Bill Summary – FastDemocracy

SB 67
                      Department of Legislative Services
                              Maryland General Assembly
                                    2021 Session
                           FISCAL AND POLICY NOTE
                                Enrolled - Revised
Senate Bill 67                (Chair, Education, Health, and Environmental Affairs
                              Committee, et al.) (By Request - Departmental -
                              Maryland Institute for Emergency Medical Services
                              Systems)
Education, Health, and Environmental Affairs        Health and Government Operations
      Emergency Medical Services – Paramedics – Vaccination Administration
This emergency departmental bill authorizes a paramedic to administer influenza and
hepatitis B immunizations and tuberculin skin testing to ambulance service personnel
within the jurisdiction of the paramedic. A written agreement authorizing these services
may be between an ambulance service medical director and the local health department
(LHD) in which the services are performed. Services may be provided under the direction
of the paramedic’s ambulance service medical director. The bill also authorizes a
paramedic to administer influenza and COVID-19 immunizations as part of a population
health outreach effort conducted by the appropriate LHD or a hospital or health system in
the State. Authorization to administer influenza and COVID-19 immunizations as
part of a population health outreach effort terminates January 1, 2023.
                                    Fiscal Summary
State Effect: The bill does not substantively change State activities or finances.
Local Effect: The bill does not substantively change local activities or finances.
Small Business Effect: The Maryland Institute for Emergency Medical Services Systems
(MIEMSS) has determined that this bill has minimal or no impact on small business
(attached). The Department of Legislative Services concurs with this assessment. (The
attached assessment does not reflect amendments to the bill.)
                                         Analysis
Bill Summary: Influenza and COVID-19 immunizations must be (1) provided under the
direction of the emergency medical services (EMS) operational program medical director,
ambulance service medical director, or other qualified physician and authorized by
MIEMSS and (2) provided in accordance with a written agreement between the
paramedic’s EMS operational program or ambulance service and the LHD or a hospital or
health system. A written agreement must include provisions for (1) the administration of a
vaccine to an individual at least 18 years of age; (2) storage and inventory of medication;
(3) distribution of appropriate vaccine information statements; (4) documentation of patient
consent; (5) recognition of adverse effects; (6) referral and follow-up; and (7) appropriate
documentation of vaccine administration.
Current Law: Subject to the rules, regulations, protocols, orders, and standards of the
EMS Board, a paramedic may administer influenza and hepatitis B immunizations and
tuberculosis skin testing, in a nonemergency environment, to public safety personnel within
the jurisdiction of the paramedic. These services must be (1) authorized by a written
agreement between the provider’s jurisdictional EMS operational program medical
director and the LHD; (2) under the direction of the jurisdictional EMS operational
program medical director; and (3) approved by MIEMSS.
Background: The bill is intended to permit paramedics to assist LHDs and hospitals and
health systems in vaccination initiatives targeted to address population health needs
(including assisting with COVID-19 vaccination efforts), as well as to permit both public
safety and ambulance service paramedics to administer vaccines and tuberculin skin testing
to their own personnel through occupational health programs.
                                Additional Information
Prior Introductions: None.
Designated Cross File:      HB 1313 (Delegate Mangione) - Health and Government
Operations.
Information Source(s): Maryland Association of County Health Officers; Maryland
Institute for Emergency Medical Services Systems; Maryland Department of Health;
Department of Legislative Services
SB 67/ Page 2
Fiscal Note History:    First Reader - January 12, 2021
an/ljm                  Third Reader - February 3, 2021
                               Revised - Amendment(s) - February 3, 2021
                        Enrolled - April 30, 2021
                               Revised - Amendment(s) - April 30, 2021
Analysis by: Jennifer B. Chasse                   Direct Inquiries to:
                                                  (410) 946-5510
                                                  (301) 970-5510
SB 67/ Page 3
      ANALYSIS OF ECONOMIC IMPACT ON SMALL BUSINESSES
TITLE OF BILL:       Emergency Medical          Services   –   Paramedics   –   Vaccination
                     Administration
BILL NUMBER:         SB 67
PREPARED BY:         Patricia Gainer, JD, MPA, Deputy Director, MIEMSS
PART A. ECONOMIC IMPACT RATING
This agency estimates that the proposed bill:
       XXX      WILL HAVE MINIMAL OR NO ECONOMIC IMPACT ON MARYLAND SMALL
                BUSINESS
                             OR
                WILL HAVE MEANINGFUL ECONOMIC IMPACT ON MARYLAND SMALL
                BUSINESSES
PART B. ECONOMIC IMPACT ANALYSIS
No known economic impact.
SB 67/ Page 4
Statutes affected: 
Text - First - Emergency Medical Services – Paramedics – Vaccination Administration: 13-516 Education
Text - Third - Emergency Medical Services – Paramedics – Vaccination Administration: 13-516 Education
Text - Enrolled - Emergency Medical Services – Paramedics – Vaccination Administration: 2-019C [], 13-516 Education, 13-516 Education, 2-021 Education