As chair of the Health and Government Operations Insurance Subcommittee, a great deal of my time was spent meeting with the ACA workgroup to address the changes in federal health care laws and the rising cost of health care. That work is reflected in the bills mentioned earlier. I was also heavily involved in negotiating an agreement between Pharmacy Benefit Managers and independent pharmacists that will protect these small businesses who have been put at risk by cuts in reimbursements. At the request of the hospice providers, I passed a bill that created safe processes for hospice workers to dispose of opioids used to lessen pain for those at end of life (HB 407). This was needed to prevent these drugs from entering the black market. My work to help mid-level health providers included statues to define the standards for practice for both nurse anesthetists and midwives (HB 863 and 1437). For the last several years, members of the visually impaired community were looking for a way to enforce accommodation requirements for state websites. I was successful in passing a bill that defined the guidelines for enforcement, including penalties for companies who did not comply (HB 1088).
A MOST AMAZING MOMENT OF THE 2018 SESSION
This year I sponsored HB 902, which prohibited the use of “conversion therapy” by licensed health professionals. This “therapy” is an ineffective and unsafe practice used to “convert” an individual with a differing sexual orientation to heterosexual. The Senate cross-file (SB 1028) came to the House floor first and I was the floor leader on this bill. The youngest member, Del. Meagan Simonaire, stood up and told the story of a girl who discovered that she was bisexual in high school and how her family had recommended conversion therapy so she could become heterosexual. She spoke poignantly about the self-loathing and depression, which lingers today, because of that sense of rejection. It was only at the end of her remarks that she revealed that it was her personal story. Debate was closed and the bill passed, 95—27. We wanted her moving words to be the final debate on this issue and we did not proceed with HB 902; the Senate version has passed both houses and is with the Governor awaiting his signature.
I had the opportunity to work on bills in a variety of areas this year and I was successful on 5 of them. HB 221/SB 223 puts the Maryland Council on the Advancement of School-Based Health Centers under the Department of Health in order to assure that all aspects of the public health network are considered as the Council determines how to best incorporate the services of these clinics into the network and better serve the families. HB 789 was created to address the sustainability of condo and homeowners associations, and common ownership communities, by making it easier to update their governing documents to meet current needs. Soon biological medicines that can be interchanged with the expensive name-brand products will be available. Maryland will be ready with the passage of HB 1273/SB 997, which will permit pharmacists to substitute these medicines unless the physician requires otherwise. Passage of HB 482/SB 385 updates the standards of practice for nurses. HB 725 allows the family of a dentist, who passes away unexpectedly without having planned for their practice, to own and maintain the practice for a year in order to have time to find alternatives for patients and the staff.
HB 1214/SB 1013 would have set up the licensure for a dental therapist, a mid-level dentist practitioner. It did not pass, but the discussions identified a problem of access to dentists, especially for low income, aging and individuals with disabilities; advocates have agreed to work with me over the interim to determine the best options to create a comprehensive network for dental care.
I was the primary sponsor of six bills which will now become law. I am most proud of the bill HB1277(SB0336) which requires that hospitals work with lay caregivers—the folks who will take care of their family members and friends when they are discharged—so the care at home will be most helpful in the full recovery of the loved one. We set the foundation for youngsters who age out of foster care to have covered dental services until they are 26 if needed – HB0511(SB0252). Starting in October, when a state employee is disciplined, they must be given clear information about the reason for the discipline and the reason for the specific penalty. This will empower both employers and employees in this process – SB0942 (HB1495).There were some hard losses this year. One bill, HB1499(SB0413), would have provided sustained funding for people with disabilities who are experiencing crisis in their living situation and perhaps get a small number of those individuals off of the waiting list of more than 7,000 people. A second, HB1269 (SB0223), would have allowed for people who have experienced discrimination in a public accommodation the right to bring civil action if the business is not willing to correct the situation. Another bill, HB1418 (SB0898) would have provided for restaurants and other public accommodations to have available to them an epi pin to use if a customer goes into anaphylactic shock while on the premises, perhaps saving the person’s life. I will continue to work with supporters and opponents of these bills during the interim to see if we can find common ground on behalf of our residents. Read more in My 2016 End of Session Letter
I sponsored a number of bills this year that were designed to give residents greater access to services and information. I am proudest of HB 755, Public Information Act – Enforcement, Fees and Exemptions. This bill essentially reforms the current PIA processes, which have not been revised in 45 years. I believe that transparency and accessibility of information is essential to good, effective government. Constituents need information to know how their money is being spent and in order to provide elected leaders feedback based on what they learn. We can then make informed policy. This bill standardizes processes for requesting and granting information and sets up the PIA Compliance Board and the Office of the Public Access Ombudsman. It was the result of collaboration among 22 “good government” groups, including the press, the office of the Attorney General, the Maryland Association of Counties, and the Maryland Municipal League. I am very grateful for these groups devoting many hours to getting a bill that is a win-win for all groups—especially our community members.
Last year I began my efforts to maximize the services available in our school-based health centers. This year we passed HB 375, Education – Maryland Council on Advancement of School-based Health Centers. This new council includes high level representatives of health agencies, practitioners, hospitals, and school personnel. It is charged with assessing how the services currently are working and making recommendations on how to improve. Ultimately it is our goal to have these centers be an integral part of our public health safety net.
Certified Nurse Practitioners are becoming more and more a part of our health care system. They are highly trained and skilled providers who provide essential services to patients in many settings. They consult and collaborate with all other providers. However, there was a barrier to their independent practice in some bureaucratic documentation. HB 999, Nurse Practitioners Full Practice Authority Act of 2015 was passed to remove this barrier.
I will need to follow up in the future on a couple of important bills that were not passed this session. One would have declared June to be Alzheimers’ and Brain Awareness month, which would have been dedicated to education and outreach on these disorders which are reaching epidemic proportions. Another would have required hospitals to identify and provide “reasonable” training to family care givers who support their loved ones when they are discharged from the hospital. I have already made connections with the major hospitals and the Maryland Hospital Association on how this kind of service might be provided within their current practices. We will work on that over the interim. Check out My 2015 End of Session Letter and the 2015 D19 Annapolis Report
I personally sponsored ten bills, two of which are particularly important to District 19. One would establish a task force to study how to integrate School-Based Health Centers (HB783) into the public health network. We have two such centers in D19, one at Weller Road Elementary School and one at Northwood High School. They currently provide a full range of services for students whose families cannot afford other health care providers. After much discussion with the relevant stakeholders, a letter from the Maryland Secretary of Health and Mental Hygiene was sent to the Chair of the Health and Government Operations Committee assuring the members of the General Assembly that the Department will make these goals a priority over the next year and there will be a report with recommendations before the next session. This letter fulfilled the goal of this legislation, so I withdrew HB783. I will be following up with DHMH over the interim to get progress reports.
A second bill, HB710 – Workplace Safety Assessment and Safety Program, establishes a standing committee in State hospitals, nursing homes and long term care facilities to address physical injuries that may occur in these settings because of the affects of Alzheimer’s and related disorders. I had the pleasure of working closely with the Alzheimer’s Association and the AFSCME and the SEIU while drafting this legislation. It was important to make sure this bill does not place blame on the patients or nursing home residents for their illness. Rather, this bill acknowledges that the staffs who directly work with the residents often have the most innovative ideas about how to provide a positive environment which minimizes aggressive behaviors. I am proud to say that the Alzheimer’s Association has decided to use this bill as a template for similar legislation in other States, as well as on the National level.
Other bills I have sponsored and are on their way to the governor’s desk require criminal background checks for certain health care providers (HB 401), defined the role and supervision of pharmacy interns (HB 1218) and allowed the State Board of Examiners to call for a cease and desist order for Hearing Aide Dispensers and Speech-Language Pathologists who are practicing without a license (HB 403). For more information, see My 2014 End of Session Wrap-Up.