This post summarizes the status of Health and Human Services bills that MACo took a position on during the 2016 Regular Session.
Health Occupations – State Board of Environmental Health Specialists – Sunset Extension and Revisions: HB 497 / SB 200 as originally introduced repealed the State Board of Environmental Health Specialists and shifts licensure responsibilities to a national organization.
MACo opposed this legislation due to concerns that shifting state licensure oversight and requirements to the National Environmental Health Association (NEHA) would create barriers to employee recruitment and difficulties with employee retention. NEHA licensure requirements will create a more stringent and expensive path to licensure than what is currently in place in Maryland – an additional deterrent to new employee prospects. Furthermore, in many cases hard-working and experienced employees will have to take and pass the NEHA test to continue to work. An additional subset of employees may not be able to meet the minimum education requirements under NEHA that were not required when first licensed to practice in the state decades ago. Both of these classes of state licensed specialists would potentially face termination.
Final Status: The bills were significantly amended to address MACo concerns. As amended the bill extends the sunset for the State Board of Environmental Health Specialists to 2027 and includes some reporting requirements for the board. HB 497/SB 200 passed the General Assembly and await the Governors Signature.
Prescription Drug Monitoring Program – Revisions: HB 456 / SB 382 seeks to implement one of the recommendations generated by the Heroin and Opioid Emergency Task Force by requiring prescribers and dispensers to register with and use Maryland’s Prescription Drug Monitoring Program (PDMP) before prescribing or dispensing controlled dangerous substances with potential for abuse. As part of its 2016 legislative initiatives, MACo advocated for comprehensive legislation and budget initiatives to address the growing opioid problem confronting each county and Maryland citizens.
MACo supported this legislation, as the changes made to the PDMP will help to bolster the State’s efforts to identify and deter drug abuse and diversion while supporting access to legitimate medical uses of medication with high potential for abuse.
Final Status: HB 456 was heard by the House Health and Government Operations Committee and SB 382 was heard by the Senate Finance Committee. A similar pair of bills HB 427/SB 537 were also introduced to accomplish the same goals. The committees worked to address differences and similarities between the two pairs of bills. Ultimately, HB 427/SB 537 were amended in committee and passed by the General Assembly. The bills await the Governors Signature.
Other Tobacco Products – Local Laws for Sale and Distribution – Intent of the General Assembly: HB 1485 would reverse a Maryland Court of Appeals decision that preempts local tobacco regulation.In 2013, the Maryland Court of Appeals ruled that a Prince George’s County ordinance regulating the size of cigar packs was preempted by the General Assembly. The broad interpretation of the ruling in Altadis v. Prince George’s County is that the local governments may not regulate the packaging and sale of tobacco products, including cigars, as State law has occupied that field.
MACo supported this bill because it would clarify the legislative intent and ensure that all counties were in the position to protect youth and their communities.
Final Status: This bill was heard by the House Economic Matters Committee but no further action was taken.
Cigarette Restitution Fund – Establishment of Behavioral Health Treatment Account and Funding for Substance Use Treatment Services: HB 1618 / SB 1144 seeks to create a separate behavioral health treatment account in the Cigarette Restitution Fund. The account would be dedicated to funding residential treatment services, recovery support housing, and crisis response services for individuals suffering from substance use disorders. It would also provide funding for rate adjustments for community-based agencies or programs funded by the Behavioral Health Administration or Medicaid. Access and availability to treatment in communities across the state is severely lacking.
MACo supported this legislation because the ability to treat substance use and mental health disorders should not be frustrated by lack of treatment providers, poor reimbursement rates, and a demand that exceeds capacity. HB 1618 offered a potential source of funding that may alleviate the strain that lack of resources places on the behavioral health system.
Final Status: SB 1144 was heard by the Senate Budget and Tax Committee but no further action was taken. HB 1618 passed out of the House. It was amended in the Senate and made it to passed third reader on the Senate floor. However, this legislation failed to pass the General Assembly.
Health – Prohibition on Distribution of Tobacco Products and Electronic Smoking Devices to Minors – Civil Enforcement: SB 114 would authorize counties to issue a civil citation to a person or business who distributes certain tobacco products and electronic smoking devices to minors. This is important, as local governments are best situated to understand the dynamic of tobacco use and the needs of their communities. While there are state criminal laws prohibiting tobacco sales to minors, there is no state agency that actively enforces the law. Consequently, in many jurisdictions it is up to the local health departments – to the limited extent they can under law – to enforce prohibitions preventing youth access and sales to minors.
MACo supported this bill because it would ensure that all counties were in the position to protect youth and their communities.
Final Status: The bill was assigned to the Senate Finance Committee but withdrawn by the sponsor.
Electronic Smoking Devices – E-Liquid Containers – Child-Resistant Packaging: SB 204 prohibited a retailer from distributing to a consumer e-liquid containers unless the container is distributed in child-resistant packaging. The bill also established civil penalties and authorized a sworn law enforcement officer, a county health officer, or a designee of a county health officer to issue civil citations for a violation of the act.
Final Status: The bill was assigned to the Senate Finance Committee but withdrawn by the sponsor. A federal law had passed requiring child-resistant packaging making the state legislation unnecessary.
Maryland Health Care Commission – Certificate of Need Review – Interested Party: SB 352 expands the definition of “interested parties” for Certificate Of Need (CON) applications in cases where there is a review of a replacement health care facility proposed by or on behalf of regional health systems. In those cases, a neighboring jurisdiction would be considered an interested party if it does not contain a proposed replacement health care facility but is served by the facility under review. These jurisdictions currently have no voice in the matter.
MACo supported this legislation as it affords counties whose residents would be affected by changes to a regional health care facility with an opportunity to have a say in the process.
Final Status: This bill was passed by the General Assembly and awaits the Governors signature.
Public Health – Opioid-Associated Disease Prevention and Outreach Programs: HB 468 / SB 97 allows each jurisdiction to consider a syringe service, by creating a comprehensive, public health-based structure governing the authorization, qualifications, and operating requirements for individual programs. This includes provisions that require programs to provide linkage to drug counseling, treatment and recovery services; testing for HIV, viral hepatitis, and sexually transmitted diseases; HIV and viral hepatitis education; overdose prevention education and access to or referrals to obtain naloxone. Currently, only Prince George’s County and Baltimore City are authorized to operate such programs.
MACo supported this bill with amendments to the “local option” authority. As written, the Department of Health and Mental Hygiene and the county Health Officer approve whether individual syringe programs may operate within a given jurisdiction. Rather, MACo urged that the governing body of the jurisdiction, elected by and accountable to residents of the county, should determine whether syringe service programs are authorized to operate. This would ensures an open, publicly inclusive process for any such decision.
Final Status: This legislation passed the General Assembly without the MACo amendment and awaits the Governors signature.