Closing Dates for the Maryland Register

Schedule of Closing Dates and Issue Dates for the
Maryland Register ................................................................... 1036

COMAR Research Aids

Table of Pending Proposals ......................................................... 1037

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name Page

08 Department of Natural Resources ......................... 1040, 1045

09 Maryland Department of Labor ............................. 1041, 1046

10 Maryland Department of Health .................. 1041, 1044, 1048

12 Department of Public Safety and Correctional Services ... 1052

14 Independent Agencies ........................................... 1042, 1057

26 Department of the Environment ...................................... 1059

30 Maryland Institute for Emergency Medical Services
Systems (MIEMSS) ..................................................... 1061

31 Maryland Insurance Administration ................................ 1043

PERSONS WITH DISABILITIES

Individuals with disabilities who desire assistance in using the publications and services of the Division of State Documents are encouraged to call (410) 974-2486, or (800) 633-9657, or FAX to (410) 974-2546, or through Maryland Relay.

Final Action on Regulations

08 DEPARTMENT OF NATURAL RESOURCES

FISHERIES SERVICE

General 1040

Fish . 1040

Endangered and Threatened Fish Species . 1040

Shellfish Aquaculture and Leasing . 1040

09 MARYLAND DEPARTMENT OF LABOR

COMMISSIONER OF FINANCIAL REGULATION

Mortgage Lenders . 1041

Money Transmitters . 1041

RACING COMMISSION

Thoroughbred Rules . 1041

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Applied Behavior Analysis Services . 1041

Statewide Evaluation and Planning Services . 1041

FOOD

Food Service Facilities . 1042

BOARD OF PHYSICIANS

General Licensure Regulations . 1042

HEALTH SERVICES COST REVIEW COMMISSION

Uniform Accounting and Reporting System for Hospitals and
Related Institutions . 1042

BOARD OF SOCIAL WORK EXAMINERS

Continuing Education Requirements . 1042

14 INDEPENDENT AGENCIES

MARYLAND CENTER FOR SCHOOL SAFETY

Certification and Training for School Security Employees and
School Resource Officers . 1042

Critical, Life-Threatening Incidents . 1043

31 MARYLAND INSURANCE ADMINISTRATION

ASSETS, LIABILITIES, RESERVES, AND INVESTMENTS
OF INSURERS

Credit for Reinsurance ............................................................. 1043

Withdrawal of Regulations

10 MARYLAND DEPARTMENT OF HEALTH

MENTAL HYGIENE REGULATIONS

Involuntary Admission to Inpatient Mental Health
Facilities ................................................................................ 1044

Proposed Action on Regulations

08 DEPARTMENT OF NATURAL RESOURCES

FISHERIES SERVICE

Sharks . 1045

Gear 1045

09 MARYLAND DEPARTMENT OF LABOR

RACING COMMISSION

Harness Racing ........................................................................ 1046

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Physicians' Services . 1048

Doula Services . 1049

MARYLAND HEALTHCHOICE PROGRAM

Maryland Medicaid Managed Care Program: Managed Care
Organizations . 1049

Maryland Medicaid Managed Care Program: Benefits . 1049

MARYLAND HEALTH CARE COMMISSION

State Health Plan for Facilities and Services: Acute Care
Hospital Services . 1050

BOARD OF DENTAL EXAMINERS

Dental Radiation Technologist 1051

12 DEPARTMENT OF PUBLIC SAFETY AND
CORRECTIONAL SERVICES

DIVISION OF CORRECTION

Inmate Mail 1052

OPERATIONS

Incarcerated Individual Mail 1052

PATUXENT INSTITUTION

Inmate Mail 1052

14 INDEPENDENT AGENCIES

MARYLAND AUTOMOBILE INSURANCE FUND

Uninsured Persons' Claims for Compensation from the
Maryland Automobile Insurance Fund . 1057

26 DEPARTMENT OF ENVIRONMENT

AIR QUALITY

NO_x Ozone Season Emission Caps for Non-Trading Large
NO_x Units . 1059

30 MARYLAND INSTITUTE FOR EMERGENCY
MEDICAL SERVICES SYSTEMS (MIEMSS)

GENERAL

Definitions . 1061

EMERGENCY MEDICAL SERVICES PROVIDERS

Licensure and Certification . 1061

GENERAL

Documents Incorporated by Reference . 1064

Special Documents

MARYLAND HEALTH CARE COMMISSION

SCHEDULES FOR CERTIFICATE OF NEED
REVIEW ...................................................................... 1065

General Notices

STATE COLLECTION AGENCY LICENSING BOARD

Public Meeting . 1068

DEPARTMENT OF THE ENVIRONMENT

Public Meeting . 1068

FIRE PREVENTION COMMISSION

Public Meeting . 1068

MARYLAND DEPARTMENT OF HEALTH/SYRINGE
SERVICE PROGRAMS STANDING ADVISORY
COMMITTEE

Public Meeting . 1068

MARYLAND HEALTH CARE COMMISSION

Public Meeting . 1068

MARYLAND DEPARTMENT OF TRANSPORTATION/
MARYLAND BOARD OF AIRPORT ZONING APPEALS

Public Meeting on Regulations . 1068

COMAR Online

The Code of Maryland Regulations is available at www.dsd.state.md.us as a free service of the Office of the Secretary of State, Division of State Documents. The full text of regulations is available and searchable. Note, however, that the printed COMAR continues to be the only official and enforceable version of COMAR.

The Maryland Register is also available at www.dsd.state.md.us.

For additional information, visit www.dsd.maryland.gov, Division of State Documents, or call us at (410) 974-2486 or 1 (800) 633-9657.

Availability of Monthly List of
Maryland Documents

The Maryland Department of Legislative Services receives copies of all publications issued by State officers and agencies. The Department prepares and distributes, for a fee, a list of these publications under the title ‘‘Maryland Documents’’. This list is published monthly, and contains bibliographic information concerning regular and special reports, bulletins, serials, periodicals, catalogues, and a variety of other State publications. ‘‘Maryland Documents’’ also includes local publications.

Anyone wishing to receive ‘‘Maryland Documents’’ should write to: Legislative Sales, Maryland Department of Legislative Services, 90 State Circle, Annapolis, MD 21401.

CLOSING DATES AND ISSUE DATES THROUGH
DECEMBER 2024^†

Issue Date	Emergency and Proposed Regulations 5 p.m.*	Notices, etc. 10:30 a.m.	Final Regulations 10:30 a.m.
2023
December 15	November 27	December 4	December 6
December 29	December 11	December 18	December 20
2024
January 12	December 22**	December 29**	January 3
January 26	January 8	January 12**	January 17
February 9	January 22	January 29	January 31
February 23	February 5	February 12	February 14
March 8	February 16**	February 26	February 28
March 22	March 4	March 11	March 13
April 5	March 18	March 25	March 27
April 19	April 1	April 8	April 10
May 3	April 15	April 22	April 24
May 17	April 29	May 6	May 8
May 31	May 13	May 20	May 22
June 14	May 24**	June 3	June 5
June 28	June 10	June 17	June 18**
July 12	June 24	July 1	July 3
July 26	July 8	July 15	July 17
August 9	July 22	July 29	July 31
August 23	August 5	August 12	August 14
September 6	August 19	August 26	August 28
September 20	August 30**	September 9	September 11
October 4	September 16	September 23	September 25
October 18	September 30	October 7	October 9
November 1	October 11**	October 21	October 23
November 15	October 28	November 4	November 6
December 2***	November 8**	November 18	November 20
December 13	November 25	December 2	December 4
December 27	December 9	December 16	December 18

^† Please note that this table is provided for planning purposes and that the Division of State Documents (DSD) cannot guarantee submissions will be published in an agency’s desired issue. Although DSD strives to publish according to the schedule above, there may be times when workload pressures prevent adherence to it.

* Also note that proposal deadlines are for submissions to DSD for publication in the Maryland Register and do not take into account the 15-day AELR review period. The due date for documents containing 8 to 18 pages is 48 hours before the date listed; the due date for documents exceeding 18 pages is 1 week before the date listed.

NOTE: ALL DOCUMENTS MUST BE SUBMITTED IN TIMES NEW ROMAN, 9-POINT, SINGLE-SPACED FORMAT. THE PAGE COUNT REFLECTS THIS FORMATTING.

** Note closing date changes.

*** Note issue date changes.

The regular closing date for Proposals and Emergencies is Monday.

RegCodificationSystem
Cumulative Table of COMAR Regulations
Adopted, Amended, or Repealed

This table, previously printed in the Maryland Register lists the regulations, by COMAR title, that have been adopted, amended, or repealed in the Maryland Register since the regulations were originally published or last supplemented in the Code of Maryland Regulations (COMAR). The table is no longer printed here but may be found on the Division of State Documents website at www.dsd.state.md.us.

Table of Pending Proposals

The table below lists proposed changes to COMAR regulations. The proposed changes are listed by their COMAR number, followed by a citation to that issue of the Maryland Register in which the proposal appeared. Errata and corrections pertaining to proposed regulations are listed, followed by “(err)” or “(corr),” respectively. Regulations referencing a document incorporated by reference are followed by “(ibr)”. None of the proposals listed in this table have been adopted. A list of adopted proposals appears in the Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed.

01 EXECUTIVE DEPARTMENT

01.02.08.02,.03,.09,.10 • 50:23 Md. R. 1006 (11-17-23)

03 COMPTROLLER OF THE TREASURY

03.01.05.01—.07 • 50:22 Md. R. 979 (11-3-23)

05 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT

05.03.09.01—.11 • 50:7 Md. R. 304 (4-7-23)

05.20.05.01—.12 • 49:25 Md. R. 1054 (12-2-22)

08 DEPARTMENT OF NATURAL RESOURCES

08.02.11.01 • 50:22 Md. R. 982 (11-3-23)

08.02.11.04,.06 • 50:22 Md. R. 983 (11-3-23)

08.02.13.06 • 50:21 Md. R. 953 (10-20-23)

08.02.15.04,.05,.07 • 50:20 Md. R. 904 (10-6-23)

08.02.22.01,.03 • 50:24 Md. R. 1045 (12-1-23)

08.02.25.06 • 50:24 Md. R. 1045 (12-1-23)

08.04.16.02 • 50:21 Md. R. 954 (10-20-23)

08.07.08.08 • 50:18 Md. R. 809 (9-8-23)

09 MARYLAND DEPARTMENT OF LABOR

09.10.02.43,.53 • 50:24 Md. R. 1046 (12-1-23)

09.12.56.01—.05 • 50:23 Md. R. 1007 (11-17-23) (ibr)

09.15.02.07 • 50:22 Md. R. 985 (11-3-23)

09.22.01.13 • 50:3 Md. R. 92 (2-10-23)

09.24.05.03 • 50:21 Md. R. 956 (10-20-23)

09.24.05.05 • 50:21 Md. R. 957 (10-20-23)

09.36.07.02 • 50:17 Md. R. 772 (8-25-23)

10 MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 (2nd volume)

10.09.02.05,.07 • 50:24 Md. R. 1048 (12-1-23) (ibr)

10.09.16.01—.13 • 50:4 Md. R. 136 (2-24-23)

10.09.24.03 • 50:18 Md. R. 814 (9-8-23)

10.09.36.03-2 • 50:18 Md. R. 814 (9-8-23)

10.09.39.02,.06 • 50:24 Md. R. 1049 (12-1-23)

10.09.41.03,.04,.07 • 50:16 Md. R. 730 (8-11-23)

Subtitles 10—22 (3rd volume)

10.11.04.02,.04 • 50:15 Md. R. 689 (7-28-23)

10.19.07.02 • 50:13 Md. R. 530 (6-30-23)

10.19.08.01—.06 • 50:13 Md. R. 530 (6-30-23)

Subtitles 23—36 (4th volume)

10.24.10.01 • 50:24 Md. R. 1050 (12-1-23) (ibr)

10.27.01.05 • 50:20 Md. R. 907 (10-6-23)

10.29.02.03 • 50:20 Md. R. 907 (10-6-23)

10.29.03.03 • 50:20 Md. R. 907 (10-6-23)

10.29.04.03 • 50:20 Md. R. 907 (10-6-23)

10.34.34.02—.12 • 50:13 Md. R. 533 (6-30-23)

Subtitles 37—52 (5th volume)

10.41.01.01—.04 • 50:16 Md. R. 738 (8-11-23)

10.41.02.01,.02,.04 • 50:16 Md. R. 738 (8-11-23)

10.41.03.02,.03,.05,.06 • 50:16 Md. R. 738 (8-11-23)

10.41.04.01,.02,.06,.08 • 50:16 Md. R. 738 (8-11-23)

10.41.05.01—.07 • 50:16 Md. R. 738 (8-11-23)

10.41.08.01-1,.02,.06,.08,.11,.12,.14 • 50:16 Md. R. 738 (8-11-23)

10.41.09.02 • 50:16 Md. R. 738 (8-11-23)

10.41.11.01—.10 • 50:16 Md. R. 738 (8-11-23)

10.41.13.02,.04 • 50:16 Md. R. 738 (8-11-23)

10.43.10.01—.06 • 50:20 Md. R. 910 (10-6-23)

10.44.01.01—.39 • 50:20 Md. R. 911 (10-6-23)

10.44.19.05—.12 • 50:24 Md. R. 1051 (12-1-23)

10.44.20.02 • 50:20 Md. R. 918 (10-6-23)

10.44.22.02,.04—.06,.08—.15 • 50:20 Md. R. 918 (10-6-23)

Subtitles 53—68 (6th volume)

10.52.08.01—.16 • 50:18 Md. R. 816 (9-8-23)

10.53.08.05 • 50:17 Md. R. 773 (8-25-23)

10.53.09.01—.04 • 50:17 Md. R. 773 (8-25-23)

10.60.01.03,.05 • 50:18 Md. R. 816 (9-8-23)

10.63.01.02,.05 • 50:4 Md. R. 143 (2-24-23)

10.63.02.02 • 50:4 Md. R. 143 (2-24-23)

10.63.03.20,.21 • 50:4 Md. R. 143 (2-24-23)

10.65.01.04—.16 • 50:18 Md. R. 817 (9-8-23)

10.65.07.01—04 • 50:18 Md. R. 817 (9-8-23)

10.65.11.01—.10 • 50:18 Md. R. 817 (9-8-23)

10.67.04.20 • 50:24 Md. R. 1049 (12-1-23)

10.67.06.28 • 50:24 Md. R. 1049 (12-1-23)

11 DEPARTMENT OF TRANSPORTATION

Subtitles 01—10

11.04.02.05 • 50:20 Md. R. 923 (10-6-23)

Subtitles 11—23 (MVA)

11.12.01.14 • 50:15 Md. R. 698 (7-28-23)

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

12.02.20.01—.08 • 50:24 Md. R. 1052 (12-1-23)

12.03.03.01—.12 • 50:24 Md. R. 1052 (12-1-23)

12.12.20.01—.08 • 50:24 Md. R. 1052 (12-1-23)

13A STATE BOARD OF EDUCATION

13A.01.05.01—.04,.08,.10,.12 • 50:19 Md. R. 856 (9-22-23)

13A.01.07.01—.07 • 50:19 Md. R. 858 (9-22-23)

13A.07.06.01—.15 • 50:14 Md. R. 621 (7-14-23) (ibr)

13A.07.08.01—.08 • 50:22 Md. R. 986 (11-3-23)

13A.08.01.17 • 50:20 Md. R. 924 (10-6-23)

13A.12.01.01—.14 • 50:14 Md. R. 633 (7-14-23)

13A.12.02.01—.29 • 50:14 Md. R. 633 (7-14-23)

13A.12.03.01—.12 • 50:14 Md. R. 633 (7-14-23)

13A.12.04.01—.16 • 50:14 Md. R. 633 (7-14-23)

13A.12.05.01—.15 • 50:14 Md. R. 633 (7-14-23)

13A.12.06.01—.09 • 50:14 Md. R. 633 (7-14-23)

13A.12.07.01—.08 • 50:14 Md. R. 633 (7-14-23)

50:15 Md. R. 707 (7-28-23) (err)

13A.15.01.02 • 50:20 Md. R. 927 (10-6-23)

13A.15.05.03 • 50:20 Md. R. 927 (10-6-23)

13A.15.10.02 • 50:20 Md. R. 927 (10-6-23)

13A.15.11.04—.06 • 50:20 Md. R. 927 (10-6-23)

13A.15.13.04-1 • 50:20 Md. R. 932 (10-6-23)

13A.15.14.01,.02 • 50:20 Md. R. 932 (10-6-23)

13A.16.01.02 • 50:20 Md. R. 927 (10-6-23)

13A.16.05.11 • 50:20 Md. R. 927 (10-6-23)

13A.16.10.04 • 50:20 Md. R. 927 (10-6-23)

13A.16.11.04—.06 • 50:20 Md. R. 927 (10-6-23)

13A.16.17.04-1 • 50:20 Md. R. 932 (10-6-23)

13A.16.18.01,.02 • 50:20 Md. R. 932 (10-6-23)

13A.17.01.02 • 50:20 Md. R. 927 (10-6-23)

13A.17.05.11 • 50:20 Md. R. 927 (10-6-23)

13A.17.10.04 • 50:20 Md. R. 927 (10-6-23)

13A.17.11.04—.06 • 50:20 Md. R. 927 (10-6-23)

13A.17.15.04-1 • 50:20 Md. R. 932 (10-6-23)

13A.17.16.01,.02 • 50:20 Md. R. 932 (10-6-23)

13A.18.01.02 • 50:20 Md. R. 927 (10-6-23)

13A.18.05.11 • 50:20 Md. R. 927 (10-6-23)

13A.18.10.04 • 50:20 Md. R. 927 (10-6-23)

13A.18.11.04—.06 • 50:20 Md. R. 927 (10-6-23)

13A.18.14.04-1 • 50:20 Md. R. 932 (10-6-23)

13A.18.15.01,.02 • 50:20 Md. R. 932 (10-6-23)

13B MARYLAND HIGHER EDUCATION COMMISSION

13B.08.20.02—.13 • 50:4 Md. R. 158 (2-24-23)

14 INDEPENDENT AGENCIES

14.01.01.01—.05 • 50:19 Md. R. 861 (9-22-23)

14.01.04.01—.05 • 50:19 Md. R. 864 (9-22-23)

14.07.04.01,.03—.06 • 50:24 Md. R. 1057 (12-1-23)

14.22.01.02,.03,.07—.11 • 50:23 Md. R. 1008 (11-17-23)

14.35.07.08,.12,.14,.19 • 50:22 Md. R. 988 (11-3-23)

14.35.14.06,.07 • 50:22 Md. R. 988 (11-3-23)

14.35.15.05,.06,.08 • 50:22 Md. R. 988 (11-3-23)

14.35.16.07 • 50:22 Md. R. 988 (11-3-23)

14.38.01.03 • 50:23 Md. R. 1011 (11-17-23)

15 MARYLAND DEPARTMENT OF AGRICULTURE

15.01.18.01—.03,.05,.07,.09 • 50:22 Md. R. 990 (11-3-23)

20 PUBLIC SERVICE COMMISSION

20.63.01.01,.02 • 50:23 Md. R. 1012 (11-17-23)

20.63.03.01—.05 • 50:23 Md. R. 1012 (11-17-23)

20.63.04.01,.02 • 50:23 Md. R. 1012 (11-17-23)

20.63.05.01—.03 • 50:23 Md. R. 1012 (11-17-23)

20.63.07.01—.14 • 50:23 Md. R. 1012 (11-17-23)

20.63.11.01—.03 • 50:23 Md. R. 1012 (11-17-23)

20.63.12.01—.06 • 50:23 Md. R. 1012 (11-17-23)

20.63.13.01 • 50:23 Md. R. 1012 (11-17-23)

20.63.14.01—.04 • 50:23 Md. R. 1012 (11-17-23)

20.63.15.01—.05 • 50:23 Md. R. 1012 (11-17-23)

20.63.16.01—.04 • 50:23 Md. R. 1012 (11-17-23)

20.63.17.01—.03 • 50:23 Md. R. 1012 (11-17-23)

20.63.18.01—.03 • 50:23 Md. R. 1012 (11-17-23)

20.63.19.01—.05 • 50:23 Md. R. 1012 (11-17-23)

20.63.20.01—.03 • 50:23 Md. R. 1012 (11-17-23)

21 STATE PROCUREMENT REGULATIONS

21.05.02.14 • 50:13 Md. R. 539 (6-30-23)

21.05.03.03 • 50:13 Md. R. 539 (6-30-23)

21.11.03.10 • 50:13 Md. R. 539 (6-30-23)

21.11.11.07—.09 • 50:23 Md. R. 1023 (11-17-23)

22 STATE RETIREMENT AND PENSION SYSTEM

22.01.14.02 • 50:20 Md. R. 936 (10-6-23)

22.07.01.02 • 50:20 Md. R. 936 (10-6-23)

22.07.02.01 • 50:20 Md. R. 936 (10-6-23)

26 DEPARTMENT OF THE ENVIRONMENT

Subtitles 01—07 (Part 1)

26.04.01.01,.01-1,.20,.37 • 50:3 Md. R. 106 (2-10-23) (ibr)

Subtitles 08—12 (Part 2)

26.08.02.03-2 • 50:23 Md. R. 1023 (11-17-23)

26.11.40.02,.03 • 50:24 Md. R. 1059 (12-1-23)

26.11.43.01—.05 • 50:18 Md. R. 836 (9-8-23) (ibr)

30 MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

30.01.01.02 • 50:24 Md. R. 1061 (12-1-23)

30.01.02.01 • 50:24 Md. R. 1064 (12-1-23) (ibr)

30.02.02.04,.06—.09 • 50:24 Md. R. 1061 (12-1-23)

30.03.06.04-1 • 50:23 Md. R. 1028 (11-17-23)

33 STATE BOARD OF ELECTIONS

33.01.05.06 • 50:17 Md. R. 779 (8-25-23)

33.11.03.06 • 50:23 Md. R. 1029 (11-17-23)

33.11.04.03 • 50:23 Md. R. 1029 (11-17-23)

33.13.21.01—.05 • 50:15 Md. R. 705 (7-28-23)

33.16.02.01 • 50:17 Md. R. 779 (8-25-23)

33.16.06.04 • 50:23 Md. R. 1029 (11-17-23)

33.18.01.02 • 50:15 Md. R. 705 (7-28-23)

33.21.03.02 • 50:17 Md. R. 779 (8-25-23)

35 DEPARTMENT OF VETERANS AFFAIRS

35.06.01.02 • 50:22 Md. R. 991 (11-3-23)

Final Action on Regulations

Symbol Key

• Roman type indicates text already existing at the time of the proposed action.

• Italic type indicates new text added at the time of proposed action.

• Single underline, italic indicates new text added at the time of final action.

• Single underline, roman indicates existing text added at the time of final action.

• [[Double brackets]] indicate text deleted at the time of final action.

Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 02 FISHERIES SERVICE

08.02.01 General

Authority: Natural Resources Article, §4-1006.1, Annotated Code of Maryland

Notice of Final Action

[23-192-F]

On November 21, 2023, the Secretary of Natural Resources adopted amendments to Regulation .12 under COMAR 08.02.01 General. This action, which was proposed for adoption in 50:20 Md. R. 890—901 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

JOSH KURTZ
Secretary of Natural Resources

Subtitle 02 FISHERIES SERVICE

08.02.01 General

Authority: Natural Resources Article, §4-407, Annotated Code of Maryland

Notice of Final Action

[23-206-F]

On November 21, 2023, the Secretary of Natural Resources adopted amendments to Regulation .13 under COMAR 08.02.01 General. This action, which was proposed for adoption in 50:20 Md. R. 901—902 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

JOSH KURTZ
Secretary of Natural Resources

Subtitle 02 FISHERIES SERVICE

08.02.05 Fish

Authority: Natural Resources Article, §4-215, Annotated Code of Maryland

Notice of Final Action

[23-209-F]

On November 21, 2023, the Secretary of Natural Resources adopted amendments to Regulation .21 under COMAR 08.02.05 Fish. This action, which was proposed for adoption in 50:20 Md. R. 902 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

JOSH KURTZ
Secretary of Natural Resources

Subtitle 02 FISHERIES SERVICE

Notice of Final Action

[23-190-F]

On November 21, 2023, the Secretary of Natural Resources adopted:

(1) New Regulation .31 under COMAR 08.02.05 Fish; and

(2) Amendments to Regulation .03 under COMAR .08.02.12 Endangered and Threatened Fish Species.

This action, which was proposed for adoption in 50:20 Md. R. 902—904 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

JOSH KURTZ
Secretary of Natural Resources

Subtitle 02 FISHERIES SERVICE

08.02.23 Shellfish Aquaculture and Leasing

Authority: Natural Resources Article, §4-11A-12, Annotated Code of Maryland

Notice of Final Action

[23-197-F]

On November 21, 2023, the Secretary of Natural Resources adopted new Regulation .05 under COMAR 08.02.23 Shellfish Aquaculture and Leasing. This action, which was proposed for adoption in 50:19 Md. R. 855—856 (September 22, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

JOSH KURTZ
Secretary of Natural Resources

Title 09
MARYLAND DEPARTMENT OF LABOR

Subtitle 03 COMMISSIONER OF FINANCIAL REGULATION

09.03.06 Mortgage Lenders

Authority: Financial Institutions Article, §§2-105.1 and 11-503, Annotated Code of Maryland

Notice of Final Action

[23-179-F]

On November 17, 2023, the Commissioner of Financial Regulation adopted new Regulation .28 under COMAR 09.03.06 Mortgage Lending. This action, which was proposed for adoption in 50:18 Md. R. 810—812 (September 8, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

ANTONIO P. SALAZAR
Commissioner of Financial Regulation

Subtitle 03 COMMISSIONER OF FINANCIAL REGULATION

09.03.14 Money Transmitters

Authority: Business Regulation Article, §2-105; Financial Institutions Article, §§2-105.1, 12-401, and 12-403; Annotated Code of Maryland

Notice of Final Action

[22-315-F]

On November 17, 2023, the Commissioner of Financial Regulation adopted the recodification of existing Regulation .01 to be Regulation .02 and new Regulations .01 and .03—.18 under COMAR 09.03.14 Money Transmitters. This action, which was proposed for adoption in 50:4 Md. R. 125—135 (February 24, 2023), and reproposed for adoption in 50:18 Md. R. 812—813 (September 8, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

ANTONIO P. SALAZAR
Commissioner of Financial Regulation

Subtitle 10 RACING COMMISSION

09.10.01 Thoroughbred Rules

Authority: Business Regulation Article, §11-210, Annotated Code of Maryland

Notice of Final Action

[23-140-F]

On October 3, 2023, the Maryland Racing Commission adopted amendments to Regulation .07 under COMAR 09.10.01 Thoroughbred Rules. This action, which was proposed for adoption in 50:15 Md. R. 684—685 (July 28, 2023), has been adopted as proposed.

Effective Date: January 1, 2024.

J. MICHAEL HOPKINS
Executive Director

Subtitle 10 RACING COMMISSION

09.10.01 Thoroughbred Rules

Authority: Business Regulation Article, §11-210, Annotated Code of Maryland

Notice of Final Action

[23-141-F]

On October 3, 2023, the Maryland Racing Commission adopted amendments to Regulation .17 under COMAR 09.10.01 Thoroughbred Rules. This action, which was proposed for adoption in 50:15 Md. R. 685 (July 28, 2023), has been adopted as proposed.

Effective Date: January 1, 2024.

J. MICHAEL HOPKINS
Executive Director

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.28 Applied Behavior Analysis Services

Authority: Health-General Article, §§2-104(b), 2-105(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Final Action

[23-116-F]

On November 17, 2023, the Secretary of Health adopted amendments to Regulations .01, .02, .04, and .06 under COMAR 10.09.28 Applied Behavior Analysis Services. This action, which was proposed for adoption in 50:13 Md. R. 522—524 (June 30, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

LAURA HERRERA SCOTT
Secretary of Health

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.30 Statewide Evaluation and Planning Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Final Action

[23-133-F]

On November 17, 2023, the Secretary of Health adopted new Regulation .01, amendments to and the recodification of existing Regulations .01—.08 and .10 to be Regulations .02—.09 and .11, respectively, and the recodification of existing Regulation .09 to be Regulation .10 under COMAR 10.09.30 Statewide Evaluation and Planning Services. This action, which was proposed for adoption in 50:15 Md. R. 685—689 (July 28, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

LAURA HERRERA SCOTT
Secretary of Health

Subtitle 15 FOOD

10.15.03 Food Service Facilities

Authority: Health-General Article, §§18–102, 21-101, 21-102, 21-202,
21-211, 21-234, 21-301, 21-304, 21-308, 21-309.1, 21-309.2, 21-324.1, and 21-330.1, Annotated Code of Maryland

Notice of Final Action

[23-134-F]

On November 17, 2023, the Secretary of Health adopted amendments to Regulations .02 and .27 under COMAR 10.15.03 Food Service Facilities. This action, which was proposed for adoption in 50:15 Md. R. 690—691 (July 28, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

LAURA HERRERA SCOTT
Secretary of Health

Subtitle 32 BOARD OF PHYSICIANS

10.32.01 General Licensure Regulations

Authority: Health Occupations Article, §§14-207, 14-317, 14-320, and
14-320.1, Annotated Code of Maryland

Notice of Final Action

[23-211-F]

On November 21, 2023, the Secretary of Health adopted amendments to Regulations .05, .11, and .12 under COMAR 10.32.01 General Licensure Regulations. This action, which was proposed for adoption in 50:20 Md. R. 908—910 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

LAURA HERRERA SCOTT
Secretary of Health

Subtitle 37 HEALTH SERVICES COST REVIEW COMMISSION

10.37.01 Uniform Accounting and Reporting System for Hospitals and Related Institutions

Authority: Health-General Article, §§19-207 and 19-215, Annotated Code of Maryland

Notice of Final Action

[23-162-F-I]

On November 8, 2023, the Health Services Cost Review Commission adopted amendments to Regulation .02 under COMAR 10.37.01 Uniform Accounting and Reporting System for Hospitals and Related Institutions. This action, which was proposed for adoption in 50:17 Md. R. 772—773 (August 25, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

ADAM KANE
Chair
Health Services Cost Review Commission

Subtitle 42 BOARD OF SOCIAL WORK EXAMINERS

10.42.06 Continuing Education Requirements

Authority: Health Occupations Article, §§19-205 and 19-308, Annotated Code of Maryland

Notice of Final Action

[23-147-F]

On November 17, 2023, the Secretary of Health adopted amendments to Regulations .02, .03, and .05—.11 under COMAR 10.42.06 Continuing Education Requirements. This action, which was proposed for adoption in 50:15 Md. R. 695—698 (July 28, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

LAURA HERRERA SCOTT
Secretary of Health

Title 14
INDEPENDENT AGENCIES

Subtitle 40 MARYLAND CENTER FOR SCHOOL SAFETY

14.40.04 Certification and Training for School Security Employees and School Resource Officers

Authority: Education Article, §§7-151(k), 7-1503(g), and 7-1508, Annotated Code of Maryland

Notice of Final Action

[23-151-F]

On November 13, 2023, the Maryland Center for School Safety adopted amendments to Regulations .01—.03 under COMAR 14.40.04 Certification and Training for School Security Employees and School Resource Officers. This action, which was proposed for adoption in 50:15 Md. R. 700—701 (July 28, 2023), has been adopted with the nonsubstantive changes shown below.

Effective Date: December 11, 2023.

Attorney General’s Certification

In accordance with State Government Article, §10-113, Annotated Code of Maryland, the Attorney General certifies that the following changes do not differ substantively from the proposed text. The nature of the changes and the basis for this conclusion are as follows:

On May 8, 2023, the Subcabinet for the Maryland Center for School Safety (MCSS) approved amendments to COMAR 14.40.04. After public comment, the Subcabinet agreed to make one nonsubstantive change to the proposed regulation to correct an editing error. MCSS’s proposed revisions does not change the position of any group affected by the regulation, decrease any benefits, or increase administrative burdens, and the rights, duties, and obligations of school resource officers and school security employees are not substantially affected.

Regulation .03A: “Or an approved local training” was reinserted as it appeared in the original regulation and reflects the requirement under Education Article, §7-1508, Annotated Code of Maryland. The removal of this language was an unintended error which occurred as a result of the placement of the brackets in the proposed action. Reinsertion of this language accurately reflects the requirement in Education Article, §7-1508(b)(4) and (5), Annotated Code of Maryland, that permits school resource officers and school security employees to receive approved local training. The public did not expect that change to be made and the change corrects the mistake in bracketing.

“A change that merely conveys a requirement already specified by statute does not require reproposal since public comment could have no effect.” 75 Opinions of the Attorney General 27 (1990) citing Vega v. National Union Fire Ins. Co., 682 P.2d 73, 77 n.9 (Haw. 1984). This change would simply leave language that already exists in the regulation and aligns with the statute. This change has no effect on the administrative burden on school resource officers or school security employees nor does it reduce the benefits of the regulation.

.03 School Resource Officers and School Security Employees Certification Training.

A. A school resource officer or school security employee shall complete the Center’s model curriculum or an approved local training, as required under Education Article, §7-1508, Annotated Code of Maryland.

B.—D. (proposed text unchanged)

KATE BRYAN
Executive Director

Subtitle 40 MARYLAND CENTER FOR SCHOOL SAFETY

14.40.05 Critical, Life-Threatening Incidents

Authority: Education Article, §§7-1503(g) and 7-1510, Annotated Code of Maryland

Notice of Final Action

[23-152-F]

On November 13, 2023, the Maryland Center for School Safety adopted the amendments to Regulations .03 and .04 under COMAR 14.40.05 Critical Life Threatening Incidents. This action, which was proposed for adoption in 50:15 Md. R. 702 (July 28, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

KATE BRYAN
Executive Director

Title 31
MARYLAND INSURANCE ADMINISTRATION

Subtitle 05 ASSETS, LIABILITIES, RESERVES, AND INVESTMENTS OF INSURERS

31.05.08 Credit for Reinsurance

Authority: Insurance Article, §§1-101(jj), 2-109, 2-205, 2-209, and 5-901—
5-917, Annotated Code of Maryland

Notice of Final Action

[23-212-F]

On November 21, 2023, the Maryland Insurance Administration adopted amendments to Regulation .28 under COMAR 31.05.08 Credit for Reinsurance. This action, which was proposed for adoption in 50:20 Md. R. 937 (October 6, 2023), has been adopted as proposed.

Effective Date: December 11, 2023.

KATHLEEN A. BIRRANE
Insurance Commissioner

Withdrawal of Regulations
Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 21 MENTAL HYGIENE REGULATIONS

10.21.01 Involuntary Admission to Inpatient Mental Health Facilities

Authority: Health-General Article, §§7.5-204—7.5-205, 10-603, 10-615—10-616, 10-619, 10-625, and 10-806(d)(3), Annotated Code of Maryland

Notice of Withdrawal

[22-196-W]

Pursuant to State Government Article, §10-116(b), Annotated Code of Maryland, notice is given that the proposal to amend Regulations .04 and .08 under COMAR 10.21.01 Involuntary Admission to Inpatient Mental Health Facilities, which was published in 49:23 Md. R. 1000—1001 (November 4, 2022), has been withdrawn by operation of law.

GAIL S. KLAKRING
Administrator
Division of State Documents

Proposed Action on Regulations

Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 02 FISHERIES SERVICE

Notice of Proposed Action

[23-242-P]

The Secretary of Natural Resources proposes to amend:

(1) Regulations .01 and .03 under COMAR 08.02.22 Sharks; and

(2) Regulation .06 under COMAR 08.02.25 Gear.

Statement of Purpose

The purpose of this action is to make minor changes to the shark and gear regulations by amending, removing, and, in some instances, moving certain shortline rules from the shark chapter to the gear chapter that are better suited there. The removal of the duplicate rules regarding shortlines from the shark chapter and the consolidation of the rules in the gear chapter will make the most logical sense and aid in enforcement issues.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Gear — Shortlines, Regulatory Staff, Department of Natural Resources, Fishing and Boating Services, 580 Taylor Avenue, E-4, Annapolis, MD 21401, or call 410-260-8300, or submit comments to https://dnr.maryland.gov/fisheries/pages/‌regulations/changes.aspx#shortline. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

08.02.22 Sharks

Authority: Natural Resources Article, §4-2A-03, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(9) (text unchanged)

(10) “Shortline” means a fishing line [containing 50 or fewer hooks and measuring less than 500 yards in length] meeting the requirements of COMAR 08.02.25.06.

(11)—(13) (text unchanged)

.03 Commercial Fishery.

A—C. (text unchanged)

D. Gear.

(1) (text unchanged)

[(2) A maximum of two shortlines are allowed per vessel.

(3) Any vessel using a shortline shall:

(a) Use corrodible circle hooks;

(b) Practice the protocols and possess the federally required release equipment for pelagic and bottom longlines for the safe handling, release, and disentanglement of sea turtles and other nontarget species; and

[(4)] (2) (text unchanged)

E. (text unchanged)

08.02.25 Gear

Authority: Natural Resources Article, §4-221, Annotated Code of Maryland

.06 Commercial — Finfish Trotlines.

A.—G. (text unchanged)

H. Shortlines.

(1)—(3) (text unchanged)

(4) A maximum of two shortlines are allowed per vessel.

(5) Any vessel using a shortline shall:

(a) Practice the protocols and possess the federally required release equipment for pelagic and bottom longlines for the safe handling, release, and disentanglement of sea turtles and other nontarget species; and

(b) Have all captains and vessel owners federally certified in using handling and release equipment.

[(4)] (6) (text unchanged)

JOSH KURTZ
Secretary of Natural Resources

Title 09
MARYLAND DEPARTMENT OF LABOR

Subtitle 10 RACING COMMISSION

09.10.02 Harness Racing

Authority: Business Regulation Article, §11-210, Annotated Code of Maryland

Notice of Proposed Action

[23-244-P]

The Maryland Racing Commission proposes to amend Regulations .43 and .53 under COMAR 09.10.02 Harness Racing.

Statement of Purpose

The purpose of this action is to delete obsolete language and increase certain fees.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to J. Michael Hopkins, Executive Director, Maryland Racing Commission, 300 East Towsontown Blvd Towson, MD 21286, or call 410-428-2391, or email to mike.hopkins@maryland.gov. Comments will be accepted through January 15, 2024. A public hearing has not been scheduled.

Open Meeting

Final action on the proposal will be considered by the Maryland Racing Commission during a public meeting to be held on February 6, 2024, at 12:30 p.m., at Laurel Park.

.43 Foaled Stakes Program.

A.—D. (text unchanged)

E. Registration. Except as provided in §F of this regulation, to register a yearling the Advisory Committee shall be provided on or before May 15 with a:

(1) (text unchanged)

[(2) Photocopy of the yearling’s USTA registration certificate or its equivalent; and]

[(3)] (2) [$20] $40 registration fee.

F. Late or Incomplete Registration.

[(1)] If a yearling was not registered in accordance with the provisions of §E of this regulation, the yearling shall be registered with the Advisory Committee Administrator if the following are received between May 16 and December 31:

[(a)] (1) A completed registration form; and

[(b) A photocopy of the yearling’s USTA registration certificate or its equivalent; and]

[(c)] (2) Either:

(a) A $500 late fee[.] by December 31; or

(b) A $1,000 late fee by March 15.

[(2) If a photocopy of the USTA registration certification or its equivalent is not submitted in compliance with any of the provisions under this regulation, the:

(a) Yearling shall be ineligible for participation in the Foaled Stakes Program; and

(b) Registration fee shall be forfeited.]

G. Sustaining Fees.

(1) Except as provided in §G(2) of this regulation, the following sustaining fees are required by the following dates for the maintenance of a horse’s eligibility:

(a) First sustaining fee as a 2-year-old, [$120] $150 by March 15;

(b) Second sustaining fee as a 2-year-old, [$120] $200 by May 15; and

(2)—(3) (text unchanged)

H. (text unchanged)

I. Declaration Fee. A declaration fee of [$150] $250 is required to be made by the post time for the race into which the horse is declared.

J.—P. (text unchanged)

Q. Breeder Awards.

(1) [A 10] An 8 percent Breeder Award, based upon the amount of the purse distributed, shall be [divided between] awarded to the dam [and sire] of a horse, if the horse:

(a)—(b) (text unchanged)

[(2) Of the 10 percent awarded under §Q(1) of this regulation:

(a) 8 percent shall be awarded to the dam of the horse; and

(b) 2 percent shall be awarded to the sire of the horse, if the sire:

(i) Is still standing at stud in Maryland;

(ii) Died while standing at stud in Maryland;

(iii) Retired while standing at stud in Maryland; or

(iv) Left Maryland for breeding purposes in the southern hemisphere after the Maryland breeding season and, if still alive, returns to Maryland for the next breeding season.]

(2) A 4 percent stallion award based upon the amount of the purse distributed in a “final”, shall be awarded to the sire of the horse provided the stallion was a registered Maryland stallion at the time of conception.

(3) (text unchanged)

R.—T. (text unchanged)

U. Purse Distribution.

[(1) The purse in each race shall be divided in the following manner:

(a) 50 percent, 25 percent, 12 percent, 8 percent, and 5 percent to the first five finishers, respectively, if five or more horses finish;

(b) 50 percent, 25 percent, 15 percent, and 10 percent to the first four finishers, respectively, if only four horses finish;

(d) 65 percent and 35 percent to the first two finishers, respectively, if only two horses finish; or

(e) 65 percent to the finisher and 35 percent is retained by the Standardbred Fund for the applicable year of foaling, sex and gait division if only one horse finishes.

(2) Unless the Commission eliminates the races for one of the age groups in accordance with §M of this regulation, the purse monies to be distributed each year on behalf of the Foaled Stakes Program shall be divided equally between races for 2-year-olds and races for 3-year-olds.

(3) Unless the Commission eliminates the races for one of the gaits in accordance with §M of this regulation, the purse monies in each age category shall be divided equally between races for trotters and races for pacers.]

(1) Purses for all races shall be divided:

(a) 50 percent to the winner;

(b) 25 percent to second;

(c) 12 percent to third;

(d) 8 percent to fourth; and

(e) 5 percent to fifth.

(2) In the event fewer than five horses start, undistributed purse money shall be retained by the Race Fund.

(3) Walkovers will be paid 50 percent of the advertised purse.

(4) Unless the Commission eliminates the races for one of the age groups in accordance with §R of this regulation, the purse monies to be distributed each year on behalf of the Sire Stakes Program shall be divided equally between races for 2-year-olds and races for 3-year-olds.

(5) Unless the Commission eliminates the races for one of the gaits in accordance with §R of this regulation, the purse monies in each age category shall be divided equally between races for trotters and races for pacers.

V. (text unchanged)

.53 Sire Stakes Program.

A.—C. (text unchanged)

D. Registration as a Maryland Stallion.

[(1)] A stallion shall be registered by the Advisory Committee if the completed forms for the stallion’s registration are received by the Advisory Committee Administrator by:

[(a)] (1) December 1 of the year preceding the one for which the stallion is registered together with a [$250] $500 fee; [or]

[(b)] (2) [February] January 1 of the year for which the stallion is registered together with a $750 fee, if the stallion is not registered by the previous December 1[.]; or

(3) February 1 of the year for which the stallion is registered together with a $1,500 fee, if the stallion is not registered by the previous December 1.

[(2) To complete the registration of a Maryland stallion, a USTA registration certificate or its equivalent concerning the stallion shall be delivered to the Advisory Committee Administrator not later than February 15 of the year of registration.

(3) If the stallion’s USTA registration certificate or its equivalent is not received by the Advisory Committee Administrator in a timely manner, the stallion owner shall be penalized $250.]

E. Loss of Maryland Stallion Registration Status.

(1) A stallion shall lose its status as a registered Maryland stallion if:

(a) The stallion stands during the year anywhere other than in Maryland or in the southern hemisphere; or

(b) The stallion leaves the breeding location in Maryland during the Maryland breeding season of February 15 through July 1 except as provided under §E(2) or (3) of this regulation[; or].

[(c) There is a failure to comply with the provisions of §D(2) of this regulation.]

(2) A registered Maryland stallion may participate in racing during the breeding season provided the stallion is returned within 24 hours if the [stallion is:] Administrator is notified and proper reports are filed.

[(a) 100 percent Maryland owned; and

(b) Bred only to mares owned or leased by the stallion owner.]

(3) When a Stallion May Be Moved.

(a) A stallion may be moved to another location within the State from its registered breeding location during the breeding season [to have semen collected] for breeding purposes, provided the stallion is returned [the same day] within 24 hours and the Standardbbred Race Fund Administrator is provided a detailed monthly report on the stallion’s movements, including the following:

[(a)] (i)—[(b)] (ii) (text unchanged)

(b) A stallion moved for emergency veterinarian care shall be returned when medically released and a detailed report is provided to the Administrator.

(4)—(5) (text unchanged)

F. Requirements of the Owner of a Registered Stallion.

(1)—(2) (text unchanged)

(3) Failure to comply with the provisions of §F(1) and (2) of this regulation shall subject the owner of the stallion, for each month the owner is delinquent, to a penalty of:

(a) $500 for a stallion with a registered stud fee of less than $500; or

[(b) An amount equal to the stud fee of the stallion if the registered stud fee of the stallion is more than $500; or]

[(c)] (b) (text unchanged)

(4) Failure to comply with the provisions of §F(1) and (2) of this regulation by February 15 of the year following the year to be covered by the Mares Bred report shall:

(a) (text unchanged)

(b) Subject the stallion owner, for each foal that remains eligible for the Sires Stakes Program, to a penalty of:

(i) $500 for a stallion with a registered stud fee of less than $500; or

[(ii) An amount equal to the stud fee of the stallion if the registered stud fee of the stallion is over $500; or]

[(iii)] (ii) $1,500 for a stallion with a private, [or] undesignated or stud fee over $500.

G.—H. (text unchanged)

I. Registration. Except as provided in §J of this regulation, in order to register a yearling, the Advisory Committee Administrator shall be provided on or before May 15 with a:

(1) Completed form for the registration of the yearling; and

[(2) Photocopy of the yearling’s USTA registration certificate; and]

[(3)] (2) [$20] $40 registration fee.

J. Late or Incomplete Registration.

[(1)] If a yearling was not registered in accordance with the provisions of §I of this regulation, the yearling shall be registered with the Advisory Committee Administrator if the following are received between May 16 of the yearling year and [December 31] March 15 of the 2-year-old year:

[(a)] (1) (text unchanged)

[(b) A photocopy of the yearling’s USTA registration certificate; and]

[(c)] (2) A $500 late fee by December 31[.]; or

(3) A $1,000 late fee by March 15.

[(2) If a photocopy of the USTA registration certification or its equivalent is not submitted in compliance with any of the provisions for doing so under this regulation, the:

(a) Yearling shall be ineligible for participation in the Sires Stakes Program; and

(b) Registration fee shall be forfeited.]

K. Sustaining Fees.

(1) Except as provided in §K(2) of this regulation, the following sustaining fees are required by the following dates for the maintenance of a horse’s eligibility:

(a) First sustaining fee as a 2-year-old, [$120] $150 by March 15;

(b) Second sustaining fee as a 2-year-old, [$120] $200 by May 15; and

(2)—(3) (text unchanged)

L. (text unchanged)

M. Declaration Fee.

(1)—(2) (text unchanged)

(3) The declaration fee is [$250] $400.

N.—T. (text unchanged)

U. Breeder Awards.

(1) [A 10] An 8 percent Breeder Award, based upon the amount of the purse distributed in a “final”, shall be [divided between] awarded to the dam [and sire] of a horse, if the horse:

(a)—(b) (text unchanged)

[(2) Of the 10 percent awarded under §U(1) of this regulation:

(a) 8 percent shall be awarded to the dam of the horse; and

(b) Except as provided in §U(4) of this regulation, 2 percent shall be awarded to the sire of the horse, if the sire:

(i) Is still standing at stud in Maryland;

(ii) Died while standing at stud in Maryland;

(iii) Retired while standing at stud in Maryland; or

(iv) Left Maryland for breeding purposes in the southern hemisphere after the Maryland breeding season and, if still alive, returns to Maryland for the next breeding season.]

(2) A 4 percent stallion award based upon the amount of the purse distributed in a “final”, shall be awarded to the sire of the horse provided the sire was a registered Maryland stallion at the time of conception.

(3) (text unchanged)

[(4) The requirements placed on the sire of a horse, set forth in §U(2)(b) of this regulation are not applicable to the sire of any horse foaled in or after 2005.]

V.—Z. (text unchanged)

AA. Purse Distribution.

[(1) The purse in each race shall be divided in the following manner:

(a) 50 percent, 25 percent, 12 percent, 8 percent, and 5 percent to the first five finishers, respectively, if five or more horses finish;

(b) 50 percent, 25 percent, 15 percent, and 10 percent to the first four finishers, respectively, if only four horses finish;

(d) 65 percent and 35 percent to the first two finishers, respectively, if only two horses finish; or

(e) 65 percent to the finisher and 35 percent is retained by the Standardbred Fund for the applicable year of foaling, sex and gait division if only one horse finishes.

(2) Unless the Commission eliminates the races for one of the age groups in accordance with §R of this regulation, the purse monies to be distributed each year on behalf of the Sires Stakes Program shall be divided equally between races for 2-year-olds and races for 3-year-olds.

(3) Unless the Commission eliminates the races for one of the gaits in accordance with §R of this regulation, the purse monies in each age category shall be divided equally between races for trotters and races for pacers.]

(1) Purses for all races shall be divided:

(a) 50 percent to the winner;

(b) 25 percent to second;

(c) 12 percent to third;

(d) 8 percent to fourth; and

(e) 5 percent to fifth.

(2) In the event fewer than five horses start, undistributed purse money shall be retained by the Race Fund.

(3) Walkovers will be paid 50 percent of the advertised purse.

BB. (text unchanged)

TAMMY LAFFERTY
Chairman
Maryland Racing Commission

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.02 Physicians’ Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[23-257-P-I]

The Secretary of Health proposes to amend Regulations .05 and .07 under COMAR 10.09.02 Physicians’ Services.

Statement of Purpose

The purpose of this action is to:

(1) Update the Maryland Medical Assistance Program Professional Service Provider Manual and Fee Schedule incorporated by reference; and

(2) Remove the language limiting coverage of vaccines required solely for travel outside the continental United States.

Estimate of Economic Impact

I. Summary of Economic Impact. Effective July 1, 2023, the reimbursement rates for doula attendance at labor and delivery will increase by 228.57 percent ($745,650).

II. Types of Economic Impact.

Impacted Entity	Revenue (R+/R-) Expenditure (E+/E-)	Magnitude
A. On issuing agency:
Maryland Department of Health	(E+)	$745,650
B. On other State agencies:	NONE
C. On local governments:	NONE

	Benefit (+) Cost (-)	Magnitude
D. On regulated industries or trade groups:
Maryland Medicaid providers	(+)	$745,650
E. On other industries or trade groups:	NONE
F. Direct and indirect effects on public:	NONE

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. This amount assumes:

(1) Reimbursement rates for evaluation and management (E&M) procedures are maintained at 100 percent of the 2022 Medicare rate effective July 1, 2022. The total impact for FY 2023 is $0.

(2) For dates of service beginning July 1, 2023, the Maryland Medical Assistance reimbursement rates for doula attendance at labor and delivery will increase by 228.57 percent. This represents an estimated $745,650 increase in total funds (50 percent general funds $372,825, 50 percent federal funds $372,825).

D. See A above.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small businesses. An analysis of this economic impact follows:

To the extent that providers governed by COMAR 10.09.02 qualify as small businesses, they will be able to deliver community violence prevention services and receive a proportion of the reimbursement opportunity.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

Editor’s Note on Incorporation by Reference

Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the Professional Services Provider Manual and Fee Schedule (Effective January 2023) has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories was published in 50:1 Md. R. 7 (January 13, 2023), and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.05 Limitations.

A. Services which are not covered are:

(1)—(8) (text unchanged)

[(9) Immunizations required solely for travel outside the continental United States;]

[(10)] (9)—[(23)] (22) (text unchanged)

B.—I. (text unchanged)

.07 Payment Procedures.

A.—C. (text unchanged)

D. The Maryland Medical Assistance Program’s procedures for payment are contained in the following documents, the provisions of which are incorporated by reference:

(1) The Professional Services Provider Manual and Fee Schedule (Effective [July 2022] January 2023); and

(2) (text unchanged)

E.—P. (text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

Notice of Proposed Action

[23-260-P]

The Secretary of Health proposes to amend:

(1) Regulations .02 and .06 under COMAR 10.09.39 Doula Services;

(2) Regulation .20 under COMAR 10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations; and

(3) Regulation .28 under COMAR 10.67.06 Maryland Medicaid Managed Care Program: Benefits.

Statement of Purpose

The purpose of this action is to:

(1) Remove the list of approved doula organizations and fees from the regulations and appropriately reference the existing Professional Services Provider Manual and Fee Schedule incorporated by reference under COMAR 10.09.02.07D; and

(2) Add doula services to the self-referred services list for Managed Care Organizations, effective through December 31, 2025.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.39 Doula Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.02 Certification Requirements.

[A provider shall be certified by one of the following organizations, and present proof of all specified certifications for each organization:

A. Doula Trainings International: Birth Doula and Postpartum Doula Certifications;

B. The Childbirth and Postpartum Professional Association (CAPPA): Certified Labor Doula, Certified Postpartum Doula, and Certified Community Lactation Educator Certifications;

C. Black Doula Training (BDT), formerly the International Black Doula Institute (IBDI): Pregnancy & Childbirth Doula Certification, Postpartum & Newborn Certification, and Lactation/Breastfeeding Certificate of Completion;

D. Ancient Song Doula Services: Full Spectrum Labor & Postpartum Certification;

E. Mamatoto Village: Community Birth Worker Certification;

F. Doulas of North America (DONA): Birth Doula and Postpartum Doula Certifications;

G. International Childbirth Education Association (ICEA): Birth Doula, and Postpartum Doula Certifications;

H. Childbirth International (CBI): Birth Doula, and Postpartum Doula Certifications; or

I. MaternityWise: Labor Doula, and Postpartum Doula Certifications.]

A provider shall be certified as described in the Professional Services Provider Manual and Fee Schedule under COMAR 10.09.02.07D.

.06 Payment Procedures.

A.—G. (text unchanged)

H. Reimbursement.

(1) (text unchanged)

(2) [Effective January 1, 2022, rates for the services outlined in this chapter shall be as follows:

(a) For prenatal care services, $16.62 per 15-minute unit of service, up to 4 units of service per visit;

(b) For labor and delivery attendance, a flat rate of $350; and

(c) For postpartum care services, $19.62 per 15-minute units of service, up to 4 units of service per visit.] The provider shall be reimbursed in accordance with COMAR 10.09.02.07D.

Subtitle 67 MARYLAND HEALTHCHOICE PROGRAM

10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations

Authority: Health-General Article, §§2-104, 15-101, 15-102.3, and 15-103; Insurance Article, §§15-112, 15-605, and 15-1008; Annotated Code of Maryland

.20 MCO Payment for Self-Referred, Emergency, Physician, and Hospital Services.

A. MCO Payment for Self-Referred Services.

(1)—(3) (text unchanged)

(4) An MCO shall reimburse out-of-plan providers rendering pregnancy-related services, as described in COMAR [10.67.06.28C and K] 10.67.06.28, at the Medicaid rate.

(5)—(10) (text unchanged)

(11) An MCO shall reimburse out-of-plan doulas at the Medicaid fee-for-service rate for services performed during the prenatal, labor and delivery, and postpartum periods of pregnancy as described in COMAR 10.67.06.28 through December 31, 2025.

B. (text unchanged)

C. MCO Payment to an Out-of-Network Federally Qualified Health Center for Services Immediately Required Due to an [Unforseen] Unforeseen Illness, Injury, or Condition.

(1) Effective October 1, 2010, an MCO shall reimburse an out-of-network federally qualified health center (FQHC) for services provided to an enrollee that are immediately required due to an [unforseen] unforeseen illness, injury, or condition if:

(a)—(e) (text unchanged)

(2)—(5) (text unchanged)

D.—E. (text unchanged)

10.67.06 Maryland Medicaid Managed Care Program: Benefits

Authority: Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland

.28 Benefits — Self-Referral Services.

A. An MCO shall be financially responsible for reimbursing, in accordance with COMAR 10.67.04.20, an out-of-plan provider chosen by the participant for the following services:

(1)—(7) (text unchanged)

(8) Emergency services as described in COMAR 10.67.05.08B; [and]

(9) Prenatal, intrapartum, and postpartum services performed at a free-standing birth center located in Maryland or a contiguous state[.]; and

(10) Doula services, through December 31, 2025.

B.—C. (text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

Subtitle 24 MARYLAND HEALTH CARE COMMISSION

10.24.10 State Health Plan for Facilities and Services: Acute Care Hospital Services

Authority: Health–General Article, §§19-109(a)(1) and (a)(3), 19-118,
19-120, and 19-126, et seq., Annotated Code of Maryland

Notice of Proposed Action

[23-250-P-I]

The Maryland Health Care Commission proposes to repeal existing Regulation .01 and adopt new Regulation .01 under COMAR 10.24.10: State Health Plan for Facilities and Services: Acute Care Hospital Services. This action was considered by the Commission at an open meeting on October 19, 2023, notice of which was given through publication in the Maryland Register, in accordance with General Provisions Article §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to repeal existing Regulation .01 and adopt new Regulation .01 under COMAR 10.24.10: State Health Plan for Facilities and Services: Acute Care Hospital Services. The proposed regulation is necessary to respond to statutory changes since this chapter was updated in 2009 and align the Commission’s procedures for reviewing hospital projects under the Certificate of Need program. The proposed regulation incorporates statutory changes to the Commission’s authority over hospital capital projects, by changing the capital expenditure threshold that would trigger a Certificate of Need review. The statute changed as a result of legislation passed in the 2019 Session (HB 646/SB597). The proposed regulation also incorporates updated, relevant methodologies of the Health Services Cost Review Commission.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Eileen Fleck, Chief, Acute Care Policy and Planning, Maryland Health Care Commission, 4160 Patterson Avenue, Baltimore, MD 21215, or call 410-764-3287, or email to mhcc_regs.comment@maryland.gov. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

Open Meeting

Final action on the proposal will be considered by the Maryland Health Care Commission during a public meeting to be held on February 15, 2024 at 1:00 pm, at 4160 Patterson Avenue, Room 100, Baltimore, MD 21212 and virtually at https://mhcc.maryland.gov/mhcc/pages/home/meeting_schedule/meeting_schedule.aspx?id=0.

Editor’s Note on Incorporation by Reference

Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the State Health Plan for Facilities and Services: Acute Care Hospital Services has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories was published in 50:1 Md. R. 7 (January 13, 2023), and is available online at www.dsd.maryland.gov. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.01 Incorporation by Reference.

The State Health Plan for Facilities and Services: Acute Care Hospital Services is incorporated by reference.

RANDOLPH S. SERGENT, ESQ.
Chair

Subtitle 44 BOARD OF DENTAL EXAMINERS

10.44.19 Dental Radiation Technologist

Authority: Health Occupations Article, §4-505, Annotated Code of Maryland

Notice of Proposed Action

[23-235-P]

The Secretary of Health proposes to amend Regulation .05, repeal existing Regulation .06, amend and recodify existing Regulation .07 to be Regulation .06, and recodify existing Regulations .08—.12 to be .07—.11 under COMAR 10.44.19 Dental Radiation Technologist. This action was considered by the Board of Dental Examiners at a public meeting held on July 19, 2023, notice of which was given under the Notice of Public Meetings link on the Board’s website pursuant to General Provisions Article §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Increase the number of hours of the Board’s required infection control course from 2 to 3 hours as a condition of certificate renewal and certificate reinstatement;

(2) Delineate the content of the required infection control course; and

(3) Repeal the one-time transitional renewal for even-numbered certificate holders.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

.05 Term and Renewal of Certification.

A. [Except as provided in Regulation .06 of this chapter, a] A certification as a dental radiation technologist expires on the second anniversary of the issuance of the certification unless it is renewed for an additional 2-year term as provided in this regulation.

B.—C. (text unchanged)

D. In addition to the requirements of §C of this regulation, a dental radiation technologist seeking renewal of a certificate [in 2011 or thereafter] shall complete a 2-hour Board-approved course on infection control.

E. In addition to the requirements of §C of this regulation, a dental radiation technologist seeking renewal of a certificate in 2025 and thereafter shall complete a 3-hour Board-approved course on infection control.

F. The infection control course identified in §E of this regulation shall be a single 3-hour course, which teaches the practices contained in the document Centers for Disease Control and Prevention, Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; October 2016, or its successor document.

[E.] G. — [F.] H. (text unchanged)

[G.] I. Notwithstanding the provisions of §E of this regulation, the Board may charge the dental radiation technologist with unprofessional conduct as provided in Regulation [.12] .11 of this chapter.

[.07] .06 Reinstatement.

A. An individual holding an expired certification to practice dental radiation technology may apply for reinstatement if the individual:

[A.] (1) (text unchanged)

[B.] (2) Provides proof of 10 hours of dental continuing education from Board-approved courses of which:

[(1)] (a)—[(2)] (b) (text unchanged)

[C.] (3) (text unchanged)

B. Commencing on January 1, 2025, and thereafter, a dental radiation technologist who applies for reinstatement of an expired certification shall complete the 3-hour Board-approved infection control course identified in Regulation .05E and F of this chapter.

LAURA HERRERA SCOTT
Secretary of Health

Title 12
DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

Notice of Proposed Action

[23-258-P]

The Secretary of Public Safety and Correctional Services, in cooperation with the Commissioner of Correction and Director of Patuxent Institution, proposes to:

(1) Repeal Regulations .01—.08 under COMAR 12.02.20 Inmate Mail;

(2) Adopt new Regulations .01—.12 under a new chapter, COMAR 12.03.03 Incarcerated Individual Mail; and

(3) Repeal Regulations .01—.08 under COMAR 12.12.20 Inmate Mail.

Statement of Purpose

The purpose of this action is two-fold. The Department of Public Safety and Correctional Services (Department) seeks first to repeal two largely duplicative chapters addressing the procedures through which an incarcerated individual’s mail is received, sent, and distributed within the Department’s correctional facilities and to promulgate mail procedures under a single chapter under Subtitle .03 Operations. The new and consolidated chapter clarifies procedures, reduces duplication, and creates a uniform process for handling incarcerated individuals’ mail for all applicable divisions of the Department’s correctional operations. Through the repeal of COMAR 12.02.20 and 12.12.20 and their promulgation under a single chapter, COMAR 12.03.03, the Department seeks to update antiquated definitions, improve procedures for handling incoming mail and packages, and reduce the number of overdoses by incarcerated individuals through increased identification and capture of contraband.

The second purpose of this action is to create and evaluate two pilot programs related to mail handling and distribution. The Department proposes to conduct a mailroom pilot program at the Division of Correction’s Eastern Correctional Institution to evaluate the implementation and effects of scanning and reproducing incoming incarcerated individuals’ mail; and to conduct a pilot project to develop the best practices for verifying incoming mail, marked by the sender as “legal mail”, as material that meets definition of legal mail as established in this chapter.

The Department is also proposing to conduct the developed pilot projects in cooperation with representatives of recognized advocacy organizations dedicated to ensuring the wellbeing and fair treatment of incarcerated individuals.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Keith D. Dickens, Deputy Commissioner of Correction, Department of Public Safety and Correctional Services, 6776 Reisterstown Road, Baltimore, MD 21215, or call 410-585-3233, or email to keith.dickens@maryland.gov. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

Subtitle 03 OPERATIONS

12.03.03 Incarcerated Individual Mail

Authority: Correctional Services Article, §§2-109(c), 3-205, and 4-208, Annotated Code of Maryland

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Commissioner” means the Commissioner of Correction.

(2) “Contraband” has the meaning stated in Criminal Law Article, §9-410, Annotated Code of Maryland.

(3) “Correctional facility” has the meaning stated in Correctional Services Article, §1-101, Annotated Code of Maryland.

(4) “Director” means the Director of Patuxent Institution.

(5) General Mail.

(a) “General mail” means correspondence, written materials, and publications, including but not limited to letters, cards, newspapers, magazines, newsletters, flyers, and advertisements:

(i) Addressed to or from an incarcerated individual; and

(ii) Leaving or entering the correctional facility by the United States Postal Service or by a recognized courier system.

(b) “General mail” does not mean:

(i) Legal mail as defined in this section;

(ii) A written communication among incarcerated individuals within the correctional facility;

(iii) A package; or

(iv) An initial package as defined in this section.

(6) “Hostile work environment” means a workplace where discriminatory intimidation, ridicule, or insult are so severe or pervasive that the conditions of an individual’s employment are altered to the point of creating an abusive working environment.

(7) Indigent Incarcerated Individual.

(a) “Indigent incarcerated individual” means an incarcerated individual who, within the previous payroll period:

(i) Has not received pay for an assignment in work or school and has less than $6 in the incarcerated individual’s spending account; or

(ii) Has been admitted to a correctional facility and does not have at least $6 in the incarcerated individual’s spending account on admission.

(b) “Indigent incarcerated individual” does not mean an incarcerated individual who, in order to be eligible for the benefits described in Regulation .03 of this chapter, manipulates the incarcerated individual’s account balance.

(8) “Initial package” means a package of purchased retail items or goods delivered to an incarcerated individual within 90 days of an incarcerated individual’s admission to the correctional facility.

(9) “Legal mail” means mail that is either addressed by an incarcerated individual to, or received on official stationery from, any of the following individuals or agencies:

(a) A court;

(b) A judge;

(c) A clerk of court;

(d) An attorney;

(e) The American Civil Liberties Union;

(f) The Legal Aid Bureau;

(g) The contractual service provider for incarcerated individual legal services;

(h) The Secretary of Public Safety and Correctional Services;

(i) The Commissioner of Correction;

(j) The Commissioner of Pretrial Detention and Services;

(k) The Director of Patuxent Institution;

(l) The Director of the Division of Parole and Probation;

(m) The Director of Criminal Justice Information System–Central Repository; and

(n) Elected or appointed public officials.

(10) “Mail” means general and legal mail.

(11) “Managing official” has the meaning stated in Correctional Services Article, §1-101, Annotated Code of Maryland.

(12) Package.

(a) “Package” means any container or wrapping of a purchased retail item or good that is used to deliver the retail item or good to an incarcerated individual from outside the secure perimeter of the correctional facility.

(b) “Package” includes:

(i) An initial package;

(ii) An incarcerated individual’s catalog or commercial retail order, including but not limited to a food item, portable music player, television, gaming system, video game, book, and item of clothing; and

(iii) A delivery from one correctional facility to another.

(13) “Property officer” means a Department employee responsible for receiving and controlling an incarcerated individual’s belongings in accordance with established incarcerated individual personal property procedures.

(14) “Retail” means the sale of an item or good to an individual in a small quantity that the individual uses for personal consumption and not for resale.

(15) “Sexually explicit” means a pictorial, written, or verbal depiction of actual or simulated sexual behavior, including:

(a) Bestiality;

(b) A minor or minors depicted in the nude or partially nude;

(c) Masturbation;

(d) Sadistic or masochistic abuse;

(e) A sexual act as defined in Criminal Law Article, §3-301, Annotated Code of Maryland;

(f) Sexual contact as defined in Criminal Law Article, §3-301, Annotated Code of Maryland; and

(g) Vaginal intercourse as defined in Criminal Law Article, §3-301, Annotated Code of Maryland.

.02 General Policy.

A. An incarcerated individual is allowed to send or receive mail consistent with the United States Constitution, federal law and regulations, and Maryland law and regulations.

B. Mail may not be handled by any incarcerated individual other than the incarcerated individual to whom the mail is addressed.

C. The volume of mail an incarcerated individual sends or receives may not be limited unless there is justification in accordance with procedures established in Regulation .08 of this chapter.

D. A restriction may not be placed on an incarcerated individual’s mail for disciplinary reasons unless an incarcerated individual specifically abuses this privilege.

E. A restriction may not be placed on an incarcerated individual’s mail because of the incarcerated individual’s use of an officially adopted religious or gender-affirming name.

F. Mail Inspection and Delivery Time Requirements.

(1) Upon delivery to the mailroom, incoming mail shall be date stamped with the date it was received at the correctional facility.

(2) Legal mail may not be held for more than 48 hours, excluding weekends and holidays, except when it contains contraband.

(3) Legal mail shall be inspected and delivered as set forth in Regulation .08 of this chapter.

(4) Incoming general mail that is conducive to photocopying may not be held for more than 72 hours, excluding weekends and holidays, except when it contains contraband.

(5) To facilitate effective search procedures and to reduce the amount of controlled dangerous substances and other contraband containing injurious materials, general mail coming into a correctional facility that is not conducive to photocopying or scanning, such as a magazine or newspaper, may not be held for more than 80 hours, excluding weekends and holidays, except when it contains contraband.

G. Contraband may not be mailed or otherwise conveyed into a correctional facility. Contraband includes, but is not limited to, material that:

(1) Describes escape plans, devices, or paraphernalia;

(2) Describes the construction or use of weapons, ammunition, bombs, incendiary devices, or other means of inflicting bodily harm;

(3) Describes procedures for brewing alcoholic beverages or the manufacture of drugs;

(4) Is written in code;

(5) Is sexually explicit;

(6) Depicts a nude person under the age of 18;

(7) If not withheld, may create a hostile work environment for employees who are required to inspect, view, read, or overhear the reading of mail during the normal course of their duties;

(8) Describes theory, design, or manufacture of prison security systems or equipment, including prison communication systems or equipment;

(9) Instructs an incarcerated individual in the commission of violations of Department regulations that may produce a breach of security or order in the correctional facility;

(10) Advocates or instructs in the formation of incarcerated individual unions;

(11) May be contaminated with controlled dangerous substances, or substances such as paint, crayon, marker, ink, glitter, cloth, string, tape, glue, epoxy, metal, plastic, wood, stickers, scents, or stain that may obscure detection of CDS; or

(12) Poses a direct and immediate danger of violence or physical harm to a person or persons, based upon the current circumstances within the correctional facility.

H. Except for an indigent incarcerated individual’s mail, an incarcerated individual shall affix proper postage to all outgoing mail.

.03 Mailroom Pilot Programs.

A. The Department may conduct pilot projects to demonstrate and evaluate new approaches to managing incoming incarcerated individual mail, as follows:

(1) Mail to or from an Incarcerated Individual’s Attorney. The Department may establish a pilot program to verify that mail marked by the sender as legal mail sent by, or on behalf of, an attorney to an incarcerated individual meets the definition of legal mail as stated in Regulation .01 of this chapter.

(2) General Mail.

(a) The Department may establish a pilot program for incoming general mail consistent with this chapter that centralizes the collection, photocopying or scanning, and electronic distribution of incoming general mail at a specified Division of Correction correctional facility.

(b) To reduce the amount of controlled dangerous substances and other contraband entering the correctional facility, the Division shall:

(i) Except for bound publications or other unsuitable items, photocopy or scan all incoming general mail; and

(ii) Provide an incarcerated individual with clear unobstructed photocopies or electronic copies of an incarcerated individual’s incoming general mail, unless the mail is withheld in accordance with the procedures established in Regulation .10 of this chapter.

(c) The Department shall store, in accordance with §A(2)(d) of this regulation, the original incoming general mail for the later of:

(i) The time frame established for an incarcerated individual to file a complaint through the informal and formal Administrative Remedy Procedure (ARP) established in COMAR 12.02.28; or

(ii) Until a decision has been issued by the Commissioner in response to an incarcerated individual ARP complaint.

(d) The Department shall establish and maintain appropriate safeguards, such as access restrictions, records controls, and lockable cabinets and rooms to ensure the security of incoming general mail.

(e) Except under §A(2)(f) and (g) of this regulation, the Department shall securely dispose of the original general mail after the photocopied or scanned mail has been delivered and either the:

(i) Time frame for filing an ARP complaint has expired; or

(ii) Incarcerated individual’s ARP complaint has been resolved.

(f) The Department may not as part of this subsection photocopy, scan, or dispose of legal mail.

(g) The Department may not destroy mail subject to a legal hold notice directing that an incarcerated individual’s general mail be retained.

(h) A document destruction services contractor shall collect and destroy the stored original general mail at the expiration of the period specified in §A(2)(b) of this regulation.

B. The Department shall:

(1) Develop pilot projects in cooperation with representatives of recognized advocacy organizations dedicated to ensuring the wellbeing and fair treatment of incarcerated individuals; and

(2) Provide adequate notice of a pilot program through the Maryland Register and the Department’s public website so that an interested individual has a reasonable opportunity to be informed.

.04 Indigent Incarcerated Individual’s Mail.

A. Upon the request of an indigent incarcerated individual, staff shall provide an incarcerated individual with pen, paper, envelopes, and first-class postage for seven letters per week.

B. If an incarcerated individual requires additional materials or postage for legal correspondence, an incarcerated individual may request these through the mailroom supervisor or designee.

C. The mailroom supervisor shall grant the request for additional materials or postage for legal correspondence, unless it is determined that the postage provision is being abused, in which case the mailroom supervisor shall refer the request and findings to the managing official, or designee, for disposition.

D. The mailroom supervisor shall encourage the indigent incarcerated individual to set mail priorities within the seven-letter allowance.

.05 Outgoing General Mail.

A. The managing official shall ensure that staff assigned to forward general mail to the United States Postal Service or other recognized courier date-stamp the outgoing general mail on the date it is received from the incarcerated individual.

B. Except as provided in §F of this regulation, outgoing general mail may not be held for more than 24 hours excluding weekends and holidays.

C. An incarcerated individual shall include an incarcerated individual’s own name, identification number, and the return address of the correctional facility on outgoing mail.

D. If an incarcerated individual wants to mail money from the incarcerated individual’s account with a letter, an incarcerated individual shall forward the letter and an unsealed envelope, together with the proper withdrawal voucher, to the person or unit designated by internal correctional facility directives.

E. The managing official or designee may not open outgoing general mail unless clear evidence exists to warrant inspection.

F. The managing official or designee who opens and inspects outgoing general mail shall:

(1) Ensure that the reasons for the inspection and results of the inspection are documented; and

(2) Withhold outgoing general mail only when it is:

(a) Found to contain contraband;

(b) Evidence for a rule violation under COMAR 12.03.01; or

(c) A basis for requesting an investigation by the Department’s Intelligence and Investigative Division or other law enforcement agency.

.06 Incoming General Mail.

A. A person sending general mail to an incarcerated individual shall:

(1) Include an incarcerated individual’s name and identification number on the outside of the envelope; and

(2) Ensure that the general mail envelope:

(a) Is not larger than 12 inches wide or 15 inches long;

(b) Does not exceed 3.5 ounces; and

(c) Does not contain more than 12 photographs.

B. When a single piece of incoming general mail sent to an incarcerated individual exceeds the allowable size, weight, or content specified in §A(2) of this regulation, correctional staff shall issue a notification to the incarcerated individual indicating that a piece of oversized mail was received and returned to the sender.

C. When the overall volume of an incarcerated individual’s general mail exceeds a limitation imposed by a managing official, correctional staff shall follow the procedures established in Regulation .09 of this chapter.

D. Inspection and Delivery of Incoming Mail.

(1) Correctional staff shall open incoming general mail before delivery to an incarcerated individual, and inspect it only for:

(a) Money orders;

(b) Cash;

(c) Stamps;

(d) Checks; and

(e) Contraband.

(2) Correctional staff shall follow established procedures for handling money orders, cash, stamps, checks, and contraband received in the mail.

(3) Inspected incoming general mail shall be delivered as set forth in Regulation .02F of this chapter.

E. Document Reproduction and Delivery.

(1) Following inspection, incoming general mail at a pilot site shall be reproduced by photocopy or electronic scan, to include:

(a) Every side of each page or item contained in or on the envelope;

(b) The outer envelope, including the incarcerated individual’s mailing address and the sender’s return address; and

(c) All enclosed contents, including a letter, postcard, or other form of correspondence, photographs, drawings, printed material, and publication clippings.

(2) Disposition and destruction of original general mail after photocopying or electronic scanning shall be handled as set forth in Regulation .03A of this chapter.

.07 Packages.

A. In accordance with COMAR 12.02.17, all packages received by mailroom staff, regardless of external packaging and point of origin, shall be inspected and delivered to a correctional facility’s incarcerated individual property room to be inventoried and inspected to ensure that:

(1) The package does not contain contraband;

(2) Ownership of the purchased or received property, good, or retail item is properly established and documented; and

(3) The incoming property does not exceed the established limits of an incarcerated individual’s personal property allowance.

B. Upon receipt of a package, mailroom staff or the property officer shall notify an incarcerated individual within 48 hours that an incarcerated individual’s package has been delivered to the incarcerated individual property room for inspection and inventory.

C. The incoming property delivered to a correctional facility as a package for an incarcerated individual may not be held for inspection and inventory for more than 7 business days, except when it contains contraband or exceeds the allowable property amount as set forth in COMAR 12.02.17.02.

.08 Legal Mail.

A. Incoming or outgoing mail that is marked as, or purports to constitute, legal mail but does not meet the definition of legal mail shall be:

(1) Refused and returned to sender; or

(2) If reasonable cause exists to believe that the mail has been sent for a fraudulent or criminal purpose, forwarded to the Department’s Intelligence and Investigative Division.

B. When legal mail is delivered to an incarcerated individual:

(1) It shall be delivered to the incarcerated individual to whom it is addressed by:

(a) Mailroom staff; or

(b) Non-mail-room staff authorized to deliver mail to an incarcerated individual;

(2) Mailroom staff shall log receipt and disposition of the legal mail in accordance with facility procedures for logging incarcerated individual legal mail which, at a minimum, records:

(a) The date received by the mailroom;

(b) The incarcerated individual’s name, identification number, and housing assignment verified by the facility’s traffic and housing assignment report;

(c) The sender’s name and address;

(d) The number of legal mail items being delivered to an incarcerated individual;

(e) The incarcerated individual’s acceptance or refusal of the legal mail; and

(f) If appropriate, the disposition of legal mail refused by an incarcerated individual;

(3) Mailroom staff shall make a photocopy of the envelope containing the legal mail; and

(4) Mailroom and correctional staff delivering the legal mail to an incarcerated individual shall:

(a) Properly identify an incarcerated individual by inspecting an incarcerated individual’s facility identification card and the information from the traffic and housing assignment reports;

(b) Open the envelope in the presence of the incarcerated individual to whom it is addressed;

(c) Without specifically reading the contents, inspect the enclosed contents for contraband only;

(d) Deliver the contents and the photocopy of the envelope used to send the legal mail;

(e) Have an incarcerated individual sign a receipt for the delivery of legal mail or, if appropriate, a refusal to accept the legal mail; and

(f) Return the original envelope and the receipt or refusal for legal mail to the mailroom for disposition according to facility procedures.

.09 Limiting Mail Volume.

A. As stated in Regulation .02 of this chapter, the volume of general mail an incarcerated individual sends or receives may not be limited unless there is substantial justification.

B. The managing official, or designee, shall make the decision to limit the volume of an incarcerated individual’s general mail on a case-by-case basis.

C. Just cause for limiting the volume of mail an incarcerated individual sends or receives includes:

(1) An increased and substantiated risk for the introduction of contraband to the correctional facility;

(2) Placement of an undue burden upon mailroom staff to inspect and process an incarcerated individual’s mail within the allotted time frames; and

(3) If delivered, the volume of received mail would cause an incarcerated individual to exceed the limits of an incarcerated individual’s personal property allowance.

D. Notification of General Mail Volume Being Limited.

(1) Staff shall provide an incarcerated individual and, if applicable, the sender with two copies of a written notification that describes the limitations to be placed on the volume of an incarcerated individual’s general mail, and set forth the reasons for the limitations in detail.

(2) The notification constitutes a written report signed by the managing official of the decision to limit the volume of an incarcerated individual’s general mail and shall include:

(a) A summary of the evidence;

(b) The decision;

(c) The reason for the decision; and

(d) The facts upon which the decision is based.

(3) Staff shall provide the written notification to an incarcerated individual and the sender, if applicable, within 48 hours of the managing official placing the limitation on an incarcerated individual’s general mail volume.

(4) Staff shall advise an incarcerated individual and, if applicable, the sender that a written appeal may be filed within 10 business days from the date an incarcerated individual is notified of the managing official’s decision to limit the incarcerated individual’s volume of mail.

(5) The notification provides a section for the incarcerated individual or sender to appeal the decision.

E. General Mail Exceeding the Permissible Volume.

(1) If an incarcerated individual for whom a volume limit has been set is sent an amount of general mail that exceeds the permissible volume and the excess portion can be reasonably severed then staff shall give the incarcerated individual to whom the item is addressed the choice of:

(a) Returning the mail as a whole; or

(b) Receiving the acceptable portion and disposing of the excess portion by selecting one of the methods listed under §E(2) of this regulation.

(2) An incarcerated individual may choose to dispose of the excess portion of general mail by:

(a) Destroying it;

(b) Returning it to the sender or sending it to an address specified by an incarcerated individual at an incarcerated individual’s expense;

(c) Donating it to a charity; or

(d) Arranging for it to be picked up by a visitor in accordance with established procedures.

(3) If the sender has not previously been notified of the managing official’s decision to limit the volume of the incarcerated individual’s mail, the incarcerated individual or the sender, or both, may appeal to the managing official as set forth in §F of this regulation.

F. Appeal Process for Limitations on Volume of Received General Mail.

(1) If an incarcerated individual or sender objects to the limitation, the incarcerated individual or sender, or both, may, not more than 10 business days after receipt of managing official’s written decision under §D(5) of this regulation, file an appeal with the managing official.

(2) Pending the outcome of the appeal process through the incarcerated individual grievance process, correctional staff shall securely store the excess volume of mail.

(3) The managing official shall respond to an incarcerated individual and sender’s appeal within 5 business days of receipt of the appeal.

(4) If a managing official fails to respond to an appeal within 5 business days, the incarcerated individual or the sender, or both, may appeal to the Commissioner or Director, as applicable.

(5) Staff shall send a written notification to the incarcerated individual and, if applicable, the sender that includes:

(a) The managing official’s decision regarding the appeal; and

(b) Information on how to appeal the managing official’s decision to the Commissioner or Director.

(6) Not more than 5 business days after receiving the managing official’s response to the appeal or the failure of the managing official to respond to an appeal, the incarcerated individual or sender, or both, may send a written appeal of the managing official’s decision, or failure to respond, to the Commissioner or Director, as applicable, and state the reasons for the appeal.

G. Within 5 business days of receiving the incarcerated individual or sender’s written appeal, the Commissioner or Director, as applicable, shall affirm, reverse, or modify the managing official’s decision to limit the volume of an incarcerated individual’s mail.

H. An incarcerated individual may appeal the Commissioner’s or Director’s response to the Incarcerated Individual Grievance Office.

.10 Withholding Mail.

A. The managing official, or designee, shall make the decision to withhold mail on an item-by-item basis, and an item excluded on one occasion may not be routinely excluded on another occasion.

B. The managing official, or designee, may not withhold an incarcerated individual’s mail for religious, philosophical, political, social, or sexual content, unless it meets the definition of sexually explicit mail as set forth in Regulation .01 of this chapter, or because the content of the incarcerated individual’s mail is unpopular or repugnant.

C. Incoming mail as set forth in Regulation .05 of this chapter may be withheld:

(1) As a whole if the mail in its entirety is subject to rejection; or

(2) In part if only a portion or a particular section or item within the mail is subject to rejection.

D. Notification of Mail Being Withheld.

(1) Staff shall provide an incarcerated individual and the sender with two copies of a written notification that describes the contraband information or materials that are being withheld, and set forth the reason for withholding the mail in detail.

(2) The notification constitutes a written report of the managing official’s decision to withhold the contraband information or materials in a piece of mail, and the notification shall include:

(a) A summary of the evidence;

(b) The decision;

(c) The reason for the decision; and

(d) The facts upon which the decision is based.

(3) Staff shall provide the written notification to an incarcerated individual within 48 hours after the managing official’s decision to withhold contraband information or materials from an incarcerated individual.

(4) The written notification provides a section for the sender or incarcerated individual to appeal the managing official’s decision.

E. If the rejected portion can be reasonably severed, and before removal of any portion of the piece of mail, staff shall give an incarcerated individual to whom the mail is addressed the choice of:

(1) Returning the mail as a whole;

(2) Receiving the acceptable portion and disposing of the rejected portion by:

(a) Destroying it;

(b) Sending it to an address specified by an incarcerated individual at an incarcerated individual’s expense;

(c) Donating it to a charity; or

(d) Arranging for it to be picked up by a visitor in accordance with established procedures;

(3) Disposing of the mail as a whole by selecting one of the methods listed under §E(2)of this regulation; or

(4) Appealing to the managing official.

F. Appeal Process for Withheld Mail.

(1) If the rejected portion of the mail cannot be severed, can be severed, or if the mail is being withheld in its entirety, and the incarcerated individual to whom the mail is addressed chooses to appeal, staff shall advise an incarcerated individual and, if applicable, the sender that a written appeal may be filed within 10 business days from the date an incarcerated individual is notified of the managing official’s decision to limit the incarcerated individual’s volume of mail.

(2) Pending the outcome of the appeal process, correctional staff shall securely store the withheld mail.

(3) The managing official shall respond within 5 business days to an incarcerated individual or sender’s appeal.

(4) If a managing official fails to respond to an appeal within 5 business days of receipt, the incarcerated individual or the sender, or both, may send a written appeal of the withholding decision to the Commissioner or Director, as applicable.

(5) Staff shall send a written notification to the incarcerated individual and, if applicable, the sender that includes:

(a) The managing official’s decision regarding the appeal; and

(b) Information on how to appeal the managing official’s decision to the Commissioner or Director.

G. The Commissioner or Director, as applicable, shall affirm, reverse, or modify the managing official’s decision within 5 business days of receiving the incarcerated individual or sender’s written appeal.

H. An incarcerated individual may appeal the Commissioner’s or Director’s response to the Incarcerated Individual Grievance Office.

I. If the decision of the managing official, Commissioner, or Director, in cases when an appeal is taken, is that mail as a whole shall be withheld from an incarcerated individual, staff shall dispose of the mail by:

(1) Sending the mail at an incarcerated individual’s expense to the sender or to any addressee an incarcerated individual chooses; or

(2) Disposing of the mail in a manner specified by an incarcerated individual and approved by the managing official.

J. If only a portion of the mail is withheld, the rejected portion shall be removed and the remainder delivered to the incarcerated individual within 5 business days after the final decision.

K. The withheld and removed portion of the mail shall be handled as set forth in §I of this regulation.

.11 Undeliverable Mail.

A. If mail is received for an incarcerated individual for whom no forwarding address is available, or if an incarcerated individual has escaped or died, staff shall return the first-class and legal mail to the sender.

B. Unless the postal endorsement requires forwarding or return to sender, staff shall discard undeliverable second-class and third-class mail addressed to an incarcerated individual not assigned to the correctional facility.

.12 Additional Requirements of the Managing Official.

A. A managing official shall ensure that employees who handle incarcerated individual mail are familiar with the requirements of this chapter.

B. A managing official shall develop a correctional facility mail security plan that, at minimum, addresses:

(1) Risk assessment;

(2) A plan to protect staff and other individuals from hazards that may be delivered in the mail;

(3) Standard operating procedures;

(4) Security screening procedures;

(5) Training of mailroom staff;

(6) Testing and preparedness responses to emergency situations;

(7) Threat management; and

(8) Annual reviews of a correctional facility’s mail security plan.

CAROLYN J. SCRUGGS
Secretary of Public Safety and Correctional Services

Title 14
INDEPENDENT AGENCIES

Subtitle 07 MARYLAND AUTOMOBILE INSURANCE FUND

14.07.04 Uninsured Persons’ Claims for Compensation from the Maryland Automobile Insurance Fund

Authority: [Article 48A, §243H(b), (d)] Insurance Article, §20-201(d)(3)(iii), Annotated Code of Maryland

Notice of Proposed Action

[23-263-P]

The Executive Director of the Maryland Automobile Insurance Fund proposes to amend Regulations .01 and .03—.06 under COMAR 14.07.04 Uninsured Persons’ Claims for Compensation from the Maryland Automobile Insurance Fund.

Statement of Purpose

The purpose of this action is to:

(1) Update statutory references from Article 48A to current Insurance Article, Annotated Code of Maryland.

(2) Increase the deductible limit to $250 to be consistent with Insurance Article, §20-601, Annotated Code of Maryland.

(3) Expand the definition of motor vehicle to include references to Transportation Article, Annotated Code of Maryland, and define “family member.”

(4) Clarify the existing requirements that the claimant has made all reasonable efforts to confirm that the at-fault vehicle was uninsured, and that no other insurance exists to pay the claim.

(5) Specify that a notice must be filed within 180 days as required by Insurance Article, §20-603, Annotated Code of Maryland.

(6) Specify that the claimant certifies that any material misrepresentation on the claim form constitutes grounds for denying the claim.

(7) Add new language to address a recurrent issue concerning obtaining medical information about a claimant’s prior injury or medical conditions that are relevant to the claimants’ injury.

(8) Require a claimant to provide a statement under oath if requested by the Fund. This will enhance the Fund’s ability to investigate and resolve cases.

(9) Implement rules adopted by the Court of Appeals that require proper service and a judgement to support a claim.

(10) Make grammatical and technical corrections.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Sandra Dodson, Government Relations Senior Manager, Maryland Automobile Insurance Fund, 1215 E. Fort Ave., Suite 400, Baltimore, MD 21230, or call 667-210-5182, or email to sdodson@marylandauto.net. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

.01 Authority.

[These regulations are] This chapter is promulgated by the Executive Director of the Fund pursuant to the authority vested in the Executive Director under [Article 48A, §243H(b) and (d)] Insurance Article, §20-201(d)(3)(iii), Annotated Code of Maryland.

.03 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “Claimant” means any qualified person making claim for damages for personal injury or death, or damage to property in excess of [$100] $250, by reason of the negligent conduct of an uninsured owner or operator of a motor vehicle, as these claims are further defined in [Article 48A, §243H(a)(1)—(3)] Insurance Article, §20-601, Annotated Code of Maryland.

(3) (text unchanged)

(4) “Executive Director” means the Executive Director of the Maryland Automobile Insurance Fund, as defined by [Article 48A, §243(b)] Insurance Article, §20-203, Annotated Code of Maryland.

(5) “Family member” means any person related by blood, marriage, or adoption.

[(5)] (6) (text unchanged)

[(6)] (7) Motor Vehicle.

(a) “Motor vehicle” means [an automobile and any other] a vehicle [, including a trailer,] that is operated or designed for operation upon a public road by any power other than animal or muscular power and is required to maintain automobile insurance under Transportation Article, §17-103, Annotated Code of Maryland.

(b) “Motor vehicle” does not include:

(i) A moped, as defined in Transportation Article, §11-134.1, Annotated Code of Maryland;

(ii) A motor scooter, as defined in Transportation Article, §11.134.5, Annotated Code of Maryland; or

(iii) An electric bicycle, as defined in Transportation Article, §11-117.1, Annotated Code of Maryland.

[(7)] (8) — [10] (11) (text unchanged)

[(11)] (12) “Uninsured motor vehicle” means a motor vehicle which has:

(a) No security in force meeting the requirements of Transportation Article, §17-103, Annotated Code of Maryland; [and] or

(b) (text unchanged)

[(12)] (13) (text unchanged)

Note: Click here for form.

.04 Filing a Notice of Claim.

A. There is no longer a notice of intention to make a claim allowed by law, only the Notice of Claim as provided for in these regulations and in [Article 48A, §243H(d)] Insurance Article, §20-603(b), Annotated Code of Maryland. A claimant may, however, file an Initial Notice of Claim, on a form prepared by the Fund, while verifying whether the claim is covered under [Article 48A, §243H] Insurance Article, §20-601, Annotated Code of Maryland. [An acknowledgement of the postcard may not be given and a claim file may not be created as a result of the card being filed.] The Fund shall furnish a form on request.

B. A claimant shall file the Notice of Claim not later than 180 days after the date of the accident[, as complete as practicable]. If not, the claimant cannot recover from the Fund, unless the claimant qualifies for one of the exceptions described in [Article 48A, §243H(c)(1)— (3)] Insurance Article, §20-603(a), Annotated Code of Maryland. Before filing the Notice of Claim, the claimant shall have made[, to the extent practicable,] a significant good faith investigation of the claimant’s eligibility, damages, and the responsibility of the uninsured owner or operator, and the claimant shall supply that information in the Notice of Claim. The claimant shall have made all reasonable efforts to confirm that no automobile insurance exists for the at fault vehicle or any other applicable insurance coverage and shall confirm there is no uninsured motorist coverage as defined in Transportation Article, §17-103(b)(4), or Insurance Article, §19-509 or 19-509.1, Annotated Code of Maryland.

C. The claimant shall sign and file the Notice of Claim on the form prescribed by the Fund. [A form shall be furnished on request.] The claimant’s signature on the form certifies any material misrepresentation made by the claimant constitutes grounds for denying the claim. A notice is not filed unless it is received by the Fund within 180 days.

D. The Notice of Claim shall contain information and documentation substantiating all the matters described in §§E—M, of this regulation. It [should] shall include all information and documentation as of the date of filing. If the Notice of Claim is not substantially complete [to the extent practicable when submitted,] the Fund may return it to the claimant.

E. (text unchanged)

F. Claimants may not be eligible for [uninsured motorist] Uninsured Division benefits from a policy of automobile liability insurance. Claimants shall show that:

(1) (text unchanged)

(2) None of their family members with whom they regularly live own an automobile registered in Maryland;

(3) A vehicle in which they were an operator or passengers had no available insurance; [and]

(4) The motor vehicle at fault had no insurance on the date of the accident[.]; and

(5) All denial or disclaimers are valid under the law.

G. Documentation which is generally acceptable for the requirements of §F[,] of this regulation[,] includes records, affidavits, and certifications from the Motor Vehicle Administration and insurance companies which may provide or have provided coverage for the claimant or the claimant’s family members, or the uninsured owner or operator involved in the accident. Claimants shall also furnish the complete names, dates of birth, and, if known, social security numbers of all members of their immediate household 16 years old or older.

H.—I. (text unchanged)

J. If a claimant sustained any personal injury in the accident, the claimant shall submit or have the claimant’s doctors send to the Fund reports of all medical treatment, therapy, and consultation which the claimant received from the doctors or others under their supervision[,] for the claimant’s injuries. The report shall include dates and nature of treatment or therapy, and any diagnosis and prognosis of the injuries. At the Fund’s request, the claimant shall provide complete information regarding the claimant’s prior injuries and medical conditions that are relevant to the claimant’s injuries.

K. (text unchanged)

L. When a claimant submits a Notice of Claim, the claimant shall submit any police and other accident reports available. A claimant shall submit to a statement under oath as requested by the Fund regarding eligibility, the accident facts, and injuries.

M. (text unchanged)

.05 Settlement of Claims Involving a Disappearing Motorist or Unidentified Motorist.

A. (text unchanged)

B. Whenever a disappearing motorist has injured a claimant or damaged the claimant’s property, the claimant shall show, before any payment can be made, that all reasonable efforts have been made to learn the whereabouts of the owner and operator of the uninsured vehicle, for the purpose of filing a legal action against the owner and operator and obtaining personal service of process on them as required by the Maryland Rules of Procedure, but that they cannot be located. [The claimant shall also show that the suit papers have been twice returned, unserved on the owner and operator of the uninsured vehicle, unless the Fund is satisfied that the owner and operator have disappeared and cannot be located for service of process.]

C.—E. (text unchanged)

.06 Settlement of Claims Involving Known Uninsured Motorists.

A. (text unchanged)

B. If a claimant does not arrive at an agreed settlement with the Fund, the Fund shall notify the claimant in writing that the claimant’s only remedy will be to file suit against the uninsured owner or operator. The claimant shall show that service has been perfected and a judgment has been obtained against the owner or operator, or both the owner and operator, of the uninsured vehicle. The Fund may not be a party to the suit until the claimant has first obtained a judgment against the uninsured owner or operator or unless the Fund elects to intervene as a party. The Fund may not be obligated to intervene.

C.—D. (text unchanged)

E. If the uninsured does not settle with the claimant and the Fund, the Fund shall give the uninsured owner or operator notice, by certified mail, return receipt requested, to the uninsured owner or operator’s last known address, as provided for in [Article 48A, §243H(b)(3)] Insurance Article, §20-605, Annotated Code of Maryland. After 30 days have passed, the Fund may settle with the claimant or require the claimant to proceed to file suit and proceed to trial against the uninsured owner or operator. If the Fund elects to settle, the claimant shall assign his judgment or causes of action against the uninsured to the Fund and agree to cooperate in any suit or trial which the Fund may bring against the uninsured. If a claimant does not cooperate at any time during the suit or trial, the claimant may be compelled to cooperate by court order.

F. The Fund may assign counsel to represent an uninsured owner or operator. The uninsured owner or operator shall cooperate with the Fund in the defense of the action. If the uninsured does not cooperate, the Fund may apply to the court for an order directing cooperation or may send the uninsured owner or operator notice of the Fund’s and counsel’s withdrawal in the manner provided for in [Article 48A, §243H(b)(3)] Insurance Article, §20-606, Annotated Code of Maryland, and by rule of court.

G. (text unchanged)

ALFRED W. REDMER, JR.
Executive Director

Title 26
DEPARTMENT OF ENVIRONMENT

Subtitle 11 AIR QUALITY

26.11.40 NO_x Ozone Season Emission Caps for Non-Trading Large NO_x Units

Authority: Environment Article, §§1-404, 2-103, and 2-301—2-303, Annotated Code of Maryland

Notice of Proposed Action

[23-225-P]

The Secretary of the Environment proposes to amend Regulations .02 and .03 under COMAR 26.11.40 NO_x Ozone Season Emission Caps for Non-Trading Large NO_x units.

Statement of Purpose

The purpose of this action is to propose amendments to Regulations .02 and .03 under COMAR 26.11.40 NO_x Ozone Season Emission Caps for Non-Trading Large NO_x Units to update certain facilities ozone season emission caps and update a reference to the EPA’s Cross State Air Pollution Rule trading program.

This action will be submitted to the U.S. Environmental Protection Agency (EPA) for approval as part of Maryland’s SIP.

Background

The Maryland Department of the Environment (MDE or the Department) will re-allocate the NO_x ozone season emission caps under COMAR 26.11.40.03 due to one large industrial source shutting down. The origination of the NO_x ozone season emissions budget is described below.

In 1998, EPA promulgated the NO_x Budget Trading Program (NBP) as a central component of the broader NO_x SIP Call. The NO_x SIP Call was designed to mitigate significant transport of NO_x in the eastern United States during the warm summer months, referred to as the ozone season, when ground-level ozone concentrations are highest.

In 2000, Maryland had two regulations that satisfied EPA’s NO_x SIP Call requirements. At that time, COMAR 26.11.29 NO_x Reduction and Trading Program and COMAR 26.11.30 Policies and Procedures Relating to Maryland’s NO_x Reduction and Trading Program were part of Maryland’s SIP (MDE Revision #00-05). Under this SIP, all large sources of NO_x were to report ozone season NO_x emission tonnage to EPA. EPA allocated each State a specific NO_x ozone season emission budget cap to satisfy 40 CFR §51.121. Under the NO_x SIP Call, EPA named the large sources of NO_x either electric generating units (EGU) or non-EGU. However, these terms and definitions have since been revised or replaced. The large sources of NO_x were boilers and combustion turbines that either met an applicability threshold of being over 25 MW or over 250 MMBtu/hr.

Since 2000, Maryland and the EPA have revised and developed additional regulations that deal with NO_x reductions from these same NO_x SIP Call sources. The EPA NO_x Budget Trading Program evolved into the Trading Programs for large NO_x sources. The EPA requirements are under 40 CFR Part 96 “NO_x Budget Trading Program and Clean Air Interstate Rule (CAIR) NO_x and SO₂ Trading Programs for SIPs” and Part 97 “Federal NO_x Budget Trading Program, CAIR NO_x and SO2 Trading Programs, and Cross-State Air Pollution Rule (CSAPR) NO_x and SO2 Trading Programs”. The EPA’s CAIR and CSAPR programs were developed to limit emissions from fossil fuel-fired sources that are part of the electricity grid and are greater than 25 MW (EGUs). Each affected State was tasked with preparing a plan to address the non-trading units—or boilers, combustion turbines, or combined cycle units with a maximum design heat input greater than 250mmBtu/hr—that do not meet the applicability criteria under the CAIR or CSAPR trading programs.

The NO_x budget that Maryland must meet for the non-trading large NO_x units was established in Maryland’s SIP revision to comply with the NO_X SIP Call and matches the budget for those units listed under 40 CFR Appendix C to Subpart E of Part 97 “Final Section 126 Rule: Trading Budget” Table. The non-EGU (column 2) is the NO_x tonnage cap that the State must meet for all applicable non-trading large NO_x units. This table shows a NO_x budget of 1,013 tons for non-trading units in Maryland.

In 2010, under COMAR 26.11.14.07, the Department allocated all of the non-trading large NO_x units budget tonnage to the only identified source subject to these requirements. This source was the Luke Paper Mill, a kraft pulp papermill in operation since 1959. Also in 2010, Maryland removed the NO_x SIP call regulations COMAR 26.11.29 and COMAR 26.11.30. (Of note, in 2010 and 2015, COMAR 26.11.29 and COMAR 26.11.30 were re-codified and now cover requirements for Natural Gas Compression Stations and Cement Plants, respectively.)

In 2018, the Department reviewed State sources that could be subject to the non-trading large unit requirements of the NO_x SIP Call and created a new COMAR chapter 26.11.40 to address additional facilities that fall under the non-trading large NO_x unit requirements of the NO_X SIP Call. Four affected sources, including the Luke Paper Mill, were allocated a NO_x ozone season emissions cap and the remainder of the budget was applied to a new unit set aside for future sources.

In addition to establishing an ozone season NO_x budget tonnage cap, the regulations also require “Part 75” monitoring for non-trading large NO_x units. Per 40 CFR §51.121(i)(4), applicable sources are required to comply with the monitoring provisions of 40 CFR Part 75 Continuous Emissions Monitor (CEM), Subpart H (§§ 75.70 — 75.75). Subpart H is titled “NO_x Mass Emissions Provisions” and details the CEM recording and record-keeping requirements that non-trading large NO_x units must employ. Under COMAR 26.11.01.11E(2), the Department specifies additional CEM Data Reporting Requirements.

In 2020, the affected source Luke Paper Mill, VERSO Corporation, located in Luke, Maryland: Units No. 24, 25 and 26 shut down. Therefore, the Department proposes to re-allocate NO_x ozone season tonnage caps by removing the Luke Paper Mill, as well as correct the references for the trading program. The Department proposes the amendments to remain current with the requirements under 40 CFR §51.121 “Findings and requirements for submission of State implementation plan revisions relating to emissions of oxides of nitrogen”.

Sources Affected and Location

This regulation is applicable throughout the entire State.

The following “Affected Sources and Units” have been identified in Maryland.

• American Sugar Refining (Domino Sugar), located in Baltimore, Maryland: Unit No. C6;

• Cove Point LNG Terminal, Dominion Energy, located in Lusby, Maryland: Units No. Frame 5-1 (Turbine S009), Frame 5-2 (Turbine S010), Frame 7-A, Frame 7-B, Aux A and Aux B;

• National Institutes of Health, Located in Bethesda, Maryland: Unit 1156; and

• A person who owns or operates a new unit subject to this COMAR 26.11.40.

Requirements

In 2018, COMAR 26.11.40 established NO_x ozone season tonnage caps and NO_x monitoring requirements for large NO_x sources in the State of Maryland that are not covered under the CSAPR trading program. Now, the Department is proposing amendments to update certain facilities ozone season emission caps and update a reference to the EPA’s CSAPR trading program.

COMAR 26.11.40.02 currently identifies the CSAPR trading program that was in effect in 2018. In 2019, the EPA updated the CSAPR program and created a new trading group, the CSAPR NO_x Ozone Season Group 3 Trading Program, with revisions in 2021. Since the CSAPR program is ever evolving, the Department proposes to change the CSAPR trading program reference to a more generic reference that will incorporate future changes. The CSAPR trading program reference helps distinguish sources that are regulated under the CSAPR EGU program versus the non-trading program.

COMAR 26.11.40.03 identifies the existing sources and gives each source a NO_x emission tonnage cap so that the non-trading large NO_x unit emissions for the entire State does not exceed 1,013 tons as required under Maryland’s SIP revision addressing the NO_x SIP Call. Each affected source is required to limit their ozone season NO_x emissions to meet or be under the NO_x ozone season tonnage cap in the table under COMAR 26.11.40.03B. The proposed amendments remove one source that has permanently shut down and revises the new unit set aside allocations. The remaining affected facilities will not see a change in their emission cap.

The Department proposes to remove the Luke Paper Mill and their 656 tons and add the 656 tons to the New Unit Set Aside for the NO_x ozone season tonnage emission cap. The New Unit Set Aside NO_x ozone season tonnage emission cap will be 752 tons.

Should a new source with a non-trading large unit wish to open in Maryland, there will be 752 tons of NO_x available from the new unit set aside. Additionally, existing affected sources may use the new unit set aside for an expansion with approval.

The NO_x ozone season tonnage cap for each facility was calculated using permit conditions, regulatory emission rates and capacity factors. The Department worked with the facilities to determine an appropriate unit tonnage. Each facility has been allocated a cap based on the calculations. The new unit set aside is the remaining tons available to any new source identified to meet the applicability of COMAR 26.11.40.02. Ozone season NO_x emissions from new sources applicable to this chapter may not exceed the new unit set aside allocations as identified in the table under proposed COMAR 26.11.40.03B.

Projected Emission Reductions

The NO_x SIP Call requirements have been in place within Maryland for several decades and the NO_x emission benefits have already been realized. This proposed action satisfies the NO_x SIP Call requirements and maintains a NO_x cap for affected sources. No additional NO_x emission reductions are projected.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Randy Mosier, Deputy Program Manager, Air Quality Planning Program, Air and Radiation Administration , 1800 Washington Blvd., Baltimore, MD 21230, or call 410-537-4488, or email to randy.mosier@maryland.gov. Comments will be accepted through January 4, 2024. The Department of the Environment will hold a virtual public hearing on the proposed action on January 4, 2024.

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https://meet.goto.com/202015741

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United States (Toll Free): 1 877 309 2073

Access Code: 202-015-741

Interested persons are invited to attend and express their views. Comments must be received by 5 p.m. on January 4, 2024.

Comments may be sent to Randy Mosier, Deputy Program Manager, Air Quality Planning Program, Department of the Environment, 1800 Washington Boulevard, Suite 730, Baltimore, MD 21230-1720, or by email at randy.mosier@maryland.gov. For more information contact Mr. Mosier at telephone 410-537-4488 or email randy.mosier@maryland.gov.

This public hearing announcement and supporting documents can be found at the Department’s website https://mde.maryland.gov/programs/regulations/air/Pages/reqcomments.aspx.

.02 Applicability.

A. The owner or operator of a non-trading large NO_x unit, that is not a unit subject to [the federal Cross State Air Pollution Rule NO_x Ozone Season Group 2 Trading Program established under 40 CFR Part 97, Subpart EEEEE] a federal trading program for ozone season emissions of NO_X established under 40 CFR Part 97 to address interstate transport of ozone and NO_X in accordance with 40 CFR 52.38(b), or a state trading program for ozone season emissions of NO_X approved by the EPA Administrator as meeting the requirements of 40 CFR 52.38(b), shall comply with the ozone season NO_x emission limitation, monitoring, record-keeping, and reporting requirements for ozone season emissions of NO_x set forth in this chapter.

B. (text unchanged)

C. Affected Sources and Units.

(1) — (2) (text unchanged)

[(3) Luke Paper Mill Units No. 24, 25 and 26;]

[(4)] (3)—[(5)] (4) (text unchanged)

.03 NO_x Ozone Season Emission Caps.

A. (text unchanged)

B. NO_x Ozone Season Emission Caps.

(1) (text unchanged)

(2) Table — NO_x Ozone Season Emission Caps.

Affected Sources	NO_x Ozone Season Emission Caps [Beginning May 1, 2018]
American Sugar	24 tons
Cove Point LNG	214 tons
[Luke Paper Mill]	[656 tons]
National Institutes of Health	23 tons
New Unit Set Aside	[96] 752 tons
Total	1013 tons

C. (text unchanged)

SERENA MCILWAIN
Secretary of the Environment

Title 30
MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

Notice of Proposed Action

[23-234-P]

The Maryland Institute for Emergency Medical Systems Services proposes to amend:

(1) Regulation .02 under 30.01.01 Definitions; and

(2) Regulations .04 and .06—.09 under COMAR 30.02.02 Licensure and Certification.

This action was considered by the EMS Board at its regular meeting held on September 12, 2023.

Statement of Purpose

The purpose of this action is to update Maryland’s EMS clinician licensure and certification process to reflect best practices and to make the process more clear and concise and easier to understand and regulate.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Beverly Whitmer, Director, EMS Clinician Services, MIEMSS, 653 West Pratt Street, Baltimore, MD 21201, or call 410-706-3993, or email to bwhitmer@miemss.org. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

Subtitle 01 GENERAL

30.01.01 Definitions

Authority: Education Article, §13-516, Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(13) (text unchanged)

(13-1) “EMS clinician” means an individual licensed or certified by the EMS Board to provide emergency medical services.

(14)—(21) (text unchanged)

Subtitle 02 Emergency Medical Services Providers

30.02.02 Licensure and Certification

Authority: Education Article, §13-516, Annotated Code of Maryland

.04 Reciprocity.

A.—B. (text unchanged)

C. In addition to the requirements of §A of this regulation, an applicant for emergency medical technician reciprocal certification shall:

(1) Submit evidence of current:

(a) Certification as an emergency medical technician or paramedic in another state if that state follows the national educational standards; or

(b) Registration with the National Registry of Emergency Medical Technicians as an emergency medical technician or higher; and

[(c) Registration with the National Registry of Emergency Medical Technicians as an Emergency Medical Technician-Intermediate; or

(d) Registration with the National Registry of Emergency Medical Technician as a paramedic; and]

(2) Successfully complete a:

(a) [12-hour skills refresher course approved by MIEMSS; or] MIEMSS-approved protocol orientation; and

(b) [Protocol review and system orientation, including skills check-off, as approved by MIEMSS] MIEMSS-approved skills verification.

[D. In addition to the requirements of §A of this regulation, an applicant for reciprocal CRT licensure shall:

(1) Submit evidence of either;

(a) Current active status registration in an EMT-I/99 with the National Registry of Emergency Medical Technicians;

(b) Both;

(i) Current registration or licensure as an EMT-I/99 in a state that follows the national standards; and

(ii) Previous registration as an EMT-I/99 with the National Registry of Emergency Medical Technicians; or

(2) Successfully complete a Maryland protocol review session approved by MIEMSS; and

(3) Pass a written CRT protocol examination approved by MIEMSS.]

[E.] D. In addition to the requirements of §A of this regulation, an applicant for reciprocal paramedic licensure shall:

(1) Submit evidence of [current] active status registration as a paramedic with the National Registry of Emergency Medical Technicians; and

(2) Successfully complete a [Maryland protocol review session; and] MIEMSS-approved protocol orientation.

[(3) Pass a paramedic protocol examination approved by MIEMSS.]

[F. In addition to the requirements of §A of this regulation, an applicant for EMD reciprocal licensure shall

submit evidence of certification or licensure as an EMD by an EMD training program approved by the EMS Board.]

E. Expiration Date.

(1) For an EMR or EMT who is issued a certificate:

(a) Between February and July 31, the expiration date shall be July 31 plus 1 year, or

(b) Between August 1 and January 31, the expiration date shall be January 31 plus 1 year.

(2) For a paramedic who is issued a reciprocal license, the expiration date shall be 30 days after the individual’s current National Registry of Emergency Medical Technicians certification expires.

.06 Issuance of License or Certificate.

A. (text unchanged)

B. The license or certificate shall bear the emergency medical service [provider’s] clinician’s name[,] and identification number, the effective date of the license or certificate, and the [date of] expiration date of the license or certificate.

C. An applicant may not provide patient care as an EMS [provider] clinician until the applicant has received a current license or certificate from the EMS Board, except under supervision and in the course of participating in an [approved EMS training program or approved EMS course] education program that has been approved by the EMS Board.

D. An EMS [provider] clinician shall, whenever possible, carry the identification card issued by MIEMSS showing the [provider] clinician is licensed or certified by the EMS Board while performing the EMS [provider’s] clinician’s duties.

E. MIEMSS shall maintain a registry of licensed or certified EMS [providers] clinicians.

F. An EMS [provider] clinician shall notify the MIEMSS [Office of Education, Licensure and Certification] Office of EMS Clinician Services in writing within 30 days of any change in:

(1) (text unchanged)

(2) Address; [or]

(3) Email;

(4) Phone number; or

[(3)] (5) (text unchanged)

G. (text unchanged)

H. Unless the certificate is the initial certificate issued under COMAR 30.02.02.04 or is extended, revoked, or suspended, the certificate of an emergency medical responder or emergency medical technician is valid:

(1) In the initial certification period for at least 36 months, but not more than 42 months, as follows:

(a) Applicants for emergency medical responder and emergency medical technician certification who successfully complete the certification [examination] requirements between [January] February 1 and [June 30] July 31 are issued a certificate which is effective from the date of successful completion of all [required] certification [examinations] requirements and expires on [June 30] July 31, 3 years from the year of issuance; or

(b) Applicants for emergency medical responder and emergency medical technician certification who successfully complete the emergency medical technician [examination] requirements between [July] August 1 and [December] January 31 are issued a certificate which is effective from the date of successful completion of all [required] certification [examinations] requirements and expires on [December] January 31, 3 years from the year of issuance; and

(2) (text unchanged)

I. Unless the license is extended, revoked, or suspended, the license of a CRT is valid[:

(1) In the initial licensure period, from the date of successful completion of all required licensure examinations until April 30 of the year the individual’s registration with the National Registry of Emergency Medical Technicians expires;

(2) In each subsequent licensure period, for 2 years from the previous expiration date;

(3) If issued under a CRT update program, through which the candidate becomes an EMT-I/99 with the National Registry of Emergency Medical Technicians:

(a) Until April 30 of the second year after issue;

(b) In each subsequent licensure period,] for [two] 2 years from the previous expiration date.

J. Unless the license is extended, revoked, or suspended, the license of a paramedic is valid:

(1) In the initial licensure period, from the date of successful completion of all [required] licensure [examinations] requirements until [April 30] 30 days after the expiration of [the year] the individual’s registration with the National Registry of Emergency Medical Technicians [expires]; and

(2) In each subsequent licensure period, [for 2 years from the previous expiration date] until 30 days after the expiration of the individual’s registration with the National Registry of Emergency Medical Technicians.

K. Unless the license is extended, revoked, or suspended, the license of an EMD is valid:

(1) In the initial licensure period, [from the date of registration to the date of expiration of the individual’s registration with a proprietary EMD program; and] for at least 24 months, but not more than 32 months, as follows:

(a) Applicants for emergency medical dispatcher who register with a national organization approved by the EMS Board between January 1 and June 30 are issued a certificate which is effective from the date of successful completion of all required certification examinations and expires on June 30, 2 years from the year of issuance; or

(b) Applicants for emergency medical dispatcher who register with a national organization approved by the EMS Board between July 1 and December 31 are issued a certificate which is effective from the date of successful completion of all required certification examinations and expires on December 31, 2 years from the year of issuance; and

(2) (text unchanged)

.07 Renewal.

A. [At least 8 weeks before] Prior to the expiration date of each license or certificate, MIEMSS shall [mail] send renewal notices to each EMS [provider] clinician whose license or certificate is expiring[. The renewal notice shall be sent to the EMS provider’s most recent address on file with the MIEMSS Office of Education, Licensure, and Certification, based on the initial application or information as updated by the EMS provider], using the clinician’s contact information as specified under Regulation .06F of this chapter.

B. The renewal notice shall state the date the current [licensure] license or [certification] certificate expires.

C. An EMS [provider] clinician who wishes to renew a license or certificate [before the expiration date] shall submit [a complete] an application and any required supporting materials as specified in each applicable provision of this chapter to MIEMSS on a form approved by MIEMSS at least 2 weeks before the expiration date [together with verification of any required affiliation including verification of protocol currency].

D. If applying for renewal as an emergency medical responder, the individual shall submit to MIEMSS evidence of:

(1) Current active status registration as an emergency medical responder or higher with the National Registry of Emergency Medical Technicians; or

[(2) Successful completion a 12 hour refresher course; or]

[(3)] (2) [Successful] Documentation of successful completion of:

(a) [A 6 hour or greater skills proficiency course; and] 8 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle;

(b) [Two hours of:] The 3 most recent years of Annual EMS Protocol Updates; and

[(i) Medical knowledge training;

(ii) Trauma knowledge training; and

(iii) Affiliation optional training;]

(c) A MIEMSS-approved skills competency verification.

E. If applying for renewal as an emergency medical technician, the individual shall submit to MIEMSS evidence of an affiliation with an EMS Operational Program, and:

(1) Current active status registration as an emergency medical technician or higher with the National Registry of Emergency Medical Technicians and the 3 most recent years of Annual EMS Protocol Updates; or

[(2) Successful completion a 12 hour refresher course; or]

[(3)] (2) [Successful] Documentation of successful completion of:

(a) [An approved skills competency evaluation and;] 20 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle; and

(b) [12 hours of approved continuing education content, including online competency-based courses, or traditional classroom content; or] The 3 most recent years of Annual EMS Protocol Updates; and

(c) A MIEMSS-approved skills competency verification.

[(4) Successful completion of:

(a) A 12 hour or greater skills proficiency course; and

(b) Four hours of:

(i) Medical knowledge training;

(ii) Trauma knowledge training; and

(iii) Affiliation optional training;]

F. If applying for renewal as a CRT the individual shall submit to MIEMSS evidence of an affiliation with an EMS Operational Program, and:

(1) Current active status registration as [an EMT Intermediate 99 or higher with] a paramedic with the National Registry of Emergency Medical Technicians, completion of the 2 most recent years of Annual EMS Protocol Updates, and completion of any MIEMSS-assigned ALS education; or

[(2) If applying for renewal as a CRT who has completed the CRT update program but does not have current active NREMT I99 status, documentation of completion of all continuing education and skills proficiency verification requirements equivalent to the standards required for renewal as a Paramedic with the National Registry of Emergency Medical Technicians.]

(2) Documentation of successful completion of:

(a) 60 hours of continuing education equivalent to the requirements of a paramedic renewing with the National Registry of Emergency Medical Technicians, including the 2 most recent years of Annual EMS Protocol Updates and any MIEMSS-assigned ALS education during the clinician’s current licensure cycle; and

(b) A MIEMSS-approved skills competency verification.

G. If applying for renewal as a paramedic, the individual shall submit to MIEMSS evidence of current active status registration as a paramedic with the National Registry of Emergency Medical Technicians, completion of the 2 most recent years of Annual EMS Protocol Updates, completion of any MIEMSS-assigned ALS education, and evidence of affiliation with an EMS Operational Program.

H. If applying for renewal as an EMD, the individual shall submit evidence of an affiliation with an EMS Operational program, and:

(1) Continued, active status [registration with an approved national EMD program] certification as an EMD by a national organization approved by the EMS Board; or

(2) (text unchanged)

[I. Approved online or distributive learning may be utilized to achieve the continuing education requirements.]

[J.] I.—[K.] J. (text unchanged)

.08 Inactive Status.

A. The EMS Board may place an EMS [provider] clinician on inactive status if the EMS [provider] clinician:

(1) (text unchanged)

(2) [Requests to be placed on] Applies for inactive status by submitting an application on a form the EMS Board requires; [or]

(3) In the case of a paramedic [or a CRT initially licensed after June 30, 2001] , fails to maintain continuous, active status registration with the National Registry of Emergency Medical Technicians as a [provider] clinician, unless the [provider] clinician has requested and received an extension of the individual’s license from MIEMSS[.]; or

(4) Fails to complete a MIEMSS-approved skills competency verification for renewal.

B. An EMS [provider] clinician on inactive status may not provide emergency medical services in this State except in rare instances at the scene of a medical emergency.

C. An EMS [provider] clinician on inactive status may apply for active status if the individual:

(1)—(3) (text unchanged)

(4) If the individual has been on inactive status for a period greater than 1 year, [attends a skills review session approved by MIEMSS, or conducted by an approved ALS training program] completes the most recent protocol update course and a MIEMSS-approved skills competency verification.

D. A clinician whose license is on inactive status, as specified in §A of this regulation, may apply for renewal if all other requirements for renewal are met.

[D.] E. Except in the instance of an EMS [provider] clinician on active military duty, inactive status does not affect the term of an EMS [provider’s] clinician’s license or certificate.

[E.] F. An EMS [provider] clinician on active military duty may be granted an extended inactive status that shall end 1 year after the date of deactivation from active military duties that otherwise prevent a clinician from completing the requirements to maintain licensure.

[F.] G. (text unchanged)

.09 Reinstatement.

A. An individual whose license or certificate has expired and who has failed to renew the license or certificate may be reinstated as an EMS [provider] clinician if all requirements for reinstatement are met.

B. An applicant for reinstatement as an EMS [provider] clinician shall apply for reinstatement:

(1) As an emergency medical responder [or emergency medical technician], not later than 3 years after the expiration of the applicant’s emergency medical responder [or emergency medical technician] certification, or at any time if the applicant has current active status registration as an emergency medical responder with the National Registry of the Emergency Medical Technicians;

(2) As an emergency medical technician, not later than 3 years after the expiration of the applicant’s emergency medical technician certification, or at any time if the applicant has current active status registration as an emergency medical technical with the National Registry of Emergency Medical Technicians;

[(2)] (3) As an EMD, not later than 2 years after the expiration of the applicant’s EMD licensure, or at any time if the applicant has current active status registration with a nationally recognized EMD program;

[(3)] (4) As a CRT, not later than 2 years after the expiration of the applicant’s CRT licensure, or at any time if the applicant has current active status registration as a paramedic with the National Registry of Emergency Medical Technicians; or

[(4)] (5) (text unchanged)

C. An applicant for reinstatement as an EMS [provider] clinician shall:

(1)— (2) (text unchanged)

[D. If applying for reinstatement more than 1 year after the expiration of the individuals licensure or certification, in addition to the requirements of §C of this regulation, within 6 months of completion of the required continuing education, an applicant for reinstatement shall, if applying for reinstatement as:

(1) An emergency medical responder, pass the emergency medical responder:

(a) Practical certification examination administered by the approved training program, and

(b) Written certification examination approved and administered by MIEMSS;

(2) An emergency medical technician, pass the emergency medical technician written and practical certification examinations approved by MIEMSS;

(3) A CRT:

(a) Successfully complete a Maryland protocol review session approved by MIEMSS; and

(b) Pass a CRT licensure examination approved by MIEMSS;

(4) A paramedic:

(a) Successfully complete a Maryland Protocol Review class, and

(b) Pass a paramedic licensure examination approved by MIEMSS; or

(5) An EMD, pass an EMD written licensure examination approved and administered by MIEMSS.

E. Upon completion of the requirements for reinstatement, if the application for reinstatement was:

(1) More than 1 year from the date of expiration, the individual shall receive a license or certificate which is valid for the appropriate license or certificate period; or

(2) 1 year or less from the date of expiration, the individual shall receive a license or certificate which is valid for the appropriate license or certificate period minus the period of expiration.]

D. Upon fulfilling the requirements for reinstatement of a certificate or license, the date of expiration of the new certificate or license shall be the date of expiration if the certificate or license had not lapsed. If that date has passed, the new expiration date shall be that of an initial certificate or license.

THEODORE DELBRIDGE, M.D. M.P.H.
Executive Director

Subtitle 01 GENERAL

30.01.02 Documents Incorporated by Reference

Authority: Education Article, §§13-509 and 13-516, Annotated Code of Maryland

Notice of Proposed Action

[23-255-P-I]

The Maryland State Emergency Medical Services Board proposes to amend Regulation .01 under COMAR 30.01.02 Documents Incorporated by Reference. This action was considered by the State EMS Board at its open meeting held on March 14, 2023, pursuant to General Provisions Article §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to amend the year of the Maryland Medical Protocols for Emergency Medical Services incorporated by reference to reflect the most current edition of the document.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Sheile McAllister, Administrative Assistant, MIEMSS-OAG, 653 West Pratt Street, Baltimore, MD 21201, or call 410-706-4449, or email to smcallister@miemss.org. Comments will be accepted through January 2, 2024. A public hearing has not been scheduled.

Editor’s Note on Incorporation by Reference

Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the Maryland Medical Protocols for Emergency Medical Services (MIEMSS July 1, 2023 Edition) has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories was published in 50:1 Md. R. 7 (January 13, 2023), and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.01 Incorporation by Reference.

A. (text unchanged)

B. Documents Incorporated.

(1) “Maryland Medical Protocols for Emergency Medical Services (MIEMSS July 1, [2022] 2023 Edition)”. This document can be obtained through the Maryland Institute for Emergency Medical Services Systems at 653 W. Pratt Street, Baltimore, Maryland 21201 (410-706-4449).

(2)—(4) (text unchanged)

THEODORE R. DELBRIDGE, M.D. M.P.H.
Executive Director

Special Documents

MARYLAND HEALTH CARE COMMISSION

SCHEDULES FOR CERTIFICATE OF NEED REVIEW

The Maryland Health Care Commission (MHCC or Commission) provides the following schedules to interested members of the public and sponsors of health care facility and service projects subject to Certificate of Need (CON) review and approval. Not every type of project is subject to the requirements of CON review and approval or included in this review schedule. In these cases, persons seeking CON approval for a project may file a letter of intent at any time. The procedural regulations governing CON reviews, COMAR 10.24.01, have been revised with an effective date of December 1, 2023. The newly adopted regulations will apply to all projects subject to this schedule. (See COMAR 10.24.01.07 and .08 for additional information on CON application filing and project review.)

The general criteria for Certificate of Need review are set forth at COMAR 10.24.01.08G(3). The first criterion is evaluation of the project according to all relevant State Health Plan standards, policies, and criteria. State Health Plan regulations can be accessed at https://mhcc.maryland.gov/mhcc/pages/hcfs/hcfs_shp/hcfs_shp.aspx.

This Certificate of Need review schedule updates the last schedule published in the Maryland Register on March 10, 2023, Volume 50, Issue 5, pages 199-202. This review schedule is not a solicitation by the Commission for Certificate of Need applications, and does not indicate, in and of itself, that additional capacity is needed in services subject to Certificate of Need review, or that Certificate of Need applications submitted for the services described will be approved by the Commission.

Applicants are encouraged to discuss their development plans and projects with the Commission Staff prior to filing letters of intent or applications.

Letters of Intent and applications for scheduled reviews may only be received and reviewed according to these published schedules. All Letters of Intent and Certificate of Need applications, including the required number of copies of CON applications, must be received at the offices of the Maryland Health Care Commission, 4160 Patterson Avenue, Baltimore, Maryland 21215, no later than 4:30 p.m. on the scheduled date of submission. Letters of Intent should be filed by US mail and email to mhcc.confilings@maryland.gov and wynee.hawk1@maryland.gov and ruby.potter@maryland.gov Letters of intent for projects not covered by this review schedule may be filed at any time.

For further information about review schedules or procedures, contact Jeanne-Marie Gawel, Acting Chief, Certificate of Need, at (410) 764-3371 or jeanne-marie.gawel@maryland.gov

The Commission will use the following regional configuration of jurisdictions for the General Hospital Project, Special Hospital Project, Freestanding Ambulatory Surgical Facility Project, and Comprehensive Care Facility Project Review Schedules:

Western Maryland:

Allegany, Frederick, Garrett, and Washington

Central Maryland:

Anne Arundel, Baltimore City, Baltimore County, Carroll, Harford, and Howard

Eastern Shore:

Caroline, Cecil, Dorchester, Kent, Queen Anne’s, Somerset, Talbot, Wicomico, and Worcester

Montgomery & Southern Maryland:

Calvert, Charles, Montgomery, Prince George’s, and St. Mary’s

General Hospital Projects

The Commission hereby publishes the following schedules for the submission of Certificate of Need applications by general hospitals, for projects that involve: (1) capital expenditures by or on behalf of general hospitals that exceed the applicable capital expenditure threshold; (2) proposed changes in bed capacity or operating room capacity at existing hospitals; (3) the relocation of a general hospital; and/or (4) a change in the type or scope of any health care service offered by a general hospital, as specified at COMAR 10.24.01.02A, except for neonatal intensive care. Please note that the following schedule does not apply to the establishment of a new general hospital.

Schedule One
All General Hospital Projects

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Montgomery & Southern Maryland	February 2, 2024	February 14, 2024	April 5, 2024
Western Maryland	March 1, 2024	March 13, 2024	May 3, 2024
Central Maryland	April 5, 2024	April 17, 2024	June 7, 2024
Eastern Shore	May 3, 2024	May 15, 2024	July 5, 2024

Schedule Two

All General Hospital Projects

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Montgomery & Southern Maryland	August 2, 2024	August 14, 2024	October 4, 2024
Western Maryland	September 6, 2024	September 18, 2024	November 8, 2024
Central Maryland	October 4, 2024	October 16, 2024	December 6, 2024
Eastern Shore	November 1, 2024	November 13, 2024	January 3, 2025

Special Hospital Projects (Pediatric, Psychiatric, Chronic, and Rehabilitation)

The Commission hereby publishes the following schedules for the submission of Certificate of Need applications by special hospitals, for projects that involve: (1) capital expenditures by or on behalf of special hospitals that exceed the applicable capital expenditure threshold; (2) proposed changes in bed capacity at existing special hospitals; (3) the relocation of a special hospital; and/or (4) a change in the type or scope of any health care service offered by a special hospital, as specified at COMAR 10.24.01.02A. Please note that the following schedule does not apply to establishment of a new special hospital.

Schedule One
Special Hospitals (Pediatric, Psychiatric, Chronic, and Rehabilitation)

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Central Maryland	February 2, 2024	February 14, 2024	April 5, 2024
Eastern Shore	March 1, 2024	March 13, 2024	May 3, 2024
Montgomery & Southern Maryland	April 5, 2024	April 17, 2024	June 7, 2024
Western Maryland	May 10, 2024	May 22, 2024	July 12, 2024

Schedule Two
Special Hospitals (Pediatric, Psychiatric, Chronic, and Rehabilitation)

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Central Maryland	August 2, 2024	August 14, 2024	October 4, 2024
Eastern Shore	September 6, 2024	September 18, 2024	November 8, 2024
Montgomery & Southern Maryland	October 4, 2024	October 16, 2024	December 6, 2024
Western Maryland	November 1, 2024	November 13, 2024	January 3, 2025

Freestanding Ambulatory Surgical Facility Projects

The Commission hereby publishes the following schedules for the submission of Certificate of Need applications to establish freestanding ambulatory surgical facilities, add operating rooms at an existing freestanding ambulatory surgical facility, or make a capital expenditure by a hospital for a freestanding ambulatory surgical facility project that requires Certificate of Need review and approval. The definition of freestanding ambulatory surgical facility can be found at Health-General Article §19-114(b).

Schedule One
Freestanding Ambulatory Surgical Facility Projects

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Central Maryland	February 2, 2024	February 14, 2024	April 5, 2024
Eastern Shore	March 1, 2024	March 13, 2024	May 3, 2024
Montgomery & Southern Maryland	April 5, 2024	April 17, 2024	June 7, 2024
Western Maryland	May 10, 2024	May 22, 2024	July 12, 2024

Schedule Two

Freestanding Ambulatory Surgical Facility Projects

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Central Maryland	August 2, 2024	August 14, 2024	October 4, 2024
Eastern Shore	September 6, 2024	September 18, 2024	November 8, 2024
Montgomery & Southern Maryland	October 4, 2024	October 16, 2024	December 6, 2024
Western Maryland	November 1, 2024	November 13, 2024	January 3, 2025

Comprehensive Care Facilities

The Commission hereby republishes the following schedule for the review of projects proposed in CON applications that do not involve an increase in CCF bed capacity in the jurisdiction in which the project is located. These include projects that relocate an existing facility or, in effect, relocate CCF bed capacity from an existing facility to a new site within the same jurisdiction. At the time of the letter of intent submission, an applicant shall demonstrate compliance with the requirements of COMAR 10.24.20.05A(8) by submitting an analysis of the average CMS star ratings of applicable facilities. The applicant may interpret “average” to be mean or median.

Schedule One

Comprehensive Care Facility Services

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Montgomery & Southern Maryland	December 29, 2023	January 10, 2024	February 27, 2024
Western Maryland	December 29, 2023	January 10, 2024	February 27, 2024
Central Maryland	February 2, 2024	February 14, 2024	April 5, 2024
Eastern Shore	March 1, 2024	March 13, 2024	May 3, 2024

Schedule Two
Comprehensive Care Facility Services

Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Montgomery & Southern Maryland	August 2, 2024	August 14, 2024	October 4, 2024
Western Maryland	September 6, 2024	September 18, 2024	November 8, 2024
Central Maryland	October 4, 2024	October 16, 2024	December 6, 2024
Eastern Shore	November 1, 2024	November 13, 2024	January 3, 2025

Freestanding Medical Facility Projects

The Commission hereby publishes the following statewide schedule for Certificate of Need review of proposed projects by general hospitals to establish or relocate freestanding medical facilities (FMFs) and proposed capital expenditures by hospitals for FMF projects that exceed the applicable capital expenditure threshold. Please note that these schedules do not apply to the filing of a request for an Exemption from Certificate of Need by a general hospital seeking to convert to a freestanding medical facility.

Schedule One
Freestanding Medical Facility Projects

Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
February 2, 2024	February 14, 2024	April 5, 2024

Cardiac Surgery Services

The Maryland Health Care Commission provides the following schedule for the review of applications for Certificates of Need (“CON”) by general hospitals seeking to introduce cardiac surgery services. This review schedule is not a solicitation by the Commission for CON applications, and it does not indicate that additional capacity is needed or that CON applications submitted will be approved by the Commission. Applicants are encouraged to discuss their development plans and projects with the Commission staff prior to filing Letters of Intent. Please note that there is no scheduled review cycle for the Baltimore/Upper Shore region because the applicable State Health Plan, COMAR 10.24.17, states that, “a new cardiac surgery program will only be considered in a health planning region if the most recently approved program in the health planning region has been in operation for at least three years.” The most recently approved program in the Baltimore/Upper Shore region initiated operation in December, 2020.

Region Definitions for Cardiac Surgery

Metropolitan Washington Region:

Calvert, Charles, Frederick, Montgomery, Prince George’s, and St. Mary’s

Eastern (Lower Shore) Region:

Dorchester, Somerset, Wicomico, and Worcester

Western Region:

Allegany, Garrett, and Washington

Schedule One
Cardiac Surgery Services

Planning Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Metropolitan Washington	February 2, 2024	February 14, 2024	April 5, 2024
Eastern (Lower Shore)	March 1, 2024	March 13, 2024	May 3, 2024
Western	April 5, 2024	April 17, 2024	June 7, 2024

Schedule Two
Cardiac Surgery Services

Planning Region	Letter of Intent Due Date	Pre-Application Conference Date	Application Submission Date
Metropolitan Washington	August 2, 2024	August 14, 2024	October 4, 2024
Eastern (Lower Shore)	September 6, 2024	September 18, 2024	November 8, 2024
Western	October 4, 2024	October 16, 2024	December 6, 2024

Home Health Agency Projects

There are no scheduled CON review cycles for Home Health Agency applicants at this time.

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General Notices

Notice of ADA Compliance

The State of Maryland is committed to ensuring that individuals with disabilities are able to fully participate in public meetings. Anyone planning to attend a meeting announced below who wishes to receive auxiliary aids, services, or accommodations is invited to contact the agency representative at least 48 hours in advance, at the telephone number listed in the notice or through Maryland Relay.