Maryland health

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Requiring the Governor to include $100,000 in the annual budget beginning in fiscal year 2021 for the Maryland Prenatal and Infant Care Coordination Services Grant Program Fund; establishing the Task Force on Maryland Maternal and Child Health; requiring the Task Force to study and make recommendations, including programs that the Maryland Medical Assistance Program should implement; requiring the Task Force to report its findings and recommendations to the General Assembly on or before November 1, 2019; etc.

Nuclear share is nuclear generation divided by all in-state generation. Nuclear development or other in-state generation resources concern this mix; procurement targets and authorizations are distinct from an operating plant or measured output. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Nuclear share of in-state electricity generation. This record’s connection to the topic does not establish an effect on the measured result.

Requiring that an application for a certificate of public convenience and necessity for certain generating stations located within a certain at-risk area to include with the application a baseline understanding of risk, disparities, and environmental needs (BURDEN) report describing and including information on certain environmental and public health burdens; altering the contents of a certain notice that must be provided on receipt of an application for a certificate of public convenience and necessity; etc.

Firearm mortality includes suicide, homicide, and other intents. The provision concerns firearm access, safety, or prevention of firearm injury and may address only part of the death count. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

Imposing an excise tax on certain gross receipts of certain firearms dealers derived from the sales of firearms, firearm accessories, and ammunition in the State and sales of firearms to residents of the State; requiring the Comptroller to distribute a portion of the tax revenues to the Maryland Violence Intervention Program, the Center for Firearm Violence Prevention, the Coordinated Community Supports Partnership, the Survivors of Homicide Victims Program, the Trauma Physician Services Fund, and the Cowley Shock Trauma Center; etc.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Establishing the Task Force to Study Forced Infant Separation From Incarcerated Individuals to study and make recommendations regarding methods to reduce forced infant separation in the State and facilitate bonds between postpartum incarcerated individuals and their children; and requiring the Task Force to report its findings and recommendations to the General Assembly on or before December 1, 2027.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Establishing the Task Force to Study Forced Infant Separation From Incarcerated Individuals to study and make recommendations regarding methods to reduce forced infant separation in the State and facilitate bonds between postpartum incarcerated individuals and their children; and requiring the Task Force to report its findings and recommendations to the General Assembly on or before December 1, 2025.

The relationship concerns proposed violence-prevention funding. The tax proposal did not become law and does not establish fewer firearm deaths. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

HB 387 Department of Legislative Services Maryland General Assembly 2025 Session FISCAL AND POLICY NOTE First Reader House Bill 387 (Delegate Mireku - North, et al. ) Ways and Means Comprehensive Community Safety Funding Act This bill establishes an 11% firearm excise tax on the gross receipts of a federally licensed firearms dealer derived from (1) the retail sale of firearms in the State and (2) the retail sale of firearms to State residents from a federally licensed firearms dealer that is located outside the State. The bill requires specified distributions of the revenue from the excise tax. The bill also provides for the filing of specified tax returns and for the administration of the tax by the Comptroller. The bill takes effect July 1, 2027. Fiscal Summary State Effect: Special fund revenues increase by $15.0 million in FY 2028 and by $16.2 million in FY 2030. Special fund expenditures for administrative costs increase by $2.2 million in FY 2028 and by $0.6 million in FY 2030. Future year expenditures reflect annualization and inflation. ($ in millions) FY 2026 FY 2027 FY 2028 FY 2029 FY 2030 SF Revenue $0 $0 $15.0 $15.6 $16.2 SF Expenditure $0 $0 $2.2 $0.6 $0.6 Net Effect $0.0 $0.0 $12.8 $14.9 $15.5 Note: () = decrease; GF = general funds; FF = federal funds; SF = special funds; - = indeterminate increase; (-) = indeterminate decrease Local Effect: None. Small Business Effect: Potential meaningful. Small businesses that sell firearms will be subject to the new excise tax. However, some portion of the cost of the new tax may be passed on to the consumers through increased prices. HB 387/ Page 2 Analysis Bill Summary: The bill establishes an 11% firearm excise tax on the gross receipts of the sale of firearms in the State by a federally licensed firearms dealer located both within the State and outside the State. The bill specifies the distribution of revenue from the excise tax, administration of the excise tax by the Comptroller, filing of excise tax returns by licensed dealers, and the paying of excise taxes by licensed dealers. The excise tax does not apply to the sale of a firearm to (1) a law enforcement agency; (2) the armed forces of the United States; (3) the National Guard; (4) a law enforcement officer; (5) a retired law enforcement officer; or (6) an individual for the exclusive purpose of competition shooting or match shooting. The excise tax applies to (1) a retail sale made on or after July 1, 2027, by a federally licensed firearms dealer that is a large retailer and (2) a retail sale made by any other federally licensed firearms dealer on or after July 1, 2028. For a federally licensed firearms dealer that is located outside the State, the excise tax only applies if the federally licensed firearms dealer, during the previous calendar year or the current calendar year (1) derives gross revenue from the sale of firearms to residents of the State that exceeds $100,000 or (2) sells firearms to residents of the State for delivery into the State in 200 or more separate transactions. Distribution of the Firearm Excise Tax Revenue Revenue from the firearm excise tax must be distributed equally to the following:  the Coordinated Community Supports Partnership Fund;  the Maryland Trauma Physician Services Fund;  the R Adams Cowley Shock Trauma Center at the University of Maryland Medical System;  the Maryland Violence Intervention and Prevention Program Fund;  the Survivors of Homicide Victims Grant Program within the G overnor’s Office of Crime Prevention and Policy; and  the Center for Firearm Violence Prevention and Intervention within the Maryland Department of Health. The bill specifies that it is the intent of the General Assembly that the excise tax revenue supplement, and not supplant, any other funding for these funds required by law. HB 387/ Page 3 Firearm Excise Tax Returns A federally licensed firearms dealer must complete, under oath, and file an excise tax return with the Comptroller (1) on or before the 25th day of the month that follows the month in which the person sells any firearms within the boundaries of the State or to residents of the State and (2) if specified by the Comptroller, by regulation, on other dates for each month in which the licensee does not sell any firearms in the State or to residents of the State. A person required to file an excise tax return must file with the return an attachment that states any information required by the Comptroller to determine the gross receipts derived from the sales of firearms in the State or to residents of the State. A person required to file an excise tax return must maintain records of the firearms sold in the State or to residents of the State and the basis for the calculation of the excise tax owed. Payment of Firearm Excise Taxes Each person required to file an excise tax return must pay the firearm excise tax in the manner required by the Comptroller, with the return that covers the period in which the person sold firearms in the State or to residents of the State. If a corporation, other than a nonstock, nonprofit corporation, is required to pay the excise tax, personal liability for the tax and interest and penalties on the tax extends to any officer of the corporation who exercises direct control over its fiscal management. If a limited liability company, or limited liability partnership, including a limited partnership registered as a limited liability limited partnership, is required to pay the excise tax, personal liability for the tax and interest and penalties on the tax extends to any person who exercises direct control over the fiscal management of the limited liability company or limited liability partnership. The Comptroller may require a person subject to the firearms excise tax to post security for the excise tax in the amount that the Comptroller determines. A person who willfully fails to file a required firearm excise tax return is guilty of a misdemeanor and, on conviction, is subject to a fine of up to $5,000 or imprisonment of up to five years or both. Definitions A federally licensed firearms dealer is a person licensed by the federal Bureau of Alcohol, Tobacco, Firearms and Explosives to deal in firearms. Gross receipts are defined as the total amount of the sale or lease or rental price of the retail sale by a person, valued in money, whether received in money or otherwise, without any deduction for (1) the cost of the property sold; (2) the cost of the materials used, labor or

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Requiring the Division of Correction to allow a certain pregnant woman and a certain woman who recently gave birth to transfer to the prerelease unit for women for 1 year following the birth; establishing the Healthy Start Bonding Program to facilitate strong bonds between incarcerated women and their children; and requiring the Division to allow liberal visitation between certain individuals and certain children under certain circumstances.

The relationship concerns proposed violence-prevention funding. The tax proposal did not become law and does not establish fewer firearm deaths. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

HB 935 Department of Legislative Services Maryland General Assembly 2024 Session FISCAL AND POLICY NOTE First Reader House Bill 935 (Delegate Mireku - North, et al. ) Ways and Means Comprehensive Community Safety Funding Act This bill establishes an 11% firearm, firearm accessory, and ammunition (FFAA) excise tax on the gross receipts of a federally licensed firearms dealer derived from the sales of firearms, firearm accessories, and ammunition in the State. The bill requires specified distributions of the revenue from the excise tax. The bill provides for the filing of specified tax returns and for the administration of the tax by the Comptroller. The bill takes effect July 1, 2025. Fiscal Summary State Effect: Special fund revenues increase by approximately $22.4 million in FY 2026 and by $25.0 million in FY 2029. Special fund expenditures for administrative costs increase by $3.7 million in FY 2026 and by $716,500 in FY 2029. Future year expenditures reflect annualization and inflation. ($ in millions) FY 2025 FY 2026 FY 2027 FY 2028 FY 2029 SF Revenue $0 $22.4 $23.2 $24.1 $25.0 SF Expenditure $0 $3.7 $0.7 $0.7 $0.7 Net Effect $0.0 $18.7 $22.6 $23.4 $24.3 Note:() = decrease; GF = general funds; FF = federal funds; SF = special funds; - = indeterminate increase; (-) = indeterminate decrease Local Effect: None. Small Business Effect: Potential meaningful. Small businesses that sell firearms, firearm accessories, and ammunition will be subject to the new excise tax. However, some portion of the cost of the new tax may be passed on to the consumers through increased prices. HB 935/ Page 2 Analysis Bill Summary: The bill establishes an 11% FFAA excise tax on the gross receipts of the sale of firearms, firearm accessories, and ammunition in the State by a federally licensed firearms dealer. The bill specifies the distribution of revenue from the excise tax, administration of the excise tax by the Comptroller, filing of excise tax returns by licensed dealers, and the paying of excise taxes by licensed dealers. Distribution of the Firearm, Firearm Accessory, and Ammunition Excise Tax Revenue Revenue from the FFAA excise tax must be distributed as follows:  44% to the Maryland Trauma Physician Services Fund;  29% to the R Adams Cowley Shock Trauma Center at the University of Maryland Medical System;  23% to the Violence Intervention and Prevention Program Fund;  2% to the Survivors of Homicide Victims Grant Program within the G overnor’s Office of Crime Prevention and Policy; and  2% to the Center for Firearm Violence Prevention and Intervention within the Maryland Department of Health. The bill specifies that it is the intent of the General Assembly that the excise tax revenue supplement, and not supplant, any other funding for these funds required by law. Firearm, Firearm Accessory, and Ammunition Excise Tax Returns A federally licensed firearms dealer must complete, under oath, and file an FFAA excise tax return with the Comptroller: (1) on or before the 25th day of the month that follows the month in which the person sells any firearms, firearm accessories, or ammunition within the boundaries of the State; and (2) if specified by the Comptroller, by regulation, on other dates for each month in which the licensee does not sell any firearms, firearm accessories, or ammunition in the State. A person required to file an excise tax return must file with the return an attachment that states any information required by the Comptroller to determine the gross receipts derived from the sales of firearms, firearm accessories, and ammunition in the State. A person required to file an excise tax return must maintain records of the firearms, firearms accessories, and ammunition sold in the State and the basis for the calculation of the FFAA excise tax owed. HB 935/ Page 3 Payment of Firearm, Firearm Accessory, and Ammunition Excise Taxes Each person required to file an excise tax return must pay the FFAA excise tax in the manner required by the Comptroller, with the return that covers the period in which the person sold firearms, firearm accessories, or ammunition in the State. If a corporation, other than a nonstock, nonprofit corporation, is required to pay the FFAA excise tax, personal liability for the tax and interest and penalties on the tax extends to any officer of the corporation who exercises direct control over its fiscal management. If a limited liability company, or limited liability partnership, including a limited partnership registered as a limited liability limited partnership, is required to pay the FFAA excise tax, personal liability for the tax and interest and penalties on the tax extends to any person who exercises direct control over the fiscal management of the limited liability company or limited liability partnership. The Comptroller may require a person subject to the FFAA excise tax to post security for the excise tax in the amount that the Comptroller determines. A person who willfully fails to file a required FFAA excise tax return is guilty of a misdemeanor and, on conviction, is subject to a fine up to $5,000 or imprisonment up of to five years or both. Definitions A federally licensed firearms dealer is a person licensed by the federal Bureau of Alcohol, Tobacco, Firearms and Explosives to deal in firearms. A firearm accessory is: (1) a magazine or magazine loader; (2) a firearm scope or optic; (3) a stock; (4) a grip; (5) a handguard; or (6) body armor. Gross receipts are defined as the total amount of the sale or lease or rental price of the retail sale by a person, valued in money, whether received in money or otherwise, without any deduction for: (1) the cost of the property sold; (2) the cost of the materials used, labor or service cost, interest paid, losses, or any other expense; or (3) the cost of transportation of the property. Gross receipts do not include: (1) cash discounts allowed and taken on sales; (2) the sale price of property returned by customers when that amount is refunded in cash or credit unless the customer, in order to obtain the refund, is required to purchase other property at a price greater than the amount charged for the property that is returned; (3) the price received for labor or services used in installing or applying the property sold; and (4) the amount of any tax imposed by the United States, the State, a county, or a municipality on or with respect to retail sales whether imposed on the person or the consumer.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Requiring the Division of Correction to allow a certain pregnant woman and a certain woman who recently gave birth to transfer to the prerelease unit for women for a certain time period; establishing the Healthy Start Bonding Program to facilitate strong bonds between incarcerated women and their children; and requiring the Division to allow liberal visitation between certain individuals and certain children under certain circumstances.

The fact measures whether residents under 65 have insurance. Eligibility, enrollment, and premium assistance concern that status; covered-service or provider-payment changes alone do not establish a change in insured status. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: People under 65 without health insurance. This record’s connection to the topic does not establish an effect on the measured result.

Altering the duties of the Health Insurance Coverage Protection Commission to require the Commission to study and make recommendations regarding individual and group health insurance market stability.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Altering the scope of practice of licensed direct-entry midwives; providing that the practice of direct-entry midwifery is independent and not does not require oversight by another health care practitioner; repealing the requirement that licensed direct-entry midwives report certain information to the Direct-Entry Midwifery Advisory Committee; altering the disciplinary actions that may be taken against a licensed direct-entry midwife or an applicant for a license; etc.

The fact measures whether residents under 65 have insurance. Eligibility, enrollment, and premium assistance concern that status; covered-service or provider-payment changes alone do not establish a change in insured status. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: People under 65 without health insurance. This record’s connection to the topic does not establish an effect on the measured result.

Altering the financial eligibility criteria for the home- and community-based services waiver submitted by the Maryland Department of Health to the Centers for Medicare and Medicaid Services to include categorically needy individuals with an income disregard up to 300% of the Supplemental Security Income monthly benefit amount and a certain community spouse resource allowance; requiring the Department to adopt regulations to establish a timeline within which the Department is required to approve or deny the application of an applicant; etc.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Allowing a licensed direct-entry midwife to assume or take responsibility for a client who had a previous cesarean section and regulating the circumstances under which the responsibility may be assumed or taken; altering the required contents of a certain informed consent agreement; and requiring the State Board of Nursing, in consultation with certain stakeholders, to develop a transport protocol for clients who had a previous cesarean section.

The fact measures whether residents under 65 have insurance. Eligibility, enrollment, and premium assistance concern that status; covered-service or provider-payment changes alone do not establish a change in insured status. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: People under 65 without health insurance · Residents who are foreign-born. This record’s connection to the topic does not establish an effect on the measured result.

Requiring the Maryland Health Benefit Exchange and the Maryland Department of Health to develop a report comparing options for offering affordable health care and dental care coverage to State residents who are ineligible for the Maryland Medical Assistance Program, the Maryland Children's Health Program, qualified health plans, or stand-alone dental plans due to the individuals' immigration status; and requiring the Maryland Health Benefit Exchange to report its findings and recommendations by October 31, 2023.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Allowing a licensed direct-entry midwife to assume or take responsibility for a client who had a previous cesarean section and regulating the circumstances under which the responsibility may be assumed or taken; altering the required contents of a certain informed consent agreement; and requiring the State Board of Nursing, in consultation with certain stakeholders, to develop a transport protocol for clients who had a previous cesarean section.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Allowing a licensed direct-entry midwife to assume or take responsibility for a patient who had a previous cesarean section and regulating the circumstances under which the responsibility may be assumed or taken.

Maryland counts deaths during pregnancy or within one year afterward from all causes, not only deaths caused by pregnancy. The provision concerns maternal care, safety, or mortality measurement within that population. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Pregnancy-associated deaths reviewed. This record’s connection to the topic does not establish an effect on the measured result.

Altering the circumstances under which a licensed direct-entry midwife is prohibited from taking certain responsibility for a patient who had a previous cesarean section; and requiring a licensed direct-entry midwife to consult with a health care practitioner and document the consultation if a patient had a previous cesarean section that resulted in a confirmed low transverse incision and was performed at least 18 months before the expected date of birth for the current pregnancy.

The fact measures whether residents under 65 have insurance. Eligibility, enrollment, and premium assistance concern that status; covered-service or provider-payment changes alone do not establish a change in insured status. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: People under 65 without health insurance. This record’s connection to the topic does not establish an effect on the measured result.

Altering the required contents of a certain waiver submitted by the Maryland Department of Health to the Centers for Medicare and Medicaid Services; requiring the Department to send monthly letters to individuals who are eligible or likely to be eligible for waiver participation; requiring that certain letters be sent in a sufficient quantity to allow at least 7,500 individuals to participate in the waiver; requiring the Department to ensure that certain individuals receive certain services within a certain period of time; etc.

Firearm mortality includes suicide, homicide, and other intents. The provision concerns firearm access, safety, or prevention of firearm injury and may address only part of the death count. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

Altering a certain provision relating to the storage of firearms and ammunition in a location that can be accessed by an unsupervised minor; and requiring the Deputy Secretary for Public Health Services to develop a youth suicide prevention and firearm safe storage guide, with recommendations from a stakeholder committee.

Firearm mortality includes suicide, homicide, and other intents. The provision concerns firearm access, safety, or prevention of firearm injury and may address only part of the death count. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

Altering a certain prohibition to prohibit a person from storing or leaving a firearm in a location where a minor could gain access to the firearm; altering a certain exception to the prohibition; establishing certain exceptions to the prohibition; prohibiting a person from storing or leaving a firearm in a location where an unsupervised minor could gain access to the firearm, an unsupervised minor does gain access to the firearm, and the firearm causes harm to the minor or another person; establishing certain penalties; etc.

Firearm mortality includes suicide, homicide, and other intents. The provision concerns firearm access, safety, or prevention of firearm injury and may address only part of the death count. This relationship does not establish causation. Actions after the fact’s measurement period cannot explain its earlier value.

Retained Maryland evidence context: Firearm deaths. This record’s connection to the topic does not establish an effect on the measured result.

Altering a certain prohibition to prohibit a person from storing or leaving a loaded or unloaded firearm in a location where a minor could gain access to the firearm; repealing a certain exception to the prohibition; prohibiting a person from storing or leaving a loaded or unloaded firearm in a location where an unsupervised minor could gain access to the firearm and an unsupervised minor does gain access to the firearm; etc.