Members of the Maryland House Health and Government Operations Committee met last week to discuss a series of bills that will be voted on in the future. Bill topics included reciprocal licenses, wages and benefits for nursing home workers, and vaccine administration.
House Bill 146 would allow health occupations boards to create reciprocal licensure agreements with other states. Matt Dudzic from the Maryland Board of Physicians said these licensure agreements must be similar across different states’ health occupations boards.
“It does not require boards to enter into these reciprocal licensure [agreements],” Dudzic said. “The arrangement must work both ways.”
Dudzic brought up the Interstate Medical Licensure Compact between Maryland, Virginia, and the District of Columbia that took effect in 2023. He said 236 physicians became licensed within the first nine months, with 115 from Virginia and 121 from the District of Columbia.
“It has been so successful that the board has been looking for ways to expand the program,” Dudzic said.
He said the active compact is limited to those who practice medicine, and noted how 11 other regulated healthcare options are vital, like respiratory therapists and radiographers, which are essential healthcare members that need to be included in licensure agreements. HB 146 would allow the board to explore developmental agreements for all healthcare practitioners for the purpose of increasing and strengthening the state’s workforce.
HB 68 relates to continuing care retirement communities (CCRCs), which are professionally managed retirement communities that offer continuums of care, like assisted living and skilled nursing facilities. Concerns have been raised about transparency, changes in services without notification, and deposits among these facilities.
HB 68 would increase accountability and transparency by allowing two residents onto the CCRC Board, and by allowing the Maryland Department of Aging to collect information on internal grievances filed by residents at each location.
Allison Ciborowski, a staff member at LeadingAge Maryland, spoke in opposition to this bill and said there are two problematic provisions. Ciborowski said CCRCs operate through a complex financial framework that are driven by entrance fees, and that HB 68 would create disruptions in financial exchanges.
She said some stakeholders are concerned about fee reimbursement timelines for heirs, and if a resident dies or moves out from a CCRC facility, it can sometimes take years to get those entrance fees or deposits back. While Ciborowski acknowledged frustration surrounding reimbursement timelines, she said CCRCs are issuing refunds adequately under their contracts, and that it isn’t a widespread issue.
“The bill seeks to increase from one to two the number of full voting resident members on CCRC boards, and increases resident representation on corporate level boards,” Ciborowski said. “We agree that resident involvement is important. Maryland already exceeds most other states in this area. We’re only one of three states in the country that requires full voting resident members on boards. However, we don’t believe those justify or prove additional resident voting members adds value or efficacy to boards or governance.”
Del. Terri Hill (D — Howard County) addressed those in opposition and said CCRCs aren’t paying individuals back for entrance fees or deposits until after a room is inhabited by a new resident. Hill suggested CCRCs are using up the money instead of keeping it in a safe stash to reimburse folks. She’s also concerned about the order of individuals who receive reimbursements.
“If I’ve got $1,000 and some family’s owed $100, some family is owed $200, somebody’s owed $300, and somebody’s owed $400, it shouldn’t matter the order in which it goes out—at least that’s the way I learned math,” Hill said. “The issue is that if somebody’s unit is not selling, and so they keep being pushed and pushed and pushed, they’re never getting their money back, but you still have to pay that money so the sequence in which you give it should not affect your stability unless you’re floating the money and don’t have it.”
HB 462 would require the governor’s budget to include an eight percent increase for nursing home workers over a three year period, beginning in 2025.
“Secondly, this bill ensures 75 percent of the eight percent increase go to funding towards workers and staff that offer direct care, indirect care, direct care support services, and patient care to residents in nursing homes,” said Del. Ashanti Martinez (D — Prince George’s), bill sponsor.
The bill would also require providers to document and report fund disbursements to the Department of Health.
“Nursing homes are a critical part of every community,” Martinez said. “The reality is, we expect nursing home staff to satisfy needs, while also being underpaid and overworked.”
Martinez mentioned how 96 percent of nursing homes across the US are having difficulty hiring workers, and that HB 462 ensures the maintenance of quality of care.
HB 34 would create an interstate social worker licensure compact to eliminate barriers to practice and provide social workers mobility, in addition to supporting the relocation of military spouses. This bill would continue patients’ continuity of care when traveling while allowing the recruitment of workers across state lines.
HB 76 would allow pharmacists to order and administer specific vaccines for certain age groups. This would alter the vaccines a pharmacist could administer to children at least five years of age.