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Advocacy Update February 10, 2018
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LeadingAge Maryland


Join Us for Regular Legislative Update Calls During the 2018 Session

Friday mornings at 11:00AM. Dial 310-372-7549, pass code 505134

February 16, 2018

March 2, 2018

March 10, 2018

March 16, 2018

March 30, 2018

April 13, 2018


Be Sure to Attend the LeadingAge Maryland Legislative Dinner March 22

For the past several years, LeadingAge Maryland has hosted very successful informational dinners with leaders of our nonprofit organizations and members of the Maryland Senate Finance Committee and the House Health and Government Operations Committee. This year the dinner will be held on March 22 at the Chart House in Annapolis. It is a great opportunity to build relationships that matter. If you missed it last year, you will want to be sure to attend in 2018.


Mark Your Calendars for Hill Visits March 21, 2018

Once again, in conjunction with the LeadingAge PEAK conference, LeadingAge Maryland will be conducting visits to Maryland members of Congress. Please plan to join us.

Maryland Legislative Update


The $44 billion budget has no new taxes, does not cut services or raid special funds. The budget leaves nearly $1 billion in reserves and continues to fully fund K-12 education. The budget includes more than $11.5 billion for Maryland’s Medicaid program, which currently provides health coverage to nearly 1.4 million Marylanders. An additional $17.6 million is included to bring physician rates under Medicaid up to 93 percent of Medicare rates.


Provision of Services- Related Bills


SB 325, Serafini, Nursing Homes – Provision of Beds with Bed Rails

Requires that each nursing home notify a resident, or the resident’s representative, on admission of the resident of the availability of beds with bed rails to provide a resident, per federal law, a bed with bed rails on request of the resident of their representative. Sponsor made clear that he recognizes that this can’t be accomplished on the State level.


HB 375, J. Lewis, CCRC – Continuing Care Agreements – Actuarial Studies

This bill makes changes to the law applicable to CCRCs. It distinguishes among 3 types of continuing are agreements: Extensive Agreement; Modified Agreement; Fee for service agreement

The contents of the renewal CCRC application are modified regarding submission of an actuarial study. Providers with extensive or modified agreements must submit an actuarial study every 3 years and providers with fee for service must do so every 5 years.

LeadingAge Maryland testified in opposition to this bill.


SB 425/HB 344, Bates and Jones, Continuing Care Agreements - Termination - Notice and Contractual Entrance Fee Refunds

Repealing the requirement that continuing care agreements contain the provision that payment of a contractual entrance fee refund after occupancy is conditioned on the reoccupancy or recontracting of the subscriber’s unit and that the provider agreed to make reasonable efforts to satisfy the condition. The bill also allows a subscriber to terminate the agreement by written termination notice to the provider at least 30 days before the effective date of termination. Lastly, if the subscriber terminates based upon death or election, the provider shall pay any contractual entrance fee refund within 30 days after the subscriber’s death or the effective date of termination. LeadingAge Maryland testified in opposition to this bill.


House Bill 482, Angel, Public Health – Assisted Living Programs – Educational Materials on Influenza Virus

On or before September 1 each year, each assisted living program shall provide its residents with educational material on the influenza virus. The educational material provided under this section must include: the most recent influenza virus vaccination recommendations made by the federal advisory committee on immunization practices and published in the morbidity and mortality weekly report by the federal centers for disease control and prevention; the availability, effectiveness, and known contraindications of immunization against the influenza virus; the causes and symptoms of the influenza virus; and the means by which the influenza virus is spread.


SB 386, Mathias, Maryland Nursing Home Resident Protection Act of 2018

SB 386 requires the Department of Health:

  • Shall investigate a complaint against a nursing home within 10 days after receiving the complaint.
  • If the department receives a complaint against a nursing home alleging immediate jeopardy to a resident, the department shall make every effort to investigate the complaint within 24 hours after receiving the complaint and investigate the complaint not later than 48 hours after receiving the complaint.
  • The department shall develop a clear and easy–to–understand graphic data dashboard that includes:


From the hearing: This bill was introduced to require OHCQ to address complaints in a more efficient and complete manner. Support for the bill focused on need for quality care and supporting OHCQ’s budget to hire more surveyors, empower OHCQ to do its job. Per OHCQ’s budget hearing, the analyst made mention that last year was the worst year for survey completion and time it took to address complaints. Opposition focused on the Dashboard and how it will paint the industry unfairly, the majority of complaints (70%) are deemed unsubstantiated, there is a due process issue for nursing homes if residents can simply self-report and this is misleading. In the fiscal note, OHCQ makes clear that if this bill passes, it could be unable to meet its state and federal requirements. The Chairman connected this issue to the delay in payment for Medicaid eligibility and how the lack of cash flow means nursing homes are unable to hire and address quality issues and concerns that could be raised. In the OHCQ budget hearing, it intends to hire more surveyors – 9 per year over a 7 year period. Chairman suggested that the Finance Committee could write a letter to Budget & Tax Committee supporting OHCQ’s budget.


SB 409, Robinson, Task Force to Study the Residential Environment of Seniors in Baltimore City

Establishing the Task Force to Study the Residential Environment of Seniors in Baltimore City; providing for the composition, chair, and staffing of the Task Force; requiring the Task Force to study issues and make recommendations related to the improvement of the residential environment of seniors living in Baltimore City; requiring the Task Force to make a report on or before December 1, 2018


HB687, Haynes, Senior Apartment Housing Facilities - Baltimore City - Security Guard Services

This bill requires a property management company of a “senior apartment housing facility” in Baltimore City to contract with a licensed security guard agency to provide security services at the facility at all times when the property management company is not open for conducting business at the facility. This bill was introduced last session and was defeated.


HB 1299, Lam, Nursing Facilities - Discharge Plans - Review and Signature Requirement

Requiring that a certain social worker, nurse, nurse practitioner, physician's assistant, or physician review and sign a certain discharge plan for a resident of a nursing facility before the nursing facility discharges the resident. Bill not posted as of 2/9


SB 4, Senator Nathan Pulliam, Department of Aging - Study of Nursing Home Care - OHCQ

Requiring the Department of Aging to study the quality of care in nursing homes and requiring the Department of Aging to study the quality of care in nursing homes and to review, assess, and examine the number of complaints regarding patient care, certain matters related to the quality of care in nursing homes, the results of scheduled and unscheduled nursing home inspections by OHCQ, the number and level of compensation of inspectors with OHCQ. Department to report its findings and recommendations to the Governor and the General Assembly on or before December 1, 2018. The Senator is a nurse and according to her office, hears from constituents and has seen problems with patients in nursing homes that she believes should never happen.


HB 257, Krimm, Department of Aging - Contract Review

For each contract that the Department of Aging has required a local county agency or office of

aging to enter into as a prerequisite for the area agency to receive funding, the Secretary of Aging shall:(1) conduct a review of the contract which includes: (i) a determination of whether the vendor is fulfilling its obligations under the contract; (ii) an identification of vendor costs under the contract and an assessment of whether another vendor could perform the same scope at a lesser cost; and (iii) a survey of whether the area agencies have any suggested changes to the vendor scope or obligations under the contract; and (2) make recommendations regarding: (i) the review conducted under paragraph (1) of this subsection; and (ii) whether issuing an invitation for bids or request for proposals for a new contract is in the best interests of the State.


SB 13/HB 115, Rosapepe, Morhaim, Electronic Prescription Records Cost Saving Act of 2018

Requiring a dispenser of a prescription drug to submit prescription information to the State-designated health information exchange; requiring prescription information to be submitted electronically; prohibiting the State health information exchange from imposing any fees or assessments; requiring the State health information exchange to make prescription information available to a health care provider for purposes of treatment and care coordination of a patient


SB174/ HB 134, Middleton and A. Kelly, Health Insurance - Health Benefit Plan Premium Rate Review Process

When determining to modify or disapprove a premium rate filing, the Maryland Insurance Commission under the bill must consider the carrier’s specific experience with high-risk members and the impact of a rate filing to improve health outcomes and lower claim costs.


HB407/SB 232, Cullison- Feldman,Public Health - General Hospice Care Programs - Collection and Disposal of Unused Prescription Medication

Requiring a general hospice care program to establish a written unused prescription medication collection and disposal policy that includes certain provisions; requiring an employee of a general hospice care program to immediately collect and dispose of a certain patient's unused prescription medication


    SB 259/HB 626, Middleton and Cullison, Maryland Medical Assistance Program - Medication Adherence Technology Pilot Program

    This bill establishes a pilot program in the Department of Health and Mental Hygiene (DHMH) to expand the use of medication adherence technology to increase prescription drug adherence of Medicaid recipients who are diagnosed as having a severe and persistent mental illness. By September 1, 2021, DHMH must report on the pilot program to the Governor and specified committees of the General Assembly.


    HB 660, Reznik, Public Health - State-Provided Health Care Benefits for State Residents (HealthcareMaryland)

    Establishing the Office of Health Care Coverage in the Maryland Department of Health to establish and carry out the HealthcareMaryland Program to provide benefits to State residents who do not receive federal benefits through Medicare, TRICARE, plans that are subject to ERISA, or any other federal medical program; requiring the Office to contract with a certain number of managed care organizations; requiring certain employers to pay to the Secretary of Labor, Licensing, and Regulation a certain annual payroll tax. This bill creates a State-based single payer healthcare policy in Maryland.

    SB 994/HB1541, Peters/Ebersole, Disclosure of Tax Benefits - Nonprofit Hospitals

    Each year nonprofit hospitals as defined in Section 19-301 of the Health General Article shall submit to the Comptroller an itemized list of the tax benefits the hospital received during the previous taxable year. The Comptroller must review each itemized list, prepare a report summarizing the aggregate value of the tax benefits received by each nonprofit hospital and post the report on the Comptroller’s website. The Comptroller, in consultation with the employee group designated as the exclusive representative for nonprofit hospital employees (SEIU), shall adopt regulations necessary to carry this out including regulations that establish formatting standards for the itemized list and the date each year by which a nonprofit hospital must submit the itemized list required under this section.




    HB 98/SB 135, Speaker & Senate President (Governor’s Paid Sick Leave), Paid Leave Compromise Act of 2018

    The General Assembly has overridden the Governor’s veto on the legislature’s paid sick leave for 15 employees. The Governor’s bill would require businesses with at least 25 employees to offer paid sick leave, phasing in the rule over three years by applying it to companies of different sizes during that span. Businesses could also get a waiver if they prove that providing sick leave would cause a significant financial hardship. The Governor said he will propose legislation to create tax credits for businesses with fewer than 50 employees that provide paid leave benefits (HB 99/SB 134). A bill to postpone implementation in order to wait for Department of Labor guidance has passed the Senate, but not the House.


    HB 99/SB 134 Speaker/Senate President (Governor’s bill) Small Business Relief Tax Credit

    Authorizing a tax credit against the State income tax for certain small businesses that provide certain employer benefits to qualified employees who earn equal to or less than 200% of the annual federal poverty guidelines for a single person, earns paid time off and receives transportation benefits, an educational assistance program or employer contributions to a health savings account. The bill provides for the calculation of the credit.


    SB 163/HB 490, Nathan-Pulliam and Lam, Public Health – Community Health Workers – Advisory Committee and Certification

    Establishing the State Community Health Worker Advisory Committee; requiring the Advisory Committee to advise the Maryland Department of Health on certain matters relating to the certification and training of community health workers; requiring the Department to adopt certain regulations for accrediting community health worker training programs; requiring the Department to adopt regulations relating to the certification of community health workers


    SB 235, Robinson,Labor and Employment - Minimum Wage - Indexing

    Beginning July 1, 2019 and every July 1 thereafter, the State Minimum Wage, from the Commissioner of Labor, will be increased and rounded to the nearest cent equal to the average percentage growth in the Consumer Price Index (CPI) for the immediate preceding 12 month period. If there was a decline in the CPI, the wage remains the same.


    SB 368, McFadden, Labor and Employment – State Minimum Wage Rate – Increase

    This bill specifies the State minimum wage rate in effect for certain periods based on small employer size and increases the State minimum wage based on the annual growth of the CPI.


    SB 377/HB512, Lee/K. Young, Labor and Employment – Pay Scale and Wage History Information

    An employer shall provide the pay scale for a position to an applicant for employment on request. An employer may not:

    • rely on the wage history of an applicant for employment in screening or considering the applicant for employment or in determining the wages for the applicant
    • rely on the wage history of an employee in considering the employee for a new position with the employer, including promotion, or in determining the wages for the employee; or
    • seek the wage history information: for an applicant for employment orally, in writing, or through an employee or an agent or from a current or former employee or for any employee from a former employer.
    • an employer may rely on wage history if the employer makes an offer of employment, with an offer of compensation, to the applicant and the applicant thereafter voluntarily provides the applicant’s wage history to support a wage higher than the wage offered by the employer, the employer makes an offer of a new position, with an offer of compensation, to an employee, and the employee thereafter voluntarily provides the employee’s wage history to support a wage higher than the wage offered by the employer or the employer is using the employee’s wage history with the employer to support paying a higher wage to the employee than the employer would otherwise pay the employee for the position an applicant
    • If an employer knew or reasonable should have known that the employer’s actions violates these provisions, an affected applicant for employment may bring an action against the employer for injunctive relief and to recover actual damages, an additional equal amount as liquidated damages, and special damages not to exceed $10,000
    • An employer may not refuse to interview, hire or promote or employ or retaliate against an applicant for employment who did not provide wage history.
    • If the Labor Commissioner determines that an employer violated these provisions, the Commissioner shall issue an order compelling compliance and may assess a civil penalty up to $1,000 for each applicant or up to $5,000 for each applicant if the violation occurred within 3 years after an applicant filed a previous complaint that led to a determination that the violation occurred. The bill provides factors for the Commissioner to consider in determining a penalty.


    HB 540, Korman,Labor and Employment - Pre-Tax Transportation Fringe Benefit - Requirement (Maryland Pre-Tax Commuter Benefit Act)

    Employers, other than those who employ fewer than 20 employees, must offer employees who work more than 30 hours per week, a “pre–tax transportation fringe benefit” consistent with the provisions and limits of § 132(f)(1)(a), (b), and (d) of the Internal Revenue Code at the maximum benefit levels allowable under federal law. If an employer violates this provision, an employee may submit to the Commissioner of Labor a written complaint. Whenever the commissioner determines that this section has been violated, the Commissioner may try to resolve any issue involved in the violation informally by mediation or ask the attorney general to bring an action on behalf of the employee. The attorney general may bring an action where the violation allegedly occurred, for injunctive relief, damages, or other relief. 21 An employer that violates this section is subject to a civil penalty not exceeding $500.


    SB 543/HB 664, Madaleno/Hettleman, Labor and Employment - Payment of the Minimum Wage Required

    Specifying the State minimum wage rate that is in effect for certain time periods; increasing, except under certain circumstances, the State minimum wage rate based on the annual growth in the Consumer Price Index for All Urban Consumers for the Washington-Baltimore metropolitan area; specifying the tip credit amount that is in effect for certain time periods; prohibiting an employer, beginning July 1, 2026, from including the tip credit amount as part of the wage of certain employees.


    HB 779, Wivell, Maryland Healthy Working Families Act - Exemption - Facility With On-Site Health Clinic

    Exempting from certain provisions of law concerning earned sick and safe leave certain employees who regularly work at facilities at which the employers offer the employees access to on-site health clinics that have operating costs of at least $1,000,000 per year. Bill not posted.



    Consumer Interest


    SB 75, Senator Klausmeier, Income Tax - Credit for Long-Term Care Premiums

    This bill alters the existing one-time long-term care insurance premiums income tax credit by allowing the credit to be claimed for every year a policy is in force. In tax years 2019 and 2020, individuals can claim a maximum credit of $250 for each year the policy is in effect; the maximum credit that can be claimed is increased to $500 beginning in tax year 2021. The changes in the credit are applicable only to policies issued after December 31, 2018. The bill takes effect July 1, 2018.


    SB 206, Manno, Long-Term Care Insurance - Premium Rates and Benefits

    Prohibiting the Maryland Department of Health from considering certain benefits and distributions for purposes of determining allowable yearly income under the Maryland Medical Assistance Program; prohibiting a certain carrier from increasing a certain premium under a policy or contract of long-term care insurance from June 1, 2018, to December 31, 2019, both inclusive; authorizing a certain carrier to increase a certain premium beginning January 1, 2020, only if certain conditions are met


    HB 945, Kramer, Long–Term Care Insurance – Premium Rate Increases – Restriction

    (Equity in Long–Term Care Insurance Premiums Act)

    This bill prohibits an insurance carrier from imposing a premium rate increase for a policy or long term care insurance in a year in which the carrier or any entity with which the carrier is affiliated pays a dividend or comparable payment to its shareholders or a bonus or benefit to any executive officers of the carrier or any entity with which the carrier is affiliated to the fixed compensation provided to the Executive Officers for services provided by those officers.


    HB 946, Kramer, Long–Term Care Insurance – Nonforfeiture Benefits

    A carrier must provide to an insured under a policy or contract of long–term care insurance a nonforfeiture benefit if the insured has maintained the policy or contract of long–term care insurance through the carrier for at least 10 years, the insured has paid in full all premiums for the policy or contract of long–term care insurance and the policy or contract of long–term care insurance is terminated by the insured within 12 months after receiving notice of an increase of the insured’s premium under the policy or contract of long–term care insurance. The nonforfeiture benefit must be equivalent to at least the accumulated value of all premiums paid by the insured under the policy or contract of long–term care insurance and adjusted for inflation based on the consumer price index for the washington–baltimore metropolitan area


    HB 983, Kramer, Long-Term Care Insurance - Limitation on Renewal Premium Rate Increases

    In the years 2019 through 2021, a carrier may not impose an annual increase of a renewal premium rate that exceeds 5% for a policy or contract of long–term care insurance issued, delivered, or renewed in the state on or after January 1, 2019.


    SB 1011/HB 1167, Feldman/JPM,Protect Maryland Health Care Act of 2018

    Establishing the Maryland Insurance Stabilization Fund and the Health Insurance Down Payment Escrow Fund; specifying the purposes of the funds; requiring, beginning on a certain date, an individual to maintain certain coverage for certain individuals; requiring that an individual pay a certain payment under certain circumstances; requiring the Exchange to take certain steps to facilitate the enrollment of certain individuals into certain coverage under certain circumstances;


    SB 878/HB 1317, Feldman/Kelly, Health Insurance – Medicaid Buy–In Task Force

    The purpose of the Task Force is to make recommendations regarding the feasibility of a Medicaid buy–in program to expand the health care coverage choices available to individuals purchasing coverage. The bill sets forth the composition of the task force and what is to be reported and studied


    HB 58 Delegate Ben Brooks,Income Tax - Subtraction Modification - Retirement Income

    Including income from certain retirement plans within a subtraction modification allowed under the Maryland income tax for retired individuals who are at least 65 years old or who are disabled or whose spouse is disabled


    SB 11, Senator Ron Young,Income Tax - Subtraction Modification - Retirement Income

    Including income from certain retirement plans within a certain subtraction modification allowed under the Maryland income tax for; altering the calculation of the subtraction modification; increasing the maximum amount of the subtraction modification allowed for certain taxable years; and prohibiting an individual from qualifying for the subtraction if the total income from all qualified plans for the taxable year exceeds $100,000.


    SB 427, Bates, Property Tax Credit - Elderly Individuals and Veterans – Eligibility

    This bill alters one of the eligibility criteria for a local option property tax credit for elderly individuals by removing the requirement that the individual must have lived in the same dwelling for at least the preceding 40 years. In lieu of this existing requirement, the bill provides that the individual must have lived in the county for the preceding 25 years and the dwelling for which the tax credit is claimed must be located in that county. The bill takes effect June 1, 2018, and applies to taxable years beginning after June 30, 2018.


    HB 802, Fisher, Retire Act of 2018

    This bill expands the existing State income tax pension exclusion subtraction modification by allowing income from the following plans or sources to be included within the subtraction modification: (1) individual retirement accounts and annuities under Section 408 of the Internal Revenue Code (IRC); (2) Roth individual retirement accounts under Section 408(a) of the IRC; (3) simplified employee pensions under Section 408(k) of the IRC; (4) ineligible deferred compensation plans under Section 457(f) of the IRC; and (5) certain unearned income as defined by the bill. The bill also removes certain limitations on the maximum amount of the pension exclusion that may be claimed.


    HB 1377, Morgan, Income Tax - Subtraction Modification - Income From Retirement Plans

    Providing a subtraction modification under the Maryland income tax under certain circumstances for certain retirement income of an individual who is at least 65 years old or totally disabled or whose spouse is totally disabled; providing for the calculation of the subtraction modification; requiring the Comptroller, for purposes of the calculation, to determine a certain maximum benefit; applying the Act to taxable years beginning after December 31, 2017


    HB 1645, Gilchrist, Income Tax - Subtraction Modification - Retirement Income

    Altering the calculation of the maximum subtraction modification allowed under the Maryland income tax for certain retirement income for certain taxable years; repealing a certain obsolete provision relating to a rollover IRA retirement plan; including income from an individual retirement account or a certain annuity within a certain subtraction modification for certain retirement income under certain circumstances

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