Maryland – Proposed Legislation for Customer Use of Restrooms

In Maryland, as in most States, restroom availability for customers of a business establishment is mandated by the State Building Code.  Unfortunately this code does not address enforcement if a customer is in a non-food serving establishment.  A few years ago the Maryland Legislature passed a bill that helped address the problem.  The Bill led to Section § 24-209 of Maryland code which requires that the request to use the restroom of a retail establishment by patron with a medical condition be honored.  Currently a 2004 Senate Bill 304 is being considered that would add teeth to § 24-209. Unfortunately it also introduces a requirement to prove the medical condition.  As noted in the Letters to Elected Officials this approach does not fully address the problem and appears in conflict with the intent of the Building Code

Metroped Note: highlighting and bold face added – Refer to State for official references

Maryland adopts its toilet availability requirements from the 2000 National Standard Plumbing Code and from the 2001 Supplement.  The State is in the process of upgrading to the 2003 version.  The following are the issue relevant sections of the 2003 NSPC code.

7.21.4 Separate Facilities
Separate toilet facilities shall be provided for each sex.

EXCEPTIONS:  [ deleted text ]

3. In businesses, occupancies with a total floor area of 1500 square feet or less, one toilet facility, de-signed for use by no more than one person at a time, shall satisfy the requirements for serving customers and employees of both sexes.

4. In mercantile occupancies with a net occupiable floor area of 1500 square feet or less that is accessible to customers, one toilet facility designed for use by no more than one person at a time, shall satisfy the requirements for serving customers and employees of both sexes.

7.21.7 Facilities in Mercantile and Business Occupancies Serving Customers
a. Requirements for customers and employees shall be permitted to be met with a single set of restrooms accessible to both groups. The required number of fixtures shall be the greater of the required number for employees or the required number for customers.
b. Fixtures for customer use shall be permitted to be met by providing a centrally located facility accessible to several stores. The maximum distance of entry from any store to this facility shall not exceed 500 feet.
c. In stores with a floor area of 150 square feet or less, the requirement to provide facilities for employees shall be permitted to be met by providing a centrally located facility accessible to several stores. The maximum distance of entry from any store to this facility shall not exceed 300 feet.
d. Drinking water facilities are not required for customers where normal occupancy is short term.
e. For establishments less than 1500 square feet in total floor area, one water closet and one lavatory in a restroom with a lockable door shall be permitted to provide the requirements for serving the customers and employees.

Local Jurisdictions often strengthen the code requirements.  As an example some Counties include the following amendment.

Amend Table 7.21.1.”Minimum Number of Required Plumbing Fixtures
In item no. 7, “Mercantile,” delete row (a) in its entirety and in the next row, in the “Description” after “Uses” insert

“All gasoline service stations shall provide toilet facilities to the public when open for business. There shall be separate facilities for men and women.”

Metroped Note: Using the above as an example,  to whom would one complain if not allowed to use the toilet facilities at a gasoline service station and what is the penalty?

 § 21-325. Restrooms required in certain places.

(a) Food establishments.- Each food establishment shall have: (1) A convenient toilet that is: (i) Except as provided in subsection (c) of this section, separated from any room in which food is manufactured, prepared, packed, canned, frozen, sold, or distributed; (ii) Kept in a sanitary condition; and (iii) Properly ventilated; and(b) Public facilities in certain food service facilities.- Each food service facility which prepares food and provides seating for patrons established after January 1, 1979 shall have available for the public: (1) A convenient toilet that is kept in a sanitary condition; and (2) A convenient lavatory that is: (i) Supplied with soap, water, towels or other approved hand drying devices; (ii) Kept in a sanitary condition; and (iii) Properly ventilated.

(c) Construction within larger rooms.- A room that houses a toilet may be constructed within a larger room in which food is manufactured, prepared, packed, canned, frozen, sold, or distributed.
[1987, ch. 297.]

§ 24-209. Use of retail establishment’s employee restrooms by certain customers – In general

(a) “Customer” defined.- In this section, “customer” means an individual who:

(1) Suffers from Crohn’s disease, ulcerative colitis or any other inflammatory bowel disease, or any other medical condition that requires immediate access to a toilet facility; or

(2) Utilizes an ostomy device

(b) In general.- At the request of a customer, and where a public restroom is not readily available, each retail establishment with 20 or more employees that has a toilet facility for its employees shall allow the customer to use the facility.

(c) Employee toilet not public restroom.- Notwithstanding any provision of this section, an employee toilet facility is not to be considered a public restroom.

HEALTH-GENERAL TITLE 24
MISCELLANEOUS PROVISIONS
SUBTITLE 2. BUILDINGS AND COMMERCIAL ESTABLISHMENTS

The above was based on

1987 Senate Bill 413

Maryland Law Senate Bill 413 sponsored by Senator Barbara Hoffman.
It was signed into law by Gov. William Donald Schaefer in April, 1987.
It was added to Article-Health-Environmental, Section11-209 Annotated Code of Maryland

The law specifically says that any customer who suffers from Crohn’s disease, ulcerative colitis or any other inflammatory bowel disease or another medical condition that requires immediate access to a toilet facility; or utilizes an ostomy device at the request of the customer, and where a public restroom is not readily available, each retail establishment with 20 or more employees that has a toilet facility for its employees shall allow the customer to use the facility.
2004 SENATE BILL 304   PRI Note: Bill adds teeth to § 24-209Entitled: Retail Establishments – Immediate Restroom Access

Synopsis: Making it a misdemeanor, subject to a $50 fine, for an employee of a retail establishment with 20 or more employees to refuse to allow a customer access to a toilet facility for employees when a public restroom is not readily available and when the customer shows the employee evidence of a specified medical condition, such as an identification card issued by a specified health organization.
Source: Maryland 2004 Regular Session bill information
Unofficial Copy of full 2004 Senate Bill 304

TO: Judiciary Committee
RE: SB 304
FR: Pearl Lewis
President/Founder, Maryland Patient Advocacy Group
Founder, Crohn’s and Colitis Foundation of Maryland
Director Patient Advocacy. Foundation for Children with
Atypical HUS
Member, Consumer Action Board, Medicare Rights Center
Founder, Maryland Renal Coalition

Denial of immediate access to a bathroom causes extreme pain and suffering, both physical and mental to thousands of Marylanders afflicted with a wide range of medical conditions such as Crohn’s disease, ulcerative colitis, an ostomy, UTIs, incontinence – common in 35% of women over 65 and men over 70 and a myriad of other conditions. To address this issue Senator Barbara Hoffman and myself, initiated SB 413 which mandates access to bathrooms in retail establishment by customers having a medical condition requiring immediate bathroom access. Governor Schaefer signed it into law in April of 1987. Despite 17 years on the books many retail establishments are not in compliance.

SB 304 would only add a fine for non-compliance with existing law. In the Senate, in discussion with Tom Sequella of the Retailers Association, we agreed that all that was necessary was an identification letter from a persons own physician stating that immediate bathroom access was necessary – NO INVOLVEMENT OF LOCAL HEALTH DEPARTMENTS.

There is no fiscal impact and no opposition to this bill.

We ask your favorable report.
Below is additional information on this situation in Maryland as well as the health effects of denying bathroom access.

The sanitation standard in Maryland plumbing code, as well as codes of every state, is intended to ensure people will not suffer the adverse health effects that can result if toilets are not available when… needed. Individuals vary significantly in the frequency with which they need to urinate and defecate, with pregnant women, women with stress incontinence, and men with prostatic hypertrophy needing to urinate more frequently. Increased frequency of voiding may also be caused by various medications, by environmental factors such as cold, and by high fluid intake, which may be necessary in hot environment. Diet, medication use, and medical condition are among the factors that can affect the frequency of defecation.
Medical studies show the importance of regular urination, with women generally needing to void more frequently than men. Adverse health effects that may result from voluntary urinary retention include increased frequency of urinary tract infections (UTIs), which can lead to more serious infections and, in rare situations, renal damage (see, e.g., Nielsen, A. Waite, W., “Epidemiology of Infrequent Voiding and Associated Symptoms,” Scand J Urol Nephrol Supplement 157). UTIs during pregnancy have been associated with low birthweight babies, who are at risk for additional health problems compared to normal weight infants (see, Naeye, R.L., “Causes of the Excess Rates of Perinatal Mortality and the Prematurity in Pregnancies Complicated by Maternity Urinary Tract Infections,” New England J. Medicine 1979; 300(15); 819-823). Medical evidence also shows that health problems, including constipation, abdominal pain, diverticuli, and hemorrhoids, can result if individuals delay defecation (see National Institutes of Health (NIH) Publication No. 95-2754, July 1995).

Maryland House of Delegates, Judiciary Committee
Lowe House Office Building, Room 121
84 College Ave.
Annapolis, MD 21401 – 1991

Dear Delegates:

I am the Director of the Public Restroom Initiative.

Many Marylanders who travel to the Washington D.C. Metro area are aware of our successful effort to have the Metrorail station restrooms opened to the public. While the building codes of the various jurisdictions required restrooms for all station occupants there was no enforcement mechanism. I was pleased to acknowledge, via the Media and our mailing list, the effective support of the Maryland WMATA Board Members, all of whom voted for the more enforceable restroom policy.

I have recently learned of potential Maryland legislation (SB304) that will further strengthen the ability of people who are citizens of, who work in, or who are visiting Maryland to find and be able to use a restroom when it becomes critical. I am concerned, however, that not everyone who needs this legislation will benefit. Visitors to Maryland, for example, cannot be expected to have the necessary identification or paper work, nor will someone experiencing a bad reaction from recently eaten food. Maryland currently has excellent toilet requirements code based on the 2001 National Standards Plumbing Code Supplement and will soon be adopting the improved 2003 version. Rather than pass a new law that will conflict with this code, please consider language that works in concert with the existing and 2003 code.

For information that documents the broad scope of the problem, may I suggest you review the material at this web page: pr/Who.htm

Maryland House of Delegates, Judiciary Committee** You can help by letting the Maryland Legislature know you care **

Maryland House of Delegates, Judiciary Committee
Lowe House Office Building, Room 121
84 College Ave.
Annapolis, MD 21401 – 1991

or by email

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