An individual who on June 30, 1981 is licensed as a nurse midwife by this State is governed by this title and any other provisions that concern additional acts in the practice of registered nursing that relate to the practice of nurse midwifery. §8-6A-01. IN EFFECT (a) In this subtitle the following words have the meanings indicated. (b) "Applicant" means, unless the context requires otherwise: (1) An individual applying for an initial certificate by examination or endorsement; (2) A certificate holder applying for renewal of a certificate; or (3) An individual applying for reinstatement of a certificate in accordance with § 8-6A-10 of this subtitle. (c) (1) "Approved dialysis technician training program" means a course of training approved by the Board that: (i) Prepares the applicant for national certification; (ii) Meets the requirements of 42 C.F.R. § 494.140(e)(3); and (iii) Meets the requirements set by the Board in regulation. (2) "Approved dialysis technician training program" includes the courses required for national certification as: (i) A Certified Clinical Hemodialysis Technician by the Nephrology Nursing Certification Commission; (ii) A Clinical Nephrology Technician by the National Nephrology Certification Organization; or (iii) A Certified Hemodialysis Technician by the Board of Nephrology Examiners Nursing Technology. (d) "Approved medication technician training program" means a course of training approved by the Board that meets the basic medication technician core curriculum and the medication technician content training specific to the setting in which the medication technician will work. (e) "Approved nursing assistant training program" means a course of training that meets the basic nursing assistant curriculum prescribed and approved by the Board. (f) "Board" means the State Board of Nursing. (g) "Certificate" means a certificate issued by the Board to practice as a certified nursing assistant, a certified dialysis technician, or a certified medication technician in the State. (h) "Certificate holder" means a certified nursing assistant, dialysis technician, or medication technician who has: (1) An active certificate; (2) An inactive certificate; (3) A temporary certificate; (4) An expired temporary certificate; (5) An expired certificate; (6) A lapsed certificate; (7) A suspended certificate; or (8) A certificate subject to a reprimand, probation, or suspension. (i) "Certified dialysis technician" means an individual who: (1) Has completed a Board-approved dialysis technician program; and (2) Is certified by the Board as a dialysis technician. (j) "Certified medication technician" means an individual who: (1) Has completed a Board-approved medication technician training program; (2) Is certified by the Board as a medication technician; and (3) Subject to regulations adopted by the Board, routinely performs: (i) Nursing tasks related to the administration of medication, delegated by a registered nurse, licensed practical nurse, or advanced practice nurse; or (ii) Technical tasks related to the administration of medication delegated by a licensed certified midwife. (k) "Certified medicine aide" means a certified nursing assistant who has completed a Board-approved course in medication administration. (l) "Certified nursing assistant": (1) Means an individual regardless of title who, for compensation and subject to regulations adopted by the Board, routinely performs: (i) Nursing tasks delegated by a registered nurse, licensed practical nurse, or advanced practice registered nurse; or (ii) Technical tasks delegated by a licensed certified midwife; and (2) Does not include a certified dialysis technician or a certified medication technician. (m) "Department" means the Maryland Department of Health. (n) "Expired certificate" means a certificate that was not renewed before the expiration date of the certificate as established under § 8-6A-08(a) of this title. (o) "Geriatric nursing assistant" means a certified nursing assistant who has successfully completed the requirements for geriatric nursing assistant mandated under federal law and the regulations of the Board. (p) "Lapsed certificate" means a certificate that was not renewed because a certificate holder failed to renew the certificate or otherwise did not meet the renewal requirements of this subtitle. §8-6A-01. ** TAKES EFFECT APRIL 1, 2026 PER CHAPTER 416 OF 2025** (a) In this subtitle the following words have the meanings indicated. (b) "Applicant" means, unless the context requires otherwise: (1) An individual applying for an initial certificate by examination or endorsement; (2) A certificate holder applying for renewal of a certificate; or (3) An individual applying for reinstatement of a certificate in accordance with § 8-6A-10 of this subtitle. (c) "Approved acute care nursing assistant training program" means a course of training that meets the acute care nursing assistant curriculum approved by the Board. (d) (1) "Approved dialysis technician training program" means a course of training approved by the Board that: (i) Prepares the applicant for national certification; (ii) Meets the requirements of 42 C.F.R. § 494.140(e)(3); and (iii) Meets the requirements set by the Board in regulation. (2) "Approved dialysis technician training program" includes the courses required for national certification as: (i) A Certified Clinical Hemodialysis Technician by the Nephrology Nursing Certification Commission; (ii) A Clinical Nephrology Technician by the National Nephrology Certification Organization; or (iii) A Certified Hemodialysis Technician by the Board of Nephrology Examiners Nursing Technology. (e) "Approved medication technician training program" means a course of training approved by the Board that meets the basic medication technician core curriculum and the medication technician content training specific to the setting in which the medication technician will work. (f) "Approved nursing assistant training program" means a course of training that: (1) Meets the requirements under federal and State law; and (2) Is approved by the Board. (g) "Board" means the State Board of Nursing. (h) "Certificate" means a certificate issued by the Board to practice as a certified nursing assistant, a certified dialysis technician, or a certified medication technician in the State. (i) "Certificate holder" means a certified nursing assistant, dialysis technician, or medication technician who has: (1) An active certificate; (2) An inactive certificate; (3) A temporary certificate; (4) An expired temporary certificate; (5) An expired certificate; (6) A lapsed certificate; (7) A suspended certificate; or (8) A certificate subject to a reprimand, probation, or suspension. (j) "Certified dialysis technician" means an individual who: (1) Has completed a Board-approved dialysis technician program; and (2) Is certified by the Board as a dialysis technician. (k) "Certified medication technician" means an individual who: (1) Has completed a Board-approved medication technician training program; (2) Is certified by the Board as a medication technician; and (3) Subject to regulations adopted by the Board, routinely performs: (i) Nursing tasks related to the administration of medication, delegated by a registered nurse, licensed practical nurse, or advanced practice nurse; or (ii) Technical tasks related to the administration of medication delegated by a licensed certified midwife. (l) "Certified medicine aide" means a certified nursing assistant who: (1) Has completed a Board-approved course in medication administration; and (2) Is certified as a medicine aide by the Board. (m) (1) "Certified nursing assistant" means an individual regardless of title who, for compensation and subject to regulations adopted by the Board, routinely performs: (i) Nursing tasks delegated by a registered nurse, licensed practical nurse, or advanced practice registered nurse; or (ii) Technical tasks delegated by a licensed certified midwife. (2) "Certified nursing assistant" does not include a certified dialysis technician or a certified medication technician. (n) (1) "Certified nursing assistant-I" means a certified nursing assistant who meets the requirements set by the Board and under federal law to practice in any setting. (2) "Certified nursing assistant-I" includes: (i) A certified nursing assistant who was certified as a geriatric nursing assistant on March 31, 2026; (ii) A certified medicine aide; and (iii) A certified nursing assistant who is approved under § 8- 6A-05(c)(5) of this subtitle. (o) "Certified nursing assistant-II" means a certified nursing assistant: (1) Who, on March 31, 2026, was certified as a nursing assistant and was not authorized to practice in a nursing facility or skilled nursing facility; and (2) Whose authority to practice in a nursing facility or skilled nursing facility continues to be restricted because the certified nursing assistant has not been approved as a certified nursing assistant-I under § 8-6A-05(c)(5) of this subtitle. (p) "Department" means the Maryland Department of Health. (q) "Expired certificate" means a certificate that was not renewed before the expiration date of the certificate as established under § 8-6A-08(a) of this title. (r) "Lapsed certificate" means a certificate that was not renewed because a certificate holder failed to renew the certificate or otherwise did not meet the renewal requirements of this subtitle. (s) "Nursing assistant competency evaluation" means an examination approved by the Board that: (1) Determines the competency of the individual to practice as a certified nursing assistant-I; and (2) Meets the requirements under federal law. §8-6A-02. IN EFFECT (a) Subject to subsection (f) of this section and except as otherwise provided in this subtitle, an individual shall be certified by the Board to practice as a nursing assistant, dialysis technician, or medication technician before the individual may practice as a nursing assistant, dialysis technician, or medication technician in the State. (b) This subtitle does not apply to an individual who: (1) Practices a health occupation that the individual is authorized to practice under this article; (2) Provides for the gratuitous care of friends, domestic partners, or family members; (3) Performs nursing assistant tasks while a nursing student enrolled in an accredited nursing program and practicing under the direct supervision of qualified faculty or preceptors; (4) Performs nursing assistant tasks as a student while: (i) Enrolled in a Board-approved nursing assistant training program; and (ii) Practicing under the direct supervision of qualified faculty or preceptors; (5) Performs medication technician tasks as a student while practicing under the direct supervision of qualified faculty; (6) Performs dialysis technician tasks as a student while under the direct supervision of qualified faculty; or (7) Works as a principal or school secretary, does not administer medication as a routine part of the position, and has completed training by the delegating nurse for the occasion where the individual may need to administer medication in the absence of the nurse or medication technician. (c) Nothing in this section shall preclude a registered nurse or licensed practical nurse from delegating a nursing or other technical task to an unlicensed individual provided that acceptance of delegated nursing or other technical tasks does not become a routine part of the unlicensed individual's job duties. (d) (1) Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude an advanced practice registered nurse from delegating a nursing or other technical task to an assistant if: (i) The assistant performs only tasks that the assistant is trained to perform; and (ii) The delegating advanced practice registered nurse provides: 1. Instruction to the assistant on the delegated task; and 2. On-site supervision of the assistant performing the delegated task. (2) The Board shall adopt regulations to carry out this subsection, including regulations that: (i) Provide for the manner in which an advanced practice registered nurse delegates a nursing or other technical task to an assistant; (ii) Establish limitations on the authority of an advanced practice registered nurse to delegate nursing or other technical tasks to an assistant; and (iii) Otherwise clarify the scope of this subsection. (e) (1) Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude a licensed certified midwife from delegating a technical task to an assistant if: (i) The assistant performs only tasks that the assistant is trained to perform; and (ii) The delegating licensed certified midwife provides: 1. Instruction to the assistant on the delegated task; and 2. On-site supervision of the assistant performing the delegated task. (2) The Board shall adopt regulations to carry out this subsection, including regulations that: (i) Provide for the manner in which a licensed certified midwife delegates a technical task to an assistant; (ii) Establish limitations on the authority of a licensed certified midwife to delegate technical tasks to an assistant; and (iii) Otherwise clarify the scope of this subsection. (f) An individual shall be certified by the Board to practice as a nursing assistant and as a dialysis technician before the individual may practice as a dialysis technician in a State-owned hospital or State-owned facility. §8-6A-02. ** TAKES EFFECT APRIL 1, 2026 PER CHAPTER 416 OF 2025 ** (a) Subject to subsection (f) of this section and except as otherwise provided in this subtitle, an individual shall be certified by the Board to practice as a nursing assistant, dialysis technician, or medication technician before the individual may practice as a nursing assistant, dialysis technician, or medication technician in the State. (b) This subtitle does not apply to an individual who: (1) Practices a health occupation that the individual is authorized to practice under this article; (2) Provides for the gratuitous care of friends, domestic partners, or family members; (3) Performs nursing assistant tasks while a nursing student enrolled in an accredited nursing program and practicing under the direct supervision of qualified faculty or preceptors; (4) Performs nursing assistant tasks as a student while: (i) 1. Enrolled in a Board-approved nursing assistant training program; or 2. Enrolled in an acute care nursing assistant training program; and (ii) Practicing under the direct supervision of qualified faculty or preceptors; (5) Performs nursing assistant tasks as a student while enrolled in an accredited nursing program after the successful completion of the portion of the approved nursing education program that the Board determines meets the requirements of an approved nursing assistant training program or medication administration course; (6) Performs medication technician tasks as a student while practicing under the direct supervision of qualified faculty; (7) Performs dialysis technician tasks as a student while under the direct supervision of qualified faculty; (8) Works as a principal or school secretary, does not administer medication as a routine part of the position, and has completed training by the delegating nurse for the occasion where the individual may need to administer medication in the absence of the nurse or medication technician; or (9) Practices as a certified nursing assistant-I for less than 4 months in accordance with 42 C.F.R. § 483.35(d). (c) This section does not preclude a registered nurse or licensed practical nurse from delegating a nursing or other technical task to an unlicensed individual if acceptance of delegated nursing or other technical tasks does not become a routine part of the unlicensed individual's job duties. (d) (1) Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude an advanced practice registered nurse from delegating a nursing or other technical task to an assistant if: (i) The assistant performs only tasks that the assistant is trained to perform; and (ii) The delegating advanced practice registered nurse provides: 1. Instruction to the assistant on the delegated task; and 2. On-site supervision of the assistant performing the delegated task. (2) The Board shall adopt regulations to carry out this subsection, including regulations that: (i) Provide for the manner in which an advanced practice registered nurse delegates a nursing or other technical task to an assistant; (ii) Establish limitations on the authority of an advanced practice registered nurse to delegate nursing or other technical tasks to an assistant; and (iii) Otherwise clarify the scope of this subsection. (e) (1) Subject to regulations adopted by the Board under paragraph (2) of this subsection, this section does not preclude a licensed certified midwife from delegating a technical task to an assistant if: (i) The assistant performs only tasks that the assistant is trained to perform; and (ii) The delegating licensed certified midwife provides: 1. Instruction to the assistant on the delegated task; and 2. On-site supervision of the assistant performing the delegated task. (2) The Board shall adopt regulations to carry out this subsection, including regulations that: (i) Provide for the manner in which a licensed certified midwife delegates a technical task to an assistant; (ii) Establish limitations on the authority of a licensed certified midwife to delegate technical tasks to an assistant; and (iii) Otherwise clarify the scope of this subsection. (f) An individual shall be certified by the Board to practice as a nursing assistant and as a dialysis technician before the individual may practice as a dialysis technician in a State-owned hospital or State-owned facility.
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