Maryland

Maryland credentials three types of addiction counselors. A Certified Supervised Counselor–Alcohol and Drug requires an associate degree, completed relevant education courses and two years of supervised experience. A Certified Associate Counselor–Alcohol and Drug requires a bachelor’s degree, completed relevant education courses and three years of experience. A Licensed Clinical Alcohol and Drug Counselor requires a graduate degree, completed relevant education courses and 100 hours of face-to-face supervision. Code of Md. Reg. §10.58.07 and Maryland Board of Professional Counselors and Therapists

A licensed professional counselor engages professionally in counseling and appraisal activities by providing services involving the application of counseling principles and methods in the diagnosis, prevention, treatment, and amelioration of psychological problems and emotional or mental conditions of individuals or groups. Md. Health Occupations Code §17-101(v)

As of August 2018, 287 NPs in Maryland have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority and with proper training or appropriate experience an NP with full practice authority can receive a federal waiver to dispense buprenorphine-containing products. An NP in a collaborative relationship may be able to receive a federal waiver with proper training or experience as long as the NP’s collaborating physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Md. Regs. Code §10-27.07.07 and Md. Health Occupations Code §8-101

As of August 2018, 51 PAs in Maryland have received a federal waiver to treat opioid dependency with buprenorphine-containing products. A PA in Maryland may prescribe controlled substances when delegated by a supervising physician. With proper training or appropriate experience a PA in Maryland can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Code of Md. Regs. §10.32.03.08

The standards for the certification of peer recovery specialists, including experience, training, and supervision requirements, are developed and administered by a third-party certification provider.

Full independent practice and prescriptive authority.

A CNM may perform the following functions:

1. Independent management of clients appropriate to the skill and educational preparation of the CNM and the nurse midwife’s clinical practice guidelines.
2. Consult or collaborate with a physician or other health care provider as needed.
3. Refer clients with complications beyond the scope of practice of the CNM to a licensed physician. Code of Md. Reg. §10.27.05.06

A certified midwife may prescribe substances commonly used in the practice of nurse midwifery and controlled substances on Schedules II-V. Code of Md. Reg. §10.27.05.11

Transition to independent practice and prescribing period required.

During the first 18 months, an NP must have a mentorship with a physician or NP who has full practice authority. This mentor shall be available for advice, consultation and collaboration as needed. Code of Md. Reg. §10.27.07.01

An NP may independently prescribe and dispense drugs, devices and Schedules II-V controlled substances. Md. Regs. Code §10-27.07.07

NPs are authorized to sign medical orders for life-sustaining treatment forms. Md. Code of Regulations §10.01.21

NPs are recognized in state policy as a primary care provider. A primary care provider is a nurse practitioner certified in any of the following areas of specialization: adult, pediatric, geriatric, OB/GYN, school nurse or family. Maryland Primary Care Program 

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Md. Code Ann. §11–101(2)(h)

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. Md. Code Ann. §11–404(a)(3)

Optometrists may not prescribe controlled substances. Md. Code Ann. §11–404(a)(1)

A dental hygienist may practice under the general supervision of a licensed dentist, meaning the dentist must authorize the procedure but need not be present during the procedure’s performance. Md. Ann. Code §10.44.21.10

Statute does not identify dental therapists as an oral health provider.

Telehealth means the delivery of medically necessary services, including but not limited to dental services, to a patient through the use of technology-assisted communication. Md. Ann. Code §15-141.2

Maryland has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

A pharmacist may substitute a generically equivalent drug or device product, a therapeutically equivalent brand name drug or device product or an interchangeable biological product, of the same dosage form and strength, for any brand name the drug or device product originally prescribed. Md. Health Occupations Code §12–504

Pharmacists may prescribe and dispense contraceptive medications and self–administered contraceptive devices after completing a training program approved by the Board of Pharmacy for prescribing and dispensing contraceptives. The pharmacists must provide a self–screening risk assessment tool that a patient must use before a pharmacist may prescribe contraceptives. After dispensing the contraceptive, the pharmacist must refer the patient for any additional care to the patient’s primary care practitioner or a reproductive health care practitioner. Md. Health Occupations Code §12–511

Maryland does not allow pharmacists to prescribe tobacco cessation aids.

Continuous supervision of a PA by a physician is required. This can include on-site supervision, written instructions, electronic communication, or assignment of an alternative physician. The delegation agreement made between the physician and PA outlines the relationship and requirements that need to be included as required by statute. Code of Md. Reg. §10.32.03.07

Prescriptive authority is given to the PA by the supervising physician as outlined in the delegation agreement. The PA may prescribe drugs, devices and controlled substances. Code of Md. Regs. §10.32.03.08

Patient services that may be provided by a PA are outlined in law. A delegation agreement between the PA and the physician will include the medical acts delegated to the PA that are within the scope of practice of the supervising physician and appropriate to the PA’s education, training and level of competence. Code of Md. Reg. §10.32.03.06