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Laws

of the

State of Maryland

At the Session of the General Assembly Begun and Held in the City of Annapolis on the Fourteenth Day of January 2015

and Ending on the Thirteenth Day of April 2015

Bills vetoed by the Governor appear after the Laws

______

VOLUME IV ______

The Department of Legislative Services General Assembly of Maryland

prepared this document.

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2457 Lawrence J. Hogan, Jr., Governor Chapter 466

Chapter 466

(Senate Bill 210) AN ACT concerning

Educational Institutions of Postsecondary Education – Personal Electronic Account – Privacy Protection

FOR the purpose of prohibiting an educational institution institution of postsecondary

education from requiring, requesting, suggesting, or causing a student, an applicant, or a prospective student to grant access to, allow observation of, or disclose information that allows access to or observation of the individual’s personal electronic account; prohibiting an educational institution institution of postsecondary education from compelling a student, an applicant, or a prospective student, as a condition of acceptance or participation in curricular or extracurricular activities, to add certain individuals to a certain list of contacts or to change certain privacy settings; prohibiting an educational institution institution of postsecondary education from taking or threatening to take certain actions against a student, or failing or refusing to admit an applicant, as a result of the student’s or applicant’s refusal to grant access to, allow observation of, or disclose certain information relating to a personal electronic account, add certain individuals to a certain list of contacts, or change certain privacy settings; providing that this Act may not be construed to prohibit an educational institution institution of postsecondary education from requesting or requiring a student to disclose access information to certain electronic accounts, to prohibit or restrict an educational institution institution of postsecondary education from viewing, accessing, or utilizing certain information that is available in the public domain publicly accessible or available to an educational institution institution of postsecondary education as the result of certain actions of the student, to create a duty to search or monitor the activity of a personal electronic account, to make an educational institution institution of postsecondary education liable for failing to request or require a student, an applicant, or a prospective student to grant access to, allow observation of, or disclose certain information relating to a personal electronic account, to prohibit a student, an applicant, or a prospective student from allowing a certain individual to view certain communications, or to apply to a certain investigation conducted by a certain department of or in accordance with a certain policy or protocol of an institution of postsecondary education; authorizing the governing board of an institution of postsecondary education to adopt a policy authorizing an employee to request a student to create a certain personal electronic account for a certain purpose; authorizing an individual who is the subject of a violation of this Act to take certain legal action; establishing that an educational institution’s institution of postsecondary education’s action in compliance with federal or State law is an affirmative defense to a claim under this Act; defining certain terms; and generally relating to the personal electronic accounts of students, applicants, and prospective students of educational institutions of postsecondary education.

Chapter 466 Laws of Maryland – 2015 Session 2458 BY adding to Article – Education

Section 26–401 to be under the new subtitle “Subtitle 4. Personal Electronic Account Privacy Protection”

Annotated Code of Maryland (2014 Replacement Volume and 2014 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:

Article – Education

SUBTITLE 4. PERSONAL ELECTRONIC ACCOUNT PRIVACY PROTECTION. 26–401. (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED. (2) “ACCESS INFORMATION” MEANS A USER NAME, A PASSWORD, LOG–IN INFORMATION, AN ACCOUNT NAME, OR ANY OTHER SECURITY INFORMATION THAT PROTECTS ACCESS TO A PERSONAL ELECTRONIC ACCOUNT. (3) “EDUCATIONAL INSTITUTION” MEANS A PUBLIC OR PRIVATE EDUCATIONAL INSTITUTION THAT OFFERS STUDENTS AN ORGANIZED COURSE OF STUDY OR TRAINING THAT IS ACADEMIC, TECHNICAL, TRADE–ORIENTED, OR PREPARATORY FOR GAINFUL EMPLOYMENT IN A RECOGNIZED OCCUPATION INSTITUTION OF POSTSECONDARY EDUCATION” HAS THE MEANING STATED IN § 10–101(I) OF THIS ARTICLE. (4) (I) “PERSONAL ELECTRONIC ACCOUNT” MEANS AN ACCOUNT CREATED VIA AN ELECTRONIC MEDIUM OR A SERVICE THAT ALLOWS USERS TO CREATE, SHARE, OR VIEW USER–GENERATED CONTENT, INCLUDING UPLOADING OR DOWNLOADING VIDEOS OR STILL PHOTOGRAPHS, BLOGS, VIDEO BLOGS, PODCASTS, MESSAGES, ELECTRONIC MAIL, INTERNET WEB SITE PROFILES OR LOCATIONS, OR ANY OTHER ELECTRONIC INFORMATION. (II) “PERSONAL ELECTRONIC ACCOUNT” DOES NOT INCLUDE AN ACCOUNT THAT IS OPENED ON BEHALF OF, OR OWNED OR PROVIDED BY, AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION. (5) “STUDENT” INCLUDES AN INDIVIDUAL WHO IS A PARTICIPANT, TRAINEE, OR STUDENT IN AN ORGANIZED COURSE OF STUDY OR TRAINING OFFERED BY AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION.


(B) SUBJECT TO SUBSECTION (C) OF THIS SECTION, AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION MAY NOT: (1) REQUIRE, REQUEST, SUGGEST, OR CAUSE A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT TO GRANT ACCESS TO, ALLOW OBSERVATION OF, OR DISCLOSE INFORMATION THAT ALLOWS ACCESS TO OR OBSERVATION OF THE INDIVIDUAL’S PERSONAL ELECTRONIC ACCOUNT; (2) COMPEL A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT, AS A CONDITION OF ACCEPTANCE OR PARTICIPATION IN CURRICULAR OR EXTRACURRICULAR ACTIVITIES, TO: (I) ADD TO THE LIST OF CONTACTS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT ANY INDIVIDUAL, INCLUDING A COACH, A TEACHER, AN ADMINISTRATOR, ANOTHER EMPLOYEE OF THE EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION, OR A VOLUNTEER; OR (II) CHANGE THE PRIVACY SETTINGS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT; (3) TAKE ANY ACTION OR THREATEN TO TAKE ANY ACTION TO DISCHARGE, DISCIPLINE, PROHIBIT FROM PARTICIPATING IN CURRICULAR OR EXTRACURRICULAR ACTIVITIES, OR OTHERWISE PENALIZE A STUDENT AS A RESULT OF THE STUDENT’S REFUSAL TO: (I) GRANT ACCESS TO, ALLOW OBSERVATION OF, OR DISCLOSE ANY INFORMATION THAT ALLOWS ACCESS TO OR OBSERVATION OF A PERSONAL ELECTRONIC ACCOUNT; (II) ADD ANY INDIVIDUAL TO THE LIST OF CONTACTS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT; OR (III) CHANGE THE PRIVACY SETTINGS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT; OR (4) FAIL OR REFUSE TO ADMIT AN APPLICANT AS A RESULT OF THE APPLICANT’S REFUSAL TO: (I) GRANT ACCESS TO, ALLOW OBSERVATION OF, OR DISCLOSE ANY INFORMATION THAT ALLOWS ACCESS TO OR OBSERVATION OF A PERSONAL ELECTRONIC ACCOUNT; (II) ADD ANY INDIVIDUAL TO THE LIST OF CONTACTS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT; OR

Chapter 466 Laws of Maryland – 2015 Session 2460 (III) CHANGE THE PRIVACY SETTINGS ASSOCIATED WITH A PERSONAL ELECTRONIC ACCOUNT. (C) THIS SECTION MAY NOT BE CONSTRUED TO: (1) PROHIBIT AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION FROM REQUESTING OR REQUIRING A STUDENT TO DISCLOSE ACCESS INFORMATION TO ALLOW THE EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION TO GAIN ACCESS TO AN ELECTRONIC ACCOUNT: (I) OPENED AT THE EDUCATIONAL INSTITUTION’S INSTITUTION OF POSTSECONDARY EDUCATION’S BEHEST; OR (II) PROVIDED BY THE EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION; (2) PROHIBIT OR RESTRICT AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION FROM VIEWING, ACCESSING, OR UTILIZING INFORMATION ABOUT A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT THAT: (I) CAN BE OBTAINED WITHOUT ACCESS INFORMATION; (II) IS AVAILABLE IN THE PUBLIC DOMAIN PUBLICLY ACCESSIBLE; OR (III) IS AVAILABLE TO THE EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION AS THE RESULT OF ACTIONS UNDERTAKEN INDEPENDENTLY BY THE STUDENT; (3) CREATE A DUTY REQUIRING AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION TO SEARCH OR MONITOR THE ACTIVITY OF A PERSONAL ELECTRONIC ACCOUNT; (4) MAKE AN EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION LIABLE FOR FAILING TO REQUEST OR REQUIRE A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT TO GRANT ACCESS TO, ALLOW OBSERVATION OF, OR DISCLOSE INFORMATION THAT ALLOWS ACCESS TO OR OBSERVATION OF THE INDIVIDUAL’S PERSONAL ELECTRONIC ACCOUNT; (5) PROHIBIT A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT FROM ALLOWING AN ATHLETIC COACH OR ADMINISTRATOR TO VIEW THE


STUDENT’S, APPLICANT’S, OR PROSPECTIVE STUDENT’S PUBLICLY ACCESSIBLE COMMUNICATIONS; OR (6) APPLY TO: (I) A SUSPECTED CRIMINAL ACTIVITY INVESTIGATION INTO THE PUBLICLY ACCESSIBLE COMMUNICATIONS OF A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT THAT IS PERFORMED BY A PUBLIC SAFETY DEPARTMENT OR POLICE AGENCY OF AN INSTITUTION OF POSTSECONDARY EDUCATION; OR (II) AN INVESTIGATION, AN INQUIRY, OR A DETERMINATION RELATING TO THE PUBLICLY ACCESSIBLE COMMUNICATIONS OF A STUDENT, AN APPLICANT, OR A PROSPECTIVE STUDENT THAT IS CONDUCTED IN ACCORDANCE WITH THE HEALTH OR PUBLIC SAFETY ADMINISTRATION ASSESSMENT POLICY OR PROTOCOL OF AN INSTITUTION OF POSTSECONDARY EDUCATION. (D) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION, THE GOVERNING BOARD OF AN INSTITUTION OF POSTSECONDARY EDUCATION MAY ADOPT A POLICY AUTHORIZING AN EMPLOYEE OF THE INSTITUTION OF POSTSECONDARY EDUCATION TO REQUEST A STUDENT, IN ORDER TO COMPLETE AN ACADEMIC OR CAREER–BASED ACTIVITY, TO CREATE A GENERIC PERSONAL ELECTRONIC ACCOUNT. (D) (E) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION, AN INDIVIDUAL WHO IS THE SUBJECT OF A VIOLATION OF ANY PROVISION OF THIS SECTION MAY: (I) BRING A CIVIL ACTION TO ENJOIN THE VIOLATION OR FOR DAMAGES; (II) ADD A CLAIM FOR DAMAGES TO AN ACTION SEEKING INJUNCTIVE RELIEF; AND (III) RECOVER NOT MORE THAN $1,000 IN DAMAGES PLUS REASONABLE ATTORNEY’S FEES AND COURT COSTS. (2) AN INDIVIDUAL MAY NOT BRING AN ACTION FOR DAMAGES OR ADD A CLAIM FOR DAMAGES TO AN ACTION SEEKING INJUNCTIVE RELIEF UNDER THIS SECTION UNTIL AT LEAST 60 DAYS AFTER MAKING A WRITTEN DEMAND OF THE ALLEGED VIOLATOR FOR NOT MORE THAN $1,000 THAT: (I) INCLUDES REASONABLE DOCUMENTATION OF THE VIOLATION; AND

Chapter 467 Laws of Maryland – 2015 Session 2462

(II) IS SERVED IN THE MANNER PROVIDED FOR SERVICE OF PROCESS IN A CIVIL ACTION UNDER THE MARYLAND RULES OR BY CERTIFIED MAIL TO THE RESIDENCE OR PRINCIPAL OFFICE OR PLACE OF BUSINESS OF THE ALLEGED VIOLATOR. (3) AN ACTION UNDER THIS SUBSECTION MAY BE BROUGHT IN THE DISTRICT COURT FOR THE COUNTY IN WHICH: (I) THE ALLEGED VIOLATION OCCURRED; OR (II) THE ALLEGED VIOLATOR RESIDES OR HAS A PRINCIPAL OFFICE OR PLACE OF BUSINESS. (E) (F) IT IS AN AFFIRMATIVE DEFENSE TO ANY CLAIM UNDER THIS SECTION THAT THE EDUCATIONAL INSTITUTION INSTITUTION OF POSTSECONDARY EDUCATION ACTED TO COMPLY WITH THE REQUIREMENTS OF A FEDERAL OR STATE LAW. SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 1, 2015. Approved by the Governor, May 12, 2015.

Chapter 467

(House Bill 947) AN ACT concerning

Professional Standards and Teacher Education Board – School Counselors – Certification Renewal Requirement

(Lauryn’s Law) FOR the purpose of requiring the Professional Standards and Teacher Education Board to

require, beginning on or before a certain date, certain applicants for renewal of certification certificate holders applying for renewal of a certificate as a school counselor to have successfully completed a certain number of credit hours of continuing professional development in a certain course regarding the recognition of, initial screening for, and response to emotional and behavioral distress in students and other individuals; requiring a certain course to include certain information; obtained, by a method determined by the Board, certain knowledge and skills required to understand and respond to the social, emotional, and personal development of students; requiring the Board to adopt certain regulations; and


generally relating to a certification renewal requirement for school counselors by the Professional Standards and Teacher Education Board.

BY adding to Article – Education

Section 6–704.1 Annotated Code of Maryland (2014 Replacement Volume and 2014 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:

Article – Education 6–704.1. (A) BEGINNING ON OR BEFORE JULY 1, 2016, THE BOARD SHALL REQUIRE AN APPLICANT FOR RENEWAL OF A CERTIFICATE A CERTIFICATE HOLDER APPLYING FOR RENEWAL OF A CERTIFICATE AS A SCHOOL COUNSELOR TO HAVE SUCCESSFULLY COMPLETED 1 CREDIT HOUR OF CONTINUING PROFESSIONAL DEVELOPMENT IN AN EVIDENCE–BASED COURSE THAT PROVIDES OBTAINED, BY A METHOD DETERMINED BY THE BOARD, THE KNOWLEDGE AND SKILL STANDARDS REGARDING THE RECOGNITION OF, INITIAL SCREENING FOR, AND RESPONSE TO EMOTIONAL AND BEHAVIORAL DISTRESS IN STUDENTS AND OTHER INDIVIDUALS, INCLUDING INDICATORS OF SUBSTANCE ABUSE, VIOLENCE, MENTAL ILLNESS, AND YOUTH SUICIDE. (B) THE COURSE REQUIRED UNDER SUBSECTION (A) OF THIS SECTION SHALL INCLUDE: (1) STRATEGIES FOR HELPING AN INDIVIDUAL EXPERIENCING A MENTAL HEALTH OR SUBSTANCE ABUSE CRISIS; (2) AN INTRODUCTION TO THE RISK FACTORS AND WARNING SIGNS FOR MENTAL ILLNESS AND SUBSTANCE ABUSE PROBLEMS; (3) INFORMATION OF EVIDENCE–SUPPORTED TREATMENT AND SELF–HELP STRATEGIES; AND (4) IDENTIFYING PROFESSIONAL HELP AND OTHER SUPPORTS AND RESOURCES FOR INDIVIDUALS IN CRISIS. SKILLS REQUIRED TO UNDERSTAND AND RESPOND TO THE SOCIAL, EMOTIONAL, AND PERSONAL DEVELOPMENT OF STUDENTS, INCLUDING KNOWLEDGE AND SKILLS RELATING TO:


(1) THE RECOGNITION OF INDICATORS OF MENTAL ILLNESS AND BEHAVIORAL DISTRESS, INCLUDING DEPRESSION, TRAUMA, VIOLENCE, YOUTH SUICIDE, AND SUBSTANCE ABUSE; AND (2) THE IDENTIFICATION OF PROFESSIONAL RESOURCES TO HELP STUDENTS IN CRISIS. (C) (B) THE BOARD SHALL ADOPT REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION. SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 1, 2015. Approved by the Governor, May 12, 2015.

Chapter 468


Nurse Practitioner Full Practice Authority Act of 2015

Certified Nurse Practitioners – Authority to Practice FOR the purpose of repealing a certain prohibition against a certified nurse practitioner

practicing in the State unless the nurse practitioner has an approved attestation that the nurse practitioner has an agreement for collaboration and consulting with a certain physician and will practice in accordance with certain standards; requiring a nurse practitioner to practice in accordance with certain standards; repealing a requirement that the State Board of Nursing maintain a certain attestation and make the attestation available to the State Board of Physicians; requiring the State Board of Nursing, in consultation with the State Board of Physicians, to develop a certain plan requiring certain applicants for initial certification as a nurse practitioner to identify, on a certain application, a certified nurse practitioner or a licensed physician to act as a mentor for a certain time period; altering the definition of “practice as a nurse practitioner” to include consulting and collaborating with a certain physician or any other health care provider as needed; defining a certain term; requiring the State Board of Nursing to adopt certain regulations; and generally relating to the practice of nurse practitioners in the State.

BY adding to Article – Health Occupations Section 8–101(j)

2465 Lawrence J. Hogan, Jr., Governor Chapter 468 Annotated Code of Maryland (2014 Replacement Volume) BY repealing and reenacting, with amendments, Article – Health Occupations Section 8–101(j) through (n) and 8–302(b) Annotated Code of Maryland (2014 Replacement Volume) BY repealing and reenacting, without amendments, Article – Health Occupations

Section 8–302(a) Annotated Code of Maryland (2014 Replacement Volume) BY repealing and reenacting, with amendments, Article – Health Occupations

Section 8–302(b) Annotated Code of Maryland (2014 Replacement Volume) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:

Article – Health Occupations 8–101. (J) “MENTOR” MEANS A CERTIFIED NURSE PRACTITIONER OR A LICENSED PHYSICIAN: (1) WHO HAS 3 OR MORE YEARS OF CLINICAL PRACTICE EXPERIENCE; AND (2) WITH WHOM AN INDIVIDUAL APPLYING FOR CERTIFICATION AS A CERTIFIED NURSE PRACTITIONER WILL CONSULT AND COLLABORATE WITH AS NEEDED IN ACCORDANCE WITH § 8–302(B)(5)(I) OF THIS TITLE. [(j)] (K) “Nurse practitioner” means an individual who: (1) Is licensed by the Board to practice registered nursing; and (2) Is certified by the Board to practice as a nurse practitioner. [(k)] (L) “Practice as a nurse practitioner” means to independently:


(1) Perform an act under subsection [(m)](N) of this section; (2) Conduct a comprehensive physical assessment of an individual; (3) Establish a medical diagnosis for common chronic stable or short–term health problems; (4) Order, perform, and interpret laboratory tests; (5) Prescribe drugs as provided under § 8–508 of this title; (6) Perform diagnostic, therapeutic, or corrective measures; (7) [Refer] CONSULT AND COLLABORATE WITH, OR REFER an individual to, an appropriate licensed physician or ANY other health care provider AS NEEDED; and (8) Provide emergency care. [(l)] (M) “Practice licensed practical nursing” means to perform in a team relationship an act that requires specialized knowledge, judgment, and skill based on principles of biological, physiological, behavioral, or sociological science to: (1) Administer treatment or medication to an individual; (2) Aid in the rehabilitation of an individual; (3) Promote preventive measures in community health; (4) Give counsel to an individual; (5) Safeguard life and health; (6) Teach or supervise; or (7) Perform any additional acts authorized by the Board under § 8–205 of this title. [(m)] (N) (1) “Practice registered nursing” means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the biological, physiological, behavioral, or sociological sciences as the basis for assessment, nursing diagnosis, planning, implementation, and evaluation of the practice of nursing in order to: (i) Maintain health; (ii) Prevent illness; or

2467 Lawrence J. Hogan, Jr., Governor Chapter 468 (iii) Care for or rehabilitate the ill, injured, or infirm. (2) For these purposes, “practice registered nursing” includes: (i) Administration; (ii) Teaching; (iii) Counseling; (iv) Supervision, delegation and evaluation of nursing practice; (v) Execution of therapeutic regimen, including the administration of medication and treatment; (vi) Independent nursing functions and delegated medical functions; and (vii) Performance of additional acts authorized by the Board under § 8–205 of this title. [(n)] (O) “Registered nurse” means, unless the context requires otherwise, an individual who is licensed by the Board to practice registered nursing. 8–302. (a) Except as otherwise provided in this title, to qualify for a license or certification, an applicant shall be an individual who submits to a criminal history records check in accordance with § 8–303 of this subtitle and meets the requirements of this section. (b) (1) An applicant for certification as an advanced practice nurse shall: (i) Be a registered nurse; (ii) Complete an education program approved by the Board; (iii) Submit to the Board: 1. A completed application for certification as a nurse practitioner, nurse anesthetist, nurse midwife, nurse psychotherapist, or clinical nurse specialist for each area in which certification is sought; 2. Documentation of an active license in good standing as a registered nurse in the State;

Chapter 468 Laws of Maryland – 2015 Session 2468 3. Documentation that the applicant has graduated from an accredited program for advanced practice nursing for nurse practitioners, nurse anesthetists, nurse midwives, nurse psychotherapists, or clinical nurse specialists; and 4. Documentation of certification as a nurse practitioner, nurse anesthetist, nurse midwife, nurse psychotherapist, or clinical nurse specialist by a nationally recognized certifying body approved by the Board; and (iv) Meet any other requirements that the Board sets. (2) (i) An individual certified as a nurse practitioner by a national certifying body prior to October 1, 2010 who is certified by the Board and in good standing shall be deemed to meet the education requirements under subsection (b)(1)(iii)3 of this section. (ii) An individual certified as a nurse anesthetist, nurse midwife, nurse psychotherapist, or clinical nurse specialist who is certified by the Board and in good standing prior to October 1, 2012, shall be deemed to meet the education requirements under subsection (b)(1)(iii)3 of this section. (3) In addition to the requirements for renewal of a license under § 8–312 of this subtitle, the Board may establish continuing education or competency requirements for the renewal of a certificate under this subsection. (4) (i) Subject to the provisions of this subsection, the Board may waive any requirement of this subsection for an applicant who is licensed or certified to practice as a nurse practitioner, nurse anesthetist, nurse midwife, nurse psychotherapist, or clinical nurse specialist in any other state or country. (ii) The Board may grant a waiver under this paragraph only if the applicant: 1. Pays the application fee required by the Board under § 8–304 of this subtitle; 2. Became licensed or certified in the other state or country under requirements substantially equivalent to the certification requirements of this title; and 3. Meets any other qualifications established by the Board. (5) [(i) A certified nurse practitioner may not practice in the State unless the nurse practitioner has an approved attestation that: 1. The nurse practitioner has an agreement for collaboration and consulting with a physician licensed under Title 14 of this article and will refer to and consult with physicians and other health care providers as needed; and

2469 Lawrence J. Hogan, Jr., Governor Chapter 468 2. The] A nurse practitioner [will] SHALL practice in accordance with the standards of practice of the American [Academy] ASSOCIATION of Nurse Practitioners or any other national certifying body recognized by the Board. [(ii) The Board shall: 1. Maintain an approved attestation; and 2. Make the approved attestation available to the State Board of Physicians on the request of the State Board of Physicians.] (5) (I) AN APPLICANT FOR INITIAL CERTIFICATION AS A 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. (II) A CERTIFIED 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. (6) Unless authorized to practice as a nurse practitioner under this title, a person may not: (i) Represent to the public by title or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice as a nurse practitioner in this State; (ii) Use as a title or describe the services the person provides by use of the words “nurse practitioner” or “certified registered nurse practitioner”; or (iii) Use the abbreviation “N.P.”, “C.R.N.P.”, or any other words, letters, or symbols with the intent to represent that the person practices as a nurse practitioner. (7) Unless authorized to practice as a nurse anesthetist under this title, a person may not: (i) Practice nurse anesthesia unless certified by the Board in accordance with this section; or

Chapter 468 Laws of Maryland – 2015 Session 2470 (ii) Use the title “certified nurse anesthetist”, “nurse anesthetist”, or any other words, letters, or symbols with the intent to represent that the person practices as a nurse anesthetist. (8) Unless authorized to practice as a nurse midwife under this title, a person may not: (i) Practice nurse midwifery unless certified by the Board in accordance with this section; or (ii) Use the title “certified nurse midwife”, “nurse midwife”, or any other words, letters, or symbols with the intent to represent that the person practices as a nurse midwife. (9) Unless authorized to practice as a nurse psychotherapist under this title, a person may not: (i) Practice as a nurse psychotherapist unless certified by the Board in accordance with this section; or (ii) Use the title “advanced practice nurse”, “certified nurse psychotherapist”, “registered nurse/psychiatric mental health”, “nurse psychotherapist”, or any other words, letters, or symbols with the intent to represent that the person practices as a nurse psychotherapist. (10) Unless authorized to practice as a clinical nurse specialist under this title, a person may not: (i) Practice as a clinical nurse specialist unless certified by the Board in accordance with this section; or (ii) Use the title “certified clinical nurse specialist”, “clinical nurse specialist”, “clinical registered nurse specialist”, “clinical nurse specialist graduate”, or any other words, letters, or symbols with the intent to represent that the person practices as a clinical nurse specialist. SECTION 2. AND BE IT FURTHER ENACTED, That: (a) The State Board of Nursing, in consultation with the State Board of Physicians, shall develop a plan for implementing the provisions of this Act. (b) The plan developed under subsection (a) of this section shall provide for the repeal of obsolete regulations and the notification of certified nurse practitioners in the State of the effect of this Act.

2471 Lawrence J. Hogan, Jr., Governor Chapter 469 SECTION 2. AND BE IT FURTHER ENACTED, That the State Board of Nursing shall adopt the regulations necessary to carry out the provisions of §§ 8–101(l)(7) and 8–302(b)(5)(i) of the Health Occupations Article, as enacted by Section 1 of this Act. SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2015. Approved by the Governor, May 12, 2015.

Chapter 469


Behavioral Health Administration – Powers, Duties, and Responsibilities FOR the purpose of establishing certain powers, duties, and responsibilities of the Director

of the Behavioral Health Administration in the Department of Health and Mental Hygiene; requiring the Secretary of Health and Mental Hygiene to provide certain facilities for certain purposes to the extent of certain funds; establishing certain duties of the Behavioral Health Administration; requiring the Secretary to adopt certain regulations; prohibiting discrimination against certain individuals by certain hospitals or programs; requiring certain behavioral health programs to be licensed by the Secretary, with certain exceptions; authorizing the Secretary to require certain accreditation as a condition of licensure; authorizing certain licensing fees; establishing that individuals served by a behavioral health program have certain rights; requiring the Department of Health and Mental Hygiene to adopt certain regulations; prohibiting an individual or organization from operating a behavioral health program in violation of certain provisions of law; establishing a certain criminal fine; authorizing the Department of Health and Mental Hygiene to pursue an injunction under certain circumstances; requiring certain halfway houses for certain individuals with certain substance–related disorders to be licensed in accordance with certain provisions of law; establishing certain zoning provisions for certain halfway houses; requiring the Director on or after a certain date to prepare and implement a certain mental health plan in concert with certain entities; altering certain provisions of law relating to county mental health advisory committees; requiring certain private group homes to be licensed in accordance with certain provisions of law; altering a certain exception to a certain prohibition on review of a certain court record relating to a certain petition; establishing certain duties of certain local behavioral health authorities and local addictions authorities under certain circumstances; requiring core service agencies, local addictions authorities, and local behavioral health authorities to submit a certain plan to the Director; establishing certain duties of the Director regarding the initiation of the development of core service agencies, local addictions authorities, and local


behavioral health authorities, under certain circumstances; establishing certain duties of the Director related to assuring the continuing provision of certain services; authorizing the Director to deny approval of a local addictions authority or local behavioral health authority and cease funding or request the return of unspent funds by a local addictions authority or local behavioral health authority under certain circumstances; authorizing a county to terminate its local addictions authority or local behavioral health authority in a certain manner; prohibiting the Director from requiring a local addictions authority or local behavioral health authority to provide certain services; altering certain provisions of law relating to a certain mental health crisis response system; repealing certain limitations on admission to certain private group homes; repealing certain provisions of law setting salaries of employees of certain community mental health programs; repealing a certain program for certain hearing–impaired individuals with a mental disorder; establishing certain legislative policy; adding and altering certain defined terms; making conforming, clarifying, technical, and stylistic changes; and generally relating to behavioral health care and the Behavioral Health Administration in the Department of Health and Mental Hygiene.

BY repealing Article – Health – General

Section 8–402 through 8–404, 8–702, 8–703, 10–515, 10–517, 10–520 through 10–523, 10–604, 10–901, and 10–905; and 10–908 through 10–913 and the part “Part II. Program for Hearing Impaired Individuals”

Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement) BY repealing and reenacting, with amendments, Article – Education

Section 7–4A–03(a)(9)(xi) Annotated Code of Maryland (2014 Replacement Volume and 2014 Supplement) BY repealing and reenacting, with amendments, Article – Health – General

Section 4–307(a)(3) and (h), 5–705(b)(11), 5–803(1), 5–805(a)(1), 7.5–101, 7.5–204, 8–101, 10–101, 10–207(b)(1) and (d), 10–308(f) and (g), 10–309(a), 10–312(b)(4)(i)5., 10–516, 10–518, 10–630(b)(5), 10–701(a)(6), 10–1101,; 10–1201, 10–1202(a), (b), (c), and (d)(2) (d)(1), (2), (3), (4)(iii), and (7), 10–1202.1(b), (c)(2)(i), and (f), and 10–1203, to be under the amended subtitle “Subtitle 12. Core Service Agencies, Local Addictions Authorities, and Local Behavioral Health Authorities”; 16–101(b)(2) and (e)(2)(i) and (v), 16–201.2(a)(3) and (4), 16–204(c), and 19–2301(d)(10) and (11)

Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement) BY adding to Article – Health – General


Section 7.5–205 and 7.5–206; 7.5–301 through 7.5–304 to be under the new subtitle “Subtitle 3. Behavioral Health Programs”; and 8–405, 8–406, and 16–201.2(a)(6)

Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement) BY repealing and reenacting, without amendments, Article – Health – General

Section 10–630(a) and 16–101(e)(1) Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement) BY repealing and reenacting, with amendments, Article – Health – General

Section 10–1401(b), 10–1403(a)(1)(ii) and (b), and 10–1404(b) Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement)

(As enacted by Chapter 371 of the Acts of the General Assembly of 2002) BY adding to Article – Health – General

Section 10–1401(d) Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement)

(As enacted by Chapter 371 of the Acts of the General Assembly of 2002) BY repealing and reenacting, with amendments, Article – Human Services

Section 8–101(e), 8–302(2)(iii), 8–406(a)(1)(iv), and 8–407(4) Annotated Code of Maryland (2007 Volume and 2014 Supplement) BY adding to Article – Human Services

Section 8–101(k–1) Annotated Code of Maryland (2007 Volume and 2014 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That Section(s) 8–402 through 8–404, 8–702, 8–703, 10–515, 10–517, 10–520 through 10–523, 10–604, 10–901, and 10–905; and 10–908 through 10–913 and the part “Part II. Program for Hearing Impaired Individuals” of Article – Health – General of the Annotated Code of Maryland be repealed. SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read as follows:


Article – Education 7–4A–03. (a) The Council consists of the following 25 members: (9) The following members appointed by the Governor: (xi) A representative of the Behavioral Health Administration [or], a core service agency, OR A LOCAL BEHAVIORAL HEALTH AUTHORITY.

Article – Health – General 4–307. (a) (3) “Core service agency” [means an organization approved by the Behavioral Health Administration to manage mental health resources and services in a designated area or to a designated target population] HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. (h) This section may not be construed to prevent the disclosure of a medical record that relates to the provision of mental health services between or among the health care providers that participate in the approved plan of a core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY for the delivery of mental health services, if a recipient: (1) Has received a current list of the participating providers; and (2) Has signed a written agreement with the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY to participate in the client information system developed by the agency. 5–705. (b) The local team membership shall be drawn from the following individuals, organizations, agencies, and areas of expertise, when available: (11) A psychiatrist or psychologist with experience in child abuse and neglect or child injury, appointed by the director of the county mental health agency [or], core service agency, OR LOCAL BEHAVIORAL HEALTH AUTHORITY; 5–803. The Committee shall:

2475 Lawrence J. Hogan, Jr., Governor Chapter 469 (1) Evaluate causes or factors contributing to deaths in facilities or programs: (i) Operated or licensed by the Developmental Disabilities Administration; (ii) Licensed by the Behavioral Health Administration to provide mental health services AND IDENTIFIED IN § 10–713(A) OF THIS ARTICLE; or (iii) Operating by waiver under § 7–903(b) of this article; 5–805. (a) (1) Except as provided in paragraph (3) of this subsection, the Office of Health Care Quality shall review each death of an individual with developmental disabilities or with a mental illness who, at the time of death, resided in or was receiving services from any program or facility licensed or operated by the Developmental Disabilities Administration or operating by waiver under § 7–903(b) of this article, or any program approved, licensed, or operated by the Department under § 10–406[, § 10–901, or § 10–902] OF THIS ARTICLE OR ANY PROGRAM IDENTIFIED IN § 10–713(A) of this article. 7.5–101. (a) In this title the following words have the meanings indicated. (B) (1) “ADDICTIVE DISORDER” MEANS A CHRONIC DISORDER OF THE BRAIN’S REWARD–ACTIVATION SYSTEM IN WHICH BEHAVIOR BECOMES REPETITIVE, THERE IS THE INDIVIDUAL PATHOLOGICALLY PURSUES REWARD OR RELIEF BY SUBSTANCE USE OR OTHER BEHAVIORS, WITH DIMINISHED CONTROL, AND THE INDIVIDUAL PERSISTS IN THE BEHAVIOR DESPITE ADVERSE CONSEQUENCES. (2) “ADDICTIVE DISORDER” INCLUDES GAMBLING, WHICH IS THE ONLY NONSUBSTANCE–RELATED ADDICTIVE DISORDER RECOGNIZED BY MARYLAND LAW. [(b)] (C) “Administration” means the Behavioral Health Administration. [(c)] (D) “Behavioral health” includes [substance use] SUBSTANCE–RELATED disorders, addictive disorders, and mental disorders. [(d)] (E) “Behavioral health care” includes prevention, screening, early intervention, treatment, recovery, support, wraparound, and rehabilitation services, for individuals with [substance use] SUBSTANCE–RELATED disorders, addictive disorders, mental disorders, or a combination of these disorders.


(F) “BEHAVIORAL HEALTH PROGRAM” MEANS A SUBSTANCE–RELATED DISORDERS PROGRAM, A MENTAL HEALTH PROGRAM, OR AN ADDICTIVE DISORDERS PROGRAM, OR A PROGRAM THAT CONSISTS OF MORE THAN ONE OF THESE PROGRAMS. (G) “CORE SERVICE AGENCY” MEANS THE DESIGNATED COUNTY OR MULTICOUNTY AUTHORITY THAT IS RESPONSIBLE FOR PLANNING, MANAGING, AND MONITORING PUBLICLY FUNDED MENTAL HEALTH SERVICES. [(e)] (H) “Director” means the Director of the Administration. (I) “FAMILY SUPPORT SERVICES” MEANS A SET OF NONCLINICAL ACTIVITIES PROVIDED BY FAMILY MEMBERS OF INDIVIDUALS WITH MENTAL HEALTH OR SUBSTANCE–RELATED DISORDERS AND ADDICTIVE DISORDERS TO SUPPORT INDIVIDUALS WITH MENTAL HEALTH OR SUBSTANCE–RELATED DISORDERS AND ADDICTIVE DISORDERS OR THEIR FAMILIES. (J) “LOCAL ADDICTIONS AUTHORITY” MEANS THE DESIGNATED COUNTY OR MULTICOUNTY AUTHORITY THAT IS RESPONSIBLE FOR PLANNING, MANAGING, AND MONITORING PUBLICLY FUNDED SUBSTANCE–RELATED DISORDERS AND ADDICTIVE DISORDER SERVICES. (K) “LOCAL BEHAVIORAL HEALTH AUTHORITY” MEANS THE DESIGNATED COUNTY OR MULTICOUNTY AUTHORITY THAT IS RESPONSIBLE FOR PLANNING, MANAGING, AND MONITORING PUBLICLY FUNDED MENTAL HEALTH, SUBSTANCE–RELATED DISORDER, AND ADDICTIVE DISORDER SERVICES. (L) (1) “MENTAL DISORDER” MEANS A BEHAVIORAL OR EMOTIONAL ILLNESS THAT RESULTS FROM A PSYCHIATRIC OR NEUROLOGICAL DISORDER. (2) “MENTAL DISORDER” INCLUDES A MENTAL ILLNESS THAT SO SUBSTANTIALLY IMPAIRS THE MENTAL OR EMOTIONAL FUNCTIONING OF AN INDIVIDUAL AS TO MAKE CARE OR TREATMENT NECESSARY OR ADVISABLE FOR THE WELFARE OF THE INDIVIDUAL OR FOR THE SAFETY OF THE PERSON OR PROPERTY OF ANOTHER. (3) “MENTAL DISORDER” DOES NOT INCLUDE AN INTELLECTUAL DISABILITY. (M) “MENTAL HEALTH PROGRAM” MEANS A SET OF SERVICES THAT CONSISTS OF COMMUNITY–BASED TREATMENT, CARE, OR REHABILITATION SERVICES, OR ANY COMBINATION OF THESE, FOR INDIVIDUALS WITH A MENTAL DISORDER.


(N) “PEER SUPPORT SERVICES” MEANS A SET OF NONCLINICAL ACTIVITIES PROVIDED BY INDIVIDUALS IN RECOVERY FROM MENTAL DISORDERS, SUBSTANCE–RELATED DISORDERS, OR ADDICTIVE DISORDERS WHO USE THEIR PERSONAL, LIVED EXPERIENCES AND TRAINING TO SUPPORT OTHER INDIVIDUALS WITH MENTAL DISORDERS, SUBSTANCE–RELATED DISORDERS, OR ADDICTIVE DISORDERS. (O) “RECOVERY RESIDENCE” MEANS A SERVICE THAT: (1) PROVIDES ALCOHOL–FREE AND ILLICIT–DRUG–FREE HOUSING TO INDIVIDUALS WITH SUBSTANCE–RELATED DISORDERS OR ADDICTIVE DISORDERS OR CO–OCCURRING MENTAL DISORDERS AND SUBSTANCE–RELATED DISORDERS OR ADDICTIVE DISORDERS; AND (2) DOES NOT INCLUDE CLINICAL TREATMENT SERVICES. (P) (1) “SUBSTANCE–RELATED DISORDER” MEANS ALCOHOL ABUSE, ALCOHOL DEPENDENCE, ALCOHOL MISUSE, DRUG ABUSE, DRUG DEPENDENCE, DRUG MISUSE, OR ANY COMBINATION OF THESE: (I) AN ALCOHOL USE DISORDER, ALCOHOL ABUSE, ALCOHOL DEPENDENCE, ALCOHOL MISUSE, ALCOHOL INTOXICATION, OR ALCOHOL WITHDRAWAL; (II) A NONALCOHOL SUBSTANCE USE DISORDER, DRUG DEPENDENCE, DRUG MISUSE, NONALCOHOL SUBSTANCE INDUCED INTOXICATION, OR NONALCOHOL SUBSTANCE WITHDRAWAL; OR (III) ANY COMBINATION OF THE DISORDERS LISTED IN ITEMS (I) AND (II) OF THIS PARAGRAPH. (2) “SUBSTANCE–RELATED DISORDER” INCLUDES SUBSTANCE USE DISORDERS AND SUBSTANCE INDUCED DISORDERS. (Q) “SUBSTANCE–RELATED DISORDERS PROGRAM” MEANS A SET OF SERVICES THAT: (1) ARE COMMUNITY–BASED, INCLUDING THOSE SERVICES PROVIDED BY THE STATE OR ANY OF ITS POLITICAL SUBDIVISIONS; AND (2) CONSIST OF: (I) ANY COMBINATION OF TREATMENT, CARE, OR REHABILITATION FOR INDIVIDUALS WITH A SUBSTANCE–RELATED DISORDER; OR

Chapter 469 Laws of Maryland – 2015 Session 2478 (II) EDUCATION FOR INDIVIDUALS KNOWN TO BE AT RISK OF DEVELOPING SUBSTANCE–RELATED DISORDERS. 7.5–204. (a) The Director is responsible for carrying out the powers, duties, and responsibilities of the Administration. (b) In addition to the powers set forth elsewhere in this title, the Director may: (1) Within the amounts made available by appropriation or grant, make any agreement or joint financial arrangement to do or have done anything necessary, desirable, or proper to carry out the purposes of this title AND TITLES 8 AND 10 OF THIS ARTICLE; (2) Organize and manage the Administration in a manner that will enable it best to discharge the duties of the Administration; (3) Appoint the number of assistant directors and staff provided for in the State budget; (4) Remove an assistant director for incompetence or misconduct; and (5) Unless expressly provided otherwise by law, assign to any subordinate unit or individual in the Administration any function that is imposed by law on the Director. (c) In addition to the duties set forth elsewhere in this title, the Director shall[: (1) Adopt regulations to carry out the provisions of this title, including provisions setting reasonable fees for the issuance and renewal of licenses; and (2) Do] DO anything necessary or proper to carry out the scope of this title AND TITLES 8 AND 10 OF THIS ARTICLE. [(d) The Director is responsible for supervising the custody, care, and treatment of individuals who have mental disorders. (e) The Director shall provide facilities for the care and treatment of individuals who have mental disorders. (f) (1) The Director shall establish programs for research and development of care and treatment for individuals who have behavioral health disorders.

2479 Lawrence J. Hogan, Jr., Governor Chapter 469 (2) The Director may provide money for a public or nonprofit organization to carry out pilot or demonstration projects regarding individuals who have behavioral health disorders.] (D) IT IS THE POLICY OF THE STATE THAT THE DIRECTOR MAY COLLABORATE WITH OTHER STATE AGENCIES TO PROMOTE COORDINATED CARE AND TREATMENT OF INDIVIDUALS WHO HAVE BEHAVIORAL HEALTH DISORDERS. 7.5–205. (A) THE SECRETARY SHALL PROVIDE FACILITIES FOR THE CARE AND TREATMENT OF INDIVIDUALS WHO HAVE MENTAL DISORDERS, TO THE EXTENT THAT FUNDS ARE PROVIDED IN THE STATE BUDGET FOR THIS PURPOSE. (B) TO THE EXTENT TO WHICH FUNDS ARE PROVIDED IN THE STATE BUDGET, THE THE ADMINISTRATION SHALL: (1) SUPERVISE THE CUSTODY, CARE, AND TREATMENT OF INDIVIDUALS IN STATE FACILITIES WHO HAVE MENTAL DISORDERS; (2) PROVIDE OVERSIGHT OF COMMUNITY–BASED SERVICES FOR PERSONS WITH BEHAVIORAL HEALTH DISORDERS; AND (3) ESTABLISH PROGRAMS FOR RESEARCH AND DEVELOPMENT OF CARE AND TREATMENT FOR INDIVIDUALS WHO HAVE BEHAVIORAL HEALTH DISORDERS. (C) THE ADMINISTRATION MAY PROVIDE FUNDS FOR A PUBLIC OR NONPROFIT ORGANIZATION TO CARRY OUT PILOT OR DEMONSTRATION PROJECTS RELATING TO INDIVIDUALS WHO HAVE BEHAVIORAL HEALTH DISORDERS. (D) THE SECRETARY SHALL ADOPT REGULATIONS TO CARRY OUT THE PROVISIONS OF THIS TITLE AND TITLES 8 AND 10 OF THIS ARTICLE, INCLUDING PROVISIONS SETTING REASONABLE FEES FOR THE ISSUANCE AND RENEWAL OF LICENSES. 7.5–206. NO OTHERWISE–QUALIFIED INDIVIDUAL WITH A BEHAVIORAL HEALTH DISORDER, SOLELY BY REASON OF THE INDIVIDUAL’S STATUS AS AN INDIVIDUAL WITH A BEHAVIORAL HEALTH DISORDER, SHALL BE DENIED THE SERVICES OF, OR BE SUBJECTED TO DISCRIMINATION BY, ANY PUBLIC OR PRIVATE HOSPITAL OR COMMUNITY–BASED TREATMENT PROGRAM.


SUBTITLE 3. BEHAVIORAL HEALTH PROGRAMS. 7.5–301. (A) EXCEPT AS OTHERWISE PROVIDED IN THIS SECTION, A BEHAVIORAL HEALTH PROGRAM SHALL BE LICENSED BY THE SECRETARY BEFORE PROGRAM SERVICES MAY BE PROVIDED IN THIS STATE. (B) THE SECRETARY MAY EXEMPT THE FOLLOWING PERSONS FROM THE LICENSURE REQUIREMENTS OF THIS SECTION: (1) A HEALTH PROFESSIONAL, IN EITHER SOLO OR GROUP PRACTICE, WHO IS LICENSED UNDER THE HEALTH OCCUPATIONS ARTICLE AND WHO IS PROVIDING MENTAL HEALTH OR SUBSTANCE–RELATED DISORDER SERVICES ACCORDING TO THE REQUIREMENTS OF THE APPROPRIATE PROFESSIONAL BOARD; (2) ALCOHOLICS ANONYMOUS, NARCOTICS ANONYMOUS, RECOVERY RESIDENCES, PEER SUPPORT SERVICES, FAMILY SUPPORT SERVICES, OR OTHER SIMILAR ORGANIZATIONS, IF THE ORGANIZATION HOLDS MEETINGS OR PROVIDES SUPPORT SERVICES BUT DOES NOT PROVIDE ANY TYPE OF TREATMENT; (3) AN EMPLOYEES’ ASSISTANCE PROGRAM OF A BUSINESS ENTITY; (4) OUTPATIENT BEHAVIORAL HEALTH TREATMENT AND REHABILITATION SERVICES PROVIDED IN A REGULATED SPACE IN A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE, IF THE SERVICES ARE ACCREDITED BY AN APPROVED ACCREDITATION ORGANIZATION UNDER ITS BEHAVIORAL HEALTH STANDARDS; OR (5) A PRIVATE THERAPEUTIC GROUP HOME AS DEFINED IN § 10–920 OF THIS ARTICLE. 7.5–302. (A) REGULATIONS ADOPTED UNDER THIS SUBTITLE SHALL INCLUDE: (1) THE REQUIREMENTS FOR LICENSURE OF A BEHAVIORAL HEALTH PROGRAM; (2) THE PROCESS FOR A BEHAVIORAL HEALTH PROGRAM TO APPLY FOR A LICENSE; (3) A DESCRIPTION OF THE BEHAVIORAL HEALTH PROGRAMS THAT ARE REQUIRED TO BE LICENSED;

2481 Lawrence J. Hogan, Jr., Governor Chapter 469 (4) ANY REQUIREMENTS FOR THE GOVERNANCE OF A BEHAVIORAL HEALTH PROGRAM, INCLUDING A PROVISION PROHIBITING A CONFLICT OF INTEREST BETWEEN THE INTERESTS OF THE PROVIDER AND THOSE OF THE INDIVIDUAL RECEIVING SERVICES; (5) PROVISIONS FOR INSPECTIONS OF A BEHAVIORAL HEALTH PROGRAM, INCLUDING INSPECTION AND COPYING OF THE RECORDS OF A BEHAVIORAL HEALTH PROGRAM IN ACCORDANCE WITH STATE AND FEDERAL LAW; AND (6) PROVISIONS FOR DENIALS, SANCTIONS, SUSPENSIONS, AND REVOCATIONS OF LICENSES, INCLUDING IMPOSITION OF CIVIL MONETARY PENALTIES, AND NOTICE AND AN OPPORTUNITY TO BE HEARD. (B) (1) THE SECRETARY MAY REQUIRE A BEHAVIORAL HEALTH PROGRAM TO BE GRANTED ACCREDITATION BY AN ACCREDITATION ORGANIZATION APPROVED BY THE SECRETARY UNDER TITLE 19, SUBTITLE 23 OF THIS ARTICLE AS A CONDITION OF LICENSURE UNDER REGULATIONS ADOPTED UNDER THIS SUBTITLE. (2) BY BECOMING LICENSED IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION, A PROGRAM AGREES TO COMPLY WITH ALL APPLICABLE STANDARDS OF THE ACCREDITATION ORGANIZATION. (C) REGULATIONS ADOPTED UNDER THIS SUBTITLE MAY INCLUDE PROVISIONS SETTING REASONABLE FEES FOR APPLYING FOR A LICENSE AND FOR THE ISSUANCE AND RENEWAL OF LICENSES. 7.5–303. EACH INDIVIDUAL SERVED BY A BEHAVIORAL HEALTH PROGRAM IS ENTITLED TO THE RIGHTS IDENTIFIED THAT ARE: (1) IDENTIFIED IN THE BEHAVIORAL HEALTH PROGRAM’S ACCREDITATION STANDARDS THAT ARE ADOPTED; OR (2) ESTABLISHED FOR NONACCREDITED BEHAVIORAL HEALTH PROGRAMS BY THE DEPARTMENT IN REGULATIONS. 7.5–304. (A) AN INDIVIDUAL OR ORGANIZATION MAY NOT OPERATE A BEHAVIORAL HEALTH PROGRAM IN VIOLATION OF THIS SUBTITLE.

Chapter 469 Laws of Maryland – 2015 Session 2482 (B) AN INDIVIDUAL OR ORGANIZATION THAT OPERATES A BEHAVIORAL HEALTH PROGRAM WITHOUT THE LICENSE REQUIRED BY THIS SUBTITLE IS GUILTY OF A MISDEMEANOR AND ON CONVICTION IS SUBJECT TO A FINE NOT EXCEEDING $10,000 FOR EACH VIOLATION. (C) THE DEPARTMENT MAY FILE FOR AND PURSUE AN INJUNCTION TO PREVENT AN INDIVIDUAL OR ORGANIZATION FROM OPERATING A BEHAVIORAL HEALTH PROGRAM WITHOUT THE LICENSE REQUIRED BY THIS SUBTITLE. 8–101. (a) In this title the following words have the meanings indicated. (B) (1) “ADDICTIVE DISORDER” MEANS A CHRONIC DISORDER OF THE BRAIN’S REWARD–ACTIVATION SYSTEM IN WHICH BEHAVIOR BECOMES REPETITIVE, THERE IS THE INDIVIDUAL PATHOLOGICALLY PURSUES REWARD OR RELIEF BY SUBSTANCE ABUSE OR OTHER BEHAVIORS, WITH DIMINISHED CONTROL, AND THE INDIVIDUAL PERSISTS IN THE BEHAVIOR DESPITE ADVERSE CONSEQUENCES. (2) “ADDICTIVE DISORDER” INCLUDES GAMBLING, WHICH IS THE ONLY NONSUBSTANCE–RELATED ADDICTIVE DISORDER RECOGNIZED BY MARYLAND LAW. [(b)] (C) “Administration” means the Behavioral Health Administration. [(c)] (D) “Administrator” means the program director or the clinical director of an alcohol or drug abuse treatment facility or a health care facility. [(d)] (E) “Alcohol abuse” means a disease that is characterized by a pattern of pathological use of alcohol with repeated attempts to control its use, and with significant negative consequences in at least one of the following areas of life: medical, legal, financial, or psycho–social. [(e)] (F) “Alcohol dependence” means a disease characterized by: (1) Alcohol abuse; and (2) Physical symptoms of withdrawal or tolerance. [(f)] (G) “Alcohol misuse” means: (1) Unlawful use of alcohol; (2) Alcohol abuse; or

2483 Lawrence J. Hogan, Jr., Governor Chapter 469 (3) Alcohol dependence. [(g) “Detoxification facility” means a facility that provides direct or indirect services to an acutely intoxicated individual to fulfill the physical, social, and emotional needs of the individual by: (1) Monitoring the amount of alcohol and other toxic agents in the body of the individual; (2) Managing withdrawal symptoms; and (3) Motivating the individual to participate in the appropriate addictions treatment programs for alcohol or drug abuse.] (h) “Director” means the Director of the Administration. (i) “Drug” means: (1) A controlled dangerous substance that is regulated under the Maryland Controlled Dangerous Substances Act; (2) A prescription medication; or (3) A chemical substance when used for unintended and harmful purposes. (j) “Drug abuse” means a disease which is characterized by a pattern of pathological use of a drug with repeated attempts to control the use, and with significant negative consequences in at least one of the following areas of life: medical, legal, financial, or psycho–social. (k) “Drug dependence” means a disease characterized by: (1) Drug abuse; and (2) Physical symptoms of withdrawal or tolerance. (l) “Drug misuse” means: (1) Unlawful use of a drug; (2) Drug abuse; or (3) Drug dependence. [(m) “Substance use disorder” means alcohol abuse, alcohol dependence, alcohol misuse, drug abuse, drug dependence, drug misuse, or any combination of these.]

Chapter 469 Laws of Maryland – 2015 Session 2484 (M) “HALFWAY HOUSE” MEANS A CLINICALLY MANAGED, LOW INTENSITY RESIDENTIAL TREATMENT SERVICE FOR INDIVIDUALS WITH SUBSTANCE–RELATED DISORDERS WHO ARE CAPABLE OF SELF–CARE BUT ARE NOT READY TO RETURN TO INDEPENDENT LIVING. (N) “LARGE HALFWAY HOUSE” MEANS A HALFWAY HOUSE THAT ADMITS AT LEAST 9 BUT NOT MORE THAN 16 INDIVIDUALS. (O) (1) “MENTAL DISORDER” MEANS A BEHAVIORAL OR EMOTIONAL ILLNESS THAT RESULTS FROM A PSYCHIATRIC OR NEUROLOGICAL DISORDER. (2) “MENTAL DISORDER” INCLUDES A MENTAL ILLNESS THAT SO SUBSTANTIALLY IMPAIRS THE MENTAL OR EMOTIONAL FUNCTIONING OF AN INDIVIDUAL AS TO MAKE CARE OR TREATMENT NECESSARY OR ADVISABLE FOR THE WELFARE OF THE INDIVIDUAL OR FOR THE SAFETY OF THE PERSON OR PROPERTY OF ANOTHER. (3) “MENTAL DISORDER” DOES NOT INCLUDE AN INTELLECTUAL DISABILITY. (P) “RECOVERY RESIDENCE” MEANS A SERVICE THAT: (1) PROVIDES ALCOHOL–FREE AND ILLICIT–DRUG–FREE HOUSING TO INDIVIDUALS WITH SUBSTANCE–RELATED DISORDERS OR ADDICTIVE DISORDERS OR CO–OCCURRING MENTAL DISORDERS AND SUBSTANCE–RELATED DISORDERS OR ADDICTIVE DISORDERS; AND (2) DOES NOT INCLUDE CLINICAL TREATMENT SERVICES. (Q) “SMALL HALFWAY HOUSE” MEANS A HALFWAY HOUSE THAT ADMITS AT LEAST 4 BUT NOT MORE THAN 8 INDIVIDUALS. (R) (1) “SUBSTANCE–RELATED DISORDER” MEANS ALCOHOL ABUSE, ALCOHOL DEPENDENCE, ALCOHOL MISUSE, DRUG ABUSE, DRUG DEPENDENCE, DRUG MISUSE, OR ANY COMBINATION OF THESE: (I) ALCOHOL USE DISORDER, ALCOHOL ABUSE, ALCOHOL DEPENDENCE, ALCOHOL MISUSE, ALCOHOL INTOXICATION, OR ALCOHOL WITHDRAWAL; (II) NONALCOHOL SUBSTANCE USE DISORDER, DRUG DEPENDENCE, DRUG MISUSE, NONALCOHOL SUBSTANCE INDUCED INTOXICATION, OR NONALCOHOL SUBSTANCE WITHDRAWAL; OR

2485 Lawrence J. Hogan, Jr., Governor Chapter 469 (III) ANY COMBINATION OF THE DISORDERS LISTED IN ITEMS (I) AND (II) OF THIS PARAGRAPH. (2) “SUBSTANCE–RELATED DISORDER” INCLUDES SUBSTANCE USE DISORDERS AND SUBSTANCE INDUCED DISORDERS. (S) “WITHDRAWAL MANAGEMENT” MEANS DIRECT OR INDIRECT SERVICES FOR AN ACUTELY INTOXICATED INDIVIDUAL TO FULFILL THE PHYSICAL, SOCIAL, AND EMOTIONAL NEEDS OF AN INDIVIDUAL BY: (1) MONITORING THE AMOUNT OF ALCOHOL AND OTHER TOXIC AGENTS IN THE BODY OF THE INDIVIDUAL; (2) MANAGING WITHDRAWAL SYMPTOMS; AND (3) MOTIVATING AN INDIVIDUAL TO PARTICIPATE IN THE APPROPRIATE SUBSTANCE–RELATED DISORDER PROGRAMS. 8–405. (A) A HALFWAY HOUSE SHALL BE LICENSED IN ACCORDANCE WITH TITLE 7.5 OF THIS ARTICLE. (B) THE SECRETARY SHALL ADOPT REGULATIONS FOR ESTABLISHING, LICENSING, AND OPERATING HALFWAY HOUSES. 8–406. (A) A SMALL HALFWAY HOUSE: (1) IS DEEMED CONCLUSIVELY A SINGLE–FAMILY DWELLING FOR PURPOSES OF ZONING; AND (2) IS PERMITTED TO LOCATE IN ALL RESIDENTIAL ZONES. (B) A LARGE HALFWAY HOUSE IS DEEMED CONCLUSIVELY A MULTI–FAMILY DWELLING AND IS PERMITTED TO LOCATE IN ZONES OF SIMILAR DENSITY. (C) A HALFWAY HOUSE IS NOT SUBJECT TO ANY SPECIAL EXCEPTION, CONDITIONAL USE PERMIT, OR PROCEDURE THAT DIFFERS FROM THAT REQUIRED FOR A SINGLE–FAMILY DWELLING OR A MULTIFAMILY DWELLING OF SIMILAR DENSITY IN THE SAME ZONE.


(D) A GENERAL ZONING ORDINANCE THAT CONFLICTS WITH THE PROVISIONS OF THIS SECTION IS SUPERSEDED BY THIS SECTION, TO THE EXTENT OF THE CONFLICT. 10–101. (a) In this title the following words have the meanings indicated. (b) “Administration” means the Behavioral Health Administration. (c) (1) “Admission” means the process by which an individual is accepted as a resident in: (i) An inpatient facility; or (ii) A Veterans’ Administration hospital in this State that provides care or treatment for individuals who have mental disorders. (2) “Admission” includes the physical act of the individual entering the facility or Veterans’ Administration hospital. (D) “BEHAVIORAL HEALTH CARE” INCLUDES PREVENTION, SCREENING, EARLY INTERVENTION, TREATMENT, RECOVERY, SUPPORT, WRAPAROUND, AND REHABILITATION SERVICES FOR INDIVIDUALS WITH SUBSTANCE–RELATED DISORDERS, ADDICTIVE DISORDERS, MENTAL DISORDERS, OR A COMBINATION OF THESE DISORDERS. (E) “CORE SERVICE AGENCY” MEANS THE DESIGNATED COUNTY OR MULTICOUNTY AUTHORITY THAT IS RESPONSIBLE FOR PLANNING, MANAGING, AND MONITORING PUBLICLY FUNDED MENTAL HEALTH SERVICES. [(d)] (F) “Director” means the Director of the Behavioral Health Administration. [(e)] (G) (1) Except as otherwise provided in this title, “facility” means any public or private clinic, hospital, or other institution that provides or purports to provide treatment or other services for individuals who have mental disorders. (2) “Facility” does not include a Veterans’ Administration hospital. (H) “LOCAL BEHAVIORAL HEALTH AUTHORITY” MEANS THE DESIGNATED COUNTY OR MULTICOUNTY AUTHORITY THAT IS RESPONSIBLE FOR PLANNING, MANAGING, AND MONITORING PUBLICLY FUNDED MENTAL HEALTH, SUBSTANCE–RELATED DISORDER, AND ADDICTIVE DISORDER SERVICES.


[(f)] (I) (1) “Mental disorder” means a behavioral or emotional illness that results from a psychiatric or neurological disorder. (2) “Mental disorder” includes a mental illness that so substantially impairs the mental or emotional functioning of an individual as to make care or treatment necessary or advisable for the welfare of the individual or for the safety of the person or property of another. (3) “Mental disorder” does not include an intellectual disability. [(g)] (J) “State Advisory Council” means the State Advisory Council on Mental Hygiene. [(h)] (K) “State facility” means a facility that is owned or operated by the Department. [(i)] (L) “Treatment” means any professional care or attention that is given in a facility, private therapeutic group home for children and adolescents, or Veterans’ Administration hospital to improve or to prevent the worsening of a mental disorder. 10–207. (b) (1) [By] ON OR AFTER October 1, 1993, within existing resources and in concert with local core service agencies OR LOCAL BEHAVIORAL HEALTH AUTHORITIES, the Director shall prepare a comprehensive mental health plan which identifies the needs of all individuals who have a serious mental disorder and who are targeted for services in the “Comprehensive Mental Health Services Plan” submitted by the State to the federal government in accordance with § 1925 of the Public Health Service Act. (d) The Director shall, in concert with local core service agencies OR LOCAL BEHAVIORAL HEALTH AUTHORITIES, implement each plan to the extent that resources are available. 10–308. (f) In Baltimore City, the governing body may designate [Baltimore Mental Health Systems, Inc.,] BEHAVIORAL HEALTH SYSTEMS BALTIMORE the [core service agency] LOCAL BEHAVIORAL HEALTH AUTHORITY for Baltimore City under Subtitle 12 of this title, as the mental health advisory committee for Baltimore City. (g) In Anne Arundel County, the governing body may designate Anne Arundel County Mental Health Agency, Inc., the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY for Anne Arundel County under Subtitle 12 of this title, as the mental health advisory committee for Anne Arundel County. 10–309.

Chapter 469 Laws of Maryland – 2015 Session 2488 (a) (1) The mental health advisory committee of each county shall consist of: (i) As nonvoting ex officio members, the following individuals or their designees: 1. The health officer for the county; 2. A representative of a State inpatient facility that serves that county, appointed as provided in paragraph (2) of this subsection; 3. The county mental health director; 4. The director of the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY, if any; and 5. In jurisdictions with designated State inpatient beds located in local general hospitals, a representative from that facility; and (ii) As voting members, appointed by the governing body of the county and representative of the county’s major socio–economic and ethnic groups: 1. At least 5, but not more than 7, representatives selected from among the following groups or agencies: A. The governing body; B. The county department of education; C. The local department of social services; D. The practicing physicians; E. Mental health professionals who are not physicians; F. The clergy; G. The legal profession; H. A local law enforcement agency; I. A local general hospital that contains an inpatient psychiatric unit; J. The Department of Aging; K. The Department of Juvenile Services;

2489 Lawrence J. Hogan, Jr., Governor Chapter 469 L. The local alcohol and drug abuse agency; and M. A local community rehabilitation or housing program; and 2. At least 5 individuals selected from among the following groups or organizations and appointed as provided in paragraph (3) of this subsection: A. At least 2 individuals who are currently receiving or who have in the past received mental health services; B. Parents or other relatives of adults with mental disorders; C. Parents or other relatives of children or adolescents with emotional, behavioral, or mental disorders the onset of which occurred during childhood or adolescence; D. The local mental health association, if any; and E. A member of the general public. (2) If more than one State inpatient facility serves a county, a representative from at least 1 of the facilities shall be appointed by the Director. (3) At least one–half of the voting members shall be appointed from among the individuals listed in paragraph (1)(ii)2A through C of this subsection. (4) Notwithstanding paragraphs (1) through (3) of this subsection, if the governing body of Baltimore City or Anne Arundel County designates a core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY as the mental health advisory committee, the mental health advisory committee shall consist of the governing body of the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY. 10–312. (b) Each county advisory committee and intercounty advisory committee shall: (4) (i) Prepare and disseminate an annual report to the following: 5. The director of the local core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY, if any; 10–516. (A) A PRIVATE GROUP HOME SHALL BE LICENSED IN ACCORDANCE WITH TITLE 7.5 OF THIS ARTICLE.

Chapter 469 Laws of Maryland – 2015 Session 2490 [(a)] (B) The Secretary shall adopt rules and regulations for establishing, licensing, and operating private group homes. [(b) These rules and regulations shall ensure at least: (1) That the proposed staff will be adequate to supervise properly the individuals in the private group home; (2) That the procedure under which the proposed private group home will receive, investigate, document, and dispose of written complaints from neighborhood residents is acceptable; and (3) That the proposed care or treatment: (i) Reasonably can be expected to benefit the individuals in the private group home; and (ii) Will be provided by an adequate staff or, under agreement, by a provider of mental health services.] 10–518. (a) [To qualify for a license, an applicant shall satisfy the Secretary that the proposed private group home: (1) Is needed; (2) Is compatible with the nature and character of the area involved; (3) Is near transportation facilities; (4) Meets or, on completion, will meet the requirements of this subtitle and the rules and regulations that the Secretary adopts under this subtitle; and (5) Meets or, on completion, will meet all general zoning requirements that apply to the site and that relate to: (i) The height and size of any buildings that are involved; (ii) The land that may be covered or occupied; (iii) The size of yards that require open space; (iv) The density of population; and (v) The use of the land and buildings.

2491 Lawrence J. Hogan, Jr., Governor Chapter 469 (b) (1)] A small private group home: [(i)] (1) Is deemed conclusively a single–family dwelling; and [(ii)] (2) Is permitted to locate in all residential zones. [(2)] (B) A large private group home is deemed conclusively a multi–family dwelling and is permitted to locate in zones of similar density. [(3)] (C) A private group home [may] IS not [be] subject to any special exception, conditional use permit, or procedure that differs from that required for a single–family dwelling or a multi–family dwelling of similar density in the same zone. [(4)] (D) A general zoning ordinance that conflicts with the provisions of this section is superseded by this section to the extent of the conflict. 10–630. (a) All court records relating to a petition for an emergency evaluation made under this subtitle are confidential and the contents may not be divulged, by subpoena or otherwise, except by order of the court on good cause shown. (b) This section does not prohibit review of a court record relating to a petition by: (5) Authorized personnel of the local core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY; 10–701. (a) (6) “State facility” means [a] AN INPATIENT facility that is maintained under the direction of the Behavioral Health Administration. 10–1101. This title may be cited as the “Maryland Mental [Hygiene] HEALTH Law”.

Subtitle 12. Core Service Agencies, LOCAL ADDICTIONS AUTHORITIES, AND LOCAL BEHAVIORAL HEALTH AUTHORITIES.

10–1201. (a) In this subtitle the following words have the meanings indicated.


(b) “Core service agency” [means the designated county or multicounty authority that is responsible for planning, managing, and monitoring publicly funded mental health services] HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. (C) “LOCAL ADDICTIONS AUTHORITY” HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. (D) “LOCAL BEHAVIORAL HEALTH AUTHORITY” HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. [(c)] (E) “Services to persons with mental illnesses” means the health care and community support rendered to a recipient primarily in connection with the diagnosis, evaluation, treatment, case management, rehabilitation, or supervised housing for individuals with serious mental disorders. 10–1202. (a) A core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY shall: (1) Be an agent of a county or Baltimore City government which may include a local health department; (2) Unless an exception is requested by an individual county and is granted by the Secretary, serve a county or counties with an estimated population of over 80,000 people; (3) Either purchase services or provide the services directly; (4) Annually submit a program plan to the secretaries of the affected State departments for review and to the Secretary DIRECTOR for approval; and (5) Meet the standards required under this subtitle and, as needed, the rules and regulations set by the Secretary. (b) A core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY may not be a for–profit entity. (c) Each core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY shall function under the Secretary’s authority. (d) Once established in a jurisdiction, the core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY shall:


(1) Submit, on an annual basis, a program plan to the [Secretary] DIRECTOR for approval; (2) Incorporate in its method of governance a mechanism for the local county mental health advisory committee, LOCAL DRUG AND ALCOHOL ABUSE COUNCIL, or joint mental health and substance abuse SUBSTANCE–RELATED committee to serve as the advisory committee to the core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY and, if serving more than 1 unit of government, a method of representation serving those jurisdictions; (3) Implement guidelines developed by the [Secretary] DIRECTOR which establish or designate the AUTHORITY OF THE local mental health advisory [committee’s authority] COMMITTEE, LOCAL DRUG AND ALCOHOL ABUSE COUNCIL, OR JOINT MENTAL HEALTH AND SUBSTANCE–RELATED COMMITTEE to advise and assist in the planning and evaluation of the publicly funded mental health AND SUBSTANCE–RELATED DISORDER services; (4) In accordance with guidelines developed by the Secretary DIRECTOR, develop planning, management, and accountability mechanisms for the delivery of services including: (iii) A yearly summary which includes at a minimum: 1. Relevant financial statements; and 2. Program evaluation reports which articulate the core service agency’s, LOCAL ADDICTIONS AUTHORITY’S, OR LOCAL BEHAVIORAL HEALTH AUTHORITY’S ability to identify the outcomes of services provided for the target populations and the effects of those services on program planning for the target population; (7) Provide clear guidelines to avoid either the appearance or occurrence of conflicts of interest in the direction and operation of the core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY or organizations which provide mental health OR SUBSTANCE–RELATED services. 10–1202.1. (b) (1) The purpose of this section is to authorize the establishment of a quasi–public authority which may be activated by Howard County, if the county decides to designate a quasi–public authority as the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY to perform the duties imposed under this subtitle. (2) This section has no effect on any other form of core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY, whether it is a unit of Howard County government, a local health department, or a private, nonprofit corporation.

Chapter 469 Laws of Maryland – 2015 Session 2494 (c) (2) The quasi–public authority shall: (i) Serve as the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY for the jurisdiction; and (f) Howard County shall send to the Secretary a copy of any ordinance or resolution activating a quasi–public authority which will serve as a core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY. 10–1203. (a) To the extent resources are available, the [Secretary] DIRECTOR, after consultation with the Maryland Advisory Council on Mental Hygiene as established in Subtitle 3 of this title and federal requirements mandated under P.L. 99–660, may initiate the development of core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES as a mechanism for community planning, management, and financing of mental health AND SUBSTANCE–RELATED DISORDER services. (b) When core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES are initiated, the [Secretary] DIRECTOR shall: (1) Define the priority populations to be served by the core service agencies, with a special emphasis on the provision of services to the seriously mentally ill populations LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES; (2) Define the essential mental health, SUBSTANCE–RELATED DISORDER, and associated support services to be provided under the auspices of the core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES; (3) Define the essential administrative functions to be carried out by core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES; and (4) Outline the requirements for the core service agencies’, LOCAL ADDICTIONS AUTHORITIES’, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES’ governance structure. (c) To assure the continuing provision of appropriate services, the [Secretary] DIRECTOR shall:


(1) Annually review and may approve the core service agencies’, LOCAL ADDICTIONS AUTHORITIES’, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES’ program plan; (2) In conjunction with the appropriate authorities, establish and maintain a funding mechanism for the core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES which may include the allocation of funds for inpatient services; (3) Develop a mechanism whereby any unexpended funds remaining at the end of the year shall remain with the core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES or the community providers; (4) Establish procedures to facilitate intraagency and interagency linkages at State and local levels with the core service agencies, LOCAL ADDICTIONS AUTHORITIES, OR LOCAL BEHAVIORAL HEALTH AUTHORITIES; and (5) Establish procedures within the Behavioral Health Administration for a process regarding program, policy, or contract disputes that gives all community mental health AND SUBSTANCE–RELATED DISORDER programs regulated by the Administration the right to: (i) Access the mediation process established by the Administration; and (ii) If dissatisfied with the outcome of the mediation by the Administration, request a hearing with the Office of Administrative Hearings in accordance with Title 10, Subtitle 2 of the State Government Article. [(d) The Secretary may adopt regulations to carry out the provisions of this subtitle. (e)] (D) If a core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY violates any provision of this subtitle, the [Secretary] DIRECTOR may deny approval of the core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY and, after written notification of denial of approval, cease funding or request the return of unspent funds by the core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY. [(f)] (E) If a county elects to terminate its core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY, the county may do so upon 90 days’ written notice to the [Secretary] DIRECTOR.


[(g)] (F) The [Secretary] DIRECTOR may not require a core service agency, LOCAL ADDICTIONS AUTHORITY, OR LOCAL BEHAVIORAL HEALTH AUTHORITY to provide services the Department does not provide funding for. 10–1401. (b) “Core service agency” has the meaning stated in [§ 10–1201 of this title] § 7.5–101 OF THIS ARTICLE. (D) “LOCAL BEHAVIORAL HEALTH AUTHORITY” HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. 10–1403. (a) The Crisis Response System shall include: (1) A crisis communication center in each jurisdiction or region to provide: (ii) Coordination with the local core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY, police, emergency medical service personnel, and mental health providers; and (b) The Crisis Response System services shall be implemented as determined by the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY serving each jurisdiction. 10–1404. (b) The Administration shall implement the Crisis Response System, in collaboration with core service agencies OR LOCAL BEHAVIORAL HEALTH AUTHORITIES, on a regional or jurisdictional basis as federal funding or funding from other sources becomes available. 16–101. (b) (2) As to a recipient of services under the Maryland Mental [Hygiene] HEALTH Law, a word used in this title has the same meaning as is indicated by a definition of the word in § 7.5–101 OR § 10–101 of this article. (e) (1) “Recipient of services” means an individual who receives care, maintenance, treatment, or support in a facility or program that is operated or funded wholly or partly by the Department. (2) “Recipient of services” includes:

2497 Lawrence J. Hogan, Jr., Governor Chapter 469 (i) An individual in a public facility under the Maryland Mental [Hygiene] HEALTH Law; (v) An individual in a private therapeutic group home from which this State obtains residential care under the Maryland Mental [Hygiene] HEALTH Law. 16–201.2. (a) (3) “Community mental health services provider” means a community–based mental health program approved by the Department or an individual practitioner who contracts with the Department or the appropriate core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY. (4) “Core service agency” has the meaning stated in [§ 10–1201] § 7.5–101 of this article. (6) “LOCAL BEHAVIORAL HEALTH AUTHORITY” HAS THE MEANING STATED IN § 7.5–101 OF THIS ARTICLE. 16–204. (c) The Department may collect fees from a core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY for the cost of treatment of individuals whom the core service agency authorizes as eligible for admission into a State facility as described in Title 10, Subtitle 4 of this article. Any such fees collected by the Department for the admission and treatment of individuals authorized by the core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY shall be kept by the Department to be used to maintain and operate the respective State facility. 19–2301. (d) “Health care facility” means: (10) A [substance use] SUBSTANCE–RELATED disorder program as defined in [§ 8–403] § 7.5–101 of this article; and (11) A mental health program as defined in [§ 10–901] § 7.5–101 of this article.

Article – Human Services 8–101. (e) “Core service agency” [means the designated county or multicounty authority that is responsible for planning, managing, and monitoring publicly funded mental health


services as provided under Title 10, Subtitle 12] HAS THE MEANING STATED IN § 7.5–101 of the Health – General Article. (K–1) “LOCAL BEHAVIORAL HEALTH AUTHORITY” HAS THE MEANING STATED IN § 7.5–101 OF THE HEALTH – GENERAL ARTICLE. 8–302. A local management board may be composed of: (2) a senior representative or department head of the: (iii) core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY; 8–406. (a) Each local care team shall include: (1) at least one representative from: (iv) if determined to be appropriate by the Behavioral Health Administration, the local core service agency OR LOCAL BEHAVIORAL HEALTH AUTHORITY; 8–407. A local care team shall: (4) identify and share resource development needs and communicate with the care management entity, local core service agencies, OR LOCAL BEHAVIORAL HEALTH AUTHORITY, provider networks, local management boards, and other local care teams in surrounding jurisdictions; and SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2015. Approved by the Governor, May 12, 2015.

Chapter 470



Individuals With Developmental Disabilities – Providers – Licenses FOR the purpose of requiring a person to be licensed by the Department of Health and

Mental Hygiene before the person may provide services to an individual with a developmental disability or a recipient of individual support services; repealing the authority of the Developmental Disabilities Administration to license certain persons to provide certain services; requiring the Department to adopt certain regulations; altering the circumstances under which the Deputy Secretary for Developmental Disabilities may waive the requirement for a certain license; requiring the Department to make a certain approval of the composition of a governing body; requiring the Secretary of Health and Mental Hygiene to adopt certain rules and regulations; requiring an applicant for a certain license to submit a certain application to the Department in a certain manner; requiring an applicant to meet certain requirements to be issued a certain license; requiring the Department to conduct a certain investigation; authorizing the Department to deny a certain license under certain circumstances; altering a certain definition; requiring the Department to conduct certain inspections and to evaluate the performance of certain surveyors; requiring the Department to define certain criteria; repealing the authority of the Administration and the Office of Health Care Quality to adopt certain regulations; making conforming changes; authorizing the Department to impose certain sanctions; prohibiting a certain civil money penalty from exceeding a certain amount; requiring the Department to consider certain factors in establishing the amount of a certain civil money penalty; requiring the Department to offer a licensee an opportunity for a certain resolution under certain circumstances; requiring the Department to provide certain notice and an opportunity for a hearing under certain circumstances; requiring the Department to have the burden of proof with respect to the imposition of a certain penalty; repealing the authority of the Administration to impose a certain sanction; making a certain technical correction; providing for the effective date of this Act; and generally relating to the licensing of providers of services to an individual with a developmental disability or a recipient of individual support services by the Department of Health and Mental Hygiene.

BY repealing and reenacting, with amendments, Article – Health – General

Section 7–903 through 7–907, 7–909, and 7–910 Annotated Code of Maryland (2009 Replacement Volume and 2014 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:

Article – Health – General 7–903.


(a) (1) In addition to any other license required by law, a person shall be licensed by the [Administration] DEPARTMENT before the person may provide [the following] services to an individual with developmental disability or a recipient of individual support services[: (1) Day habilitation services; (2) Residential services; (3) Services coordination; (4) Vocational services; (5) More than 1 family support service, as defined under § 7–701 of this title; (6) More than 1 individual support service; and (7) More than 1 community supported living arrangements service]. (2) THE DEPARTMENT SHALL ADOPT REGULATIONS PROVIDING FOR THE SERVICES REQUIRING LICENSURE UNDER PARAGRAPH (1) OF THIS SUBSECTION. (b) (1) If a person is licensed or certified by another State agency or accredited by [a national accreditation agency such as the Accreditation Council for Persons with Developmental Disabilities (ACDD) or the Council for Accreditation for Rehabilitation Facilities (CARF)] AN ORGANIZATION APPROVED BY THE SECRETARY IN ACCORDANCE WITH § 19–2302 OF THIS ARTICLE to provide services to an individual with a developmental disability or a recipient of individual support services, the Deputy Secretary may waive the requirement for a license by the [Administration] DEPARTMENT. (2) Upon a showing by the Deputy Secretary that the licensed, certified, or accredited person is out of compliance with licensing regulations adopted by the Secretary the Deputy Secretary may revoke the waiver. 7–904. (a) The Secretary shall adopt rules and regulations for the licensing of services for an individual with developmental disability or a recipient of individual support services. (b) The rules and regulations shall ensure that services to an individual with developmental disability or a recipient of individual support services are provided in accordance with the policy stated in Subtitle 1 of this title. (c) (1) The rules and regulations shall require that:

2501 Lawrence J. Hogan, Jr., Governor Chapter 470 (i) At least 75% of the governing body of a licensee shall be residents of the State or reside within a 100–mile radius of the administrative offices of the licensee, which shall be located in the State; and (ii) No employee of a licensee or immediate family member of an employee of a licensee may serve as a voting member of the governing body of a licensee unless: 1. The employee receives services from the licensee; or 2. The [Administration] DEPARTMENT explicitly approves the composition of the governing body through an innovative program service plan in accordance with COMAR 10.22.02.09.F. (2) The requirements of paragraph (1)(i) of this subsection may be waived if a community–based advisory board or committee is established by the licensee and approved by the Department. (d) The rules and regulations shall [also require that an applicant for a license under this section shall demonstrate to the Department the applicant’s capability to provide for or arrange for the provision of all applicable services required by this chapter TITLE by submitting, at a minimum, the following documents to the Department: (1) A business plan that clearly demonstrates the ability of the applicant to provide services in accordance with Maryland regulations and funding requirements; (2) A summary of the applicant’s demonstrated experience in the field of developmental disabilities, in accordance with standards developed by the Department; (3) Prior licensing reports issued within the previous 10 years from any in–State or out–of–state entities associated with the applicant, including deficiency reports and compliance records on which the State may make reasoned decisions about the qualifications of the applicant; and (4) A written quality assurance plan, approved by the Developmental Disabilities Administration, to address how the applicant will ensure the health and safety of the individuals served by the applicant and the quality of services provided to individuals by the applicant]: (1) REQUIRE AN APPLICANT FOR A LICENSE UNDER THIS SECTION TO SUBMIT ALL DOCUMENTS SPECIFIED IN THE RULES AND REGULATIONS TO DETERMINE THE CAPABILITY OF THE APPLICANT TO PROVIDE FOR OR ARRANGE FOR THE PROVISION OF ALL APPLICABLE SERVICES REQUIRED B

laws state of marylandmsa.maryland.gov/megafile/msa/speccol/sc5300/sc...trade – oriented, or ......

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