reglab/statecodes huggingface dataset:
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6A - Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians › Section 8-6A-15 - Examination of Certified Nursing Assistant, Certified Dialysis Technician, or Certified Medication Technician

(a)    If, during the review of an application for certification or investigation of an allegation brought against a certified nursing assistant, certified dialysis technician, or certified medication technician under this subtitle, the Board has reason to believe and objective evidence that the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician may cause harm to a person affected by the practice of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician, the Board, on its own initiative, shall direct the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to submit to an appropriate examination by a health care provider designated by the Board.
(b)    In return for the privilege to practice as a certified nursing assistant, certified dialysis technician, or certified medication technician in the State, an applicant, certified nursing assistant, certified dialysis technician, or certified medication technician is deemed to have:
(1)    Consented to submit to an examination under this section if requested by the Board in writing; and
(2)    Waived any legal claim of privilege as to the testimony or examination reports of the examining health care provider.
(c)    The failure or refusal of an applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to submit to an examination required under subsection (b) of this section is prima facie evidence of the inability of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician to competently practice as a certified nursing assistant, certified dialysis technician, or certified medication technician, unless the Board finds that the failure or refusal was beyond the control of the applicant, certified nursing assistant, certified dialysis technician, or certified medication technician.
(d)    The Board shall pay the cost of any examination made in accordance with the provisions of this section.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6A - Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians › Section 8-6A-16 - Disclosure of Criminal Activity

If the Board determines that the information contained in a record concerns possible criminal activity of an individual who routinely provides nursing and nursing related tasks delegated by a registered nurse or licensed practical nurse for compensation, the Board shall disclose the information to a law enforcement or prosecutorial official.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6A - Certification of Nursing Assistants, Dialysis Technicians, and Medication Technicians › Section 8-6A-17 - Authority of Board

(a)    The authority of the Board established under this subtitle:
(1)    Vests with the Board at the time an individual applies for certification;
(2)    Continues during periods of certification; and
(3)    Includes authority over an individual holding an expired certificate, a lapsed certificate, or a temporary certificate that has expired under § 8–6A–07(f) of this subtitle.
(b)    The authority of the Board shall be continuous over an individual applicant or certificate holder and may not be divested by withdrawal of an application, when a certificate expires or lapses, or when a temporary certificate expires.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-01 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “Applicant” means, unless the context requires otherwise:
(1)    An individual applying for an initial license by examination or endorsement;
(2)    A licensee applying for renewal of a license; or
(3)    An individual applying for reinstatement of a license in accordance with § 8–6B–14 of this subtitle.
(c)    “Board” means the State Board of Nursing.
(d)    “Committee” means the Electrology Practice Committee.
(e)    “Electrologist” means an individual who practices electrology.
(f)    “Electrology instructor” means an individual who practices electrology and teaches an electrology education program.
(g)    “Expired license” means, unless the context requires otherwise, a license that was not renewed before the expiration date of the license as established by § 8–6B–14(a) of this subtitle.
(h)    “Lapsed license” means, unless the context requires otherwise, a license that was not renewed because a licensee failed to renew the license or otherwise did not meet the renewal requirements of this subtitle.
(i)    “License” means, unless the context requires otherwise, a license issued by the Board:
(1)    To practice electrology; or
(2)    To practice electrology and teach an electrology education program.
(j)    “Licensed electrologist” means, unless the context requires otherwise, an electrologist who is licensed by the Board to practice electrology.
(k)    “Licensed electrology instructor” means, unless the context requires otherwise, an electrologist who is licensed by the Board to practice electrology and teach an electrology education program.
(l)    “Licensee” means, unless the context requires otherwise, a licensed electrologist or licensed electrology instructor who has:
(1)    An active license;
(2)    An inactive license;
(3)    An expired license;
(4)    A lapsed license;
(5)    A suspended license; or
(6)    a license subject to a reprimand, probation, or suspension.
(m)    “Practice electrology” means to remove hair permanently through the use of electrical instruments.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-04 - Fees

(a)    (1)    The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to electrologists.
(2)    The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure and the other services provided to electrologists.
(b)    (1)    The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.
(2)    The Comptroller shall distribute all fees to the Board.
(c)    The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-05 - Electrology Practice Committee

(a)    There is an Electrology Practice Committee within the Board.
(b)    (1)    The Committee consists of three members appointed by the Board.
(2)    Of the three Committee members:
(i)    Two shall be licensed electrologists or licensed electrology instructors; and
(ii)    One shall be a consumer member.
(c)    Each member of the Committee shall be a citizen of the United States and a resident of the State.
(d)    Each electrologist member of the Committee shall have practiced electrology actively in the State for at least 5 years immediately before appointment.
(e)    The consumer member of the Committee:
(1)    Shall be a member of the general public;
(2)    May not be or ever have been:
(i)    An electrologist;
(ii)    A health care professional; or
(iii)    In training to be an electrologist or a health care professional;
(3)    May not have a household member who is an electrologist, a health care professional, in training to be an electrologist, or in training to be a health care professional; and
(4)    May not:
(i)    Participate or ever have participated in a commercial or professional field related to electrology;
(ii)    Have a household member who participates in a commercial or professional field related to electrology; or
(iii)    Have, or have had within 2 years before appointment, a substantial financial interest in a person regulated by the Board.
(f)    (1)    The term of a member is 4 years.
(2)    The terms of the members are staggered as required by the provisions for members of the Committee on July 1, 2003.
(3)    At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4)    A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.
(5)    A member may not serve more than two consecutive full terms.
(6)    To the extent practicable, the Board shall fill any vacancy on the Committee within 60 days of the date of the vacancy.
(g)    A majority of the full authorized membership of the Committee is a quorum.
(h)    In addition to any other meeting requirements of this title, the Committee  shall meet:
(1)    At the request of the executive director of the Board; or
(2)    As necessary to conduct Board business.
(i)    In accordance with the State budget, each member of the Committee  is entitled to:
(1)    Compensation, at a rate determined by the Board, for each day, or part of a day, on which the member is engaged in the duties of the Committee; and
(2)    Reimbursement for expenses under the Standard State Travel Regulations.
(j)    (1)    The Board may remove a member for incompetence or misconduct.
(2)    The Board may remove a member who is absent from two successive Committee meetings without adequate reason.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-06 - Miscellaneous Powers and Duties

In addition to the powers set forth elsewhere in this subtitle, the Committee shall:
(1)    Make recommendations to the Board regarding regulations necessary to carry out the provisions of this subtitle;
(2)    Make recommendations to the Board regarding a code of ethics for the practice of electrology;
(3)    Make recommendations to the Board regarding the requirements for licensure as an electrologist or an electrology instructor;
(4)    Review applications for licensure as an electrologist or electrology instructor and make recommendations to the Board;
(5)    Maintain a list of all currently licensed electrologists and electrology instructors;
(6)    Make recommendations to the Board regarding continuing education requirements for electrologists;
(7)    At the request of the Board, investigate complaints against licensed electrologists;
(8)    Review electrology education programs both in the State and out of state in accordance with § 8–6B–16 of this subtitle to determine compliance with the standards of that section and make recommendations to the Board regarding approval or disapproval of these programs;
(9)    Review advertising by licensed electrologists and by institutions that offer an electrology program and make recommendations to the Board, as necessary;
(10)    At the request of the Board, after the Board has received a written and signed complaint, including a referral from the Commissioner of Labor and Industry, conduct an unannounced inspection of the office of an electrologist, other than an office of an electrologist in a hospital, related institution, freestanding medical facility, or a freestanding birthing center, to determine compliance at that office with the Centers for Disease Control and Prevention’s guidelines on universal precautions and make recommendations to the Board, as necessary;
(11)    At the request of the Board, after the Board has received notice that an electrologist has opened an office, after notifying the electrologist, conduct an inspection of the office to determine compliance with the Board’s regulations relating to the minimum requirements for an office and make recommendations to the Board, as necessary;
(12)    Advise the Board on matters relating to the practice of electrology;
(13)    Keep a record of its proceedings; and
(14)    Submit an annual report to the Board.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-07 - License Required; Exception

(a)    Except as otherwise provided in this subtitle, an individual shall be licensed by the Board before the individual may practice electrology or teach an electrology education program in the State.
(b)    This section does not apply to a student who is practicing electrology as part of an approved clinical electrology education program.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-08 - Qualifications of Applicants

(a)    To qualify for a license, an applicant shall be an individual who submits to a criminal history records check in accordance with § 8–303 of this title and meets the requirements of this section.
(b)    The applicant shall be of good moral character.
(c)    The applicant shall be at least 18 years old.
(d)    Except as otherwise provided in this subtitle, an applicant shall be a high school graduate or have completed equivalent education and have completed satisfactorily:
(1)    An electrology education program, taught by a licensed electrology instructor, that includes at least 600 hours of instruction, and has been approved by the Board; or
(2)    An electrology education program in any other state that the Board determines is substantially equivalent to that required by item (1) of this subsection.
(e)    (1)    Except as otherwise provided in this subtitle, each applicant shall pass:
(i)    An examination approved by the Board; and
(ii)    A clinical examination approved by the Board.
(2)    Applicants are responsible for scheduling the examinations required under paragraph (1) of this subsection.
(f)    In addition to the other requirements of this section, an applicant for an electrology instructor license shall:
(1)    Be a licensed electrologist;
(2)    Have practiced electrology actively for at least 5 years immediately before the application;
(3)    Pass an examination approved by the Board; and
(4)    Meet any other requirements set forth in regulations adopted by the Board under § 8–6B–03 of this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-09 - Applications for License

(a)    To apply for a license, an applicant shall:
(1)    Submit to a criminal history records check in accordance with § 8-303 of this title;
(2)    Submit to the Board:
(i)    An application on the form that the Board requires;
(ii)    Written, verified evidence that the requirement of item (1) of this subsection is being met; and
(iii)    Evidence of compliance with the requirements of § 8-6B-08 of this subtitle; and
(3)    Pay to the Board a fee set by the Board.
(b)    The Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-10 - Examinations

(a)    An applicant who otherwise qualifies for a license is entitled to be examined as provided in this section.
(b)    An applicant shall take a written examination approved by the Board.
(c)    (1)    The Board or the Board’s designee shall give clinical examinations to applicants.
(2)    The Board or the Board’s designee may give reexaminations to applicants who fail the clinical examination.
(d)    The Board or the Board’s designee shall notify each qualified applicant of the time and place of examination for the written and clinical examinations.
(e)    Except as otherwise provided under this subtitle, the Board shall determine the passing score for examinations given under this subtitle.
(f)    (1)    An applicant may retake a written examination or a failed section of a written examination after paying a reexamination fee set by the Board or the administrator of a national examination.
(2)    An applicant who fails two reexaminations may retake the written examination only if the applicant:
(i)    Retakes the entire examination;
(ii)    Pays the full examination fee; and
(iii)    Completes an education program that the Board requires.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-11 - Waiver of Examination Requirements -- Out-of-State Licenses

(a)    Subject to the provisions of this section, the Board may issue a license by endorsement and waive the examination requirement of this subtitle for an individual who is licensed to practice electrology in another state.
(b)    The Board may issue a license by endorsement under this section only if the applicant:
(1)    Pays the license fee required by the Board; and
(2)    Provides adequate evidence that the applicant:
(i)    Meets the qualifications otherwise required by this subtitle;
(ii)    Became licensed in the other state after passing in that state, or any other state, an examination that is substantially equivalent to an examination approved by the Board; and
(iii)    Became licensed in the other state after meeting requirements that are substantially equivalent to the requirements of this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-12 - Issuance and Contents of License; Criminal History Record Information

(a)    Subject to subsection (c) of this section, the Board shall issue a license to any applicant who:
(1)    Meets the requirements of this subtitle; and
(2)    Pays a license fee set by the Board.
(b)    The Board shall include on each license that the Board issues a license designation as:
(1)    Licensed electrologist; or
(2)    Licensed electrology instructor.
(c)    (1)    On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 8-303 of this title, in determining whether to grant a license, the Board shall consider:
(i)    The age at which the crime was committed;
(ii)    The circumstances surrounding the crime;
(iii)    The length of time that has passed since the crime;
(iv)    Subsequent work history;
(v)    Employment and character references; and
(vi)    Other evidence that demonstrates that the applicant does not pose a threat to the public health or safety.
(2)    The Board may not issue a license if the criminal history record information required under § 8-303 of this title has not been received.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-13 - Scope of License

(a)    An electrologist’s license issued under this subtitle authorizes the licensee to practice electrology while the license is effective.
(b)    An electrology instructor’s license issued under this subtitle authorizes the licensee to practice electrology and to teach an electrology education program while the license is effective.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-15 - Surrender of License

(a)    Unless the Board agrees to accept the surrender of a license, a licensed electrologist or licensed electrology instructor may not surrender the license.
(b)    The Board may require terms and conditions on an agreement with the licensed electrologist or licensed electrology instructor to accept surrender of the license.
(c)    An agreement to accept the surrender of a license is a final order of the Board and is a public record.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-16 - Electrology Education Program

(a)    Before an institution may operate an electrology education program in the State, the Board shall approve the program.
(b)    The Board shall approve an electrology education program in the State if:
(1)    The Maryland Higher Education Commission approves the program; and
(2)    The institution that offers the program submits evidence to the Board that the institution is prepared to:
(i)    Meet the standards established in regulations adopted by the Board under § 8-6B-03 of this subtitle; and
(ii)    Carry out an education program in:
1.    The theory of electrology; or
2.    The clinical practice of electrology.
(c)    (1)    The Board periodically may evaluate electrology programs in the State and prepare a written report.
(2)    If an institution that offers an approved electrology education program violates any of the standards set by the Board under this subtitle, the Board shall give the institution specific, written notice of the violation.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-17 - Withdrawal of Approval

Subject to the hearing provisions of § 8-317 of this title and § 8-6B-19 of this subtitle, the Board may remove an institution from its list of institutions that offer approved electrology education programs if the institution:
(1)    Is guilty of fraud or deceit in obtaining or attempting to obtain approval;
(2)    Acts in a manner inconsistent with generally accepted standards for the practice of electrology;
(3)    Advertises in a manner that the Board determines violates § 8-6B-22 of this subtitle;
(4)    Violates the standards set under this subtitle and does not correct the violation in a reasonable time after notice is given; or
(5)    No longer operates a program that qualifies for approval under this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-19 - Hearings for Actions Under 8-6b-17 or 8-6b-18

(a)    Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under § 8-6B-17 or § 8-6B-18 of this subtitle, it shall give the person against whom the action is contemplated an opportunity for a hearing before the Board.
(b)    The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.
(c)    The hearing notice to be given to the person shall be sent by certified mail, return receipt requested, to the last known address of the person at least 30 days before the hearing.
(d)    The person may be represented at the hearing by counsel.
(e)    (1)    The Board may issue subpoenas and administer oaths in connection with a proceeding under this section.
(2)    If, without lawful excuse, a person disobeys a subpoena from the Board or an order by the Board to take an oath, testify, or answer a question, then on petition of the Board, a court of competent jurisdiction:
(i)    Shall compel compliance with the subpoena; and
(ii)    May hold the person in contempt of court.
(f)    If after due notice the person against whom the action is contemplated fails or refuses to appear, nevertheless the Board may hear and determine the matter.
(g)    The hearing of charges may not be stayed or challenged by procedural defects alleged to have occurred prior to the filing of charges.
(h)    (1)    After the Board conducts an investigation under this subtitle, the Board may issue an advisory letter to the licensee.
(2)    The Board may disclose an advisory letter issued under this subsection to the public.
(3)    The issuance of an advisory letter under this subsection may not:
(i)    Be considered a disciplinary action under § 8–6B–18 of this subtitle; and
(ii)    Be reported to any licensing entity, employer, or insurance company as a disciplinary action.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-20 - Penalty Instead of Suspension or in Addition to Suspension or Revocation

(a)    If after a hearing under § 8-6B-19 of this subtitle the Board finds that there are grounds under that section to suspend or revoke a license, the Board may impose a penalty not exceeding $5,000:
(1)    Instead of suspending the license; or
(2)    In addition to suspending or revoking the license.
(b)    The Board shall adopt rules and regulations to set standards for the imposition of penalties under this section.
(c)    The Board shall pay a penalty collected under this section into the General Fund of the State.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-21 - Review

(a)    Except as provided in subsection (b) of this section, a person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.
(b)    A person aggrieved by a final decision of the Board pursuant to § 8–6B–19 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act.
(c)    An order of the Board may not be stayed pending review.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-22 - Reinstatement of Suspended or Revoked Licenses

(a)    If a license was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a license was surrendered, the Board may reinstate the license if the licensee:
(1)    Applies to the Board for reinstatement;
(2)    Meets the requirements for renewal under § 8–6B–14 of this subtitle;
(3)    Meets any other requirements for reinstatement as established by the Board; and
(4)    Submits to a criminal history records check in accordance with § 8–303 of this title.
(b)    If a licensee meets the requirements of subsection (a) of this section, the Board may:
(1)    Reinstate the license;
(2)    Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or
(3)    Deny reinstatement of the license.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-23 - Mispresentation; Advertising; Use of Titles

(a)    Unless authorized to practice electrology, or to teach an electrology program under this subtitle, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice electrology or to teach an electrology education program in the State.
(b)    Neither a licensee nor an institution that offers an approved electrology education program may advertise in a manner that is unreasonable, misleading, or fraudulent.
(c)    Unless authorized to practice electrology or instruct electrology under this subtitle, a person:
(1)    May not use the designation “electrologist”, “licensed electrologist”, “licensed electrology instructor”, or “electrology instructor”; and
(2)    May not use the abbreviation “L.E.” or “L.E.I.”.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-24 - Instruments and Procedures

(a)    The Board shall adopt rules and regulations that specify the types of instruments and procedures that the Board approves for use in the practice and teaching of electrology.
(b)    A licensee may use only those types of instruments and procedures in the practice of electrology or teaching of the clinical practice of electrology that are approved by the Board.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-29 - Authority of Board

(a)    The authority of the Board established under this subtitle:
(1)    Vests with the Board at the time an individual applies for licensure;
(2)    Continues during periods of licensure; and
(3)    Includes authority over an individual holding an expired license or a lapsed license.
(b)    The authority of the Board shall be continuous over an individual applicant or licensee and may not be divested by withdrawal of an application or when a license expires or lapses.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6B - Electrologists › Section 8-6B-30 - Termination of Subtitle

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, and subject to the termination of this title under § 8–802 of this title, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2023.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-01 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “ACME” means the Accreditation Commission for Midwifery Education, or a successor organization that is an accrediting agency for nurse–midwifery and direct–entry midwifery education programs and is approved by the United States Department of Education.
(c)    “AIMM” means the Association of Independent Midwives of Maryland or a successor organization that is a professional organization representing independent midwives in the State.
(d)    “Board” means the State Board of Nursing.
(e)    “Committee” means the Direct–Entry Midwifery Advisory Committee established under  § 8–6C–11 of this subtitle.
(f)    “Health care practitioner” means:
(1)    An individual certified as a nurse–midwife or a nurse practitioner under this title; or
(2)    A physician licensed under Title 14 of this article.
(g)    (1)    “Health care provider” means a health care practitioner or a hospital.
(2)    “Health care provider” includes agents or employees of a health care practitioner or a hospital.
(h)    “Hospital” has the meaning stated in § 19–301 of the Health – General Article.
(i)    “License” means, unless the context requires otherwise, a license issued by the Board to practice direct–entry midwifery.
(j)    (1)    “Licensed direct–entry midwife” means an individual who has been granted a license under this subtitle to practice direct–entry midwifery.
(2)    “Licensed direct–entry midwife” does not include a licensed nurse certified as a nurse–midwife under this title.
(k)    “Low–risk pregnancy” means a pregnancy, labor, and delivery and postpartum, newborn, and  interconceptional care that does not include a condition that requires a mandatory transfer under § 8–6C–03.
(l)    “MEAC” means the Midwifery Education and Accreditation Council, or a successor organization that is a national accreditation agency for midwifery education approved by the United States Department of Education.
(m)    “NARM” means the North American Registry of Midwives, or a successor organization that is an international certification agency that establishes and administers certification for the certified professional midwife credential.
(n)    (1)    “Patient” means a woman for whom a  licensed direct–entry midwife performs services.
(2)    “Patient” includes a woman’s newborn for the purpose of perinatal or postpartum care.
(o)    “Postpartum period” means the first 6 weeks after delivery.
(p)    (1)    “Practice direct–entry midwifery” means:
(i)    Providing  maternity care that is consistent with a midwife’s training, education, and experience; and
(ii)    Identifying and referring patients who require medical care to an appropriate health care provider.
(2)    “Practice direct–entry midwifery” includes the activities described in § 8–6C–02 of this subtitle.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-03 - Transfer to Health Care Practitioner Under Certain Conditions

A licensed direct–entry midwife may not assume or continue to take responsibility for a patient’s pregnancy and birth care and shall arrange for the orderly transfer of care to a health care practitioner for a patient who is already under the care of the licensed direct–entry midwife, if any of the following disorders or situations is found to be present at the initial interview or if any of the following disorders or situations occur as prenatal care proceeds:
(1)    Diabetes mellitus, including uncontrolled gestational diabetes;
(2)    Hyperthyroidism treated with medication;
(3)    Uncontrolled hypothyroidism;
(4)    Epilepsy with seizures or antiepileptic drug use during the previous 12 months;
(5)    Coagulation disorders;
(6)    Chronic pulmonary disease;
(7)    Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of a physician licensed under Title 14 of this article or a licensed nurse certified as a nurse–midwife or a nurse practitioner under this title that midwifery care may proceed;
(8)    Hypertension, including pregnancy–induced hypertension (PIH);
(9)    Renal disease;
(10)    Except as otherwise provided in § 8–6C–04(a)(11) of this subtitle, Rh sensitization with positive antibody titer;
(11)    Previous uterine surgery, including a cesarean section or myomectomy;
(12)    Indications that the fetus has died in utero;
(13)    Premature labor (gestation less than 37 weeks);
(14)    Multiple gestation;
(15)    Noncephalic presentation at or after 38 weeks;
(16)    Placenta previa or abruption;
(17)    Preeclampsia;
(18)    Severe anemia, defined as hemoglobin less than 10 g/dL;
(19)    Uncommon diseases and disorders, including Addison’s disease, Cushing’s disease, systemic lupus erythematosus, antiphospholipid syndrome, scleroderma, rheumatoid arthritis, periarteritis nodosa, Marfan’s syndrome, and other systemic and rare diseases and disorders;
(20)    AIDS/HIV;
(21)    Hepatitis A through G and non–A through G;
(22)    Acute toxoplasmosis infection, if the patient is symptomatic;
(23)    Acute Rubella infection during pregnancy;
(24)    Acute cytomegalovirus infection, if the patient is symptomatic;
(25)    Acute Parvovirus infection, if the patient is symptomatic;
(26)    Alcohol abuse, substance abuse, or prescription abuse during pregnancy;
(27)    Continued daily tobacco use into the second trimester;
(28)    Thrombosis;
(29)    Inflammatory bowel disease that is not in remission;
(30)    Primary genital herpes simplex virus infection during the third trimester or active genital herpes lesions at the time of labor;
(31)    Significant fetal congenital anomaly;
(32)    Ectopic pregnancy;
(33)    Prepregnancy body mass index (BMI) of less than 18.5 or 35 or more; or
(34)    Post term maturity (gestational age 42 0/7 weeks and beyond).
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-05 - Assistant

At the time of delivery, a licensed direct–entry midwife shall be assisted by a second individual who:
(1)    Has completed the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) within the previous 2 years; and
(2)    Has the skills and equipment necessary to perform a full resuscitation of the newborn in accordance with the principles of NRP.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-06 - License Required

(a)    Except as otherwise provided in this subtitle, an individual shall be licensed by the Board before the individual may practice direct–entry midwifery in the State.
(b)    This section does not apply to:
(1)    An individual who assists at a birth in an emergency;
(2)    An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice direct–entry midwifery; or
(3)    A student who is practicing direct–entry midwifery while engaged in an approved clinical midwife educational experience under the supervision of a licensed direct–entry midwife.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-07 - Duties Where Patient Chooses Home Birth in Prohibited Situations

(a)    If a patient chooses to give birth at home in a situation prohibited by this subtitle or in which a licensed direct–entry midwife recommends transfer, the licensed direct–entry midwife shall:
(1)    Transfer care of the patient to an appropriate health care practitioner;
(2)    Complete the standard form developed under § 8–6C–08(e) of this subtitle and submit the completed form to the accepting health care practitioner; and
(3)    Cease to take responsibility for the patient’s pregnancy care within 1 week after the transfer.
(b)    If birth is imminent and the patient refuses to be transferred after the licensed direct–entry midwife determines that a transfer is necessary, the licensed direct–entry midwife shall:
(1)    Call 9–1–1 and remain with the patient until emergency services personnel arrive; and
(2)    Transfer care and give a verbal report of the care provided to the emergency medical services providers.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-08 - Written Plan for Emergency Transfer Required

(a)    A  licensed direct–entry midwife shall develop a general written plan for their practice for:
(1)    Emergency transfer of a patient, newborn, or both;
(2)    Transport of a newborn to a newborn nursery or neonatal intensive care nursery; and
(3)    Transport of a patient to an appropriate hospital with a labor and delivery unit.
(b)    The Committee shall review and  recommend approval to the Board of the plan required under subsection (a) of this section.
(c)    The plan required under subsection (a) of this section shall be provided to any hospital identified in the plan.
(d)    (1)    In addition to the general written plan required under subsection (a) of this section, a  licensed direct–entry midwife shall prepare a plan that is specific to each patient and share the plan with the patient.
(2)    The plan required under paragraph (1) of this subsection shall:
(i)    Include procedures and processes to be undertaken in the event of an emergency for the mother, the newborn, or both;
(ii)    Identify the hospital closest to the address of the planned home birth that has a labor and delivery unit;
(iii)    Include a care plan for the newborn; and
(iv)    Identify the pediatric health care practitioner who will be notified after delivery in accordance with § 8–6C–02(b)(15) of this subtitle to receive the transfer of care of the newborn.
(e)    (1)    The Board, in consultation with stakeholders, shall develop a  standard form for use in all cases in which a transfer occurs during prenatal care, labor, or postpartum.
(2)    The form shall include the medical information needed by the health care practitioner receiving the patient.
(f)    (1)    After a decision to transport a patient has been made, the licensed direct–entry midwife shall:
(i)    Call the receiving health care provider;
(ii)    Inform the health care provider of the incoming patient; and
(iii)    Accompany the patient to the hospital.
(2)    On arrival at the hospital, the licensed direct–entry midwife shall provide:
(i)    To the staff of the hospital:
1.    The standard form developed under subsection (e) of this section; and
2.    The complete medical records of the patient; and
(ii)    To the accepting health care practitioner, a verbal summary of the care provided to the patient by the licensed direct–entry midwife.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-09 - Standardized Informed Consent Agreement

(a)    Before initiating care, a licensed direct–entry midwife shall obtain a signed copy of the Board–approved informed consent agreement in accordance with this section.
(b)    (1)    The Board, in consultation with stakeholders, shall review and update as necessary the informed consent agreement at least every 4 years.
(2)    The agreement reviewed under paragraph (1) of this subsection shall include acknowledgment by the patient of receipt, at a minimum, of the following:
(i)    The licensed direct–entry midwife’s training and experience;
(ii)    Instructions for obtaining a copy of the regulations adopted by the Board under this subtitle;
(iii)    Instructions for obtaining a copy of the NARM certification requirements;
(iv)    Instructions for filing a complaint with the Board;
(v)    Notice of whether the licensed direct–entry midwife has professional liability insurance coverage;
(vi)    A description of the procedures, benefits, and risks of home births, including those conditions that may arise during delivery; and
(vii)    Any other information that the Board requires.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-10 - Reports

(a)    On or before October 1 each year, a licensed direct–entry midwife shall report to the Committee, in a form specified by the Board, the following information regarding cases in which the licensed direct–entry midwife assisted during the previous fiscal year when the intended place of birth at the onset of care was an out–of–hospital setting:
(1)    The total number of patients served as primary caregiver at the onset of care;
(2)    The number, by county, of live births attended as primary caregiver;
(3)    The number, by county, of cases of fetal demise, infant deaths, and maternal deaths attended as primary caregiver at the discovery of the demise or death;
(4)    The number of women whose primary care was transferred to another health care practitioner during the antepartum period and the reason for transfer;
(5)    The number, reason for, and outcome of each nonemergency hospital transfer during the intrapartum or postpartum period;
(6)    The number, reason for, and outcome of each urgent or emergency transport of an expectant mother in the antepartum period;
(7)    The number, reason for, and outcome of each urgent or emergency transport of an infant or mother during the intrapartum or immediate postpartum period;
(8)    The number of planned out–of–hospital births at the onset of labor and the number of births completed in an out–of–hospital setting;
(9)    A brief description of any complications resulting in the morbidity or mortality of a mother or a neonate; and
(10)    Any other information required by the Board in regulations.
(b)    The Board shall send a written notice of noncompliance to each licensee who fails to meet the reporting requirements under subsection (a) of this section.
(c)    A licensed direct–entry midwife who fails to comply with the reporting requirements under this section shall be prohibited from license renewal until the information required under subsection (a) of this section is reported.
(d)    The Committee shall maintain the confidentiality of any report submitted under subsection (a) of this section.
(e)    Notwithstanding any other provision of law, a licensed direct–entry midwife shall be subject to the same reporting requirements as other health care practitioners who provide care to individuals in accordance with this title.
(f)    A licensed direct–entry midwife attending an out–of–hospital delivery shall:
(1)    For any live birth, complete and submit a birth certificate in accordance with § 4–208 of the Health – General Article; and
(2)    For any death, make all medical records available and communicate relevant circumstances of the death to the individual responsible for completing the certificate of death under § 4–212 or § 4–213 of the Health – General Article.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-12 - Duties of Committee

(a)    The Committee shall:
(1)    Review applications for licensure as a licensed direct–entry midwife and make recommendations to the Board regarding applicants;
(2)    Maintain a list of all licensed direct–entry midwives;
(3)    Make recommendations to the Board regarding continuing education requirements for licensed direct–entry midwives;
(4)    Review advertising by licensed direct–entry midwives and by institutions that offer a direct–entry midwife program and make recommendations to the Board, as necessary;
(5)    Advise the Board on matters relating to the practice of direct–entry midwifery;
(6)    Collect the reports required to be submitted by each licensed direct–entry midwife under § 8–6C–10(a) of this subtitle;
(7)    Make recommendations to the Board regarding regulations relating to the practice of direct–entry midwifery that are necessary to carry out the provisions of this subtitle;
(8)    At the request of the Board, investigate complaints against licensed direct–entry midwives;
(9)    Keep a record of the Committee’s proceedings; and
(10)    Subject to subsection (b) of this section, beginning November 1, 2016, and on each November 1 thereafter, submit a report to the Board, including:
(i)    A summary of the information included in reports submitted to the Committee by licensed direct–entry midwives under § 8–6C–10(a) of this subtitle; and
(ii)    Any other information identified by the Board.
(b)    The Committee may not include any personally identifying information in the report submitted to the Board under subsection (a)(10) of this section.
(c)    Beginning December 1, 2016, and on each December 1 thereafter, the Board shall submit to the Senate Education, Health, and Environmental Affairs Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article:
(1)    The report submitted to the Board under subsection (a)(10) of this section;
(2)    In consultation with the Committee, any recommendations regarding the continuation and improvement of the licensure of licensed direct–entry midwives in the State;
(3)    Any recommendations regarding expanding the scope of practice of licensed direct–entry midwives; and
(4)    Any recommendations, including recommendations for legislation, regarding the scope of practice of licensed direct–entry midwives to include vaginal birth after cesarean.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-13 - Qualifications for License

(a)    In addition to the education and training requirements under subsection (b) of this section, to qualify for a license, an applicant shall:
(1)    Submit to a criminal history records check in accordance with § 8–303 of this title;
(2)    Be of good moral character;
(3)    Be a high school graduate or have completed equivalent education;
(4)    Be at least 21 years old;
(5)    Hold a current cardiopulmonary resuscitation (CPR) certification issued by the American Red Cross or the American Heart Association; and
(6)    Have completed in the past 2 years the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP).
(b)    An applicant:
(1)    Shall hold a current valid Certified Professional Midwife credential granted by NARM; and
(2)    (i)    Shall have completed a midwifery education program that is accredited by MEAC or ACME;
(ii)    Shall have completed the NARM Midwifery Bridge Certificate program; or
(iii)    If the applicant was certified by NARM as a certified professional midwife on or before January 15, 2017, through a non–MEAC accredited program, but otherwise qualifies for licensure, shall provide:
1.    Verification of completion of NARM–approved clinical requirements; and
2.    Evidence of completion, in the past 2 years, of an additional 50 hours of continuing education units approved by the Board and accredited by MEAC, the American College of Nurse Midwives, or the Accrediting Council for Continuing Medical Education, including:
A.    14 hours of obstetric emergency skills training such as a birth emergency skills training (BEST) or an advanced life saving in obstetrics (ALSO) course; and
B.    The remaining 36 hours divided among and including hours in the areas of pharmacology, lab interpretation of pregnancy, antepartum complications, intrapartum complications, postpartum complications, and neonatal care.
2023 Maryland Statutes › Health Occupations › Title 8 - Nurses › Subtitle 6C - Licensed Direct-Entry Midwives › Section 8-6C-14 - License -- Application; Fee

To apply for a license, an applicant shall:
(1)    Submit to a criminal history records check in accordance with § 8–303 of this title;
(2)    Submit to the Board:
(i)    An application on the form that the Board requires; and
(ii)    Written, verified evidence that the requirement of item (1) of this subsection is being met; and
(3)    Pay to the Board a fee set by the Board.