Residential Service Agencies - Private Duty Nursing - On-Site Nurse Training Programs
Summary
HB1284 requires the Maryland Department of Health to adopt regulations allowing residential service agencies to provide post-hire training to licensed nurses. The bill specifically addresses agencies that provide private duty nursing services and permits them, under certain conditions, to employ nurses who do not yet meet the Department’s clinical experience requirements if the agency provides training and a competency evaluation.
To use this authority, a residential service agency must establish a training program designed to ensure safe and competent care based on patient needs, provide clinical supervision by a registered nurse qualified in private duty nursing, assign the nurse to a qualified preceptor or clinical supervisor until competency is demonstrated, document completion of competency standards in the nurse’s personnel file, and conduct competency evaluations at least annually or more often if required for disciplinary purposes. The Department must approve the training program and competency evaluation, and the bill states that it does not change occupational licensure, scope of practice, or standards of care.
Impact
The bill amends § 19-4A-03 of the Health-General Article and adds new § 19-4A-03.2, expanding the regulatory framework for residential service agencies that provide home health care and private duty nursing. It gives the Department of Health explicit authority to regulate on-site nurse training after hire and creates a pathway for agencies to employ nurses who have not met existing clinical experience thresholds, so long as the agency meets training, supervision, documentation, and competency requirements. The law takes effect October 1, 2026.
Sentiment
The bill appears to have been broadly supported and noncontroversial in the legislature. It passed the House 130-0 and the Senate 34-0, indicating unanimous approval in both chambers. The absence of committee transcript material suggests there was little recorded public dispute or debate, and the final enactment reflects a consensus that the measure would help agencies train nurses while maintaining oversight and patient safety.
Contention
No significant opposition is reflected in the available record. The main policy issue embedded in the bill is balancing workforce flexibility for residential service agencies against patient safety and professional standards. The bill addresses that concern by requiring Department-approved training, supervision by qualified registered nurses, competency documentation, and periodic evaluations, while also clarifying that it does not alter licensure or scope-of-practice rules. Any potential concern would likely come from stakeholders focused on nursing quality assurance or from agencies seeking flexibility in hiring, but the vote history suggests those concerns were resolved or minimal.
Relating to certain municipal regulation of certain mixed-use and multifamily residential development projects and conversion of certain commercial buildings to mixed-use and multifamily residential occupancy.