Public Health Reform Act

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
Italics indicate opposite chamber/conference committee amendments.
*hb1109*

HOUSE BILL 1109
J1 (6lr3025)
ENROLLED BILL
— Health and Appropriations/Finance and Budget and Taxation —
Introduced by Chair, Health Committee and Delegates Cullison, A. Johnson,
S. Johnson, and Kerr Kerr, Alston, Guzzone, Hill, Kaufman, Lopez,
Martinez, Rosenberg, Ross, Taveras, White Holland, and Woorman

Read and Examined by Proofreaders:

_______________________________________________
Proofreader.
_______________________________________________
Proofreader.

Sealed with the Great Seal and presented to the Governor, for his approval this

_______ day of _______________ at ________________________ o’clock, ________M.

______________________________________________
Speaker.

CHAPTER ______

AN ACT concerning 1

Public Health Reform Act 2

FOR the purpose of requiring the Maryland Department of Health to organize the 3
Maryland Medical Reserve Corps; requiring the Maryland Department of Health to 4
notify each health officer for a county of a certain procurement to offer the 5
opportunity for the county health department to join the procurement; authorizing 6
a health officer for a county to make an appointment to a position without the 7
approval of the Maryland Department of Health or the Department of Budget and 8
Management if the position is fully funded without State funding; authorizing a 9
health officer for a county to enter into certain contracts if the Secretary of Health 10
does not respond to a request for approval within a certain time period; authorizing 11
the Secretary of Health and, under certain circumstances, the Deputy Secretary for 12
Public Health to delegate the authority to approve certain contracts authorizing a 13
2 HOUSE BILL 1109

health officer for a county to enter into certain contracts if the Secretary of Health does 1
not respond to a request for approval within a certain time period ; altering the 2
membership, leadership selection process, and staffing of the Commission on Public 3
Health on Public Health ; requiring the Commission on Public Health on Public 4
Health to provide oversight over the implementation o f recommendations made by 5
the Commission on Public Health; establishing the Public Health Workforce 6
Development Fund; requiring that interest earnings of the Public Health Workforce 7
Development Fund remain in the Public Health Workforce Development Fund; 8
authorizing the Maryland Department of Health and the Health Services Cost Review 9
Commission to transfer money from the Population Health Improvement Fund to the 10
Public Health Workforce Development Fund in a manner consistent with a certain 11
agreement; on Public Health; establishing the Public Health Workforce Development 12
Fund; requiring that interest earnings of the Public Health Workforce Development 13
Fund remain in the Public Health Workforce Development Fund; authorizing the 14
Maryland Department of Health a nd the Health Services Cost Review Commission 15
to transfer money from the Population Health Improvement Fund to the Public 16
Health Workforce Development Fund; requiring the Department of Legislative 17
Services to develop a process to assess the health equity i mpacts of relevant 18
legislation; altering the membership of the Maryland Corps Program Advisory 19
Board; requiring the Commission on Public Health to establish a Community 20
Benefits Modernization subcommittee; requiring the Maryland Department of 21
Health to convene a certain workgroup; and generally relating to public health. 22

BY repealing and reenacting, without amendments, 23
Article – Health – General 24
Section 1–101(a) and (e), 13–5102, and 13–5602(a) and, 13–5102, and 13–5602(a) 25
Annotated Code of Maryland 26
(2023 Replacement Volume and 2025 Supplement) 27

BY adding to 28
Article – Health – General 29
Section 2–104.1; and 2–1101 through 2–1103 to be under the new subtitle “Subtitle 30
11. Maryland Medical Reserve Corps”; and 24–2801 and 24–2802 to be under 31
the new subtitle “Subtitle 28. Public Health Workforce Development Fund”; and 32
24–2801 and 24–2802 to be under the new subtitle “Subtitle 28. Public Health 33
Workforce Development Fund” 34
Annotated Code of Maryland 35
(2023 Replacement Volume and 2025 Supplement) 36

BY repealing and reenacting, with amendments, 37
Article – Health – General 38
Section 3–306, and, 13–5103 through 13–5106, and 13–5602(f), and 13–5602(f) 39
Annotated Code of Maryland 40
(2023 Replacement Volume and 2025 Supplement) 41

BY repealing and reenacting, with amendments, 42
Article – Health – General 43
HOUSE BILL 1109 3

Section 13–5107 1
Annotated Code of Maryland 2
(2023 Replacement Volume and 2025 Supplement) 3
(As enacted by Chapter 787 of the Acts of the General Assembly of 2024) 4

BY repealing and reenacting, without amendments, 5
Article – State Finance and Procurement 6
Section 6–226(a)(2)(i) and (ii) 7
Annotated Code of Maryland 8
(2021 Replacement Volume and 2025 Supplement) 9

BY repealing and reenacting, with amendments, 10
Article – State Finance and Procurement 11
Section 6–226(a)(2)(iii)212. and 213. 12
Annotated Code of Maryland 13
(2021 Replacement Volume and 2025 Supplement) 14

BY adding to 15
Article – State Finance and Procurement 16
Section 6–226(a)(2)(iii)214. 17
Annotated Code of Maryland 18
(2021 Replacement Volume and 2025 Supplement) 19

BY repealing and reenacting, without amendments, 20
Article – State Finance and Procurement 21
Section 6–226(a)(2)(i) and (ii) 22
Annotated Code of Maryland 23
(2021 Replacement Volume and 2025 Supplement) 24

BY repealing and reenacting, with amendments, 25
Article – State Finance and Procurement 26
Section 6–226(a)(2)(iii)212. and 213. 27
Annotated Code of Maryland 28
(2021 Replacement Volume and 2025 Supplement) 29

BY adding to 30
Article – State Finance and Procurement 31
Section 6–226(a)(2)(iii)214. 32
Annotated Code of Maryland 33
(2021 Replacement Volume and 2025 Supplement) 34

BY adding to 35
Article – State Government 36
Section 2–1505.3 37
Annotated Code of Maryland 38
(2021 Replacement Volume and 2025 Supplement) 39

4 HOUSE BILL 1109

BY repealing and reenacting, with amendments, 1
Article – State Government 2
Section 21–203(a) 3
Annotated Code of Maryland 4
(2021 Replacement Volume and 2025 Supplement) 5

BY repealing and reenacting, without amendments, 6
Article – State Government 7
Section 21–203(b) 8
Annotated Code of Maryland 9
(2021 Replacement Volume and 2025 Supplement) 10

BY repealing and reenacting, with amendments, 11
Chapter 385 of the Acts of the General Assembly of 2023, as amended by Chapter 12
787 of the Acts of the General Assembly of 2024 13
Section 2 14

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
That the Laws of Maryland read as follows: 16

Article – Health – General 17

1–101. 18

(a) In this article the following words have the meanings indicated. 19

(e) “Health officer” means, unless expressly provided otherwise, the Baltimore 20
City Commissioner of Health or the health officer of a county. 21

2–104.1. 22

(A) BEFORE PROCURING A SY STEM FOR COLLECTING AND STORING 23
ELECTRONIC HEALTH RE CORDS, AS DEFINED IN § 19–142 OF THIS ARTICLE , THE 24
DEPARTMENT SHALL CONSULT WITH LOCAL HEALTH DEPARTMENTS TO ASSESS THE 25
NECESSARY QUALITIES OF AN ELECTRONIC HEALTH RECORDS SYSTEM. 26

(B) IF THE DEPARTMENT PROCURES A SYSTEM FOR COLLECTIN G AND 27
STORING ELECTRONIC HEALTH RECORDS, THE DEPARTMENT SHALL NOTIFY EACH 28
HEALTH OFFICER FOR A COUNTY AND OFFER THE COUNTY HEALTH DEPARTMENT 29
THE OPPORTUNITY TO JOIN THE PROCUREMENT. 30

SUBTITLE 11. MARYLAND MEDICAL RESERVE CORPS. 31

2–1101. 32

HOUSE BILL 1109 5

IN THIS SUBTITLE , “CORPS” MEANS THE MARYLAND MEDICAL RESERVE 1
CORPS. 2

2–1102. 3

(A) THE DEPARTMENT SHALL ORGA NIZE THE MARYLAND MEDICAL 4
RESERVE CORPS. 5

(B) THE PURPOSE OF THE CORPS IS TO PROVIDE A STATEWIDE VOLUNTEER 6
NETWORK INTEGRATED INTO COMMUNITY EMERGENCY SYSTEMS TO FACIL ITATE A 7
COORDINATED APPROACH TO VOLUNTEER MANAGEMENT. 8

(C) THE CORPS SHALL INCLUDE CLINICAL AND NONCLINICAL PERSONNEL 9
CAPABLE OF ASSISTING DURING CRI SES THAT STRAIN THE HEALTH CARE SYSTEM 10
OR PUBLIC HEALTH SYS TEM, INCLUDING PUBLIC HEALTH EMERGENCIES, DISEASE 11
OUTBREAKS, AND NATURAL DISASTERS. 12

2–1103. 13

THE DEPARTMENT SHALL: 14

(1) MAINTAIN AN EFFICIENT AND MODERN ELECTRONI C 15
REGISTRATION SYSTEM TO REGIST ER AND TRACK VOLUNTE ERS FOR THE CORPS; 16
AND 17

(2) DESIGNATE A PUBLIC HEALTH EMERGENCY SURGE 18
COORDINATOR AMONG ITS STAFF TO COORDINATE AND PLAN IMPROVEMENT S TO 19
THE CORPS. 20

3–306. 21

(a) Except as provided by agreement between the Secreta ry and the local 22
governing body, and in addition to the powers and duties set forth elsewhere, each health 23
officer has the powers and duties set forth in this section. 24

(b) A health officer may obtain samples of food and drugs for analysis. 25

(c) (1) The health officer for a county is the executive officer and secretary of 26
the county board of health. 27

(2) (I) Except in Montgomery County, the health officer for a county 28
shall appoint the staff of the county health department. 29

6 HOUSE BILL 1109

(II) IF A POSITION WITH A COUNTY HEALTH DEPART MENT IS 1
FULLY FUNDED WITHOUT THE USE OF STATE FUNDING, THE HEALTH OFFICER FOR 2
THE COUNTY MAY APPOINT AN INDIVIDUAL TO THE POSITION WITHOUT APPROVAL 3
BY THE SECRETARY OR THE SECRETARY OF BUDGET AND MANAGEMENT. 4

(3) The health officer for a county shall have an office at an accessible place 5
in the county. 6

(4) (i) The health officer for a county shall enforce throughout the 7
county: 8

1. Under the direction of the Secretary, the State health laws 9
and the policies, rules, and regulations that the Secretary adopts; and 10

2. Except as provided in subparagraph (ii) of this paragraph, 11
under the direction of the county board of health, the rules and regulations that the county 12
board of health adopts. 13

(ii) The health officer for a county shall enforce in each municipality 14
or special taxing district in the county the rules or regulations that the county board of 15
health adopts unless the municipality or district has a charter provision or ordinance that: 16

1. Covers the same subjec t matter as the county rule or 17
regulation; 18

2. Is at least as restrictive as the county rule or regulation; 19
and 20

3. Includes provisions for enforcement. 21

(5) A health officer shall perform any investigation or other duty or 22
function directed by t he Secretary or the county board of health and submit appropriate 23
reports to them. 24

(d) (1) Subject to the consent of the governing body of the county and the 25
written approval of the Secretary, a health officer for a county may enter into a contract or 26
any other written agreement to assist or participate in the delivery of health care services 27
with a person that is authorized to provide, finance, coordinate, facilitate, or otherwise 28
deliver health care services in the State. 29

(2) (I) IF THE SECRETARY DOES NOT RESPOND TO A REQUEST FOR 30
WRITTEN APPROVAL WITHIN 7 DAYS AFTER RECEIVING THE REQUEST, THE HEALTH 31
OFFICER FOR THE COUN TY MAY ENTER THE CON TRACT OR WRITTEN AGR EEMENT 32
THE SECRETARY MAY DELEGATE APPROVAL AUTHORITY UNDER PARAGRAPH (1) OF 33
THIS SUBSECTION TO THE DEPUTY SECRETARY FOR PUBLIC HEALTH SERVICES. 34

HOUSE BILL 1109 7

(II) IF THE SECRETARY DELEGATES A UTHORITY TO THE 1
DEPUTY SECRETARY FOR PUBLIC HEALTH SERVICES UNDER SUBPAR AGRAPH (I) 2
OF THIS PARAGRAPH, THE DEPUTY SECRETARY MAY DELEGATE THE AUTHORITY TO 3
LOCAL HEALTH OFF ICERS IF THE SECRETARY DOES NOT RE SPOND TO A REQUEST 4
FOR WRITTEN APPROVAL WITHIN 7 DAYS AFTER RECEIVING THE REQUEST , THE 5
HEALTH OFFICER FOR T HE COUNTY MAY ENTER THE CONTRACT OR WRIT TEN 6
AGREEMENT. 7

(e) (1) Except as provided in paragraph (2) of this subsection, a health officer 8
for a county and the Baltimore City Commissioner of Health may authorize the county 9
health department to retain all collections, including any unspent balance at the end of a 10
fiscal year, received from: 11

(i) Fees authorized under this article; 12

(ii) Fees authorized under the Environment Article; and 13

(iii) Fees derived from charges authorized under Title 16, Subtitle 2 14
of this article. 15

(2) The authority to retain collections under paragraph (1) of this 16
subsection does not apply: 17

(i) To license fees set by a county governing body or Baltimore City 18
and paid to the chief financial officer of the county or Baltimore City as authorized under 19
State law; 20

(ii) To fees that must be transferred to the General Fund un der § 21
4–217(c) of this article from the fees collected for each birth certificate issued or report 22
issued that a search was made but the requested record is not on file; or 23

(iii) If the retention of collections would be inconsistent with 24
established local practice. 25

(3) Each health officer for a county and the Baltimore City Commissioner 26
of Health shall report annually to the Secretary on the use of collections retained under 27
paragraph (1) of this subsection. 28

(F) A HEALTH OFFICER FOR A COUNTY MAY S ERVE ON THE BOARD OF A 29
HOSPITAL IN THE STATE AS A REPRESENTATIVE OF A LOCAL HEALTH DEPARTMENT 30
ONLY IF THE HEALTH O FFICER DOES NOT ACCE PT PAYMENT FOR THE H EALTH 31
OFFICER’S SERVICE ON THE BOARD. 32

[(f)] (G) The Secretary may delegate duties, powers, and funct ions as provided 33
in this article to a health officer for a county or other county official authorized to 34
administer and enforce health and environmental laws. 35
8 HOUSE BILL 1109

13–5102. 1

There is a Commission on Public Health. 2

13–5103. 3

(a) The Commission consists of the following members: 4

(1) One member of the Senate of Maryland, appointed by the President of 5
the Senate; 6

(2) One member of the House of Delegates, appointed by the Speaker of the 7
House; 8

(3) THE SECRETARY OF BUDGET AND MANAGEMENT, OR THE 9
SECRETARY’S DESIGNEE; 10

(4) THE SECRETARY OF INFORMATION TECHNOLOGY, OR THE 11
SECRETARY’S DESIGNEE; 12

[(3)] (5) The Deputy Secretary for Public Health, or the Deputy 13
Secretary’s designee; 14

[(4)] (6) The Deputy Secretary for [Behavioral Health] OPERATIONS, or 15
the Deputy Secretary’s designee; 16

[(5) The Director of the Office of Minority Health and Health Disparities, or 17
the Director’s designee; and] 18

(7) THE CHIEF EXECUTIVE OFFICER OF THE CHESAPEAKE 19
REGIONAL INFORMATION SYSTEM FOR OUR PATIENTS (CRISP), OR THE CHIEF 20
EXECUTIVE OFFICER’S DESIGNEE; AND 21

[(6)] (8) The following members, appointed by the Governor: 22

(i) Three local health officers of whom: 23

1. One shall be from a rural jurisdiction; 24

2. One shall be from a suburban jurisdiction; and 25

3. One shall be from an urban jurisdiction; 26

HOUSE BILL 1109 9

(ii) Two representatives from State academic institutions with 1
expertise in public health systems; AND 2

(iii) A faculty member from a public health program at a historically 3
Black college or university[; and]. 4

[(iv)] (B) [At least three but not more than five ] THE GOVERNOR 5
MAY APPOINT NOT MORE THAN TWO members of the public with [demonstrated interest] 6
EXPERIENCE in public health [and experience in at least one of the following areas: 7

1. Health equity; 8

2. Information technology; 9

3. Workforce; and 10

4. Population health ] AS ADDITIONAL MEMBER S OF THE 11
COMMISSION. 12

[(b) In performing the duties of the Commission, the Commission shall consult 13
with, as appropriate and necessary: 14

(1) The Maryland Health Care Commission; 15

(2) The Health Services Cost Review Commission; 16

(3) The Maryland Community Health Resources Commission; 17

(4) The Department of Budget and Management; 18

(5) The Department of General Services; 19

(6) The Maryland Department of Disabilities; 20

(7) The State–designated health data utility; and 21

(8) Any other State agency as appropriate.] 22

(c) (1) The Commission [shall] MAY establish [the following] workgroups[: 23

(i) Funding; 24

(ii) Governance and organizational capabilities; 25

(iii) Workforce; 26

10 HOUSE BILL 1109

(iv) Data and information technology; and 1

(v) Communication and public engagement ] AT THE DISCRETION 2
OF THE COMMISSION. 3

(2) [Each workgroup established under paragraph (1) of this subsection 4
shall include: 5

(i) Two members of the Commission; and 6

(ii) Members of the public with relevant experience in the subject 7
matter of the workgroup who may include: 8

1. Primary and specialty care practitioners; 9

2. Payors; 10

3. Consumer advocates; 11

4. Hospital executives; 12

5. Safety net health care providers; 13

6. Public health practitioners; 14

7. Community–based organizations; and 15

8. Faith–based organizations ] THE CHAIR OF THE 16
COMMISSION MAY APPOINT MEMBERS OF THE PUBLIC TO A WORKGROUP. 17

[(3) The purpose of the workgroups established under paragraph (1) of this 18
subsection is to foster broad engagement and provide expertise for the purpose of informing 19
the work and recommendations of the Commission.] 20

(d) To the extent practicable and consistent with federal and State law, the 21
membership of the Commission and workgroups established under this section shall reflect 22
the racial, ethnic, and gender diversity of the State. 23

(e) (1) [The] SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION A ND 24
EXCEPT AS PROVIDED I N PARAGRAPH (3) OF THIS SUBSECTION , THE Commission 25
shall [be cochaired by: 26

(1) One member appointed under subsection (a)(6)(i) of this section, 27
designated by the Governor; 28

HOUSE BILL 1109 11

(2) One member appointed under subsection (a)(6)(ii) of this section, 1
designated by the Governor; and 2

(3) The member appointed under subsection (a)(6)(iii) of this section ] 3
SELECT A CHAIR AND A VICE CHAIR FROM AMONG ITS MEMBERS. 4

(2) TO QUALIFY TO SERVE AS CHAIR OF THE COMMISSION, THE 5
MEMBER MUST AGREE TO PROVIDE STAFF FOR THE COMMISSION ON SELECTION AS 6
CHAIR. 7

(3) THE MEMBERS OF THE COMMISSION MAY NOT SELECT AS CHAIR 8
A MEMBER LISTED IN SUBSECTION (A)(3), (4), (5), OR (6) OF THIS SECTION. 9

(f) A member of the Commission: 10

(1) May not receive compensation as a member of the Commission; but 11

(2) Is entitled to reimbursement for expenses under the Standard State 12
Travel Regulations, as provided in the State budget. 13

13–5104. 14

(A) The [academic institutions represented by the cochairs ] CHAIR of the 15
Commission shall provide staff support for the Commission. 16

(B) IF THE CHAIR FAILS TO PROVIDE STAFFING FOR THE COMMISSION, THE 17
MEMBERS SHALL SELECT A NEW CHAIR IN ACCORDANCE WITH § 13–5103(E) OF THIS 18
SUBTITLE. 19

13–5105. 20

(A) The purpose of the Commission is to make recommendations to improve the 21
delivery of foundational public health services in the State. 22

(B) THE COMMISSION SHALL PROV IDE OVERSIGHT OVER GUIDANCE FOR 23
IMPLEMENTATION OF THE COMMISSION’S RECOMMENDATIONS. 24

(C) THE DEPARTMENT SHALL PROV IDE AN UPDATE REGARD ING THE 25
IMPLEMENTATION OF TH E COMMISSION’S RECOMMENDATIONS TO THE 26
COMMISSION EACH QUARTER. 27

13–5106. 28

(a) The Commission shall assess the foundational public health capabilities of the 29
Department and local health departments in the State. 30
12 HOUSE BILL 1109

(b) (1) In conducting the assessment required under subsection (a) of this 1
section, the Commission shall: 2

(i) Explain the impact of the foundational public health capabilities 3
on the State’s ability to address foundational public health areas, including as the 4
foundational public health areas relate to behavioral health; 5

(ii) Explain the impact of the foundational public health capabilities 6
on the State’s ability to respond to COVID–19, overdoses, maternal and infant mortality, 7
and other major public health challenges as appropriate; and 8

(iii) Provide public outreach to hold at least three public meetings in 9
different areas of the State that include an opportunity for public comment. 10

(2) In conducting the assessment required under subsection (a) of this 11
section, the Commission may: 12

(i) Request deidentified and publicly available data from the 13
Department, local health departments, and the State–designated health data utility; and 14

(ii) Request interviews with State and local health officials. 15

(c) (1) Based on the assessment conducted under subsection (a) of this section, 16
the Commission shall make recommendations for reform in the following areas: 17

(i) Organization of State and local public health departments; 18

(ii) Information technology, information exchange, and data and 19
analytics; 20

(iii) Workforce, including human resources and use of the [medical 21
reserve corps for public health] MARYLAND MEDICAL RESERVE CORPS ESTABLISHED 22
UNDER TITLE 2, SUBTITLE 11 OF THIS ARTICLE; 23

(iv) Procurement, including oversight of contractors; 24

(v) Funding; 25

(vi) Communication and public engagement; and 26

(vii) Any other area considered appropriate by the Commission. 27

(2) The recommendations made under paragraph (1) of this subsection 28
shall include the funding or legislation required to implement the recommendation, if any. 29

HOUSE BILL 1109 13

(3) The Commission shall justify each recommendation made under 1
paragraph (1) of this subsection based on how the recommendation contributes to the 2
provision of foundational public health services. 3

(4) (i) The Commission shall make a draft of its recommendations 4
available for public comment for 30 days. 5

(ii) The final report of the Commission shall include a response to 6
any substantive public comment received on the draft recommendations. 7

(5) (i) The Commission shall use best efforts to reach consensus on its 8
recommendations. 9

(ii) If the Commission cannot reach consensus on its 10
recommendations, the Commission shall include the opportunity for dissenting comments 11
in the Commission’s final report. 12

13–5107. 13

[(a)] On or bef ore [December 1, 2023 ] JANUARY 1 EACH YEAR, the Commission 14
shall submit [an interim ] A report ON THE IMPLEMENTATIO N OF ITS 15
RECOMMENDATIONS AND BARRIERS TO IMPLEMEN TATION to the Governor and, in 16
accordance with § 2–1257 of the State Government Article, the Senate Budget and Taxation 17
Committee, the Senate Finance Committee, the House Appropriations Committee, and the 18
House Health [and Government Operations] Committee. 19

[(b) On or before December 1, 2024, the Commission shall submit an interim 20
report of its findings and recommendations to the Governor and, in accordance with § 21
2–1257 of the State Government Article, the Senate Budget and Taxation Committee, the 22
Senate Finance Committee, the House Appropriations Committee, and the House Health 23
and Government Operations Committee. 24

(c) On or before October 1, 2025, the Commission shall submit a final report of its 25
findings and recommendations to the Governor and, in accordance with § 2 –1257 of the 26
State Government Article, the Senate Budget and Taxation Committee, the Senate Finance 27
Committee, the House Appropriations Committee, and the House Health and Government 28
Operations Committee.] 29

13–5602. 30

(a) There is a Population Health Improvement Fund. 31

(f) (1) Subject to [paragraph] PARAGRAPHS (2) AND (3) of this subsection, 32
the Fund may be used only for expenses associated with statewide population health 33
improvement initiatives in alignment with the statewide health equity plan a s directed by 34
the Secretary. 35
14 HOUSE BILL 1109

(2) Activities paid for by the Fund must support the goal of meeting the 1
statewide population health targets outlined in the AHEAD Model State Agreement with the 2
Center for Medicare and Medicaid Services and have at least one of the following functions: 3

(i) Reducing rates of common preventable health conditions; 4

(ii) Addressing health–related social needs; or 5

(iii) Reducing or eliminating health disparities. 6

(3) THE DEPARTMENT AND THE HEALTH SERVICES COST REVIEW 7
COMMISSION MAY , IN A MANNER CONSISTE NT WITH THE AHEAD MODEL STATE 8
AGREEMENT, TRANSFER MONEY FROM THE FUND TO THE PUBLIC HEALTH 9
WORKFORCE DEVELOPMENT FUND ESTABLISHED UNDE R § 24–2802 OF THIS 10
ARTICLE. 11

SUBTITLE 28. PUBLIC HEALTH WORKFORCE DEVELOPMENT FUND. 12

24–2801. 13

IN THIS SUBTITLE , “FUND” MEANS THE PUBLIC HEALTH WORKFORCE 14
DEVELOPMENT FUND. 15

24–2802. 16

(A) THERE IS A PUBLIC HEALTH WORKFORCE DEVELOPMENT FUND. 17

(B) THE PURPOSE OF THE FUND IS TO SUPPORT TH E EDUCATION AND 18
TRAINING OF THE PUBLIC HEALTH WORKFORCE. 19

(C) THE MARYLAND COMMUNITY HEALTH RESOURCES COMMISSION SHALL 20
ADMINISTER THE FUND. 21

(D) (1) THE FUND IS A SPECIAL , NONLAPSING FUND THAT IS NOT 22
SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 23

(2) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 24
AND THE COMPTROLLER SHALL ACCOUNT FOR THE FUND. 25

(E) THE FUND CONSISTS OF: 26

(1) MONEY APPROPRIATED IN THE STATE BUDGET TO THE FUND; 27

(2) INTEREST EARNINGS OF THE FUND; 28
HOUSE BILL 1109 15

(3) ANY MONEY TRANSFERRED FROM THE POPULATION HEALTH 1
IMPROVEMENT FUND UNDER § 13–5602 OF THIS ARTICLE; AND 2

(4) ANY OTHER MONEY FROM ANY OTHER SOURCE ACCEPTED FOR THE 3
BENEFIT OF THE FUND. 4

(F) THE FUND MAY BE USED ONLY TO SUPPORT THE EDUCA TION AND 5
TRAINING OF THE PUBLIC HEALTH WORKFORCE. 6

(G) (1) THE STATE TREASURER SHALL INVEST THE MONEY OF THE FUND 7
IN THE SAME MANNER AS OTHER STATE MONEY MAY BE INVESTED. 8

(2) ANY INTEREST EARNINGS OF THE FUND SHALL BE CREDITE D TO 9
THE FUND. 10

(H) EXPENDITURES FROM THE FUND MAY BE MADE ONLY IN ACCORDANCE 11
WITH THE STATE BUDGET. 12

Article – State Finance and Procurement 13

6–226. 14

(a) (2) (i) This paragraph does not apply in fiscal years 2024 through 2028. 15

(ii) Notwithstanding any other provision of law, and unless 16
inconsistent with a federal law, grant agreement, or other federal requirement or with the 17
terms of a gift or settlement agreement, net interest on all State money allocated by the State 18
Treasurer under this section to special funds or accounts, and otherwise entitled to receive 19
interest earnings, as accounted for by the Comptroller, shall accrue to the General Fund of 20
the State. 21

(iii) The provisions of subparagraph (ii) of this paragraph do not 22
apply to the following funds: 23

212. the Department of Social and Economic Mobility Special 24
Fund; [and] 25

213. the Population Health Improvement Fund; AND 26

214. THE PUBLIC HEALTH WORKFORCE DEVELOPMENT 27
FUND. 28

13–5602. 29

16 HOUSE BILL 1109

(a) There is a Population Health Improvement Fund. 1

(f) (1) Subject to [paragraph] PARAGRAPHS (2) AND (3) of this subsection, 2
the Fund may be used only for expenses associated with statewide population health 3
improvement initiatives in alignment with the statewide health equity plan as directed by 4
the Secretary. 5

(2) Activities paid for by the Fund must support the goal of meeting the 6
statewide population health targets outlined in the AHEAD Model State Agreement with 7
the Center for Medicare and Medicaid Services and have at least one of the following 8
functions: 9

(i) Reducing rates of common preventable health conditions; 10

(ii) Addressing health–related social needs; or 11

(iii) Reducing or eliminating health disparities. 12

(3) THE DEPARTMENT AND THE HEALTH SERVICES COST REVIEW 13
COMMISSION MAY TRANSF ER MONEY FROM THE FUND TO THE PUBLIC HEALTH 14
WORKFORCE DEVELOPMENT FUND ESTABLISHED UNDE R § 24–2802 OF THIS 15
ARTICLE. 16

SUBTITLE 28. PUBLIC HEALTH WORKFORCE DEVELOPMENT FUND. 17

24–2801. 18

IN THIS SUBTITLE , “FUND” MEANS THE PUBLIC HEALTH WORKFORCE 19
DEVELOPMENT FUND. 20

24–2802. 21

(A) THERE IS A PUBLIC HEALTH WORKFORCE DEVELOPMENT FUND. 22

(B) THE PURPOSE OF THE FUND IS TO SUPPORT TH E EDUCATION AND 23
TRAINING OF THE PUBLIC HEALTH WORKFORCE. 24

(C) THE MARYLAND COMMUNITY HEALTH RESOURCES COMMISSION 25
SHALL ADMINISTER THE FUND. 26

(D) (1) THE FUND IS A SPECIAL , NONLAPSING FUND THAT IS NOT 27
SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 28

HOUSE BILL 1109 17

(2) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 1
AND THE COMPTROLLER SHALL ACCOUNT FOR THE FUND. 2

(E) THE FUND CONSISTS OF: 3

(1) MONEY APPROPRIATED IN THE STATE BUDGET TO THE FUND; 4

(2) INTEREST EARNINGS OF THE FUND; 5

(3) ANY MONEY TRANSFERRED FROM THE POPULATION HEALTH 6
IMPROVEMENT FUND UNDER § 13–5602 OF THIS ARTICLE; AND 7

(4) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FO R 8
THE BENEFIT OF THE FUND. 9

(F) THE FUND MAY BE USED ONLY TO SUPPORT THE EDUCA TION AND 10
TRAINING OF THE PUBLIC HEALTH WORKFORCE. 11

(G) (1) THE STATE TREASURER SHALL INVEST THE MONEY OF THE FUND 12
IN THE SAME MANNER AS OTHER STATE MONEY MAY BE INVESTED. 13

(2) ANY INTEREST EARNINGS OF THE FUND SHALL BE CREDITED TO 14
THE FUND. 15

(H) EXPENDITURES FROM THE FUND MAY BE MADE ONLY IN ACCORDANCE 16
WITH THE STATE BUDGET. 17

Article – State Finance and Procurement 18

6–226. 19

(a) (2) (i) This paragraph does not apply in fiscal years 2024 through 2028. 20

(ii) Notwithstanding any other provision of law, and unless 21
inconsistent with a federal law, grant agreement, or other federal requirement or with the 22
terms of a gift or settlement agreement, net interest on all State mo ney allocated by the 23
State Treasurer under this section to special funds or accounts, and otherwise entitled to 24
receive interest earnings, as accounted for by the Comptroller, shall accrue to the General 25
Fund of the State. 26

(iii) The provisions of subpa ragraph (ii) of this paragraph do not 27
apply to the following funds: 28

18 HOUSE BILL 1109

212. the Department of Social and Economic Mobility Special 1
Fund; [and] 2

213. the Population Health Improvement Fund; AND 3

214. THE PUBLIC HEALTH WORKFORCE DEVELOPMENT 4
FUND. 5

Article – State Government 6

2–1505.3. 7

THE DEPARTMENT OF LEGISLATIVE SERVICES, IN CONSULTATION WITH THE 8
LEGISLATIVE POLICY COMMITTEE, SHALL DEVELOP A PROC ESS TO ASSESS THE 9
HEALTH EQUITY IMPACTS OF RELEVANT LEGISLATION. 10

21–203. 11

(a) (1) There is a Maryland Corps Program Advisory Board. 12

(2) The Advisory Board consists of the following members: 13

(i) a Board Chair, appointed by the Governor; 14

(ii) two members jointly appointed by the President of the Senate 15
and the Speaker of the House: 16

1. one of whom must represent a service organization in the 17
State; and 18

2. one of whom shall be: 19

A. a current participant in a public service program; or 20

B. a former participant in a public service program whose 21
participation ended during the preceding 3 years; 22

(iii) one member appointed by the President of the Senate; 23

(iv) one member appointed by the Speaker of the House; and 24

(v) [four] FIVE members appointed by the Governor[,]: 25

1. one of whom shall be a representative from th e Maryland 26
State Service Commission; AND 27
HOUSE BILL 1109 19

2. ONE OF WHOM SHALL BE A HEALTH OFFICER , AS 1
DEFINED IN § 1–101 OF THE HEALTH – GENERAL ARTICLE. 2

(b) In making appointments to the Advisory Board, the President, Speaker, and 3
Governor shall consider: 4

(1) the professional or personal experience of the individual in community 5
or other service, nonprofit management, civic engagement, or volunteerism; 6

(2) the cultural, geographic, racial, ethnic, and gender diversity of the 7
State; and 8

(3) an individual’s experience and knowledge in workforce development, 9
including regional workforce needs, training, career development programming, and 10
workforce investment boards. 11

Chapter 385 of the Acts of 2023, as amended by Chapter 787 of the Acts of 2024 12

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 13
1, 2023. It shall remain effective for a period of [3] 5 years and 1 month and, at the end of 14
June 30, [2026] 2028, this Act, with no further action required by the General Assembly, 15
shall be abrogated and of no further force and effect. 16

SECTION 2. AND BE IT FURTHER ENACTED, That it is the intent of the General 17
Assembly that the Maryland Medical Reserve Corps required to be organized under § 18
2–1102 of the Health – General Article, as enacte d by Section 1 of this Act, replace the 19
Maryland Responds Health Reserve Corps. 20

SECTION 3. AND BE IT FURTHER ENACTED, That: 21

(a) (1) The Commission on Public Health, in consultation with the Maryland 22
Department of Health and the Health Services Cost Review Commission, shall establish a 23
community benefits modernization subcommittee. 24

(2) The subcommittee may include members and nonmembers of the 25
Commission. 26

(3) To the extent practicable, the membership of the subcommittee shall 27
reflect the racial, ethnic, and gender diversity of the State. 28

(b) The subcommittee shall: 29

(1) review federal and State requirements governing hospital community 30
benefit activities, including community health needs assessments and implementation 31
strategies, definitions of allowable activities, and reporting requirements; 32
20 HOUSE BILL 1109

(2) analyze a landscape assessment of other states’ community benefit 1
spending requirements and policies, including those related to the development of the 2
community health needs assessment and how implementation plans are operationalized; 3

(3) evaluate the scope and impact of community benefit activities 4
conducted by hospitals in the State, including the processes for local community health 5
needs assessment, implementation plan development and deployme nt, and trends in 6
spending per allowable category; 7

(4) identify gaps that exist between community benefit investment and 8
State and local health priority areas; and 9

(5) develop recommendations to: 10

(i) modernize the State’s community benefit spend ing standards, 11
policies, and reporting requirements while focusing on how to maximize community benefit 12
investment to meet State health improvement priorities; and 13

(ii) ensure alignment of community benefit with State health 14
improvement priorities, including statutory or regulatory changes, funding, and reporting 15
requirements to modernize the community benefits in the State. 16

(c) The Chair of the Commission on Public Health shall provide staffing for the 17
subcommittee. 18

(d) (1) On or before August 1, 2027, the subcommittee shall submit a report of 19
its findings and recommendations to the Commission on Public Health. 20

(2) On or before September 1, 2027, the Commission on Public Health shall 21
submit a report of the subcommittee’s findings and recommendations to the Governor and, 22
in accordance with § 2 –1257 of the State Government Article, the Senate Budget and 23
Taxation Committee, the Senate Finance Committee, the House Appropriations 24
Committee, and the House Health Committee. 25

SECTION 4. 3. AND BE IT FURTHER ENACTED, That the Maryland Department 26
of Health shall convene a workgroup with representatives from the Department of Budget 27
and Management and up to five representatives of local health officers to review local 28
health department recruiting and cla ssification processes and identify potential methods 29
for increasing efficiencies related to the processes. 30

SECTION 3. 5. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 31
July 1, 2026. Section 3 of this Act shall remain effective for a period of 1 year and 6 months 32
and, at the end of June 30 December 31, 2027, Section 3 of this Act, with no further action 33
required by the General Assembly, shall be abrogated and of no further force and effect. 34