Effective Date: June 1, 2004

For more information, please contact: Bret Schreiber

HB588  University System of Maryland - City of College Park - Payments in Lieu of Taxes PG 330-04
House Bill 588 requires the University System of Maryland to make payments in lieu of taxes to the City of College Park for any property that the System purchases subject to the property tax on January 1, 2004. The payments required shall be the product of multiplying the applicable college park property tax rate times the full assessed value of the real and personal property tax of the land as determined under the tax property article.

Effective Date: October 1, 2004

For more information, please contact: Bret Schreiber

HB732  Intercounty Connector - Prohibition
House Bill 732 prohibits the Maryland Department of Transportation and the Maryland Transportation Authority from spending any funds or granting any approvals or permits relating to the right-of-way acquisition for, or the design or construction of, the Intercounty Connector.

Effective Date: October 1, 2004

For more information, please contact: Bret Schreiber

For more information, please contact: Sheila Higdon

HB556  Medical Records - Physician Orders for Life-Sustaining Treatment
This bill would create a "Physician's Orders for Life-Sustaining Treatment" form that would document the patient's preferences for: the use of life-sustaining procedures, transfer to a hospital, any other matter considered appropriate by the Office of the Attorney General to accomplish the purposes of this form. This form would have to be consistent with the decisions of a competent individual, an advance directive of an individual incapable of making an informed decision, or a health care agent. This form has to be signed by the attending physician but may be completed by any health care provider under the attending's supervision. This form must accompany the patient when they are transferred to another health care provider or discharged.

Effective Date: October 1, 2004

For more information, please contact: Suchita Lorick

HB602  State Board of Nursing - Nursing Assistants and Medication Technicians - Certification
The bill requires an individual to be certified by the State Board of Nursing before practicing as a medication technician. Following completion of a Board-approved course in medication administration, the individual would become a "certified medication technician". The bill also stipulates terms for recertification of the CMT.

Effective Date: October 1, 2004

For more information, please contact: Sheila Higdon

HB715  Hospitals - Maternity Patients - Shaken Baby Syndrome
This bill would require hospitals that provide maternity and OB services to provide written information about Shaken Baby Syndrome to a maternity patient prior to discharge. It would require a signature from the patient acknowledging receipt of the materials and a copy to be stored on file at the hospital. The Maryland Center for Maternal and Child Health in the Family Health Administration would provide this information in both English and Spanish.

Effective Date: October 1, 2004

For more information, please contact: Suchita Lorick

SB361  Health Occupations - State Board of Dental Examiners - Issuance of Permits
The bill alters the authority of the State Board of Dental Examiners to adopt regulations governing the administration of conscious sedation. It prohibits the Board from issuing a permit to a facility where a dentist administers nitrous oxide alone and not in conjunction with another method of diminishing pain or medication used for the diminution or elimination of anxiety.

Effective Date: October 1, 2004

For more information, please contact: Sheila Higdon

SB406  State Board of Nursing - Skilled Nursing Assistants - Establishment and Certification
The bill requires the State Board of Nursing to adopt regulations establishing categories of skilled nursing assistants and qualifications for each category. It also provides that skilled nursing assistants must meet requirements set by the Board to qualify for certification and renewal of certification.

Effective Date: October 1, 2004

For more information, please contact: Sheila Higdon

(i) $360,000 to Allegany College of Maryland, and
(ii) $240,000 to Garrett Community College.

Effective Date: July 1, 2004

For more information, please contact: Bret Schreiber

HB959  Higher Education - University System of Maryland - Governing Authority
House Bill 959 provides that the authority of the Board of Regents of the University System of Maryland may not be superseded by any other State agency or office in management affairs except by provision of law that specifically references the University System. The bill allows the University System to create personnel positions without requiring a specific provision in the State budget. Previously, personnel positions had to be identified in the state budget.

Effective Date: July 1, 2004

For more information, please contact: Bret Schreiber

SB289  Higher Education - Community Colleges - Funding
Senate Bill 289 declares the intent of the General Assembly to restore full funding in FY 2005 for the Senator John A. Cade Funding Formula for Community Colleges.

Effective Date: July 1, 2004

For more information, please contact: Bret Schreiber

SB428  State Government - State Team Sport - Lacrosse
Senate Bill 428 designates lacrosse as the state team sport in Maryland.

Effective Date: October 1, 2004

For more information, please contact: Bret Schreiber

SB473  College Affordability - University System of Maryland - Cap on Tuition Increases
Senate Bill 473 states that the Board of Regents may not approve and a constituent institution may not impose an increase in the tuition charged for an academic year to a resident undergraduate or graduate student that exceeds the consumer price index for the preceding calendar year.

Effective Date: July 1, 2004 (The bill sunsets on June 30, 2006)

For more information, please contact: Bret Schreiber

SB615  Higher Education - Maryland Digital Library - Established
Senate Bill 615 establishes the Maryland Digital Library (MDL), as a program within the Maryland Higher Education Commission. This bill will codify the existing practices among the participating MDL members, enhance academic library cooperation throughout the State, and foster the development of Maryland library services for the 21st century. The legislation is budget neutral.

This program began in FY 2001. MDL was supported by funds provided by the State through MHEC. In FY 2002, with over 50 academic library participants, MDL was funded partially by MHEC and partially by the individual institutions. Since July of 2002, MDL has been totally self-funded, and through consortial purchasing, provides a core set of electronic journals, reference works, e-books and databases to support teaching and research throughout the State. Since FY 2001, students and faculty at participating Maryland colleges and universities have conducted over 4 million searches and retrieved over 3.5 million electronic journal articles and books.

The provision of these "virtual" library services to support teaching and research in Maryland is just one of the programmatic elements of the MDL. Other important initiatives include:

· Digitizing and creating Internet access to unique collections in Maryland academic libraries
· providing shared access to online library catalogs for students and faculty and MDL participating institutions
· developing programs to train Maryland library users to access materials via the Internet:

For more information, please contact: Bret Schreiber

For more information, please contact: Jim Kaufman

SB529  Health Insurance - Maryland Health Insurance Plan - Specialist Services
The bill requires that any plan offered by the Maryland Health Insurance Plan that includes specialty services must allow a member to use an out-of-network specialist if no in-network specialties are within 25 miles of the member's residence. In addition, the plan may not impose a higher co-payment or coinsurance requirement for using the out-of-network provider.

Effective Date: October 1, 2004

For more information, please contact: Jim Kaufman

SB715  Access to Health Care and Community Health Care Safety Net Act of 2004
The bill expands access to care for low income and uninsured Marylanders through several new or modified programs. First, the bill expands Medicaid eligibility for individuals whose annual household income is at or below 100% of poverty. However, this expansion is limited to primary and specialty health care services, excluding hospitalization. The bill creates the Small Employer Health Insurance Program that will offer business with less than 50 employees an affordable health insurance option. For employees who qualify for Medicaid, the Small Employer program shall submit the employer health insurance contribution to DHMH to serve as the State matching funds in order to leverage federal Medicaid funds.

The bill creates a seven member Community Health Resources Commission, which is charged with the following:

- adopting regulations related to enforcement of this bill
- establishing criteria to qualify as a community health resource, including:

· a federally qualified health center
· an FQHC "look-alike",
· a community health center,
· a migrant health center,
· a health care program for the homeless,
· a primary care program for a public housing project,
· a local nonprofit and community owned health care program,
· a school based clinic,
· a teaching clinic,
· any other program or center determined by the Commission - identifying services a community health resource shall provide including family medicine, general internal medicine, general pediatric care, laboratory service, pharmacy services, and OB/GYN services

- administering operating and capital grants for qualifying health resources,
- assisting individuals with incomes less than 300% of poverty in accessing care through community health resources,
- creating sliding scale fees for individuals between 100% to 300% of poverty,
- serving as the State's liaison to the Federal Bureau of Primary Heath Care to identity health professional shortages, medically underserved areas, and medically underserved populations
- establishing uniform data collection on primary care services and individual served,
- developing a uniform information and data management system to be used by all centers that will be integrated with local hospitals to track treatment and provide real-time indicators of available resources,
- developing incentives for specialists to serve referrals from community health resources to include reduce licensure fees and tax credits/dedications for providing uncompensated care,
- working with the Motor Vehicle Administration to collect voluntary information on income and insurance status to refer individuals to care.

1. a 2% premium tax on HMOs and MCOs
2. a 6% payroll tax on non-profit businesses and an 8% payroll tax on for-profit companies that employ more than 10,000 employees
      a. a business may claim a credit against the payroll tax, up to the amount of the tax, for employer expenditures to provide health insurance
       b. the payroll tax is only applied to wages taxable for Social Security (FICA) purpose
       c. the employer may exclude wages paid to an employee who is enrolled in or eligible for Medicare

The nine member Advisory Council on School Based Community Health Centers Expansion is charged with recommending how to expand school-based community health centers, creating a premium and sliding fee schedule, creating an MCO and private insurance reimbursement rate schedule for school-based community health providers, and identifying barriers to reimbursement of licensed health care providers.

Other Provisions

The bill creates a revolving loan fund and a new Market Tax Credit program to assist lending institutions and community development groups in obtaining capital financing through federal programs to support community health resources. The bill also creates a Capital Bond Committee to assist FQHCs in applying for grants from the State's Federally Qualified Health Centers Grant Program. This program assists FQHCs in constructing, renovating, or equipping new facilities. The bill limits the grant to the lesser of $500,000 or 50% of project costs, except for projects in designated areas that are eligible for poverty area funding under federal regulations, in which the maximum grant of $500,000 may be used to cover up to 75% of the project costs.

The bill also modifies the hospital's community assessment report to include a description of efforts to assist specialists in serving the uninsured. The Community Health Resources Commission is required to identify methods to increase reimbursement rates paid by private and public insurances to providers who offer services through the community health resource programs.

Finally, the bill states that a health insurance carrier, including an HMO (but does not specify an MCO), shall not discriminate against any provider who is located in the carrier's service area, is willing to meet the terms for provider participation, and is a qualified community health resource. This section also requires the carrier to pay a community health resource provider a rate that is equal to the rate paid to FQHCs as required by §1902(A)(13)(e) of the Social Security Act.

Effective Date: October 1, 2004 (Note, many provisions of the bill are subject to the approval of federal waivers and may impact specific implementation dates)

For more information, please contact: Jim Kaufman

SB737  Public-Private Partnership for Health Coverage for All Marylanders
The Health Care for All bill attempts to expand health insurance coverage to all Marylanders through a combination of a Medicaid expansion and a modification of the Maryland Health Insurance Plan (MHIP) to a new program, MDCare. The Medicaid expansion is for parents up to 100% of poverty. In this expansion, the Department may not require an asset test for parents or children, allow self-declaration of income and eligibility information, allow renewal procedures be conducted by mail, and guarantee enrollment for 12 months.

The bill removes the CHIP family contribution for families with incomes between 85% and 200% of poverty and expands CHIP eligibility to 400% of poverty. In addition, a child eligible for CHIP may not enroll if the parent is insured through an employer health plan that offers family coverage, the employer's contribution is at least 30% of the annual premiums, the benefits are equal to the Comprehensive Standard Health Benefit Plan, and the premium required is more than 6% of the family's income. If the employer sponsored plan does not meet these requirements, the child will be assigned to an MCO, with a sliding scale premium rate.

The bill also modifies the current Maryland Health Insurance Plan (MHIP) and renames it MDCare. MDCare is defined as a quasi-public nonprofit corporation designed to provide affordable, comprehensive health benefits to the uninsured. This section defines an uninsured person as someone whose annual family income is below 150% of poverty in FY 2005 or beginning in FY 2006 and thereafter, family income below 350% of poverty. In order to quality for MDCare, the individual's employer does not offer health insurance benefits comparable to the Comprehensive Standard Health Benefit Plan or offers a plan that costs more than 3% of the person's income for individual coverage or 6% for family coverage. Other provisions of the bill relating to MDCare include:

· Adding eight additional members to the current MHIP board including representatives of the disabilities community, small business community, labor unions, physicians, and consumers,
· Maximizing volume discounts by allowing MDCare to aggregate the purchase of prescription drugs for enrollees in MDCare, the Senior Prescription Drug Program, and Medicaid,
· Allowing MDCare enrollees to choose an FQHC or school-based health center as the primary care provider, and
· Collecting premiums from MDCare enrollees that will be placed in the MDCare fund -- premiums and cost sharing arrangements will be on a sliding scale

The bill establishes the Maryland Quality Institute to develop standardized clinical practice guidelines. The guidelines will be distributed to private and public health plans and provider organizations. In addition, the bill creates an MDCare Universal Coverage Oversight Commission. The Commission is charged with studying the State's progress in achieving universal health coverage, means to closing gaps in coverage, the impact of employer coverage requirements on employment levels, and the appropriateness of the benefits package.

To support the costs of MDCare, the bill levies a payroll tax of 4.5% on federal Social Security wages on employers with less than 10,000 employees. The payroll tax rate increases to 6% for non-profit organizations that employ more than 10,000 employees, while the rate increase to 8% on for-profit companies that employ more than 10,000 individuals. In order to account for inflation, the MDCare Board may increase the payroll tax annually; however, the rate may not exceed 5.5% of the total wages paid to employees during the calendar year. The employer may claim a credit against the payroll tax, up to the limit of the tax, for expenditures related to providing employee health insurance benefits.

The bill also levies a $0.50 cigarette tax that will be placed into a special fund used to increase Medicaid provider reimbursement rates. The fund will transfer $100 million to Medicaid and any remaining balances to the State's General Fund annually.

Section 16 of the bill requires MDCare's Board to develop an internet based "electronic-care management" (e-CM) system. The system shall include verification of eligibility, referral management, automatic claims submission, and direct deposit of reimbursements to provider accounts. This section requires a phase-in but requires all primary care providers with significant MDCare caseloads to participate in the e-CM program.

Effective Date: July 1, 2004 (Note, various sections have different implementation dates due to complexity of the bill)

For more information, please contact: Jim Kaufman

Funds in the watershed restoration fund may be used only to award grants for up to 100% of eligible costs of projects relating to planning, design, construction, and upgrade of a wastewater facility with enhanced nutrient removal technology with a design capacity of 500,000 gallons or more per day. The fund may also be used for a portion of the operation and maintenance costs related to the enhanced nutrient removal technology, and for reasonable administrative costs incurred by a billing authority for a wastewater facility collecting the surcharge.

The bill also establishes a Watershed Restoration Fund Advisory Committee. The Committee is charged with performing an analysis of the cost of nutrient removal from wastewater facilities, identifying additional sources for funding, and to make recommendations regarding the appropriate environmental surcharge to be assessed in FY 2008 and subsequent years.

Effective Date: July 1, 2004

For more information, please contact: Heather Woods Barthel

SB393   Election Law - Voting Systems - Voter-Verified Paper Records
Senate Bill 393 requires that any voting system that does not use a document ballot produce a paper record of a voter's ballot choices and provide the voter with an opportunity to inspect the paper record. The bill requires that the paper records be preserved at the polling place in a manner similar to document ballots so that the paper records may later be used in a manual recount if necessary.

Effective Date: October 1, 2004

For more information, please contact: Bret Schreiber

For more information, please contact: Suchita Lorick

SB662   Public Safety - Handgun Identification Requirements - Repeal
This bill would repeal a provision requiring handgun manufacturers to ship the following with the handgun: a shell casing of a projectile discharged from the gun and information required for identification of the gun and shell casing. It would also repeal the provision requiring the dealer receiving the handgun to report to the State Police that the manufacturer complied with the above requirements and forward the sealed container to the State Police upon sale of the handgun. Additionally, it would repeal the requirement that the police crime laboratory enter relevant information into a database.

Effective Date: October 1, 2004

For more information, please contact: Suchita Lorick

SB496   Public Health - Compulsive Gambling Treatment Program
This bill would establish the Compulsive Gambling Treatment Program within DHMH and would also require the Governor to directly allocate $200,000 on a one-time basis to the Compulsive Gambling Center, Inc. to enable the Center to provide residential and outpatient treatment services to compulsive gamblers and their families. Funds would need to be appropriated in a supplemental budget for FY2005 or FY2006 if not included in FY2005.

Effective Date: Emergency Measure (effective upon enactment)

For more information, please contact: Suchita Lorick

Effective Date: July 1, 2004

For more information, please contact: Heather Woods Barthel

SB545  Medical Malpractice Insurance - Base Rates
If an insurer charges different rates for different medical specialties or combinations of medical specialties, the base rate paid by the highest-rated medical specialty or combination of medical specialties may not be greater than 600% of the base rate paid by the lowest-rated medical specialty or combination of medical specialties.

Effective Date: October 1, 2004

For more information, please contact: Heather Woods Barthel

SB708  Medical Malpractice Insurance - Policies with Deductibles
Each insurer that offers medical malpractice insurance policies in the state shall offer, in addition to a basic policy, policies with deductibles in the amounts of $10,000, $25,000, and $50,000. The bill also requires the Maryland Insurance Administration to report to the Senate Finance Committee and the House Economic Matters Committee on or before November 30, 2006 on the effectiveness of this policy.

Effective Date: October 1, 2004

For more information, please contact: Heather Woods Barthel

Legislative Session Office
47 State Circle, Suite 203
Annapolis, MD 21401
410-269-0057
fax 410-269-1574