 2 licensed practical nurse members, at least 1 shall practice in a long–term care nursing facility.
(b)
(1)
The Governor shall appoint:
(i)
The advanced practice registered nurse members, with the advice of the Secretary, from a list of qualified individuals jointly developed in accordance with the requirements of subsection (a)(3)(i) of this section and submitted to the Secretary and the Governor by the:
(1)
Maryland Association of Nurse Anesthetists, Inc.;
(2)
Nurse Practitioners Association of Maryland, Inc.;
(3)
Maryland Academy of Advanced Practice Clinicians;
(4)
Maryland Chapter, American College of Nurse–Midwives; and
(5)
Psychiatric Advance Practice Nurses of Maryland; and
(ii)
The other registered nurse members, with the advice of the Secretary, from:
(1)
A list of qualified individuals submitted to the Secretary and the Governor by:
(A)
The Maryland Nurses Association, Inc.; or
(B)
Any other professional nursing organization that represents at least 25 licensed registered nurses; or
(2)
A valid petition submitted to the Secretary and the Governor by a registered nurse with an active license under this title.
(2)
The Governor shall appoint the licensed practical nurse members, with the advice of the Secretary, from:
(i)
A list of qualified individuals submitted to the Secretary and the Governor by:
(1)
The Maryland Licensed Practical Nurse Association, Inc.; or
(2)
Any other professional nursing organization representing at least 25 licensed practical nurses; or
(ii)
A valid petition submitted to the Secretary and the Governor by a licensed practical nurse with an active license under this title.
(3)
A list submitted to the Secretary and the Governor under this subsection shall be 5 times the number of vacancies.
(4)
A petition submitted to the Secretary and the Governor under this subsection shall:
(i)
For a registered nurse member vacancy, have at least 25 signatures of support from registered nurses with active licenses in the State;
(ii)
For an advanced practice registered nurse member vacancy, have at least 25 signatures of support from advanced practice registered nurses with active licenses in the State; and
(iii)
For a licensed practical nurse member vacancy, have at least 25 signatures of support from licensed practical nurses with active licenses in the State.
(5)
The Board shall provide notice of a vacancy on the Board to:
(i)
All registered nurses, advanced practice registered nurses, and licensed practical nurses with an active license in the State; and
(ii)
All appropriate professional nursing organizations.
(6)
The Governor may request an additional list of 5 nominees for each vacancy from the appropriate professional nursing organizations.
(7)
The Governor shall make the appointment for each vacancy from the lists or petitions submitted under this subsection.
(8)
The Governor shall appoint the consumer members with the advice of the Secretary and the advice and consent of the Senate.
(9)
To the extent practicable, the members appointed to the Board shall reasonably reflect the geographic, racial, ethnic, cultural, and gender diversity of the State.
(c)
Each member of the Board shall be:
(1)
A citizen of the United States; and
(2)
A resident of this State.
(d)
(1)
A registered nurse member of the Board shall:
(i)
Have graduated from an approved school of nursing or its equivalent; and
(ii)
Have at least 5 years of experience in nursing administration, education, or practice, which includes at least the 3 years immediately before the appointment.
(2)
A member of the Board who is an advanced practice registered nurse shall:
(i)
Hold a current license to practice registered nursing in this State;
(ii)
Hold a current certification in an advanced practice registered nursing specialty in this State; and
(iii)
Have at least 5 years of experience in an advanced practice registered nursing education program or practice, including at least the 3 years immediately before the appointment.
(e)
A licensed practical nurse member of the Board shall have at least 5 years of experience in the practice of licensed practical nursing, which includes at least the 3 years immediately before the appointment.
(f)
Each consumer member of the Board:
(1)
Shall be a member of the general public;
(2)
May not be or ever have been a registered nurse or licensed practical nurse or in training to become a registered nurse or licensed practical nurse;
(3)
May not have a household member who is a registered nurse or licensed practical nurse or in training to become a registered nurse or licensed practical nurse;
(4)
May not participate or ever have participated in a commercial or professional field related to registered nursing or licensed practical nursing;
(5)
May not have a household member who participates in a commercial or professional field related to registered nursing or licensed practical nursing; or
(6)
May not have had within 2 years before appointment a substantial financial interest in a person who is regulated by the Board.
(g)
While a member of the Board, a consumer member may not have a substantial financial interest in a person regulated by the Board.
(h)
Before taking office, each appointee to the Board shall take the oath required by Article I, § 9 of the Maryland Constitution.
(i)
(1)
The term of a member is 4 years, except that the initial term of 1 of the consumer members is 2 years.
(2)
The terms of the members are staggered as required by the terms provided for members of the Board on July 1, 1981.
(3)
At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4)
A member who is appointed after a term has begun may serve an additional 2 consecutive full terms.
(5)
A member may not serve more than 2 consecutive full terms.
(6)
To the extent practicable, the Governor shall fill any vacancy on the Board within 60 days of the date of the vacancy.
(j)
(1)
The Governor may remove a member for incompetence, misconduct, neglect of a duty required by law, unprofessional conduct, or dishonorable conduct.
(2)
Upon the recommendation of the Secretary, the Governor may remove a member whom the Secretary finds to have been absent from 2 successive Board meetings without adequate reason.
Md. Code Ann., Health Occ. § 8-203 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–203LinkCopy Citation
(a)
(1)
Subject to paragraph (2) of this subsection, from among its members, the Board shall elect a president and a secretary once every 2 years in June or as required by subsection (c) of this section.
(2)
The president of the Board shall be a registered nurse.
(3)
The president shall serve a 2–year term unless:
(i)
The term of the member serving as the president expires before the end of the member’s term as president; or
(ii)
The president resigns.
(b)
The Board shall determine:
(1)
The manner of election of officers; and
(2)
The duties of each officer.
(c)
If a vacancy occurs under subsection (a)(3)(ii) of this section, the Board shall hold a special election to elect a president to complete the term of the vacating president within 30 days of the date of the vacancy.
Md. Code Ann., Health Occ. § 8-204 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–204LinkCopy Citation
(a)
A majority of the appointed members serving on the Board is a quorum.
(b)
In addition to the other meeting requirements of this title, the Board shall meet:
(1)
At the request of the Secretary; or
(2)
If necessary to transact its business.
(c)
In accordance with the State budget, each member of the Board is entitled to:
(1)
Compensation, at a rate determined by the Board, for each day on which the member is engaged in the duties of the member’s office; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations.
(d)
(1)
(i)
The Secretary may employ a staff for the Board in accordance with the State budget.
(ii)
The Secretary may designate one of the staff who is a registered nurse as an executive director.
(2)
The Secretary may set the compensation of an employee of the Board in a position that:
(i)
Is unique to the Board;
(ii)
Requires specific skills or experience to perform the duties of the position; and
(iii)
Does not require the employee to perform functions that are comparable to functions performed in other units of the Executive Branch of State government.
(3)
The Secretary of Budget and Management, in consultation with the Secretary, shall determine the positions for which the Secretary may set compensation under paragraph (2) of this subsection.
Md. Code Ann., Health Occ. § 8-205 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–205LinkCopy Citation
(a)
In addition to the powers and duties set forth elsewhere in this title, the Board has the following powers and duties:
(1)
To adopt rules and regulations to carry out the provisions of this title;
(2)
To set standards for the practice of registered nursing, advanced practice registered nursing, licensed practical nursing, certified nursing assistants, certified dialysis technicians, certified medication technicians, electrology, direct–entry midwifery, and certified midwifery;
(3)
To adopt rules and regulations for the performance of delegated medical functions that are recognized jointly by the State Board of Physicians and the State Board of Nursing, under § 14–306(d) of this article;
(4)
To adopt rules and regulations for the performance of additional nursing acts that:
(i)
May be performed under any condition authorized by the Board, including emergencies; and
(ii)
Require education and clinical experience;
(5)
To adopt rules and regulations for registered nurses to perform independent nursing functions that:
(i)
Require formal education and clinical experience; and
(ii)
May be performed under any condition authorized by the Board, including emergencies;
(6)
To adopt rules and regulations for licensed practical nurses to perform additional acts in the practice of registered nursing that:
(i)
Require formal education and clinical experience;
(ii)
May be performed under any condition authorized by the Board, including emergencies; and
(iii)
Are recognized by the Nursing Board as proper for licensed practical nurses to perform;
(7)
To keep a record of its proceedings;
(8)
To submit to the Governor, the Secretary, and, in accordance with § 2–1257 of the State Government Article, the General Assembly, an annual report that includes:
(i)
The following data calculated on a fiscal year basis:
(1)
The number of initial and renewal licenses and certificates issued;
(2)
The number of positive and negative criminal history records checks results received;
(3)
The number of individuals denied initial or renewal licensure or certification due to positive criminal history records checks results;
(4)
The number of individuals denied licensure or certification due to reasons other than a positive criminal history records check;
(5)
The number of new complaints received;
(6)
The number of complaints carried over from year to year;
(7)
The most common grounds for complaints;
(8)
The number and types of disciplinary actions taken by the Board; and
(9)
Any additional aggregate data, identified by the Board in consultation with stakeholders, determined to be necessary to facilitate workforce and health planning purposes that does not reference any individual’s name or other personal identifier; and
(ii)
By analyzing information gathered from renewal applications submitted under § 8–312 of this title, an evaluation of the State’s nursing workforce by certification level, region, and type of workplace, including hospitals and home health workers;
(9)
To enforce the employment record requirements of this title;
(10)
To keep separate lists, which lists are open to reasonable public inspection, of all:
(i)
Registered nurses licensed under this title;
(ii)
Licensed practical nurses licensed under this title;
(iii)
Nurse midwives certified under this title;
(iv)
Nurse practitioners certified under this title;
(v)
Nurse anesthetists certified under this title;
(vi)
Clinical nurse specialists certified under this title;
(vii)
Certified medication technicians certified under this title;
(viii)
Electrologists licensed under this title;
(ix)
Direct–entry midwives licensed under this title;
(x)
Certified midwives licensed under this title; and
(xi)
Other licensees with a nursing specialty that is certified under this title;
(11)
To collect any funds of the Board;
(12)
To report any alleged violation of this title to the State’s Attorney of the county where the alleged violation occurred;
(13)
In accordance with the State budget, to incur any necessary expense for prosecution of an alleged violation of this title;
(14)
On receipt of a written and signed complaint, including a referral from the Commissioner of Labor and Industry, conduct an unannounced inspection of the office of a nurse in independent practice, other than an office of a nurse in independent practice in a hospital, related institution, freestanding medical facility, or a freestanding birthing center, to determine compliance at that office with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(15)
To maintain a nurse aide registry that complies with federal law;
(16)
To appoint standing and ad hoc committees from among Board members as necessary; and
(17)
To delegate to the executive director of the Board the authority to discharge Board duties deemed appropriate and necessary by the Board and to hold the executive director accountable to the Board.
(b)
With regard to any list kept by the Board under subsection (a)(10) of this section, upon written request from an individual licensee the Board shall delete that individual’s name from any licensee list purchased from the Board.
(c)
(1)
The Board is the only unit of the Department that is responsible for adopting rules and regulations to determine:
(i)
Individuals to whom any act of the practice of registered nursing and licensed practical nursing may be delegated; and
(ii)
The acts that may be delegated safely.
(2)
The Department shall retain its authority to require training for nonlicensed patient care personnel under § 19–308.1 of the Health – General Article.
Md. Code Ann., Health Occ. § 8-205.1 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–205.1LinkCopy Citation
(a)
If the Board, while reviewing an application for licensure or investigating an allegation brought against a licensee under this title, has reason to believe and objective evidence that the applicant or licensee may cause harm to individuals affected by the applicant’s or licensee’s practice of nursing or certified midwifery, the Board shall require the applicant or licensee to submit to an appropriate examination by a health care provider designated by the Board.
(b)
In return for the privilege to practice nursing or certified midwifery in the State, the applicant or licensee is deemed to have:
(1)
Consented to submit to an examination under this section, if requested by the Board in writing; and
(2)
Waived any claim of privilege as to the testimony or examination reports of the examining health care professional.
(c)
The failure or refusal of the applicant or licensee to submit to an examination required under subsection (b) of this section is prima facie evidence of the applicant’s or licensee’s inability to practice nursing or certified midwifery competently, unless the Board finds that the failure or refusal was beyond the control of the licensee.
(d)
The Board shall pay the cost of any examination made under this section.
Md. Code Ann., Health Occ. § 8-206 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–206LinkCopy Citation
(a)
There is a Board of Nursing Fund.
(b)
(1)
The Board may set reasonable fees for the issuance and renewal of licenses and its other services.
(2)
The fees charged shall be set so as to produce funds to approximate the cost of maintaining the Board as provided in subsection (e) of this section.
(3)
(i)
In addition to the fee set by the Board under this title for the renewal of a nurse practitioner who holds an advanced practice registered nurse certification, the Board shall assess a separate $15 fee for the renewal of the nurse practitioner, regardless of the number of certifications held by the nurse practitioner.
(ii)
The Board shall pay the fee collected under subparagraph (i) of this paragraph to the Nurse Practitioner Preceptorship Tax Credit Fund established under § 10–739 of the Tax – General Article.
(c)
The Board shall publish in its rules and regulations the fees that it sets.
(d)
(1)
The Board shall pay all fees collected under the provisions of this title to the Comptroller of the State.
(2)
The Comptroller shall distribute the fees received from the Board to the Board of Nursing Fund.
(e)
(1)
The Board of Nursing Fund shall be used exclusively to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this title.
(2)
(i)
The Board of Nursing Fund is a continuing, nonlapsing fund, not subject to § 7–302 of the State Finance and Procurement Article.
(ii)
Any unspent portions of the Board of Nursing Fund may not be transferred or revert to the General Fund of the State, but shall remain in the Board of Nursing Fund to be used for the purposes specified in this title.
(3)
No other State money may be used to support the Board of Nursing Fund.
(f)
(1)
The Chairman of the Board or the designee of the Chairman shall administer the Board of Nursing Fund.
(2)
Money in the Board of Nursing Fund may be expended only for any lawful purpose authorized by the provisions of this title.
(g)
The Legislative Auditor shall audit the accounts and transactions of the Board of Nursing Fund as provided in § 2–1220 of the State Government Article.
Md. Code Ann., Health Occ. § 8-207 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–207LinkCopy Citation
A person shall have the immunity from liability described under § 5-708 of the Courts and Judicial Proceedings Article for giving information to the Board or otherwise participating in its activities.
Md. Code Ann., Health Occ. § 8-208 (2026)
Title 8. Nurses
Subtitle 2. State Board of Nursing
§ 8–208LinkCopy Citation
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“Applicant” means an individual who has submitted an application to the Board to be licensed as a registered nurse, licensed practical nurse, electrologist, licensed direct–entry midwife, or licensed certified midwife or to be certified as an advanced practice registered nurse, a nursing assistant, a dialysis technician, or a medication technician in this State.
(3)
“Participant” means a registered nurse, an advanced practice registered nurse, a licensed practical nurse, a nursing assistant, a medication technician, an electrologist, a licensed direct–entry midwife, a licensed certified midwife, a certified dialysis technician, or an applicant enrolled in the safe practice program.
(4)
“Program” means the safe practice program.
(5)
“Substance use disorder” means a disorder that occurs when an individual exhibits a pattern of behaviors ranging from the misuse of, dependence on, or addiction to drugs, alcohol, or other chemicals.
(b)
(1)
There is a Safe Practice Committee in the Board.
(2)
The Board may create one or more safe practice committees.
(c)
(1)
The Committee shall consist of 6 members.
(2)
Of the 6 Committee members:
(i)
3 shall be licensed registered nurses, who have demonstrated expertise in the field of substance use disorders or psychiatric nursing;
(ii)
1 shall be a registered nurse, who has demonstrated expertise in the area of pain management;
(iii)
1 shall be a licensed practical nurse; and
(iv)
1 shall be a consumer member, who is knowledgeable in the field of substance use disorders.
(d)
(1)
The Board shall determine the term of a member of the Committee.
(2)
At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(3)
A Committee 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.
(4)
The Board may remove a Committee member for incompetence or misconduct.
(e)
(1)
The Committee shall elect a chairperson and a vice–chairperson.
(2)
The manner of election of officers shall be as the Committee determines.
(f)
A majority of the members then serving on the Committee is a quorum.
(g)
The Committee shall determine the times and places of its meetings.
(h)
Each member of the Committee is entitled to:
(1)
Compensation in accordance with the State budget; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(i)
The Board may employ a staff to carry out the activities of the Committee in accordance with the State budget.
(j)
In addition to the powers set forth elsewhere in this subtitle, the Committee may:
(1)
Evaluate those registered nurses, advanced practice registered nurses, licensed practical nurses, nursing assistants, medication technicians, electrologists, licensed direct–entry midwives, licensed certified midwives, certified dialysis technicians, or applicants who request participation in the program according to the guidelines prescribed by the Board and consider the recommendations for admission into the program;
(2)
Receive and review information concerning a participant in the program;
(3)
Consider in the case of each participant whether the participant may safely continue or resume to practice or qualify for licensure or certification to practice; and
(4)
Have meetings as necessary to consider the requests of registered nurses, advanced practice registered nurses, licensed practical nurses, nursing assistants, medication technicians, electrologists, licensed direct–entry midwives, licensed certified midwives, certified dialysis technicians, or applicants to participate in the program, and consider reports regarding participants.
(k)
In addition to the duties set forth elsewhere in this subtitle, the Committee shall:
(1)
Prepare reports to be submitted to the Board; and
(2)
Set forth in writing for each participant in the program a plan or agreement that establishes for that participant the requirements for supervision and monitoring.
(l)
The Committee shall inform each licensee, certificate holder, or applicant who requests participation in the program of:
(1)
The procedures followed in the program;
(2)
The rights and responsibilities of a participant in the program; and
(3)
The possible results of noncompliance with the program.
(m)
(1)
Each licensee, certificate holder, or applicant who requests to participate in the program shall agree to cooperate with the individual plan or agreement designed by the Committee.
(2)
Any failure to comply with the conditions of a plan or agreement may result in the participant being expelled from the program.
(3)
(i)
The Committee shall report to the Board the name and license number of a registered nurse, licensed practical nurse, electrologist, licensed direct–entry midwife, or licensed certified midwife, the name and certificate number of an advanced practice registered nurse, a nursing assistant, a medication technician, or a certified dialysis technician, or the name of an applicant who is expelled from the program for failure to comply with the conditions of a plan or agreement.
(ii)
The program shall transfer to the Board all records of any participant expelled from the program.
(4)
If a participant is expelled from the program, the Board may:
(i)
Initiate disciplinary action in accordance with the provisions of §§ 8–316 and 8–317, §§ 8–6A–10 and 8–6A–10.1, §§ 8–6B–18 and 8–6B–19, § 8–6C–20, or § 8–6D–10 of this title; and
(ii)
Summarily suspend the license or certificate of any licensee or certificate holder in accordance with Title 10, Subtitle 2 of the State Government Article.
(n)
After the Committee has determined that a participant no longer requires monitoring and may practice safely, the Committee shall purge and destroy all records relating to the participant’s participation in the program.
(o)
All Board and Committee records concerning a participant in the program are confidential and are not subject to discovery or subpoena in any civil or criminal action or disclosure under Title 4 of the General Provisions Article.
(p)
The Board shall provide for the representation of any individual making reports to the Committee or the Board under this section in any action for defamation directly resulting from reports or information given to the Committee or the Board regarding a participant’s participation in the program.
(q)
(1)
The Committee shall submit to the Board a report each year and at the request of the Board.
(2)
The reports shall include:
(i)
Information concerning the number of cases accepted, denied, or terminated with compliance or noncompliance; and
(ii)
A cost analysis of the program.
Subtitle 3
(a)
Except as otherwise provided in this title or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice registered nursing in this State.
(b)
Except as otherwise provided in this title or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice licensed practical nursing in this State.
(c)
Except as otherwise provided in this title or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be certified as an advanced practice registered nurse before the individual may practice advanced practice registered nursing in this State.
(d)
Subsections (a), (b), and (c) of this section do not apply to:
(1)
A student enrolled in an approved education program while practicing registered nursing or licensed practical nursing in that program;
(2)
A student enrolled in a graduate level accredited program for advanced practice registered nursing while practicing advanced practice registered nursing in that program;
(3)
An individual employed by the federal government to practice registered nursing or licensed practical nursing while practicing within the scope of that employment, if the individual is authorized by any state to practice registered nursing or licensed practical nursing;
(4)
An individual permitted to practice registered nursing or licensed practical nursing under rules and regulations adopted by the Board, if the individual:
(i)
Otherwise has qualified to practice registered nursing or licensed practical nursing in any other state or country and is in this State temporarily; or
(ii)
(1)
Has an application for a license pending before the Board; and
(2)
(A)
Has not taken the examination required under this title;
(B)
Has taken an examination under this title, but the results of the examination are not yet known;
(C)
Has taken and passed an examination under this title, but is waiting for the completion of the criminal history records check; or
(D)
Has taken and failed an examination required under this title but has not failed the examination more than one time within the 120–day period immediately following the submission of the application to the Board;
(5)
An individual permitted to practice advanced practice registered nursing under rules and regulations adopted by the Board;
(6)
An individual who provides gratuitous care for friends, domestic partners, or family members; or
(7)
An individual who responds to a disaster situation in this State to practice registered nursing or licensed practical nursing, if:
(i)
The individual has an active unencumbered license to practice registered nursing or licensed practical nursing in another state and the individual is assigned by:
(1)
The American Red Cross; or
(2)
A member of the Maryland Emergency Management Assistance Compact under § 14–803 of the Public Safety Article;
(ii)
The Governor has declared a State of Emergency by Executive Order or proclamation in accordance with § 3–401 of the State Government Article; and
(iii)
The individual reports to the designated staging area in accordance with § 14–803(2)(b)(5)(iv) of the Public Safety Article.
(e)
A registered nurse or licensed practical nurse in a party state to the Nurse Multistate Licensure Compact shall hold a license in only one party state at a time, that is issued by the home state in accordance with Subtitle 7A of this title.
(f)
A registered nurse who has been granted multistate licensing privileges by a party state to the Nurse Multistate Licensure Compact set forth in Subtitle 7A of this title may practice registered nursing in the State.
(g)
A licensed practical nurse who has been granted multistate licensing privileges by a party state to the Nurse Multistate Licensure Compact set forth in Subtitle 7A of this title may practice practical nursing in the State.
(a)
Except as otherwise provided in this title, to qualify for a license, an applicant shall be an individual who submits to a criminal history records check in accordance with § 8–303 of this subtitle and meets the requirements of this section.
(b)
An applicant for a license to practice registered nursing shall complete satisfactorily and meet all requirements for a diploma or degree from:
(1)
An entry–level registered nursing education program approved by the Board; or
(2)
An entry–level registered nursing education program in any other state or country that the Board finds substantially equivalent to the education program in this State at the time of the applicant’s graduation.
(c)
An applicant for a license to practice licensed practical nursing shall:
(1)
Meet all requirements for a high school diploma or its equivalent; and
(2)
Complete satisfactorily and meet all requirements for a diploma from:
(i)
A licensed practical nursing education program or its equivalent approved by the Board; or
(ii)
An education program in licensed practical nursing in any other state or country that the Board finds substantially equivalent to the education program in this State at the time of the applicant’s graduation.
(d)
Except as otherwise provided in this title, the applicant shall pass an examination developed by the National Council of State Boards of Nursing and administered at a testing site approved by the National Council.
(e)
(1)
Except as otherwise provided in this subsection, the Board shall require as part of its examination or licensing procedures that an applicant for a license to practice registered nursing or licensed practical nursing demonstrate a written and oral competency in the English language.
(2)
Acceptable proof of proficiency in the communication of the English language under this section includes:
(i)
After at least 3 years of enrollment, graduation from a recognized English–speaking undergraduate school;
(ii)
Graduation from a recognized English–speaking professional school;
(iii)
Completion of at least 5 years of practicing nursing in another state or English–speaking territory of the United States;
(iv)
Passing an English proficiency exam approved by the U.S. Department of Health and Human Services; or
(v)
Holding a valid, unencumbered multistate license under the Nurse Licensure Compact.
(3)
If any disciplinary charge or action that involves a problem with communicating in the English language is brought against a licensee under this title, the Board shall require the licensee to take and pass a Board approved standardized test of English language competency.
(4)
The Board may not require that an applicant for a license to practice registered nursing or licensed practical nursing who is or was previously licensed in any other state to practice registered nursing or licensed practical nursing to demonstrate competency in the English language as part of its examination or licensing procedures if the other state has an English language competency component as part of its examination or licensing procedures.
(5)
(i)
The Board may issue a temporary license to any applicant for a license to practice registered nursing or licensed practical nursing who was previously licensed in any other state to practice registered nursing or licensed practical nursing and who, except for the competency in the English language component, is otherwise qualified for a license.
(ii)
A temporary license issued under this subsection is valid only until the date when the next test to demonstrate competency in the English language is given.
(f)
An applicant for a license under this section shall be of good moral character.
(a)
Except as otherwise provided in this title, to qualify for advanced practice certification, an applicant shall:
(1)
Be of good moral character;
(2)
Submit to a criminal history records check in accordance with § 8–303 of this subtitle; and
(3)
Meet the requirements of this section.
(b)
An applicant for certification as an advanced practice registered nurse shall:
(1)
(i)
Be a registered nurse; or
(ii)
Have a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact;
(2)
Complete an education program approved by the Board;
(3)
Submit to the Board:
(i)
A completed application for certification as an advanced practice registered nurse for each area in which certification is sought;
(ii)
Documentation of:
(1)
An active license in good standing as a registered nurse in the State; or
(2)
A multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact;
(iii)
Documentation that the applicant has graduated from a graduate level accredited program for advanced practice registered nursing; and
(iv)
Documentation of certification as an advanced practice registered nurse by a national certifying body recognized by the Board;
(4)
Meet the English language competency requirements under § 8–302(e) of this subtitle; and
(5)
Meet any other requirements set by the Board.
(c)
An individual certified as a clinical nurse specialist who was certified by a national certifying body recognized by the Board before October 1, 2012, shall be deemed to meet the requirements for certification under subsection (b) of this section while the individual remains certified and in good standing.
(d)
(1)
An applicant for initial certification as a registered nurse practitioner who has not been certified by the Board or any other board of nursing shall identify on the application for certification a mentor who will consult and collaborate with the applicant for 18 months beginning on the date the application for certification is received by the Board.
(2)
A certified registered nurse practitioner shall practice in accordance with the standards of practice of the American Association of Nurse Practitioners or any other national certifying body recognized by the Board.
(e)
An advanced practice registered nurse who qualifies for certification by the Board by having a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact shall ensure, at all times, that the Board has current documentation of certification as an advanced practice registered nurse by a national certifying body as required under subsection (b)(3)(iv) of this section for the area of specialty for which the advanced practice registered nurse is certified by the Board.
(f)
(1)
(i)
Except as provided in subparagraph (ii) of this paragraph, an advanced practice registered nurse’s certification expires on the same date as the advanced practice registered nurse’s license to practice registered nursing.
(ii)
The term of certification for an advanced practice registered nurse who qualifies for certification by the Board by having a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact:
(1)
Is 2 years; and
(2)
Expires on the 28th day of the birth month of the advanced practice registered nurse in an odd–numbered year for a birth date ending in an odd–numbered year or in an even–numbered year for a birth date ending in an even–numbered year.
(2)
Before an advanced practice registered nurse’s certification expires, the advanced practice registered nurse may renew the certification for an additional 2–year term if the advanced practice registered nurse is otherwise entitled to be licensed.
(3)
The Board may not renew the certification of an advanced practice registered nurse if the Board does not have documentation of the licensee’s current certification as an advanced practice registered nurse by a national certifying body recognized by the Board as required under subsection (b)(3)(iv) of this section for the area of specialty for which the advanced practice registered nurse is certified by the Board.
The Board shall require a criminal history records check in accordance with § 8–303 of this subtitle for:
(1)
Applicants for certification as a forensic nurse examiner;
(2)
Applicants for certification as a workers’ compensation case manager;
(3)
Selected annual renewal applicants for certification as a forensic nurse examiner or workers’ compensation case manager, as required by regulations adopted by the Board; and
(4)
Applicants for reinstatement as a certified forensic nurse examiner or workers’ compensation case manager, if the applicant files for reinstatement after failing to renew the certification for a period of 1 year or more.
(a)
In this section, “Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.
(b)
As part of an application to the Central Repository for a State and national criminal history records check, an applicant shall submit to the Central Repository:
(1)
A complete set of legible fingerprints taken in a format approved by the Director of the Central Repository and the Director of the Federal Bureau of Investigation;
(2)
The fee authorized under § 10–221(b)(7) of the Criminal Procedure Article for access to Maryland criminal history records; and
(3)
The mandatory processing fee required by the Federal Bureau of Investigation for a national criminal history records check.
(c)
In accordance with §§ 10–201 through 10–229 of the Criminal Procedure Article, the Central Repository shall forward to the Board and to the applicant the criminal history record information of the applicant.
(d)
(1)
If criminal history record information is reported to the Central Repository after the date of the initial criminal history records check, the Central Repository shall provide to the Board a revised printed statement of the individual’s State criminal history record.
(2)
The Board shall notify each applicant that:
(i)
The applicant’s fingerprints will be retained by the Central Repository; and
(ii)
All new and additional criminal information will be reported to the Board.
(3)
The Board may enter into an agreement with the Central Repository and the Federal Bureau of Investigation to carry out this subsection.
(e)
If an applicant has made two or more unsuccessful attempts at securing legible fingerprints, the Board may accept an alternate method of criminal history records check as permitted by the Director of the Central Repository and the Director of the Federal Bureau of Investigation.
(f)
Information obtained from the Central Repository under this section:
(1)
Is confidential;
(2)
May not be redisseminated; and
(3)
May be used only for the licensing purpose authorized by this title.
(g)
The subject of a criminal history records check under this section may contest the contents of the printed statement issued by the Central Repository as provided in § 10–223 of the Criminal Procedure Article.
To apply for a license to practice registered nursing or licensed practical nursing, an applicant shall:
(1)
Submit to a criminal history records check in accordance with § 8–303 of this subtitle;
(2)
Submit to the Board:
(i)
An application on the form that the Board requires, including a current address;
(ii)
Written, verified evidence that the requirement of item (1) of this section is being met or has been met;
(iii)
Written, verified evidence of completion of the appropriate education requirements of § 8–302 of this subtitle; and
(iv)
Written, verified evidence satisfactory to the Board that the applicant’s primary state of residence is Maryland or a state that is not a party state to the Nurse Licensure Compact set forth in Subtitle 7A of this title; and
(3)
Pay to the Board the application fee set by the Board.
(a)
Except as otherwise provided in subsections (b) and (c) of this section, an applicant who otherwise qualifies for a license as a registered nurse or as a licensed practical nurse is entitled to be examined for that license as provided in this section.
(b)
An applicant whose primary state of residence is a party state to the Nurse Licensure Compact set forth in Subtitle 7A of this title, other than Maryland, is not entitled to be examined for a license as a registered nurse or licensed practical nurse in the State.
(c)
Subject to the hearing provisions of § 8–317 of this subtitle, the Board may deny the right to be examined for a license as a registered nurse or as a licensed practical nurse to any applicant who is found to have violated any provision of § 8–316 of this subtitle.
(d)
(1)
In this subsection, “preceptorship program” means:
(i)
An organized system of clinical experience that pairs a nursing student enrolled in a nursing education program that is recognized by the Board with a registered nurse who meets the qualifications as a preceptor for the purpose of attaining specified learning objectives; or
(ii)
An individualized and supervised clinical experience offered by an institution employing nurses that complies with the requirements for temporary licensure for the purpose of facilitating an inactive licensee to return to active practice in accordance with the requirements of paragraph (2) of this subsection.
(2)
An applicant whose nursing education program was completed 5 or more years prior to passing the licensure examination and who has not practiced for at least 1,000 hours in the previous 5 years may only be issued an inactive license until submission to the Board of satisfactory evidence that the applicant has successfully completed:
(i)
A nursing review course approved by the Board; or
(ii)
A preceptorship program approved by the Board.
(e)
(1)
Except as provided in paragraph (2) of this subsection, an applicant who fails an examination may retake the examination if the applicant pays the reexamination fee set by the Board for each reexamination.
(2)
The Board, by rule or regulation, may limit the number of times that an applicant may be reexamined after two failures and may limit the interval of time between reexaminations.
An applicant qualifies for certification as an advanced practice registered nurse only if the applicant passes a Board–approved national examination for advanced practice registered nurses.
(a)
Subject to the provisions of this section, the Board may issue a license by endorsement and waive any appropriate examination requirement of this title for an applicant who has an active unencumbered license to practice registered nursing or licensed practical nursing in any other state or country.
(b)
The Board may issue a license by endorsement under this section only if the applicant:
(1)
Submits to the Board an application on the form that the Board requires;
(2)
Submits to a criminal history records check in accordance with § 8–303 of this subtitle;
(3)
Pays the application fee set by the Board under § 8–304 of this subtitle; and
(4)
(i)
(1)
Holds a valid, unencumbered multistate license under the Nurse Licensure Compact; or
(2)
Except as provided in subsection (c) of this section, provides adequate evidence that:
(A)
At the time the applicant graduated from a nursing education program approved in the other state or country, the program was substantially equivalent to the education program approved in this State;
(B)
At the time the applicant became licensed or registered in the other state or country, the applicant passed in that or any other state or country an examination that was similar to the examination that then was given in this State; and
(ii)
Meets the qualifications otherwise required by this title.
(c)
(1)
An applicant for licensure as a registered nurse by endorsement who cannot provide the evidence required under subsection (b)(4)(i) of this section may qualify for licensure as a registered nurse by endorsement if the applicant meets the requirements of paragraph (2) of this subsection.
(2)
An applicant may qualify for licensure as a registered nurse by endorsement if the applicant has:
(i)
Completed satisfactorily and met all requirements for an associate or a baccalaureate degree in registered nursing from a college or university that, at the time of the applicant’s graduation, is:
(1)
Accredited by a national or regional nursing accreditation agency that is recognized by the Secretary of the U.S. Department of Education or the Council for Higher Education Accreditation; and
(2)
Approved by the board of nursing or other applicable state regulator in the state in which the program is located; and
(ii)
Completed a minimum number of direct patient care practice hours as required by regulations adopted by the Board.
(a)
Subject to subsection (c) of this section, the Board shall license any applicant who meets the requirements for a license as:
(1)
A registered nurse under this title; or
(2)
A licensed practical nurse under this title.
(b)
(1)
The Board shall:
(i)
Issue each new licensee a license number and registration certificate that indicates that the initial license was issued by the Board; and
(ii)
Electronically record each license in the Board’s database and on the Board’s Web site.
(2)
Each license shall include:
(i)
Any expiration date;
(ii)
The type of license; and
(iii)
Any certification.
(c)
(1)
On receipt of the criminal history record information of an applicant for licensure or certification forwarded to the Board in accordance with § 8–303 of this subtitle, in determining whether to grant a license or a certificate, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.
(2)
(i)
Except as provided in subparagraph (ii) of this paragraph, the Board may not issue a license or a certificate if the criminal history record information required under § 8–303 of this subtitle has not been received.
(ii)
The Board may grant a 90–day extension of a temporary license pending receipt of criminal history record information.
(a)
If an individual has been licensed by the Board to practice registered nursing or licensed practical nursing in this State in accordance with the requirements of this subtitle, the individual may be subsequently licensed as a registered nurse or as a licensed practical nurse on inactive status.
(b)
The Board shall place a licensee on inactive status and record the inactive status in the Board’s database and on the Board’s Web site if the licensee:
(1)
(i)
Has not satisfactorily completed 1,000 hours of active nursing practice within the 5–year period immediately preceding the date of anticipated renewal;
(ii)
Chooses inactive status; or
(iii)
Submits documentation of a medical condition that the Board determines will prevent the licensee from practicing as a registered nurse or licensed practical nurse;
(2)
(i)
Completes the biennial application for inactive status; and
(ii)
If applicable, provides documentation of a continuing medical condition; and
(3)
Pays the applicable fees as required by the Board.
(c)
A licensee on inactive status may not practice nursing in this State, but:
(1)
A registered nurse on inactive status may use the title “Registered Nurse”, or the abbreviation “RN”; and
(2)
A practical nurse on inactive status may use the title “Licensed Practical Nurse”, or the abbreviation “LPN”.
(d)
(1)
A licensee on inactive status may apply for reactivation of the license to practice nursing if the licensee:
(i)
Meets the renewal requirements of § 8–312 of this subtitle; and
(ii)
If applicable, submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists.
(2)
If a licensee meets the requirements of paragraph (1) of this subsection, the Board shall:
(i)
Record the status of the licensee as active in the Board’s database and on the Board’s Web site; and
(ii)
Reactivate the licensee’s license to practice nursing in this State.
(e)
(1)
If a licensee is granted inactive status because of a medical condition, the Board may not charge a fee to place the licensee on or remove the licensee from inactive status.
(2)
If a licensee is granted inactive status because of a medical condition, the inactive status:
(i)
May not be considered a disciplinary action under § 8–316 of this subtitle; and
(ii)
May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.
(a)
A license to practice registered nursing authorizes the licensee to practice registered nursing while the license is effective.
(b)
A licensee may practice registered nursing using only the name in which the license has been issued.
(a)
Subject to the provisions of this section, a license to practice licensed practical nursing authorizes the licensed practical nurse to practice licensed practical nursing while the license is effective.
(b)
(1)
The licensed practical nurse is a recognized member of the health professional team and performs an integral part of nursing.
(2)
Except as provided in the rules and regulations of the Board adopted under § 8-205 of this title, a licensed practical nurse may practice licensed practical nursing only in a team relationship with at least one licensed health professional who is not a licensed practical nurse.
(c)
A licensed practical nurse may administer treatment or medication only if the treatment or medication is prescribed by an individual who is authorized by law to prescribe medication or treatment.
(d)
A licensed practical nurse may teach or supervise commensurate with the education and demonstrated competencies of the licensed practical nurse.
(e)
A licensed practical nurse may practice practical nursing using only the name in which the license has been issued.
(a)
A license expires on the 28th day of the birth month of the licensee and may not be renewed for a term longer than 2 years.
(b)
(1)
At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:
(i)
First–class mail to the last known mailing address of the licensee; or
(ii)
Electronic means to the last known electronic address of the licensee.
(2)
If a licensee is required to have a criminal history records check before a license may be renewed, the Board shall send the licensee the documents necessary for initiating the criminal history records check in conjunction with the renewal notice required under paragraph (1) of this subsection.
(c)
Before a license expires, the licensee periodically may renew it for an additional term, if the licensee:
(1)
Otherwise is entitled to be licensed;
(2)
Pays to the Board:
(i)
A renewal fee set by the Board; or
(ii)
A renewal fee that is set by the Board if the licensee certifies to the Board that the licensee provides professional services only as a volunteer; and
(3)
Submits to the Board by paper application or electronic means:
(i)
A renewal application on the form that the Board requires that includes workforce data information necessary for the report required under § 8–205(a) of this title; and
(ii)
Satisfactory evidence of completion of:
(1)
1,000 hours of active nursing practice within the 5–year period immediately preceding the date of renewal;
(2)
A course of instruction, commonly known as a refresher course, approved by the Board;
(3)
A preceptorship program provided by an employer and approved by the Board; or
(4)
A minimum number of continuing education units as required by regulations adopted by the Board.
(d)
The Board may grant a 30–day extension, beyond a license’s expiration date, to a licensee so that the licensee may renew the license before it expires.
(e)
(1)
Each licensee shall notify the Board in writing of any change in the name or address of the licensee within 60 days after the change occurred.
(2)
If a licensee fails to notify the Board within the time required under this subsection, subject to the hearing provisions of § 8–317 of this subtitle, the Board may impose an administrative penalty of $100.
(f)
(1)
Subject to subsection (g) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.
(2)
A volunteer’s license issued under subsection (c)(2)(ii) of this section shall be clearly designated as a volunteer’s license.
(g)
(1)
(i)
A criminal history records check is required in accordance with § 8–303 of this subtitle on:
(1)
Selected annual renewal applicants as determined by regulations adopted by the Board; and
(2)
Each licensee who files for reinstatement under § 8–313 of this subtitle after failing to renew the license for a period of 1 year or more.
(ii)
An additional criminal history records check shall be performed every 12 years thereafter.
(2)
On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 8–303 of this subtitle, in determining whether to initiate a disciplinary action against a licensee based on the information received, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.
(3)
The Board may not renew a license without written documentation that the applicant has submitted to a criminal history records check required under § 8–303 of this subtitle.
The Board shall reinstate the license of a licensee who has failed to renew the license for any reason if the licensee meets the renewal requirements of § 8–312 of this subtitle.
(a)
Unless the Board agrees to accept the surrender of a license, a licensed registered nurse, licensed practical nurse, or holder of a temporary license may not surrender the license.
(b)
The Board may require terms and conditions on an agreement with the licensee to accept surrender of the license.
(c)
An agreement to accept the surrender of a license is a final order of the Board and is a public record.
(a)
The Board may issue a temporary license to any applicant who:
(1)
Submits to a criminal history records check in accordance with § 8–303 of this subtitle;
(2)
(i)
Is licensed by any other state; or
(ii)
Has taken and passed an examination under this title, but is waiting for the completion of the criminal history records check;
(3)
Submits to the Board:
(i)
An application on the form required by the Board;
(ii)
Written, verified evidence that the requirement of item (1) of this subsection is being met; and
(iii)
Any other document required by the Board; and
(4)
Pays the fee required by the Board.
(b)
(1)
A temporary license issued to an individual who is authorized to practice registered nursing in another state or who has taken and passed an examination under this title authorizes the holder to practice registered nursing in this State while the temporary license is effective.
(2)
A temporary license issued to an individual who is authorized to practice licensed practical nursing in another state or who has taken and passed an examination under this title authorizes the holder to practice licensed practical nursing in this State while the temporary license is effective.
(c)
(1)
A temporary license may not be renewed.
(2)
Unless the Board suspends or revokes a temporary license, each temporary license expires 90 days after the date of issue.
(3)
A temporary license may be extended up to an additional 90 days if the applicant is awaiting the completion of criminal history record information.
(4)
A temporary license may be extended every 90 days, provided that the total length of renewal does not exceed 12 months from the date the original temporary license was issued, if the applicant does not meet the practice requirement as provided for in regulation.
(d)
The Board shall revoke a temporary license if the criminal history record information forwarded to the Board in accordance with § 8–303 of this subtitle reveals that the applicant or licensee has been convicted or pled guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.
(a)
Subject to the hearing provisions of § 8–317 of this subtitle, the Board may deny a license or grant a license, including a license subject to a reprimand, probation, or suspension, to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee:
(1)
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;
(2)
Fraudulently or deceptively uses a license;
(3)
Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;
(4)
Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;
(5)
Willfully and knowingly:
(i)
Files a false report or record of an individual under the licensee’s care;
(ii)
Gives any false or misleading information about a material matter in an employment application;
(iii)
Fails to file or record any health record that is required by law;
(iv)
Obstructs the filing or recording of any health record as required by law; or
(v)
Induces another individual to fail to file or record any health record as required by law;
(6)
Knowingly does any act that has been determined by the Board, in its rules and regulations, to exceed the scope of practice authorized to the individual under this title;
(7)
Provides professional services while:
(i)
Under the influence of alcohol; or
(ii)
Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;
(8)
Does an act that is inconsistent with generally accepted professional standards in the practice of registered nursing or licensed practical nursing;
(9)
Is grossly negligent in the practice of registered nursing or licensed practical nursing;
(10)
Has violated any provision of this title;
(11)
Submits a false statement to collect a fee;
(12)
Is physically or mentally incompetent;
(13)
Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;
(14)
Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;
(15)
Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(16)
Is in independent practice and fails to display the notice required under § 8–506 of this title;
(17)
Is in breach of a service obligation resulting from the applicant’s or licensee’s receipt of State or federal funding for the applicant’s or licensee’s nursing education;
(18)
Has a substance use disorder;
(19)
Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;
(20)
Fails to cooperate with a lawful investigation conducted by the Board;
(21)
Is expelled from the safe practice program established pursuant to § 8–208 of this title for failure to comply with the conditions of the program;
(22)
Delegates nursing acts or responsibilities to an individual that the applicant or licensee knows or has reason to know lacks the ability or knowledge to perform;
(23)
Delegates to an unlicensed individual nursing acts or responsibilities the applicant or licensee knows or has reason to know are to be performed only by a registered nurse or licensed practical nurse;
(24)
Fails to properly supervise individuals to whom nursing acts or responsibilities have been delegated;
(25)
Engages in conduct that violates the professional code of ethics;
(26)
Is professionally incompetent;
(27)
Practices registered nursing or licensed practical nursing without a license before obtaining or renewing a license, including any period when practicing registered nursing or licensed practical nursing on an expired license or a lapsed license;
(28)
When holding an expired license or a lapsed license or after a temporary license has expired in accordance with § 8–315(c) of this subtitle, commits any act that would be grounds for disciplinary action under this section;
(29)
Practices registered nursing or licensed practical nursing on a nonrenewed license for a period of 16 months or longer;
(30)
Violates regulations adopted by the Board or an order from the Board;
(31)
Performs an act that is beyond the licensee’s knowledge and skills;
(32)
Fails to submit to a criminal history records check in accordance with § 8–303 of this subtitle;
(33)
When acting in a supervisory position, directs another nurse to perform an act that is beyond the nurse’s knowledge and skills;
(34)
When acting in a supervisory position, directs another nurse to delegate a nursing task to an individual when that nurse reasonably believes:
(i)
The individual lacks the knowledge and skills to perform the task; or
(ii)
The patient’s condition does not allow delegation of the nursing task;
(35)
Has misappropriated the property of a patient or a facility; or
(36)
Fails to comply with § 1–223 of this article.
(b)
If, after a hearing under § 8–317 of this subtitle, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a license to practice registered nursing or licensed practical nursing, to reprimand a licensee, or place a licensee on probation, the Board may impose a penalty not exceeding $5,000 instead of or in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.
(c)
In addition to any sanction authorized under this section, the Board may require a licensee to comply with specified terms and conditions determined by the Board.
(a)
Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under § 8–312 or § 8–316 of this subtitle or § 8–404, § 8–6C–20, or § 8–6D–10 of this title, it shall give the person against whom the action is contemplated an opportunity for a hearing before the Board.
(b)
The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.
(c)
The hearing notice to be given to the person shall be sent by certified mail, return receipt requested, to the last known address of the person at least 30 days before the hearing.
(d)
The person may be represented at the hearing by counsel.
(e)
If after due notice the individual against whom the action is contemplated fails or refuses to appear, nevertheless the Board may hear and determine the matter.
(f)
(1)
Over the signature of the president, the executive director, or the deputy director as authorized by the executive director of the Board, the Board may issue subpoenas and administer oaths in connection with any investigation under this title and any hearings or proceedings before it.
(2)
If a person, without lawful excuse, disobeys a subpoena from the Board or an order by the Board to take an oath, testify, or answer questions, on petition of the Board a court of competent jurisdiction may compel compliance with the subpoena and hold the individual in contempt of court.
(g)
(1)
After the Board conducts an investigation under this title, the Board may issue an advisory letter to the licensee or holder of a multistate licensing privilege.
(2)
The Board may disclose an advisory letter issued under this subsection to the public.
(3)
The issuance of an advisory letter under this subsection may not:
(i)
Be considered a disciplinary action under § 8–316 of this subtitle; and
(ii)
Be reported to any licensing entity, employer, or insurance company as a disciplinary action.
(a)
Except as provided in this section for an action under § 8–316 of this subtitle, any person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.
(b)
Any person aggrieved by a final decision of the Board under § 8–316 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act.
(c)
A Board decision may not be stayed while judicial review is pending.
(a)
If a license was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a license was surrendered, the Board may reinstate the license if the licensee:
(1)
Applies to the Board for reinstatement;
(2)
Meets the requirements for renewal under § 8–312 of this subtitle;
(3)
Meets any other requirements for reinstatement as established by the Board; and
(4)
Submits to a criminal history records check in accordance with § 8–303 of this subtitle.
(b)
If a licensee meets the requirements of subsection (a) of this section, the Board may:
(1)
Reinstate the license;
(2)
Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or
(3)
Deny reinstatement of the license.
(a)
Except by the express stipulation and consent of all parties to a proceeding before the Board or any of its investigatory bodies, in a civil action, the proceedings, records, and files of the Board or any of its investigatory bodies are not discoverable and are not admissible in evidence.
(b)
This section does not apply to a civil action brought by a party to a proceeding before the Board who claims to be aggrieved by the decision of the Board.
(c)
If any medical or hospital record or any other exhibit is subpoenaed and otherwise is admissible in evidence, the use of the record or exhibit in a proceeding before the Board or any of its investigatory bodies does not prevent its production in any other proceeding.
(a)
The Board may disclose any information contained in the proceedings, records, and files of the Board to any health occupation regulatory board of the State or another state if the health occupation regulatory board requests the information in writing.
(b)
A health occupation regulatory board that receives information from the Board under subsection (a) of this section may not redisclose the information without the consent of the Board.
(a)
The authority of the Board established under this subtitle:
(1)
Vests with the Board at the time an individual applies for licensure or to practice under the multistate licensing privilege;
(2)
Continues during periods of licensure; and
(3)
Includes authority over an individual holding an expired license, a lapsed license, or a temporary license that has expired under § 8–315(c) of this subtitle.
(b)
The authority of the Board shall be continuous over an individual applicant, licensee, or holder of a multistate licensing privilege and may not be divested by withdrawal of an application, when a license expires or lapses, or when a temporary license expires.
Subtitle 4. Approved Nursing Education Programs
Md. Code Ann., Health Occ. § 8-401 (2026)
Title 8. Nurses
Subtitle 4. Approved Nursing Education Programs
§ 8–401LinkCopy Citation
(a)
The Board may approve any registered nursing or licensed practical nursing education program at an institution in this State.
(b)
The Board shall:
(1)
Keep a list of institutions in this State that currently have an approved registered nursing or licensed practical nursing education program;
(2)
Set standards for approval of education programs for registered nurses and licensed practical nurses at institutions in this State;
(3)
Determine the Maryland passing rate for the national nurse licensure examination each year;
(4)
Evaluate the need for an education program for registered nurses or licensed practical nurses in the geographic area in which the program is proposed to be located; and
(5)
Survey approved nursing education programs as it considers necessary.
Md. Code Ann., Health Occ. § 8-402 (2026)
Title 8. Nurses
Subtitle 4. Approved Nursing Education Programs
§ 8–402LinkCopy Citation
Before an institution conducts a registered nursing or licensed practical nursing education program in this State, the institution shall obtain approval from:
(1)
The Board by submitting evidence that it is prepared to:
(i)
Carry out a program in registered nursing education or licensed practical nursing education; and
(ii)
Meet the standards established by the Board under this title; and
(2)
The appropriate State education board.
Md. Code Ann., Health Occ. § 8-403 (2026)
Title 8. Nurses
Subtitle 4. Approved Nursing Education Programs
§ 8–403LinkCopy Citation
(a)
The Board shall have its representatives survey:
(1)
Each registered nursing and licensed practical nursing program when the program is first established in this State; and
(2)
From time to time, each existing registered nursing and licensed practical nursing program in this State.
(b)
The representatives who make the survey shall submit a written report to the Board.
Md. Code Ann., Health Occ. § 8-404 (2026)
Title 8. Nurses
Subtitle 4. Approved Nursing Education Programs
§ 8–404LinkCopy Citation
(a)
Except as provided in subsection (b) of this section, the Board may remove an institution from its list of institutions that offer approved nursing education programs in this State if the institution violates the standards set under this title or by the Board.
(b)
(1)
At least 30 days before the Board may issue a formal notice of violation to an institution, the Board shall notify the chief administrator of the institution and the chief administrator of the nursing education program of the institution that the Board is considering issuing a formal notice of violation.
(2)
During the 30-day period provided in paragraph (1) of this subsection, the Board shall provide the chief administrator of the institution and the chief administrator of the nursing education program an opportunity to meet with representatives of the Board.
(c)
Any action taken under this section shall be in accordance with the hearing and administrative and judicial review provisions of §§ 8-316 and 8-317 of this title.
Subtitle 5
The Board shall evaluate continuously master planning by other agencies that may affect nursing practice in this State.
(a)
The Board shall appoint or recognize specific task advisory committees.
(b)
Each advisory committee consists of at least three members appointed by the Board.
(c)
Each committee member shall have expertise in the specific problem or area of nursing practice that is under investigation.
(d)
Each member of a committee is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(e)
Each advisory committee shall:
(1)
Help the Board to forecast directions in nursing practice;
(2)
Help the Board evaluate the impact of identified issues on nursing practice; and
(3)
Make recommendations to the Board when appropriate.
(a)
The Board may appoint peer advisory committees to provide the Board with expert advice related to the practice of nursing by advanced practice nurses and the practice of midwifery by licensed certified midwives.
(b)
A member of a peer advisory committee is entitled to receive:
(1)
Compensation, as determined by the Board; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(a)
(1)
In this section, “employer” means:
(i)
A public employer;
(ii)
A private employer; or
(iii)
An employment agency.
(2)
“Employer” does not include a private employer who employs a licensee for personal or family use.
(b)
On the request of the Board, an employer shall report the name and license number of each licensee employed or placed to practice registered nursing, licensed practical nursing, or certified midwifery.
(a)
Except as provided in subsection (b) of this section, the following applies:
(1)
If a nursing administrator, a registered nurse, an advanced practice registered nurse, a licensed practical nurse, or a certified nursing assistant knows of an action or condition that might be grounds for action under § 8–316 or Subtitle 6A of this title, the nursing administrator, registered nurse, advanced practice registered nurse, licensed practical nurse, or certified nursing assistant shall report the action or condition to the Board; and
(2)
An individual shall have the immunity from liability described under § 5–709 of the Courts and Judicial Proceedings Article for making a report as required by this subsection.
(b)
If a nurse administrator, a registered nurse, an advanced practice registered nurse, a licensed practical nurse, or a certified nursing assistant has reason to know that a licensee or certificate holder has committed an action or has a condition that might be grounds for reprimand or probation of the licensee or certificate holder or suspension or revocation of the license under § 8–316 or § 8–6A–10 of this title because the licensee or certificate holder has a substance use disorder, the nurse administrator, registered nurse, advanced practice registered nurse, licensed practical nurse, or certified nursing assistant is not required to report the licensee or certificate holder to the Board if:
(1)
The nurse administrator, registered nurse, advanced practice registered nurse, licensed practical nurse, or certified nursing assistant knows that the licensee or certificate holder is in an alcohol or drug treatment program that is accredited by the Joint Commission on Accreditation of Healthcare Organizations, is certified by the Department, or is under the care of a health care practitioner who is competent and capable of dealing with substance use disorder;
(2)
The nurse administrator, registered nurse, advanced practice registered nurse, licensed practical nurse, or certified nursing assistant is able to verify that the licensee or certificate holder remains in the treatment program until discharge; and
(3)
The action or condition of the licensee or certificate holder has not caused injury to any individual while the licensee is practicing registered nursing or licensed practical nursing or the certificate holder is working as an advanced practice registered nurse or a nursing assistant.
(c)
An individual is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of patient substance use disorder records.
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“Midwife” means a registered nurse certified as a nurse–midwife or a licensed certified midwife.
(3)
“Nurse practitioner” means a registered nurse who is:
(i)
Certified as a nurse practitioner; and
(ii)
Authorized to prescribe drugs under regulations adopted by the Board.
(4)
“Personally prepare and dispense” means that a nurse practitioner:
(i)
Is physically present on the premises where the prescription is filled; and
(ii)
Performs a final check of the prescription before it is provided to the patient.
(5)
“Starter dosage” means an amount of drug sufficient to begin therapy:
(i)
Of short duration of 72 hours or less; or
(ii)
Prior to obtaining a larger quantity of the drug to complete therapy.
(b)
A nurse practitioner or midwife may personally prepare and dispense a starter dosage of any drug the nurse practitioner or midwife is authorized to prescribe to a patient of the nurse practitioner or midwife if:
(1)
The starter dosage complies with the labeling requirements of § 12–505 of this article;
(2)
No charge is made for the starter dosage; and
(3)
The nurse practitioner or midwife enters an appropriate record in the patient’s medical record.
(c)
In accordance with the provisions of subsection (d) of this section, a nurse practitioner may personally prepare and dispense any drug that a nurse practitioner may prescribe to the extent permitted by law in the course of treating a patient at:
(1)
A medical facility or clinic that specializes in the treatment of medical cases reimbursable through workers’ compensation insurance;
(2)
A medical facility or clinic that is operated on a nonprofit basis;
(3)
A health center that operates on a campus of an institution of higher education;
(4)
A public health facility, a medical facility under contract with a State or local health department, or a facility funded with public funds; or
(5)
A nonprofit hospital or a nonprofit hospital outpatient facility as authorized under the policies established by the hospital.
(d)
A nurse practitioner who personally prepares and dispenses a drug in the course of treating a patient as authorized under subsection (c) of this section shall:
(1)
Comply with the labeling requirements of § 12–505 of this article;
(2)
Record the dispensing of the prescription drug on the patient’s chart;
(3)
Allow the Office of Controlled Substances Administration to enter and inspect the nurse practitioner’s office at all reasonable hours; and
(4)
Except for starter dosages or samples dispensed without charge, provide the patient with a written prescription, maintain prescription files, and maintain a separate file for Schedule II prescriptions for a period of at least 5 years.
(a)
In this section, “law enforcement agency” includes:
(1)
A State, county, or municipal police department or agency;
(2)
A sheriff’s office;
(3)
A State’s Attorney’s office; and
(4)
The Office of the Attorney General.
(b)
A law enforcement agency that receives a complaint of death or bodily harm allegedly caused by a nurse who holds a license or certificate under this title shall notify the Board of the complaint.
(a)
The Board may conduct a demonstration study to evaluate a proposed change to regulations regarding nursing practices or the activities of nursing assistants, dialysis technicians, or medication technicians in a practice setting.
(b)
A demonstration study enables the Board, in a controlled practice setting, to determine:
(1)
The safety of the proposed practice or activity; and
(2)
The appropriate education or training requirements for a proposed practice or activity.
(c)
(1)
The Board shall:
(i)
Approve the demonstration study design; and
(ii)
Select the testing facilities.
(2)
The Board may waive selected nursing practice requirements during a demonstration study.
A registered nurse or licensed practical nurse working in a methadone clinic licensed by the Maryland Department of Health may dispense methadone in accordance with regulations jointly developed and adopted by the Board and the State Board of Pharmacy.
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“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.
(3)
(i)
“Device” means an item used in the diagnosis, treatment, or prevention of disease.
(ii)
“Device” does not include:
(1)
Surgical or dental instruments;
(2)
Physical therapy equipment;
(3)
X–ray apparatuses; or
(4)
Component parts of or accessories for any of the items described in items 1 through 3 of this subparagraph.
(4)
(i)
“Dispense” means a procedure that results in the receipt of a drug or device by a patient or a patient’s agent.
(ii)
“Dispense” includes:
(1)
Interpreting an authorized prescriber’s prescription for a drug or device;
(2)
Selecting and labeling the drug or device prescribed;
(3)
Measuring and packaging the drug or device in accordance with State and federal law; and
(4)
Documenting the transaction in the patient’s medical record.
(5)
“Drug” means, unless the context requires otherwise, a prescription or nonprescription drug.
(6)
“Formulary” means a list of drugs and devices.
(7)
“Nonprescription drug or device” means a drug or device that:
(i)
May be sold without a prescription; and
(ii)
Is labeled for use by a consumer in accordance with State and federal law.
(8)
“Personally prepare and dispense” means to:
(i)
Physically prepare a prescription;
(ii)
Perform a final check of the prescription before dispensing it to a patient; and
(iii)
Not delegate any step of the dispensing process.
(9)
“Prescription drug” means a drug that, under § 21–220 of the Health – General Article, may be dispensed only on the prescription of an authorized prescriber.
(b)
If a registered nurse complies with the requirements of this section, the registered nurse may personally prepare and dispense drugs and devices or provide, without a prescription, nonprescription drugs and devices in a local health department:
(1)
In accordance with the Overdose Response Program under Title 13, Subtitle 31 of the Health – General Article or the Expedited Partner Therapy Pilot Program under § 18–214.1 of the Health – General Article; or
(2)
To patients in need of communicable disease, alcohol and drug abuse, family planning, or reproductive health services.
(c)
A registered nurse may personally prepare and dispense drugs and devices or provide, without a prescription, nonprescription drugs and devices if the registered nurse:
(1)
Complies with the formulary developed and approved under § 3–403(b) of the Health – General Article;
(2)
Has successfully completed a training program administered by the Department in accordance with § 3–405 of the Health – General Article;
(3)
Maintains the patient’s health record in a manner that ensures the confidentiality of the patient’s drug and device medication record in accordance with State and federal laws;
(4)
Complies with drug and device storage and inventory procedures in accordance with Department policy; and
(5)
For a prescription drug or device, has received a prescription from an authorized prescriber employed at a local health department.
(a)
In this section, “perioperative assessment and management” means the assessment and management of a patient preoperatively, intraoperatively, and postoperatively.
(b)
(1)
A nurse anesthetist may perform the following functions:
(i)
Perioperative assessment and management of patients requiring anesthesia services;
(ii)
Administration of anesthetic agents;
(iii)
Management of fluids in intravenous therapy;
(iv)
Respiratory care; and
(v)
Subject to paragraph (4) of this subsection, prescription, ordering, and administration of drugs, including a drug that is classified as a controlled dangerous substance under Title 5, Subtitle 4 of the Criminal Law Article.
(2)
A nurse anesthetist has the right and obligation to refuse to perform a delegated act if in the nurse anesthetist’s judgment, the act is:
(i)
Unsafe;
(ii)
An invalidly prescribed medical act; or
(iii)
Beyond the clinical skills of the nurse anesthetist.
(3)
Paragraph (1) of this subsection may not be construed to authorize a nurse anesthetist to:
(i)
Diagnose a medical condition;
(ii)
Provide care that is not consistent with the scope of practice of nurse anesthetists; or
(iii)
Provide care for which the nurse anesthetist does not have proper education and experience.
(4)
A nurse anesthetist may prescribe drugs under paragraph (1) of this subsection:
(i)
Only in an amount that does not exceed a 10–day supply;
(ii)
Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and
(iii)
Only in connection with the delivery of anesthesia services.
(c)
A nurse anesthetist shall collaborate with an anesthesiologist, a licensed physician, or a dentist in the following manner:
(1)
An anesthesiologist, a licensed physician, or a dentist shall be physically available to the nurse anesthetist for consultation at all times during the administration of, and recovery from, anesthesia;
(2)
An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and
(3)
If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.
(d)
The nurse anesthetist shall ensure that a qualified anesthesia provider:
(1)
Performs a thorough and complete preanesthetic assessment;
(2)
Obtains informed consent for the planned anesthetic intervention from the patient or an individual responsible for the patient; and
(3)
Formulates a patient–specific plan for anesthesia care.
(e)
The nurse anesthetist as part of the standards of practice shall:
(1)
Implement and adjust an anesthesia care plan as needed to adapt to the patient’s response to the anesthesia;
(2)
Monitor a patient’s physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;
(3)
Enter prompt, complete, and accurate documentation of pertinent information on a patient’s record;
(4)
Transfer responsibility for care of a patient to other qualified providers in a manner that ensures continuity of care and patient safety;
(5)
Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;
(6)
Maintain appropriate infection control standards;
(7)
Evaluate anesthesia care to ensure its quality;
(8)
Maintain continual competence in anesthesia practice; and
(9)
Respect and maintain the basic rights of patients.
(f)
This section may not be construed to require a written collaboration agreement between a nurse anesthetist and an anesthesiologist, a physician, or a dentist.
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“Clinical nurse specialist” means an individual who:
(i)
(1)
Is licensed by the Board to practice registered nursing; or
(2)
Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and
(ii)
Is certified by the Board to practice as a clinical nurse specialist.
(3)
(i)
“Practice as a clinical nurse specialist” means to:
(1)
Provide direct care to patients with complex needs;
(2)
Act as a consultant to another health care provider as needed;
(3)
Conduct health–related research; and
(4)
Provide education and guidance for staff nurses.
(ii)
“Practice as a clinical nurse specialist” includes:
(1)
Ordering, performing, and interpreting laboratory tests;
(2)
Ordering diagnostic tests and using the findings or results in the care of patients;
(3)
Prescribing drugs and durable medical equipment under regulations adopted by the Board;
(4)
Ordering home health and hospice care; and
(5)
Initiating, monitoring, and altering appropriate therapies or treatments.
(b)
Practice as a clinical nurse specialist is governed by rules and regulations that are adopted under § 8–205 of this title and that concern additional acts in the practice of registered nursing.
(a)
Each advanced practice registered nurse practicing as an advanced practice registered nurse in the State shall notify a patient in writing if:
(1)
The advanced practice registered nurse does not maintain professional liability insurance coverage; or
(2)
The advanced practice registered nurse’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.
(b)
The written notification provided to the patient under subsection (a) of this section shall be:
(1)
Provided:
(i)
At the first visit by the patient during any period in which the advanced practice registered nurse does not maintain professional liability insurance, unless the visit is for the purpose of receiving incidental medical care that will be rendered free of charge; and
(ii)
As part of each informed consent obtained before any procedure or operation discussed or offered for the patient’s consideration is performed;
(2)
Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and
(3)
Retained by the advanced practice registered nurse as part of the advanced practice registered nurse’s patient records.
(c)
Each advanced practice registered nurse practicing as an advanced practice registered nurse in the State who does not maintain professional liability insurance coverage shall post this information in a conspicuous location in the advanced practice registered nurse’s place of practice.
Subtitle 6. Special Nurse Midwife Provisions
Md. Code Ann., Health Occ. § 8-601 (2026)
Title 8. Nurses
Subtitle 6. Special Nurse Midwife Provisions
§ 8–601LinkCopy Citation
In this subtitle:
(1)
“Practice nurse midwifery” means the management and care of essentially normal newborns and of essentially normal women antepartally, intrapartally and postpartally.
(2)
“Practice nurse midwifery” includes:
(i)
Family planning and well woman reproductive care;
(ii)
The prescribing of substances commonly used in the practice of nurse midwifery;
(iii)
The prescribing of controlled substances on Schedules II, III, IV, and V commonly used in the practice of nurse midwifery; and
(iv)
The dispensing of the substances prescribed in accordance with the provisions of items (ii) and (iii) of this paragraph in the course of treating a patient:
(1)
At a medical facility or clinic that is operated on a nonprofit basis;
(2)
At a health center that operates on a campus of an institution of higher education;
(3)
At a public health facility, a medical facility under contract with a State or local health department, or a facility funded with public funds; or
(4)
With a starter dosage of a drug as authorized under § 8–508 of this title.
Md. Code Ann., Health Occ. § 8-602 (2026)
Title 8. Nurses
Subtitle 6. Special Nurse Midwife Provisions
§ 8–602LinkCopy Citation
The practice of nurse midwifery is governed by rules and regulations that are adopted under § 8-205 of this title and that concern additional acts in the practice of registered nursing.
Md. Code Ann., Health Occ. § 8-603 (2026)
Title 8. Nurses
Subtitle 6. Special Nurse Midwife Provisions
§ 8–603LinkCopy Citation
An individual who on June 30, 1981 is licensed as a nurse midwife by this State is governed by this title and any other provisions that concern additional acts in the practice of registered nursing that relate to the practice of nurse midwifery.
Md. Code Ann., Health Occ. § 8-604 (2026)
Title 8. Nurses
Subtitle 6. Special Nurse Midwife Provisions
§ 8–604LinkCopy Citation
(a)
Each nurse midwife practicing as a nurse midwife in the State shall notify a patient in writing or by written electronic communication if:
(1)
The nurse midwife does not maintain professional liability insurance coverage; or
(2)
The nurse midwife’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.
(b)
The written notification provided to the patient under subsection (a) of this section shall be:
(1)
Provided:
(i)
At the first visit by the patient during the period in which the nurse midwife does not maintain professional liability insurance, unless the visit is for the purpose of receiving incidental medical care that will be rendered free of charge; and
(ii)
As part of each informed consent obtained before any procedure discussed or offered for the patient’s consideration is performed;
(2)
Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and
(3)
Retained by the nurse midwife as part of the nurse midwife’s patient records.
(c)
Each nurse midwife practicing as a nurse midwife in the State who does not maintain professional liability insurance coverage shall post this information in a conspicuous location in the nurse midwife’s place of practice.
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
Md. Code Ann., Health Occ. § 8-6A-01 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-01LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“Applicant” means, unless the context requires otherwise:
(1)
An individual applying for an initial certificate by examination or endorsement;
(2)
A certificate holder applying for renewal of a certificate; or
(3)
An individual applying for reinstatement of a certificate in accordance with § 8–6A–10 of this subtitle.
(c)
(1)
“Approved dialysis technician training program” means a course of training approved by the Board that:
(i)
Prepares the applicant for national certification;
(ii)
Meets the requirements of 42 C.F.R. § 494.140(e)(3); and
(iii)
Meets the requirements set by the Board in regulation.
(2)
“Approved dialysis technician training program” includes the courses required for national certification as:
(i)
A Certified Clinical Hemodialysis Technician by the Nephrology Nursing Certification Commission;
(ii)
A Clinical Nephrology Technician by the National Nephrology Certification Organization; or
(iii)
A Certified Hemodialysis Technician by the Board of Nephrology Examiners Nursing Technology.
(d)
“Approved medication technician training program” means a course of training approved by the Board that meets the basic medication technician core curriculum and the medication technician content training specific to the setting in which the medication technician will work.
(e)
“Approved nursing assistant training program” means a course of training that meets the basic nursing assistant curriculum prescribed and approved by the Board.
(f)
“Board” means the State Board of Nursing.
(g)
“Certificate” means a certificate issued by the Board to practice as a certified nursing assistant, a certified dialysis technician, or a certified medication technician in the State.
(h)
“Certificate holder” means a certified nursing assistant, dialysis technician, or medication technician who has:
(1)
An active certificate;
(2)
An inactive certificate;
(3)
A temporary certificate;
(4)
An expired temporary certificate;
(5)
An expired certificate;
(6)
A lapsed certificate;
(7)
A suspended certificate; or
(8)
A certificate subject to a reprimand, probation, or suspension.
(i)
“Certified dialysis technician” means an individual who:
(1)
Has completed a Board–approved dialysis technician program; and
(2)
Is certified by the Board as a dialysis technician.
(j)
“Certified medication technician” means an individual who:
(1)
Has completed a Board–approved medication technician training program;
(2)
Is certified by the Board as a medication technician; and
(3)
Subject to regulations adopted by the Board, routinely performs:
(i)
Nursing tasks related to the administration of medication, delegated by a registered nurse, licensed practical nurse, or advanced practice nurse; or
(ii)
Technical tasks related to the administration of medication delegated by a licensed certified midwife.
(k)
“Certified medicine aide” means a certified nursing assistant who has completed a Board–approved course in medication administration.
(l)
“Certified nursing assistant”:
(1)
Means an individual regardless of title who, for compensation and subject to regulations adopted by the Board, routinely performs:
(i)
Nursing tasks delegated by a registered nurse, licensed practical nurse, or advanced practice registered nurse; or
(ii)
Technical tasks delegated by a licensed certified midwife; and
(2)
Does not include a certified dialysis technician or a certified medication technician.
(m)
“Department” means the Maryland Department of Health.
(n)
“Expired certificate” means a certificate that was not renewed before the expiration date of the certificate as established under § 8–6A–08(a) of this title.
(o)
“Geriatric nursing assistant” means a certified nursing assistant who has successfully completed the requirements for geriatric nursing assistant mandated under federal law and the regulations of the Board.
(p)
“Lapsed certificate” means a certificate that was not renewed because a certificate holder failed to renew the certificate or otherwise did not meet the renewal requirements of this subtitle.
Md. Code Ann., Health Occ. § 8-6A-02 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-02LinkCopy Citation
(a)
Subject to subsection (f) of this section and except as otherwise provided in this subtitle or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be certified by the Board to practice as a nursing assistant, dialysis technician, or medication technician before the individual may practice as a nursing assistant, dialysis technician, or medication technician in the State.
(b)
This subtitle does not apply to an individual who:
(1)
Practices a health occupation that the individual is authorized to practice under this article;
(2)
Provides for the gratuitous care of friends, domestic partners, or family members;
(3)
Performs nursing assistant tasks while a nursing student enrolled in an accredited nursing program and practicing under the direct supervision of qualified faculty or preceptors;
(4)
Performs nursing assistant tasks as a student while:
(i)
(1)
Enrolled in a Board–approved nursing assistant training program; or
(2)
Enrolled in an acute care nursing assistant training program; and
(ii)
Practicing under the direct supervision of qualified faculty or preceptors;
(5)
Performs nursing assistant tasks as a student while enrolled in an accredited nursing program after the successful completion of the portion of the approved nursing education program that the Board determines meets the requirements of an approved nursing assistant training program or medication administration course;
(6)
Performs medication technician tasks as a student while practicing under the direct supervision of qualified faculty;
(7)
Performs dialysis technician tasks as a student while under the direct supervision of qualified faculty;
(8)
Works as a principal or school secretary, does not administer medication as a routine part of the position, and has completed training by the delegating nurse for the occasion where the individual may need to administer medication in the absence of the nurse or medication technician; or
(9)
Practices as a certified nursing assistant–I for less than 4 months in accordance with 42 C.F.R. § 483.35(d).
(c)
This section does not preclude a registered nurse or licensed practical nurse from delegating a nursing or other technical task to an unlicensed individual if acceptance of delegated nursing or other technical tasks does not become a routine part of the unlicensed individual’s job duties.
(d)
(1)
Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude an advanced practice registered nurse from delegating a nursing or other technical task to an assistant if:
(i)
The assistant performs only tasks that the assistant is trained to perform; and
(ii)
The delegating advanced practice registered nurse provides:
(1)
Instruction to the assistant on the delegated task; and
(2)
On–site supervision of the assistant performing the delegated task.
(2)
The Board shall adopt regulations to carry out this subsection, including regulations that:
(i)
Provide for the manner in which an advanced practice registered nurse delegates a nursing or other technical task to an assistant;
(ii)
Establish limitations on the authority of an advanced practice registered nurse to delegate nursing or other technical tasks to an assistant; and
(iii)
Otherwise clarify the scope of this subsection.
(e)
(1)
Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude a licensed certified midwife from delegating a technical task to an assistant if:
(i)
The assistant performs only tasks that the assistant is trained to perform; and
(ii)
The delegating licensed certified midwife provides:
(1)
Instruction to the assistant on the delegated task; and
(2)
On–site supervision of the assistant performing the delegated task.
(2)
The Board shall adopt regulations to carry out this subsection, including regulations that:
(i)
Provide for the manner in which a licensed certified midwife delegates a technical task to an assistant;
(ii)
Establish limitations on the authority of a licensed certified midwife to delegate technical tasks to an assistant; and
(iii)
Otherwise clarify the scope of this subsection.
(f)
Except as provided in §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be certified by the Board to practice as a nursing assistant and as a dialysis technician before the individual may practice as a dialysis technician in a State–owned hospital or State–owned facility.
Md. Code Ann., Health Occ. § 8-6A-03 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-03LinkCopy Citation
(a)
An individual shall be certified as a nursing assistant by the Board before the individual may:
(1)
Use the title “certified nursing assistant”;
(2)
Use the initials “C.N.A.” after the name of the individual; or
(3)
Represent to the public that the individual is certified as a nursing assistant.
(b)
An individual shall be certified as a medication technician by the Board before the individual may:
(1)
Use the title “certified medication technician”;
(2)
Use the initials “C.M.T.” after the name of the individual; or
(3)
Represent to the public that the individual is certified as a medication technician.
(c)
An individual shall be certified as a dialysis technician by the Board before the individual may:
(1)
Use the title “certified dialysis technician”;
(2)
Use the initials “C.D.T.” after the name of the individual; or
(3)
Represent to the public that the individual is a certified dialysis technician.
(d)
An individual may not practice, attempt to practice, or offer to practice as a certified dialysis technician or a certified medication technician without certification from the Board.
Md. Code Ann., Health Occ. § 8-6A-04 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-04LinkCopy Citation
(a)
(1)
The Board shall set reasonable fees for the issuance and renewal of certificates and other services it provides to certified nursing assistants, certified dialysis technicians, and certified medication technicians.
(2)
The fees charged shall be set to produce funds to approximate the cost of maintaining the certification program and the other services provided to certified nursing assistants, certified dialysis technicians, and certified medication technicians.
(b)
(1)
The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.
(2)
The Comptroller shall distribute all the fees to the State Board of Nursing Fund established under § 8–206 of this title.
Md. Code Ann., Health Occ. § 8-6A-05 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-05LinkCopy Citation
(a)
The Board, after consultation with relevant stakeholders, shall adopt regulations establishing:
(1)
Qualifications for certified nursing assistants, including certified medicine aides;
(2)
Qualifications for certified dialysis technicians;
(3)
Qualifications for certified medication technicians;
(4)
Standards for qualification of applicants for certification, including the applicant’s criminal history, work record, and prohibitions against behavior which may be potentially harmful to patients; and
(5)
Standards for the online provision of didactic instruction in a nursing assistant training program that meets the requirements established by the Board.
(b)
(1)
To qualify for certification as a nursing assistant, a certified medicine aide, a dialysis technician, or a medication technician, an applicant shall meet the requirements set by the Board.
(2)
Requirements set by the Board under paragraph (1) of this subsection regarding qualifications for certification as a certified nursing assistant–I shall include provisions to allow an individual who has been practicing as a temporary nursing assistant, in accordance with the waiver of the requirements of 42 C.F.R. § 483.35(d) issued by the Centers for Medicare and Medicaid Services on March 6, 2020, to apply on–the–job experience as a nursing assistant toward the total number of training hours required for certification as a certified nursing assistant–I.
(c)
(1)
An applicant for a certificate shall:
(i)
Submit to a criminal history records check in accordance with § 8–303 of this title;
(ii)
Submit to the Board:
(1)
An application to the Board on the form that the Board requires; and
(2)
Written verification that the requirement in item (i) of this paragraph is being or has been met;
(iii)
Provide evidence, as required by the Board, of successful completion of:
(1)
An approved nursing assistant training program or approved acute care nursing assistant training program;
(2)
An approved dialysis technician training program;
(3)
An approved course in medication administration; or
(4)
A portion of an approved nursing education program that the Board determines meets the requirements of an approved nursing assistant training program or medication administration course;
(iv)
Pay to the Board an application fee set by the Board;
(v)
Be of good moral character;
(vi)
Be at least 16 years old to apply for certification as a nursing assistant;
(vii)
Be at least 18 years old to apply for certification as a dialysis technician; and
(viii)
Be at least 18 years old to apply for certification as a medication technician.
(2)
(i)
An applicant for certification as a certified nursing assistant shall submit to the Board satisfactory evidence of passing a nursing assistant competency evaluation.
(ii)
An applicant who has completed an approved acute care nursing assistant training program shall be deemed to have fulfilled the classroom and clinical standards to sit for the nursing assistant competency evaluation.
(3)
An applicant for a certificate may not:
(i)
Have committed any act or omission that would be grounds for discipline or denial of certification under this subtitle; and
(ii)
Have a record of abuse, negligence, misappropriation of a resident’s property, or any disciplinary action taken or pending in any other state or territory of the United States against the certification of the nursing assistant or medication technician in the state or territory.
(4)
Beginning April 1, 2026, a certified nursing assistant–II may be certified as a certified nursing assistant–I by:
(i)
Submitting an application to the Board on the form that the Board requires; and
(ii)
Providing satisfactory evidence of:
(1)
Successful completion of an approved nursing assistant training program; and
(2)
Passing a nursing assistant competency evaluation.
Md. Code Ann., Health Occ. § 8-6A-06 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-06LinkCopy Citation
Every applicant for certification by endorsement shall:
(1)
Pay the required application fee;
(2)
Submit the information required by the Board in the manner and form specified by the Board; and
(3)
Submit written evidence that the applicant:
(i)
Is certified to practice as a nursing assistant or dialysis technician by another state or territory of the United States with requirements that are essentially similar to the requirements for certification established in this subtitle and that the certification is in good standing;
(ii)
Has not committed any act or omission that would be grounds for discipline or denial of certification under this subtitle;
(iii)
Has successfully completed nursing assistant training or dialysis technician training that meets the standards for an approved nursing assistant training program or dialysis technician training program established under this subtitle and the standards adopted by the Board; and
(iv)
Has no record of abuse, negligence, or misappropriation of a resident’s property or any disciplinary action taken or pending in any other state or territory of the United States against the certification of the nursing assistant or dialysis technician in the state or territory.
Md. Code Ann., Health Occ. § 8-6A-07 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-07LinkCopy Citation
(a)
Subject to subsection (g) of this section, the Board shall certify any applicant who meets the requirements of this subtitle.
(b)
(1)
The Board shall:
(i)
Issue each new certified nursing assistant, dialysis technician, or medication technician a certificate number and registration certificate that indicates the initial certificate was issued by the Board; and
(ii)
Electronically record each certificate in the Board’s database and on the Board’s website.
(2)
Each certificate shall include:
(i)
Any expiration date;
(ii)
The type of certificate; and
(iii)
Any specific category of nursing assistant.
(c)
An individual who has met the requirements for a certified nursing assistant shall be certified with the title of “certified nursing assistant”.
(d)
An individual who routinely performs nursing tasks delegated by a registered nurse or licensed practical nurse for compensation and has also completed a Board–approved course in medication administration shall be certified with the title of “certified medicine aide”.
(e)
An individual who has met the requirements for a certified dialysis technician shall be certified with the title of “certified dialysis technician”.
(f)
An individual who has met the requirements for a certified medication technician shall be certified with the title of “certified medication technician”.
(g)
(1)
The Board may issue a temporary practice certificate to an applicant who:
(i)
Has met the appropriate certification requirements of this subtitle to the satisfaction of the Board; and
(ii)
Does not have a criminal record and has not been the subject of a health professional disciplinary action in this State or another jurisdiction.
(2)
Unless the Board suspends or revokes a temporary practice certificate, the temporary practice certificate expires 90 days after issuance.
(3)
A temporary practice certificate may be extended up to an additional 90 days if the applicant is awaiting the completion of criminal history record information.
(h)
A medication technician graduate may practice for no more than 90 days from the date of completion of a medication technician training program without certification by the Board.
(i)
(1)
On receipt of the criminal history record information of an applicant for certification as a certified nursing assistant or dialysis technician forwarded to the Board in accordance with § 8–303 of this title, in determining whether to grant a certificate, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.
(2)
The Board may not issue a certificate if the criminal history record information required under § 8–303 of this title has not been received.
Md. Code Ann., Health Occ. § 8-6A-08 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-08LinkCopy Citation
(a)
A certificate expires on the 28th day of the birth month of the nursing assistant, dialysis technician, or medication technician, unless the certificate is renewed for a 2–year term as provided in this section.
(b)
(1)
At least 3 months before a certificate expires, the Board shall send a renewal notice to the certificate holder by:
(i)
First–class mail to the last known mailing address of the certificate holder; or
(ii)
Electronic means to the last known electronic address of the certificate holder.
(2)
A renewal notice shall state:
(i)
The date on which the current certificate expires;
(ii)
The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the certificate expires; and
(iii)
The amount of the renewal fee.
(3)
If a certificate holder is required to have a criminal history records check before a certificate may be renewed, the Board shall send the certificate holder the documents necessary for initiating the criminal history records check in conjunction with the renewal notice required under paragraph (1) of this subsection.
(c)
Before a certificate expires, a nursing assistant periodically may renew it for an additional term, if the certificate holder:
(1)
Otherwise is entitled to be certified;
(2)
Submits to the Board a renewal application on the form that the Board requires;
(3)
Pays to the Board a renewal fee set by the Board; and
(4)
Provides satisfactory evidence of completion of:
(i)
16 hours of active nursing assistant practice within the 2–year period immediately preceding the date of expiration; or
(ii)
If the nursing assistant did not complete 16 hours of active practice as required under item (i) of this item, an approved nursing assistant training program or an approved nursing assistant refresher training program as required in regulations adopted by the Board in accordance with subsection (m) of this section.
(d)
In addition to the requirements in subsection (c)(1), (2), and (3) of this section, a certified medicine aide shall:
(1)
Provide satisfactory evidence of completion of 100 hours of practice as a certified medicine aide in the 2–year period preceding the date of expiration; and
(2)
Successfully complete a Board–approved medicine aide continuing education program.
(e)
Before a certificate expires, a dialysis technician periodically may renew it for an additional term, if the certificate holder:
(1)
Otherwise is entitled to be certified;
(2)
Submits to the Board a renewal application on the form that the Board requires;
(3)
Pays to the Board a renewal fee set by the Board;
(4)
Has completed:
(i)
(1)
16 hours of practice as a dialysis technician in the 2–year period immediately preceding the date of expiration; and
(2)
3 hours of continuing education approved by the Board; or
(ii)
A dialysis technician training program approved by the Board; and
(5)
Has an active national certification listed in § 8–6A–01(c)(2) of this subtitle.
(f)
Before a certificate expires, a medication technician periodically may renew it for an additional term, if the certificate holder:
(1)
Otherwise is entitled to be certified;
(2)
Submits to the Board a renewal application on the form that the Board requires;
(3)
Pays to the Board a renewal fee set by the Board;
(4)
Every 2 years, provides satisfactory evidence of completion of a Board–approved clinical refresher course; and
(5)
Provides satisfactory evidence of completion of 100 hours of practice as a certified medication technician within the 2–year period preceding the date of renewal.
(g)
The Board may grant a 30–day extension, beyond a certificate’s expiration date, to a certificate holder so that the certificate holder may renew the certificate before it expires.
(h)
The Board shall reinstate the certificate of a certificate holder who has failed to renew the certificate for any reason if the certificate holder meets the applicable renewal requirements of subsections (c) through (f) and (l)(1)(i)2 of this section.
(i)
Subject to subsection (j) of this section, the Board shall renew the certificate of each nursing assistant, dialysis technician, or medication technician who meets the requirements of this section.
(j)
(1)
Within 60 days after a change has occurred, each certificate holder shall notify the Board in writing of any change in a name or address.
(2)
If the certificate holder fails to notify the Board within the time required under this subsection, the Board may impose an administrative penalty of $25 on the certificate holder.
(k)
The Board shall pay any penalty collected under this section to the General Fund of the State.
(l)
(1)
(i)
The Board shall require criminal history records checks in accordance with § 8–303 of this title on:
(1)
Selected applicants for certification as a certified nursing assistant, medication technician, or dialysis technician who renew their certificates every 2 years as determined by regulations adopted by the Board; and
(2)
Each former certified nursing assistant, medication technician, or dialysis technician who files for reinstatement under subsection (h) of this section after failing to renew the certificate for a period of 1 year or more.
(ii)
An additional criminal history records check shall be performed every 12 years thereafter.
(2)
On receipt of the criminal history record information of a certificate holder forwarded to the Board in accordance with § 8–303 of this title, in determining whether to initiate disciplinary action against the certificate holder based on the information received, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the certificate holder poses a threat to the public health or safety.
(3)
The Board may not renew a certificate without written documentation that the applicant has submitted to a criminal history records check as required under § 8–303 of this title.
(m)
(1)
If an individual has been certified by the Board to practice as a nursing assistant, dialysis technician, or medication technician in the State in accordance with the requirements of this subtitle, the individual subsequently may be certified as a nursing assistant, dialysis technician, or medication technician on inactive status.
(2)
The Board shall place a certificate holder on inactive status and record the inactive status in the Board’s database and on the Board’s website if the certificate holder:
(i)
Submits documentation of a medical condition that the Board determines will prevent the certificate holder from practicing as a nursing assistant, dialysis technician, or medication technician; and
(ii)
Completes the biennial application for inactive status and submits documentation of a continuing medical condition.
(3)
A certificate holder on inactive status may apply for reactivation of the certificate if the certificate holder:
(i)
Submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists; and
(ii)
Meets the renewal requirements of this section.
(4)
If a certificate holder meets the requirements of paragraph (3) of this subsection, the Board shall:
(i)
Record the status of the certificate holder as active in the Board’s database and on the Board’s website; and
(ii)
Reactivate the certificate holder’s certificate to practice as a nursing assistant, dialysis technician, or medication technician in the State.
(5)
The Board may not charge a fee to place the certificate holder on or remove the certificate holder from inactive status under this subsection.
(6)
Inactive status:
(i)
May not be considered a disciplinary action under § 8–6A–10 of this subtitle; and
(ii)
May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.
(n)
(1)
The Board shall adopt regulations to specify:
(i)
The circumstances under which a nursing assistant, as a condition of renewal, is required to complete either an approved nursing assistant training program or an approved nursing assistant refresher training program; and
(ii)
The number of didactic instruction hours and clinical training hours the nursing assistant training program or nursing assistant refresher training program must have to be approved.
(2)
Regulations adopted under paragraph (1) of this subsection must be consistent with federal law.
Md. Code Ann., Health Occ. § 8-6A-09 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-09LinkCopy Citation
(a)
The Board may impose a civil fine not exceeding $50 on a certified nursing assistant, a certified dialysis technician, or a certified medication technician who fails to renew a certificate within 30 days after its expiration date and practices as a certified nursing assistant, certified dialysis technician, or certified medication technician during the period of expiration.
(b)
The Board shall pay any penalty collected under this section to the General Fund of the State.
Md. Code Ann., Health Occ. § 8-6A-10 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-10LinkCopy Citation
(a)
Subject to the hearing provisions of § 8–317 of this title and § 8–6A–10.1 of this subtitle, the Board may deny a certificate or grant a certificate, including a certificate subject to a reprimand, probation, or suspension, to any applicant, reprimand any certificate holder, place any certificate holder on probation, or suspend or revoke the certificate of a certificate holder, if the applicant or certificate holder:
(1)
Fraudulently or deceptively obtains or attempts to obtain a certificate for the applicant or for another;
(2)
Fraudulently or deceptively uses a certificate;
(3)
Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;
(4)
Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;
(5)
Files a false report or record of an individual under the certificate holder’s care;
(6)
Gives any false or misleading information about a material matter in an employment application;
(7)
Fails to file or record any health record that is required by law;
(8)
Induces another individual to fail to file or record any health record that is required by law;
(9)
Has violated any order, rule, or regulation of the Board relating to the practice or certification of a nursing assistant, dialysis technician, or medication technician;
(10)
Provides services as a nursing assistant, dialysis technician, or medication technician while:
(i)
Under the influence of alcohol; or
(ii)
Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;
(11)
Has a substance use disorder;
(12)
Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;
(13)
Has acted in a manner inconsistent with the health or safety of an individual under the applicant or certificate holder’s care;
(14)
Has practiced as a nursing assistant, dialysis technician, or medication technician in a manner which fails to meet generally accepted standards for the practice of a nursing assistant, dialysis technician, or medication technician;
(15)
Has physically, verbally, or psychologically abused, neglected, or otherwise harmed an individual under the applicant or certificate holder’s care;
(16)
Has a physical or mental condition which renders the applicant or certificate holder unable to practice as a certified nursing assistant, certified dialysis technician, or certified medication technician with reasonable skill and safety to the patients and which may endanger the health or safety of individuals under the care of the applicant or certificate holder;
(17)
Has violated the confidentiality of information or knowledge as prescribed by law concerning any patient;
(18)
Has misappropriated patient or facility property;
(19)
Performs certified nursing assistant, certified dialysis technician, or certified medication technician functions incompetently;
(20)
Has violated any provision of this title or has aided or knowingly permitted any individual to violate any provision of this title;
(21)
Submits a false statement to collect a fee;
(22)
Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the applicant or certificate holder is certified and qualified to render because the individual is HIV positive;
(23)
Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(24)
Fails to cooperate with a lawful investigation conducted by the Board;
(25)
Fails to comply with instructions and directions of the supervising registered nurse or licensed practical nurse;
(26)
When holding an expired certificate or a lapsed certificate, commits any act that would be grounds for disciplinary action under this section;
(27)
Practices as a nursing assistant, dialysis technician, or medication technician before obtaining or renewing the certificate, including any time period when practicing as a nursing assistant, dialysis technician, or medication technician on an expired certificate or a lapsed certificate;
(28)
Impersonates another individual:
(i)
Licensed under the provisions of this title; or
(ii)
Who holds a certificate issued under the provisions of this title;
(29)
Engages in conduct that violates the code of ethics;
(30)
Performs activities that exceed the education and training of the certified nursing assistant, certified dialysis technician, or certified medication technician;
(31)
Is expelled from the safe practice program established pursuant to § 8–208 of this title for failure to comply with the conditions of the program;
(32)
Fails to submit to a criminal history records check in accordance with § 8–303 of this title as required under § 8–6A–05(c)(2) of this subtitle;
(33)
Abandons a patient; or
(34)
Is a director of nursing, or acts in the capacity of a director of nursing and knowingly employs an individual who is not authorized to perform delegated nursing duties under this subtitle.
(b)
If, after a hearing under § 8–317 of this title and § 8–6A–10.1 of this subtitle, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a certificate to practice as a certified nursing assistant, certified dialysis technician, or certified medication technician, to reprimand a certificate holder, or place a certificate holder on probation, the Board may impose a penalty not exceeding $500 instead of or in addition to suspending or revoking the certificate, reprimanding the certificate holder, or placing the certificate holder on probation.
(c)
(1)
If a certificate issued under this subtitle was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a certificate was surrendered, the Board may reinstate the certificate if the certificate holder:
(i)
Applies to the Board for reinstatement;
(ii)
Meets the requirements for renewal under § 8–6A–08 of this subtitle;
(iii)
Meets any other requirements for reinstatement as established by the Board in regulations; and
(iv)
Submits to a criminal history records check in accordance with § 8–303 of this title.
(2)
If a certificate holder meets the requirements of paragraph (1) of this subsection, the Board may:
(i)
Reinstate the certificate;
(ii)
Reinstate the certificate subject to terms and conditions that the Board considers necessary, including a period of probation; or
(iii)
Deny reinstatement of the certificate.
Md. Code Ann., Health Occ. § 8-6A-10.1 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-10.1LinkCopy Citation
(a)
Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under § 8–6A–10 of this subtitle, the Board shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board.
(b)
The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.
(c)
The hearing notice to be given to the individual shall be sent by certified mail, return receipt requested, to the last known address of the individual at least 30 days before the hearing.
(d)
The individual may be represented at the hearing by counsel.
(e)
If, after due notice, the individual against whom the action is contemplated fails or refuses to appear, the Board may hear and determine the matter.
(f)
(1)
Over the signature of the president, the executive director, or the deputy director as authorized by the executive director of the Board, the Board may issue subpoenas and administer oaths in connection with any investigation under this subtitle and any hearings or proceedings before the Board.
(2)
If an individual, without lawful excuse, disobeys a subpoena from the Board or an order by the Board to take an oath, testify, or answer questions, on petition of the Board a court of competent jurisdiction may compel compliance with the subpoena and hold the individual in contempt of court.
(g)
(1)
After the Board conducts an investigation under this subtitle, the Board may issue an advisory letter to the certificate holder.
(2)
The Board may disclose an advisory letter issued under this subsection to the public.
(3)
The issuance of an advisory letter under this subsection:
(i)
May not be considered a disciplinary action under § 8–6A–10 of this subtitle; and
(ii)
May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.
Md. Code Ann., Health Occ. § 8-6A-11 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-11LinkCopy Citation
(a)
Any person aggrieved by a final decision of the Board under § 8–6A–10 of this subtitle may only take a direct judicial appeal as allowed by the Administrative Procedure Act.
(b)
A Board decision may not be stayed while judicial review is pending.
Md. Code Ann., Health Occ. § 8-6A-12 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-12LinkCopy Citation
(a)
Unless the Board agrees to accept the surrender of a certificate, a certified nursing assistant, certified dialysis technician, or certified medication technician may not surrender the certificate.
(b)
The Board may require terms and conditions on an agreement with the certified nursing assistant, certified dialysis technician, or certified medication technician to accept surrender of the certificate.
(c)
An agreement to accept the surrender of a certificate is a final order of the Board and is a public record.
Md. Code Ann., Health Occ. § 8-6A-13 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-13LinkCopy Citation
(a)
The Board shall appoint an advisory committee consisting of at least 17 members.
(b)
Of the 17 committee members:
(1)
Six shall be nursing assistants:
(i)
One shall be an acute care nursing assistant;
(ii)
One shall be a home care nursing assistant;
(iii)
One shall be a long–term care nursing assistant;
(iv)
One shall be an adult medical day care nursing assistant;
(v)
At least one of the nursing assistant members shall be a member of a union; and
(vi)
One shall be an independent contractor;
(2)
Three shall be registered nurses:
(i)
One shall be an acute care registered nurse;
(ii)
One shall be a home care registered nurse; and
(iii)
One shall be a long–term care registered nurse;
(3)
Two shall be administrators from licensed health care facilities;
(4)
One shall be a licensed practical nurse;
(5)
One shall be an individual who teaches a nursing assistant course;
(6)
One shall be a consumer member who has received care, or has a family member who has received care from a nursing assistant;
(7)
One shall be a representative of the Department;
(8)
One shall be a certified medication technician; and
(9)
One shall be a certified dialysis technician.
(c)
The Board shall appoint an alternate for each of the six nursing assistant members in the event that the nursing assistant member is unable to discharge the duties of the committee.
(d)
Each member of the advisory committee must:
(1)
Be a citizen of the United States;
(2)
Be a resident of the State; and
(3)
Have practiced in the member’s health occupation for at least 5 years immediately preceding the member’s appointment.
(e)
(1)
The term of an advisory committee member is 4 years.
(2)
At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(3)
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.
(4)
A member may not serve more than two consecutive full terms.
(5)
To the extent practicable, the Board shall fill any vacancy on the advisory committee within 60 days after the date of the vacancy.
(f)
(1)
In addition to any other meeting requirements under this title, the advisory committee shall meet:
(i)
At least once a month; and
(ii)
At the request of the Executive Director of the Board.
(2)
A majority of the full membership of the advisory committee is a quorum.
(g)
The advisory committee shall:
(1)
Evaluate training programs and make recommendations for approval by the Board;
(2)
Develop and recommend regulations to enforce the provisions of this subtitle;
(3)
Evaluate candidates as required and recommend action to the Board;
(4)
Review investigations of complaints against nursing assistants or medication technicians and make recommendations to the Board for disciplinary action;
(5)
Keep a record of its proceedings; and
(6)
Submit an annual report to the Board.
(h)
A member of the advisory committee is entitled to receive:
(1)
Compensation, as determined by the Board; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(i)
The Board may remove a member:
(1)
For incompetence or misconduct; or
(2)
Who is absent from two successive committee meetings without adequate reason.
Md. Code Ann., Health Occ. § 8-6A-14 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-14LinkCopy Citation
(a)
The Board, in conjunction with the Maryland Higher Education Commission, shall approve each nursing assistant training program prior to its implementation and provide periodic survey of all programs in the State.
(b)
The Board in conjunction with the Department, Maryland Higher Education Commission, and the affected industry shall develop regulations for nursing assistant training programs.
(c)
The curriculum content for an approved nursing assistant training program shall include:
(1)
Content consistent with State licensing requirements in the Health – General Article and all federal requirements;
(2)
All basic skills required of a nursing assistant regardless of the setting of the practice; and
(3)
Any skills required for certification in a specific category.
(d)
Any additional clinical practice skills specific to a setting of practice shall be taught in that setting as a part of the employment training process in that setting.
(e)
The Board may make survey visits from time to time, without prior notice, to all certified nursing assistant training programs.
(f)
The provisions of this section may not be interpreted to impose additional requirements for geriatric nursing assistants beyond those required under federal law.
Md. Code Ann., Health Occ. § 8-6A-14.1 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-14.1LinkCopy Citation
The Board may make survey visits from time to time, without prior notice, to all Board–approved medication technician training and dialysis technician training programs.
Md. Code Ann., Health Occ. § 8-6A-15 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-15LinkCopy Citation
(a)
If, during the review of an application for certification or investigation of an allegation brought against a certified nursing assistant, certified dialysis technician, or certified medication technician under this subtitle, the Board has reason to believe and objective evidence that the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician may cause harm to a person affected by the practice of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician, the Board, on its own initiative, shall direct the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to submit to an appropriate examination by a health care provider designated by the Board.
(b)
In return for the privilege to practice as a certified nursing assistant, certified dialysis technician, or certified medication technician in the State, an applicant, certified nursing assistant, certified dialysis technician, or certified medication technician is deemed to have:
(1)
Consented to submit to an examination under this section if requested by the Board in writing; and
(2)
Waived any legal claim of privilege as to the testimony or examination reports of the examining health care provider.
(c)
The failure or refusal of an applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to submit to an examination required under subsection (b) of this section is prima facie evidence of the inability of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to competently practice as a certified nursing assistant, certified dialysis technician, or certified medication technician, unless the Board finds that the failure or refusal was beyond the control of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician.
(d)
The Board shall pay the cost of any examination made in accordance with the provisions of this section.
Md. Code Ann., Health Occ. § 8-6A-16 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-16LinkCopy Citation
If the Board determines that the information contained in a record concerns possible criminal activity of an individual who routinely provides nursing and nursing related tasks delegated by a registered nurse or licensed practical nurse for compensation, the Board shall disclose the information to a law enforcement or prosecutorial official.
Md. Code Ann., Health Occ. § 8-6A-17 (2026)
Title 8. Nurses
Subtitle 6A. Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians
§ 8–6A-17LinkCopy Citation
(a)
The authority of the Board established under this subtitle:
(1)
Vests with the Board at the time an individual applies for certification;
(2)
Continues during periods of certification; and
(3)
Includes authority over an individual holding an expired certificate, a lapsed certificate, or a temporary certificate that has expired under § 8–6A–07(f) of this subtitle.
(b)
The authority of the Board shall be continuous over an individual applicant or certificate holder and may not be divested by withdrawal of an application, when a certificate expires or lapses, or when a temporary certificate expires.
Subtitle 6B. Electrologists
Md. Code Ann., Health Occ. § 8-6B-01 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-01LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“Applicant” means, unless the context requires otherwise:
(1)
An individual applying for an initial license by examination or endorsement;
(2)
A licensee applying for renewal of a license; or
(3)
An individual applying for reinstatement of a license in accordance with § 8–6B–14 of this subtitle.
(c)
“Board” means the State Board of Nursing.
(d)
“Committee” means the Electrology Practice Committee.
(e)
“Electrologist” means an individual who practices electrology.
(f)
“Electrology instructor” means an individual who practices electrology and teaches an electrology education program.
(g)
“Expired license” means, unless the context requires otherwise, a license that was not renewed before the expiration date of the license as established by § 8–6B–14(a) of this subtitle.
(h)
“Lapsed license” means, unless the context requires otherwise, a license that was not renewed because a licensee failed to renew the license or otherwise did not meet the renewal requirements of this subtitle.
(i)
“License” means, unless the context requires otherwise, a license issued by the Board:
(1)
To practice electrology; or
(2)
To practice electrology and teach an electrology education program.
(j)
“Licensed electrologist” means, unless the context requires otherwise, an electrologist who is licensed by the Board to practice electrology.
(k)
“Licensed electrology instructor” means, unless the context requires otherwise, an electrologist who is licensed by the Board to practice electrology and teach an electrology education program.
(l)
“Licensee” means, unless the context requires otherwise, a licensed electrologist or licensed electrology instructor who has:
(1)
An active license;
(2)
An inactive license;
(3)
An expired license;
(4)
A lapsed license;
(5)
A suspended license; or
(6)
a license subject to a reprimand, probation, or suspension.
(m)
“Practice electrology” means to remove hair permanently through the use of electrical instruments.
Md. Code Ann., Health Occ. § 8-6B-02 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-02LinkCopy Citation
This subtitle does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.
Md. Code Ann., Health Occ. § 8-6B-03 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-03LinkCopy Citation
The Board shall adopt regulations for the licensure of electrologists and for the practice of electrology.
Md. Code Ann., Health Occ. § 8-6B-04 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-04LinkCopy Citation
(a)
(1)
The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to electrologists.
(2)
The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure and the other services provided to electrologists.
(b)
(1)
The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.
(2)
The Comptroller shall distribute all fees to the Board.
(c)
The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.
Md. Code Ann., Health Occ. § 8-6B-05 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-05LinkCopy Citation
(a)
There is an Electrology Practice Committee within the Board.
(b)
(1)
The Committee consists of three members appointed by the Board.
(2)
Of the three Committee members:
(i)
Two shall be licensed electrologists or licensed electrology instructors; and
(ii)
One shall be a consumer member.
(c)
Each member of the Committee shall be a citizen of the United States and a resident of the State.
(d)
Each electrologist member of the Committee shall have practiced electrology actively in the State for at least 5 years immediately before appointment.
(e)
The consumer member of the Committee:
(1)
Shall be a member of the general public;
(2)
May not be or ever have been:
(i)
An electrologist;
(ii)
A health care professional; or
(iii)
In training to be an electrologist or a health care professional;
(3)
May not have a household member who is an electrologist, a health care professional, in training to be an electrologist, or in training to be a health care professional; and
(4)
May not:
(i)
Participate or ever have participated in a commercial or professional field related to electrology;
(ii)
Have a household member who participates in a commercial or professional field related to electrology; or
(iii)
Have, or have had within 2 years before appointment, a substantial financial interest in a person regulated by the Board.
(f)
(1)
The term of a member is 4 years.
(2)
The terms of the members are staggered as required by the provisions for members of the Committee on July 1, 2003.
(3)
At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4)
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.
(5)
A member may not serve more than two consecutive full terms.
(6)
To the extent practicable, the Board shall fill any vacancy on the Committee within 60 days of the date of the vacancy.
(g)
A majority of the full authorized membership of the Committee is a quorum.
(h)
In addition to any other meeting requirements of this title, the Committee shall meet:
(1)
At the request of the executive director of the Board; or
(2)
As necessary to conduct Board business.
(i)
In accordance with the State budget, each member of the Committee is entitled to:
(1)
Compensation, at a rate determined by the Board, for each day, or part of a day, on which the member is engaged in the duties of the Committee; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations.
(j)
(1)
The Board may remove a member for incompetence or misconduct.
(2)
The Board may remove a member who is absent from two successive Committee meetings without adequate reason.
Md. Code Ann., Health Occ. § 8-6B-06 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-06LinkCopy Citation
In addition to the powers set forth elsewhere in this subtitle, the Committee shall:
(1)
Make recommendations to the Board regarding regulations necessary to carry out the provisions of this subtitle;
(2)
Make recommendations to the Board regarding a code of ethics for the practice of electrology;
(3)
Make recommendations to the Board regarding the requirements for licensure as an electrologist or an electrology instructor;
(4)
Review applications for licensure as an electrologist or electrology instructor and make recommendations to the Board;
(5)
Maintain a list of all currently licensed electrologists and electrology instructors;
(6)
Make recommendations to the Board regarding continuing education requirements for electrologists;
(7)
At the request of the Board, investigate complaints against licensed electrologists;
(8)
Review electrology education programs both in the State and out of state in accordance with § 8–6B–16 of this subtitle to determine compliance with the standards of that section and make recommendations to the Board regarding approval or disapproval of these programs;
(9)
Review advertising by licensed electrologists and by institutions that offer an electrology program and make recommendations to the Board, as necessary;
(10)
At the request of the Board, after the Board has received a written and signed complaint, including a referral from the Commissioner of Labor and Industry, conduct an unannounced inspection of the office of an electrologist, other than an office of an electrologist in a hospital, related institution, freestanding medical facility, or a freestanding birthing center, to determine compliance at that office with the Centers for Disease Control and Prevention’s guidelines on universal precautions and make recommendations to the Board, as necessary;
(11)
At the request of the Board, after the Board has received notice that an electrologist has opened an office, after notifying the electrologist, conduct an inspection of the office to determine compliance with the Board’s regulations relating to the minimum requirements for an office and make recommendations to the Board, as necessary;
(12)
Advise the Board on matters relating to the practice of electrology;
(13)
Keep a record of its proceedings; and
(14)
Submit an annual report to the Board.
Md. Code Ann., Health Occ. § 8-6B-07 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-07LinkCopy Citation
(a)
Except as otherwise provided in this subtitle or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice electrology or teach an electrology education program in the State.
(b)
This section does not apply to a student who is practicing electrology as part of an approved clinical electrology education program.
Md. Code Ann., Health Occ. § 8-6B-08 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-08LinkCopy Citation
(a)
To qualify for a license, an applicant shall be an individual who submits to a criminal history records check in accordance with § 8–303 of this title and meets the requirements of this section.
(b)
The applicant shall be of good moral character.
(c)
The applicant shall be at least 18 years old.
(d)
Except as otherwise provided in this subtitle, an applicant shall be a high school graduate or have completed equivalent education and have completed satisfactorily:
(1)
An electrology education program, taught by a licensed electrology instructor, that includes at least 600 hours of instruction, and has been approved by the Board; or
(2)
An electrology education program in any other state that the Board determines is substantially equivalent to that required by item (1) of this subsection.
(e)
(1)
Except as otherwise provided in this subtitle, each applicant shall pass:
(i)
An examination approved by the Board; and
(ii)
A clinical examination approved by the Board.
(2)
Applicants are responsible for scheduling the examinations required under paragraph (1) of this subsection.
(f)
In addition to the other requirements of this section, an applicant for an electrology instructor license shall:
(1)
Be a licensed electrologist;
(2)
Have practiced electrology actively for at least 5 years immediately before the application;
(3)
Pass an examination approved by the Board; and
(4)
Meet any other requirements set forth in regulations adopted by the Board under § 8–6B–03 of this subtitle.
Md. Code Ann., Health Occ. § 8-6B-09 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-09LinkCopy Citation
(a)
To apply for a license, an applicant shall:
(1)
Submit to a criminal history records check in accordance with § 8-303 of this title;
(2)
Submit to the Board:
(i)
An application on the form that the Board requires;
(ii)
Written, verified evidence that the requirement of item (1) of this subsection is being met; and
(iii)
Evidence of compliance with the requirements of § 8-6B-08 of this subtitle; and
(3)
Pay to the Board a fee set by the Board.
(b)
The Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle.
Md. Code Ann., Health Occ. § 8-6B-10 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-10LinkCopy Citation
(a)
An applicant who otherwise qualifies for a license is entitled to be examined as provided in this section.
(b)
An applicant shall take a written examination approved by the Board.
(c)
(1)
The Board or the Board’s designee shall give clinical examinations to applicants.
(2)
The Board or the Board’s designee may give reexaminations to applicants who fail the clinical examination.
(d)
The Board or the Board’s designee shall notify each qualified applicant of the time and place of examination for the written and clinical examinations.
(e)
Except as otherwise provided under this subtitle, the Board shall determine the passing score for examinations given under this subtitle.
(f)
(1)
An applicant may retake a written examination or a failed section of a written examination after paying a reexamination fee set by the Board or the administrator of a national examination.
(2)
An applicant who fails two reexaminations may retake the written examination only if the applicant:
(i)
Retakes the entire examination;
(ii)
Pays the full examination fee; and
(iii)
Completes an education program that the Board requires.
Md. Code Ann., Health Occ. § 8-6B-11 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-11LinkCopy Citation
(a)
Subject to the provisions of this section, the Board may issue a license by endorsement and waive the examination requirement of this subtitle for an individual who is licensed to practice electrology in another state.
(b)
The Board may issue a license by endorsement under this section only if the applicant:
(1)
Pays the license fee required by the Board; and
(2)
Provides adequate evidence that the applicant:
(i)
Meets the qualifications otherwise required by this subtitle;
(ii)
Became licensed in the other state after passing in that state, or any other state, an examination that is substantially equivalent to an examination approved by the Board; and
(iii)
Became licensed in the other state after meeting requirements that are substantially equivalent to the requirements of this subtitle.
Md. Code Ann., Health Occ. § 8-6B-12 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-12LinkCopy Citation
(a)
Subject to subsection (c) of this section, the Board shall issue a license to any applicant who:
(1)
Meets the requirements of this subtitle; and
(2)
Pays a license fee set by the Board.
(b)
The Board shall include on each license that the Board issues a license designation as:
(1)
Licensed electrologist; or
(2)
Licensed electrology instructor.
(c)
(1)
On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 8-303 of this title, in determining whether to grant a license, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates that the applicant does not pose a threat to the public health or safety.
(2)
The Board may not issue a license if the criminal history record information required under § 8-303 of this title has not been received.
Md. Code Ann., Health Occ. § 8-6B-13 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-13LinkCopy Citation
(a)
An electrologist’s license issued under this subtitle authorizes the licensee to practice electrology while the license is effective.
(b)
An electrology instructor’s license issued under this subtitle authorizes the licensee to practice electrology and to teach an electrology education program while the license is effective.
Md. Code Ann., Health Occ. § 8-6B-14 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-14LinkCopy Citation
(a)
A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.
(b)
A license may not be renewed for a term longer than 2 years.
(c)
(1)
At least 3 months before a license expires, the Board shall send a renewal notice to the licensee, by:
(i)
First–class mail to the last known mailing address of the licensee; or
(ii)
Electronic means to the last known electronic address of the licensee.
(2)
A renewal notice shall state:
(i)
The date on which the current license expires;
(ii)
The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and
(iii)
The amount of the renewal fee.
(d)
Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term, if the licensee:
(1)
Otherwise is entitled to be licensed;
(2)
Pays to the Board a renewal fee set by the Board; and
(3)
Submits to the Board:
(i)
A renewal application on the form that the Board requires; and
(ii)
Satisfactory evidence of compliance with any continuing education requirement set under this subtitle for license renewal.
(e)
In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition to the renewal of licenses under this section.
(f)
Subject to subsection (k) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.
(g)
If a licensee fails to provide satisfactory evidence of compliance with any continuing education requirements set under this subtitle for license renewal, the Board shall place the licensee on inactive status.
(h)
(1)
The Board shall place a licensee on inactive status and record the inactive status in the Board’s database and on the Board’s Web site, if the licensee submits to the Board:
(i)
An application for inactive status on the form required by the Board;
(ii)
If applicable, documentation of a medical condition that the Board determines will prevent the licensee from practicing electrology; and
(iii)
If applicable, the inactive status fee set by the Board.
(2)
The Board shall reactivate the license of an individual who is on inactive status and record the status of the licensee as active in the Board’s database and on the Board’s Web site, if the individual:
(i)
Complies with any continuing education requirement established by the Board for this purpose;
(ii)
If applicable, submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists;
(iii)
If applicable, pays to the Board a reactivation fee set by the Board; and
(iv)
Is otherwise entitled to be licensed.
(3)
If the individual has been on inactive status for 5 years or more, before the Board may reactivate the license, the individual must pass an examination approved by the Board.
(4)
(i)
If a licensee is granted inactive status because of a medical condition, the Board may not charge a fee to place the licensee on or remove the licensee from inactive status.
(ii)
If a licensee is granted inactive status because of a medical condition, the inactive status:
(1)
May not be considered a disciplinary action under § 8–6B–18 of this subtitle; and
(2)
May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.
(i)
The Board, in accordance with its rules and regulations, shall reinstate the license of an individual who has failed to renew the license for any reason if the individual:
(1)
Is otherwise entitled to be licensed;
(2)
Complies with any continuing education requirement established by the Board for this purpose;
(3)
Pays to the Board a reinstatement fee set by the Board;
(4)
For an expired license or lapsed license that has been expired or lapsed for more than 1 year, completes a criminal history records check in accordance with § 8–303 of this title; and
(5)
Applies to the Board for reinstatement of the license within 5 years after the license expires.
(j)
(1)
The Board may not reinstate the license of an electrologist or an electrology instructor who fails to apply for reinstatement of the license within 5 years after the license expires.
(2)
The electrologist or electrology instructor may become licensed by meeting the current requirements for obtaining a new license under this subtitle.
(k)
(1)
(i)
The Board shall require a criminal history records check on selected annual renewal applicants as determined by regulations adopted by the Board in accordance with § 8–303 of this title.
(ii)
An additional criminal history records check shall be performed every 12 years thereafter.
(2)
On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 8–303 of this title, in determining whether to initiate disciplinary action against a licensee based on the information received, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates that the licensee does not pose a threat to the public health or safety.
(3)
The Board may not renew a license without written documentation that the applicant has submitted to the criminal history records check required under § 8–303 of this title.
Md. Code Ann., Health Occ. § 8-6B-15 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-15LinkCopy Citation
(a)
Unless the Board agrees to accept the surrender of a license, a licensed electrologist or licensed electrology instructor may not surrender the license.
(b)
The Board may require terms and conditions on an agreement with the licensed electrologist or licensed electrology instructor to accept surrender of the license.
(c)
An agreement to accept the surrender of a license is a final order of the Board and is a public record.
Md. Code Ann., Health Occ. § 8-6B-16 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-16LinkCopy Citation
(a)
Before an institution may operate an electrology education program in the State, the Board shall approve the program.
(b)
The Board shall approve an electrology education program in the State if:
(1)
The Maryland Higher Education Commission approves the program; and
(2)
The institution that offers the program submits evidence to the Board that the institution is prepared to:
(i)
Meet the standards established in regulations adopted by the Board under § 8-6B-03 of this subtitle; and
(ii)
Carry out an education program in:
(1)
The theory of electrology; or
(2)
The clinical practice of electrology.
(c)
(1)
The Board periodically may evaluate electrology programs in the State and prepare a written report.
(2)
If an institution that offers an approved electrology education program violates any of the standards set by the Board under this subtitle, the Board shall give the institution specific, written notice of the violation.
Md. Code Ann., Health Occ. § 8-6B-17 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-17LinkCopy Citation
Subject to the hearing provisions of § 8-317 of this title and § 8-6B-19 of this subtitle, the Board may remove an institution from its list of institutions that offer approved electrology education programs if the institution:
(1)
Is guilty of fraud or deceit in obtaining or attempting to obtain approval;
(2)
Acts in a manner inconsistent with generally accepted standards for the practice of electrology;
(3)
Advertises in a manner that the Board determines violates § 8-6B-22 of this subtitle;
(4)
Violates the standards set under this subtitle and does not correct the violation in a reasonable time after notice is given; or
(5)
No longer operates a program that qualifies for approval under this subtitle.
Md. Code Ann., Health Occ. § 8-6B-18 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-18LinkCopy Citation
(a)
Subject to the hearing provisions of § 8–317 of this title and § 8–6B–19 of this subtitle, the Board may deny a license to an applicant, grant a license, including a license subject to a reprimand, probation, or suspension, to an applicant, reprimand a licensee, place a licensee on probation, or suspend or revoke a license if the applicant or licensee:
(1)
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;
(2)
Fraudulently or deceptively uses a license;
(3)
As part of the practice of electrology, knowingly does an act that exceeds the scope of the practice of electrology;
(4)
Is grossly negligent in practicing or teaching an electrology education program;
(5)
Acts in a manner inconsistent with generally accepted standards for the practice of electrology;
(6)
Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;
(7)
Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;
(8)
Provides professional services while:
(i)
Under the influence of alcohol; or
(ii)
Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;
(9)
Uses types of instruments or procedures in the practice of electrology that are not approved by the Board;
(10)
Advertises in a manner that violates this subtitle;
(11)
Uses a title not authorized by § 8–6B–23 of this subtitle;
(12)
Is currently adjudicated as being a disabled individual under Title 13 of the Estates and Trusts Article;
(13)
Practices electrology with an unauthorized individual or supervises or aids an unauthorized individual in the practice of electrology;
(14)
Willfully makes or files a false report or record in the practice of electrology;
(15)
Willfully fails to file or record any report as required by law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;
(16)
Submits a false statement to collect a fee;
(17)
Violates a provision of this subtitle or a rule or regulation adopted by the Board;
(18)
Uses or promotes or causes the use of a misleading, deceiving, or untruthful advertising matter, promotional literature, or testimonial;
(19)
Is professionally, physically, or mentally incompetent;
(20)
Promotes the sale of devices, appliances, or goods to a patient so as to exploit the patient for financial gain;
(21)
Behaves immorally in the practice of electrology;
(22)
Commits an act of unprofessional conduct in the practice of electrology;
(23)
Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;
(24)
Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(25)
Fails to submit to a criminal history records check in accordance with § 8–303 of this title;
(26)
Fails to allow an inspection under § 8–6B–06(10) and (11) of this subtitle;
(27)
Fails to cooperate with a lawful investigation conducted by the Board;
(28)
Practices electrology without a license before obtaining or renewing a license, including any period when practicing electrology on an expired license or a lapsed license; or
(29)
After failing to renew a license, commits any act that would be grounds for disciplinary action under this section.
(b)
In addition to any sanction authorized under this section, the Board may require a licensee to comply with specified terms and conditions determined by the Board.
Md. Code Ann., Health Occ. § 8-6B-19 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-19LinkCopy Citation
(a)
Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under § 8-6B-17 or § 8-6B-18 of this subtitle, it shall give the person against whom the action is contemplated an opportunity for a hearing before the Board.
(b)
The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.
(c)
The hearing notice to be given to the person shall be sent by certified mail, return receipt requested, to the last known address of the person at least 30 days before the hearing.
(d)
The person may be represented at the hearing by counsel.
(e)
(1)
The Board may issue subpoenas and administer oaths in connection with a proceeding under this section.
(2)
If, without lawful excuse, a person disobeys a subpoena from the Board or an order by the Board to take an oath, testify, or answer a question, then on petition of the Board, a court of competent jurisdiction:
(i)
Shall compel compliance with the subpoena; and
(ii)
May hold the person in contempt of court.
(f)
If after due notice the person against whom the action is contemplated fails or refuses to appear, nevertheless the Board may hear and determine the matter.
(g)
The hearing of charges may not be stayed or challenged by procedural defects alleged to have occurred prior to the filing of charges.
(h)
(1)
After the Board conducts an investigation under this subtitle, the Board may issue an advisory letter to the licensee.
(2)
The Board may disclose an advisory letter issued under this subsection to the public.
(3)
The issuance of an advisory letter under this subsection may not:
(i)
Be considered a disciplinary action under § 8–6B–18 of this subtitle; and
(ii)
Be reported to any licensing entity, employer, or insurance company as a disciplinary action.
Md. Code Ann., Health Occ. § 8-6B-20 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-20LinkCopy Citation
(a)
If after a hearing under § 8-6B-19 of this subtitle the Board finds that there are grounds under that section to suspend or revoke a license, the Board may impose a penalty not exceeding $5,000:
(1)
Instead of suspending the license; or
(2)
In addition to suspending or revoking the license.
(b)
The Board shall adopt rules and regulations to set standards for the imposition of penalties under this section.
(c)
The Board shall pay a penalty collected under this section into the General Fund of the State.
Md. Code Ann., Health Occ. § 8-6B-21 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-21LinkCopy Citation
(a)
Except as provided in subsection (b) of this section, a person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.
(b)
A person aggrieved by a final decision of the Board pursuant to § 8–6B–19 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act.
(c)
An order of the Board may not be stayed pending review.
Md. Code Ann., Health Occ. § 8-6B-22 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-22LinkCopy Citation
(a)
If a license was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a license was surrendered, the Board may reinstate the license if the licensee:
(1)
Applies to the Board for reinstatement;
(2)
Meets the requirements for renewal under § 8–6B–14 of this subtitle;
(3)
Meets any other requirements for reinstatement as established by the Board; and
(4)
Submits to a criminal history records check in accordance with § 8–303 of this title.
(b)
If a licensee meets the requirements of subsection (a) of this section, the Board may:
(1)
Reinstate the license;
(2)
Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or
(3)
Deny reinstatement of the license.
Md. Code Ann., Health Occ. § 8-6B-23 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-23LinkCopy Citation
(a)
Unless authorized to practice electrology, or to teach an electrology program under this subtitle, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice electrology or to teach an electrology education program in the State.
(b)
Neither a licensee nor an institution that offers an approved electrology education program may advertise in a manner that is unreasonable, misleading, or fraudulent.
(c)
Unless authorized to practice electrology or instruct electrology under this subtitle, a person:
(1)
May not use the designation “electrologist”, “licensed electrologist”, “licensed electrology instructor”, or “electrology instructor”; and
(2)
May not use the abbreviation “L.E.” or “L.E.I.”.
Md. Code Ann., Health Occ. § 8-6B-24 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-24LinkCopy Citation
(a)
The Board shall adopt rules and regulations that specify the types of instruments and procedures that the Board approves for use in the practice and teaching of electrology.
(b)
A licensee may use only those types of instruments and procedures in the practice of electrology or teaching of the clinical practice of electrology that are approved by the Board.
Md. Code Ann., Health Occ. § 8-6B-27 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-27LinkCopy Citation
A person who violates any provision of § 8–6B–23 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.
Md. Code Ann., Health Occ. § 8-6B-28 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-28LinkCopy Citation
This subtitle may be cited as the “Maryland Electrologists Act”.
Md. Code Ann., Health Occ. § 8-6B-29 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-29LinkCopy Citation
(a)
The authority of the Board established under this subtitle:
(1)
Vests with the Board at the time an individual applies for licensure;
(2)
Continues during periods of licensure; and
(3)
Includes authority over an individual holding an expired license or a lapsed license.
(b)
The authority of the Board shall be continuous over an individual applicant or licensee and may not be divested by withdrawal of an application or when a license expires or lapses.
Md. Code Ann., Health Occ. § 8-6B-30 (2026)
Title 8. Nurses
Subtitle 6B. Electrologists
§ 8–6B-30LinkCopy Citation
Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, and subject to the termination of this title under § 8–802 of this title, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.
Subtitle 6C. Licensed Direct-Entry Midwives
Md. Code Ann., Health Occ. § 8-6C-01 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-01LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“ACME” means the Accreditation Commission for Midwifery Education, or a successor organization that is an accrediting agency for nurse–midwifery and direct–entry midwifery education programs and is approved by the United States Department of Education.
(c)
“AIMM” means the Association of Independent Midwives of Maryland or a successor organization that is a professional organization representing independent midwives in the State.
(d)
“Board” means the State Board of Nursing.
(e)
“Committee” means the Direct–Entry Midwifery Advisory Committee established under § 8–6C–11 of this subtitle.
(f)
“Health care practitioner” means:
(1)
An individual certified as a nurse–midwife or a nurse practitioner under this title; or
(2)
A physician licensed under Title 14 of this article.
(g)
(1)
“Health care provider” means a health care practitioner or a hospital.
(2)
“Health care provider” includes agents or employees of a health care practitioner or a hospital.
(h)
“Hospital” has the meaning stated in § 19–301 of the Health – General Article.
(i)
“License” means, unless the context requires otherwise, a license issued by the Board to practice direct–entry midwifery.
(j)
(1)
“Licensed direct–entry midwife” means an individual who has been granted a license under this subtitle to practice direct–entry midwifery.
(2)
“Licensed direct–entry midwife” does not include a licensed nurse certified as a nurse–midwife under this title.
(k)
“Low–risk pregnancy” means a pregnancy, labor, and delivery and postpartum, newborn, and interconceptional care that does not include a condition that requires a mandatory transfer under § 8–6C–03.
(l)
“MEAC” means the Midwifery Education and Accreditation Council, or a successor organization that is a national accreditation agency for midwifery education approved by the United States Department of Education.
(m)
“NARM” means the North American Registry of Midwives, or a successor organization that is an international certification agency that establishes and administers certification for the certified professional midwife credential.
(n)
(1)
“Patient” means an individual for whom a licensed direct–entry midwife performs services.
(2)
“Patient” includes an individual’s newborn for the purpose of perinatal or postpartum care.
(o)
“Postpartum period” means the first 6 weeks after delivery.
(p)
(1)
“Practice direct–entry midwifery” means:
(i)
Providing maternity care that is consistent with a midwife’s training, education, and experience; and
(ii)
Identifying and referring patients who require medical care to an appropriate health care provider.
(2)
“Practice direct–entry midwifery” includes the activities described in § 8–6C–02 of this subtitle.
Md. Code Ann., Health Occ. § 8-6C-02 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-02LinkCopy Citation
(a)
The practice of direct–entry midwifery includes:
(1)
Providing the necessary supervision, care, and advice to a patient during a low–risk pregnancy, labor, delivery, and postpartum period; and
(2)
Newborn care authorized under this subtitle that is provided in a manner that is:
(i)
Consistent with national direct–entry midwifery standards; and
(ii)
Based on the acquisition of clinical skills necessary for the care of pregnant women and newborns, including antepartum, intrapartum, and postpartum care.
(b)
The practice of direct–entry midwifery also includes:
(1)
Obtaining informed consent to provide services to the patient;
(2)
Discussing:
(i)
Any general risk factors associated with the services to be provided;
(ii)
Any specific risk factors pertaining to the health and circumstances of the individual patient;
(iii)
Conditions that preclude care by a licensed direct–entry midwife; and
(iv)
The conditions under which consultation, transfer of care, or transport of the patient must be implemented;
(3)
Obtaining a health history of the patient and performing a physical examination;
(4)
Developing a written plan of care specific to the patient, to ensure continuity of care throughout the antepartum, intrapartum, and postpartum periods, that includes:
(i)
A plan for the management of any specific risk factors pertaining to the individual health and circumstances of the individual patient; and
(ii)
A plan to be followed in the event of an emergency, including a plan for transportation;
(5)
Evaluating the results of patient care;
(6)
Consulting and collaborating with a health care practitioner regarding the care of a patient, and referring and transferring care to a health care provider, as required;
(7)
Referral of all patients, within 72 hours after delivery, to a pediatric health care practitioner for care of the newborn;
(8)
As approved by the Board:
(i)
Obtaining and administering medications; and
(ii)
Obtaining and using equipment and devices;
(9)
Obtaining appropriate screening and testing, including laboratory tests, urinalysis, and ultrasound;
(10)
Providing care during the antepartum period, with consultation or referral as required;
(11)
Providing care during the intrapartum period, including:
(i)
Monitoring and evaluating the condition of the patient and fetus;
(ii)
Performing emergency procedures, including:
(1)
Administering approved medications;
(2)
Administering intravenous fluids for stabilization;
(3)
Performing an emergency episiotomy; and
(4)
Providing care while on the way to a hospital under circumstances in which emergency medical services have not been activated;
(iii)
Activating emergency medical services for an emergency; and
(iv)
Delivering in an out–of–hospital setting;
(12)
Participating in peer review as required under § 8–6C–18(e)(2) of this subtitle;
(13)
Providing care during the postpartum period, including:
(i)
Suturing of first and second degree perineal or labial lacerations, or suturing of an episiotomy with the administration of a local anesthetic; and
(ii)
Making further contact with the patient within 48 hours, within 2 weeks, and at 6 weeks after the delivery to assess for hemorrhage, preeclampsia, thrombo–embolism, infection, and emotional well–being;
(14)
Providing routine care for the newborn for up to 72 hours after delivery, exclusive of administering immunizations, including:
(i)
Immediate care at birth, including resuscitating as needed, performing a newborn examination, and administering intramuscular vitamin K and eye ointment for prevention of ophthalmia neonatorum;
(ii)
Assessing newborn feeding and hydration;
(iii)
Performing metabolic screening and reporting on the screening in accordance with the regulations related to newborn screenings that are adopted by the Department;
(iv)
Performing critical congenital heart disease screening and reporting on the screening in accordance with the regulations related to newborn screenings that are adopted by the Department;
(v)
If unable to perform the screening required under item (iii) or (iv) of this item, referring the newborn to a pediatric health care practitioner to perform the screening within 24 to 48 hours after delivery; and
(vi)
Referring the infant to an audiologist for a hearing screening in accordance with the regulations related to newborn screenings that are adopted by the Department;
(15)
Within 24 hours after delivery, notifying a pediatric health care practitioner of the delivery;
(16)
Within 72 hours after delivery:
(i)
Transferring health records to the pediatric health care practitioner, including documentation of the performance of the screenings required under item (14)(iii) and (iv) of this subsection; and
(ii)
Referring the newborn to a pediatric health care practitioner;
(17)
Providing the following care of the newborn beyond the first 72 hours after delivery:
(i)
Weight checks and general observation of the newborn’s activity, with abnormal findings communicated to the newborn’s pediatric health care practitioner;
(ii)
Assessment of newborn feeding and hydration; and
(iii)
Lactation support and counseling; and
(18)
Providing limited services to the patient after the postpartum period, including:
(i)
Lactation support and counseling; and
(ii)
Counseling and referral for all family planning methods.
(c)
The practice of direct–entry midwifery does not include:
(1)
Pharmacological induction or augmentation of labor or artificial rupture of membranes prior to the onset of labor;
(2)
Surgical delivery or any surgery except an emergency episiotomy;
(3)
Use of forceps or vacuum extractor;
(4)
Except for the administration of a local anesthetic, administration of an anesthetic;
(5)
Administration of any kind of narcotic analgesic; or
(6)
Administration of any prescription medication in a manner that violates this subtitle.
(d)
The practice of direct–entry midwifery is independent and does not require oversight by another health care practitioner.
Md. Code Ann., Health Occ. § 8-6C-03 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-03LinkCopy Citation
A licensed direct–entry midwife may not assume or continue to take responsibility for a patient’s pregnancy and birth care and shall arrange for the orderly transfer of care to a health care practitioner for a patient who is already under the care of the licensed direct–entry midwife, if any of the following disorders or situations is found to be present at the initial interview or if any of the following disorders or situations occur as prenatal care proceeds:
(1)
Diabetes mellitus, including uncontrolled gestational diabetes;
(2)
Hyperthyroidism treated with medication;
(3)
Uncontrolled hypothyroidism;
(4)
Epilepsy with seizures or antiepileptic drug use during the previous 12 months;
(5)
Coagulation disorders;
(6)
Chronic pulmonary disease;
(7)
Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of a physician licensed under Title 14 of this article or a licensed nurse certified as a nurse–midwife or a nurse practitioner under this title that midwifery care may proceed;
(8)
Hypertension, including pregnancy–induced hypertension (PIH);
(9)
Renal disease;
(10)
Previous uterine surgery, including a cesarean section or myomectomy;
(11)
Indications that the fetus has died in utero;
(12)
Premature labor (gestation less than 37 weeks);
(13)
Multiple gestation;
(14)
Noncephalic presentation at or after 38 weeks;
(15)
Placenta previa or abruption;
(16)
Preeclampsia;
(17)
Severe anemia, defined as hemoglobin less than 10 g/dL:
(i)
That has been measured after treatment; or
(ii)
Based on blood tests performed at or after 36 weeks;
(18)
Uncommon diseases and disorders, including Addison’s disease, Cushing’s disease, systemic lupus erythematosus, antiphospholipid syndrome, scleroderma, rheumatoid arthritis, periarteritis nodosa, and Marfan’s syndrome;
(19)
AIDS/HIV;
(20)
Hepatitis;
(21)
Acute toxoplasmosis infection, if the patient is symptomatic;
(22)
Acute Rubella infection during pregnancy;
(23)
Acute cytomegalovirus infection, if the patient is symptomatic;
(24)
Acute Parvovirus infection, if the patient is symptomatic;
(25)
Alcohol abuse, substance abuse, or prescription abuse during pregnancy;
(26)
Continued daily tobacco use into the second trimester;
(27)
Thrombosis;
(28)
Inflammatory bowel disease that is not in remission;
(29)
Primary genital herpes simplex virus infection during the third trimester or active genital herpes lesions at the time of labor;
(30)
Significant fetal congenital anomaly that directly impacts the birthing process or requires immediate emergency care, as determined by the Board in regulations;
(31)
Ectopic pregnancy; or
(32)
Post term maturity (gestational age 42 0/7 weeks and beyond).
Md. Code Ann., Health Occ. § 8-6C-04 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-04LinkCopy Citation
(a)
A licensed direct–entry midwife shall consult with a health care practitioner, and document the consultation, the recommendations of the consultation, and the discussion of the consultation with the client, if any of the following conditions are present during the course of care:
(1)
Significant mental disease, including depression, bipolar disorder, schizophrenia, and other conditions that impair the ability of the patient to participate effectively in the patient’s care or that require the use of psychotropic drugs to control the condition;
(2)
Second or third trimester bleeding;
(3)
Intermittent use of alcohol into the second trimester;
(4)
Asthma;
(5)
Diet–controlled gestational diabetes;
(6)
History of genetic problems, intrauterine death after 20 weeks’ gestation, or stillbirth;
(7)
Abnormal pap smear;
(8)
Possible ectopic pregnancy;
(9)
Tuberculosis;
(10)
Controlled hypothyroidism, being treated with thyroid replacement and euthyroid, and with thyroid test numbers in the normal range;
(11)
Rh sensitization with positive antibody titer;
(12)
Breech presentation between 35 and 38 weeks;
(13)
Transverse lie or other abnormal presentation between 35 and 38 weeks;
(14)
Premature rupture of membranes at 37 weeks or less;
(15)
Small for gestational age or large for gestational age fetus;
(16)
Polyhydramnios or oligohydramnios;
(17)
Previous LEEP procedure or cone biopsy;
(18)
Previous obstetrical problems, including uterine abnormalities, placental abruption, placenta accreta, obstetric hemorrhage, incompetent cervix, or preterm delivery for any reason;
(19)
Postterm maturity (41 0/7 to 6/7 weeks gestational age);
(20)
Inflammatory bowel disease, in remission;
(21)
Active genital herpes lesions during pregnancy except as required by § 8–6C–03(29) of this subtitle;
(22)
Prepregnancy body mass index (BMI) of less than 18.5 or 35 or more; or
(23)
Significant fetal congenital anomaly.
(b)
Subject to subsection (c) of this section, a licensed direct–entry midwife shall arrange immediate emergency transfer to a hospital if:
(1)
The patient requests transfer; or
(2)
The patient or newborn is determined to have any of the following conditions during labor, delivery, or the immediate postpartum period:
(i)
Unforeseen noncephalic presentation;
(ii)
Unforeseen multiple gestation;
(iii)
Nonreassuring fetal heart rate or pattern, including tachycardia, bradycardia, significant change in baseline, and persistent late or severe variable decelerations;
(iv)
Prolapsed cord;
(v)
Unresolved maternal hemorrhage;
(vi)
Retained placenta;
(vii)
Signs of fetal or maternal infection;
(viii)
Patient with a third– or fourth–degree laceration or a laceration beyond the licensed direct–entry midwife’s ability to repair;
(ix)
Apgar of less than seven at 5 minutes;
(x)
Significant congenital anomalies that directly affect delivery or immediate postpartum care or require immediate emergency care, as determined by the Board in regulations;
(xi)
Need for chest compressions during neonatal resuscitation;
(xii)
Newborn with persistent central cyanosis;
(xiii)
Newborn with persistent grunting and retractions;
(xiv)
Newborn with abnormal vital signs;
(xv)
Gross or thick meconium staining, when discovered; or
(xvi)
Newborn with excessive dehydration due to inability to feed.
(c)
If transfer is not possible because of imminent delivery, the licensed direct–entry midwife shall consult with a health care provider for guidance on further management of the patient and to determine when transfer may be safely arranged, if required.
(d)
(1)
A licensed direct–entry midwife shall immediately transfer the care of a patient to a health care provider for the treatment of any significant postpartum morbidity, including:
(i)
Uncontrolled postpartum hemorrhage;
(ii)
Preeclampsia;
(iii)
Thrombo–embolism;
(iv)
An infection; or
(v)
A postpartum mental health disorder.
(2)
A licensed direct–entry midwife who is required to transfer care of a patient under paragraph (1) of this subsection may continue other aspects of postpartum care in consultation with the treating health care practitioner.
Md. Code Ann., Health Occ. § 8-6C-05 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-05LinkCopy Citation
At the time of delivery, a licensed direct–entry midwife shall be assisted by a second individual who:
(1)
Has completed the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) within the previous 2 years; and
(2)
Has the skills and equipment necessary to perform a full resuscitation of the newborn in accordance with the principles of NRP.
Md. Code Ann., Health Occ. § 8-6C-06 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-06LinkCopy Citation
(a)
Except as otherwise provided in this subtitle or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice direct–entry midwifery in the State.
(b)
This section does not apply to:
(1)
An individual who assists at a birth in an emergency;
(2)
An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice direct–entry midwifery; or
(3)
A student who is practicing direct–entry midwifery while engaged in an approved clinical midwife educational experience under the supervision of a licensed direct–entry midwife.
Md. Code Ann., Health Occ. § 8-6C-07 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-07LinkCopy Citation
(a)
If a patient chooses to give birth at home in a situation prohibited by this subtitle or in which a licensed direct–entry midwife recommends transfer, the licensed direct–entry midwife shall:
(1)
Transfer care of the patient to an appropriate health care practitioner;
(2)
Complete the standard form developed under § 8–6C–08(e) of this subtitle and submit the completed form to the accepting health care practitioner; and
(3)
Cease to take responsibility for the patient’s pregnancy care within 1 week after the transfer.
(b)
If birth is imminent and the patient refuses to be transferred after the licensed direct–entry midwife determines that a transfer is necessary, the licensed direct–entry midwife shall:
(1)
Call 9–1–1 and remain with the patient until emergency services personnel arrive; and
(2)
Transfer care and give a verbal report of the care provided to the emergency medical services providers.
Md. Code Ann., Health Occ. § 8-6C-08 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-08LinkCopy Citation
(a)
A licensed direct–entry midwife shall develop a general written plan for their practice for:
(1)
Emergency transfer of a patient, newborn, or both;
(2)
Transport of a newborn to a newborn nursery or neonatal intensive care nursery; and
(3)
Transport of a patient to an appropriate hospital with a labor and delivery unit.
(b)
The Committee shall review and recommend approval to the Board of the plan required under subsection (a) of this section.
(c)
(1)
In addition to the general written plan required under subsection (a) of this section, a licensed direct–entry midwife shall prepare a plan that is specific to each patient and share the plan with the patient.
(2)
The plan required under paragraph (1) of this subsection shall:
(i)
Include procedures and processes to be undertaken in the event of an emergency for the mother, the newborn, or both;
(ii)
Identify the hospital closest to the address of the planned home birth that has a labor and delivery unit;
(iii)
Include a care plan for the newborn; and
(iv)
Identify the pediatric health care practitioner who will be notified after delivery in accordance with § 8–6C–02(b)(15) of this subtitle to receive the transfer of care of the newborn.
(d)
(1)
The Board, in consultation with stakeholders, shall develop a standard form for use in all cases in which a transfer occurs during prenatal care, labor, or postpartum.
(2)
The form shall include the medical information needed by the health care practitioner receiving the patient.
(e)
After a decision to transport a patient has been made, the licensed direct–entry midwife shall:
(1)
Call the receiving health care provider;
(2)
Inform the health care provider of the incoming patient;
(3)
Accompany the patient to the hospital if determined to be appropriate by the licensed direct–entry midwife and the receiving health care provider; and
(4)
Provide:
(i)
To the staff of the hospital:
(1)
The standard form developed under subsection (d) of this section; and
(2)
The medical records of the patient or newborn, as determined by the Board in regulations and as requested by the receiving health care provider; and
(ii)
To the accepting health care practitioner, a verbal summary of the care provided to the patient by the licensed direct–entry midwife.
Md. Code Ann., Health Occ. § 8-6C-09 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-09LinkCopy Citation
(a)
Before initiating care, a licensed direct–entry midwife shall obtain a signed copy of the Board–approved informed consent agreement in accordance with this section.
(b)
(1)
The Board, in consultation with stakeholders, shall review and update as necessary the informed consent agreement at least every 4 years.
(2)
The agreement reviewed under paragraph (1) of this subsection shall include acknowledgment by the patient of receipt, at a minimum, of the following:
(i)
The licensed direct–entry midwife’s training and experience;
(ii)
Instructions for obtaining a copy of the regulations adopted by the Board under this subtitle;
(iii)
Instructions for obtaining a copy of the NARM certification requirements;
(iv)
Instructions for filing a complaint with the Board;
(v)
Notice of whether the licensed direct–entry midwife has professional liability insurance coverage;
(vi)
A description of the procedures, benefits, and risks of home births, including those conditions that may arise during delivery; and
(vii)
Any other information that the Board requires.
Md. Code Ann., Health Occ. § 8-6C-10 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-10LinkCopy Citation
(a)
Notwithstanding any other provision of law, a licensed direct–entry midwife shall be subject to reporting requirements adopted by the Board in regulations in consultation with the Committee and any other stakeholders determined appropriate by the Board.
(b)
A licensed direct–entry midwife attending an out–of–hospital delivery shall:
(1)
For any live birth, complete and submit a birth certificate in accordance with § 4–208 of the Health – General Article; and
(2)
For any death, make all medical records available and communicate relevant circumstances of the death to the individual responsible for completing the certificate of death under § 4–212 or § 4–213 of the Health – General Article.
Md. Code Ann., Health Occ. § 8-6C-11 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-11LinkCopy Citation
(a)
There is a Direct–Entry Midwifery Advisory Committee within the Board.
(b)
(1)
The Committee consists of seven members appointed by the Board.
(2)
Of the seven members:
(i)
Subject to paragraph (3) of this subsection and subsection (d) of this section, three shall be licensed direct–entry midwives;
(ii)
Two shall be licensed nurses certified as nurse–midwives;
(iii)
One shall be a representative of the Maryland Hospital Association; and
(iv)
One shall be a consumer member.
(3)
(i)
The Board shall appoint the licensed direct–entry midwife members of the Committee from a list of qualified individuals submitted to the Board by AIMM.
(ii)
The Board may request an additional list of qualified individuals from AIMM if the initial list is determined to be inadequate.
(c)
Each member of the Committee shall be a citizen of the United States and a resident of the State.
(d)
Each licensed direct–entry midwife member of the Committee:
(1)
Shall meet the licensure requirements of this subtitle; and
(2)
May not be a licensed nurse who is certified as a nurse–midwife.
(e)
The consumer member of the Committee:
(1)
Shall be a member of the general public;
(2)
May not be or ever have been:
(i)
A licensed direct–entry midwife;
(ii)
A licensed nurse certified as a midwife;
(iii)
A health care practitioner who is directly involved with pregnancy or labor; or
(iv)
In training to be a licensed direct–entry midwife, a licensed nurse certified as a midwife, or a health care practitioner who is directly involved with pregnancy or labor;
(3)
May not have a household member who is:
(i)
A licensed direct–entry midwife, a licensed nurse who is certified as a nurse–midwife, or a health care practitioner who is directly involved with pregnancy or labor; or
(ii)
In training to be a licensed direct–entry midwife, a licensed nurse who is certified as a nurse–midwife, or a health care practitioner who is directly involved with pregnancy or labor;
(4)
May not:
(i)
Participate or ever have participated in a commercial or professional field related to the practice of direct–entry midwifery;
(ii)
Have a household member who participates in a commercial or professional field related to the practice of direct–entry midwifery; or
(iii)
Have, or have had within 2 years before appointment, a substantial financial interest in a person who is regulated by the Board.
(f)
The Committee shall elect a chair from among its members to a 2–year term.
(g)
(1)
The term of a member is 4 years.
(2)
The terms of the members are staggered as required by the terms provided for members of the Committee on October 1, 2015.
(3)
At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4)
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.
(5)
A member may not serve more than two consecutive full terms.
(6)
To the extent practicable, the Board shall fill any vacancy on the Committee within 60 days of the date of the vacancy.
(h)
A majority of the full authorized membership of the Committee is a quorum.
(i)
In addition to any other meeting requirements of this title, the Committee shall meet:
(1)
At the request of the executive director of the Board; and
(2)
As necessary to conduct Board or Committee business.
(j)
In accordance with the State budget, each member of the Committee is entitled to:
(1)
Compensation, at a rate determined by the Board, for each day, or part of a day, on which the member is engaged in the duties of the Committee; and
(2)
Reimbursement for expenses under the Standard State Travel Regulations.
(k)
(1)
The Board may remove a member for incompetence or misconduct.
(2)
The Board may remove a member who is absent from two successive Committee meetings without adequate reason.
Md. Code Ann., Health Occ. § 8-6C-12 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-12LinkCopy Citation
(a)
The Committee shall:
(1)
Review applications for licensure as a licensed direct–entry midwife and make recommendations to the Board regarding applicants;
(2)
Maintain a list of all licensed direct–entry midwives;
(3)
Make recommendations to the Board regarding continuing education requirements for licensed direct–entry midwives;
(4)
Review advertising by licensed direct–entry midwives and by institutions that offer a direct–entry midwife program and make recommendations to the Board, as necessary;
(5)
Advise the Board on matters relating to the practice of direct–entry midwifery;
(6)
Collect the reports required to be submitted by each licensed direct–entry midwife under § 8–6C–10(a) of this subtitle;
(7)
Make recommendations to the Board regarding regulations relating to the practice of direct–entry midwifery that are necessary to carry out the provisions of this subtitle;
(8)
At the request of the Board, investigate complaints against licensed direct–entry midwives;
(9)
Keep a record of the Committee’s proceedings; and
(10)
Subject to subsection (b) of this section, beginning November 1, 2016, and on each November 1 thereafter, submit a report to the Board, including:
(i)
A summary of the information included in reports submitted to the Committee by licensed direct–entry midwives under § 8–6C–10(a) of this subtitle; and
(ii)
Any other information identified by the Board.
(b)
The Committee may not include any personally identifying information in the report submitted to the Board under subsection (a)(10) of this section.
(c)
Beginning December 1, 2016, and on each December 1 thereafter, the Board shall submit to the Senate Education, Health, and Environmental Affairs Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article:
(1)
The report submitted to the Board under subsection (a)(10) of this section;
(2)
In consultation with the Committee, any recommendations regarding the continuation and improvement of the licensure of licensed direct–entry midwives in the State;
(3)
Any recommendations regarding expanding the scope of practice of licensed direct–entry midwives; and
(4)
Any recommendations, including recommendations for legislation, regarding the scope of practice of licensed direct–entry midwives to include vaginal birth after cesarean.
Md. Code Ann., Health Occ. § 8-6C-13 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-13LinkCopy Citation
(a)
In addition to the education and training requirements under subsection (b) of this section, to qualify for a license, an applicant shall:
(1)
Submit to a criminal history records check in accordance with § 8–303 of this title;
(2)
Be of good moral character;
(3)
Be a high school graduate or have completed equivalent education;
(4)
Be at least 21 years old;
(5)
Hold a current cardiopulmonary resuscitation (CPR) certification issued by the American Red Cross or the American Heart Association; and
(6)
Have completed in the past 2 years the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP).
(b)
An applicant:
(1)
Shall hold a current valid Certified Professional Midwife credential granted by NARM; and
(2)
(i)
Shall have completed a midwifery education program that is accredited by MEAC or ACME;
(ii)
Shall have completed the NARM Midwifery Bridge Certificate program; or
(iii)
If the applicant was certified by NARM as a certified professional midwife on or before January 15, 2017, through a non–MEAC accredited program, but otherwise qualifies for licensure, shall provide:
(1)
Verification of completion of NARM–approved clinical requirements; and
(2)
Evidence of completion, in the past 2 years, of an additional 50 hours of continuing education units approved by the Board and accredited by MEAC, the American College of Nurse Midwives, or the Accrediting Council for Continuing Medical Education, including:
(A)
14 hours of obstetric emergency skills training such as a birth emergency skills training (BEST) or an advanced life saving in obstetrics (ALSO) course; and
(B)
The remaining 36 hours divided among and including hours in the areas of pharmacology, lab interpretation of pregnancy, antepartum complications, intrapartum complications, postpartum complications, and neonatal care.
Md. Code Ann., Health Occ. § 8-6C-14 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-14LinkCopy Citation
To apply for a license, an applicant shall:
(1)
Submit to a criminal history records check in accordance with § 8–303 of this title;
(2)
Submit to the Board:
(i)
An application on the form that the Board requires; and
(ii)
Written, verified evidence that the requirement of item (1) of this subsection is being met; and
(3)
Pay to the Board a fee set by the Board.
Md. Code Ann., Health Occ. § 8-6C-15 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-15LinkCopy Citation
(a)
(1)
The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to licensed direct–entry midwives.
(2)
The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure and other services provided to licensed direct–entry midwives.
(b)
(1)
The Board shall pay all fees collected under this subtitle to the Comptroller.
(2)
The Comptroller shall distribute all fees to the Board.
(c)
The fees collected under this section shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by this subtitle.
Md. Code Ann., Health Occ. § 8-6C-16 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-16LinkCopy Citation
(a)
Subject to subsection (c) of this section, the Board shall issue a license to an applicant who:
(1)
Meets the requirements of this subtitle; and
(2)
Pays a fee set by the Board.
(b)
The Board shall include on each license that the Board issues a designation of licensed direct–entry midwife.
(c)
(1)
On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 8–303 of this title, in determining whether to grant a license, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.
(2)
The Board may not issue a license if the criminal history record information required under § 8–303 of this title has not been received.
Md. Code Ann., Health Occ. § 8-6C-17 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-17LinkCopy Citation
A license issued under this subtitle authorizes the licensee to practice direct–entry midwifery while the license is active.
Md. Code Ann., Health Occ. § 8-6C-18 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-18LinkCopy Citation
(a)
A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.
(b)
A license may not be renewed for a term longer than 2 years.
(c)
(1)
At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:
(i)
First–class mail to the last known mailing address of the licensee; or
(ii)
Electronic means to the last known electronic address of the licensee.
(2)
A renewal notice shall state:
(i)
The date on which the current license expires;
(ii)
The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and
(iii)
The amount of the renewal fee.
(d)
Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term if the licensee:
(1)
Otherwise is entitled to be licensed;
(2)
Pays to the Board a renewal fee set by the Board; and
(3)
Submits to the Board:
(i)
A renewal application on the form that the Board requires; and
(ii)
Satisfactory evidence of compliance with any continuing education or other competency requirements set under this subtitle for license renewal.
(e)
In addition to any other qualifications and requirements established by the Board for license renewal, the Board shall require:
(1)
20 accredited and Board–approved continuing education units to be completed every 2 years;
(2)
4 hours of peer review in accordance with NARM standards for official peer review to be completed every 2 years; and
(3)
Submission of the annual reports required under § 8–6C–10(a) of this subtitle.
(f)
Subject to subsection (l) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.
(g)
The Board shall place a licensee on inactive status if the licensee:
(1)
Fails to provide satisfactory evidence of compliance with any continuing education requirements set under this section for license renewal; or
(2)
Fails to submit the annual report required under § 8–6C–10(a) of this subtitle.
(h)
The Board shall place a licensee on inactive status if the licensee submits to the Board:
(1)
An application for inactive status on the form required by the Board; and
(2)
The inactive status fee set by the Board.
(i)
The Board shall reactivate the license of an individual who is on inactive status if the individual:
(1)
Complies with any continuing education and data reporting requirements established by the Board for this purpose;
(2)
Pays to the Board a reactivation fee set by the Board; and
(3)
Is otherwise entitled to be licensed.
(j)
The Board, in accordance with its regulations, shall reinstate the license of an individual who has failed to renew the license for any reason if the individual:
(1)
Is otherwise entitled to be licensed;
(2)
Complies with any continuing education and data reporting requirements established by the Board for this purpose;
(3)
Pays to the Board a reinstatement fee set by the Board;
(4)
For an expired license or lapsed license that has been expired or lapsed for more than 1 year, completes a criminal history records check in accordance with § 8–303 of this title; and
(5)
Applies to the Board for reinstatement of the license within 5 years after the license expires.
(k)
(1)
The Board may not reinstate the license of a licensed direct–entry midwife who fails to apply for reinstatement of the license within 5 years after the license expires.
(2)
The individual may become licensed by meeting the current requirements for obtaining a new license under this subtitle.
(l)
(1)
A licensee shall submit to an additional criminal history records check every 12 years.
(2)
On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 8–303 of this title, in determining whether to renew a license, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.
(3)
The Board may not renew a license if the criminal history record information required under § 8–303 of this title has not been received.
Md. Code Ann., Health Occ. § 8-6C-19 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-19LinkCopy Citation
(a)
Unless the Board agrees to accept the surrender of the license:
(1)
A licensed direct–entry midwife may not surrender a license; and
(2)
A license may not lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.
(b)
The Board may set conditions on an agreement with the licensed direct–entry midwife under investigation or against whom charges are pending to accept surrender of the license.
Md. Code Ann., Health Occ. § 8-6C-20 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-20LinkCopy Citation
(a)
Subject to the hearing provisions of § 8–317 of this title, the Board may deny a license or grant a license, including a license subject to a reprimand, probation, or suspension, to an applicant, reprimand a licensee, place a licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee:
(1)
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;
(2)
Fraudulently or deceptively uses a license;
(3)
Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;
(4)
Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;
(5)
Willfully and knowingly:
(i)
Files a false report or record of an individual under the licensee’s care;
(ii)
Gives any false or misleading information about a material matter in an employment application;
(iii)
Fails to file or record any health record that is required by law;
(iv)
Obstructs the filing or recording of any health record as required by law; or
(v)
Induces another person to fail to file or record any health record as required by law;
(6)
Knowingly does any act that has been determined by the Board, in its regulations, to exceed the scope of practice authorized to the individual under this subtitle;
(7)
Provides professional services while:
(i)
Under the influence of alcohol; or
(ii)
Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;
(8)
Does an act that is inconsistent with generally accepted professional standards in the practice of direct–entry midwifery;
(9)
Is grossly negligent in the practice of direct–entry midwifery;
(10)
Has violated any provision of this title;
(11)
Submits a false statement to collect a fee;
(12)
Is physically or mentally incompetent;
(13)
Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;
(14)
Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(15)
Is in independent practice and fails to display the notice required under § 8–6C–23 of this subtitle;
(16)
Is habitually intoxicated;
(17)
Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;
(18)
Fails to cooperate with a lawful investigation conducted by the Board;
(19)
Is expelled from the rehabilitation program established pursuant to § 8–208 of this title for failure to comply with the conditions of the program;
(20)
Engages in conduct that violates the professional code of ethics;
(21)
Is professionally incompetent;
(22)
Practices direct–entry midwifery without a license, before obtaining or renewing a license, including any period when the license has lapsed;
(23)
After failing to renew a license or after a license has lapsed, commits any act that would be grounds for disciplinary action under this section;
(24)
Violates regulations adopted by the Board or an order from the Board;
(25)
Performs an act that is beyond the licensee’s knowledge and skills;
(26)
Fails to submit to a criminal history records check in accordance with § 8–303 of this title;
(27)
When acting in a supervisory position, directs another licensed direct–entry midwife to perform an act that is beyond the licensed direct–entry midwife’s knowledge and skills; or
(28)
Fails to file a report required under this subtitle.
(b)
If, after a hearing under § 8–317 of this title, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the Board may impose a penalty not exceeding $5,000 instead of or in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.
(c)
(1)
Subject to paragraph (2) of this subsection, an individual whose license has been suspended or revoked by the Board shall return the license to the Board.
(2)
If a suspended or revoked license has been lost, the individual shall file with the Board a verified statement to that effect.
Md. Code Ann., Health Occ. § 8-6C-21 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-21LinkCopy Citation
(a)
Unless authorized to practice direct–entry midwifery, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice direct–entry midwifery in the State.
(b)
A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent.
(c)
Unless authorized to practice direct–entry midwifery under this subtitle, an individual may not use the abbreviation “LDEM” or use the designation “licensed direct–entry midwife”.
(d)
Unless authorized to practice direct–entry midwifery under this subtitle or certified as a nurse midwife under this title, an individual may not use the designation “midwife”.
Md. Code Ann., Health Occ. § 8-6C-22 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-22LinkCopy Citation
(a)
Except for any willful or grossly negligent act, a health care provider or emergency room personnel who work at a hospital, or emergency medical services providers or ambulance personnel, may not be held civilly liable for an action arising solely from an injury resulting from an act or omission of a licensed direct–entry midwife, even if the person has consulted with the licensed direct–entry midwife or accepted a referral from the licensed direct–entry midwife.
(b)
A health care practitioner who consults with a licensed direct–entry midwife or receives notification of a delivery under § 8–6C–02(b)(15) of this subtitle or the transfer of records under § 8–6C–02(b)(16) of this subtitle but who does not examine or treat a patient of the licensed direct–entry midwife may not be deemed to have created a physician–patient relationship with the patient.
Md. Code Ann., Health Occ. § 8-6C-24 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-24LinkCopy Citation
(a)
This section does not apply to a violation of § 8–6C–10(a) of this subtitle.
(b)
A person who violates any provision of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.
Md. Code Ann., Health Occ. § 8-6C-25 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-25LinkCopy Citation
This subtitle may be cited as the Maryland Licensure of Direct–Entry Midwives Act.
Md. Code Ann., Health Occ. § 8-6C-26 (2026)
Title 8. Nurses
Subtitle 6C. Licensed Direct-Entry Midwives
§ 8–6C-26LinkCopy Citation
Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, and subject to the termination of this subtitle under § 8–802 of this title, this subtitle and all regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.
Subtitle 6D. Licensed Certified Midwives
Md. Code Ann., Health Occ. § 8-6D-01 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-01LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“ACME” means the Accreditation Commission for Midwifery Education, or a successor organization that is an accrediting agency for midwifery education programs and institutions and is approved by the United States Department of Education.
(c)
“AMCB” means the American Midwifery Certification Board, or a successor organization that is a certifying agency for midwifery education programs and is approved by the National Commission for Certifying Agencies.
(d)
“Applicant” means an individual who has submitted an application to the Board to be licensed as a certified midwife.
(e)
“Board” means the State Board of Nursing.
(f)
“License” means, unless the context requires otherwise, a license issued by the Board to practice certified midwifery.
(g)
(1)
“Licensed certified midwife” means an individual who has been issued a license by the Board under this subtitle to practice certified midwifery.
(2)
“Licensed certified midwife” does not include a licensed direct–entry midwife or a licensed nurse certified as a nurse–midwife under this title.
(h)
(1)
“Practice certified midwifery” means the management and care of essentially normal newborns and of essentially normal women antepartally, intrapartally, and postpartally.
(2)
“Practice certified midwifery” includes:
(i)
Family planning and well woman reproductive care;
(ii)
The prescribing of substances commonly used in the practice of midwifery;
(iii)
The prescribing of Schedule II, Schedule III, Schedule IV, and Schedule V controlled dangerous substances commonly used in the practice of midwifery; and
(iv)
The dispensing of the substances prescribed in accordance with the provisions of items (ii) and (iii) of this paragraph in the course of treating a patient:
(1)
At a medical facility or clinic that is operated on a nonprofit basis;
(2)
At a health center that operates on a campus of an institution of higher education;
(3)
At a public health facility, a medical facility under contract with a state or local health department, or a facility funded with public funds; or
(4)
With a starter dosage of a drug as authorized under § 8–508 of this title.
Md. Code Ann., Health Occ. § 8-6D-02 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-02LinkCopy Citation
(a)
Except as otherwise provided in this subtitle or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice certified midwifery in the State.
(b)
This section does not apply to:
(1)
An individual who assists at a birth in an emergency;
(2)
An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice certified midwifery;
(3)
A student who is practicing certified midwifery while engaged in an approved clinical midwifery education experience under the supervision of a licensed certified midwife or a licensed nurse certified as a nurse–midwife; or
(4)
An individual who has graduated from a graduate level accredited program for midwifery education approved by ACME, and who is:
(i)
Practicing certified midwifery under the supervision of a licensed certified midwife or a licensed nurse certified as a nurse–midwife; and
(ii)
Meets any other requirements set by the Board.
Md. Code Ann., Health Occ. § 8-6D-03 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-03LinkCopy Citation
(a)
In addition to the certification and education requirements under subsection (b) of this section, to qualify for a license, an applicant must:
(1)
Be of good moral character; and
(2)
Submit to a criminal history records check in accordance with § 8–303 of this title.
(b)
An applicant must:
(1)
Hold a current, valid certification as a certified midwife from AMCB;
(2)
Have graduated from a graduate–level accredited program for midwifery education approved by ACME; and
(3)
Have passed the AMCB examination.
Md. Code Ann., Health Occ. § 8-6D-04 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-04LinkCopy Citation
To apply for a license, an applicant shall:
(1)
Submit to a criminal history records check in accordance with § 8–303 of this title;
(2)
Submit to the Board:
(i)
An application on the form that the Board requires, including a current address;
(ii)
Written, verified evidence that the requirement of item (1) of this section is being or has been met; and
(iii)
Written, verified evidence of satisfying the requirements in § 8–6D–03(b) of this subtitle; and
(3)
Pay to the Board a fee set by the Board as required in § 8–6D–05 of this subtitle.
Md. Code Ann., Health Occ. § 8-6D-05 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-05LinkCopy Citation
(a)
(1)
The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to licensed certified midwives.
(2)
The fees charged shall be set to produce funds to approximate the cost of maintaining the licensing program and the other services to licensed certified midwives.
(b)
(1)
The Board shall pay all fees collected under this subtitle to the Comptroller.
(2)
The Comptroller shall distribute all fees to the Board of Nursing Fund.
(c)
The fees collected under this section shall be used exclusively to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by this subtitle.
Md. Code Ann., Health Occ. § 8-6D-06 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-06LinkCopy Citation
(a)
Subject to subsection (c) of this section, the Board shall issue a license to any applicant who meets the requirements of this subtitle.
(b)
(1)
The Board shall:
(i)
Issue each new licensee a license number that indicates that the initial license was issued by the Board; and
(ii)
Electronically record each license in the Board’s database and on the Board’s website.
(2)
Each license shall include an expiration date.
(c)
(1)
On receipt of the criminal history records information of an applicant for licensure in accordance with § 8–303 of this title, in determining whether to grant a license, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.
(2)
The Board may not issue a license if the criminal history records information required under § 8–303 of this title has not been received.
Md. Code Ann., Health Occ. § 8-6D-07 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-07LinkCopy Citation
A license issued under this subtitle authorizes the licensee to practice certified midwifery while the license is active.
Md. Code Ann., Health Occ. § 8-6D-08 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-08LinkCopy Citation
(a)
A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.
(b)
A license may not be renewed for a term longer than 2 years.
(c)
(1)
At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:
(i)
First–class mail to the last known mailing address of the licensee; or
(ii)
Electronic means to the last known e–mail address of the licensee.
(2)
A renewal notice shall state:
(i)
The date on which the current license expires;
(ii)
The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and
(iii)
The amount of the renewal fee.
(3)
If a licensee is required to have a criminal history records check before a license may be renewed, the Board shall send the licensee information regarding how the licensee may complete the required criminal history records check.
(d)
Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term if the licensee:
(1)
Otherwise is entitled to be licensed;
(2)
Pays to the Board a renewal fee set by the Board as required by § 8–6D–05 of this subtitle; and
(3)
Submits to the Board, by paper or electronic submission:
(i)
A renewal application on the form that the Board requires; and
(ii)
Satisfactory evidence of current certification as a certified midwife by AMCB.
(e)
The Board may grant a 30–day extension, beyond a license’s expiration date, to a licensee so that the licensee may renew the license before it expires.
(f)
Subject to subsection (i) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.
(g)
(1)
Each licensee shall notify the Board in writing of any change in the name or address of the licensee within 60 days after the change occurred.
(2)
If a licensee fails to notify the Board within the time required under this subsection, subject to the hearing provisions of § 8–317 of this title, the Board may impose an administrative penalty of $100.
(h)
The Board shall reinstate the license of a licensee who has failed to renew the license for any reason if the licensee meets the renewal requirements of this section.
(i)
(1)
(i)
A criminal history records check is required in accordance with § 8–303 of this title on:
(1)
Selected annual renewal applicants as determined by regulations adopted by the Board; and
(2)
Each licensee who files for reinstatement under subsection (h) of this section after failing to renew the license for a period of 1 year or more.
(ii)
An additional criminal history records check shall be performed every 12 years thereafter.
(2)
On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 8–303 of this title, in determining whether to initiate a disciplinary action against a licensee based on the information received, the Board shall consider:
(i)
The age at which the crime was committed;
(ii)
The circumstances surrounding the crime;
(iii)
The length of time that has passed since the crime;
(iv)
Subsequent work history;
(v)
Employment and character references; and
(vi)
Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.
(3)
The Board may not renew a license without written documentation that the applicant has submitted to a criminal history records check required under § 8–303 of this title.
Md. Code Ann., Health Occ. § 8-6D-09 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-09LinkCopy Citation
(a)
Unless the Board agrees to accept the surrender of a license, a licensed certified midwife may not surrender the license.
(b)
The Board may require terms and conditions on an agreement with the licensed certified midwife to accept surrender of the license.
(c)
An agreement to accept the surrender of a license is a final order of the Board and is a public record.
Md. Code Ann., Health Occ. § 8-6D-10 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-10LinkCopy Citation
(a)
Subject to the hearing provisions of § 8–317 of this title, the Board may deny a license or grant a license, including a license subject to a reprimand, probation, or suspension, to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee:
(1)
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;
(2)
Fraudulently or deceptively uses a license;
(3)
Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;
(4)
Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;
(5)
Willfully and knowingly:
(i)
Files a false report or record of an individual under the licensee’s care;
(ii)
Gives any false or misleading information about a material matter in an employment application;
(iii)
Fails to file or record any health record that is required by law;
(iv)
Obstructs the filing or recording of any health record as required by law; or
(v)
Induces another individual to fail to file or record any health record as required by law;
(6)
Knowingly commits any act that has been determined by the Board, in its regulations, to exceed the scope of practice authorized to the individual under this subtitle;
(7)
Provides professional services while:
(i)
Under the influence of alcohol; or
(ii)
Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;
(8)
Commits an act that is inconsistent with generally accepted professional standards in the practice of certified midwifery;
(9)
Is grossly negligent in the practice of certified midwifery;
(10)
Has violated any provision of this title;
(11)
Submits a false statement to collect a fee;
(12)
Is physically or mentally incompetent;
(13)
Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;
(14)
Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV–positive;
(15)
Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;
(16)
Has a substance use disorder;
(17)
Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;
(18)
Fails to cooperate with a lawful investigation conducted by the Board;
(19)
Is expelled from the safe practice program established in accordance with § 8–208 of this title for failure to comply with the conditions of the program;
(20)
Engages in conduct that violates the professional code of ethics;
(21)
Is professionally incompetent;
(22)
Practices certified midwifery without a license before obtaining or renewing a license, including any period when practicing certified midwifery on an expired license or a lapsed license;
(23)
When holding an expired license or a lapsed license, commits any act that would be grounds for disciplinary action under this section;
(24)
Engages in unprofessional or immoral conduct;
(25)
Violates regulations adopted by the Board or an order from the Board;
(26)
Performs an act that is beyond the licensee’s knowledge and skills;
(27)
Fails to submit to a criminal history records check in accordance with § 8–303 of this title;
(28)
Has misappropriated the property of a patient or a facility; or
(29)
Fails to comply with § 1–223 of this article.
(b)
If, after a hearing under § 8–317 of this title, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a license to practice certified midwifery, to reprimand a licensee, or to place a licensee on probation, the Board may impose a penalty not exceeding $5,000 instead of or in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.
(c)
In addition to any sanction authorized under this section, the Board may require a licensee to comply with specified terms and conditions determined by the Board.
(d)
(1)
If a license issued under this subtitle was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a license was surrendered, the Board may reinstate the license if the licensee:
(i)
Applies to the Board for reinstatement;
(ii)
Meets the requirements for renewal under § 8–6D–08 of this subtitle;
(iii)
Meets any other requirements for reinstatement as established by the Board in regulations; and
(iv)
Submits to a criminal history records check in accordance with § 8–303 of this title.
(2)
If a licensee meets the requirements of paragraph (1) of this subsection, the Board shall:
(i)
Reinstate the license;
(ii)
Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or
(iii)
Deny reinstatement of the license.
Md. Code Ann., Health Occ. § 8-6D-11 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-11LinkCopy Citation
(a)
Unless authorized to practice certified midwifery under this subtitle, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice certified midwifery in the State.
(b)
A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent.
(c)
Unless authorized to practice certified midwifery under this subtitle, an individual may not use the abbreviation “CM” or use the designation “Certified Midwife” with the intent to represent that the individual practices certified midwifery in the State.
(d)
Unless an individual is authorized to practice certified midwifery under this subtitle or is a licensed nurse certified as a nurse–midwife or as a direct–entry midwife under this title, an individual may not use the designation “Midwife”.
Md. Code Ann., Health Occ. § 8-6D-12 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-12LinkCopy Citation
(a)
Except as provided in subsection (b) of this section, the following applies:
(1)
If a licensed certified midwife knows of an action or condition that might be grounds for action under § 8–316, § 8–6A–10, or § 8–6C–20 of this title or § 8–6D–10 of this subtitle, the licensed certified midwife shall report the action or condition to the Board; and
(2)
An individual shall have the immunity from liability described under § 5–709 of the Courts Article for making a report required under item (1) of this subsection.
(b)
If a licensed certified midwife has reason to know that a licensee or certificate holder has committed an action or has a condition that might be grounds for reprimand or probation of the licensee or certificate holder or suspension or revocation of the license or certificate under § 8–316, § 8–6A–10, or § 8–6C–20 of this title or § 8–6D–10 of this subtitle because the licensee or certificate holder has a substance use disorder, the licensed certified midwife is not required to report the licensee or certificate holder to the Board if:
(1)
The licensed certified midwife knows that the licensee or certificate holder is in an alcohol or drug treatment program that is accredited by the Joint Commission, is certified by the Department, or is under the care of a health care practitioner who is competent and capable of dealing with substance use disorder;
(2)
The licensed certified midwife is able to verify that the licensee or certificate holder remains in the treatment program until discharge; and
(3)
The action or condition of the licensee or certificate holder has not caused injury to any individual while the licensee or certificate holder is practicing.
(c)
An individual is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of patient substance use disorder records.
Md. Code Ann., Health Occ. § 8-6D-13 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-13LinkCopy Citation
(a)
Except as provided in this section for an action under § 8–6D–10 of this subtitle, any person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.
(b)
Any person aggrieved by a final decision of the Board under § 8–6D–10 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act.
(c)
A Board decision may not be stayed while judicial review is pending.
Md. Code Ann., Health Occ. § 8-6D-14 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-14LinkCopy Citation
The authority of the Board established under this subtitle:
(1)
Vests with the Board at the time an individual applies for certification;
(2)
Continues during periods of licensure; and
(3)
Includes authority over an individual holding an expired license, a lapsed license, or a temporary license that has expired under § 8–6D–08 of this subtitle.
Md. Code Ann., Health Occ. § 8-6D-15 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-15LinkCopy Citation
(a)
Each licensed certified midwife practicing as a licensed certified midwife in the State shall notify a patient in writing or by written electronic communication if:
(1)
The licensed certified midwife does not maintain professional liability insurance coverage; or
(2)
The licensed certified midwife’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.
(b)
The written notification provided to the patient under subsection (a) of this section shall be:
(1)
Provided:
(i)
At the first visit by the patient during the period in which the licensed certified midwife does not maintain professional liability insurance, unless the visit is for the purpose of receiving incidental medical care that will be rendered free of charge; and
(ii)
As part of each informed consent obtained before any procedure discussed or offered for the patient’s consideration is performed;
(2)
Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and
(3)
Retained by the licensed certified midwife as part of the licensed certified midwife’s patient records.
(c)
Each licensed certified midwife practicing as a licensed certified midwife in the State who does not maintain professional liability insurance coverage shall post this information in a conspicuous location in the licensed certified midwife’s place of practice.
Md. Code Ann., Health Occ. § 8-6D-16 (2026)
Title 8. Nurses
Subtitle 6D. Licensed Certified Midwives
§ 8–6D-16LinkCopy Citation
This subtitle may be cited as the Maryland Licensure of Certified Midwives Act.
Subtitle 7
(a)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice registered nursing, advanced practice registered nursing, or licensed practical nursing in this State unless licensed by the Board to practice registered nursing, advanced practice registered nursing, or licensed practical nursing, respectively.
(b)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice electrology in this State unless licensed by the Board to practice electrology.
(c)
(1)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a certified nursing assistant unless certified by the Board as a certified nursing assistant.
(2)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a certified nursing assistant in a specific category unless certified by the Board as a certified nursing assistant in that category.
(d)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a certified medication technician in this State unless certified by the Board to practice as a certified medication technician.
(e)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a certified medicine aide unless certified by the Board to practice as a certified medicine aide.
(f)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a licensed direct–entry midwife unless licensed by the Board to practice as a licensed direct–entry midwife.
(g)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a licensed certified midwife unless licensed by the Board to practice as a licensed certified midwife.
(h)
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice as a certified dialysis technician unless certified by the Board to practice as a certified dialysis technician.
(i)
An individual may not require a licensee to perform an act that is beyond the licensee’s knowledge and skills.
(j)
An individual may not direct a licensee to delegate a nursing task to a nurse when the individual reasonably believes:
(1)
The nurse lacks the knowledge and skills to perform the nursing task; or
(2)
The patient’s condition does not allow delegation of the nursing task.
Except as otherwise provided in this title, an individual may not practice, attempt to practice, or offer to practice registered nursing, advanced practice registered nursing, or licensed practical nursing beyond the scope of the license or certificate issued to that individual.
(a)
(1)
Unless authorized to practice registered nursing under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to practice registered nursing in this State.
(2)
Unless authorized to practice advanced practice registered nursing under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to practice advanced practice registered nursing in this State.
(3)
Unless authorized to practice licensed practical nursing under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to practice licensed practical nursing in this State.
(4)
Unless authorized to provide patient care as a certified nursing assistant, dialysis technician, or medication assistant under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to provide care as a certified nursing assistant, dialysis technician, or medication assistant in this State.
(5)
Unless authorized to provide patient care in a specific category of certified nursing assistant, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to provide care as a certified nursing assistant in a specific category in this State.
(6)
Unless authorized to administer medication as a medication technician under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to administer medication as a certified medication technician in this State.
(7)
Unless authorized to administer medication as a medicine aide under this title, an individual may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is authorized to administer medication as a certified medicine aide in this State.
(b)
Unless authorized to practice registered nursing, advanced practice registered nursing, or licensed practical nursing under this title, an individual may not use the word “nurse” to describe the profession of the individual.
(c)
Unless authorized to practice registered nursing under this title, an individual may not use the words or terms “registered nurse”, the abbreviations “R.N.”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices registered nursing.
(d)
Unless authorized to practice advanced practice registered nursing under this title, an individual may not use the words or terms “nurse practitioner”, “nurse anesthetist”, “nurse midwife”, “clinical nurse specialist”, or “advanced practice registered nurse”, the abbreviations “NP”, “CRNA”, “CNS”, “A.P.R.N.”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices advanced practice registered nursing.
(e)
Unless authorized to practice licensed practical nursing under this title, an individual may not use the words or terms “licensed practical nurse”, the abbreviation “L.P.N.”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices licensed practical nursing.
(f)
Unless authorized to practice as a nursing graduate under this title, an individual may not use the words “nursing graduate”, the abbreviation “NG”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a nursing graduate.
(g)
Unless authorized to practice as a certified nursing assistant under this title, an individual may not use the words or terms “nursing assistant” or “certified nursing assistant”, the abbreviation “CNA”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a certified nursing assistant.
(h)
Unless authorized to practice as a certified medication technician under this title, an individual may not use the words or terms “medication technician” or “certified medication technician”, the abbreviation “MT”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a certified medication technician.
(i)
Unless authorized to practice as a certified medicine aide under this title, an individual may not use the words or terms “medicine aide” or “certified medicine aide” or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a certified medicine aide.
(j)
Unless authorized to practice as a certified dialysis technician under this title, an individual may not use the words or terms “dialysis technician” or “certified dialysis technician”, the abbreviation “C.D.T.”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a certified dialysis technician.
A person may not sell, fraudulently obtain, fraudulently provide, or fraudulently aid or abet the sale, fraudulent obtainment, or fraudulent provision of any record, nursing diploma, license, license renewal, certificate, or certificate renewal.
(a)
An individual may not practice registered nursing or advanced practice registered nursing under color of any diploma, license, certification, or record that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(b)
An individual may not practice licensed practical nursing under color of any diploma, license, or record that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(c)
An individual may not practice as a nursing assistant under color of any diploma, license, record, or certificate that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(d)
An individual may not practice as a certified medication technician under color of any diploma, license, record, or certificate that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(e)
An individual may not practice as a certified medicine aide under color of any diploma, license, record, or certificate that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(f)
An individual may not practice as a certified dialysis technician under color of any diploma, license, record, or certificate that is:
(1)
Illegally or fraudulently obtained; or
(2)
Signed or issued unlawfully or by fraudulent representation.
(a)
An individual may not knowingly employ to practice registered nursing any individual who is not authorized to practice registered nursing under this title.
(b)
An individual may not knowingly employ to practice advanced practice registered nursing any individual who is not authorized to practice advanced practice registered nursing under this title.
(c)
An individual may not knowingly employ to practice licensed practical nursing any individual who is not authorized to practice licensed practical nursing under this title.
(d)
An individual may not knowingly employ any individual who is not authorized to perform delegated nursing duties under this title.
(e)
An individual may not knowingly employ to practice as a certified nursing assistant any individual who is not authorized to practice as a certified nursing assistant under this title.
(f)
An individual may not knowingly employ to practice as a certified medication technician any individual who is not authorized to practice as a certified medication technician under this title.
(g)
An individual may not knowingly employ to practice as a certified medicine aide any individual who is not authorized to practice as a certified medicine aide under this title.
(h)
An individual may not knowingly employ to practice as a certified dialysis technician any individual who is not authorized to practice as a certified dialysis technician under this title.
(a)
Subject to the hearing provisions of § 8–317 of this title and in addition to any other sanction authorized for a violation of §§ 8–701 through 8–706 of this subtitle, the Board may issue a public cease and desist order, impose a civil fine of not more than $20,000 per offense, or both.
(b)
For the purposes of this section, each violation is a separate offense if the violation occurs:
(1)
At a different time, date, or location; or
(2)
On the same date and location at a different time.
(a)
An action may be maintained in the name of the State or the Board to enjoin conduct:
(1)
Prohibited under §§ 8–701 through 8–706 of this subtitle; or
(2)
That is grounds for disciplinary action under § 8–316, § 8–6A–10, § 8–6B–18, or § 8–6D–10 of this title.
(b)
An action under this section may be brought by:
(1)
The Board, in its own name;
(2)
The Attorney General, in the name of the State; or
(3)
A State’s Attorney, in the name of the State.
(c)
An action under this section shall be brought in the county where the defendant:
(1)
Resides; or
(2)
Engaged in the acts sought to be enjoined.
(a)
A person who violates any provision of § 8–701(a) through (g), § 8–703, § 8–704, or § 8–705 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $10,000 or imprisonment not exceeding 5 years or both.
(b)
Subject to the appropriate hearing and appeals provisions, the Board, on the affirmative vote of the majority of its members, may reprimand a licensee or certificate holder, place a licensee or certificate holder on probation, or suspend or revoke a license or certificate of a person who violates any provision of this subtitle.
(a)
The Board may impose a civil fine on a licensee who fails to renew a license within 30 days after the date of expiration of the license and engages in the practice of nursing during the period of expiration.
(b)
The civil fine shall be $5 a day for each day that the violation continues, up to a maximum of $500.
(c)
The Board shall pay any fine collected under this section into the General Fund of the State.
Subtitle 7A. Nurse Licensure Compact
Md. Code Ann., Health Occ. § 8-7A-01 (2026)
Title 8. Nurses
Subtitle 7A. Nurse Licensure Compact
§ 8–7A-01LinkCopy Citation
The Nurse Licensure Compact is hereby enacted and entered into with all other jurisdictions that legally join in the Compact in the form substantially as the Compact appears in this section as follows:
Article I. Findings and Declaration of Purpose.
(1)
The party states find that:
(a)
The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws;
(b)
Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public;
(c)
The expanded mobility of nurses and the use of advanced communication technologies as part of our nation’s health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation;
(d)
New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex;
(e)
The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and
(f)
Uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits.
(2)
The general purposes of this Compact are to:
(a)
Facilitate the states’ responsibility to protect the health and safety of the public;
(b)
Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;
(c)
Facilitate the exchange of information between party states in the areas of nurse regulation, investigation, and adverse actions;
(d)
Promote compliance with the laws governing the practice of nursing in each jurisdiction;
(e)
Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses;
(f)
Decrease redundancies in the consideration and issuance of nurse licenses; and
(g)
Provide opportunities for interstate practice by nurses who meet uniform licensure requirements.
Article II. Definitions.
(3)
As used in this Compact:
(a)
“Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws that is imposed by a licensing board or other authority against a nurse, including actions against an individual’s license or multistate licensure privilege such as:
(1)
Revocation;
(2)
Suspension;
(3)
Probation;
(4)
Monitoring of the licensee;
(5)
A limitation on the licensee’s practice;
(6)
A cease and desist action; or
(7)
Any other encumbrance on licensure affecting a nurse’s authorization to practice.
(b)
“Alternative program” means a nondisciplinary monitoring program approved by a licensing board.
(c)
“Commission” means the Interstate Commission of Nurse Licensure Compact Administrators.
(d)
“Compact” means this Nurse Licensure Compact.
(e)
“Coordinated licensure information system” means an integrated process for collecting, storing, and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by licensing boards.
(f)
“Current significant investigative information” means investigative information that:
(1)
A licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse to respond if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction; or
(2)
Indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and has had an opportunity to respond.
(g)
“Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of nursing imposed by a licensing board.
(h)
“Home state” means the party state that is the nurse’s primary state of residence.
(i)
“Licensing board” means a party state’s regulatory body responsible for issuing nurse licenses.
(j)
“Multistate license” means a license to practice as a registered or licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board that authorizes the licensed nurse to practice in all party states under a multistate licensure privilege.
(k)
“Multistate licensure privilege” means a legal authorization associated with a multistate license permitting the practice of nursing as either a registered nurse (RN) or LPN/VN in a remote state.
(l)
“Nurse” means a registered nurse or RN, a licensed practical nurse or LPN, or a vocational nurse or VN, as those terms are defined by each party state’s practice laws.
(m)
“Party state” means any state that has adopted this Compact.
(n)
“Remote state” means a party state, other than the home state.
(o)
“Single–state license” means a nurse license issued by a party state that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other party state.
(p)
“State” means a state, territory, or possession of the United States or the District of Columbia.
(q)
(1)
“State practice laws” means a party state’s laws, rules, and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline.
(2)
“State practice laws” does not include requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.
Article III. General Provisions and Jurisdiction.
(4)
A multistate license to practice registered or licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each party state.
(5)
(a)
A party state must implement procedures for considering the criminal history records of applicants for an initial multistate license or licensure by endorsement.
(b)
The procedures shall include the submission of fingerprints or other biometric–based information by applicants for the purpose of obtaining an applicant’s criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state’s criminal records.
(6)
Each party state shall require the following for an applicant to obtain or retain a multistate license in the home state:
(a)
Meets the home state’s qualifications for licensure or renewal of licensure, as well as all other applicable state laws; and
(b)
(1)
(i)
Has graduated or is eligible to graduate from a licensing board–approved RN or LPN/VN prelicensure education program; or
(ii)
Has graduated from a foreign RN or LPN/VN prelicensure education program that:
(1)
Has been approved by the authorized accrediting body in the applicable country; and
(2)
Has been verified by an independent credentials review agency to be comparable to a licensing board–approved prelicensure education program;
(2)
If a graduate of a foreign prelicensure education program not taught in English or if English is not the individual’s native language, has successfully passed an English proficiency examination that includes the components of reading, speaking, writing, and listening;
(3)
Has successfully passed an NCLEX–RN or NCLEX–PN Examination or recognized predecessor, as applicable;
(4)
Is eligible for or holds an active, unencumbered license;
(5)
Has submitted, in connection with an application for initial licensure or licensure by endorsement, fingerprints or other biometric data for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state’s criminal records;
(6)
Has not been convicted or found guilty, or has not entered into an agreed disposition, of a felony offense under applicable state or federal criminal law;
(7)
Has not been convicted or found guilty, or has not entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case–by–case basis;
(8)
Is not currently enrolled in an alternative program;
(9)
Is subject to self–disclosure requirements regarding current participation in an alternative program; and
(10)
Has a valid United States Social Security number.
(7)
(a)
All party states are authorized, in accordance with existing state due process laws, to take adverse action against a nurse’s multistate licensure privilege.
(b)
If a party state takes adverse action, the party state shall promptly notify the administrator of the coordinated licensure information system.
(c)
The administrator of the coordinated licensure information system shall promptly notify the home state of any adverse action taken by remote states.
(8)
(a)
A nurse practicing in a party state must comply with the state practice laws of the state in which the client is located at the time service is provided.
(b)
The practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of the party state in which the client is located.
(c)
The practice of nursing in a party state under a multistate licensure privilege subjects a nurse to the jurisdiction of the licensing board, the courts, and the laws of the party state in which the client is located at the time service is provided.
(9)
(a)
Individuals not residing in a party state shall continue to be able to apply for a party state’s single–state license as provided under the laws of each party state.
(b)
The single–state license granted to individuals not residing in a party state may not be recognized as granting the privilege to practice nursing in any other party state.
(c)
Nothing in this Compact shall affect the requirements established by a party state for the issuance of a single–state license.
(d)
Any nurse holding a home state multistate license on the effective date of this Compact may retain and renew the multistate license issued by the nurse’s then–current home state, provided that:
(1)
A nurse who changes the nurse’s home state after this Compact’s effective date must meet all applicable requirements in § 6 of this article to obtain a multistate license from the new home state; and
(2)
A nurse who fails to satisfy the multistate licensure requirements in § 6 of this article due to a disqualifying event occurring after this Compact’s effective date:
(i)
Is ineligible to retain or renew a multistate license; and
(ii)
Shall have the nurse’s multistate license revoked or deactivated in accordance with applicable rules adopted by the Commission.
Article IV. Applications for Licensure in a Party State.
(10)
(a)
Upon application for a multistate license, the licensing board in the issuing party state shall ascertain, through the coordinated licensure information system, whether:
(1)
The applicant has ever held, or is the holder of, a license issued by any other state;
(2)
There are any encumbrances on any license or multistate licensure privilege held by the applicant;
(3)
Any adverse action has been taken against any license or multistate licensure privilege held by the applicant; and
(4)
The applicant is currently participating in an alternative program.
(b)
A nurse may hold a multistate license, issued by the home state, in only one party state at a time.
(c)
(1)
If a nurse changes the nurse’s home state by moving between two party states, the nurse must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated in accordance with applicable rules adopted by the Commission.
(2)
The nurse may apply for licensure in advance of a change in the nurse’s home state.
(3)
A multistate license may not be issued by the new home state until the nurse provides satisfactory evidence of a change in the nurse’s home state to the new home state and satisfies all applicable requirements to obtain a multistate license from the new home state.
(d)
If a nurse changes the nurse’s home state by moving from a party state to a nonparty state, the multistate license issued by the prior home state will convert to a single–state license valid only in the former home state.
Article V. Additional Authorities Invested in Party State Licensing Boards.
(11)
(a)
In addition to the other powers conferred by state law, a licensing board shall have the authority to:
(1)
Take adverse action against a nurse’s multistate licensure privilege to practice within that party state;
(2)
Complete any pending investigations of a nurse who changes the nurse’s home state during the course of the investigations;
(3)
Issue cease and desist orders or impose an encumbrance on a nurse’s authority to practice within that party state;
(4)
Take appropriate action based on investigations and shall promptly report the conclusions of the investigations to the administrator of the coordinated licensure information system who shall promptly notify the new home state of any actions;
(5)
Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, as well as the production of evidence;
(6)
Obtain and submit, for each nurse licensure applicant, fingerprint or other biometric–based information to the Federal Bureau of Investigation for criminal background checks, receive the results of the Federal Bureau of Investigation record search on criminal background checks, and use the results in making licensure decisions;
(7)
If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse; and
(8)
Take adverse action based on the factual findings of a remote state, provided that the licensing board follows its own procedures for taking such adverse action.
(b)
Only the home state shall have the power to take adverse action against a nurse’s license issued by the home state.
(c)
(1)
Subpoenas issued by a licensing board in a party state for the attendance and testimony of witnesses or the production of evidence from another party state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it.
(2)
The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence are located.
(d)
(1)
For purposes of taking adverse action, the home state licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action.
(2)
If adverse action is taken by the home state against a nurse’s multistate license, the nurse’s multistate licensure privilege to practice in all other party states shall be deactivated until all encumbrances have been removed from the multistate license.
(3)
All home state disciplinary orders that impose adverse action against a nurse’s multistate license shall include a statement that the nurse’s multistate licensure privilege is deactivated in all party states during the pendency of the order.
(e)
(1)
Nothing in this Compact shall override a party state’s decision that participation in an alternative program may be used in lieu of adverse action.
(2)
The home state licensing board shall deactivate the multistate licensure privilege under the multistate license of any nurse for the duration of the nurse’s participation in an alternative program.
Article VI. Coordinated Licensure Information System and Exchange of Information.
(12)
(a)
(1)
All party states shall participate in a coordinated licensure information system of all licensed registered nurses (RNs) and licensed practical/vocational nurses (LPNs/VNs).
(2)
This system shall include information on the licensure and disciplinary history of each nurse, as submitted by party states, to assist in the coordination of nurse licensure and enforcement efforts.
(b)
The Commission, in consultation with the administrator of the coordinated licensure information system, shall formulate necessary and proper procedures for the identification, collection, and exchange of information under this Compact.
(c)
All licensing boards shall promptly report to the coordinated licensure information system:
(1)
Any adverse action;
(2)
Any current significant investigative information;
(3)
Denials of applications with the reasons for the denials; and
(4)
Nurse participation in alternative programs known to the licensing board regardless of whether such participation is deemed nonpublic or confidential under state law.
(d)
Current significant investigative information and participation in nonpublic or confidential alternative programs shall be transmitted through the coordinated licensure information system only to party state licensing boards.
(e)
Notwithstanding any other provision of law, all party state licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with nonparty states or disclosed to other entities or individuals without the express permission of the contributing state.
(f)
Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board may not be shared with nonparty states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.
(g)
Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information shall also be expunged from the coordinated licensure information system.
(h)
The Compact administrator of each party state shall furnish a uniform data set to the Compact administrator of each other party state, which shall include:
(1)
Identifying information;
(2)
Licensure data;
(3)
Information related to alternative program participation; and
(4)
Other information that may facilitate the administration of this Compact, as determined by Commission rules.
(i)
The Compact administrator of a party state shall provide all investigative documents and information requested by another party state.
Article VII. Establishment of the Interstate Commission of Nurse Licensure Compact Administrators.
(13)
(a)
(1)
The party states hereby create and establish a joint public entity known as the Interstate Commission of Nurse Licensure Compact Administrators.
(2)
The Commission is an instrumentality of the party states.
(3)
(i)
Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located.
(ii)
The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
(4)
Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
(b)
(1)
(i)
Each party state shall have and be limited to one administrator.
(ii)
(1)
Subject to subsubparagraph 2 of this subparagraph, the head of the licensing board or designee shall be the administrator of this Compact for each party state.
(2)
The Executive Director of the Maryland State Board of Nursing, or the Executive Director’s designee, is the administrator of this Compact in Maryland.
(iii)
Any administrator may be removed or suspended from office as provided by the law of the state from which the administrator is appointed.
(iv)
Any vacancy occurring in the Commission shall be filled in accordance with the laws of the party state in which the vacancy exists.
(2)
(i)
Each administrator shall be entitled to only one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission.
(ii)
An administrator shall vote in person or by such other means as provided in the bylaws.
(iii)
The bylaws may provide for an administrator’s participation in meetings by telephone or other means of communication.
(3)
(i)
The Commission shall meet at least once during each calendar year.
(ii)
Additional meetings shall be held as set forth in the bylaws or rules of the Commission.
(4)
Except as provided in paragraph (5) of this subsection, all meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Article VIII.
(5)
Subject to paragraph (6) of this subsection, the Commission may convene in a closed, nonpublic meeting if the Commission must discuss:
(i)
Noncompliance of a party state with its obligations under this Compact;
(ii)
The employment, compensation, discipline, or other personnel matters, practices, or procedures related to specific employees or other matters related to the Commission’s internal personnel practices and procedures;
(iii)
Current, threatened, or reasonably anticipated litigation;
(iv)
Negotiation of contracts for the purchase or sale of goods, services, or real estate;
(v)
Accusing any person of a crime or formally censuring any person;
(vi)
Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
(vii)
Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
(viii)
Disclosure of investigatory records compiled for law enforcement purposes;
(ix)
Disclosure of information related to any reports prepared by or on behalf of the Commission for the purpose of investigation of compliance with this Compact; or
(x)
Matters specifically exempted from disclosure by federal or state laws.
(6)
(i)
The Commission may meet in closed session only after a majority of the administrators vote to close a meeting in whole or in part.
(ii)
As soon as practicable, the Commission must make public a copy of the vote to close the meeting revealing the vote of each administrator, with no proxy votes allowed.
(7)
(i)
If a meeting, or portion of a meeting, is closed in accordance with paragraphs (5) and (6) of this subsection, the Commission’s legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision.
(ii)
The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons for the actions, including a description of the views expressed.
(iii)
All documents considered in connection with an action shall be identified in the minutes.
(iv)
All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.
(c)
The Commission shall, by a majority vote of the administrators, adopt bylaws or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of this Compact, including:
(1)
Establishing the fiscal year of the Commission;
(2)
Providing reasonable standards and procedures:
(i)
For the establishment and meetings of other committees; and
(ii)
Governing any general or specific delegation of any authority or function of the Commission;
(3)
Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings, and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public’s interest, the privacy of individuals, and proprietary information, including trade secrets;
(4)
Establishing the titles, duties and authority, and reasonable procedures for the election of the officers of the Commission;
(5)
Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission; and
(6)
Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of this Compact after the payment or reserving of all of its debts and obligations.
(d)
The Commission shall publish its bylaws and rules and any amendments in a convenient form on the Web site of the Commission.
(e)
Notwithstanding any civil service or other similar laws of any party state, the bylaws shall exclusively govern the personnel policies and programs of the Commission.
(f)
The rules shall have the force and effect of law and shall be binding in all party states.
(g)
The Commission shall maintain its financial records in accordance with the bylaws.
(h)
The Commission shall meet and take any actions that are consistent with the provisions of this Compact and the bylaws.
(i)
The Commission has the following powers:
(1)
To promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact;
(2)
To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any licensing board to sue or be sued under applicable law shall not be affected;
(3)
To purchase and maintain insurance and bonds;
(4)
To borrow, accept, or contract for services of personnel, including employees of a party state or nonprofit organizations;
(5)
To cooperate with other organizations that administer state compacts related to the regulation of nursing, including but not limited to sharing administrative or staff expenses, office space, or other resources;
(6)
To hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of this Compact, and establish the Commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;
(7)
To accept any and all appropriate donations, grants, and gifts of money, equipment, supplies, materials, and services, and to receive, utilize, and dispose of the same, provided that at all times the Commission shall avoid any appearance of impropriety or conflict of interest;
(8)
To lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve, or use any property, whether real, personal, or mixed, provided that at all times the Commission shall avoid any appearance of impropriety;
(9)
To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, whether real, personal, or mixed;
(10)
To establish a budget and make expenditures;
(11)
To borrow money;
(12)
To appoint committees, including advisory committees composed of administrators, state nursing regulators, state legislators or their representatives, consumer representatives, and other interested persons;
(13)
To provide and receive information from, and to cooperate with, law enforcement agencies;
(14)
To adopt and use an official seal; and
(15)
To perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of nurse licensure and practice.
(j)
(1)
The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
(2)
(i)
Subject to subparagraph (ii) of this paragraph, the Commission may levy on and collect an annual assessment from each party state to cover the cost of its operations, activities, and staff in its annual budget as approved by the Commission each year.
(ii)
The aggregate annual assessment amount, if any, shall be allocated based on a formula to be determined by the Commission, which shall promulgate a rule that is binding on all party states.
(3)
The Commission may not:
(i)
Incur obligations of any kind prior to securing the funds adequate to meet the obligations of the Commission; or
(ii)
Pledge the credit of any of the party states, except by, and with the authority of, the party state.
(4)
(i)
The Commission shall keep accurate accounts of all receipts and disbursements.
(ii)
Subject to subparagraph (iii) of this paragraph, the receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws.
(iii)
All receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.
(k)
The Commission shall issue an annual report.
(l)
(1)
(i)
Except as provided in subparagraph (ii) of this paragraph, the administrators, officers, executive director, employees, and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred, within the scope of Commission employment, duties, or responsibilities.
(ii)
Nothing in subparagraph (i) of this paragraph shall be construed to protect any person from suit or liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton misconduct of that person.
(2)
(i)
Except as provided in subparagraph (ii) of this paragraph, the Commission shall defend any administrator, officer, executive director, employee, or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities.
(ii)
Nothing in subparagraph (i) of this paragraph shall be construed to:
(1)
Prohibit a person from retaining the person’s own counsel; or
(2)
Protect any person from suit or liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton misconduct of that person.
(3)
(i)
Except as provided in subparagraph (ii) of this paragraph, the Commission shall indemnify and hold harmless any administrator, officer, executive director, employee, or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities.
(ii)
Nothing in subparagraph (i) of this paragraph shall be construed to protect any person from suit or liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton misconduct of that person.
Article VIII. Rulemaking.
(14)
(a)
(1)
The Commission shall exercise its rulemaking powers in accordance with the criteria in this article and the rules adopted under this article.
(2)
Rules and amendments to the rules shall become binding as of the date specified in each rule or amendment and shall have the same force and effect as provisions of this Compact.
(b)
Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
(c)
Before adoption of a final rule or rules by the Commission, and at least 60 days in advance of the meeting at which the rule or rules will be considered and voted on, the Commission shall file a notice of proposed rulemaking:
(1)
On the Web site of the Commission; and
(2)
On the Web site of each licensing board or the publication in which each party state would otherwise publish proposed rules.
(d)
The notice of proposed rulemaking shall include:
(1)
The proposed time, date, and location of the meeting in which the proposed rule or amendment will be considered and voted on;
(2)
The text of the proposed rule or amendment, and the reason for the proposed rule or amendment;
(3)
A request for comments on the proposed rule or amendment from any interested person; and
(4)
The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.
(e)
Before adoption of a proposed rule or amendment, the Commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public.
(f)
Except as provided in subsection (k) of this section, the Commission shall grant an opportunity for a public hearing before it adopts a rule or an amendment.
(g)
(1)
The Commission shall publish the place, time, and date of the scheduled public hearing.
(2)
Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.
(3)
All hearings shall be recorded, and a copy shall be made available on request.
(4)
(i)
Nothing in this section shall be construed as requiring a separate hearing on each rule or amendment.
(ii)
Rules or amendments may be grouped for the convenience of the Commission at hearings required by this section.
(h)
If no one appears at the public hearing, the Commission may proceed with adoption of the proposed rule or amendment.
(i)
Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.
(j)
The Commission shall by majority vote of all administrators:
(1)
Take final action on the proposed rule or amendment; and
(2)
Determine the effective date of the rule or amendment, if any, based on the rulemaking record and the full text of the rule or amendment.
(k)
(1)
On determination that an emergency exists, the Commission may consider and adopt an emergency rule or amendment without prior notice or an opportunity for comment or a hearing.
(2)
The usual rulemaking procedures provided in this Compact and in this section shall be retroactively applied to the rule or amendment as soon as reasonably possible, but in no event later than 90 days after the effective date of the rule or amendment.
(3)
For the purposes of this subsection, an emergency rule is one that must be adopted immediately in order to:
(i)
Meet an imminent threat to public health, safety, or welfare;
(ii)
Prevent a loss of Commission or party state funds; or
(iii)
Meet a deadline for the adoption of an administrative rule that is required by federal law or rule.
(l)
(1)
The Commission may revise a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors.
(2)
Public notice of any revisions shall be posted on the Web site of the Commission.
(3)
(i)
Subject to subparagraph (ii) of this paragraph, the revision shall be subject to challenge by any person for a period of 30 days after posting.
(ii)
The revision may be challenged only on grounds that the revision results in a material change to a rule or an amendment.
(iii)
A challenge shall be made in writing and delivered to the Commission before the end of the notice period.
(iv)
If no challenge is made, the revision will take effect without further action.
(v)
If the revision is challenged, the revision may not take effect without the approval of the Commission.
Article IX. Oversight, Dispute Resolution, and Enforcement.
(15)
(a)
(1)
Each party state shall enforce this Compact and take all actions necessary and appropriate to effectuate this Compact’s purposes and intent.
(2)
The Commission shall:
(i)
Be entitled to receive service of process in any proceeding that may affect the powers, responsibilities, or actions of the Commission; and
(ii)
Have standing to intervene in a proceeding for all purposes.
(3)
Failure to provide service of process in a proceeding to the Commission shall render a judgment or order void as to the Commission, this Compact, or the adopted rules.
(b)
(1)
If the Commission determines that a party state has defaulted in the performance of its obligations or responsibilities under this Compact or the adopted rules, the Commission shall:
(i)
Provide written notice to the defaulting state and other party states of the nature of the default, the proposed means of curing the default, or any other action to be taken by the Commission; and
(ii)
Provide remedial training and specific technical assistance regarding the default.
(2)
(i)
If a state in default fails to cure the default, the defaulting state’s membership in this Compact may be terminated on an affirmative vote of a majority of the administrators, and all rights, privileges, and benefits conferred by this Compact may be terminated on the effective date of termination.
(ii)
A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.
(3)
(i)
Termination of membership in this Compact shall be imposed only after all other means of securing compliance have been exhausted.
(ii)
Notice of intent to suspend or terminate shall be given by the Commission to the governor of the defaulting state, to the executive officer of the defaulting state’s licensing board, and to each of the party states.
(4)
A state whose membership in this Compact has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.
(5)
The Commission may not bear any costs related to a state that is found to be in default or whose membership in this Compact has been terminated unless agreed on in writing between the Commission and the defaulting state.
(6)
(i)
The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices.
(ii)
The prevailing party shall be awarded all costs of such litigation, including reasonable attorneys’ fees.
(c)
(1)
On request by a party state, the Commission shall attempt to resolve disputes related to the Compact that arise among party states and between party and nonparty states.
(2)
The Commission shall adopt a rule providing for both mediation and binding dispute resolution for disputes, as appropriate.
(3)
In the event the Commission cannot resolve disputes among party states arising under this Compact:
(i)
The party states may submit the issues in dispute to an arbitration panel, which will be composed of individuals appointed by the Compact administrator in each of the affected party states and an individual mutually agreed on by the Compact administrators of all the party states involved in the dispute; and
(ii)
The decision of a majority of the arbitrators shall be final and binding.
(d)
(1)
The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
(2)
(i)
By majority vote, the Commission may initiate legal action in the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices against a party state that is in default to enforce compliance with the provisions of this Compact and its adopted rules and bylaws.
(ii)
The relief sought may include both injunctive relief and damages.
(iii)
In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorneys’ fees.
(3)
(i)
The remedies provided for in this article may not be the exclusive remedies of the Commission.
(ii)
The Commission may pursue any other remedies available under federal or state law.
Article X. Effective Date, Withdrawal, and Amendment.
(16)
(a)
(1)
This Compact shall become effective and binding on the earlier of the date of legislative enactment of this Compact into law by no less than 26 states or December 31, 2018.
(2)
All party states to this Compact that also were parties to the prior Nurse Multistate Licensure Compact (“Prior Compact”), superseded by this Compact, shall be deemed to have withdrawn from the Prior Compact within 6 months after the effective date of this Compact.
(b)
Each party state to this Compact shall continue to recognize a nurse’s multistate licensure privilege to practice in that party state issued under the Prior Compact until such party state has withdrawn from the Prior Compact.
(c)
(1)
Any party state may withdraw from this Compact by enacting a statute repealing the Compact.
(2)
A party state’s withdrawal may not take effect until 6 months after enactment of the repealing statute.
(d)
A party state’s withdrawal or termination may not affect the continuing requirement of the withdrawing or terminated state’s licensing board to report adverse actions and significant investigations occurring before the effective date of the withdrawal or termination.
(e)
Nothing contained in this Compact shall be construed to invalidate or prevent any nurse licensure agreement or other cooperative arrangement between a party state and a nonparty state that is made in accordance with the other provisions of this Compact.
(f)
(1)
This Compact may be amended by the party states.
(2)
An amendment to this Compact may not become effective and binding on the party states unless and until it is enacted into the laws of all party states.
(g)
Representatives of nonparty states to this Compact shall be invited to participate in the activities of the Commission, on a nonvoting basis, before the adoption of this Compact by all states.
Article XI. Construction and Severability.
(17)
(a)
This Compact shall be liberally construed so as to effectuate the purposes of the Compact.
(b)
The provisions of this Compact shall be severable, and if any phrase, clause, sentence, or provision of this Compact is declared to be contrary to the constitution of any party state or of the United States, or if the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person, or circumstance may not be affected thereby.
(c)
If this Compact is held to be contrary to the constitution of a party state, this Compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters.
Md. Code Ann., Health Occ. § 8-7A-02 (2026)
Title 8. Nurses
Subtitle 7A. Nurse Licensure Compact
§ 8–7A-02LinkCopy Citation
Judicial review of the validity of discipline in another state as set forth in Article V of this Compact shall be limited to the issue of the identity of the individual who was disciplined in another state.
Md. Code Ann., Health Occ. § 8-7A-03 (2026)
Title 8. Nurses
Subtitle 7A. Nurse Licensure Compact
§ 8–7A-03LinkCopy Citation
(a)
This Nurse Licensure Compact may not nullify any other provision in this title or any other title applicable to the practice of nursing in the State.
(b)
In any instance where this Nurse Licensure Compact is silent as to an issue, the other provisions of this title and any regulations promulgated under this title shall prevail.
Md. Code Ann., Health Occ. § 8-7A-04 (2026)
Title 8. Nurses
Subtitle 7A. Nurse Licensure Compact
§ 8–7A-04LinkCopy Citation
In addition to the powers and duties set forth in this title, the Board shall promulgate regulations to effectuate the provisions of this Nurse Licensure Compact.
Md. Code Ann., Health Occ. § 8-7A-05 (2026)
Title 8. Nurses
Subtitle 7A. Nurse Licensure Compact
§ 8–7A-05LinkCopy Citation
This Nurse Licensure Compact:
(a)
Is designed to facilitate the regulation of nurses, and may not relieve employers from complying with contractual and statutorily imposed obligations; and
(b)
May not supersede existing State labor laws.
Subtitle 8
This title may be cited as the “Maryland Nurse Practice Act”.
Subject to the evaluation and reestablishment provisions of the Program Evaluation Act, the provisions of this title and of any rule or regulation adopted under this title shall terminate and be of no effect after July 1, 2030.