Overview:

The 2024 Session rang to a close at the stroke of midnight on Monday, April 8th.  The level of intensity was high during this second year of a four-year term, as close to 3,500 bills were introduced.  Legislators introduced bills that were of particular concern to them and their constituents that ran the gamut from healthcare to the environment to education to criminal justice to artificial intelligence.  Each issue was given time and attention by the 6 standing committees in the House and 4 standing committees in the Senate.

We were there every step of the way engaging at the highest levels on issues concerning continuing care retirement communities, and policies concerning long term care that impact on resident’s daily life.  We worked to elevate before the legislature and the Administration these fundamental issues that impact you.

Together with the MaCCRA Legislative Working Group we reviewed, tracked, and engaged on over 55 pieces of legislation.  Testimony and positions were submitted on 24 pieces of legislation.  A complete list of bills MaCCRA followed can be found in Appendix 1.  The following highlights MaCCRA priority legislation and legislation of note.

Priority Legislation

Continuing Care Retirement Communities:

Throughout the end of 2022 and into the late Summer, we and MaCCRA leadership attended MaCCRA Chapter meetings across the State to best understand the issues most important to each chapter and discern common areas of concern across all Chapters.  From these meetings the Legislative working group distilled what was learned and identified areas in need of statutory change.

Working with our House Sponsor Delegate Dana Stein and Senate Sponsor Senator Clarence Lam leaders who are invested in supporting and enhancing CCRC Resident’s rights, developed legislation that would:

  • Increase from 1 to 2 residents on governing boards.
  • Establish standard process for Return of deposits in the form of a first-in first-out system similar to what was established in New Jersey.
  • Grievance procedure – require the Department to collect utilization and outcomes from the CCRCs.

We initiated outreach to the two associations that represent CCRC Providers: LifeSpan and Leading Age Maryland, and the Department of Aging to review the bill and see where there were areas of agreement.  The provider groups were adamantly opposed to increasing resident representation and to making changes to the return of deposits.  The Department expressed their concerns with these provisions from the point of view that they do not have the authority to intervene or provide oversight of the interactions between residents and providers.  They state their role is to ensure CCRCs meet all requirements of law and regulation to ensure the overall financial health and solvency of the communities.

Throughout the 90-Day session there were intense negotiations and frequent revisions and proposed amendments that culminated in the bills that passed (detailed below).  To go from concept to passed legislation in the period of months is an amazing achievement.  The legislation that passed this year serves as a new starting point as we continue to advance and build forward.

HB0068 /CH0258 

(SB0076/CH0257)

Continuing Care Retirement Communities – Transparency, Grievances, and Unit Reoccupancy Delegate Stein Approved by the Governor – Chapter 258

SB0076 /CH0257

(HB0068/CH0258)

Continuing Care Retirement Communities – Transparency, Grievances, and Unit Reoccupancy Senator Lam Approved by the Governor – Chapter 257

MaCCRA Supported

House Bill 68 & Senate Bill 76[1] “requires providers to (1) post the most recent disclosure statement on their website; (2) hold a meeting open to all of the provider’s subscribers at least quarterly; (3) provide an aggregated, deidentified summary of internal grievances at the last quarterly meeting of the year; and (4) provide specified information to a subscriber or the subscriber’s beneficiary regarding entrance fee refunds if the refund is conditioned on the reoccupancy of the subscriber’s unit. The Maryland Department of Aging (MDOA) must collect specified information from providers regarding internal grievances and report on the data received by December 1 each year to specified committees of the General Assembly. The bill must be construed to apply only prospectively and may not be applied or interpreted to have any effect on or application to any cause of action arising before the effective date of the bill.

Continuing Care Agreement Contractual Entrance Fee Refunds

If an entrance fee refund is conditioned on the reoccupying of a subscriber’s unit and the unit has not been reoccupied within nine months of the subscriber’s death or the date of the contract termination, a provider must submit a written report to the subscriber or the subscriber’s beneficiary stating (1) that the unit has not been reoccupied and (2) the efforts the provider has made to reoccupy the unit. The provider must submit an updated written report to the subscriber or the subscriber’s beneficiary every six months until the subscriber’s unit has been reoccupied.

Subscriber Input

A subscriber member of a governing body may report on nonconfidential deliberations, actions, and policies of the governing body to the resident association. The governing body in its sole but reasonable discretion must determine whether a matter is confidential. If the provider does not have a governing body, a select committee of its officers or partners must meet at least quarterly with the resident association.

Reporting Requirements Regarding Internal Grievances

The bill requires MDOA, on an annual basis, to collect from each provider information about internal grievances filed for each of the provider’s facilities, including (1) the number of internal grievances filed; (2) the aggregated, deidentified summary of internal grievances; (3) whether a grievance went to mediation and the outcome of the mediation; and (4) the final disposition of each grievance. By December 1 each year, MDOA must report on the data received from each provider to specified committees of the General Assembly.”

HB1177 Continuing Care Retirement Communities – Subscriber Rights and Provider Duties Delegate Hill Did Not Pass

MaCCRA Supported

MaCCRA was in support of this bill as it both echoed provisions in HB68/SB76 and attempted to make further clarifications with regard to resident rights.  As drafted the bill would have “(1) altered requirements for subscriber input, including the membership of governing bodies of continuing care retirement communities and confidentiality requirements; (2) established requirements for providers and subscribers of continuing care retirement communities; and (3) required the Secretary of Aging to appoint a Continuing Care in a Retirement Community Ombudsman for each county, if applicable, to monitor the rights and protections provided for a subscriber or a potential subscriber. A provider may not infringe on the civil liberties of a subscriber that are protected by the State and national constitutions. The Secretary of Aging must adopt regulations regarding the Continuing Care in a Retirement Community Ombudsman.”[2]

While the bill did not pass, there was interest on the part of the House Health and Government Operations Committee to further explore and learn more about these important issues between now and the 2025 Session.

Other Issues of Note

Care Giver Expenses

SB0202 /CH0161 Department of Aging – Caregiver Expense Grant Program – Established Senator Benson Approved by the Governor – Chapter 161

MaCCRA Supported

Senate Bill 202 “establishes a Caregiver Expense Grant Program within the Maryland Department of Aging (MDOA) to award grants for qualified expenses paid or incurred by an individual who provides care to a qualified family member and whose federal adjusted gross income does not exceed $75,000 ($150,000 if a joint tax filer). An eligible caregiver may apply for a grant equal to 30% of the amount of qualified expenses that exceeds $2,000, up to a maximum grant of $2,500 per fiscal year. The Governor may include an appropriation in the annual budget bill of up to $5.0 million for the program for any fiscal year. MDOA may adopt regulations to implement the bill’s provisions. The bill takes effect July 1, 2024.

“Qualified expenses” means expenses paid or incurred by a caregiver for goods or services that relate directly to the care or support of a qualified family member. Qualified expenses include, for example, adult day care, specialized transportation, legal or financial services, or assistive care technology, among other things. A “qualified family member” is an individual who requires assistance with one or more daily living activities, as certified by a licensed physician, physician assistant, or registered nurse practitioner, and (1) is at least 60 years old or has Alzheimer’s Disease or a related disorder and is cared for by an adult relative or informal caregiver who is at least 18 years old or (2) is a child or an adult with developmental or functional disabilities and is cared for by a parent, grandparent, or other relative that is at least 55 years old.”[3]

HB0189 Maryland Medical Assistance Program – Provider Agencies and Personal Care Aides – Reimbursement and Wage Reports (Homecare Workers Employment Act of 2024) Delegate Lewis, R. Approved by the Governor – Chapter 865
SB0371 Maryland Medical Assistance Program – Provider Agencies and Personal Care Aides – Reimbursement and Wage Reports (Homecare Workers Livable Wage Act of 2024) Senator Lam Approved by the Governor – Chapter 864

MaCCRA Supported

House Bill 189 and Senate Bill 371 “requires each residential service agency (RSA), by September 1, 2025, and annually thereafter, to submit a report to the Maryland Department of Labor (MDL) documenting the RSA’s average wage rate and highest and lowest wage rates for personal care aides (PCAs). The Maryland Department of Health (MDH) must submit a specified report on the Ensuring Access to Medicaid final federal rule and the plans or steps the department will take to operationalize the rule. The bill takes effect June 1, 2024.

The reporting requirement applies to personal assistance services provided through an RSA under Community First Choice, Community Options, Community Personal Assistance Services, and any other home- and community-based services (HCBS) administered by MDH. It does not apply to personal care services provided through the Developmental Disabilities Administration.

Residential Service Agency Requirements

By September 1, 2025, and annually thereafter, each RSA must submit to MDL a report that includes documentation of the RSA’s average wage rate and highest and lowest wage rates for PCAs and any other information that MDL determines appropriate. The report must be signed by an authorized representative of the RSA.

Maryland Department of Health Requirements

Uncodified language requires MDH, by the 180th day following release of the final federal Ensuring Access to Medicaid Services rule, to report to the Senate Finance Committee and the House Health and Government Operations Committee on an overview of the final rule and the plans or steps the department will take to operationalize the rule. The report must include the process MDH will use to review wage reports of PCAs and how the data will be used to review Medicaid reimbursement rates as outlined in the rule.”[4]

Long Term Care

HB0218 (SB0086) Income Tax – Credit for Long-Term Care Premiums (Long-Term Care Relief Act of 2024) Delegate Stewart Did Not Pass
SB0086 (HB0218) Income Tax – Credit for Long-Term Care Premiums (Long-Term Care Relief Act of 2024) Senator Klausmeier Did Not Pass

 MaCCRA Supported

House Bill 218 and Senate Bill 86 would have “made several alterations to the existing, one-time income tax credit for long-term care premiums. Under the bill, the credit could have been claimed only if the insured individual was covered by long-term care insurance purchased on or before December 31, 2004; however, the credit could have been claimed in any taxable year in which the policy is in force. In addition, the bill (1) would have disallowed the credit for taxpayers younger than age 85 or with Maryland adjusted gross income of $100,000 or more (for joint filers, $200,000 or more) and (2) would have specified that the maximum value of the credit is equal to the lesser of 15% of the eligible long-term care premiums paid during the taxable year or $1,500.”[5]

 

SB0631 (HB0349) Department of Aging – Long-Term Care Insurance – Study Senator Kelly In the Senate – Withdrawn by Sponsor
HB0349 (SB0631) Department of Aging – Long-Term Care Insurance – Study Delegate Cullison In the House – Withdrawn by Sponsor

MaCCRA Supported

 

Senate Bill 631 & House Bill 349 would have “required the Department of Aging to contract with an independent consultant to complete an insurance study on public and private options for leveraging resources to help individuals prepare for long-term care services and support needs; and required the Department to submit an interim report by December 31, 2024 summarizing the progress of the study and a final report by December 31, 2025 to the Governor and General Assembly on the results of the study.”[6]

 

HB1344 Income Tax – Credit for Long-Term Care Premiums Delegate Howard Did Not Pass

MaCCRA Supported

 

House Bill 1344 would have “made various alterations to the existing, one-time income tax credit for long-term care premiums. Under the bill, the credit could have been claimed only with respect to policies purchased after December 31, 2024; however, the credit could have been claimed in any taxable year in which the policy is in force. For tax years 2025 and 2026, the maximum value of the credit would have been $250; for tax year 2027 and beyond, the maximum value of the credit would have increased to $500.”[7]

 

Prescription Drug Affordability

 

SB0388 (HB0340) Prescription Drug Affordability Board – Authority for Upper Payment Limits and Funding (Lowering Prescription Drug Costs for All Marylanders Act of 2024) Senator Gile Did Not Pass
HB0340 (SB0388) Prescription Drug Affordability Board – Authority for Upper Payment Limits and Funding (The Lowering Prescription Drug Costs For All Marylanders Now Act) Delegate Cullison Did Not Pass

MaCCRA Supported

House Bill 340 & Senate Bill 388 would have “repealed existing reporting requirements for the Prescription Drug Affordability Board (PDAB) regarding upper payment limits. Instead, on or after October 1, 2024, PDAB must have determined whether it is in the best interest of the State to set upper payment limits for all purchases and payor reimbursements of prescription drug products in the State, as specified. If PDAB determines that this is in the best interest of the State, the board must establish a specified process for setting such upper payment limits and then actually set upper payment limits in accordance with the process. For fiscal 2025 and annually thereafter, the Governor must include in the annual budget bill an appropriation of at least $1.0 million for the Prescription Drug Affordability Fund (PDAF). The bill specified the order in which PDAB must spend monies in the fund and includes a reversion provision for unexpended general fund appropriations.”[8]

 

Emergency Department Wait Times

 

HB1143 Emergency Medical Services – Maryland Emergency Department Wait Time Reduction Commission – Establishment Delegate Bhandari Approved by the Governor – Chapter 844

MaCCRA Supported

 

House Bill 1143 “establishes the Maryland Emergency Department Wait Time Reduction Commission to address factors throughout the health care system that contribute to increased emergency department (ED) wait times. The Health Services Cost Review Commission (HSCRC) must provide staff for the commission. A member of the commission may not receive compensation, but it is entitled to reimbursement for expenses. By November 1, 2025, and November 1, 2026, the commission must report to the Governor and the General Assembly on its activities, findings, and recommendations, including an update on the development, implementation, and impact of the recommended policies and programs developed by the commission to improve ED wait times.

 

Maryland Emergency Department Wait Time Reduction Commission

The commission must develop strategies and initiatives to recommend to State and local agencies, hospitals, and health care providers to reduce ED wait times, including:

  • initiatives that ensure that patients are seen in the most appropriate setting to reduce unnecessary use of EDs;
  • initiatives that improve hospital efficiency, including by increasing ED and inpatient throughput;
  • initiatives that improve post discharge resources to facilitate timely ED and inpatient discharges;
  • by identifying and recommending improvements for the collection and submission of data necessary to monitor and reduce ED wait times;
  • by making recommendations to State and local agencies, hospitals, and health care providers; and
  • by facilitating the sharing of best practices for reducing ED wait times.

The commission may:

  • recommend that State and local agencies, hospitals, and health care providers implement developed strategies and initiatives;
  • request interviews with State and local officials;
  • request data from the Maryland Department of Health (MDH), the Maryland Institute for Emergency Medical Services Systems (MIEMSS), HSCRC, the Maryland Health Care Commission (MHCC), the State-designated health information exchange, hospitals, other providers of health care services, and payors for health care services; and create advisory workgroups that do not include members of the commission.”[9]

Accommodations in Movie Theaters

HB0426 /CH0361 

(SB0092/CH0360)

Places of Public Accommodation – Motion Picture Houses – Captioning Delegate Bhandari Approved by the Governor – Chapter 361

SB0092 /CH0360 

(HB0426/CH0361)

Places of Public Accommodation – Motion Picture Houses – Captioning Senator Brooks Approved by the Governor – Chapter 360

MaCCRA Supported

 

House Bill 426 and Senate Bill 92 “requires a place of public accommodation that is a motion picture house to provide access to fully operational and well-maintained “closed movie captioning” technology for the general public for each screening of a motion picture that is produced and available with closed movie captioning, as required by Title III of the federal Americans with Disabilities Act. If a motion picture is produced and available with “open movie captioning,” a place of public accommodation that controls, operates, owns, or leases a motion picture house with eight or more screens in the State must provide open movie captioning for at least two screenings for each motion picture it screens each week; this requirement does not apply to motion pictures screened fewer than five times during a seven-day period, as specified, and is applicable only to the first three weeks after premiering in the motion picture house. Beginning three weeks after the premiere, a place of public accommodation that controls, operates, owns, or leases a motion picture house with eight or more screens in the State may provide open movie captioning with reasonable notice.”[10]

Health Care Facilities

 

SB1000 (HB1122) Maryland Health Care Commission – Nursing Homes – Acquisitions Senator Beidle Approved by the Governor – Chapter 844
HB1122 (SB1000) Maryland Health Care Commission – Nursing Homes – Acquisitions Delegate Kerr Approved by the Governor – Chapter 817

MaCCRA Supported

Senate Bill 100 and House Bill 1122 “requires a person, at least 60 days before the closing date of the acquisition of a nursing home, to submit a request for “acquisition” to the Maryland Health Care Commission (MHCC) and provide specified notice to the residents, resident representatives, and employees of the nursing home. The executive director of MHCC must review a completed request for acquisition within 45 days and, in consultation with the Secretary of Health (or their designee), may approve the acquisition, approve the acquisition with conditions, deny the acquisition, or refer the request for acquisition to MHCC for a final decision. The bill (1) removes the requirement for MHCC to provide specified written findings and recommendations to the Office of Health Care Quality (OHCQ) when evaluating a notice of acquisition or transfer of interest of a nursing home and (2) alters the requirement for the Secretary of Health to consider MHCC’s findings and decisions before taking action to approve, deny, approve with conditions, or revoke a nursing home license. By January 1, 2025, MHCC must adopt specified regulations, to be applicable to nursing home acquisitions executed after the adoption of the regulations.”[11]

Rights of Residents of Health Facilities

MaCCRA Supported

HB0723 /CH0141 

(SB0863)

Office of the Attorney General – Rights of Residents of Health Care Facilities – Injunctive Relief Speaker Approved by the Governor – Chapter 141

 

House Bill 723 “authorizes the Attorney General, to prevent irreparable harm to residents, to seek injunctive relief on behalf of the State on the basis of an imminent or ongoing violation of a specified basic right of residents of a facility or assisted living program. The Attorney General may not duplicate corrective action imposed by the Maryland Department of Health (MDH) for the same violation. The bill also alters the definition of “resident bill of rights” for residents of assisted living program facilities. The bill takes effect July 1, 2024.”[12]

 

The Fiscal Year 2025 Operating Budget (Senate Bill 360 and Senate Bill 362):

 

The Governor’s incoming Budget was introduced with a more modest approach reflective of declining revenue numbers and the end of extra federal Covid-19 related funding.

Despite the Operating Budget uncertainty, funds were included to maintain rate increases for Medicaid providers, including funding for Medicaid E&M codes at 100% of Medicare, but those rates are a decrease from last year’s 103% of Medicare and will include any federal mandated cuts to Medicare.  The Governor retained increases for behavioral health and developmental disability administration provider reimbursements.  All budget eyes are on the future as the state must contend with funding obligations for K-12 education spending in the face of declining revenues.

The Senate and the House had very different approaches to addressing the impending revenue shortfalls, most notably in the form of the House passing revenue generating measures specifically to address shortfalls in transportation funding.  Furthermore, the House advanced legislation that would have reduced the sales tax from 6% to 5% but more broadly applied the sales tax on services, as well as address corporate taxation to close perceived loopholes.  The Senate and House eventually came together on passing the Governor’s budget with some revenue generating increases, but the promise of more to be done next Session.

 

Looking Ahead:

The coming weeks and months will be an important time for MaCCRA to continue its advocacy and lay groundwork for the next Session.

In the coming weeks and months we will be working with the Legislative Working Group and other MaCCRA working groups as the 2025 Legislative agenda is developed.  We will be going out and speaking at a number of MaCCRA Chapters and will continue to spread the importance of connecting with your State legislators and building relationships.  As each Chapter does that, it strengthens the collective impact that MaCCRA has in the legislative and policy arenas.

We look forward to continuing our work with MaCCRA and building on the successes of the 2024 Session.

~ Barbara Brocato and Dan Shattuck

APPENDIX A: Chart of Bills that MaCCRA Submitted Testimony on

PRIORITY LEGISLATION

Bill/Chapter
(Cross/Chapter)
Title Sponsor

FINAL BILL

STATUS

 

HB0068 /CH0258 

(SB0076/CH0257)

Continuing Care Retirement Communities – Transparency, Grievances, and Unit Reoccupancy Delegate Stein Approved by the Governor – Chapter 258

SB0076 /CH0257 

(HB0068/CH0258)

Continuing Care Retirement Communities – Transparency, Grievances, and Unit Reoccupancy Senator Lam Approved by the Governor – Chapter 257
MACCRA Position: SUPPORT – Written and In Person Testimony
HB0218 (SB0086) Income Tax – Credit for Long-Term Care Premiums (Long-Term Care Relief Act of 2024) Delegate Stewart In the House – Hearing 2/01 at 1:00 p.m.
SB0086 (HB0218) Income Tax – Credit for Long-Term Care Premiums (Long-Term Care Relief Act of 2024) Senator Klausmeier In the Senate – Hearing 1/18 at 12:00 p.m.
MACCRA Position: SUPPORT
SB0328 Funding for Wages and Benefits for Nursing Home Workers (Nursing Home Staffing Crisis Funding Act of 2024) Senator Rosapepe In the Senate – Hearing 1/24 at 1:00 p.m.
MACCRA Position: SUPPORT no testimony
HB0032 Income Tax – Caregiver Tax Credit Delegate Harrison In the House – Hearing 2/01 at 1:00 p.m.
SB0202 /CH0161 Department of Aging – Caregiver Expense Grant Program – Established Senator Benson Approved by the Governor – Chapter 161
MaCCRA Position: Support

HB0426 /CH0361 

(SB0092/CH0360)

Places of Public Accommodation – Motion Picture Houses – Captioning Delegate Bhandari Approved by the Governor – Chapter 361

SB0092 /CH0360 

(HB0426/CH0361)

Places of Public Accommodation – Motion Picture Houses – Captioning Senator Brooks Approved by the Governor – Chapter 360
MaCCRA Position: Support with written testimony
HB0189 Maryland Medical Assistance Program – Provider Agencies and Personal Care Aides – Reimbursement and Wage Reports (Homecare Workers Employment Act of 2024) Delegate Lewis, R. IN THE HOUSE – PASSED ENROLLED
SB0371 Maryland Medical Assistance Program – Provider Agencies and Personal Care Aides – Reimbursement and Wage Reports (Homecare Workers Livable Wage Act of 2024) Senator Lam In the Senate – Returned Passed
MACCRA Position: Supported Senate Bill with written testimony
SB0208 Maryland Medical Assistance Program – Provider Agencies and Personal Care Aides – Reimbursement and Wages Senator Benson In the Senate – Withdrawn by Sponsor
MACCRA Position: Support, but bill has been withdrawn
SB0388 (HB0340) Prescription Drug Affordability Board – Authority for Upper Payment Limits and Funding (Lowering Prescription Drug Costs for All Marylanders Act of 2024) Senator Gile In the Senate – Hearing 2/07 at 2:00 p.m. (Finance)
HB0340 (SB0388) Prescription Drug Affordability Board – Authority for Upper Payment Limits and Funding (The Lowering Prescription Drug Costs For All Marylanders Now Act) Delegate Cullison In the House – Hearing 2/08 at 1:00 p.m.
MACCRA Position: Support

HB0723 /CH0141 

(SB0863)

Office of the Attorney General – Rights of Residents of Health Care Facilities – Injunctive Relief Speaker Approved by the Governor – Chapter 141
SB0863 (HB0723) Office of the Attorney General – Rights of Residents of Health Care Facilities – Injunctive Relief and Penalties President In the Senate – Hearing 3/01 at 1:00 p.m.
MACCRA Position: Support
HB0784 Task Force on Reducing Emergency Department Wait Times Delegate Bhandari In the House – Hearing 2/28 at 1:00 p.m.
HB1143 Emergency Medical Services – Maryland Emergency Department Wait Time Reduction Commission – Establishment Delegate Bhandari In the House – Passed Enrolled
MACCRA Position: Support
SB0631 (HB0349) Department of Aging – Long-Term Care Insurance – Study Senator Kelly In the Senate – Withdrawn by Sponsor
HB0349 (SB0631) Department of Aging – Long-Term Care Insurance – Study Delegate Cullison In the House – Withdrawn by Sponsor
MACCRA Position: Support
HB1344 Income Tax – Credit for Long-Term Care Premiums Delegate Howard In the House – Hearing 2/29 at 1:00 p.m.
MACCRA Position: Support
HB1177 Continuing Care Retirement Communities – Subscriber Rights and Provider Duties Delegate Hill In the House – Hearing 3/07 at 1:00 p.m.
MACCRA Position: Support with written testimony
SB1000 (HB1122) Maryland Health Care Commission – Nursing Homes – Acquisitions Senator Beidle IN THE SENATE – RETURNED PASSED
HB1122 (SB1000) Maryland Health Care Commission – Nursing Homes – Acquisitions Delegate Kerr In the House – Passed Enrolled
MACCRA Position: Support

[1] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0008/hb0068.pdf

[2] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0007/hb1177.pdf

[3] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0002/sb0202.pdf

[4] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0009/hb0189.pdf

[5] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0008/hb0218.pdf

[6] https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0349?ys=2024RS

[7] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0004/hb1344.pdf

[8] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0000/hb0340.pdf

[9] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0003/hb1143.pdf

[10] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0006/hb0426.pdf

[11] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0000/sb1000.pdf

[12] https://mgaleg.maryland.gov/2024RS/fnotes/bil_0003/hb0723.pdf