<section article="gho" article_name="Health Occupations" number="8-101" title_number="8" title_name="Nurses" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <text>In this title the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Advanced practice registered nurse” means an individual who:</text> <level label="1"> <level label="i"> <text>Is licensed by the Board to practice registered nursing; or</text> </level> <level label="ii"> <text>Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and</text> </level> </level> <level label="2"> <text>Is certified by the Board to practice as:</text> <level label="i"> <text>A nurse practitioner;</text> </level> <level label="ii"> <text>A nurse anesthetist;</text> </level> <level label="iii"> <text>A nurse midwife; or</text> </level> <level label="iv"> <text>A clinical nurse specialist.</text> </level> </level> </level> <level label="c"> <text>“Applicant” means, unless the context requires otherwise:</text> <level label="1"> <text>An individual applying for an initial license by examination or endorsement;</text> </level> <level label="2"> <text>A licensee applying for renewal of a license;</text> </level> <level label="3"> <text>An individual applying for an initial advanced practice registered nurse certification;</text> </level> <level label="4"> <text>A licensee applying for renewal of an advanced practice registered nurse certification; or</text> </level> <level label="5"> <text>An individual applying for reinstatement of a license in accordance with § 8–319 of this title.</text> </level> </level> <level label="d"> <text>“Board” means the State Board of Nursing.</text> </level> <level label="d–1"> <level label="1"> <text>“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.</text> </level> <level label="2"> <text>“Entry–level registered nursing education program” does not include degree completion programs, including:</text> <level label="i"> <text>Associate of Applied Science Degree in Nursing to Baccalaureate of Science Degree in Nursing (AAS–BSN);</text> </level> <level label="ii"> <text>Associate Degree in Nursing to Baccalaureate of Science Degree in Nursing (ADN–BSN);</text> </level> <level label="iii"> <text>Associate of Applied Science Degree in Nursing to Master of Science Degree in Nursing (AAS–MSN);</text> </level> <level label="iv"> <text>Associate Degree in Nursing to Master of Science Degree in Nursing (ADN–MSN);</text> </level> <level label="v"> <text>Baccalaureate of Science Degree in Nursing to Master of Science Degree in Nursing (BSN–MSN);</text> </level> <level label="vi"> <text>Baccalaureate of Science Degree in Nursing to Doctor of Philosophy (BSN–PHD);</text> </level> <level label="vii"> <text>Baccalaureate of Science Degree in Nursing to Doctor of Education (BSN–EDD);</text> </level> <level label="viii"> <text>Baccalaureate of Science Degree in Nursing to Doctor of Nursing Practice (BSN–DNP);</text> </level> <level label="ix"> <text>Master of Science Degree in Nursing to Doctor of Philosophy (MSN–PHD);</text> </level> <level label="x"> <text>Master of Science Degree in Nursing to Doctor of Education (MSN–EDD);</text> </level> <level label="xi"> <text>Master of Science Degree in Nursing to Doctor of Nursing Practice (MSN–DNP); and</text> </level> <level label="xii"> <text>Master of Science Degree in Nursing to Post Masters Certificate/Post Graduate Certificate.</text> </level> </level> </level> <level label="e"> <text>“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.</text> </level> <level label="f"> <text>“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.</text> </level> <level label="g"> <text>“License” means, unless the context requires otherwise, a license issued by the Board to practice:</text> <level label="1"> <text>Registered nursing;</text> </level> <level label="2"> <text>Licensed practical nursing; or</text> </level> <level label="3"> <text>Advanced practice registered nursing.</text> </level> </level> <level label="h"> <text>“Licensed practical nurse” means, unless the context requires otherwise, an individual who:</text> <level label="1"> <text>Is licensed by the Board to practice licensed practical nursing; or</text> </level> <level label="2"> <text>Has a multistate licensure privilege to practice licensed practical nursing under the Nurse Licensure Compact.</text> </level> </level> <level label="i"> <text>“Licensee” means, unless the context requires otherwise, a registered nurse or licensed practical nurse who has:</text> <level label="1"> <text>An active license;</text> </level> <level label="2"> <text>An inactive license;</text> </level> <level label="3"> <text>A temporary license;</text> </level> <level label="4"> <text>An expired temporary license;</text> </level> <level label="5"> <text>An expired license;</text> </level> <level label="6"> <text>A lapsed license;</text> </level> <level label="7"> <text>A suspended license;</text> </level> <level label="8"> <text>A license subject to a reprimand, probation, or suspension; or</text> </level> <level label="9"> <text>A multistate licensure privilege to practice registered nursing or licensed practical nursing under the Nurse Licensure Compact.</text> </level> </level> <level label="j"> <text>“Mentor” means a certified registered nurse practitioner or a licensed physician:</text> <level label="1"> <text>Who has 3 or more years of clinical practice experience; and</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="k"> <text>“Nurse anesthetist” means an individual who:</text> <level label="1"> <text>Is licensed by the Board to practice registered nursing; and</text> </level> <level label="2"> <text>Is certified by the Board to practice as a nurse anesthetist.</text> </level> </level> <level label="l"> <text>“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.</text> </level> <level label="m"> <text>“Practice as a registered nurse practitioner” means to independently:</text> <level label="1"> <text>Perform an act under subsection (o) of this section;</text> </level> <level label="2"> <text>Conduct a comprehensive physical assessment of an individual;</text> </level> <level label="3"> <text>Establish a medical diagnosis for common chronic stable or short–term health problems;</text> </level> <level label="4"> <text>Order, perform, and interpret laboratory tests;</text> </level> <level label="5"> <text>Prescribe drugs as provided under § 8–508 of this title;</text> </level> <level label="6"> <text>Perform diagnostic, therapeutic, or corrective measures;</text> </level> <level label="7"> <text>Consult and collaborate with, or refer an individual to, an appropriate licensed physician or any other health care provider as needed; and</text> </level> <level label="8"> <text>Provide emergency care.</text> </level> </level> <level label="n"> <text>“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:</text> <level label="1"> <text>Administer treatment or medication to an individual;</text> </level> <level label="2"> <text>Aid in the rehabilitation of an individual;</text> </level> <level label="3"> <text>Promote preventive measures in community health;</text> </level> <level label="4"> <text>Give counsel to an individual;</text> </level> <level label="5"> <text>Safeguard life and health;</text> </level> <level label="6"> <text>Teach or supervise; or</text> </level> <level label="7"> <text>Perform any additional acts authorized by the Board under § 8–205 of this title.</text> </level> </level> <level label="o"> <level label="1"> <text>“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:</text> <level label="i"> <text>Maintain health;</text> </level> <level label="ii"> <text>Prevent illness; or</text> </level> <level label="iii"> <text>Care for or rehabilitate the ill, injured, or infirm.</text> </level> </level> <level label="2"> <text>For these purposes, “practice registered nursing” includes:</text> <level label="i"> <text>Administration;</text> </level> <level label="ii"> <text>Teaching;</text> </level> <level label="iii"> <text>Counseling;</text> </level> <level label="iv"> <text>Supervision, delegation, and evaluation of nursing practice;</text> </level> <level label="v"> <text>Execution of therapeutic regimen, including the administration of medication and treatment;</text> </level> <level label="vi"> <text>Independent nursing functions and delegated medical functions; and</text> </level> <level label="vii"> <text>Performance of additional acts authorized by the Board under § 8–205 of this title.</text> </level> </level> </level> <level label="p"> <text>“Registered nurse” means, unless the context requires otherwise, an individual who:</text> <level label="1"> <text>Is licensed by the Board to practice registered nursing; or</text> </level> <level label="2"> <text>Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact.</text> </level> </level> <level label="q"> <text>“Registered nurse practitioner” means an individual who:</text> <level label="1"> <level label="i"> <text>Is licensed by the Board to practice registered nursing; or</text> </level> <level label="ii"> <text>Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and</text> </level> </level> <level label="2"> <text>Is certified by the Board to practice as a registered nurse practitioner.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-102" title_number="8" title_name="Nurses" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>Except as specifically provided in this title, this title does not limit the right of:</text> <level label="1"> <text>An individual to practice a health occupation that the individual is authorized to practice under this article;</text> </level> <level label="2"> <text>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</text> </level> <level label="3"> <text>An unlicensed individual to perform acts of registered nursing or acts of licensed practical nursing:</text> <level label="i"> <text>While supervised by an individual who is authorized by this State to practice registered nursing or licensed practical nursing; and</text> </level> <level label="ii"> <text>If the unlicensed individual performs only acts that are in the area of responsibility of the supervisor and under the instruction of the supervisor.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-201" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <text>There is a State Board of Nursing in the Department.</text> </section> <section article="gho" article_name="Health Occupations" number="8-202" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <level label="1"> <text>The Board consists of 14 members.</text> </level> <level label="2"> <text>Of the 14 Board members:</text> <level label="i"> <text>9 shall be registered nurses;</text> </level> <level label="ii"> <text>1 shall be a licensed nurse who is either a licensed practical nurse, a registered nurse, or an advanced practice registered nurse;</text> </level> <level label="iii"> <text>2 shall be licensed practical nurses; and</text> </level> <level label="iv"> <text>2 shall be consumers.</text> </level> </level> <level label="3"> <text>Of the 9 registered nurse members:</text> <level label="i"> <text>2 shall be advanced practice registered nurses;</text> </level> <level label="ii"> <text>1 shall be a baccalaureate nursing educator with, at least, a master’s degree in nursing or education;</text> </level> <level label="iii"> <text>1 shall be an associate degree nursing educator with, at least, a master’s degree in nursing or education;</text> </level> <level label="iv"> <text>1 shall be a practical nursing educator with, at least, a master’s degree in nursing or education;</text> </level> <level label="v"> <text>1 shall be a nurse administrator with, at least, a master’s degree in nursing administration, business administration, business management, education, or public health;</text> </level> <level label="vi"> <text>1 shall be a nurse clinician with at least a master’s degree in nursing or public health;</text> </level> <level label="vii"> <text>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</text> </level> <level label="viii"> <text>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.</text> </level> </level> <level label="4"> <text>Of the 2 licensed practical nurse members, at least 1 shall practice in a long–term care nursing facility.</text> </level> </level> <level label="b"> <level label="1"> <text>The Governor shall appoint:</text> <level label="i"> <text>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:</text> <level label="1"> <text>Maryland Association of Nurse Anesthetists, Inc.;</text> </level> <level label="2"> <text>Nurse Practitioners Association of Maryland, Inc.;</text> </level> <level label="3"> <text>Maryland Academy of Advanced Practice Clinicians;</text> </level> <level label="4"> <text>Maryland Chapter, American College of Nurse–Midwives; and</text> </level> <level label="5"> <text>Psychiatric Advance Practice Nurses of Maryland; and</text> </level> </level> <level label="ii"> <text>The other registered nurse members, with the advice of the Secretary, from:</text> <level label="1"> <text>A list of qualified individuals submitted to the Secretary and the Governor by:</text> </level> <level label="A"> <text>The Maryland Nurses Association, Inc.; or</text> </level> <level label="B"> <text>Any other professional nursing organization that represents at least 25 licensed registered nurses; or</text> </level> <level label="2"> <text>A valid petition submitted to the Secretary and the Governor by a registered nurse with an active license under this title.</text> </level> </level> </level> <level label="2"> <text>The Governor shall appoint the licensed practical nurse members, with the advice of the Secretary, from:</text> <level label="i"> <text>A list of qualified individuals submitted to the Secretary and the Governor by:</text> <level label="1"> <text>The Maryland Licensed Practical Nurse Association, Inc.; or</text> </level> <level label="2"> <text>Any other professional nursing organization representing at least 25 licensed practical nurses; or</text> </level> </level> <level label="ii"> <text>A valid petition submitted to the Secretary and the Governor by a licensed practical nurse with an active license under this title.</text> </level> </level> <level label="3"> <text>A list submitted to the Secretary and the Governor under this subsection shall be 5 times the number of vacancies.</text> </level> <level label="4"> <text>A petition submitted to the Secretary and the Governor under this subsection shall:</text> <level label="i"> <text>For a registered nurse member vacancy, have at least 25 signatures of support from registered nurses with active licenses in the State;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>For a licensed practical nurse member vacancy, have at least 25 signatures of support from licensed practical nurses with active licenses in the State.</text> </level> </level> <level label="5"> <text>The Board shall provide notice of a vacancy on the Board to:</text> <level label="i"> <text>All registered nurses, advanced practice registered nurses, and licensed practical nurses with an active license in the State; and</text> </level> <level label="ii"> <text>All appropriate professional nursing organizations.</text> </level> </level> <level label="6"> <text>The Governor may request an additional list of 5 nominees for each vacancy from the appropriate professional nursing organizations.</text> </level> <level label="7"> <text>The Governor shall make the appointment for each vacancy from the lists or petitions submitted under this subsection.</text> </level> <level label="8"> <text>The Governor shall appoint the consumer members with the advice of the Secretary and the advice and consent of the Senate.</text> </level> <level label="9"> <text>To the extent practicable, the members appointed to the Board shall reasonably reflect the geographic, racial, ethnic, cultural, and gender diversity of the State.</text> </level> </level> <level label="c"> <text>Each member of the Board shall be:</text> <level label="1"> <text>A citizen of the United States; and</text> </level> <level label="2"> <text>A resident of this State.</text> </level> </level> <level label="d"> <level label="1"> <text>A registered nurse member of the Board shall:</text> <level label="i"> <text>Have graduated from an approved school of nursing or its equivalent; and</text> </level> <level label="ii"> <text>Have at least 5 years of experience in nursing administration, education, or practice, which includes at least the 3 years immediately before the appointment.</text> </level> </level> <level label="2"> <text>A member of the Board who is an advanced practice registered nurse shall:</text> <level label="i"> <text>Hold a current license to practice registered nursing in this State;</text> </level> <level label="ii"> <text>Hold a current certification in an advanced practice registered nursing specialty in this State; and</text> </level> <level label="iii"> <text>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.</text> </level> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>Each consumer member of the Board:</text> <level label="1"> <text>Shall be a member of the general public;</text> </level> <level label="2"> <text>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;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>May not participate or ever have participated in a commercial or professional field related to registered nursing or licensed practical nursing;</text> </level> <level label="5"> <text>May not have a household member who participates in a commercial or professional field related to registered nursing or licensed practical nursing; or</text> </level> <level label="6"> <text>May not have had within 2 years before appointment a substantial financial interest in a person who is regulated by the Board.</text> </level> </level> <level label="g"> <text>While a member of the Board, a consumer member may not have a substantial financial interest in a person regulated by the Board.</text> </level> <level label="h"> <text>Before taking office, each appointee to the Board shall take the oath required by Article I, § 9 of the Maryland Constitution.</text> </level> <level label="i"> <level label="1"> <text>The term of a member is 4 years, except that the initial term of 1 of the consumer members is 2 years.</text> </level> <level label="2"> <text>The terms of the members are staggered as required by the terms provided for members of the Board on July 1, 1981.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun may serve an additional 2 consecutive full terms.</text> </level> <level label="5"> <text>A member may not serve more than 2 consecutive full terms.</text> </level> <level label="6"> <text>To the extent practicable, the Governor shall fill any vacancy on the Board within 60 days of the date of the vacancy.</text> </level> </level> <level label="j"> <level label="1"> <text>The Governor may remove a member for incompetence, misconduct, neglect of a duty required by law, unprofessional conduct, or dishonorable conduct.</text> </level> <level label="2"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-203" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The president of the Board shall be a registered nurse.</text> </level> <level label="3"> <text>The president shall serve a 2–year term unless:</text> <level label="i"> <text>The term of the member serving as the president expires before the end of the member’s term as president; or</text> </level> <level label="ii"> <text>The president resigns.</text> </level> </level> </level> <level label="b"> <text>The Board shall determine:</text> <level label="1"> <text>The manner of election of officers; and</text> </level> <level label="2"> <text>The duties of each officer.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-204" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <text>A majority of the appointed members serving on the Board is a quorum.</text> </level> <level label="b"> <text>In addition to the other meeting requirements of this title, the Board shall meet:</text> <level label="1"> <text>At the request of the Secretary; or</text> </level> <level label="2"> <text>If necessary to transact its business.</text> </level> </level> <level label="c"> <text>In accordance with the State budget, each member of the Board is entitled to:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations.</text> </level> </level> <level label="d"> <level label="1"> <level label="i"> <text>The Secretary may employ a staff for the Board in accordance with the State budget.</text> </level> <level label="ii"> <text>The Secretary may designate one of the staff who is a registered nurse as an executive director.</text> </level> </level> <level label="2"> <text>The Secretary may set the compensation of an employee of the Board in a position that:</text> <level label="i"> <text>Is unique to the Board;</text> </level> <level label="ii"> <text>Requires specific skills or experience to perform the duties of the position; and</text> </level> <level label="iii"> <text>Does not require the employee to perform functions that are comparable to functions performed in other units of the Executive Branch of State government.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-205" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <text>In addition to the powers and duties set forth elsewhere in this title, the Board has the following powers and duties:</text> <level label="1"> <text>To adopt rules and regulations to carry out the provisions of this title;</text> </level> <level label="2"> <text>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;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>To adopt rules and regulations for the performance of additional nursing acts that:</text> <level label="i"> <text>May be performed under any condition authorized by the Board, including emergencies; and</text> </level> <level label="ii"> <text>Require education and clinical experience;</text> </level> </level> <level label="5"> <text>To adopt rules and regulations for registered nurses to perform independent nursing functions that:</text> <level label="i"> <text>Require formal education and clinical experience; and</text> </level> <level label="ii"> <text>May be performed under any condition authorized by the Board, including emergencies;</text> </level> </level> <level label="6"> <text>To adopt rules and regulations for licensed practical nurses to perform additional acts in the practice of registered nursing that:</text> <level label="i"> <text>Require formal education and clinical experience;</text> </level> <level label="ii"> <text>May be performed under any condition authorized by the Board, including emergencies; and</text> </level> <level label="iii"> <text>Are recognized by the Nursing Board as proper for licensed practical nurses to perform;</text> </level> </level> <level label="7"> <text>To keep a record of its proceedings;</text> </level> <level label="8"> <text>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:</text> <level label="i"> <text>The following data calculated on a fiscal year basis:</text> <level label="1"> <text>The number of initial and renewal licenses and certificates issued;</text> </level> <level label="2"> <text>The number of positive and negative criminal history records checks results received;</text> </level> <level label="3"> <text>The number of individuals denied initial or renewal licensure or certification due to positive criminal history records checks results;</text> </level> <level label="4"> <text>The number of individuals denied licensure or certification due to reasons other than a positive criminal history records check;</text> </level> <level label="5"> <text>The number of new complaints received;</text> </level> <level label="6"> <text>The number of complaints carried over from year to year;</text> </level> <level label="7"> <text>The most common grounds for complaints;</text> </level> <level label="8"> <text>The number and types of disciplinary actions taken by the Board; and</text> </level> <level label="9"> <text>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</text> </level> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="9"> <text>To enforce the employment record requirements of this title;</text> </level> <level label="10"> <text>To keep separate lists, which lists are open to reasonable public inspection, of all:</text> <level label="i"> <text>Registered nurses licensed under this title;</text> </level> <level label="ii"> <text>Licensed practical nurses licensed under this title;</text> </level> <level label="iii"> <text>Nurse midwives certified under this title;</text> </level> <level label="iv"> <text>Nurse practitioners certified under this title;</text> </level> <level label="v"> <text>Nurse anesthetists certified under this title;</text> </level> <level label="vi"> <text>Clinical nurse specialists certified under this title;</text> </level> <level label="vii"> <text>Certified medication technicians certified under this title;</text> </level> <level label="viii"> <text>Electrologists licensed under this title;</text> </level> <level label="ix"> <text>Direct–entry midwives licensed under this title;</text> </level> <level label="x"> <text>Certified midwives licensed under this title; and</text> </level> <level label="xi"> <text>Other licensees with a nursing specialty that is certified under this title;</text> </level> </level> <level label="11"> <text>To collect any funds of the Board;</text> </level> <level label="12"> <text>To report any alleged violation of this title to the State’s Attorney of the county where the alleged violation occurred;</text> </level> <level label="13"> <text>In accordance with the State budget, to incur any necessary expense for prosecution of an alleged violation of this title;</text> </level> <level label="14"> <text>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;</text> </level> <level label="15"> <text>To maintain a nurse aide registry that complies with federal law;</text> </level> <level label="16"> <text>To appoint standing and ad hoc committees from among Board members as necessary; and</text> </level> <level label="17"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <level label="1"> <text>The Board is the only unit of the Department that is responsible for adopting rules and regulations to determine:</text> <level label="i"> <text>Individuals to whom any act of the practice of registered nursing and licensed practical nursing may be delegated; and</text> </level> <level label="ii"> <text>The acts that may be delegated safely.</text> </level> </level> <level label="2"> <text>The Department shall retain its authority to require training for nonlicensed patient care personnel under § 19–308.1 of the Health – General Article.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-205.1" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>In return for the privilege to practice nursing or certified midwifery in the State, the applicant or licensee is deemed to have:</text> <level label="1"> <text>Consented to submit to an examination under this section, if requested by the Board in writing; and</text> </level> <level label="2"> <text>Waived any claim of privilege as to the testimony or examination reports of the examining health care professional.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>The Board shall pay the cost of any examination made under this section.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-206" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <text>There is a Board of Nursing Fund.</text> </level> <level label="b"> <level label="1"> <text>The Board may set reasonable fees for the issuance and renewal of licenses and its other services.</text> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> </level> </level> </level> <level label="c"> <text>The Board shall publish in its rules and regulations the fees that it sets.</text> </level> <level label="d"> <level label="1"> <text>The Board shall pay all fees collected under the provisions of this title to the Comptroller of the State.</text> </level> <level label="2"> <text>The Comptroller shall distribute the fees received from the Board to the Board of Nursing Fund.</text> </level> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <level label="i"> <text>The Board of Nursing Fund is a continuing, nonlapsing fund, not subject to § 7–302 of the State Finance and Procurement Article.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="3"> <text>No other State money may be used to support the Board of Nursing Fund.</text> </level> </level> <level label="f"> <level label="1"> <text>The Chairman of the Board or the designee of the Chairman shall administer the Board of Nursing Fund.</text> </level> <level label="2"> <text>Money in the Board of Nursing Fund may be expended only for any lawful purpose authorized by the provisions of this title.</text> </level> </level> <level label="g"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-207" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-208" title_number="8" title_name="Nurses" subtitle_number="2" subtitle_name="State Board of Nursing"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“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.</text> </level> <level label="3"> <text>“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.</text> </level> <level label="4"> <text>“Program” means the safe practice program.</text> </level> <level label="5"> <text>“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.</text> </level> </level> <level label="b"> <level label="1"> <text>There is a Safe Practice Committee in the Board.</text> </level> <level label="2"> <text>The Board may create one or more safe practice committees.</text> </level> </level> <level label="c"> <level label="1"> <text>The Committee shall consist of 6 members.</text> </level> <level label="2"> <text>Of the 6 Committee members:</text> <level label="i"> <text>3 shall be licensed registered nurses, who have demonstrated expertise in the field of substance use disorders or psychiatric nursing;</text> </level> <level label="ii"> <text>1 shall be a registered nurse, who has demonstrated expertise in the area of pain management;</text> </level> <level label="iii"> <text>1 shall be a licensed practical nurse; and</text> </level> <level label="iv"> <text>1 shall be a consumer member, who is knowledgeable in the field of substance use disorders.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>The Board shall determine the term of a member of the Committee.</text> </level> <level label="2"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="3"> <text>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.</text> </level> <level label="4"> <text>The Board may remove a Committee member for incompetence or misconduct.</text> </level> </level> <level label="e"> <level label="1"> <text>The Committee shall elect a chairperson and a vice–chairperson.</text> </level> <level label="2"> <text>The manner of election of officers shall be as the Committee determines.</text> </level> </level> <level label="f"> <text>A majority of the members then serving on the Committee is a quorum.</text> </level> <level label="g"> <text>The Committee shall determine the times and places of its meetings.</text> </level> <level label="h"> <text>Each member of the Committee is entitled to:</text> <level label="1"> <text>Compensation in accordance with the State budget; and</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> <level label="i"> <text>The Board may employ a staff to carry out the activities of the Committee in accordance with the State budget.</text> </level> <level label="j"> <text>In addition to the powers set forth elsewhere in this subtitle, the Committee may:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>Receive and review information concerning a participant in the program;</text> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>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.</text> </level> </level> <level label="k"> <text>In addition to the duties set forth elsewhere in this subtitle, the Committee shall:</text> <level label="1"> <text>Prepare reports to be submitted to the Board; and</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="l"> <text>The Committee shall inform each licensee, certificate holder, or applicant who requests participation in the program of:</text> <level label="1"> <text>The procedures followed in the program;</text> </level> <level label="2"> <text>The rights and responsibilities of a participant in the program; and</text> </level> <level label="3"> <text>The possible results of noncompliance with the program.</text> </level> </level> <level label="m"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>Any failure to comply with the conditions of a plan or agreement may result in the participant being expelled from the program.</text> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The program shall transfer to the Board all records of any participant expelled from the program.</text> </level> </level> <level label="4"> <text>If a participant is expelled from the program, the Board may:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Summarily suspend the license or certificate of any licensee or certificate holder in accordance with Title 10, Subtitle 2 of the State Government Article.</text> </level> </level> </level> <level label="n"> <text>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.</text> </level> <level label="o"> <text>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.</text> </level> <level label="p"> <text>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.</text> </level> <level label="q"> <level label="1"> <text>The Committee shall submit to the Board a report each year and at the request of the Board.</text> </level> <level label="2"> <text>The reports shall include:</text> <level label="i"> <text>Information concerning the number of cases accepted, denied, or terminated with compliance or noncompliance; and</text> </level> <level label="ii"> <text>A cost analysis of the program.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-301" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>Subsections (a), (b), and (c) of this section do not apply to:</text> <level label="1"> <text>A student enrolled in an approved education program while practicing registered nursing or licensed practical nursing in that program;</text> </level> <level label="2"> <text>A student enrolled in a graduate level accredited program for advanced practice registered nursing while practicing advanced practice registered nursing in that program;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>An individual permitted to practice registered nursing or licensed practical nursing under rules and regulations adopted by the Board, if the individual:</text> <level label="i"> <text>Otherwise has qualified to practice registered nursing or licensed practical nursing in any other state or country and is in this State temporarily; or</text> </level> <level label="ii"> <level label="1"> <text>Has an application for a license pending before the Board; and</text> </level> <level label="2"> <level label="A"> <text>Has not taken the examination required under this title;</text> </level> </level> <level label="B"> <text>Has taken an examination under this title, but the results of the examination are not yet known;</text> </level> <level label="C"> <text>Has taken and passed an examination under this title, but is waiting for the completion of the criminal history records check; or</text> </level> <level label="D"> <text>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;</text> </level> </level> </level> <level label="5"> <text>An individual permitted to practice advanced practice registered nursing under rules and regulations adopted by the Board;</text> </level> <level label="6"> <text>An individual who provides gratuitous care for friends, domestic partners, or family members; or</text> </level> <level label="7"> <text>An individual who responds to a disaster situation in this State to practice registered nursing or licensed practical nursing, if:</text> <level label="i"> <text>The individual has an active unencumbered license to practice registered nursing or licensed practical nursing in another state and the individual is assigned by:</text> <level label="1"> <text>The American Red Cross; or</text> </level> <level label="2"> <text>A member of the Maryland Emergency Management Assistance Compact under § 14–803 of the Public Safety Article;</text> </level> </level> <level label="ii"> <text>The Governor has declared a State of Emergency by Executive Order or proclamation in accordance with § 3–401 of the State Government Article; and</text> </level> <level label="iii"> <text>The individual reports to the designated staging area in accordance with § 14–803(2)(b)(5)(iv) of the Public Safety Article.</text> </level> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-302" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>An applicant for a license to practice registered nursing shall complete satisfactorily and meet all requirements for a diploma or degree from:</text> <level label="1"> <text>An entry–level registered nursing education program approved by the Board; or</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <text>An applicant for a license to practice licensed practical nursing shall:</text> <level label="1"> <text>Meet all requirements for a high school diploma or its equivalent; and</text> </level> <level label="2"> <text>Complete satisfactorily and meet all requirements for a diploma from:</text> <level label="i"> <text>A licensed practical nursing education program or its equivalent approved by the Board; or</text> </level> <level label="ii"> <text>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.</text> </level> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>Acceptable proof of proficiency in the communication of the English language under this section includes:</text> <level label="i"> <text>After at least 3 years of enrollment, graduation from a recognized English–speaking undergraduate school;</text> </level> <level label="ii"> <text>Graduation from a recognized English–speaking professional school;</text> </level> <level label="iii"> <text>Completion of at least 5 years of practicing nursing in another state or English–speaking territory of the United States;</text> </level> <level label="iv"> <text>Passing an English proficiency exam approved by the U.S. Department of Health and Human Services; or</text> </level> <level label="v"> <text>Holding a valid, unencumbered multistate license under the Nurse Licensure Compact.</text> </level> </level> <level label="3"> <text>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.</text> </level> <level label="4"> <text>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.</text> </level> <level label="5"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> </level> </level> </level> <level label="f"> <text>An applicant for a license under this section shall be of good moral character.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-302.1" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>Except as otherwise provided in this title, to qualify for advanced practice certification, an applicant shall:</text> <level label="1"> <text>Be of good moral character;</text> </level> <level label="2"> <text>Submit to a criminal history records check in accordance with § 8–303 of this subtitle; and</text> </level> <level label="3"> <text>Meet the requirements of this section.</text> </level> </level> <level label="b"> <text>An applicant for certification as an advanced practice registered nurse shall:</text> <level label="1"> <level label="i"> <text>Be a registered nurse; or</text> </level> <level label="ii"> <text>Have a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact;</text> </level> </level> <level label="2"> <text>Complete an education program approved by the Board;</text> </level> <level label="3"> <text>Submit to the Board:</text> <level label="i"> <text>A completed application for certification as an advanced practice registered nurse for each area in which certification is sought;</text> </level> <level label="ii"> <text>Documentation of:</text> <level label="1"> <text>An active license in good standing as a registered nurse in the State; or</text> </level> <level label="2"> <text>A multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact;</text> </level> </level> <level label="iii"> <text>Documentation that the applicant has graduated from a graduate level accredited program for advanced practice registered nursing; and</text> </level> <level label="iv"> <text>Documentation of certification as an advanced practice registered nurse by a national certifying body recognized by the Board;</text> </level> </level> <level label="4"> <text>Meet the English language competency requirements under § 8–302(e) of this subtitle; and</text> </level> <level label="5"> <text>Meet any other requirements set by the Board.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <level label="1"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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:</text> <level label="1"> <text>Is 2 years; and</text> </level> <level label="2"> <text>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.</text> </level> </level> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-302.2" title_number="8" title_name="Nurses" subtitle_number="3"> <text>The Board shall require a criminal history records check in accordance with § 8–303 of this subtitle for:</text> <level label="1"> <text>Applicants for certification as a forensic nurse examiner;</text> </level> <level label="2"> <text>Applicants for certification as a workers’ compensation case manager;</text> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-303" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>In this section, “Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.</text> </level> <level label="b"> <text>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:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>The fee authorized under § 10–221(b)(7) of the Criminal Procedure Article for access to Maryland criminal history records; and</text> </level> <level label="3"> <text>The mandatory processing fee required by the Federal Bureau of Investigation for a national criminal history records check.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The Board shall notify each applicant that:</text> <level label="i"> <text>The applicant’s fingerprints will be retained by the Central Repository; and</text> </level> <level label="ii"> <text>All new and additional criminal information will be reported to the Board.</text> </level> </level> <level label="3"> <text>The Board may enter into an agreement with the Central Repository and the Federal Bureau of Investigation to carry out this subsection.</text> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>Information obtained from the Central Repository under this section:</text> <level label="1"> <text>Is confidential;</text> </level> <level label="2"> <text>May not be redisseminated; and</text> </level> <level label="3"> <text>May be used only for the licensing purpose authorized by this title.</text> </level> </level> <level label="g"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-304" title_number="8" title_name="Nurses" subtitle_number="3"> <text>To apply for a license to practice registered nursing or licensed practical nursing, an applicant shall:</text> <level label="1"> <text>Submit to a criminal history records check in accordance with § 8–303 of this subtitle;</text> </level> <level label="2"> <text>Submit to the Board:</text> <level label="i"> <text>An application on the form that the Board requires, including a current address;</text> </level> <level label="ii"> <text>Written, verified evidence that the requirement of item (1) of this section is being met or has been met;</text> </level> <level label="iii"> <text>Written, verified evidence of completion of the appropriate education requirements of § 8–302 of this subtitle; and</text> </level> <level label="iv"> <text>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</text> </level> </level> <level label="3"> <text>Pay to the Board the application fee set by the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-305" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>In this subsection, “preceptorship program” means:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>A nursing review course approved by the Board; or</text> </level> <level label="ii"> <text>A preceptorship program approved by the Board.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-306" title_number="8" title_name="Nurses" subtitle_number="3"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-307" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board may issue a license by endorsement under this section only if the applicant:</text> <level label="1"> <text>Submits to the Board an application on the form that the Board requires;</text> </level> <level label="2"> <text>Submits to a criminal history records check in accordance with § 8–303 of this subtitle;</text> </level> <level label="3"> <text>Pays the application fee set by the Board under § 8–304 of this subtitle; and</text> </level> <level label="4"> <level label="i"> <level label="1"> <text>Holds a valid, unencumbered multistate license under the Nurse Licensure Compact; or</text> </level> <level label="2"> <text>Except as provided in subsection (c) of this section, provides adequate evidence that:</text> </level> <level label="A"> <text>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;</text> </level> <level label="B"> <text>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</text> </level> </level> <level label="ii"> <text>Meets the qualifications otherwise required by this title.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>An applicant may qualify for licensure as a registered nurse by endorsement if the applicant has:</text> <level label="i"> <text>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:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>Approved by the board of nursing or other applicable state regulator in the state in which the program is located; and</text> </level> </level> <level label="ii"> <text>Completed a minimum number of direct patient care practice hours as required by regulations adopted by the Board.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-308" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>Subject to subsection (c) of this section, the Board shall license any applicant who meets the requirements for a license as:</text> <level label="1"> <text>A registered nurse under this title; or</text> </level> <level label="2"> <text>A licensed practical nurse under this title.</text> </level> </level> <level label="b"> <level label="1"> <text>The Board shall:</text> <level label="i"> <text>Issue each new licensee a license number and registration certificate that indicates that the initial license was issued by the Board; and</text> </level> <level label="ii"> <text>Electronically record each license in the Board’s database and on the Board’s Web site.</text> </level> </level> <level label="2"> <text>Each license shall include:</text> <level label="i"> <text>Any expiration date;</text> </level> <level label="ii"> <text>The type of license; and</text> </level> <level label="iii"> <text>Any certification.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The Board may grant a 90–day extension of a temporary license pending receipt of criminal history record information.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-309" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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:</text> <level label="1"> <level label="i"> <text>Has not satisfactorily completed 1,000 hours of active nursing practice within the 5–year period immediately preceding the date of anticipated renewal;</text> </level> <level label="ii"> <text>Chooses inactive status; or</text> </level> <level label="iii"> <text>Submits documentation of a medical condition that the Board determines will prevent the licensee from practicing as a registered nurse or licensed practical nurse;</text> </level> </level> <level label="2"> <level label="i"> <text>Completes the biennial application for inactive status; and</text> </level> <level label="ii"> <text>If applicable, provides documentation of a continuing medical condition; and</text> </level> </level> <level label="3"> <text>Pays the applicable fees as required by the Board.</text> </level> </level> <level label="c"> <text>A licensee on inactive status may not practice nursing in this State, but:</text> <level label="1"> <text>A registered nurse on inactive status may use the title “Registered Nurse”, or the abbreviation “RN”; and</text> </level> <level label="2"> <text>A practical nurse on inactive status may use the title “Licensed Practical Nurse”, or the abbreviation “LPN”.</text> </level> </level> <level label="d"> <level label="1"> <text>A licensee on inactive status may apply for reactivation of the license to practice nursing if the licensee:</text> <level label="i"> <text>Meets the renewal requirements of § 8–312 of this subtitle; and</text> </level> <level label="ii"> <text>If applicable, submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists.</text> </level> </level> <level label="2"> <text>If a licensee meets the requirements of paragraph (1) of this subsection, the Board shall:</text> <level label="i"> <text>Record the status of the licensee as active in the Board’s database and on the Board’s Web site; and</text> </level> <level label="ii"> <text>Reactivate the licensee’s license to practice nursing in this State.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>If a licensee is granted inactive status because of a medical condition, the inactive status:</text> <level label="i"> <text>May not be considered a disciplinary action under § 8–316 of this subtitle; and</text> </level> <level label="ii"> <text>May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-310" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>A license to practice registered nursing authorizes the licensee to practice registered nursing while the license is effective.</text> </level> <level label="b"> <text>A licensee may practice registered nursing using only the name in which the license has been issued.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-311" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <level label="1"> <text>The licensed practical nurse is a recognized member of the health professional team and performs an integral part of nursing.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>A licensed practical nurse may teach or supervise commensurate with the education and demonstrated competencies of the licensed practical nurse.</text> </level> <level label="e"> <text>A licensed practical nurse may practice practical nursing using only the name in which the license has been issued.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-312" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <level label="1"> <text>At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:</text> <level label="i"> <text>First–class mail to the last known mailing address of the licensee; or</text> </level> <level label="ii"> <text>Electronic means to the last known electronic address of the licensee.</text> </level> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <text>Before a license expires, the licensee periodically may renew it for an additional term, if the licensee:</text> <level label="1"> <text>Otherwise is entitled to be licensed;</text> </level> <level label="2"> <text>Pays to the Board:</text> <level label="i"> <text>A renewal fee set by the Board; or</text> </level> <level label="ii"> <text>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</text> </level> </level> <level label="3"> <text>Submits to the Board by paper application or electronic means:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Satisfactory evidence of completion of:</text> <level label="1"> <text>1,000 hours of active nursing practice within the 5–year period immediately preceding the date of renewal;</text> </level> <level label="2"> <text>A course of instruction, commonly known as a refresher course, approved by the Board;</text> </level> <level label="3"> <text>A preceptorship program provided by an employer and approved by the Board; or</text> </level> <level label="4"> <text>A minimum number of continuing education units as required by regulations adopted by the Board.</text> </level> </level> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="f"> <level label="1"> <text>Subject to subsection (g) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.</text> </level> <level label="2"> <text>A volunteer’s license issued under subsection (c)(2)(ii) of this section shall be clearly designated as a volunteer’s license.</text> </level> </level> <level label="g"> <level label="1"> <level label="i"> <text>A criminal history records check is required in accordance with § 8–303 of this subtitle on:</text> <level label="1"> <text>Selected annual renewal applicants as determined by regulations adopted by the Board; and</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="ii"> <text>An additional criminal history records check shall be performed every 12 years thereafter.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-313" title_number="8" title_name="Nurses" subtitle_number="3"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-314" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board may require terms and conditions on an agreement with the licensee to accept surrender of the license.</text> </level> <level label="c"> <text>An agreement to accept the surrender of a license is a final order of the Board and is a public record.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-315" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>The Board may issue a temporary license to any applicant who:</text> <level label="1"> <text>Submits to a criminal history records check in accordance with § 8–303 of this subtitle;</text> </level> <level label="2"> <level label="i"> <text>Is licensed by any other state; or</text> </level> <level label="ii"> <text>Has taken and passed an examination under this title, but is waiting for the completion of the criminal history records check;</text> </level> </level> <level label="3"> <text>Submits to the Board:</text> <level label="i"> <text>An application on the form required by the Board;</text> </level> <level label="ii"> <text>Written, verified evidence that the requirement of item (1) of this subsection is being met; and</text> </level> <level label="iii"> <text>Any other document required by the Board; and</text> </level> </level> <level label="4"> <text>Pays the fee required by the Board.</text> </level> </level> <level label="b"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <level label="1"> <text>A temporary license may not be renewed.</text> </level> <level label="2"> <text>Unless the Board suspends or revokes a temporary license, each temporary license expires 90 days after the date of issue.</text> </level> <level label="3"> <text>A temporary license may be extended up to an additional 90 days if the applicant is awaiting the completion of criminal history record information.</text> </level> <level label="4"> <text>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.</text> </level> </level> <level label="d"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-316" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a license;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Willfully and knowingly:</text> <level label="i"> <text>Files a false report or record of an individual under the licensee’s care;</text> </level> <level label="ii"> <text>Gives any false or misleading information about a material matter in an employment application;</text> </level> <level label="iii"> <text>Fails to file or record any health record that is required by law;</text> </level> <level label="iv"> <text>Obstructs the filing or recording of any health record as required by law; or</text> </level> <level label="v"> <text>Induces another individual to fail to file or record any health record as required by law;</text> </level> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>Provides professional services while:</text> <level label="i"> <text>Under the influence of alcohol; or</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="8"> <text>Does an act that is inconsistent with generally accepted professional standards in the practice of registered nursing or licensed practical nursing;</text> </level> <level label="9"> <text>Is grossly negligent in the practice of registered nursing or licensed practical nursing;</text> </level> <level label="10"> <text>Has violated any provision of this title;</text> </level> <level label="11"> <text>Submits a false statement to collect a fee;</text> </level> <level label="12"> <text>Is physically or mentally incompetent;</text> </level> <level label="13"> <text>Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;</text> </level> <level label="14"> <text>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;</text> </level> <level label="15"> <text>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;</text> </level> <level label="16"> <text>Is in independent practice and fails to display the notice required under § 8–506 of this title;</text> </level> <level label="17"> <text>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;</text> </level> <level label="18"> <text>Has a substance use disorder;</text> </level> <level label="19"> <text>Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;</text> </level> <level label="20"> <text>Fails to cooperate with a lawful investigation conducted by the Board;</text> </level> <level label="21"> <text>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;</text> </level> <level label="22"> <text>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;</text> </level> <level label="23"> <text>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;</text> </level> <level label="24"> <text>Fails to properly supervise individuals to whom nursing acts or responsibilities have been delegated;</text> </level> <level label="25"> <text>Engages in conduct that violates the professional code of ethics;</text> </level> <level label="26"> <text>Is professionally incompetent;</text> </level> <level label="27"> <text>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;</text> </level> <level label="28"> <text>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;</text> </level> <level label="29"> <text>Practices registered nursing or licensed practical nursing on a nonrenewed license for a period of 16 months or longer;</text> </level> <level label="30"> <text>Violates regulations adopted by the Board or an order from the Board;</text> </level> <level label="31"> <text>Performs an act that is beyond the licensee’s knowledge and skills;</text> </level> <level label="32"> <text>Fails to submit to a criminal history records check in accordance with § 8–303 of this subtitle;</text> </level> <level label="33"> <text>When acting in a supervisory position, directs another nurse to perform an act that is beyond the nurse’s knowledge and skills;</text> </level> <level label="34"> <text>When acting in a supervisory position, directs another nurse to delegate a nursing task to an individual when that nurse reasonably believes:</text> <level label="i"> <text>The individual lacks the knowledge and skills to perform the task; or</text> </level> <level label="ii"> <text>The patient’s condition does not allow delegation of the nursing task;</text> </level> </level> <level label="35"> <text>Has misappropriated the property of a patient or a facility; or</text> </level> <level label="36"> <text>Fails to comply with § 1–223 of this article.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-317" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>The person may be represented at the hearing by counsel.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="g"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The Board may disclose an advisory letter issued under this subsection to the public.</text> </level> <level label="3"> <text>The issuance of an advisory letter under this subsection may not:</text> <level label="i"> <text>Be considered a disciplinary action under § 8–316 of this subtitle; and</text> </level> <level label="ii"> <text>Be reported to any licensing entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-318" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>A Board decision may not be stayed while judicial review is pending.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-319" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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:</text> <level label="1"> <text>Applies to the Board for reinstatement;</text> </level> <level label="2"> <text>Meets the requirements for renewal under § 8–312 of this subtitle;</text> </level> <level label="3"> <text>Meets any other requirements for reinstatement as established by the Board; and</text> </level> <level label="4"> <text>Submits to a criminal history records check in accordance with § 8–303 of this subtitle.</text> </level> </level> <level label="b"> <text>If a licensee meets the requirements of subsection (a) of this section, the Board may:</text> <level label="1"> <text>Reinstate the license;</text> </level> <level label="2"> <text>Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or</text> </level> <level label="3"> <text>Deny reinstatement of the license.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-320" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-321" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-322" title_number="8" title_name="Nurses" subtitle_number="3"> <level label="a"> <text>The authority of the Board established under this subtitle:</text> <level label="1"> <text>Vests with the Board at the time an individual applies for licensure or to practice under the multistate licensing privilege;</text> </level> <level label="2"> <text>Continues during periods of licensure; and</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-401" title_number="8" title_name="Nurses" subtitle_number="4" subtitle_name="Approved Nursing Education Programs"> <level label="a"> <text>The Board may approve any registered nursing or licensed practical nursing education program at an institution in this State.</text> </level> <level label="b"> <text>The Board shall:</text> <level label="1"> <text>Keep a list of institutions in this State that currently have an approved registered nursing or licensed practical nursing education program;</text> </level> <level label="2"> <text>Set standards for approval of education programs for registered nurses and licensed practical nurses at institutions in this State;</text> </level> <level label="3"> <text>Determine the Maryland passing rate for the national nurse licensure examination each year;</text> </level> <level label="4"> <text>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</text> </level> <level label="5"> <text>Survey approved nursing education programs as it considers necessary.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-402" title_number="8" title_name="Nurses" subtitle_number="4" subtitle_name="Approved Nursing Education Programs"> <text>Before an institution conducts a registered nursing or licensed practical nursing education program in this State, the institution shall obtain approval from:</text> <level label="1"> <text>The Board by submitting evidence that it is prepared to:</text> <level label="i"> <text>Carry out a program in registered nursing education or licensed practical nursing education; and</text> </level> <level label="ii"> <text>Meet the standards established by the Board under this title; and</text> </level> </level> <level label="2"> <text>The appropriate State education board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-403" title_number="8" title_name="Nurses" subtitle_number="4" subtitle_name="Approved Nursing Education Programs"> <level label="a"> <text>The Board shall have its representatives survey:</text> <level label="1"> <text>Each registered nursing and licensed practical nursing program when the program is first established in this State; and</text> </level> <level label="2"> <text>From time to time, each existing registered nursing and licensed practical nursing program in this State.</text> </level> </level> <level label="b"> <text>The representatives who make the survey shall submit a written report to the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-404" title_number="8" title_name="Nurses" subtitle_number="4" subtitle_name="Approved Nursing Education Programs"> <level label="a"> <text>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.</text> </level> <level label="b"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-501" title_number="8" title_name="Nurses" subtitle_number="5"> <text>The Board shall evaluate continuously master planning by other agencies that may affect nursing practice in this State.</text> </section> <section article="gho" article_name="Health Occupations" number="8-502" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>The Board shall appoint or recognize specific task advisory committees.</text> </level> <level label="b"> <text>Each advisory committee consists of at least three members appointed by the Board.</text> </level> <level label="c"> <text>Each committee member shall have expertise in the specific problem or area of nursing practice that is under investigation.</text> </level> <level label="d"> <text>Each member of a committee is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> <level label="e"> <text>Each advisory committee shall:</text> <level label="1"> <text>Help the Board to forecast directions in nursing practice;</text> </level> <level label="2"> <text>Help the Board evaluate the impact of identified issues on nursing practice; and</text> </level> <level label="3"> <text>Make recommendations to the Board when appropriate.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-503" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A member of a peer advisory committee is entitled to receive:</text> <level label="1"> <text>Compensation, as determined by the Board; and</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-504" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <level label="1"> <text>In this section, “employer” means:</text> <level label="i"> <text>A public employer;</text> </level> <level label="ii"> <text>A private employer; or</text> </level> <level label="iii"> <text>An employment agency.</text> </level> </level> <level label="2"> <text>“Employer” does not include a private employer who employs a licensee for personal or family use.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-505" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>Except as provided in subsection (b) of this section, the following applies:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <text>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:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>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</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-508" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Midwife” means a registered nurse certified as a nurse–midwife or a licensed certified midwife.</text> </level> <level label="3"> <text>“Nurse practitioner” means a registered nurse who is:</text> <level label="i"> <text>Certified as a nurse practitioner; and</text> </level> <level label="ii"> <text>Authorized to prescribe drugs under regulations adopted by the Board.</text> </level> </level> <level label="4"> <text>“Personally prepare and dispense” means that a nurse practitioner:</text> <level label="i"> <text>Is physically present on the premises where the prescription is filled; and</text> </level> <level label="ii"> <text>Performs a final check of the prescription before it is provided to the patient.</text> </level> </level> <level label="5"> <text>“Starter dosage” means an amount of drug sufficient to begin therapy:</text> <level label="i"> <text>Of short duration of 72 hours or less; or</text> </level> <level label="ii"> <text>Prior to obtaining a larger quantity of the drug to complete therapy.</text> </level> </level> </level> <level label="b"> <text>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:</text> <level label="1"> <text>The starter dosage complies with the labeling requirements of § 12–505 of this article;</text> </level> <level label="2"> <text>No charge is made for the starter dosage; and</text> </level> <level label="3"> <text>The nurse practitioner or midwife enters an appropriate record in the patient’s medical record.</text> </level> </level> <level label="c"> <text>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:</text> <level label="1"> <text>A medical facility or clinic that specializes in the treatment of medical cases reimbursable through workers’ compensation insurance;</text> </level> <level label="2"> <text>A medical facility or clinic that is operated on a nonprofit basis;</text> </level> <level label="3"> <text>A health center that operates on a campus of an institution of higher education;</text> </level> <level label="4"> <text>A public health facility, a medical facility under contract with a State or local health department, or a facility funded with public funds; or</text> </level> <level label="5"> <text>A nonprofit hospital or a nonprofit hospital outpatient facility as authorized under the policies established by the hospital.</text> </level> </level> <level label="d"> <text>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:</text> <level label="1"> <text>Comply with the labeling requirements of § 12–505 of this article;</text> </level> <level label="2"> <text>Record the dispensing of the prescription drug on the patient’s chart;</text> </level> <level label="3"> <text>Allow the Office of Controlled Substances Administration to enter and inspect the nurse practitioner’s office at all reasonable hours; and</text> </level> <level label="4"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-509" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>In this section, “law enforcement agency” includes:</text> <level label="1"> <text>A State, county, or municipal police department or agency;</text> </level> <level label="2"> <text>A sheriff’s office;</text> </level> <level label="3"> <text>A State’s Attorney’s office; and</text> </level> <level label="4"> <text>The Office of the Attorney General.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-510" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A demonstration study enables the Board, in a controlled practice setting, to determine:</text> <level label="1"> <text>The safety of the proposed practice or activity; and</text> </level> <level label="2"> <text>The appropriate education or training requirements for a proposed practice or activity.</text> </level> </level> <level label="c"> <level label="1"> <text>The Board shall:</text> <level label="i"> <text>Approve the demonstration study design; and</text> </level> <level label="ii"> <text>Select the testing facilities.</text> </level> </level> <level label="2"> <text>The Board may waive selected nursing practice requirements during a demonstration study.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-511" title_number="8" title_name="Nurses" subtitle_number="5"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-512" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Authorized prescriber” means a licensed registered nurse, licensed dentist, licensed physician, licensed physician’s assistant, licensed podiatrist, or other individual authorized by law to prescribe prescription or nonprescription drugs or devices.</text> </level> <level label="3"> <level label="i"> <text>“Device” means an item used in the diagnosis, treatment, or prevention of disease.</text> </level> <level label="ii"> <text>“Device” does not include:</text> <level label="1"> <text>Surgical or dental instruments;</text> </level> <level label="2"> <text>Physical therapy equipment;</text> </level> <level label="3"> <text>X–ray apparatuses; or</text> </level> <level label="4"> <text>Component parts of or accessories for any of the items described in items 1 through 3 of this subparagraph.</text> </level> </level> </level> <level label="4"> <level label="i"> <text>“Dispense” means a procedure that results in the receipt of a drug or device by a patient or a patient’s agent.</text> </level> <level label="ii"> <text>“Dispense” includes:</text> <level label="1"> <text>Interpreting an authorized prescriber’s prescription for a drug or device;</text> </level> <level label="2"> <text>Selecting and labeling the drug or device prescribed;</text> </level> <level label="3"> <text>Measuring and packaging the drug or device in accordance with State and federal law; and</text> </level> <level label="4"> <text>Documenting the transaction in the patient’s medical record.</text> </level> </level> </level> <level label="5"> <text>“Drug” means, unless the context requires otherwise, a prescription or nonprescription drug.</text> </level> <level label="6"> <text>“Formulary” means a list of drugs and devices.</text> </level> <level label="7"> <text>“Nonprescription drug or device” means a drug or device that:</text> <level label="i"> <text>May be sold without a prescription; and</text> </level> <level label="ii"> <text>Is labeled for use by a consumer in accordance with State and federal law.</text> </level> </level> <level label="8"> <text>“Personally prepare and dispense” means to:</text> <level label="i"> <text>Physically prepare a prescription;</text> </level> <level label="ii"> <text>Perform a final check of the prescription before dispensing it to a patient; and</text> </level> <level label="iii"> <text>Not delegate any step of the dispensing process.</text> </level> </level> <level label="9"> <text>“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.</text> </level> </level> <level label="b"> <text>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:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>To patients in need of communicable disease, alcohol and drug abuse, family planning, or reproductive health services.</text> </level> </level> <level label="c"> <text>A registered nurse may personally prepare and dispense drugs and devices or provide, without a prescription, nonprescription drugs and devices if the registered nurse:</text> <level label="1"> <text>Complies with the formulary developed and approved under § 3–403(b) of the Health – General Article;</text> </level> <level label="2"> <text>Has successfully completed a training program administered by the Department in accordance with § 3–405 of the Health – General Article;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>Complies with drug and device storage and inventory procedures in accordance with Department policy; and</text> </level> <level label="5"> <text>For a prescription drug or device, has received a prescription from an authorized prescriber employed at a local health department.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-513" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>In this section, “perioperative assessment and management” means the assessment and management of a patient preoperatively, intraoperatively, and postoperatively.</text> </level> <level label="b"> <level label="1"> <text>A nurse anesthetist may perform the following functions:</text> <level label="i"> <text>Perioperative assessment and management of patients requiring anesthesia services;</text> </level> <level label="ii"> <text>Administration of anesthetic agents;</text> </level> <level label="iii"> <text>Management of fluids in intravenous therapy;</text> </level> <level label="iv"> <text>Respiratory care; and</text> </level> <level label="v"> <text>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.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>Unsafe;</text> </level> <level label="ii"> <text>An invalidly prescribed medical act; or</text> </level> <level label="iii"> <text>Beyond the clinical skills of the nurse anesthetist.</text> </level> </level> <level label="3"> <text>Paragraph (1) of this subsection may not be construed to authorize a nurse anesthetist to:</text> <level label="i"> <text>Diagnose a medical condition;</text> </level> <level label="ii"> <text>Provide care that is not consistent with the scope of practice of nurse anesthetists; or</text> </level> <level label="iii"> <text>Provide care for which the nurse anesthetist does not have proper education and experience.</text> </level> </level> <level label="4"> <text>A nurse anesthetist may prescribe drugs under paragraph (1) of this subsection:</text> <level label="i"> <text>Only in an amount that does not exceed a 10–day supply;</text> </level> <level label="ii"> <text>Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and</text> </level> <level label="iii"> <text>Only in connection with the delivery of anesthesia services.</text> </level> </level> </level> <level label="c"> <text>A nurse anesthetist shall collaborate with an anesthesiologist, a licensed physician, or a dentist in the following manner:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and</text> </level> <level label="3"> <text>If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.</text> </level> </level> <level label="d"> <text>The nurse anesthetist shall ensure that a qualified anesthesia provider:</text> <level label="1"> <text>Performs a thorough and complete preanesthetic assessment;</text> </level> <level label="2"> <text>Obtains informed consent for the planned anesthetic intervention from the patient or an individual responsible for the patient; and</text> </level> <level label="3"> <text>Formulates a patient–specific plan for anesthesia care.</text> </level> </level> <level label="e"> <text>The nurse anesthetist as part of the standards of practice shall:</text> <level label="1"> <text>Implement and adjust an anesthesia care plan as needed to adapt to the patient’s response to the anesthesia;</text> </level> <level label="2"> <text>Monitor a patient’s physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;</text> </level> <level label="3"> <text>Enter prompt, complete, and accurate documentation of pertinent information on a patient’s record;</text> </level> <level label="4"> <text>Transfer responsibility for care of a patient to other qualified providers in a manner that ensures continuity of care and patient safety;</text> </level> <level label="5"> <text>Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;</text> </level> <level label="6"> <text>Maintain appropriate infection control standards;</text> </level> <level label="7"> <text>Evaluate anesthesia care to ensure its quality;</text> </level> <level label="8"> <text>Maintain continual competence in anesthesia practice; and</text> </level> <level label="9"> <text>Respect and maintain the basic rights of patients.</text> </level> </level> <level label="f"> <text>This section may not be construed to require a written collaboration agreement between a nurse anesthetist and an anesthesiologist, a physician, or a dentist.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-514" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Clinical nurse specialist” means an individual who:</text> <level label="i"> <level label="1"> <text>Is licensed by the Board to practice registered nursing; or</text> </level> <level label="2"> <text>Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and</text> </level> </level> <level label="ii"> <text>Is certified by the Board to practice as a clinical nurse specialist.</text> </level> </level> <level label="3"> <level label="i"> <text>“Practice as a clinical nurse specialist” means to:</text> <level label="1"> <text>Provide direct care to patients with complex needs;</text> </level> <level label="2"> <text>Act as a consultant to another health care provider as needed;</text> </level> <level label="3"> <text>Conduct health–related research; and</text> </level> <level label="4"> <text>Provide education and guidance for staff nurses.</text> </level> </level> <level label="ii"> <text>“Practice as a clinical nurse specialist” includes:</text> <level label="1"> <text>Ordering, performing, and interpreting laboratory tests;</text> </level> <level label="2"> <text>Ordering diagnostic tests and using the findings or results in the care of patients;</text> </level> <level label="3"> <text>Prescribing drugs and durable medical equipment under regulations adopted by the Board;</text> </level> <level label="4"> <text>Ordering home health and hospice care; and</text> </level> <level label="5"> <text>Initiating, monitoring, and altering appropriate therapies or treatments.</text> </level> </level> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-515" title_number="8" title_name="Nurses" subtitle_number="5"> <level label="a"> <text>Each advanced practice registered nurse practicing as an advanced practice registered nurse in the State shall notify a patient in writing if:</text> <level label="1"> <text>The advanced practice registered nurse does not maintain professional liability insurance coverage; or</text> </level> <level label="2"> <text>The advanced practice registered nurse’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.</text> </level> </level> <level label="b"> <text>The written notification provided to the patient under subsection (a) of this section shall be:</text> <level label="1"> <text>Provided:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>As part of each informed consent obtained before any procedure or operation discussed or offered for the patient’s consideration is performed;</text> </level> </level> <level label="2"> <text>Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and</text> </level> <level label="3"> <text>Retained by the advanced practice registered nurse as part of the advanced practice registered nurse’s patient records.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-601" title_number="8" title_name="Nurses" subtitle_number="6" subtitle_name="Special Nurse Midwife Provisions"> <text>In this subtitle:</text> <level label="1"> <text>“Practice nurse midwifery” means the management and care of essentially normal newborns and of essentially normal women antepartally, intrapartally and postpartally.</text> </level> <level label="2"> <text>“Practice nurse midwifery” includes:</text> <level label="i"> <text>Family planning and well woman reproductive care;</text> </level> <level label="ii"> <text>The prescribing of substances commonly used in the practice of nurse midwifery;</text> </level> <level label="iii"> <text>The prescribing of controlled substances on Schedules II, III, IV, and V commonly used in the practice of nurse midwifery; and</text> </level> <level label="iv"> <text>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:</text> <level label="1"> <text>At a medical facility or clinic that is operated on a nonprofit basis;</text> </level> <level label="2"> <text>At a health center that operates on a campus of an institution of higher education;</text> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>With a starter dosage of a drug as authorized under § 8–508 of this title.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-602" title_number="8" title_name="Nurses" subtitle_number="6" subtitle_name="Special Nurse Midwife Provisions"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-603" title_number="8" title_name="Nurses" subtitle_number="6" subtitle_name="Special Nurse Midwife Provisions"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-604" title_number="8" title_name="Nurses" subtitle_number="6" subtitle_name="Special Nurse Midwife Provisions"> <level label="a"> <text>Each nurse midwife practicing as a nurse midwife in the State shall notify a patient in writing or by written electronic communication if:</text> <level label="1"> <text>The nurse midwife does not maintain professional liability insurance coverage; or</text> </level> <level label="2"> <text>The nurse midwife’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.</text> </level> </level> <level label="b"> <text>The written notification provided to the patient under subsection (a) of this section shall be:</text> <level label="1"> <text>Provided:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>As part of each informed consent obtained before any procedure discussed or offered for the patient’s consideration is performed;</text> </level> </level> <level label="2"> <text>Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and</text> </level> <level label="3"> <text>Retained by the nurse midwife as part of the nurse midwife’s patient records.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-01" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Applicant” means, unless the context requires otherwise:</text> <level label="1"> <text>An individual applying for an initial certificate by examination or endorsement;</text> </level> <level label="2"> <text>A certificate holder applying for renewal of a certificate; or</text> </level> <level label="3"> <text>An individual applying for reinstatement of a certificate in accordance with § 8–6A–10 of this subtitle.</text> </level> </level> <level label="c"> <level label="1"> <text>“Approved dialysis technician training program” means a course of training approved by the Board that:</text> <level label="i"> <text>Prepares the applicant for national certification;</text> </level> <level label="ii"> <text>Meets the requirements of 42 C.F.R. § 494.140(e)(3); and</text> </level> <level label="iii"> <text>Meets the requirements set by the Board in regulation.</text> </level> </level> <level label="2"> <text>“Approved dialysis technician training program” includes the courses required for national certification as:</text> <level label="i"> <text>A Certified Clinical Hemodialysis Technician by the Nephrology Nursing Certification Commission;</text> </level> <level label="ii"> <text>A Clinical Nephrology Technician by the National Nephrology Certification Organization; or</text> </level> <level label="iii"> <text>A Certified Hemodialysis Technician by the Board of Nephrology Examiners Nursing Technology.</text> </level> </level> </level> <level label="d"> <text>“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.</text> </level> <level label="e"> <text>“Approved nursing assistant training program” means a course of training that meets the basic nursing assistant curriculum prescribed and approved by the Board.</text> </level> <level label="f"> <text>“Board” means the State Board of Nursing.</text> </level> <level label="g"> <text>“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.</text> </level> <level label="h"> <text>“Certificate holder” means a certified nursing assistant, dialysis technician, or medication technician who has:</text> <level label="1"> <text>An active certificate;</text> </level> <level label="2"> <text>An inactive certificate;</text> </level> <level label="3"> <text>A temporary certificate;</text> </level> <level label="4"> <text>An expired temporary certificate;</text> </level> <level label="5"> <text>An expired certificate;</text> </level> <level label="6"> <text>A lapsed certificate;</text> </level> <level label="7"> <text>A suspended certificate; or</text> </level> <level label="8"> <text>A certificate subject to a reprimand, probation, or suspension.</text> </level> </level> <level label="i"> <text>“Certified dialysis technician” means an individual who:</text> <level label="1"> <text>Has completed a Board–approved dialysis technician program; and</text> </level> <level label="2"> <text>Is certified by the Board as a dialysis technician.</text> </level> </level> <level label="j"> <text>“Certified medication technician” means an individual who:</text> <level label="1"> <text>Has completed a Board–approved medication technician training program;</text> </level> <level label="2"> <text>Is certified by the Board as a medication technician; and</text> </level> <level label="3"> <text>Subject to regulations adopted by the Board, routinely performs:</text> <level label="i"> <text>Nursing tasks related to the administration of medication, delegated by a registered nurse, licensed practical nurse, or advanced practice nurse; or</text> </level> <level label="ii"> <text>Technical tasks related to the administration of medication delegated by a licensed certified midwife.</text> </level> </level> </level> <level label="k"> <text>“Certified medicine aide” means a certified nursing assistant who has completed a Board–approved course in medication administration.</text> </level> <level label="l"> <text>“Certified nursing assistant”:</text> <level label="1"> <text>Means an individual regardless of title who, for compensation and subject to regulations adopted by the Board, routinely performs:</text> <level label="i"> <text>Nursing tasks delegated by a registered nurse, licensed practical nurse, or advanced practice registered nurse; or</text> </level> <level label="ii"> <text>Technical tasks delegated by a licensed certified midwife; and</text> </level> </level> <level label="2"> <text>Does not include a certified dialysis technician or a certified medication technician.</text> </level> </level> <level label="m"> <text>“Department” means the Maryland Department of Health.</text> </level> <level label="n"> <text>“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.</text> </level> <level label="o"> <text>“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.</text> </level> <level label="p"> <text>“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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-02" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>This subtitle does not apply to an individual who:</text> <level label="1"> <text>Practices a health occupation that the individual is authorized to practice under this article;</text> </level> <level label="2"> <text>Provides for the gratuitous care of friends, domestic partners, or family members;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>Performs nursing assistant tasks as a student while:</text> <level label="i"> <level label="1"> <text>Enrolled in a Board–approved nursing assistant training program; or</text> </level> <level label="2"> <text>Enrolled in an acute care nursing assistant training program; and</text> </level> </level> <level label="ii"> <text>Practicing under the direct supervision of qualified faculty or preceptors;</text> </level> </level> <level label="5"> <text>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;</text> </level> <level label="6"> <text>Performs medication technician tasks as a student while practicing under the direct supervision of qualified faculty;</text> </level> <level label="7"> <text>Performs dialysis technician tasks as a student while under the direct supervision of qualified faculty;</text> </level> <level label="8"> <text>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</text> </level> <level label="9"> <text>Practices as a certified nursing assistant–I for less than 4 months in accordance with 42 C.F.R. § 483.35(d).</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>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:</text> <level label="i"> <text>The assistant performs only tasks that the assistant is trained to perform; and</text> </level> <level label="ii"> <text>The delegating advanced practice registered nurse provides:</text> <level label="1"> <text>Instruction to the assistant on the delegated task; and</text> </level> <level label="2"> <text>On–site supervision of the assistant performing the delegated task.</text> </level> </level> </level> <level label="2"> <text>The Board shall adopt regulations to carry out this subsection, including regulations that:</text> <level label="i"> <text>Provide for the manner in which an advanced practice registered nurse delegates a nursing or other technical task to an assistant;</text> </level> <level label="ii"> <text>Establish limitations on the authority of an advanced practice registered nurse to delegate nursing or other technical tasks to an assistant; and</text> </level> <level label="iii"> <text>Otherwise clarify the scope of this subsection.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>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:</text> <level label="i"> <text>The assistant performs only tasks that the assistant is trained to perform; and</text> </level> <level label="ii"> <text>The delegating licensed certified midwife provides:</text> <level label="1"> <text>Instruction to the assistant on the delegated task; and</text> </level> <level label="2"> <text>On–site supervision of the assistant performing the delegated task.</text> </level> </level> </level> <level label="2"> <text>The Board shall adopt regulations to carry out this subsection, including regulations that:</text> <level label="i"> <text>Provide for the manner in which a licensed certified midwife delegates a technical task to an assistant;</text> </level> <level label="ii"> <text>Establish limitations on the authority of a licensed certified midwife to delegate technical tasks to an assistant; and</text> </level> <level label="iii"> <text>Otherwise clarify the scope of this subsection.</text> </level> </level> </level> <level label="f"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-03" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>An individual shall be certified as a nursing assistant by the Board before the individual may:</text> <level label="1"> <text>Use the title “certified nursing assistant”;</text> </level> <level label="2"> <text>Use the initials “C.N.A.” after the name of the individual; or</text> </level> <level label="3"> <text>Represent to the public that the individual is certified as a nursing assistant.</text> </level> </level> <level label="b"> <text>An individual shall be certified as a medication technician by the Board before the individual may:</text> <level label="1"> <text>Use the title “certified medication technician”;</text> </level> <level label="2"> <text>Use the initials “C.M.T.” after the name of the individual; or</text> </level> <level label="3"> <text>Represent to the public that the individual is certified as a medication technician.</text> </level> </level> <level label="c"> <text>An individual shall be certified as a dialysis technician by the Board before the individual may:</text> <level label="1"> <text>Use the title “certified dialysis technician”;</text> </level> <level label="2"> <text>Use the initials “C.D.T.” after the name of the individual; or</text> </level> <level label="3"> <text>Represent to the public that the individual is a certified dialysis technician.</text> </level> </level> <level label="d"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-04" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <level label="1"> <text>The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.</text> </level> <level label="2"> <text>The Comptroller shall distribute all the fees to the State Board of Nursing Fund established under § 8–206 of this title.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-05" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>The Board, after consultation with relevant stakeholders, shall adopt regulations establishing:</text> <level label="1"> <text>Qualifications for certified nursing assistants, including certified medicine aides;</text> </level> <level label="2"> <text>Qualifications for certified dialysis technicians;</text> </level> <level label="3"> <text>Qualifications for certified medication technicians;</text> </level> <level label="4"> <text>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</text> </level> <level label="5"> <text>Standards for the online provision of didactic instruction in a nursing assistant training program that meets the requirements established by the Board.</text> </level> </level> <level label="b"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="c"> <level label="1"> <text>An applicant for a certificate shall:</text> <level label="i"> <text>Submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="ii"> <text>Submit to the Board:</text> <level label="1"> <text>An application to the Board on the form that the Board requires; and</text> </level> <level label="2"> <text>Written verification that the requirement in item (i) of this paragraph is being or has been met;</text> </level> </level> <level label="iii"> <text>Provide evidence, as required by the Board, of successful completion of:</text> <level label="1"> <text>An approved nursing assistant training program or approved acute care nursing assistant training program;</text> </level> <level label="2"> <text>An approved dialysis technician training program;</text> </level> <level label="3"> <text>An approved course in medication administration; or</text> </level> <level label="4"> <text>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;</text> </level> </level> <level label="iv"> <text>Pay to the Board an application fee set by the Board;</text> </level> <level label="v"> <text>Be of good moral character;</text> </level> <level label="vi"> <text>Be at least 16 years old to apply for certification as a nursing assistant;</text> </level> <level label="vii"> <text>Be at least 18 years old to apply for certification as a dialysis technician; and</text> </level> <level label="viii"> <text>Be at least 18 years old to apply for certification as a medication technician.</text> </level> </level> <level label="2"> <level label="i"> <text>An applicant for certification as a certified nursing assistant shall submit to the Board satisfactory evidence of passing a nursing assistant competency evaluation.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="3"> <text>An applicant for a certificate may not:</text> <level label="i"> <text>Have committed any act or omission that would be grounds for discipline or denial of certification under this subtitle; and</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="4"> <text>Beginning April 1, 2026, a certified nursing assistant–II may be certified as a certified nursing assistant–I by:</text> <level label="i"> <text>Submitting an application to the Board on the form that the Board requires; and</text> </level> <level label="ii"> <text>Providing satisfactory evidence of:</text> <level label="1"> <text>Successful completion of an approved nursing assistant training program; and</text> </level> <level label="2"> <text>Passing a nursing assistant competency evaluation.</text> </level> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-06" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <text>Every applicant for certification by endorsement shall:</text> <level label="1"> <text>Pay the required application fee;</text> </level> <level label="2"> <text>Submit the information required by the Board in the manner and form specified by the Board; and</text> </level> <level label="3"> <text>Submit written evidence that the applicant:</text> <level label="i"> <text>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;</text> </level> <level label="ii"> <text>Has not committed any act or omission that would be grounds for discipline or denial of certification under this subtitle;</text> </level> <level label="iii"> <text>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</text> </level> <level label="iv"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-07" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>Subject to subsection (g) of this section, the Board shall certify any applicant who meets the requirements of this subtitle.</text> </level> <level label="b"> <level label="1"> <text>The Board shall:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Electronically record each certificate in the Board’s database and on the Board’s website.</text> </level> </level> <level label="2"> <text>Each certificate shall include:</text> <level label="i"> <text>Any expiration date;</text> </level> <level label="ii"> <text>The type of certificate; and</text> </level> <level label="iii"> <text>Any specific category of nursing assistant.</text> </level> </level> </level> <level label="c"> <text>An individual who has met the requirements for a certified nursing assistant shall be certified with the title of “certified nursing assistant”.</text> </level> <level label="d"> <text>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”.</text> </level> <level label="e"> <text>An individual who has met the requirements for a certified dialysis technician shall be certified with the title of “certified dialysis technician”.</text> </level> <level label="f"> <text>An individual who has met the requirements for a certified medication technician shall be certified with the title of “certified medication technician”.</text> </level> <level label="g"> <level label="1"> <text>The Board may issue a temporary practice certificate to an applicant who:</text> <level label="i"> <text>Has met the appropriate certification requirements of this subtitle to the satisfaction of the Board; and</text> </level> <level label="ii"> <text>Does not have a criminal record and has not been the subject of a health professional disciplinary action in this State or another jurisdiction.</text> </level> </level> <level label="2"> <text>Unless the Board suspends or revokes a temporary practice certificate, the temporary practice certificate expires 90 days after issuance.</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="h"> <text>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.</text> </level> <level label="i"> <level label="1"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="2"> <text>The Board may not issue a certificate if the criminal history record information required under § 8–303 of this title has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-08" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <level label="1"> <text>At least 3 months before a certificate expires, the Board shall send a renewal notice to the certificate holder by:</text> <level label="i"> <text>First–class mail to the last known mailing address of the certificate holder; or</text> </level> <level label="ii"> <text>Electronic means to the last known electronic address of the certificate holder.</text> </level> </level> <level label="2"> <text>A renewal notice shall state:</text> <level label="i"> <text>The date on which the current certificate expires;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>The amount of the renewal fee.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> <level label="c"> <text>Before a certificate expires, a nursing assistant periodically may renew it for an additional term, if the certificate holder:</text> <level label="1"> <text>Otherwise is entitled to be certified;</text> </level> <level label="2"> <text>Submits to the Board a renewal application on the form that the Board requires;</text> </level> <level label="3"> <text>Pays to the Board a renewal fee set by the Board; and</text> </level> <level label="4"> <text>Provides satisfactory evidence of completion of:</text> <level label="i"> <text>16 hours of active nursing assistant practice within the 2–year period immediately preceding the date of expiration; or</text> </level> <level label="ii"> <text>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.</text> </level> </level> </level> <level label="d"> <text>In addition to the requirements in subsection (c)(1), (2), and (3) of this section, a certified medicine aide shall:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>Successfully complete a Board–approved medicine aide continuing education program.</text> </level> </level> <level label="e"> <text>Before a certificate expires, a dialysis technician periodically may renew it for an additional term, if the certificate holder:</text> <level label="1"> <text>Otherwise is entitled to be certified;</text> </level> <level label="2"> <text>Submits to the Board a renewal application on the form that the Board requires;</text> </level> <level label="3"> <text>Pays to the Board a renewal fee set by the Board;</text> </level> <level label="4"> <text>Has completed:</text> <level label="i"> <level label="1"> <text>16 hours of practice as a dialysis technician in the 2–year period immediately preceding the date of expiration; and</text> </level> <level label="2"> <text>3 hours of continuing education approved by the Board; or</text> </level> </level> <level label="ii"> <text>A dialysis technician training program approved by the Board; and</text> </level> </level> <level label="5"> <text>Has an active national certification listed in § 8–6A–01(c)(2) of this subtitle.</text> </level> </level> <level label="f"> <text>Before a certificate expires, a medication technician periodically may renew it for an additional term, if the certificate holder:</text> <level label="1"> <text>Otherwise is entitled to be certified;</text> </level> <level label="2"> <text>Submits to the Board a renewal application on the form that the Board requires;</text> </level> <level label="3"> <text>Pays to the Board a renewal fee set by the Board;</text> </level> <level label="4"> <text>Every 2 years, provides satisfactory evidence of completion of a Board–approved clinical refresher course; and</text> </level> <level label="5"> <text>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.</text> </level> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <text>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.</text> </level> <level label="i"> <text>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.</text> </level> <level label="j"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="k"> <text>The Board shall pay any penalty collected under this section to the General Fund of the State.</text> </level> <level label="l"> <level label="1"> <level label="i"> <text>The Board shall require criminal history records checks in accordance with § 8–303 of this title on:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="ii"> <text>An additional criminal history records check shall be performed every 12 years thereafter.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the certificate holder poses a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> <level label="m"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Completes the biennial application for inactive status and submits documentation of a continuing medical condition.</text> </level> </level> <level label="3"> <text>A certificate holder on inactive status may apply for reactivation of the certificate if the certificate holder:</text> <level label="i"> <text>Submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists; and</text> </level> <level label="ii"> <text>Meets the renewal requirements of this section.</text> </level> </level> <level label="4"> <text>If a certificate holder meets the requirements of paragraph (3) of this subsection, the Board shall:</text> <level label="i"> <text>Record the status of the certificate holder as active in the Board’s database and on the Board’s website; and</text> </level> <level label="ii"> <text>Reactivate the certificate holder’s certificate to practice as a nursing assistant, dialysis technician, or medication technician in the State.</text> </level> </level> <level label="5"> <text>The Board may not charge a fee to place the certificate holder on or remove the certificate holder from inactive status under this subsection.</text> </level> <level label="6"> <text>Inactive status:</text> <level label="i"> <text>May not be considered a disciplinary action under § 8–6A–10 of this subtitle; and</text> </level> <level label="ii"> <text>May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> <level label="n"> <level label="1"> <text>The Board shall adopt regulations to specify:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="2"> <text>Regulations adopted under paragraph (1) of this subsection must be consistent with federal law.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-09" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board shall pay any penalty collected under this section to the General Fund of the State.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-10" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a certificate for the applicant or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a certificate;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Files a false report or record of an individual under the certificate holder’s care;</text> </level> <level label="6"> <text>Gives any false or misleading information about a material matter in an employment application;</text> </level> <level label="7"> <text>Fails to file or record any health record that is required by law;</text> </level> <level label="8"> <text>Induces another individual to fail to file or record any health record that is required by law;</text> </level> <level label="9"> <text>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;</text> </level> <level label="10"> <text>Provides services as a nursing assistant, dialysis technician, or medication technician while:</text> <level label="i"> <text>Under the influence of alcohol; or</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="11"> <text>Has a substance use disorder;</text> </level> <level label="12"> <text>Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;</text> </level> <level label="13"> <text>Has acted in a manner inconsistent with the health or safety of an individual under the applicant or certificate holder’s care;</text> </level> <level label="14"> <text>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;</text> </level> <level label="15"> <text>Has physically, verbally, or psychologically abused, neglected, or otherwise harmed an individual under the applicant or certificate holder’s care;</text> </level> <level label="16"> <text>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;</text> </level> <level label="17"> <text>Has violated the confidentiality of information or knowledge as prescribed by law concerning any patient;</text> </level> <level label="18"> <text>Has misappropriated patient or facility property;</text> </level> <level label="19"> <text>Performs certified nursing assistant, certified dialysis technician, or certified medication technician functions incompetently;</text> </level> <level label="20"> <text>Has violated any provision of this title or has aided or knowingly permitted any individual to violate any provision of this title;</text> </level> <level label="21"> <text>Submits a false statement to collect a fee;</text> </level> <level label="22"> <text>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;</text> </level> <level label="23"> <text>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;</text> </level> <level label="24"> <text>Fails to cooperate with a lawful investigation conducted by the Board;</text> </level> <level label="25"> <text>Fails to comply with instructions and directions of the supervising registered nurse or licensed practical nurse;</text> </level> <level label="26"> <text>When holding an expired certificate or a lapsed certificate, commits any act that would be grounds for disciplinary action under this section;</text> </level> <level label="27"> <text>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;</text> </level> <level label="28"> <text>Impersonates another individual:</text> <level label="i"> <text>Licensed under the provisions of this title; or</text> </level> <level label="ii"> <text>Who holds a certificate issued under the provisions of this title;</text> </level> </level> <level label="29"> <text>Engages in conduct that violates the code of ethics;</text> </level> <level label="30"> <text>Performs activities that exceed the education and training of the certified nursing assistant, certified dialysis technician, or certified medication technician;</text> </level> <level label="31"> <text>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;</text> </level> <level label="32"> <text>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;</text> </level> <level label="33"> <text>Abandons a patient; or</text> </level> <level label="34"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <level label="1"> <text>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:</text> <level label="i"> <text>Applies to the Board for reinstatement;</text> </level> <level label="ii"> <text>Meets the requirements for renewal under § 8–6A–08 of this subtitle;</text> </level> <level label="iii"> <text>Meets any other requirements for reinstatement as established by the Board in regulations; and</text> </level> <level label="iv"> <text>Submits to a criminal history records check in accordance with § 8–303 of this title.</text> </level> </level> <level label="2"> <text>If a certificate holder meets the requirements of paragraph (1) of this subsection, the Board may:</text> <level label="i"> <text>Reinstate the certificate;</text> </level> <level label="ii"> <text>Reinstate the certificate subject to terms and conditions that the Board considers necessary, including a period of probation; or</text> </level> <level label="iii"> <text>Deny reinstatement of the certificate.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-10.1" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>The individual may be represented at the hearing by counsel.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="g"> <level label="1"> <text>After the Board conducts an investigation under this subtitle, the Board may issue an advisory letter to the certificate holder.</text> </level> <level label="2"> <text>The Board may disclose an advisory letter issued under this subsection to the public.</text> </level> <level label="3"> <text>The issuance of an advisory letter under this subsection:</text> <level label="i"> <text>May not be considered a disciplinary action under § 8–6A–10 of this subtitle; and</text> </level> <level label="ii"> <text>May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-11" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A Board decision may not be stayed while judicial review is pending.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-12" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>An agreement to accept the surrender of a certificate is a final order of the Board and is a public record.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-13" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>The Board shall appoint an advisory committee consisting of at least 17 members.</text> </level> <level label="b"> <text>Of the 17 committee members:</text> <level label="1"> <text>Six shall be nursing assistants:</text> <level label="i"> <text>One shall be an acute care nursing assistant;</text> </level> <level label="ii"> <text>One shall be a home care nursing assistant;</text> </level> <level label="iii"> <text>One shall be a long–term care nursing assistant;</text> </level> <level label="iv"> <text>One shall be an adult medical day care nursing assistant;</text> </level> <level label="v"> <text>At least one of the nursing assistant members shall be a member of a union; and</text> </level> <level label="vi"> <text>One shall be an independent contractor;</text> </level> </level> <level label="2"> <text>Three shall be registered nurses:</text> <level label="i"> <text>One shall be an acute care registered nurse;</text> </level> <level label="ii"> <text>One shall be a home care registered nurse; and</text> </level> <level label="iii"> <text>One shall be a long–term care registered nurse;</text> </level> </level> <level label="3"> <text>Two shall be administrators from licensed health care facilities;</text> </level> <level label="4"> <text>One shall be a licensed practical nurse;</text> </level> <level label="5"> <text>One shall be an individual who teaches a nursing assistant course;</text> </level> <level label="6"> <text>One shall be a consumer member who has received care, or has a family member who has received care from a nursing assistant;</text> </level> <level label="7"> <text>One shall be a representative of the Department;</text> </level> <level label="8"> <text>One shall be a certified medication technician; and</text> </level> <level label="9"> <text>One shall be a certified dialysis technician.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>Each member of the advisory committee must:</text> <level label="1"> <text>Be a citizen of the United States;</text> </level> <level label="2"> <text>Be a resident of the State; and</text> </level> <level label="3"> <text>Have practiced in the member’s health occupation for at least 5 years immediately preceding the member’s appointment.</text> </level> </level> <level label="e"> <level label="1"> <text>The term of an advisory committee member is 4 years.</text> </level> <level label="2"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="3"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member may not serve more than two consecutive full terms.</text> </level> <level label="5"> <text>To the extent practicable, the Board shall fill any vacancy on the advisory committee within 60 days after the date of the vacancy.</text> </level> </level> <level label="f"> <level label="1"> <text>In addition to any other meeting requirements under this title, the advisory committee shall meet:</text> <level label="i"> <text>At least once a month; and</text> </level> <level label="ii"> <text>At the request of the Executive Director of the Board.</text> </level> </level> <level label="2"> <text>A majority of the full membership of the advisory committee is a quorum.</text> </level> </level> <level label="g"> <text>The advisory committee shall:</text> <level label="1"> <text>Evaluate training programs and make recommendations for approval by the Board;</text> </level> <level label="2"> <text>Develop and recommend regulations to enforce the provisions of this subtitle;</text> </level> <level label="3"> <text>Evaluate candidates as required and recommend action to the Board;</text> </level> <level label="4"> <text>Review investigations of complaints against nursing assistants or medication technicians and make recommendations to the Board for disciplinary action;</text> </level> <level label="5"> <text>Keep a record of its proceedings; and</text> </level> <level label="6"> <text>Submit an annual report to the Board.</text> </level> </level> <level label="h"> <text>A member of the advisory committee is entitled to receive:</text> <level label="1"> <text>Compensation, as determined by the Board; and</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.</text> </level> </level> <level label="i"> <text>The Board may remove a member:</text> <level label="1"> <text>For incompetence or misconduct; or</text> </level> <level label="2"> <text>Who is absent from two successive committee meetings without adequate reason.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-14" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board in conjunction with the Department, Maryland Higher Education Commission, and the affected industry shall develop regulations for nursing assistant training programs.</text> </level> <level label="c"> <text>The curriculum content for an approved nursing assistant training program shall include:</text> <level label="1"> <text>Content consistent with State licensing requirements in the Health – General Article and all federal requirements;</text> </level> <level label="2"> <text>All basic skills required of a nursing assistant regardless of the setting of the practice; and</text> </level> <level label="3"> <text>Any skills required for certification in a specific category.</text> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>The Board may make survey visits from time to time, without prior notice, to all certified nursing assistant training programs.</text> </level> <level label="f"> <text>The provisions of this section may not be interpreted to impose additional requirements for geriatric nursing assistants beyond those required under federal law.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-14.1" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6A-15" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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:</text> <level label="1"> <text>Consented to submit to an examination under this section if requested by the Board in writing; and</text> </level> <level label="2"> <text>Waived any legal claim of privilege as to the testimony or examination reports of the examining health care provider.</text> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>The Board shall pay the cost of any examination made in accordance with the provisions of this section.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6A-16" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6A-17" title_number="8" title_name="Nurses" subtitle_number="6A" subtitle_name="Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians"> <level label="a"> <text>The authority of the Board established under this subtitle:</text> <level label="1"> <text>Vests with the Board at the time an individual applies for certification;</text> </level> <level label="2"> <text>Continues during periods of certification; and</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-01" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Applicant” means, unless the context requires otherwise:</text> <level label="1"> <text>An individual applying for an initial license by examination or endorsement;</text> </level> <level label="2"> <text>A licensee applying for renewal of a license; or</text> </level> <level label="3"> <text>An individual applying for reinstatement of a license in accordance with § 8–6B–14 of this subtitle.</text> </level> </level> <level label="c"> <text>“Board” means the State Board of Nursing.</text> </level> <level label="d"> <text>“Committee” means the Electrology Practice Committee.</text> </level> <level label="e"> <text>“Electrologist” means an individual who practices electrology.</text> </level> <level label="f"> <text>“Electrology instructor” means an individual who practices electrology and teaches an electrology education program.</text> </level> <level label="g"> <text>“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.</text> </level> <level label="h"> <text>“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.</text> </level> <level label="i"> <text>“License” means, unless the context requires otherwise, a license issued by the Board:</text> <level label="1"> <text>To practice electrology; or</text> </level> <level label="2"> <text>To practice electrology and teach an electrology education program.</text> </level> </level> <level label="j"> <text>“Licensed electrologist” means, unless the context requires otherwise, an electrologist who is licensed by the Board to practice electrology.</text> </level> <level label="k"> <text>“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.</text> </level> <level label="l"> <text>“Licensee” means, unless the context requires otherwise, a licensed electrologist or licensed electrology instructor who has:</text> <level label="1"> <text>An active license;</text> </level> <level label="2"> <text>An inactive license;</text> </level> <level label="3"> <text>An expired license;</text> </level> <level label="4"> <text>A lapsed license;</text> </level> <level label="5"> <text>A suspended license; or</text> </level> <level label="6"> <text>a license subject to a reprimand, probation, or suspension.</text> </level> </level> <level label="m"> <text>“Practice electrology” means to remove hair permanently through the use of electrical instruments.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-02" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6B-03" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>The Board shall adopt regulations for the licensure of electrologists and for the practice of electrology.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6B-04" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <level label="1"> <text>The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to electrologists.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <level label="1"> <text>The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.</text> </level> <level label="2"> <text>The Comptroller shall distribute all fees to the Board.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-05" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>There is an Electrology Practice Committee within the Board.</text> </level> <level label="b"> <level label="1"> <text>The Committee consists of three members appointed by the Board.</text> </level> <level label="2"> <text>Of the three Committee members:</text> <level label="i"> <text>Two shall be licensed electrologists or licensed electrology instructors; and</text> </level> <level label="ii"> <text>One shall be a consumer member.</text> </level> </level> </level> <level label="c"> <text>Each member of the Committee shall be a citizen of the United States and a resident of the State.</text> </level> <level label="d"> <text>Each electrologist member of the Committee shall have practiced electrology actively in the State for at least 5 years immediately before appointment.</text> </level> <level label="e"> <text>The consumer member of the Committee:</text> <level label="1"> <text>Shall be a member of the general public;</text> </level> <level label="2"> <text>May not be or ever have been:</text> <level label="i"> <text>An electrologist;</text> </level> <level label="ii"> <text>A health care professional; or</text> </level> <level label="iii"> <text>In training to be an electrologist or a health care professional;</text> </level> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>May not:</text> <level label="i"> <text>Participate or ever have participated in a commercial or professional field related to electrology;</text> </level> <level label="ii"> <text>Have a household member who participates in a commercial or professional field related to electrology; or</text> </level> <level label="iii"> <text>Have, or have had within 2 years before appointment, a substantial financial interest in a person regulated by the Board.</text> </level> </level> </level> <level label="f"> <level label="1"> <text>The term of a member is 4 years.</text> </level> <level label="2"> <text>The terms of the members are staggered as required by the provisions for members of the Committee on July 1, 2003.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member may not serve more than two consecutive full terms.</text> </level> <level label="6"> <text>To the extent practicable, the Board shall fill any vacancy on the Committee within 60 days of the date of the vacancy.</text> </level> </level> <level label="g"> <text>A majority of the full authorized membership of the Committee is a quorum.</text> </level> <level label="h"> <text>In addition to any other meeting requirements of this title, the Committee shall meet:</text> <level label="1"> <text>At the request of the executive director of the Board; or</text> </level> <level label="2"> <text>As necessary to conduct Board business.</text> </level> </level> <level label="i"> <text>In accordance with the State budget, each member of the Committee is entitled to:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations.</text> </level> </level> <level label="j"> <level label="1"> <text>The Board may remove a member for incompetence or misconduct.</text> </level> <level label="2"> <text>The Board may remove a member who is absent from two successive Committee meetings without adequate reason.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-06" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>In addition to the powers set forth elsewhere in this subtitle, the Committee shall:</text> <level label="1"> <text>Make recommendations to the Board regarding regulations necessary to carry out the provisions of this subtitle;</text> </level> <level label="2"> <text>Make recommendations to the Board regarding a code of ethics for the practice of electrology;</text> </level> <level label="3"> <text>Make recommendations to the Board regarding the requirements for licensure as an electrologist or an electrology instructor;</text> </level> <level label="4"> <text>Review applications for licensure as an electrologist or electrology instructor and make recommendations to the Board;</text> </level> <level label="5"> <text>Maintain a list of all currently licensed electrologists and electrology instructors;</text> </level> <level label="6"> <text>Make recommendations to the Board regarding continuing education requirements for electrologists;</text> </level> <level label="7"> <text>At the request of the Board, investigate complaints against licensed electrologists;</text> </level> <level label="8"> <text>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;</text> </level> <level label="9"> <text>Review advertising by licensed electrologists and by institutions that offer an electrology program and make recommendations to the Board, as necessary;</text> </level> <level label="10"> <text>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;</text> </level> <level label="11"> <text>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;</text> </level> <level label="12"> <text>Advise the Board on matters relating to the practice of electrology;</text> </level> <level label="13"> <text>Keep a record of its proceedings; and</text> </level> <level label="14"> <text>Submit an annual report to the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-07" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>This section does not apply to a student who is practicing electrology as part of an approved clinical electrology education program.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-08" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The applicant shall be of good moral character.</text> </level> <level label="c"> <text>The applicant shall be at least 18 years old.</text> </level> <level label="d"> <text>Except as otherwise provided in this subtitle, an applicant shall be a high school graduate or have completed equivalent education and have completed satisfactorily:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>An electrology education program in any other state that the Board determines is substantially equivalent to that required by item (1) of this subsection.</text> </level> </level> <level label="e"> <level label="1"> <text>Except as otherwise provided in this subtitle, each applicant shall pass:</text> <level label="i"> <text>An examination approved by the Board; and</text> </level> <level label="ii"> <text>A clinical examination approved by the Board.</text> </level> </level> <level label="2"> <text>Applicants are responsible for scheduling the examinations required under paragraph (1) of this subsection.</text> </level> </level> <level label="f"> <text>In addition to the other requirements of this section, an applicant for an electrology instructor license shall:</text> <level label="1"> <text>Be a licensed electrologist;</text> </level> <level label="2"> <text>Have practiced electrology actively for at least 5 years immediately before the application;</text> </level> <level label="3"> <text>Pass an examination approved by the Board; and</text> </level> <level label="4"> <text>Meet any other requirements set forth in regulations adopted by the Board under § 8–6B–03 of this subtitle.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-09" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>To apply for a license, an applicant shall:</text> <level label="1"> <text>Submit to a criminal history records check in accordance with § 8-303 of this title;</text> </level> <level label="2"> <text>Submit to the Board:</text> <level label="i"> <text>An application on the form that the Board requires;</text> </level> <level label="ii"> <text>Written, verified evidence that the requirement of item (1) of this subsection is being met; and</text> </level> <level label="iii"> <text>Evidence of compliance with the requirements of § 8-6B-08 of this subtitle; and</text> </level> </level> <level label="3"> <text>Pay to the Board a fee set by the Board.</text> </level> </level> <level label="b"> <text>The Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-10" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>An applicant who otherwise qualifies for a license is entitled to be examined as provided in this section.</text> </level> <level label="b"> <text>An applicant shall take a written examination approved by the Board.</text> </level> <level label="c"> <level label="1"> <text>The Board or the Board’s designee shall give clinical examinations to applicants.</text> </level> <level label="2"> <text>The Board or the Board’s designee may give reexaminations to applicants who fail the clinical examination.</text> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>Except as otherwise provided under this subtitle, the Board shall determine the passing score for examinations given under this subtitle.</text> </level> <level label="f"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>An applicant who fails two reexaminations may retake the written examination only if the applicant:</text> <level label="i"> <text>Retakes the entire examination;</text> </level> <level label="ii"> <text>Pays the full examination fee; and</text> </level> <level label="iii"> <text>Completes an education program that the Board requires.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-11" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board may issue a license by endorsement under this section only if the applicant:</text> <level label="1"> <text>Pays the license fee required by the Board; and</text> </level> <level label="2"> <text>Provides adequate evidence that the applicant:</text> <level label="i"> <text>Meets the qualifications otherwise required by this subtitle;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>Became licensed in the other state after meeting requirements that are substantially equivalent to the requirements of this subtitle.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-12" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>Subject to subsection (c) of this section, the Board shall issue a license to any applicant who:</text> <level label="1"> <text>Meets the requirements of this subtitle; and</text> </level> <level label="2"> <text>Pays a license fee set by the Board.</text> </level> </level> <level label="b"> <text>The Board shall include on each license that the Board issues a license designation as:</text> <level label="1"> <text>Licensed electrologist; or</text> </level> <level label="2"> <text>Licensed electrology instructor.</text> </level> </level> <level label="c"> <level label="1"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates that the applicant does not pose a threat to the public health or safety.</text> </level> </level> <level label="2"> <text>The Board may not issue a license if the criminal history record information required under § 8-303 of this title has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-13" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>An electrologist’s license issued under this subtitle authorizes the licensee to practice electrology while the license is effective.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-14" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.</text> </level> <level label="b"> <text>A license may not be renewed for a term longer than 2 years.</text> </level> <level label="c"> <level label="1"> <text>At least 3 months before a license expires, the Board shall send a renewal notice to the licensee, by:</text> <level label="i"> <text>First–class mail to the last known mailing address of the licensee; or</text> </level> <level label="ii"> <text>Electronic means to the last known electronic address of the licensee.</text> </level> </level> <level label="2"> <text>A renewal notice shall state:</text> <level label="i"> <text>The date on which the current license expires;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>The amount of the renewal fee.</text> </level> </level> </level> <level label="d"> <text>Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term, if the licensee:</text> <level label="1"> <text>Otherwise is entitled to be licensed;</text> </level> <level label="2"> <text>Pays to the Board a renewal fee set by the Board; and</text> </level> <level label="3"> <text>Submits to the Board:</text> <level label="i"> <text>A renewal application on the form that the Board requires; and</text> </level> <level label="ii"> <text>Satisfactory evidence of compliance with any continuing education requirement set under this subtitle for license renewal.</text> </level> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>Subject to subsection (k) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.</text> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <level label="1"> <text>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:</text> <level label="i"> <text>An application for inactive status on the form required by the Board;</text> </level> <level label="ii"> <text>If applicable, documentation of a medical condition that the Board determines will prevent the licensee from practicing electrology; and</text> </level> <level label="iii"> <text>If applicable, the inactive status fee set by the Board.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>Complies with any continuing education requirement established by the Board for this purpose;</text> </level> <level label="ii"> <text>If applicable, submits documentation satisfactory to the Board that the medical condition for which the inactive status was granted no longer exists;</text> </level> <level label="iii"> <text>If applicable, pays to the Board a reactivation fee set by the Board; and</text> </level> <level label="iv"> <text>Is otherwise entitled to be licensed.</text> </level> </level> <level label="3"> <text>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.</text> </level> <level label="4"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>If a licensee is granted inactive status because of a medical condition, the inactive status:</text> <level label="1"> <text>May not be considered a disciplinary action under § 8–6B–18 of this subtitle; and</text> </level> <level label="2"> <text>May not be reported to any certifying entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> </level> <level label="i"> <text>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:</text> <level label="1"> <text>Is otherwise entitled to be licensed;</text> </level> <level label="2"> <text>Complies with any continuing education requirement established by the Board for this purpose;</text> </level> <level label="3"> <text>Pays to the Board a reinstatement fee set by the Board;</text> </level> <level label="4"> <text>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</text> </level> <level label="5"> <text>Applies to the Board for reinstatement of the license within 5 years after the license expires.</text> </level> </level> <level label="j"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The electrologist or electrology instructor may become licensed by meeting the current requirements for obtaining a new license under this subtitle.</text> </level> </level> <level label="k"> <level label="1"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>An additional criminal history records check shall be performed every 12 years thereafter.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates that the licensee does not pose a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-15" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>Unless the Board agrees to accept the surrender of a license, a licensed electrologist or licensed electrology instructor may not surrender the license.</text> </level> <level label="b"> <text>The Board may require terms and conditions on an agreement with the licensed electrologist or licensed electrology instructor to accept surrender of the license.</text> </level> <level label="c"> <text>An agreement to accept the surrender of a license is a final order of the Board and is a public record.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-16" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>Before an institution may operate an electrology education program in the State, the Board shall approve the program.</text> </level> <level label="b"> <text>The Board shall approve an electrology education program in the State if:</text> <level label="1"> <text>The Maryland Higher Education Commission approves the program; and</text> </level> <level label="2"> <text>The institution that offers the program submits evidence to the Board that the institution is prepared to:</text> <level label="i"> <text>Meet the standards established in regulations adopted by the Board under § 8-6B-03 of this subtitle; and</text> </level> <level label="ii"> <text>Carry out an education program in:</text> <level label="1"> <text>The theory of electrology; or</text> </level> <level label="2"> <text>The clinical practice of electrology.</text> </level> </level> </level> </level> <level label="c"> <level label="1"> <text>The Board periodically may evaluate electrology programs in the State and prepare a written report.</text> </level> <level label="2"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-17" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>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:</text> <level label="1"> <text>Is guilty of fraud or deceit in obtaining or attempting to obtain approval;</text> </level> <level label="2"> <text>Acts in a manner inconsistent with generally accepted standards for the practice of electrology;</text> </level> <level label="3"> <text>Advertises in a manner that the Board determines violates § 8-6B-22 of this subtitle;</text> </level> <level label="4"> <text>Violates the standards set under this subtitle and does not correct the violation in a reasonable time after notice is given; or</text> </level> <level label="5"> <text>No longer operates a program that qualifies for approval under this subtitle.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-18" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a license;</text> </level> <level label="3"> <text>As part of the practice of electrology, knowingly does an act that exceeds the scope of the practice of electrology;</text> </level> <level label="4"> <text>Is grossly negligent in practicing or teaching an electrology education program;</text> </level> <level label="5"> <text>Acts in a manner inconsistent with generally accepted standards for the practice of electrology;</text> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>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;</text> </level> <level label="8"> <text>Provides professional services while:</text> <level label="i"> <text>Under the influence of alcohol; or</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="9"> <text>Uses types of instruments or procedures in the practice of electrology that are not approved by the Board;</text> </level> <level label="10"> <text>Advertises in a manner that violates this subtitle;</text> </level> <level label="11"> <text>Uses a title not authorized by § 8–6B–23 of this subtitle;</text> </level> <level label="12"> <text>Is currently adjudicated as being a disabled individual under Title 13 of the Estates and Trusts Article;</text> </level> <level label="13"> <text>Practices electrology with an unauthorized individual or supervises or aids an unauthorized individual in the practice of electrology;</text> </level> <level label="14"> <text>Willfully makes or files a false report or record in the practice of electrology;</text> </level> <level label="15"> <text>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;</text> </level> <level label="16"> <text>Submits a false statement to collect a fee;</text> </level> <level label="17"> <text>Violates a provision of this subtitle or a rule or regulation adopted by the Board;</text> </level> <level label="18"> <text>Uses or promotes or causes the use of a misleading, deceiving, or untruthful advertising matter, promotional literature, or testimonial;</text> </level> <level label="19"> <text>Is professionally, physically, or mentally incompetent;</text> </level> <level label="20"> <text>Promotes the sale of devices, appliances, or goods to a patient so as to exploit the patient for financial gain;</text> </level> <level label="21"> <text>Behaves immorally in the practice of electrology;</text> </level> <level label="22"> <text>Commits an act of unprofessional conduct in the practice of electrology;</text> </level> <level label="23"> <text>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;</text> </level> <level label="24"> <text>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;</text> </level> <level label="25"> <text>Fails to submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="26"> <text>Fails to allow an inspection under § 8–6B–06(10) and (11) of this subtitle;</text> </level> <level label="27"> <text>Fails to cooperate with a lawful investigation conducted by the Board;</text> </level> <level label="28"> <text>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</text> </level> <level label="29"> <text>After failing to renew a license, commits any act that would be grounds for disciplinary action under this section.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-19" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>The person may be represented at the hearing by counsel.</text> </level> <level label="e"> <level label="1"> <text>The Board may issue subpoenas and administer oaths in connection with a proceeding under this section.</text> </level> <level label="2"> <text>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:</text> <level label="i"> <text>Shall compel compliance with the subpoena; and</text> </level> <level label="ii"> <text>May hold the person in contempt of court.</text> </level> </level> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>The hearing of charges may not be stayed or challenged by procedural defects alleged to have occurred prior to the filing of charges.</text> </level> <level label="h"> <level label="1"> <text>After the Board conducts an investigation under this subtitle, the Board may issue an advisory letter to the licensee.</text> </level> <level label="2"> <text>The Board may disclose an advisory letter issued under this subsection to the public.</text> </level> <level label="3"> <text>The issuance of an advisory letter under this subsection may not:</text> <level label="i"> <text>Be considered a disciplinary action under § 8–6B–18 of this subtitle; and</text> </level> <level label="ii"> <text>Be reported to any licensing entity, employer, or insurance company as a disciplinary action.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-20" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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:</text> <level label="1"> <text>Instead of suspending the license; or</text> </level> <level label="2"> <text>In addition to suspending or revoking the license.</text> </level> </level> <level label="b"> <text>The Board shall adopt rules and regulations to set standards for the imposition of penalties under this section.</text> </level> <level label="c"> <text>The Board shall pay a penalty collected under this section into the General Fund of the State.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-21" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>An order of the Board may not be stayed pending review.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-22" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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:</text> <level label="1"> <text>Applies to the Board for reinstatement;</text> </level> <level label="2"> <text>Meets the requirements for renewal under § 8–6B–14 of this subtitle;</text> </level> <level label="3"> <text>Meets any other requirements for reinstatement as established by the Board; and</text> </level> <level label="4"> <text>Submits to a criminal history records check in accordance with § 8–303 of this title.</text> </level> </level> <level label="b"> <text>If a licensee meets the requirements of subsection (a) of this section, the Board may:</text> <level label="1"> <text>Reinstate the license;</text> </level> <level label="2"> <text>Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or</text> </level> <level label="3"> <text>Deny reinstatement of the license.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-23" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>Neither a licensee nor an institution that offers an approved electrology education program may advertise in a manner that is unreasonable, misleading, or fraudulent.</text> </level> <level label="c"> <text>Unless authorized to practice electrology or instruct electrology under this subtitle, a person:</text> <level label="1"> <text>May not use the designation “electrologist”, “licensed electrologist”, “licensed electrology instructor”, or “electrology instructor”; and</text> </level> <level label="2"> <text>May not use the abbreviation “L.E.” or “L.E.I.”.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-24" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-27" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6B-28" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>This subtitle may be cited as the “Maryland Electrologists Act”.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6B-29" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <level label="a"> <text>The authority of the Board established under this subtitle:</text> <level label="1"> <text>Vests with the Board at the time an individual applies for licensure;</text> </level> <level label="2"> <text>Continues during periods of licensure; and</text> </level> <level label="3"> <text>Includes authority over an individual holding an expired license or a lapsed license.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6B-30" title_number="8" title_name="Nurses" subtitle_number="6B" subtitle_name="Electrologists"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6C-01" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“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.</text> </level> <level label="c"> <text>“AIMM” means the Association of Independent Midwives of Maryland or a successor organization that is a professional organization representing independent midwives in the State.</text> </level> <level label="d"> <text>“Board” means the State Board of Nursing.</text> </level> <level label="e"> <text>“Committee” means the Direct–Entry Midwifery Advisory Committee established under § 8–6C–11 of this subtitle.</text> </level> <level label="f"> <text>“Health care practitioner” means:</text> <level label="1"> <text>An individual certified as a nurse–midwife or a nurse practitioner under this title; or</text> </level> <level label="2"> <text>A physician licensed under Title 14 of this article.</text> </level> </level> <level label="g"> <level label="1"> <text>“Health care provider” means a health care practitioner or a hospital.</text> </level> <level label="2"> <text>“Health care provider” includes agents or employees of a health care practitioner or a hospital.</text> </level> </level> <level label="h"> <text>“Hospital” has the meaning stated in § 19–301 of the Health – General Article.</text> </level> <level label="i"> <text>“License” means, unless the context requires otherwise, a license issued by the Board to practice direct–entry midwifery.</text> </level> <level label="j"> <level label="1"> <text>“Licensed direct–entry midwife” means an individual who has been granted a license under this subtitle to practice direct–entry midwifery.</text> </level> <level label="2"> <text>“Licensed direct–entry midwife” does not include a licensed nurse certified as a nurse–midwife under this title.</text> </level> </level> <level label="k"> <text>“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.</text> </level> <level label="l"> <text>“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.</text> </level> <level label="m"> <text>“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.</text> </level> <level label="n"> <level label="1"> <text>“Patient” means an individual for whom a licensed direct–entry midwife performs services.</text> </level> <level label="2"> <text>“Patient” includes an individual’s newborn for the purpose of perinatal or postpartum care.</text> </level> </level> <level label="o"> <text>“Postpartum period” means the first 6 weeks after delivery.</text> </level> <level label="p"> <level label="1"> <text>“Practice direct–entry midwifery” means:</text> <level label="i"> <text>Providing maternity care that is consistent with a midwife’s training, education, and experience; and</text> </level> <level label="ii"> <text>Identifying and referring patients who require medical care to an appropriate health care provider.</text> </level> </level> <level label="2"> <text>“Practice direct–entry midwifery” includes the activities described in § 8–6C–02 of this subtitle.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-02" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>The practice of direct–entry midwifery includes:</text> <level label="1"> <text>Providing the necessary supervision, care, and advice to a patient during a low–risk pregnancy, labor, delivery, and postpartum period; and</text> </level> <level label="2"> <text>Newborn care authorized under this subtitle that is provided in a manner that is:</text> <level label="i"> <text>Consistent with national direct–entry midwifery standards; and</text> </level> <level label="ii"> <text>Based on the acquisition of clinical skills necessary for the care of pregnant women and newborns, including antepartum, intrapartum, and postpartum care.</text> </level> </level> </level> <level label="b"> <text>The practice of direct–entry midwifery also includes:</text> <level label="1"> <text>Obtaining informed consent to provide services to the patient;</text> </level> <level label="2"> <text>Discussing:</text> <level label="i"> <text>Any general risk factors associated with the services to be provided;</text> </level> <level label="ii"> <text>Any specific risk factors pertaining to the health and circumstances of the individual patient;</text> </level> <level label="iii"> <text>Conditions that preclude care by a licensed direct–entry midwife; and</text> </level> <level label="iv"> <text>The conditions under which consultation, transfer of care, or transport of the patient must be implemented;</text> </level> </level> <level label="3"> <text>Obtaining a health history of the patient and performing a physical examination;</text> </level> <level label="4"> <text>Developing a written plan of care specific to the patient, to ensure continuity of care throughout the antepartum, intrapartum, and postpartum periods, that includes:</text> <level label="i"> <text>A plan for the management of any specific risk factors pertaining to the individual health and circumstances of the individual patient; and</text> </level> <level label="ii"> <text>A plan to be followed in the event of an emergency, including a plan for transportation;</text> </level> </level> <level label="5"> <text>Evaluating the results of patient care;</text> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>Referral of all patients, within 72 hours after delivery, to a pediatric health care practitioner for care of the newborn;</text> </level> <level label="8"> <text>As approved by the Board:</text> <level label="i"> <text>Obtaining and administering medications; and</text> </level> <level label="ii"> <text>Obtaining and using equipment and devices;</text> </level> </level> <level label="9"> <text>Obtaining appropriate screening and testing, including laboratory tests, urinalysis, and ultrasound;</text> </level> <level label="10"> <text>Providing care during the antepartum period, with consultation or referral as required;</text> </level> <level label="11"> <text>Providing care during the intrapartum period, including:</text> <level label="i"> <text>Monitoring and evaluating the condition of the patient and fetus;</text> </level> <level label="ii"> <text>Performing emergency procedures, including:</text> <level label="1"> <text>Administering approved medications;</text> </level> <level label="2"> <text>Administering intravenous fluids for stabilization;</text> </level> <level label="3"> <text>Performing an emergency episiotomy; and</text> </level> <level label="4"> <text>Providing care while on the way to a hospital under circumstances in which emergency medical services have not been activated;</text> </level> </level> <level label="iii"> <text>Activating emergency medical services for an emergency; and</text> </level> <level label="iv"> <text>Delivering in an out–of–hospital setting;</text> </level> </level> <level label="12"> <text>Participating in peer review as required under § 8–6C–18(e)(2) of this subtitle;</text> </level> <level label="13"> <text>Providing care during the postpartum period, including:</text> <level label="i"> <text>Suturing of first and second degree perineal or labial lacerations, or suturing of an episiotomy with the administration of a local anesthetic; and</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="14"> <text>Providing routine care for the newborn for up to 72 hours after delivery, exclusive of administering immunizations, including:</text> <level label="i"> <text>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;</text> </level> <level label="ii"> <text>Assessing newborn feeding and hydration;</text> </level> <level label="iii"> <text>Performing metabolic screening and reporting on the screening in accordance with the regulations related to newborn screenings that are adopted by the Department;</text> </level> <level label="iv"> <text>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;</text> </level> <level label="v"> <text>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</text> </level> <level label="vi"> <text>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;</text> </level> </level> <level label="15"> <text>Within 24 hours after delivery, notifying a pediatric health care practitioner of the delivery;</text> </level> <level label="16"> <text>Within 72 hours after delivery:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Referring the newborn to a pediatric health care practitioner;</text> </level> </level> <level label="17"> <text>Providing the following care of the newborn beyond the first 72 hours after delivery:</text> <level label="i"> <text>Weight checks and general observation of the newborn’s activity, with abnormal findings communicated to the newborn’s pediatric health care practitioner;</text> </level> <level label="ii"> <text>Assessment of newborn feeding and hydration; and</text> </level> <level label="iii"> <text>Lactation support and counseling; and</text> </level> </level> <level label="18"> <text>Providing limited services to the patient after the postpartum period, including:</text> <level label="i"> <text>Lactation support and counseling; and</text> </level> <level label="ii"> <text>Counseling and referral for all family planning methods.</text> </level> </level> </level> <level label="c"> <text>The practice of direct–entry midwifery does not include:</text> <level label="1"> <text>Pharmacological induction or augmentation of labor or artificial rupture of membranes prior to the onset of labor;</text> </level> <level label="2"> <text>Surgical delivery or any surgery except an emergency episiotomy;</text> </level> <level label="3"> <text>Use of forceps or vacuum extractor;</text> </level> <level label="4"> <text>Except for the administration of a local anesthetic, administration of an anesthetic;</text> </level> <level label="5"> <text>Administration of any kind of narcotic analgesic; or</text> </level> <level label="6"> <text>Administration of any prescription medication in a manner that violates this subtitle.</text> </level> </level> <level label="d"> <text>The practice of direct–entry midwifery is independent and does not require oversight by another health care practitioner.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-03" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>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:</text> <level label="1"> <text>Diabetes mellitus, including uncontrolled gestational diabetes;</text> </level> <level label="2"> <text>Hyperthyroidism treated with medication;</text> </level> <level label="3"> <text>Uncontrolled hypothyroidism;</text> </level> <level label="4"> <text>Epilepsy with seizures or antiepileptic drug use during the previous 12 months;</text> </level> <level label="5"> <text>Coagulation disorders;</text> </level> <level label="6"> <text>Chronic pulmonary disease;</text> </level> <level label="7"> <text>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;</text> </level> <level label="8"> <text>Hypertension, including pregnancy–induced hypertension (PIH);</text> </level> <level label="9"> <text>Renal disease;</text> </level> <level label="10"> <text>Previous uterine surgery, including a cesarean section or myomectomy;</text> </level> <level label="11"> <text>Indications that the fetus has died in utero;</text> </level> <level label="12"> <text>Premature labor (gestation less than 37 weeks);</text> </level> <level label="13"> <text>Multiple gestation;</text> </level> <level label="14"> <text>Noncephalic presentation at or after 38 weeks;</text> </level> <level label="15"> <text>Placenta previa or abruption;</text> </level> <level label="16"> <text>Preeclampsia;</text> </level> <level label="17"> <text>Severe anemia, defined as hemoglobin less than 10 g/dL:</text> <level label="i"> <text>That has been measured after treatment; or</text> </level> <level label="ii"> <text>Based on blood tests performed at or after 36 weeks;</text> </level> </level> <level label="18"> <text>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;</text> </level> <level label="19"> <text>AIDS/HIV;</text> </level> <level label="20"> <text>Hepatitis;</text> </level> <level label="21"> <text>Acute toxoplasmosis infection, if the patient is symptomatic;</text> </level> <level label="22"> <text>Acute Rubella infection during pregnancy;</text> </level> <level label="23"> <text>Acute cytomegalovirus infection, if the patient is symptomatic;</text> </level> <level label="24"> <text>Acute Parvovirus infection, if the patient is symptomatic;</text> </level> <level label="25"> <text>Alcohol abuse, substance abuse, or prescription abuse during pregnancy;</text> </level> <level label="26"> <text>Continued daily tobacco use into the second trimester;</text> </level> <level label="27"> <text>Thrombosis;</text> </level> <level label="28"> <text>Inflammatory bowel disease that is not in remission;</text> </level> <level label="29"> <text>Primary genital herpes simplex virus infection during the third trimester or active genital herpes lesions at the time of labor;</text> </level> <level label="30"> <text>Significant fetal congenital anomaly that directly impacts the birthing process or requires immediate emergency care, as determined by the Board in regulations;</text> </level> <level label="31"> <text>Ectopic pregnancy; or</text> </level> <level label="32"> <text>Post term maturity (gestational age 42 0/7 weeks and beyond).</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-04" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>Second or third trimester bleeding;</text> </level> <level label="3"> <text>Intermittent use of alcohol into the second trimester;</text> </level> <level label="4"> <text>Asthma;</text> </level> <level label="5"> <text>Diet–controlled gestational diabetes;</text> </level> <level label="6"> <text>History of genetic problems, intrauterine death after 20 weeks’ gestation, or stillbirth;</text> </level> <level label="7"> <text>Abnormal pap smear;</text> </level> <level label="8"> <text>Possible ectopic pregnancy;</text> </level> <level label="9"> <text>Tuberculosis;</text> </level> <level label="10"> <text>Controlled hypothyroidism, being treated with thyroid replacement and euthyroid, and with thyroid test numbers in the normal range;</text> </level> <level label="11"> <text>Rh sensitization with positive antibody titer;</text> </level> <level label="12"> <text>Breech presentation between 35 and 38 weeks;</text> </level> <level label="13"> <text>Transverse lie or other abnormal presentation between 35 and 38 weeks;</text> </level> <level label="14"> <text>Premature rupture of membranes at 37 weeks or less;</text> </level> <level label="15"> <text>Small for gestational age or large for gestational age fetus;</text> </level> <level label="16"> <text>Polyhydramnios or oligohydramnios;</text> </level> <level label="17"> <text>Previous LEEP procedure or cone biopsy;</text> </level> <level label="18"> <text>Previous obstetrical problems, including uterine abnormalities, placental abruption, placenta accreta, obstetric hemorrhage, incompetent cervix, or preterm delivery for any reason;</text> </level> <level label="19"> <text>Postterm maturity (41 0/7 to 6/7 weeks gestational age);</text> </level> <level label="20"> <text>Inflammatory bowel disease, in remission;</text> </level> <level label="21"> <text>Active genital herpes lesions during pregnancy except as required by § 8–6C–03(29) of this subtitle;</text> </level> <level label="22"> <text>Prepregnancy body mass index (BMI) of less than 18.5 or 35 or more; or</text> </level> <level label="23"> <text>Significant fetal congenital anomaly.</text> </level> </level> <level label="b"> <text>Subject to subsection (c) of this section, a licensed direct–entry midwife shall arrange immediate emergency transfer to a hospital if:</text> <level label="1"> <text>The patient requests transfer; or</text> </level> <level label="2"> <text>The patient or newborn is determined to have any of the following conditions during labor, delivery, or the immediate postpartum period:</text> <level label="i"> <text>Unforeseen noncephalic presentation;</text> </level> <level label="ii"> <text>Unforeseen multiple gestation;</text> </level> <level label="iii"> <text>Nonreassuring fetal heart rate or pattern, including tachycardia, bradycardia, significant change in baseline, and persistent late or severe variable decelerations;</text> </level> <level label="iv"> <text>Prolapsed cord;</text> </level> <level label="v"> <text>Unresolved maternal hemorrhage;</text> </level> <level label="vi"> <text>Retained placenta;</text> </level> <level label="vii"> <text>Signs of fetal or maternal infection;</text> </level> <level label="viii"> <text>Patient with a third– or fourth–degree laceration or a laceration beyond the licensed direct–entry midwife’s ability to repair;</text> </level> <level label="ix"> <text>Apgar of less than seven at 5 minutes;</text> </level> <level label="x"> <text>Significant congenital anomalies that directly affect delivery or immediate postpartum care or require immediate emergency care, as determined by the Board in regulations;</text> </level> <level label="xi"> <text>Need for chest compressions during neonatal resuscitation;</text> </level> <level label="xii"> <text>Newborn with persistent central cyanosis;</text> </level> <level label="xiii"> <text>Newborn with persistent grunting and retractions;</text> </level> <level label="xiv"> <text>Newborn with abnormal vital signs;</text> </level> <level label="xv"> <text>Gross or thick meconium staining, when discovered; or</text> </level> <level label="xvi"> <text>Newborn with excessive dehydration due to inability to feed.</text> </level> </level> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>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:</text> <level label="i"> <text>Uncontrolled postpartum hemorrhage;</text> </level> <level label="ii"> <text>Preeclampsia;</text> </level> <level label="iii"> <text>Thrombo–embolism;</text> </level> <level label="iv"> <text>An infection; or</text> </level> <level label="v"> <text>A postpartum mental health disorder.</text> </level> </level> <level label="2"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-05" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>At the time of delivery, a licensed direct–entry midwife shall be assisted by a second individual who:</text> <level label="1"> <text>Has completed the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) within the previous 2 years; and</text> </level> <level label="2"> <text>Has the skills and equipment necessary to perform a full resuscitation of the newborn in accordance with the principles of NRP.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-06" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>This section does not apply to:</text> <level label="1"> <text>An individual who assists at a birth in an emergency;</text> </level> <level label="2"> <text>An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice direct–entry midwifery; or</text> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-07" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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:</text> <level label="1"> <text>Transfer care of the patient to an appropriate health care practitioner;</text> </level> <level label="2"> <text>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</text> </level> <level label="3"> <text>Cease to take responsibility for the patient’s pregnancy care within 1 week after the transfer.</text> </level> </level> <level label="b"> <text>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:</text> <level label="1"> <text>Call 9–1–1 and remain with the patient until emergency services personnel arrive; and</text> </level> <level label="2"> <text>Transfer care and give a verbal report of the care provided to the emergency medical services providers.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-08" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>A licensed direct–entry midwife shall develop a general written plan for their practice for:</text> <level label="1"> <text>Emergency transfer of a patient, newborn, or both;</text> </level> <level label="2"> <text>Transport of a newborn to a newborn nursery or neonatal intensive care nursery; and</text> </level> <level label="3"> <text>Transport of a patient to an appropriate hospital with a labor and delivery unit.</text> </level> </level> <level label="b"> <text>The Committee shall review and recommend approval to the Board of the plan required under subsection (a) of this section.</text> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The plan required under paragraph (1) of this subsection shall:</text> <level label="i"> <text>Include procedures and processes to be undertaken in the event of an emergency for the mother, the newborn, or both;</text> </level> <level label="ii"> <text>Identify the hospital closest to the address of the planned home birth that has a labor and delivery unit;</text> </level> <level label="iii"> <text>Include a care plan for the newborn; and</text> </level> <level label="iv"> <text>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.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The form shall include the medical information needed by the health care practitioner receiving the patient.</text> </level> </level> <level label="e"> <text>After a decision to transport a patient has been made, the licensed direct–entry midwife shall:</text> <level label="1"> <text>Call the receiving health care provider;</text> </level> <level label="2"> <text>Inform the health care provider of the incoming patient;</text> </level> <level label="3"> <text>Accompany the patient to the hospital if determined to be appropriate by the licensed direct–entry midwife and the receiving health care provider; and</text> </level> <level label="4"> <text>Provide:</text> <level label="i"> <text>To the staff of the hospital:</text> <level label="1"> <text>The standard form developed under subsection (d) of this section; and</text> </level> <level label="2"> <text>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</text> </level> </level> <level label="ii"> <text>To the accepting health care practitioner, a verbal summary of the care provided to the patient by the licensed direct–entry midwife.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-09" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <level label="1"> <text>The Board, in consultation with stakeholders, shall review and update as necessary the informed consent agreement at least every 4 years.</text> </level> <level label="2"> <text>The agreement reviewed under paragraph (1) of this subsection shall include acknowledgment by the patient of receipt, at a minimum, of the following:</text> <level label="i"> <text>The licensed direct–entry midwife’s training and experience;</text> </level> <level label="ii"> <text>Instructions for obtaining a copy of the regulations adopted by the Board under this subtitle;</text> </level> <level label="iii"> <text>Instructions for obtaining a copy of the NARM certification requirements;</text> </level> <level label="iv"> <text>Instructions for filing a complaint with the Board;</text> </level> <level label="v"> <text>Notice of whether the licensed direct–entry midwife has professional liability insurance coverage;</text> </level> <level label="vi"> <text>A description of the procedures, benefits, and risks of home births, including those conditions that may arise during delivery; and</text> </level> <level label="vii"> <text>Any other information that the Board requires.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-10" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A licensed direct–entry midwife attending an out–of–hospital delivery shall:</text> <level label="1"> <text>For any live birth, complete and submit a birth certificate in accordance with § 4–208 of the Health – General Article; and</text> </level> <level label="2"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-11" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>There is a Direct–Entry Midwifery Advisory Committee within the Board.</text> </level> <level label="b"> <level label="1"> <text>The Committee consists of seven members appointed by the Board.</text> </level> <level label="2"> <text>Of the seven members:</text> <level label="i"> <text>Subject to paragraph (3) of this subsection and subsection (d) of this section, three shall be licensed direct–entry midwives;</text> </level> <level label="ii"> <text>Two shall be licensed nurses certified as nurse–midwives;</text> </level> <level label="iii"> <text>One shall be a representative of the Maryland Hospital Association; and</text> </level> <level label="iv"> <text>One shall be a consumer member.</text> </level> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The Board may request an additional list of qualified individuals from AIMM if the initial list is determined to be inadequate.</text> </level> </level> </level> <level label="c"> <text>Each member of the Committee shall be a citizen of the United States and a resident of the State.</text> </level> <level label="d"> <text>Each licensed direct–entry midwife member of the Committee:</text> <level label="1"> <text>Shall meet the licensure requirements of this subtitle; and</text> </level> <level label="2"> <text>May not be a licensed nurse who is certified as a nurse–midwife.</text> </level> </level> <level label="e"> <text>The consumer member of the Committee:</text> <level label="1"> <text>Shall be a member of the general public;</text> </level> <level label="2"> <text>May not be or ever have been:</text> <level label="i"> <text>A licensed direct–entry midwife;</text> </level> <level label="ii"> <text>A licensed nurse certified as a midwife;</text> </level> <level label="iii"> <text>A health care practitioner who is directly involved with pregnancy or labor; or</text> </level> <level label="iv"> <text>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;</text> </level> </level> <level label="3"> <text>May not have a household member who is:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="4"> <text>May not:</text> <level label="i"> <text>Participate or ever have participated in a commercial or professional field related to the practice of direct–entry midwifery;</text> </level> <level label="ii"> <text>Have a household member who participates in a commercial or professional field related to the practice of direct–entry midwifery; or</text> </level> <level label="iii"> <text>Have, or have had within 2 years before appointment, a substantial financial interest in a person who is regulated by the Board.</text> </level> </level> </level> <level label="f"> <text>The Committee shall elect a chair from among its members to a 2–year term.</text> </level> <level label="g"> <level label="1"> <text>The term of a member is 4 years.</text> </level> <level label="2"> <text>The terms of the members are staggered as required by the terms provided for members of the Committee on October 1, 2015.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member may not serve more than two consecutive full terms.</text> </level> <level label="6"> <text>To the extent practicable, the Board shall fill any vacancy on the Committee within 60 days of the date of the vacancy.</text> </level> </level> <level label="h"> <text>A majority of the full authorized membership of the Committee is a quorum.</text> </level> <level label="i"> <text>In addition to any other meeting requirements of this title, the Committee shall meet:</text> <level label="1"> <text>At the request of the executive director of the Board; and</text> </level> <level label="2"> <text>As necessary to conduct Board or Committee business.</text> </level> </level> <level label="j"> <text>In accordance with the State budget, each member of the Committee is entitled to:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>Reimbursement for expenses under the Standard State Travel Regulations.</text> </level> </level> <level label="k"> <level label="1"> <text>The Board may remove a member for incompetence or misconduct.</text> </level> <level label="2"> <text>The Board may remove a member who is absent from two successive Committee meetings without adequate reason.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-12" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>The Committee shall:</text> <level label="1"> <text>Review applications for licensure as a licensed direct–entry midwife and make recommendations to the Board regarding applicants;</text> </level> <level label="2"> <text>Maintain a list of all licensed direct–entry midwives;</text> </level> <level label="3"> <text>Make recommendations to the Board regarding continuing education requirements for licensed direct–entry midwives;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Advise the Board on matters relating to the practice of direct–entry midwifery;</text> </level> <level label="6"> <text>Collect the reports required to be submitted by each licensed direct–entry midwife under § 8–6C–10(a) of this subtitle;</text> </level> <level label="7"> <text>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;</text> </level> <level label="8"> <text>At the request of the Board, investigate complaints against licensed direct–entry midwives;</text> </level> <level label="9"> <text>Keep a record of the Committee’s proceedings; and</text> </level> <level label="10"> <text>Subject to subsection (b) of this section, beginning November 1, 2016, and on each November 1 thereafter, submit a report to the Board, including:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Any other information identified by the Board.</text> </level> </level> </level> <level label="b"> <text>The Committee may not include any personally identifying information in the report submitted to the Board under subsection (a)(10) of this section.</text> </level> <level label="c"> <text>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:</text> <level label="1"> <text>The report submitted to the Board under subsection (a)(10) of this section;</text> </level> <level label="2"> <text>In consultation with the Committee, any recommendations regarding the continuation and improvement of the licensure of licensed direct–entry midwives in the State;</text> </level> <level label="3"> <text>Any recommendations regarding expanding the scope of practice of licensed direct–entry midwives; and</text> </level> <level label="4"> <text>Any recommendations, including recommendations for legislation, regarding the scope of practice of licensed direct–entry midwives to include vaginal birth after cesarean.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-13" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>In addition to the education and training requirements under subsection (b) of this section, to qualify for a license, an applicant shall:</text> <level label="1"> <text>Submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="2"> <text>Be of good moral character;</text> </level> <level label="3"> <text>Be a high school graduate or have completed equivalent education;</text> </level> <level label="4"> <text>Be at least 21 years old;</text> </level> <level label="5"> <text>Hold a current cardiopulmonary resuscitation (CPR) certification issued by the American Red Cross or the American Heart Association; and</text> </level> <level label="6"> <text>Have completed in the past 2 years the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP).</text> </level> </level> <level label="b"> <text>An applicant:</text> <level label="1"> <text>Shall hold a current valid Certified Professional Midwife credential granted by NARM; and</text> </level> <level label="2"> <level label="i"> <text>Shall have completed a midwifery education program that is accredited by MEAC or ACME;</text> </level> <level label="ii"> <text>Shall have completed the NARM Midwifery Bridge Certificate program; or</text> </level> <level label="iii"> <text>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:</text> <level label="1"> <text>Verification of completion of NARM–approved clinical requirements; and</text> </level> <level label="2"> <text>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:</text> </level> <level label="A"> <text>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</text> </level> <level label="B"> <text>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.</text> </level> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-14" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>To apply for a license, an applicant shall:</text> <level label="1"> <text>Submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="2"> <text>Submit to the Board:</text> <level label="i"> <text>An application on the form that the Board requires; and</text> </level> <level label="ii"> <text>Written, verified evidence that the requirement of item (1) of this subsection is being met; and</text> </level> </level> <level label="3"> <text>Pay to the Board a fee set by the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-15" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <level label="1"> <text>The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to licensed direct–entry midwives.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <level label="1"> <text>The Board shall pay all fees collected under this subtitle to the Comptroller.</text> </level> <level label="2"> <text>The Comptroller shall distribute all fees to the Board.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-16" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>Subject to subsection (c) of this section, the Board shall issue a license to an applicant who:</text> <level label="1"> <text>Meets the requirements of this subtitle; and</text> </level> <level label="2"> <text>Pays a fee set by the Board.</text> </level> </level> <level label="b"> <text>The Board shall include on each license that the Board issues a designation of licensed direct–entry midwife.</text> </level> <level label="c"> <level label="1"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="2"> <text>The Board may not issue a license if the criminal history record information required under § 8–303 of this title has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-17" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>A license issued under this subtitle authorizes the licensee to practice direct–entry midwifery while the license is active.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6C-18" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.</text> </level> <level label="b"> <text>A license may not be renewed for a term longer than 2 years.</text> </level> <level label="c"> <level label="1"> <text>At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:</text> <level label="i"> <text>First–class mail to the last known mailing address of the licensee; or</text> </level> <level label="ii"> <text>Electronic means to the last known electronic address of the licensee.</text> </level> </level> <level label="2"> <text>A renewal notice shall state:</text> <level label="i"> <text>The date on which the current license expires;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>The amount of the renewal fee.</text> </level> </level> </level> <level label="d"> <text>Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term if the licensee:</text> <level label="1"> <text>Otherwise is entitled to be licensed;</text> </level> <level label="2"> <text>Pays to the Board a renewal fee set by the Board; and</text> </level> <level label="3"> <text>Submits to the Board:</text> <level label="i"> <text>A renewal application on the form that the Board requires; and</text> </level> <level label="ii"> <text>Satisfactory evidence of compliance with any continuing education or other competency requirements set under this subtitle for license renewal.</text> </level> </level> </level> <level label="e"> <text>In addition to any other qualifications and requirements established by the Board for license renewal, the Board shall require:</text> <level label="1"> <text>20 accredited and Board–approved continuing education units to be completed every 2 years;</text> </level> <level label="2"> <text>4 hours of peer review in accordance with NARM standards for official peer review to be completed every 2 years; and</text> </level> <level label="3"> <text>Submission of the annual reports required under § 8–6C–10(a) of this subtitle.</text> </level> </level> <level label="f"> <text>Subject to subsection (l) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.</text> </level> <level label="g"> <text>The Board shall place a licensee on inactive status if the licensee:</text> <level label="1"> <text>Fails to provide satisfactory evidence of compliance with any continuing education requirements set under this section for license renewal; or</text> </level> <level label="2"> <text>Fails to submit the annual report required under § 8–6C–10(a) of this subtitle.</text> </level> </level> <level label="h"> <text>The Board shall place a licensee on inactive status if the licensee submits to the Board:</text> <level label="1"> <text>An application for inactive status on the form required by the Board; and</text> </level> <level label="2"> <text>The inactive status fee set by the Board.</text> </level> </level> <level label="i"> <text>The Board shall reactivate the license of an individual who is on inactive status if the individual:</text> <level label="1"> <text>Complies with any continuing education and data reporting requirements established by the Board for this purpose;</text> </level> <level label="2"> <text>Pays to the Board a reactivation fee set by the Board; and</text> </level> <level label="3"> <text>Is otherwise entitled to be licensed.</text> </level> </level> <level label="j"> <text>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:</text> <level label="1"> <text>Is otherwise entitled to be licensed;</text> </level> <level label="2"> <text>Complies with any continuing education and data reporting requirements established by the Board for this purpose;</text> </level> <level label="3"> <text>Pays to the Board a reinstatement fee set by the Board;</text> </level> <level label="4"> <text>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</text> </level> <level label="5"> <text>Applies to the Board for reinstatement of the license within 5 years after the license expires.</text> </level> </level> <level label="k"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The individual may become licensed by meeting the current requirements for obtaining a new license under this subtitle.</text> </level> </level> <level label="l"> <level label="1"> <text>A licensee shall submit to an additional criminal history records check every 12 years.</text> </level> <level label="2"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>The Board may not renew a license if the criminal history record information required under § 8–303 of this title has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-19" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>Unless the Board agrees to accept the surrender of the license:</text> <level label="1"> <text>A licensed direct–entry midwife may not surrender a license; and</text> </level> <level label="2"> <text>A license may not lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.</text> </level> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-20" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a license;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Willfully and knowingly:</text> <level label="i"> <text>Files a false report or record of an individual under the licensee’s care;</text> </level> <level label="ii"> <text>Gives any false or misleading information about a material matter in an employment application;</text> </level> <level label="iii"> <text>Fails to file or record any health record that is required by law;</text> </level> <level label="iv"> <text>Obstructs the filing or recording of any health record as required by law; or</text> </level> <level label="v"> <text>Induces another person to fail to file or record any health record as required by law;</text> </level> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>Provides professional services while:</text> <level label="i"> <text>Under the influence of alcohol; or</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="8"> <text>Does an act that is inconsistent with generally accepted professional standards in the practice of direct–entry midwifery;</text> </level> <level label="9"> <text>Is grossly negligent in the practice of direct–entry midwifery;</text> </level> <level label="10"> <text>Has violated any provision of this title;</text> </level> <level label="11"> <text>Submits a false statement to collect a fee;</text> </level> <level label="12"> <text>Is physically or mentally incompetent;</text> </level> <level label="13"> <text>Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;</text> </level> <level label="14"> <text>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;</text> </level> <level label="15"> <text>Is in independent practice and fails to display the notice required under § 8–6C–23 of this subtitle;</text> </level> <level label="16"> <text>Is habitually intoxicated;</text> </level> <level label="17"> <text>Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;</text> </level> <level label="18"> <text>Fails to cooperate with a lawful investigation conducted by the Board;</text> </level> <level label="19"> <text>Is expelled from the rehabilitation program established pursuant to § 8–208 of this title for failure to comply with the conditions of the program;</text> </level> <level label="20"> <text>Engages in conduct that violates the professional code of ethics;</text> </level> <level label="21"> <text>Is professionally incompetent;</text> </level> <level label="22"> <text>Practices direct–entry midwifery without a license, before obtaining or renewing a license, including any period when the license has lapsed;</text> </level> <level label="23"> <text>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;</text> </level> <level label="24"> <text>Violates regulations adopted by the Board or an order from the Board;</text> </level> <level label="25"> <text>Performs an act that is beyond the licensee’s knowledge and skills;</text> </level> <level label="26"> <text>Fails to submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="27"> <text>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</text> </level> <level label="28"> <text>Fails to file a report required under this subtitle.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>If a suspended or revoked license has been lost, the individual shall file with the Board a verified statement to that effect.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-21" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent.</text> </level> <level label="c"> <text>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”.</text> </level> <level label="d"> <text>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”.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-22" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-24" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <level label="a"> <text>This section does not apply to a violation of § 8–6C–10(a) of this subtitle.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6C-25" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>This subtitle may be cited as the Maryland Licensure of Direct–Entry Midwives Act.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6C-26" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6D-01" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“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.</text> </level> <level label="c"> <text>“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.</text> </level> <level label="d"> <text>“Applicant” means an individual who has submitted an application to the Board to be licensed as a certified midwife.</text> </level> <level label="e"> <text>“Board” means the State Board of Nursing.</text> </level> <level label="f"> <text>“License” means, unless the context requires otherwise, a license issued by the Board to practice certified midwifery.</text> </level> <level label="g"> <level label="1"> <text>“Licensed certified midwife” means an individual who has been issued a license by the Board under this subtitle to practice certified midwifery.</text> </level> <level label="2"> <text>“Licensed certified midwife” does not include a licensed direct–entry midwife or a licensed nurse certified as a nurse–midwife under this title.</text> </level> </level> <level label="h"> <level label="1"> <text>“Practice certified midwifery” means the management and care of essentially normal newborns and of essentially normal women antepartally, intrapartally, and postpartally.</text> </level> <level label="2"> <text>“Practice certified midwifery” includes:</text> <level label="i"> <text>Family planning and well woman reproductive care;</text> </level> <level label="ii"> <text>The prescribing of substances commonly used in the practice of midwifery;</text> </level> <level label="iii"> <text>The prescribing of Schedule II, Schedule III, Schedule IV, and Schedule V controlled dangerous substances commonly used in the practice of midwifery; and</text> </level> <level label="iv"> <text>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:</text> <level label="1"> <text>At a medical facility or clinic that is operated on a nonprofit basis;</text> </level> <level label="2"> <text>At a health center that operates on a campus of an institution of higher education;</text> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>With a starter dosage of a drug as authorized under § 8–508 of this title.</text> </level> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-02" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>This section does not apply to:</text> <level label="1"> <text>An individual who assists at a birth in an emergency;</text> </level> <level label="2"> <text>An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice certified midwifery;</text> </level> <level label="3"> <text>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</text> </level> <level label="4"> <text>An individual who has graduated from a graduate level accredited program for midwifery education approved by ACME, and who is:</text> <level label="i"> <text>Practicing certified midwifery under the supervision of a licensed certified midwife or a licensed nurse certified as a nurse–midwife; and</text> </level> <level label="ii"> <text>Meets any other requirements set by the Board.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-03" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>In addition to the certification and education requirements under subsection (b) of this section, to qualify for a license, an applicant must:</text> <level label="1"> <text>Be of good moral character; and</text> </level> <level label="2"> <text>Submit to a criminal history records check in accordance with § 8–303 of this title.</text> </level> </level> <level label="b"> <text>An applicant must:</text> <level label="1"> <text>Hold a current, valid certification as a certified midwife from AMCB;</text> </level> <level label="2"> <text>Have graduated from a graduate–level accredited program for midwifery education approved by ACME; and</text> </level> <level label="3"> <text>Have passed the AMCB examination.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-04" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <text>To apply for a license, an applicant shall:</text> <level label="1"> <text>Submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="2"> <text>Submit to the Board:</text> <level label="i"> <text>An application on the form that the Board requires, including a current address;</text> </level> <level label="ii"> <text>Written, verified evidence that the requirement of item (1) of this section is being or has been met; and</text> </level> <level label="iii"> <text>Written, verified evidence of satisfying the requirements in § 8–6D–03(b) of this subtitle; and</text> </level> </level> <level label="3"> <text>Pay to the Board a fee set by the Board as required in § 8–6D–05 of this subtitle.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-05" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <level label="1"> <text>The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to licensed certified midwives.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <level label="1"> <text>The Board shall pay all fees collected under this subtitle to the Comptroller.</text> </level> <level label="2"> <text>The Comptroller shall distribute all fees to the Board of Nursing Fund.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-06" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>Subject to subsection (c) of this section, the Board shall issue a license to any applicant who meets the requirements of this subtitle.</text> </level> <level label="b"> <level label="1"> <text>The Board shall:</text> <level label="i"> <text>Issue each new licensee a license number that indicates that the initial license was issued by the Board; and</text> </level> <level label="ii"> <text>Electronically record each license in the Board’s database and on the Board’s website.</text> </level> </level> <level label="2"> <text>Each license shall include an expiration date.</text> </level> </level> <level label="c"> <level label="1"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="2"> <text>The Board may not issue a license if the criminal history records information required under § 8–303 of this title has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-07" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <text>A license issued under this subtitle authorizes the licensee to practice certified midwifery while the license is active.</text> </section> <section article="gho" article_name="Health Occupations" number="8-6D-08" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.</text> </level> <level label="b"> <text>A license may not be renewed for a term longer than 2 years.</text> </level> <level label="c"> <level label="1"> <text>At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by:</text> <level label="i"> <text>First–class mail to the last known mailing address of the licensee; or</text> </level> <level label="ii"> <text>Electronic means to the last known e–mail address of the licensee.</text> </level> </level> <level label="2"> <text>A renewal notice shall state:</text> <level label="i"> <text>The date on which the current license expires;</text> </level> <level label="ii"> <text>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</text> </level> <level label="iii"> <text>The amount of the renewal fee.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> <level label="d"> <text>Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term if the licensee:</text> <level label="1"> <text>Otherwise is entitled to be licensed;</text> </level> <level label="2"> <text>Pays to the Board a renewal fee set by the Board as required by § 8–6D–05 of this subtitle; and</text> </level> <level label="3"> <text>Submits to the Board, by paper or electronic submission:</text> <level label="i"> <text>A renewal application on the form that the Board requires; and</text> </level> <level label="ii"> <text>Satisfactory evidence of current certification as a certified midwife by AMCB.</text> </level> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>Subject to subsection (i) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.</text> </level> <level label="g"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="h"> <text>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.</text> </level> <level label="i"> <level label="1"> <level label="i"> <text>A criminal history records check is required in accordance with § 8–303 of this title on:</text> <level label="1"> <text>Selected annual renewal applicants as determined by regulations adopted by the Board; and</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="ii"> <text>An additional criminal history records check shall be performed every 12 years thereafter.</text> </level> </level> <level label="2"> <text>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:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iii"> <text>The length of time that has passed since the crime;</text> </level> <level label="iv"> <text>Subsequent work history;</text> </level> <level label="v"> <text>Employment and character references; and</text> </level> <level label="vi"> <text>Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-09" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>Unless the Board agrees to accept the surrender of a license, a licensed certified midwife may not surrender the license.</text> </level> <level label="b"> <text>The Board may require terms and conditions on an agreement with the licensed certified midwife to accept surrender of the license.</text> </level> <level label="c"> <text>An agreement to accept the surrender of a license is a final order of the Board and is a public record.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-10" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>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:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a license;</text> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Willfully and knowingly:</text> <level label="i"> <text>Files a false report or record of an individual under the licensee’s care;</text> </level> <level label="ii"> <text>Gives any false or misleading information about a material matter in an employment application;</text> </level> <level label="iii"> <text>Fails to file or record any health record that is required by law;</text> </level> <level label="iv"> <text>Obstructs the filing or recording of any health record as required by law; or</text> </level> <level label="v"> <text>Induces another individual to fail to file or record any health record as required by law;</text> </level> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>Provides professional services while:</text> <level label="i"> <text>Under the influence of alcohol; or</text> </level> <level label="ii"> <text>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;</text> </level> </level> <level label="8"> <text>Commits an act that is inconsistent with generally accepted professional standards in the practice of certified midwifery;</text> </level> <level label="9"> <text>Is grossly negligent in the practice of certified midwifery;</text> </level> <level label="10"> <text>Has violated any provision of this title;</text> </level> <level label="11"> <text>Submits a false statement to collect a fee;</text> </level> <level label="12"> <text>Is physically or mentally incompetent;</text> </level> <level label="13"> <text>Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;</text> </level> <level label="14"> <text>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;</text> </level> <level label="15"> <text>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;</text> </level> <level label="16"> <text>Has a substance use disorder;</text> </level> <level label="17"> <text>Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;</text> </level> <level label="18"> <text>Fails to cooperate with a lawful investigation conducted by the Board;</text> </level> <level label="19"> <text>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;</text> </level> <level label="20"> <text>Engages in conduct that violates the professional code of ethics;</text> </level> <level label="21"> <text>Is professionally incompetent;</text> </level> <level label="22"> <text>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;</text> </level> <level label="23"> <text>When holding an expired license or a lapsed license, commits any act that would be grounds for disciplinary action under this section;</text> </level> <level label="24"> <text>Engages in unprofessional or immoral conduct;</text> </level> <level label="25"> <text>Violates regulations adopted by the Board or an order from the Board;</text> </level> <level label="26"> <text>Performs an act that is beyond the licensee’s knowledge and skills;</text> </level> <level label="27"> <text>Fails to submit to a criminal history records check in accordance with § 8–303 of this title;</text> </level> <level label="28"> <text>Has misappropriated the property of a patient or a facility; or</text> </level> <level label="29"> <text>Fails to comply with § 1–223 of this article.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <level label="1"> <text>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:</text> <level label="i"> <text>Applies to the Board for reinstatement;</text> </level> <level label="ii"> <text>Meets the requirements for renewal under § 8–6D–08 of this subtitle;</text> </level> <level label="iii"> <text>Meets any other requirements for reinstatement as established by the Board in regulations; and</text> </level> <level label="iv"> <text>Submits to a criminal history records check in accordance with § 8–303 of this title.</text> </level> </level> <level label="2"> <text>If a licensee meets the requirements of paragraph (1) of this subsection, the Board shall:</text> <level label="i"> <text>Reinstate the license;</text> </level> <level label="ii"> <text>Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or</text> </level> <level label="iii"> <text>Deny reinstatement of the license.</text> </level> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-11" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>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”.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-12" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>Except as provided in subsection (b) of this section, the following applies:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <text>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:</text> <level label="1"> <text>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;</text> </level> <level label="2"> <text>The licensed certified midwife is able to verify that the licensee or certificate holder remains in the treatment program until discharge; and</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-13" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>A Board decision may not be stayed while judicial review is pending.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-14" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <text>The authority of the Board established under this subtitle:</text> <level label="1"> <text>Vests with the Board at the time an individual applies for certification;</text> </level> <level label="2"> <text>Continues during periods of licensure; and</text> </level> <level label="3"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-15" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <level label="a"> <text>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:</text> <level label="1"> <text>The licensed certified midwife does not maintain professional liability insurance coverage; or</text> </level> <level label="2"> <text>The licensed certified midwife’s professional liability insurance coverage has lapsed for any period of time and has not been renewed.</text> </level> </level> <level label="b"> <text>The written notification provided to the patient under subsection (a) of this section shall be:</text> <level label="1"> <text>Provided:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>As part of each informed consent obtained before any procedure discussed or offered for the patient’s consideration is performed;</text> </level> </level> <level label="2"> <text>Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and</text> </level> <level label="3"> <text>Retained by the licensed certified midwife as part of the licensed certified midwife’s patient records.</text> </level> </level> <level label="c"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-6D-16" title_number="8" title_name="Nurses" subtitle_number="6D" subtitle_name="Licensed Certified Midwives"> <text>This subtitle may be cited as the Maryland Licensure of Certified Midwives Act.</text> </section> <section article="gho" article_name="Health Occupations" number="8-701" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <text>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.</text> </level> <level label="i"> <text>An individual may not require a licensee to perform an act that is beyond the licensee’s knowledge and skills.</text> </level> <level label="j"> <text>An individual may not direct a licensee to delegate a nursing task to a nurse when the individual reasonably believes:</text> <level label="1"> <text>The nurse lacks the knowledge and skills to perform the nursing task; or</text> </level> <level label="2"> <text>The patient’s condition does not allow delegation of the nursing task.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-702" title_number="8" title_name="Nurses" subtitle_number="7"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-703" future_version_removed="true" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <text>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.</text> </level> <level label="4"> <text>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.</text> </level> <level label="5"> <text>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.</text> </level> <level label="6"> <text>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.</text> </level> <level label="7"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <text>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.</text> </level> <level label="i"> <text>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.</text> </level> <level label="j"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-704" title_number="8" title_name="Nurses" subtitle_number="7"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-705" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>An individual may not practice registered nursing or advanced practice registered nursing under color of any diploma, license, certification, or record that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> <level label="b"> <text>An individual may not practice licensed practical nursing under color of any diploma, license, or record that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> <level label="c"> <text>An individual may not practice as a nursing assistant under color of any diploma, license, record, or certificate that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> <level label="d"> <text>An individual may not practice as a certified medication technician under color of any diploma, license, record, or certificate that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> <level label="e"> <text>An individual may not practice as a certified medicine aide under color of any diploma, license, record, or certificate that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> <level label="f"> <text>An individual may not practice as a certified dialysis technician under color of any diploma, license, record, or certificate that is:</text> <level label="1"> <text>Illegally or fraudulently obtained; or</text> </level> <level label="2"> <text>Signed or issued unlawfully or by fraudulent representation.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-706" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>An individual may not knowingly employ to practice registered nursing any individual who is not authorized to practice registered nursing under this title.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> <level label="d"> <text>An individual may not knowingly employ any individual who is not authorized to perform delegated nursing duties under this title.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-707" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>For the purposes of this section, each violation is a separate offense if the violation occurs:</text> <level label="1"> <text>At a different time, date, or location; or</text> </level> <level label="2"> <text>On the same date and location at a different time.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-708" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>An action may be maintained in the name of the State or the Board to enjoin conduct:</text> <level label="1"> <text>Prohibited under §§ 8–701 through 8–706 of this subtitle; or</text> </level> <level label="2"> <text>That is grounds for disciplinary action under § 8–316, § 8–6A–10, § 8–6B–18, or § 8–6D–10 of this title.</text> </level> </level> <level label="b"> <text>An action under this section may be brought by:</text> <level label="1"> <text>The Board, in its own name;</text> </level> <level label="2"> <text>The Attorney General, in the name of the State; or</text> </level> <level label="3"> <text>A State’s Attorney, in the name of the State.</text> </level> </level> <level label="c"> <text>An action under this section shall be brought in the county where the defendant:</text> <level label="1"> <text>Resides; or</text> </level> <level label="2"> <text>Engaged in the acts sought to be enjoined.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-710" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-711" title_number="8" title_name="Nurses" subtitle_number="7"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>The civil fine shall be $5 a day for each day that the violation continues, up to a maximum of $500.</text> </level> <level label="c"> <text>The Board shall pay any fine collected under this section into the General Fund of the State.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-7A-01" title_number="8" title_name="Nurses" subtitle_number="7A" subtitle_name="Nurse Licensure Compact"> <text>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:</text> <text>Article I. Findings and Declaration of Purpose.</text> <level label="1"> <text>The party states find that:</text> <level label="a"> <text>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;</text> </level> <level label="b"> <text>Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public;</text> </level> <level label="c"> <text>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;</text> </level> <level label="d"> <text>New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex;</text> </level> <level label="e"> <text>The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and</text> </level> <level label="f"> <text>Uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits.</text> </level> </level> <level label="2"> <text>The general purposes of this Compact are to:</text> <level label="a"> <text>Facilitate the states’ responsibility to protect the health and safety of the public;</text> </level> <level label="b"> <text>Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;</text> </level> <level label="c"> <text>Facilitate the exchange of information between party states in the areas of nurse regulation, investigation, and adverse actions;</text> </level> <level label="d"> <text>Promote compliance with the laws governing the practice of nursing in each jurisdiction;</text> </level> <level label="e"> <text>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;</text> </level> <level label="f"> <text>Decrease redundancies in the consideration and issuance of nurse licenses; and</text> </level> <level label="g"> <text>Provide opportunities for interstate practice by nurses who meet uniform licensure requirements.</text> <text>Article II. Definitions.</text> </level> </level> <level label="3"> <text>As used in this Compact:</text> <level label="a"> <text>“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:</text> <level label="1"> <text>Revocation;</text> </level> <level label="2"> <text>Suspension;</text> </level> <level label="3"> <text>Probation;</text> </level> <level label="4"> <text>Monitoring of the licensee;</text> </level> <level label="5"> <text>A limitation on the licensee’s practice;</text> </level> <level label="6"> <text>A cease and desist action; or</text> </level> <level label="7"> <text>Any other encumbrance on licensure affecting a nurse’s authorization to practice.</text> </level> </level> <level label="b"> <text>“Alternative program” means a nondisciplinary monitoring program approved by a licensing board.</text> </level> <level label="c"> <text>“Commission” means the Interstate Commission of Nurse Licensure Compact Administrators.</text> </level> <level label="d"> <text>“Compact” means this Nurse Licensure Compact.</text> </level> <level label="e"> <text>“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.</text> </level> <level label="f"> <text>“Current significant investigative information” means investigative information that:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="g"> <text>“Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of nursing imposed by a licensing board.</text> </level> <level label="h"> <text>“Home state” means the party state that is the nurse’s primary state of residence.</text> </level> <level label="i"> <text>“Licensing board” means a party state’s regulatory body responsible for issuing nurse licenses.</text> </level> <level label="j"> <text>“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.</text> </level> <level label="k"> <text>“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.</text> </level> <level label="l"> <text>“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.</text> </level> <level label="m"> <text>“Party state” means any state that has adopted this Compact.</text> </level> <level label="n"> <text>“Remote state” means a party state, other than the home state.</text> </level> <level label="o"> <text>“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.</text> </level> <level label="p"> <text>“State” means a state, territory, or possession of the United States or the District of Columbia.</text> </level> <level label="q"> <level label="1"> <text>“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.</text> </level> <level label="2"> <text>“State practice laws” does not include requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.</text> <text>Article III. General Provisions and Jurisdiction.</text> </level> </level> </level> <level label="4"> <text>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.</text> </level> <level label="5"> <level label="a"> <text>A party state must implement procedures for considering the criminal history records of applicants for an initial multistate license or licensure by endorsement.</text> </level> <level label="b"> <text>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.</text> </level> </level> <level label="6"> <text>Each party state shall require the following for an applicant to obtain or retain a multistate license in the home state:</text> <level label="a"> <text>Meets the home state’s qualifications for licensure or renewal of licensure, as well as all other applicable state laws; and</text> </level> <level label="b"> <level label="1"> <level label="i"> <text>Has graduated or is eligible to graduate from a licensing board–approved RN or LPN/VN prelicensure education program; or</text> </level> <level label="ii"> <text>Has graduated from a foreign RN or LPN/VN prelicensure education program that:</text> <level label="1"> <text>Has been approved by the authorized accrediting body in the applicable country; and</text> </level> <level label="2"> <text>Has been verified by an independent credentials review agency to be comparable to a licensing board–approved prelicensure education program;</text> </level> </level> </level> <level label="2"> <text>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;</text> </level> <level label="3"> <text>Has successfully passed an NCLEX–RN or NCLEX–PN Examination or recognized predecessor, as applicable;</text> </level> <level label="4"> <text>Is eligible for or holds an active, unencumbered license;</text> </level> <level label="5"> <text>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;</text> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>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;</text> </level> <level label="8"> <text>Is not currently enrolled in an alternative program;</text> </level> <level label="9"> <text>Is subject to self–disclosure requirements regarding current participation in an alternative program; and</text> </level> <level label="10"> <text>Has a valid United States Social Security number.</text> </level> </level> </level> <level label="7"> <level label="a"> <text>All party states are authorized, in accordance with existing state due process laws, to take adverse action against a nurse’s multistate licensure privilege.</text> </level> <level label="b"> <text>If a party state takes adverse action, the party state shall promptly notify the administrator of the coordinated licensure information system.</text> </level> <level label="c"> <text>The administrator of the coordinated licensure information system shall promptly notify the home state of any adverse action taken by remote states.</text> </level> </level> <level label="8"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> </level> <level label="9"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>Nothing in this Compact shall affect the requirements established by a party state for the issuance of a single–state license.</text> </level> <level label="d"> <text>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:</text> <level label="1"> <text>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</text> </level> <level label="2"> <text>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:</text> <level label="i"> <text>Is ineligible to retain or renew a multistate license; and</text> </level> <level label="ii"> <text>Shall have the nurse’s multistate license revoked or deactivated in accordance with applicable rules adopted by the Commission.</text> <text>Article IV. Applications for Licensure in a Party State.</text> </level> </level> </level> </level> <level label="10"> <level label="a"> <text>Upon application for a multistate license, the licensing board in the issuing party state shall ascertain, through the coordinated licensure information system, whether:</text> <level label="1"> <text>The applicant has ever held, or is the holder of, a license issued by any other state;</text> </level> <level label="2"> <text>There are any encumbrances on any license or multistate licensure privilege held by the applicant;</text> </level> <level label="3"> <text>Any adverse action has been taken against any license or multistate licensure privilege held by the applicant; and</text> </level> <level label="4"> <text>The applicant is currently participating in an alternative program.</text> </level> </level> <level label="b"> <text>A nurse may hold a multistate license, issued by the home state, in only one party state at a time.</text> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The nurse may apply for licensure in advance of a change in the nurse’s home state.</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="d"> <text>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.</text> <text>Article V. Additional Authorities Invested in Party State Licensing Boards.</text> </level> </level> <level label="11"> <level label="a"> <text>In addition to the other powers conferred by state law, a licensing board shall have the authority to:</text> <level label="1"> <text>Take adverse action against a nurse’s multistate licensure privilege to practice within that party state;</text> </level> <level label="2"> <text>Complete any pending investigations of a nurse who changes the nurse’s home state during the course of the investigations;</text> </level> <level label="3"> <text>Issue cease and desist orders or impose an encumbrance on a nurse’s authority to practice within that party state;</text> </level> <level label="4"> <text>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;</text> </level> <level label="5"> <text>Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, as well as the production of evidence;</text> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>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</text> </level> <level label="8"> <text>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.</text> </level> </level> <level label="b"> <text>Only the home state shall have the power to take adverse action against a nurse’s license issued by the home state.</text> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="d"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <text>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.</text> </level> </level> <level label="e"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> <text>Article VI. Coordinated Licensure Information System and Exchange of Information.</text> </level> </level> </level> <level label="12"> <level label="a"> <level label="1"> <text>All party states shall participate in a coordinated licensure information system of all licensed registered nurses (RNs) and licensed practical/vocational nurses (LPNs/VNs).</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>All licensing boards shall promptly report to the coordinated licensure information system:</text> <level label="1"> <text>Any adverse action;</text> </level> <level label="2"> <text>Any current significant investigative information;</text> </level> <level label="3"> <text>Denials of applications with the reasons for the denials; and</text> </level> <level label="4"> <text>Nurse participation in alternative programs known to the licensing board regardless of whether such participation is deemed nonpublic or confidential under state law.</text> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <text>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.</text> </level> <level label="h"> <text>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:</text> <level label="1"> <text>Identifying information;</text> </level> <level label="2"> <text>Licensure data;</text> </level> <level label="3"> <text>Information related to alternative program participation; and</text> </level> <level label="4"> <text>Other information that may facilitate the administration of this Compact, as determined by Commission rules.</text> </level> </level> <level label="i"> <text>The Compact administrator of a party state shall provide all investigative documents and information requested by another party state.</text> <text>Article VII. Establishment of the Interstate Commission of Nurse Licensure Compact Administrators.</text> </level> </level> <level label="13"> <level label="a"> <level label="1"> <text>The party states hereby create and establish a joint public entity known as the Interstate Commission of Nurse Licensure Compact Administrators.</text> </level> <level label="2"> <text>The Commission is an instrumentality of the party states.</text> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.</text> </level> </level> <level label="4"> <text>Nothing in this Compact shall be construed to be a waiver of sovereign immunity.</text> </level> </level> <level label="b"> <level label="1"> <level label="i"> <text>Each party state shall have and be limited to one administrator.</text> </level> <level label="ii"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The Executive Director of the Maryland State Board of Nursing, or the Executive Director’s designee, is the administrator of this Compact in Maryland.</text> </level> </level> <level label="iii"> <text>Any administrator may be removed or suspended from office as provided by the law of the state from which the administrator is appointed.</text> </level> <level label="iv"> <text>Any vacancy occurring in the Commission shall be filled in accordance with the laws of the party state in which the vacancy exists.</text> </level> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>An administrator shall vote in person or by such other means as provided in the bylaws.</text> </level> <level label="iii"> <text>The bylaws may provide for an administrator’s participation in meetings by telephone or other means of communication.</text> </level> </level> <level label="3"> <level label="i"> <text>The Commission shall meet at least once during each calendar year.</text> </level> <level label="ii"> <text>Additional meetings shall be held as set forth in the bylaws or rules of the Commission.</text> </level> </level> <level label="4"> <text>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.</text> </level> <level label="5"> <text>Subject to paragraph (6) of this subsection, the Commission may convene in a closed, nonpublic meeting if the Commission must discuss:</text> <level label="i"> <text>Noncompliance of a party state with its obligations under this Compact;</text> </level> <level label="ii"> <text>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;</text> </level> <level label="iii"> <text>Current, threatened, or reasonably anticipated litigation;</text> </level> <level label="iv"> <text>Negotiation of contracts for the purchase or sale of goods, services, or real estate;</text> </level> <level label="v"> <text>Accusing any person of a crime or formally censuring any person;</text> </level> <level label="vi"> <text>Disclosure of trade secrets or commercial or financial information that is privileged or confidential;</text> </level> <level label="vii"> <text>Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;</text> </level> <level label="viii"> <text>Disclosure of investigatory records compiled for law enforcement purposes;</text> </level> <level label="ix"> <text>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</text> </level> <level label="x"> <text>Matters specifically exempted from disclosure by federal or state laws.</text> </level> </level> <level label="6"> <level label="i"> <text>The Commission may meet in closed session only after a majority of the administrators vote to close a meeting in whole or in part.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="7"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> </level> <level label="iii"> <text>All documents considered in connection with an action shall be identified in the minutes.</text> </level> <level label="iv"> <text>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.</text> </level> </level> </level> <level label="c"> <text>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:</text> <level label="1"> <text>Establishing the fiscal year of the Commission;</text> </level> <level label="2"> <text>Providing reasonable standards and procedures:</text> <level label="i"> <text>For the establishment and meetings of other committees; and</text> </level> <level label="ii"> <text>Governing any general or specific delegation of any authority or function of the Commission;</text> </level> </level> <level label="3"> <text>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;</text> </level> <level label="4"> <text>Establishing the titles, duties and authority, and reasonable procedures for the election of the officers of the Commission;</text> </level> <level label="5"> <text>Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission; and</text> </level> <level label="6"> <text>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.</text> </level> </level> <level label="d"> <text>The Commission shall publish its bylaws and rules and any amendments in a convenient form on the Web site of the Commission.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>The rules shall have the force and effect of law and shall be binding in all party states.</text> </level> <level label="g"> <text>The Commission shall maintain its financial records in accordance with the bylaws.</text> </level> <level label="h"> <text>The Commission shall meet and take any actions that are consistent with the provisions of this Compact and the bylaws.</text> </level> <level label="i"> <text>The Commission has the following powers:</text> <level label="1"> <text>To promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact;</text> </level> <level label="2"> <text>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;</text> </level> <level label="3"> <text>To purchase and maintain insurance and bonds;</text> </level> <level label="4"> <text>To borrow, accept, or contract for services of personnel, including employees of a party state or nonprofit organizations;</text> </level> <level label="5"> <text>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;</text> </level> <level label="6"> <text>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;</text> </level> <level label="7"> <text>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;</text> </level> <level label="8"> <text>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;</text> </level> <level label="9"> <text>To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, whether real, personal, or mixed;</text> </level> <level label="10"> <text>To establish a budget and make expenditures;</text> </level> <level label="11"> <text>To borrow money;</text> </level> <level label="12"> <text>To appoint committees, including advisory committees composed of administrators, state nursing regulators, state legislators or their representatives, consumer representatives, and other interested persons;</text> </level> <level label="13"> <text>To provide and receive information from, and to cooperate with, law enforcement agencies;</text> </level> <level label="14"> <text>To adopt and use an official seal; and</text> </level> <level label="15"> <text>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.</text> </level> </level> <level label="j"> <level label="1"> <text>The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.</text> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="3"> <text>The Commission may not:</text> <level label="i"> <text>Incur obligations of any kind prior to securing the funds adequate to meet the obligations of the Commission; or</text> </level> <level label="ii"> <text>Pledge the credit of any of the party states, except by, and with the authority of, the party state.</text> </level> </level> <level label="4"> <level label="i"> <text>The Commission shall keep accurate accounts of all receipts and disbursements.</text> </level> <level label="ii"> <text>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.</text> </level> <level label="iii"> <text>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.</text> </level> </level> </level> <level label="k"> <text>The Commission shall issue an annual report.</text> </level> <level label="l"> <level label="1"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>Nothing in subparagraph (i) of this paragraph shall be construed to:</text> <level label="1"> <text>Prohibit a person from retaining the person’s own counsel; or</text> </level> <level label="2"> <text>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.</text> </level> </level> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>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.</text> <text>Article VIII. Rulemaking.</text> </level> </level> </level> </level> <level label="14"> <level label="a"> <level label="1"> <text>The Commission shall exercise its rulemaking powers in accordance with the criteria in this article and the rules adopted under this article.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <text>Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.</text> </level> <level label="c"> <text>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:</text> <level label="1"> <text>On the Web site of the Commission; and</text> </level> <level label="2"> <text>On the Web site of each licensing board or the publication in which each party state would otherwise publish proposed rules.</text> </level> </level> <level label="d"> <text>The notice of proposed rulemaking shall include:</text> <level label="1"> <text>The proposed time, date, and location of the meeting in which the proposed rule or amendment will be considered and voted on;</text> </level> <level label="2"> <text>The text of the proposed rule or amendment, and the reason for the proposed rule or amendment;</text> </level> <level label="3"> <text>A request for comments on the proposed rule or amendment from any interested person; and</text> </level> <level label="4"> <text>The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.</text> </level> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <text>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.</text> </level> <level label="g"> <level label="1"> <text>The Commission shall publish the place, time, and date of the scheduled public hearing.</text> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <text>All hearings shall be recorded, and a copy shall be made available on request.</text> </level> <level label="4"> <level label="i"> <text>Nothing in this section shall be construed as requiring a separate hearing on each rule or amendment.</text> </level> <level label="ii"> <text>Rules or amendments may be grouped for the convenience of the Commission at hearings required by this section.</text> </level> </level> </level> <level label="h"> <text>If no one appears at the public hearing, the Commission may proceed with adoption of the proposed rule or amendment.</text> </level> <level label="i"> <text>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.</text> </level> <level label="j"> <text>The Commission shall by majority vote of all administrators:</text> <level label="1"> <text>Take final action on the proposed rule or amendment; and</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="k"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> <level label="3"> <text>For the purposes of this subsection, an emergency rule is one that must be adopted immediately in order to:</text> <level label="i"> <text>Meet an imminent threat to public health, safety, or welfare;</text> </level> <level label="ii"> <text>Prevent a loss of Commission or party state funds; or</text> </level> <level label="iii"> <text>Meet a deadline for the adoption of an administrative rule that is required by federal law or rule.</text> </level> </level> </level> <level label="l"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>Public notice of any revisions shall be posted on the Web site of the Commission.</text> </level> <level label="3"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The revision may be challenged only on grounds that the revision results in a material change to a rule or an amendment.</text> </level> <level label="iii"> <text>A challenge shall be made in writing and delivered to the Commission before the end of the notice period.</text> </level> <level label="iv"> <text>If no challenge is made, the revision will take effect without further action.</text> </level> <level label="v"> <text>If the revision is challenged, the revision may not take effect without the approval of the Commission.</text> <text>Article IX. Oversight, Dispute Resolution, and Enforcement.</text> </level> </level> </level> </level> <level label="15"> <level label="a"> <level label="1"> <text>Each party state shall enforce this Compact and take all actions necessary and appropriate to effectuate this Compact’s purposes and intent.</text> </level> <level label="2"> <text>The Commission shall:</text> <level label="i"> <text>Be entitled to receive service of process in any proceeding that may affect the powers, responsibilities, or actions of the Commission; and</text> </level> <level label="ii"> <text>Have standing to intervene in a proceeding for all purposes.</text> </level> </level> <level label="3"> <text>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.</text> </level> </level> <level label="b"> <level label="1"> <text>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:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>Provide remedial training and specific technical assistance regarding the default.</text> </level> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.</text> </level> </level> <level label="3"> <level label="i"> <text>Termination of membership in this Compact shall be imposed only after all other means of securing compliance have been exhausted.</text> </level> <level label="ii"> <text>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.</text> </level> </level> <level label="4"> <text>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.</text> </level> <level label="5"> <text>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.</text> </level> <level label="6"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The prevailing party shall be awarded all costs of such litigation, including reasonable attorneys’ fees.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>The Commission shall adopt a rule providing for both mediation and binding dispute resolution for disputes, as appropriate.</text> </level> <level label="3"> <text>In the event the Commission cannot resolve disputes among party states arising under this Compact:</text> <level label="i"> <text>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</text> </level> <level label="ii"> <text>The decision of a majority of the arbitrators shall be final and binding.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.</text> </level> <level label="2"> <level label="i"> <text>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.</text> </level> <level label="ii"> <text>The relief sought may include both injunctive relief and damages.</text> </level> <level label="iii"> <text>In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorneys’ fees.</text> </level> </level> <level label="3"> <level label="i"> <text>The remedies provided for in this article may not be the exclusive remedies of the Commission.</text> </level> <level label="ii"> <text>The Commission may pursue any other remedies available under federal or state law.</text> <text>Article X. Effective Date, Withdrawal, and Amendment.</text> </level> </level> </level> </level> <level label="16"> <level label="a"> <level label="1"> <text>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.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <level label="1"> <text>Any party state may withdraw from this Compact by enacting a statute repealing the Compact.</text> </level> <level label="2"> <text>A party state’s withdrawal may not take effect until 6 months after enactment of the repealing statute.</text> </level> </level> <level label="d"> <text>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.</text> </level> <level label="e"> <text>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.</text> </level> <level label="f"> <level label="1"> <text>This Compact may be amended by the party states.</text> </level> <level label="2"> <text>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.</text> </level> </level> <level label="g"> <text>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.</text> <text>Article XI. Construction and Severability.</text> </level> </level> <level label="17"> <level label="a"> <text>This Compact shall be liberally construed so as to effectuate the purposes of the Compact.</text> </level> <level label="b"> <text>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.</text> </level> <level label="c"> <text>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.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="8-7A-02" title_number="8" title_name="Nurses" subtitle_number="7A" subtitle_name="Nurse Licensure Compact"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-7A-03" title_number="8" title_name="Nurses" subtitle_number="7A" subtitle_name="Nurse Licensure Compact"> <level label="a"> <text>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.</text> </level> <level label="b"> <text>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.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-7A-04" title_number="8" title_name="Nurses" subtitle_number="7A" subtitle_name="Nurse Licensure Compact"> <text>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.</text> </section> <section article="gho" article_name="Health Occupations" number="8-7A-05" title_number="8" title_name="Nurses" subtitle_number="7A" subtitle_name="Nurse Licensure Compact"> <text>This Nurse Licensure Compact:</text> <level label="a"> <text>Is designed to facilitate the regulation of nurses, and may not relieve employers from complying with contractual and statutorily imposed obligations; and</text> </level> <level label="b"> <text>May not supersede existing State labor laws.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="8-801" title_number="8" title_name="Nurses" subtitle_number="8"> <text>This title may be cited as the “Maryland Nurse Practice Act”.</text> </section> <section article="gho" article_name="Health Occupations" number="8-802" title_number="8" title_name="Nurses" subtitle_number="8"> <text>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.</text> </section>