SB 604 Update: Child Abuse & Neglect – Training
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NPAM does not support SB 607 

3/26:  the HGO committee heard SB 607 (Senator Shank) – Child Abuse & Neglect – Training. The only supporters of the legislation were the Senator, MD Coalition Against Sexual Assault (MCASA) and Advocates for Children & Youth who sent their law student intern to testify. The opposition consisted of the Health Occs Board – Physicians, Nursing, Psychology, LCPCs and Dentistry. Several professional associations were also in opposition: Dentists, MNA, MedChi, Psychiatrists, Psychologists, PTs, and of course NPAM.

Right off the bat, Senator Shank used some testimony from the Senate to spin into commentary that suggested that "the laws are so confusing, no one know what to report…and there isn’t any training to tell us so.” The other two supporting organizations focused their testimony on the duty to report child abuse/neglect which is not part of the bill – the bill, as amended, solely address training.

The associations were called first out of order from the Boards, so we focused our testimony on the following areas:

  • Dentists used to have state regulations mandating child abuse training for recognizing signs of abuse such as chipped teeth, malnutrition, etc. but that the state repealed that requirement as evidence proved that the graduate degree curricula fully covered the training and that once dentists became licensed, they could pursue additional CEUs as needed.
  • Suppose a primary care Nurse working in a large medical practice sees only adult patient, but "covers” one day for a colleague who has a couple minor patients – would that nurse be in violation of the statute because he/she had gotten a waiver under the bill since his/her practice was primarily adult, but now happened to have a couple minor patients? The proposed language is drastically flawed.
  • The language directs the Health Occs Boards to establish a process for professional associations, nonprofits, educational institutions to develop the 90min training courseàwe all spoke to the need to keep the Boards and the Associations separated. The Boards can’t dictate to the Associations what CEUs to develop but can accept national certified or accredited programs offered by state associations.
  • If the course is not continually updated, providers will receive the same training over and over which will not lead to a keener ability to report suspected child abuse and neglect.
  • The Boards testified to financial issues creating the course- each board would have to create its own course for each specific provider group it regulates which will be time consuming, then will have to review the course work up licensing and renewal which will lead to potential delays in licensure.
  • My testimony focused on carefully refuting Shank’s statement as a misunderstood misrepresentation that any of my clients "don’t know what to report” but believe that the current Family Law article is layer upon layer of confounding statute that is in conflict with the 1993 AG Opinion and that that part of the statute needs to be reworked, but that we have never said that providers lack this training nor lack resources to seek out CEUs for this type of training. Shank had left the committee room while I was talking so he didn’t hear my testimony, but I received several head nods from various HGO members that understood the underlying abilities of licensed and highly trained professions not lacking in this area of expertise.

Delegate Morhaim asked several rhetorical questions to the Sponsor and to the Boards regarding the difference between teachers who are mandated to have this training because they have children in their presence and under their supervision 30-40 hours/week compared to many health care providers who may treat children for short periods of time – even in fleeting moments at times. He also talked about 20-30 years ago there was a push to mandate other training in areas such as AIDS, anthrax, fetal alcohol syndrome, and various other cultural competencies that would lead to providers being in training classes every week of the year.

With all of that said, I don’t believe the bill will be moving. I was not present after the hearing, but was told this morning that Delegate Bonnie Cullison told the Boards that they did a good job in explaining the issue and that Dan Morhaim complimented the Boards and the other Associations who were still around afterwards that he was opposed to the bill and was "with us.” I believe that the Chairman will put the bill into subcommittee where we can kill it so the committee doesn’t have to take a full vote.

I will keep everyone posted on any updates to this bill if something should arise. Big thank you to Sandi and Adele for arming me with information on national CEU requirements for NPs!

More updates to come on other bills this week!

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