DEPARTMENT OF HEALTH & MENTAL HYGIENE

OFFICE OF SECRETARY

Appointed by the Governor with Senate advice and consent, the Secretary of Health and Mental Hygiene is responsible for the functions of the Department. The Secretary also directs and coordinates numerous boards, commissions, and citizen advisory groups.

The Secretary serves on the Governor's Executive Council; the Governor's Subcabinet for Children, Youth, and Families; and the Cabinet Council on Criminal and Juvenile Justice. The Secretary also serves on the Governor's Council on Adolescent Pregnancy; the Interagency Committee on Aging Services; the Appalachian States Low-Level Radioactive Waste Commission; the Asbestos Oversight Committee; the State Child Fatality Team; the Advisory Committee for Children, Youth, and Families; the State Emergency Medical Services Board; the State Commission on Infant Mortality Prevention; the State Information Technology Board; the Maryland Medicaid Advisory Committee; the Interdepartmental Advisory Committee for Minority Affairs; the Maryland Advisory Council for New Americans; the Interagency Nutrient Reduction Oversight Committee; the State Advisory Council on Organ and Tissue Donations; the Maryland Partnership for Children, Youth, and Families; the Governor's Pesticide Council; the Safe Schools Interagency Steering Committee; and the Women's Health Promotion Council. In addition, the Secretary is a member of the Advisory Board on After-School Opportunity Programs; the Task Force on Regulatory Reform; and the Board of Directors of the Maryland Health Care Foundation.

Reporting to the Secretary, three deputy secretaries each have a specific area of responsibility: Health Care Financing, Operations, and Public Health Services. Executive Operations and Quality Management Programs also fall under the Office of Secretary, which is aided by the State Child Fatality Review Team, and the Panel to Review Off-Label Uses of Drugs.

STATE CHILD FATALITY REVIEW TEAM
The State Child Fatality Review Team formed within the Department of Health and Mental Hygiene in September 1999 (Chapter 356, Acts of 1999).

The purpose of the Team is to prevent child deaths by analyzing their causes and incidence; devising plans for change within those government agencies represented on the Team; and recommending changes in law, policy, and practice. Among other duties, the Team (in cooperation with local teams) will develop a protocol for child fatality investigations, including procedures for local health departments, law enforcement agencies, medical examiners, and departments of social services (Code Health-General Article, secs. 5-701 through 5-709).

PANEL TO REVIEW OFF-LABEL USES OF DRUGS
Appointed by the Secretary of Health and Mental Hygiene, the Panel to Review Off-Label Uses of Drugs was authorized in 1994 (Chapter 647, Acts of 1994). The Panel reviews particular cases in which there is a dispute about medical insurance payments for off-label use of drugs. The Panel investigates drugs prescribed for treatments other than those approved by the federal Food and Drug Administration and advises the Secretary of Health and Mental Hygiene whether a particular off-label use is medically appropriate. The Secretary forwards Panel recommendations to the Maryland Insurance Commissioner who may direct insurers to pay for the drug (Code 1957, Art. 48A, sec. 490AA).

OFFICE OF PUBLIC RELATIONS
Formerly under Operations, the Office of Public Relations transferred to Office of Secretary in 1999. The Office of Public Relations directs public affairs of the Department and coordinates them with departmental officials, local health officers, and the Governor's Office. The Office of Public Relations also arranges special events and disseminates employee information.

EXECUTIVE OPERATIONS & QUALITY MANAGEMENT PROGRAMS

OFFICE OF HEALTH CARE QUALITY

The Office of Health Care Quality originated in 1971 as the Division of Licensing and Certification under the Office of General Administration and reorganized in 1986 as the Office of Licensing and Certification Programs. In 1987, the Office reformed as the Licensing and Certification Administration. As the Office of Quality Assurance, it transferred from Health Care Policy, Finance, and Regulation and was placed under the Office of Secretary in March 1999. It received its present name in September 1999.

All hospitals and health-related institutions in Maryland must be licensed by the Office. The quality of care and compliance with both State and federal regulations in 8,000 health-care facilities and health-related services and programs is monitored by the Office. To regulate these institutions and programs, the Office conducts more than 10,000 inspections yearly. The Office also is responsible for inspection and certification recommendations for all health facilities participating in the Medical Assistance Program (Medicaid) and Medicare. The Office initiates administrative action against facilities that violate State rules and regulations.

The Office consists of Administration and three programs: Developmental Disabilities, Substance Abuse and Community Mental Health; Laboratory and Ambulatory Care; and Long-Term Care.

ADMINISTRATION
For the Office of Health Care Quality, Administration develops policy, operational procedures, regulations, budgets, and legislation. Under Administration are two units: Hospital; and Quality Assurance.

HOSPITAL UNIT
The Hospital Unit evaluates all hospitals, and investigates and responds to consumer complaints. The Unit licenses and certifies hospitals that participate in Medicare.

QUALITY ASSURANCE UNIT
Established in 1999, the Quality Assurance Unit investigates quality-of-care complaints referred by the Maryland Insurance Commissioner, and enforces statutory and regulatory requirements relating to the quality of care provided by health maintenance organizations (Chapter 697, Acts of 1999).

DEVELOPMENTAL DISABILITIES, SUBSTANCE ABUSE & COMMUNITY MENTAL HEALTH PROGRAM
Functions of the Developmental Disabilities, Substance Abuse and Community Mental Health Program began in 1992 as Long-Term Care, Community Mental Health and Substance Abuse Programs. The work of these units was reorganized in 1995 into two units and the Substance Abuse and Community Mental Health Program formed. In 1995, the Developmental Disabilities and Ambulatory Care Program also was created. Its ambulatory care functions were reassigned in 1997. The Program reorganized under its present name in 1997.

The Developmental Disabilities, Substance Abuse and Community Mental Health Program evaluates community residential and day programs for the developmentally disabled. It also evaluates all residential and nonresidential health-related services and programs for the mentally impaired and the alcohol and drug addicted. This program also manages the licensure of private review agents doing business in Maryland. Private review agents are third parties (often employed by insurance companies) who (in advance) approve or disapprove medical procedures to be covered by insurance.

LABORATORY PROGRAM & AMBULATORY CARE PROGRAM
Within the Office of Health Care Quality, the Laboratory Program evaluates and surveys some 2,000 laboratories, including physician office laboratories, to determine compliance with State and federal laws and regulations. The Program also coordinates and manages the State and federal Cytology Proficiency Testing Program for individuals who interpret pap smears.

The Ambulatory Care Program started as the Hospitals and Ambulatory Care Program. It reorganized in 1995 as the Developmental Disabilities and Ambulatory Care Program and adopted its present name in 1997. The Program reviews State and federal programs involving home health agencies, hospices, health maintenance organizations, major medical equipment, ambulatory care facilities, residential service agencies, and dialysis centers.

LONG-TERM CARE PROGRAM
Within the Licensing and Certification Administration, the Long-Term Care Program originated under its current name before it reformed in 1992 as Long-Term Care, Community Mental Health and Substance Abuse Programs. In 1995, it became the Long-Term Care Program, which evaluates and surveys nursing homes, adult day-care centers, and licensed and registered domiciliary-care homes.

HEALTH PROFESSIONALS BOARDS & COMMISSIONS

Health Professionals Boards and Commissions began as the Division of Boards and Commissions. The Division reorganized in 1986 as the Office of Boards and Commission Programs and, in 1993, received its present name. This office is responsible for the examination, licensing, regulation, and surveillance of health professionals in Maryland.

Under Health Professionals Boards and Commissions are the State Commission on Kidney Disease and eighteen licensing and regulatory boards:

State Acupuncture Board
State Board of Examiners for Audiologists, Hearing Aid Dispensers, & Speech-Language Pathologists
State Board of Chiropractic Examiners
State Board of Dental Examiners
State Board of Dietetic Practice
State Board of Electrologists
State Board of Morticians
State Board of Nursing
State Board of Examiners of Nursing Home Administrators
State Board of Occupational Therapy Practice
State Board of Examiners in Optometry
State Board of Pharmacy
State Board of Physical Therapy Examiners
State Board of Physician Quality Assurance
State Board of Podiatric Medical Examiners
State Board of Examiners of Professional Counselors
State Board of Examiners of Psychologists
State Board of Social Work Examiners

STATE ACUPUNCTURE BOARD

The State Acupuncture Board was created in 1994 (Chapter 620, Acts of 1994). The Board regulates the practice of acupuncture in Maryland.

Seven members constitute the Board. They are appointed to three-year terms by the Governor (Code Health Occupations Article, secs. 1A-101 through 1A-502).

STATE BOARD OF EXAMINERS FOR AUDIOLOGISTS, HEARING AID DISPENSERS, & SPEECH-LANGUAGE PATHOLOGISTS

The State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists originated from three separate boards. The first was the Board of Examiners for Hearing Aid Dealers, formed in 1969 and placed within the Department of Licensing and Regulation in 1970 (Chapter 634, Acts of 1969; Chapter 402, Acts of 1970). The other two boards - the State Board of Examiners for Audiologists, and the Board of Examiners for Speech Pathologists - both started in 1972 within the Department of Health and Mental Hygiene (Chapter 547, Acts of 1972). In 1987, the speech pathologists' board was renamed the State Board of Examiners for Speech-Language Pathologists (Chapter 478, Acts of 1987). All three boards merged in 1992 to become the State Board of Examiners for Audiologists, Hearing Aid Dealers, and Speech-Language Pathologists within the Department of Health and Mental Hygiene (Chapter 326, Acts of 1992). In 1993, the Board received its present name (Chapter 448, Acts of 1993). The Board licenses audiologists, hearing aid dispensers, and speech-language pathologists.

The Board is composed of thirteen members appointed to four-year terms by the Governor on recommendation of the Secretary of Health and Mental Hygiene. Authorization for the Board continues until July 1, 2004 (Code Health Occupations Article, secs. 2-101 through 2-501).

STATE BOARD OF CHIROPRACTIC EXAMINERS

In 1920, the State Board of Chiropractic Examiners formed (Chapter 666, Acts of 1920). The Board examines applicants for licenses, investigates complaints, and (in consultation with the Office of the Attorney General) conducts disciplinary proceedings as necessary. Each person holding a chiropractic license in Maryland must renew it every two years with the Board. The Board holds three examinations per year. It also ascertains whether schools of chiropractic meet the requirements of the law.

The Board consists of seven members appointed by the Governor with the advice of the Secretary of Health and Mental Hygiene and Senate advice and consent. Members serve four-year terms. Authorization for the Board continues until July 1, 2002 (Code Health Occupations Article, secs. 3-201 through 3-602).

MASSAGE THERAPY ADVISORY COMMITTEE
Within the State Board of Chiropractic Examiners, the Massage Therapy Advisory Committee was created in 1999 (Chapter 397, Acts of 1999). The Committee advises the Board on certification, and regulatory and disciplinary matters relating to the practice of massage therapy. Appointed by the Board, the Committee consists of six members (Code Health Occupations Article, sec. 3-5A-04).

STATE BOARD OF DENTAL EXAMINERS

Established in 1884, the State Board of Dental Examiners regulates the practice of dentistry by testing the qualifications of candidates for licenses in dentistry and in dental hygiene (Chapter 150, Acts of 1884).

All applicants for license to practice dentistry must be graduates of accredited dental colleges authorized to grant degrees in dental surgery by the laws of one of the United States or a province of Canada. For a license to practice dental hygiene, all applicants must be graduates of a school for dental hygienists that requires at least two years of study and is approved by the State Board of Dental Examiners. Examinations, held twice a year, are both written and practical. Every two years, dentists and dental hygienists must renew their licenses to practice.

Dental radiation technologists also are certified by the Board. An individual may not practice dental radiation technology in Maryland unless certified by the Board.

The Governor appoints the Board's fifteen members for four-year terms with the advice of the Secretary of Health and Mental Hygiene. Three consumer members are appointed with the advice of the Secretary and Senate advice and consent. Authorization for the Board continues until July 1, 2005 (Code Health Occupations Article, secs. 4-101 through 4-702).

STATE BOARD OF DIETETIC PRACTICE

The State Board of Dietetic Practice was authorized in 1985 to protect the public by setting standards for the practice of dietetics in Maryland (Chapter 773, Acts of 1985). The Board licenses dietitians and nutritionists in Maryland. Licenses to practice dietetics must be renewed with the Board every two years.

The Board has nine members appointed to four-year terms by the Governor. Authorization for the Board continues until July 1, 2005 (Code Health Occupations Article, secs. 5-101 through 5-502).

STATE BOARD OF ELECTROLOGISTS

The State Board of Electrologists began in 1978 (Chapter 851, Acts of 1978). The Board adopts and revises standards of electrology practice for registered electrologists and prescribes standards for educational programs leading to licensure. The Board examines and licenses qualified applicants. The Board also conducts hearings on charges calling for discipline of a licensed electrologist by penalty, denial, revocation, or suspension of a license, and causes the prosecution of all persons in violation of the Electrology Practice Act.

Five members who serve four-year terms make up the Board. Upon recommendation of the Secretary of Health and Mental Hygiene, the Governor appoints members with Senate advice and consent. Authorization for the Board continues until July 1, 2004 (Code Health Occupations Article, secs. 6-101 through 6-702).

STATE COMMISSION ON KIDNEY DISEASE

In 1971, the State Commission on Kidney Disease was authorized (Chapter 492, Acts of 1971). The Commission oversees a program of State assistance throughout Maryland for persons with chronic renal disease.

Information on the treatment of chronic renal disease in the State is gathered and disseminated by the Commission. It also sets physical and medical standards for the operation of dialysis and renal transplantation centers and sets standards for the acceptance of a patient into the treatment phase of such programs. Patients accepted for treatment are eligible for State medical assistance. For the public and providers of health services, the Commission also institutes and supervises educational programs on kidney disease and its treatment and prevention.

The Governor appoints the Commission's twelve members to four-year terms. The Commission selects the executive director (Code Health - General Article, secs. 13-301 through 13-307).

STATE BOARD OF MORTICIANS

The State Board of Morticians was established as the State Board of Undertakers of Maryland in 1902 (Chapter 160, Acts of 1902). Renamed the State Board of Funeral Directors and Embalmers in 1937, the Board received its present name in 1981 (Chapter 8, Acts of 1981).

Every funeral director and mortician in the State must register with and procure a license from the Board. The Board sets the standards for the practice of mortuary science in the State and examines applicants for licensure. The Board renews licenses every two years and has the power to suspend or revoke any license. The Board makes regulations for the enforcement of laws regarding funeral directing and mortuary science.

Upon recommendation of the Secretary of Health and Mental Hygiene and with Senate consent, the Governor appoints the Board's twelve members to four-year terms. Authorization for the Board continues until July 1, 2002 (Code Health Occupations Article, secs. 7-101 through 7-602).

STATE BOARD OF NURSING

The State Board of Nursing began as the State Board of Examiners of Nurses in 1904 (Chapter 172, Acts of 1904). It adopted its present name in 1987 (Chapter 109, Acts of 1987).

To assure safe, competent nursing care for the public, the State Board of Nursing regulates the practice of registered nurses, licensed practical nurses, nurse practitioners, nurse midwives, nurse anesthetists, nurse psychotherapists, and nursing assistants. The Board administers licensure examinations and issues licenses to those who successfully complete requirements and examinations. The Board evaluates, monitors, and approves nursing education programs; enforces the standards and defines the scope of nursing; approves refresher programs; and assesses and evaluates trends in nursing. Through its investigative unit, the Board also investigates any complaint alleging violation of the Nurse Practice Act by a nurse, conducts hearings, and takes disciplinary action as required. Such action may include emergency suspension, revocation of license, denial of licensure, probation, or fine.

With the National Council of State Boards of Nursing, the Board cooperates in the preparation of the examination used for licensure. The Board also works with health care facilities, educational institutions, professional organizations, the Maryland Higher Education Commission, the State Board of Education, the Department of Aging, county health departments, local school systems, and Department agencies.

Upon recommendation of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's eleven members for four-year terms. Two members are consumers appointed with Senate advice and consent. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs. 8-101 through 8-802).

NURSE ANESTHETIST PEER REVIEW ADVISORY COMMITTEE
The Nurse Anesthetist Peer Review Advisory Committee started as the Anesthetist Advisory Committee in 1981 and received its present name in 1994. The Committee advises the State Board of Nursing concerning the practice of anesthesia by nurses. The Committee also oversees the use of health insurance and medical assistance benefits by certified nurse anesthetists. Appointed by the State Board of Nursing, the Committee's five members serve three-year terms (Code Health Occupations Article, sec. 8-503).

NURSE-MIDWIFE PEER REVIEW ADVISORY COMMITEE
Appointed by the State Board of Nursing, the Nurse-Midwife Peer Review Advisory Committee organized in 1983 as the Certified Nurse-Midwives Advisory Council. It adopted its current name in 1997. The Committee advises the Board on the practice of nurse-midwifery. The Committee consists of at least three certified nurse-midwives who serve three-year terms (Code Health Occupations Article, sec. 8-503).

JOINT COMMITTEE ON NURSE-MIDWIFERY
Established in 1983, the Joint Committee on Nurse-Midwifery reviews and makes recommendations on all written agreements between nurse-midwives and physicians. The Committee is composed of three nurse-midwives, appointed by the State Board of Nursing; and three physicians, appointed by the State Board of Physician Quality Assurance. Members serve three-year terms (Code Health Occupations Article, sec. 8-503).

NURSE PRACTITIONER JOINT COMMITTEE
The Nurse Practitioner Joint Committee was created in 1981. The Committee reviews written agreements between nurse practitioners and physicians. The Committee then makes recommendations to the State Board of Physician Quality Assurance and the State Board of Nursing.

The Committee has six members. Three are appointed by the State Board of Physician Quality Assurance and three by the State Board of Nursing.

NURSE PRACTITIONER PEER REVIEW COMMITTEE
The Nurse Practitioner Peer Review Committee organized in 1981. It oversees the use of health insurance and medical assistance benefits by certified nurse practitioners. Appointed by the State Board of Nursing, the Committee has ten nurse practitioners representing all nurse practitioner specialties (Code Health Occupations Article, sec. 8-503).

NURSE PSYCHOTHERAPIST PEER REVIEW ADVISORY COMMITTEE
The Nurse Psychotherapist Peer Review Advisory Committee formed in 1991. It advises the State Board of Nursing on the practice of psychotherapy by clinical specialists in psychiatric and mental health nursing. The Committee also oversees the use of health insurance and medical assistance benefits by clinical specialists-psychiatry.

NURSING ASSISTANT ADVISORY COMMITTEE
Since 1999, the Nursing Assistant Advisory Committee has advised the State Board of Nursing on applications for nursing assistant certification, approval of training programs for nursing assistants, and discipline of nursing assistants.

PRACTICE ISSUES COMMITTEE
Established in 1985, the Practice Issues Committee meets monthly to study specific practice issues referred to it by the State Board of Nursing. The Committee's twelve members are assisted by consultants as needed.

REHABILITATION COMMITTEE no. 1
REHABILITATION COMMITTEE no. 2
The Rehabilitation Committee was authorized in 1988 as a nonpunitive alternative to the disciplinary process of the State Board of Nursing (Chapter 508, Acts of 1988). Nurses whose job performance is impaired by drugs, alcohol, or mental illness may participate in the Rehabilitation Program upon recommendation of the Committee. In 1992, a second committee was established to handle the volume of nurses referred to the Program.

The State Board of Nursing selects each committee's five members. They are licensed registered nurses with expertise in the field of chemical dependency or psychiatric nursing. One member is a licensed practical nurse, and one, a consumer knowledgeable in the field of chemical dependency (Code Health Occupations Article, sec. 8-208).

STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS

Established in 1970, the State Board of Examiners of Nursing Home Administrators examines, licenses, and regulates nursing home administrators (Chapter 262, Acts of 1970). Licenses must be renewed with the Board every two years. They may be revoked or suspended for cause. The Board also studies nursing homes and their administrators to improve licensing standards and enforcement procedures.

The Board is composed of eleven members appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene. The Governor names the chair and vice-chair. The Board appoints the executive director. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs. 9-101 through 9-502).

STATE BOARD OF OCCUPATIONAL THERAPY PRACTICE

The State Board of Occupational Therapy Practice was created in 1978 (Chapter 909, Acts of 1978). The Board administers, coordinates, and enforces the provisions of the Maryland Occupational Therapy Practice Act. The Board evaluates the qualifications of applicants for licensure and supervises the examination of applicants. It keeps a current list of licensed occupational therapists and occupational therapy assistants. Licenses must be renewed every two years and may be revoked or suspended for cause.

The Board's seven members are appointed for four-year terms by the Governor with the advice of the Secretary of Health and Mental Hygiene. Authorization for the Board continues until July 1, 2004 (Code Health Occupations Article, secs. 10-201 through 10-502).

STATE BOARD OF EXAMINERS IN OPTOMETRY

Formed in 1914, the State Board of Examiners in Optometry administers the optometry laws of the State and regulates the practice of optometry (Chapter 652, Acts of 1914). It examines, licenses, and registers applicants, and may revoke any certificate of registration or examination for just cause.

The Board consists of seven persons appointed to four-year terms by the Governor upon the recommendation of the Secretary of Health and Mental Hygiene from nominees of the Maryland Optometric Association. Two members are consumers appointed by the Governor on recommendation of the Secretary with Senate advice and consent. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs. 11-101 through 11-602).

STATE BOARD OF PHARMACY

Created in 1902, the State Board of Pharmacy licenses pharmacists by examination and reciprocity (Chapter 179, Acts of 1902). It also conducts a biennial re-registration program for pharmacists. The Board issues permits for the operation of retail pharmacies and for the manufacture of drugs, medicines, toilet articles, dentifrices, and cosmetics. The Board also licenses jobbers, distributors, and wholesalers or manufacturers of prescription drugs. In cooperation with the Department of Health and Mental Hygiene, the Board enforces the pharmacy and drug laws of the State.

All pharmacies or other places where prescriptions, medicines, drugs, drug products, or domestic remedies are compounded or sold are inspected by Board members and duly authorized agents of the Department of Health and Mental Hygiene. They also inspect prescriptions, medicines, drugs, drug products, or domestic products offered for sale. Pharmacists are required to keep in their places of business, for a period of not less than five years, a file of every prescription compounded or dispensed.

The Board's twelve members include ten licensed pharmacists and two consumers. All are appointed by the Governor with the advice of the Secretary of Health and Mental Hygiene for four-year terms. The Board may designate an executive director. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs. 12-101 through 12-802).

PHARMACY REVIEW COMMITTEE
In 1997, the State Board of Pharmacy was authorized to appoint a Pharmacy Review Committee (Chapter 615, Acts of 1997).

STATE BOARD OF PHYSICAL THERAPY EXAMINERS

Authorized in 1947, the State Board of Physical Therapy Examiners examines and licenses physical therapists and physical therapist assistants to practice in Maryland (Chapter 606, Acts of 1947). The Board also makes rules and regulations governing the denial, suspension, and revocation of licenses.

The Board's eight members are appointed to four-year terms by the Governor with the advice of the Secretary of Health and Mental Hygiene. Two consumer members are named with Senate advice and consent. Authorization for the Board continues until July 1, 2002 (Code Health Occupations Article, secs. 13-101 through 13-502).

STATE BOARD OF PHYSICIAN QUALITY ASSURANCE

In Maryland, authority to license physicians was granted first to the Medical and Chirurgical Faculty of the State of Maryland in their charter of 1798 (Chapter 105, Acts of 1798). From 1798 to 1838, the Faculty examined candidates, issued licenses upon payment of a fee, and prosecuted unlicensed doctors. The petitions of botanic medical practitioners influenced the legislature to pass a law in 1838 allowing any person to collect fees for medical services performed, which effectively ended the licensing of doctors for fifty years (Chapter 281, Acts of 1838).

In 1888, the State Board of Health began to license all physicians (Chapter 429, Acts of 1888). By 1892, two boards of medical examiners carried on this function. One represented the Medical and Chirurgical Faculty and the other the State Homeopathic Society (Chapter 296, Acts of 1892). The General Assembly in 1957 abolished the Homeopathic Board and set up the State Board of Medical Examiners to regulate the practice of medicine. In 1968, responsibility for disciplining licensed physicians was assigned to the Commission on Medical Discipline of Maryland (Chapter 469, Acts of 1968). Functions of both the State Board of Medical Examiners and the Commission on Medical Discipline of Maryland combined in 1988 under the State Board of Physician Quality Assurance (Chapter 109, Acts of 1988).

The State Board of Physician Quality Assurance tests and licenses physicians to practice medicine in Maryland. The Board determines the eligibility of physicians to represent themselves as specialists. For certain causes, the Board may revoke the license of any physician. The Board also registers residents and x-ray assistants. In addition, the Board certifies seven categories of allied health practitioners, including physician assistants, psychiatrists' assistants, respiratory care practitioners, medical radiation technologists, nuclear medical technologists, cardiac rescue technicians, and emergency medical technicians-paramedics. With the State Board of Nursing, the Board reviews written agreements between physicians and nurse practitioners and nurse midwives.

To determine eligibility for initial medical licensure, the Board administers the United States Medical Licensing Examination. The Board also administers the Special Purpose Examination of the Federation of State Medical Boards to some applicants and licensees to determine if they have remained competent practitioners after an absence from practicing medicine.

For certain cases, the Board may take disciplinary action, including revocation, suspension, reprimand, or probation, and may fine a licensee. Where there is an imminent threat to the public, the Board may issue an emergency suspension of a license. In an effort to prevent misconduct, the Board operates a speaker's bureau, and conducts educational programs and training sessions on certain high-risk behavioral areas. Quarterly, the Board issues a newsletter with a lead article of topical interest to the medical community as well as information about Board acts or sanctions.

The Board works closely with state and local law-enforcement agencies, as well as federal agencies, such as the Federal Bureau of Investigation and the U.S. Office of Inspector General. Since 1977, the Board has participated in the network of state disciplinary information bank of the Federation of State Medical Boards. Since 1990, the Board has served as a conduit of disciplinary information between Maryland hospitals and the National Practitioners Data Bank.

Composed of fifteen members, the Board is appointed by the Governor. One consumer member is appointed to an initial term of three years with Senate advice and consent. Other members serve four-year terms. The Governor selects a physician member as chair. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs. 14-101 through 15-502).

LICENSURE ADVISORY COMMITTEE
The Licensure Advisory Committee was formed by the State Board of Physician Quality Assurance to advise the Board on licensure issues, such as postgraduate training, examinations, and renewal and reinstatement requirements.

MEDICAL RADIATION & NUCLEAR MEDICAL TECHNOLOGY ADVISORY COMMITTEE
The Medical Radiation and Nuclear Medical Technology Advisory Committee began in 1990. The Committee reviews and makes recommendations to the State Board of Physician Quality Assurance on all applications for certification of nuclear medical technologists and medical radiation technologists. The Committee recommends to the Board the approval, modification, or disapproval of an application for certification. The Committee also recommends to the Board regulations governing nuclear medical technologists and medical radiation technologists and their practice.

PHYSICIAN ASSISTANT ADVISORY COMMITTEE
Within the State Board of Medical Examiners, the Physician Assistant Advisory Committee was created in 1986 (Chapter 759, Acts of 1986). The Committee became part of the State Board of Physician Quality Assurance in 1988 (Chapter 109, Acts of 1988).

The Committee recommends to the Board, regulations for the certification of physician assistants. To the Board, it also recommends the approval, modification, or disapproval of an application for certification. The Committee may report to the Board any alleged unauthorized practice of a physician assistant, or any conduct of a supervising physician or a physician assistant that may be cause for disciplinary action.

To perform delegated medical acts, a physician assistant must obtain an approved delegation agreement from the State Board of Physician Quality Assurance. The Committee evaluates the qualifications of the physician assistant for delegated medical acts to be performed under that agreement and recommends that the Board approve, modify, or reject the application for a delegation agreement. The Board, on review of the Committee's recommendation, may approve, modify, or disapprove a delegation agreement for good cause.

The Committee's seven members are appointed to three-year terms by the State Board of Physician Quality Assurance (Code Health Occupations Article, secs. 15-101 through 15-502).

PRACTICE OF MEDICINE ADVISORY COMMITTEE
The Practice of Medicine Advisory Committee was organized in 1992 by the State Board of Physician Quality Assurance to advise the Board on issues affecting medical licensure, such as telemedicine and delegation of medical acts.

RESPIRATORY-CARE PROFESSIONAL STANDARDS COMMITTEE
Authorized in 1988, the Respiratory-Care Professional Standards Committee formed in 1990 (Chapter 127, Acts of 1988). The Committee advises the State Board of Physician Quality Assurance on regulations governing the practice of respiratory care, and the approval, modification, or disapproval of an application for certification. The Committee refers to the Board any allegation of unauthorized practice by a respiratory care practitioner or conduct by a supervising physician or respiratory care practitioner that may be cause for disciplinary action.

STATE BOARD OF PODIATRIC MEDICAL EXAMINERS

The State Board of Podiatric Medical Examiners commenced in 1916 as the State Board of Chiropody Examiners (Chapter 173, Acts of 1916). In 1965, it became the State Board of Podiatry Examiners (Chapter 416, Acts of 1965). The Board was renamed the State Board of Podiatric Medical Examiners in 1986 (Chapter 243, Acts of 1986).

The practice of podiatry in the State is regulated by the Board. The Board evaluates credentials, gives licensure examinations, issues licenses, renews licenses biennially, approves continuing education programs, monitors compliance of licensees with continuing education requirements, and investigates allegations of professional misconduct. After a hearing, the Board may revoke the license of any podiatrist charged with malpractice or unethical conduct.

The Governor appoints the Board's seven members to four-year terms with the advice of the Secretary of Health and Mental Hygiene. Two are consumers appointed with Senate advice and consent. Authorization for the Board continues until July 1, 2002 (Code Health Occupations Article, secs. 16-101 through 16-602).

STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS

The State Board of Examiners of Professional Counselors originated in 1985 (Chapter 734, Acts of 1985). The Board certifies professional counselors and regulates professional counseling services within the State.

In 1998, the General Assembly provided for licensure of three categories of counselors offering clinical counseling: licensed clinical professional counselor; licensed clinical marriage and family therapist; and licensed clinical alcohol and drug counselor (Chapter 132, Acts of 1998).

With the advice of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's nine members to four-year terms. Authorization for the Board continues until July 1, 2004 (Code Health Occupations Article, secs. 17-101 through 17-502). Since 1997, the Governor has been authorized to appoint an advisor to the Board (Chapter 461, Acts of 1997).

STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS

The practice of psychology in Maryland is regulated by the State Board of Examiners of Psychologists. Established in 1957, the Board evaluates the qualifications of psychologists in the State and issues licenses to those who fulfill the requirements (Chapter 748, Acts of 1957). Licenses must be renewed biennially. The Board administers examinations to qualified applicants for licensing twice each year.

The Board consists of nine members appointed by the Governor with the advice of the Secretary of Health and Mental Hygiene and Senate advice and consent. Members serve four-year terms. Authorization for the Board continues until July 1, 2003 (Code Health Occupations Article, secs.18-101 through 18-502).

STATE BOARD OF SOCIAL WORK EXAMINERS

In 1975, the State Board of Social Work Examiners formed (Chapter 453, Acts of 1975). The Board issues licenses to social work associates, graduate social workers, certified social workers, and certified social workers-clinical. Under certain conditions the Board may take disciplinary measures to reprimand, suspend, revoke, or refuse to renew the license of a licensee.

The Board's seven members are appointed by the Governor for four-year terms. Two are consumers appointed on recommendation of the Secretary of Health and Mental Hygiene with Senate advice and consent. Authorization for the Board continues until July 1, 2004 (Code Health Occupations Article, secs. 19-201 through 19-502)

HEALTH CARE FINANCING

Health Care Financing began in 1975 as the Office of Regulatory Services. By 1981, responsibilities of the Office were assigned to the Assistant Secretary for Health Regulation and Policy Analysis and, by 1985, to the Assistant Secretary for Health Regulation. In 1987, Policy, Financing, and Regulation was created and, in 1988, renamed Health Care Policy, Finance, and Regulation. In December 1999, the deputy secretariat reorganized as Health Care Financing.

Health Care Financing oversees the principal health regulatory functions of the Department and provides leadership and guidance for the Department's financing and regulatory programs. This entails oversight of regulatory functions of the Maryland Health Care Commission and the State Health Services Cost Review Commission.

The Deputy Secretary for Health Care Financing develops recommendations for the Secretary of Health and Mental Hygiene to modify and shape the role of the Department. The Deputy Secretary helps define health problems, evaluates Department programs, and develops data on federal and other external trends so as to advise the Secretary on program emphasis and Department direction.

Under Health Care Financing are the Maryland Health Care Commission, and the State Health Services Cost Review Commission. The Deputy Secretary also is responsible for three offices: Health Services; Operations and Eligibility, Medical Care Programs; and Planning, Development, and Finance.

MEDICAL ASSISTANCE PROGRAM
Health Care Financing plans, directs, and evaluates the Medical Assistance Program (Medicaid). Since 1966, the Program has provided access to health care for categorically and medically needy residents throughout Maryland. Health care includes hospital services (inpatient and outpatient), laboratory and X-ray services, nursing facility services, physician services, and home health care. Additional health care is available as indicated in the Medical Assistance State Plan. The Program is implemented by three offices: Health Services; Operations and Eligibility, Medical Care Programs; and Planning, Development, and Finance.

Health care expenses of the Medical Assistance Program (Medicaid) are federally matched on a 50/50 basis for approximately 90 percent of recipients. For the remaining 10 percent, services are funded totally by State and local funds (Code Health - General Article, secs. 15-101 through 15-128).

MARYLAND HEALTH CARE COMMISSION

The Maryland Health Care Commission originated in 1993 as the Maryland Health Care Access and Cost Commission, an independent body within the Department of Health and Mental Hygiene (Chapter 9, Acts of 1993). Assuming functions of the former State Health Resources Planning Commission, it reorganized in 1999 as the Maryland Health Care Commission (Chapter 702, Acts of 1999).

The Commission promotes a health regulatory system to provide all Marylanders with financial and geographic access to quality health care at a reasonable cost. Strategies to limit health care costs and extend health care access for all Marylanders are developed by the Commission. The Commission also formulates a uniform set of benefits for the comprehensive standard health benefit plan; devises a payment system for health care services; and fosters development of practice parameters. Moreover, the Commission facilitates public disclosure of medical claims data for the development of public policy; maintains and analyzes a medical care database on health care provided by health care practitioners; and ensures the use of that database as a primary means to compile data and annually report on trends, variances, and comparisons regarding fees for service, cost of care, and malpractice. Additionally, the Commission encourages the development of clinical resource management systems that permit cost comparisons between various treatment settings and the availability of information to consumers, providers, and purchasers of health care; sets standards for the operation and licensing of medical care electronic claims clearinghouses; and reduces the costs of submitting and administering claims for health care practitioners and payors.

With Senate advice and consent, the Governor appoints the Commission's thirteen members to four-year terms. The Governor also names the chair (Code Health - General Article, secs. 19-101 through 19-227).

NURSING HOME REPORT-CARD STEERING COMMITTEE
In September 1999, the Maryland Health Care Commission formed the Nursing Home Report-Card Steering Committee. The Committee will develop a system for evaluating nursing homes. The system is to be implemented by July 2001 (Chapter 382, Acts of 1999).

STATE HEALTH SERVICES COST REVIEW COMMISSION

The State Health Services Cost Review Commission was mandated in 1971 to monitor all fiscal affairs of Maryland's hospitals and related institutions (Chapter 627, Acts of 1971). The Commission publicly may disclose a hospital's financial position, its verified total costs incurred in rendering health services, and the level of reasonableness of its rates as determined by Commission review and certification. The Commission also evaluates the adequacy of each institution's financial resources. When these resources are inadequate, the Commission seeks solutions.

For purchasers of hospital health care, the Commission assures that total costs are reasonable, aggregate rates are set in relation to a hospital's aggregate costs, and rates are set equitably.

The Commission consists of seven members appointed to four-year terms by the Governor, who names the chair. With the approval of the Governor, the Commission appoints the executive director (Code Health - General Article, secs. 19-201 through 19-227).

OFFICE OF HEALTH SERVICES

The Office of Health Services began as the Policy Administration in 1975. Renamed the Health Systems Financing Administration in 1987, and the Medical Care Policy Administration in March 1990, it became the Medical Care Services Administration in December 1999. The Office received its present name in January 2000.

Policies and regulations that establish eligibility criteria, define services, detail coverage, specify limitations, and determine reimbursement rates for the Medical Assistance Program (Medicaid) are developed and reviewed by the Office. In addition, the Office updates the State Plan for the Medical Assistance Program and secures federal approval for program changes to assure the continued availability of federal matching funds.

In October 1997, the Office reorganized into three main units: Acute and Primary Care; Long-Term Care and Community Support Services; and Long-Term Care and Waiver Services. In January 2000, it further reorganized under two administrations: HealthChoice and Acute Care; and Long Term Care and Community Support.

HEALTHCHOICE & ACUTE CARE ADMINISTRATION

CUSTOMER SUPPORT
Customer Support organized in January 2000. It oversees three divisions: Children's Services; HealthChoice Customer Relations; and Outreach and Assistance.

DIVISION OF CHILDREN'S SERVICES
The Division of Children's Services organized in May 1998.

DIVISION OF OUTREACH & ASSISTANCE
The Division of Outreach and Assistance formed in May 1998 as the Division of Outreach and Women's Services and received its current name in January 2000.

PROVIDER MANAGEMENT
Formed in January 2000, Provider Management oversees four divisions: HealthChoice Management; Hospital and Physician Services; Managed Care Quality Assurance; and Pharmacy and Clinic Services.

DIVISION OF HEALTHCHOICE MANAGEMENT
In July 1987, the Division of HealthChoice Management began as the Division of Primary Care, became the Division of Managed Care in October 1997, and received its present name in January 2000. The Division establishes and articulates the State Medicaid policies and regulations pertaining to medical and professional services. These services are provided by physicians, dentists, podiatrists, vision care providers, free-standing clinics, nurse-midwives, nurse anesthestists, nurse practitioners, and health maintenance organizations.

DIVISION OF PHARMACY & CLINIC SERVICES
The Division of Pharmacy and Clinic Services was established in July 1979 as the Division of Acute Care. It became the Division of Medical Services in October 1997 and received its current name in January 2000. The Division plans, prepares, and amends regulations, and interprets policy for the following parts of the Medical Assistance Program (Medicaid): Ambulatory Surgery; Free-standing Dialysis Centers; Hospitals; Medical Laboratories; Mental Health; Residential Treatment Centers; and Pharmacy.

LONG-TERM CARE & COMMUNITY SUPPORT SERVICES ADMINISTRATION

ACCESS, QUALITY, & PROGRAM INTEGRITY
Created in January 2000, Access, Quality, and Program Integrity oversees three divisions: Community-Based Nursing Services; Community Support Services; and Compliance: Physically Disabled and Elderly Services.

LONG-TERM CARE & WAIVER SERVICES
Under Long-Term Care and Waiver Services are three divisions: Community Long-Term Care Services; Institutional Long-Term Care Services; and Waiver Programs.

DIVISION OF COMMUNITY LONG-TERM CARE SERVICES
The Division of Community Long-Term Care Services organized as the Division of Special Populations in December 1994. It was one of two units created from the former Division of Program Services. In 1997, the Division of Special Populations reorganized as the Division of Planning and Evaluation. It received its present name in January 2000.

DIVISION OF INSTITUTIONAL LONG-TERM CARE SERVICES
In July 1979, the Division of Institutional Long-Term Care Services formed as the Division of Long-Term Care Services. It adopted its current name in January 2000. The Division administers Maryland Medicaid coverage and reimbursement for nursing home services, medical day care, and personal care.

The Division develops strategies for financing and delivering services to persons with special needs who are eligible for Medicaid. These include children and adults with chronic or mental illnesses, traumatic injury, developmental disability, AIDS, or a history of drug and alcohol abuse. Services funded entirely by the State are refinanced to include federal Medicaid funds. Financial resources and services are reallocated from institutions, such as nursing homes and State psychiatric and developmental disability facilities, to community-based services.

DIVISION OF WAIVER PROGRAMS
The Division of Waiver Programs was one of two agencies derived from the former Division of Program Services in December 1994. The Division of Waiver Programs is concerned with Medical Assistance waivers. These are exceptions granted by the federal Health Care Financing Administration to certain federal regulations governing Medicaid. Such waivers are authorized when it becomes cost effective to do so, but only if the quality of medical care is maintained (federal Social Security Act, sec. 1915). Typically, waivers help people who otherwise would require a hospital, or a facility providing skilled nursing or intermediate care.

The Division coordinates and manages three home- and community-based services waivers. These are the Model Waiver, Senior Assisted-Housing Waiver, and Developmental Disabilities Waiver. The Division also directs nine targeted case-management services programs, and two managed-care waivers and proposals (Maryland Access to Care and the Diabetes Care Waiver).

OFFICE OF OPERATIONS & ELIGIBILITY, MEDICAL CARE PROGRAMS

The Office of Operations and Eligibility, Medical Care Programs began in 1975 as the Medical Care Operations Administration. It reorganized as the Program Systems and Operations Administration in November 1993, and reclaimed its original name in July 1997. In December 1999, it became the Medical Care Operations and Eligibility Administration and, in January 2000, it adopted its current name.

Systems for prompt and accurate payment to providers of health care services are developed and maintained by the Office. It also maintains files of approved providers of services and of Maryland residents certified as eligible to receive services through the Medical Assistance Program (Medicaid). In 1999, the Office became responsible for eligibility determination and policy.

The Office is organized under two administrations: Beneficiary Services; and Systems and Operations.

DIVISION OF ADMINISTRATIVE SERVICES
The Division of Administrative Services started in March 1990. The Division conducts personnel transactions, prepares budgets, promulgates Medicaid regulations, and formulates amendments to the Medicaid State Plan.

BENEFICIARY SERVICES ADMINISTRATION

ELIGIBILITY OPERATIONS

BENEFICIARY SERVICES DIVISION
Beneficiary Enrollment Services was created in December 1999. It oversees the HealthChoice Program, which started in December 1991 as the Maryland Access to Care (MAC) Program. It reorganized as Maryland Access to Care (MAC) Recipient Services and Medical Assistance Provider Relations in November 1993 and further reformed as HealthChoice in July 1998. To improve the quality of health care for Medical Assistance recipients, HealthChoice maintains a roster of primary care physicians. Recipients having difficulty finding their own physician may choose a primary care provider enrolled with the Program. That provider then refers the recipient to medical specialists as needed. The Program enrolls both recipients and providers and informs Medical Assistance recipients about the Program.

KIDNEY DISEASE PROGRAM
The Kidney Disease Program formed in 1971. The Program financially assists Marylanders who are certified end-stage renal disease patients. This assistance for treatment is available only after all other medical and federal insurance coverage has been pursued.

PHARMACY ASSISTANCE PROGRAM
Authorized in 1978, the Pharmacy Assistance Program helps pay for certain kinds of maintenance prescription drugs for chronic conditions; anti-infective drugs, including AZT; and insulin syringes and needles. Completely State-funded, the Program is designed for low-income families and individuals who are not eligible for Medicaid (Code Health - General Article, sec. 15-124).

RECIPIENT ELIGIBILITY PROGRAMS
Recipient Eligibility Programs began as the Division of Programs and Liaison. Renamed the Division of Eligibility Services in 1989, it reorganized under its present name in November 1993.

Recipient Eligibility Programs is responsible for systems and procedures that update the Recipient Eligibility Master File; produce and issue Medical Care Program identification cards; and resolve eligibility problems. It also oversees the Buy-In Programs for Medicare (Parts A and B). Under the Buy-In Programs for Medicare, the State, through the Medical Assistance Program (Medicaid), pays federal premiums for people certified by the local department of social services as unable to cover hospital insurance (Part A) or medical insurance (Part B).

ELIGIBILITY POLICY
Eligibility Policy oversees: Eligibility Policy and Communications; Local Operations and Eligibility Management and Training; and Quality Control and Program Integrity.

SYSTEMS & OPERATIONS ADMINISTRATION

PROGRAM OPERATIONS
Program Operations oversees five divisions: Adjustments and Payment Auditing; Claims Processing; Medical Assistance Recoveries; Provider Relations; and Provider Services.

DIVISION OF CLAIMS PROCESSING
The Division of Claims Processing started as the Division of Invoice Processing and received its present name in 1989. The Division processes all claims for payment made by providers of health care services under the Medical Assistance Program (Medicaid) and the Pharmacy Assistance Program. Processing includes mail sorting, microfilming, entry of claims into the Batch and Invoice Control File of the Medicaid Management Information System, and processing of payments in excess of $2.5 billion annually for claims received, resolution of erroneous claims, and claim storage and retrieval. The Division maintains records of payments to the more than 45,000 health care providers enrolled in the Medical Assistance Program.

DIVISION OF MEDICAL ASSISTANCE RECOVERIES
In 1969, the Division of Medical Assistance Recoveries started. By 1993, it was made part of the Medical Care Finance and Compliance Administration. The Division transferred to the Medical Care Operations Administration in February 1998, and has been part of the Office of Health Services since January 2000.

The Division operates third-party liability programs. Through these, other responsible parties are pursued for payment of health care received under the Medical Assistance Program (Medicaid). Money spent on behalf of recipients is recovered from sources allowed by federal or State law.

SYSTEMS
Under Systems are two divisions: Medicaid Information Systems; and Systems Liaison Services.

DIVISION OF MEDICAID INFORMATION SYSTEMS
Established in 1982, the Division of Medicaid Information Systems serves as the data processing unit for Medical Care Programs. The Division performs systems analysis and programming, and maintains a teleprocessing network. It maintains and operates the Medicaid Management Information System (MMIS), an automated claims processing and information retrieval system mandated by the federal government. The Division also provides data processing for Geriatric Evaluation Services; Pharmacy Assistance Program; and Statewide Evaluation and Planning Services.

OFFICE OF PLANNING, DEVELOPMENT, & FINANCE

Priority projects are developed and implemented by the Office. The Office devises initiatives and conducts technical analyzes needed to address departmental, gubernatorial or legislative concerns. It analyzes evaluations and statistics for policy decisions.

Under the Office are two main units: Finance; and Planning and Development.

MARYLAND MEDICAID ADVISORY COMMITTEE
The Maryland Medicaid Advisory Committee organized as the Medical Assistance Advisory Committee. It was created for the Medical Assistance Program (Medicaid) by the Secretary of Health and Mental Hygiene in accordance with the federal Social Security Act (sec. 1902A(22)). In 1996, the legislation which enabled Medicaid recipients to be enrolled in managed health-care organizations also reconstituted the Committee as the Maryland Medicaid Advisory Committee (Chapter 352, Acts of 1996).

From the Committee the Secretary of Health and Mental Hygiene receives advice on implementation, operation, and evaluation of managed care programs for Medicaid recipients. It also reviews and makes recommendations on regulations, contracts, and quality control; assesses data; sees that information is available to Medicaid recipients in language they can understand; and otherwise assists in the transition of Medicaid to managed care.

The Committee has up to twenty-five members. Seventeen are appointed to four-year terms by the Secretary of Health and Mental Hygiene. Two are appointed by the Senate President, and three by the House Speaker. Three serve ex officio.

OPERATIONS

Operations supports the Department through financial planning, budgeting, expenditure control, personnel management, data processing and information technology, general services, grants administration, and capital construction. The Deputy Secretary for Operations also aids the Secretary of Health and Mental Hygiene in matters involving other State agencies, the legislature, the gubernatorial staff, and the federal government.

Under Operations are the Budget Management Office and five administrations: Fiscal Services; General Services; Information Resources Management; Personnel Services; and Vital Statistics. Operations also is responsible for six offices: Appointments and Executive Nominations; Community Relations; Governmental Affairs; Planning and Capital Financing; Regulations Coordination; and Volunteer Services.

BOARD OF REVIEW
The Board of Review of the Department of Health and Mental Hygiene was established in 1969 (Chapter 77, Acts of 1969). The Board decides appeals of departmental decisions as provided by law.

With Senate advice and consent, the Governor appoints the Board's seven members to three-year terms (Code Health - General Article, secs. 2-201 through 2-207).

OFFICE OF APPOINTMENTS & EXECUTIVE NOMINATIONS
Formerly under Business and Regulatory Services, the Office of Appointments and Executive Nominations transferred to Operations in 1997. The Office recruits and screens candidates for health regulatory boards and commissions, task forces, and citizen advisory boards whose members are appointed by the Governor or the Secretary of Health and Mental Hygiene.

OFFICE OF COMMUNITY RELATIONS
In 1994, the Office of Community Relations began under the Personnel Services Administration and was placed under Operations. The Office monitors Department programs and health care providers to assure that they comply with civil rights laws, mandates, and regulations. For the same purpose, the Office monitors personnel management, services, and procurement procedures of the Department. The Office also develops and monitors programs for equal opportunities for employment, including affirmative action, on-site review, outreach recruitment, and complaint processing. In addition, the Office develops and monitors programs for equal access to health care and for minority business participation in State contracts.

OFFICE OF GOVERNMENTAL AFFAIRS
The Department's liaison with State and federal government is the Office of Governmental Affairs. The Office coordinates the preparation of legislation the Department wants introduced, and analyzes other legislation for its impact on the Department.

OFFICE OF PLANNING & CAPITAL FINANCING
The Office of Planning and Capital Financing started as the Office of Planning and Policy Management and received its present name in 1994. The Office prepares the Department's annual Executive Plan, the Five-Year Capital Improvement Plan, the Master Facilities Plan, and twenty individual facility plans. The Office also is responsible for the Department's annual capital budget, real estate transactions, and bond bill submission. Internal policies and procedures are developed and promulgated through the Office. The Office also conducts special studies requested by the Secretary of Health and Mental Hygiene or the General Assembly.

OFFICE OF REGULATIONS COORDINATION
The Office of Regulations Coordination provides a central clearinghouse for health regulations. Here, regulations are reviewed and revised. The Office provides technical assistance to administrative units of the Department.

VOLUNTEER SERVICES DIVISION
The Volunteer Services Division develops and directs the Department's thirty-two volunteer services programs statewide. These programs offer citizens and community groups the opportunity to aid and enhance the lives of residents of Department hospital centers and of patients in the community. The Chief serves as liaison to the Department's Council of Auxiliaries, a private, nonprofit service organization.

BUDGET MANAGEMENT OFFICE

The Budget Management Office began as the Financial Planning Administration and received its present name in 1997. The Office monitors and controls all Department financial affairs, including liaison with the Department of Budget and Management and the General Assembly. The Administration oversees budget preparation and review, expenditure management, funding enhancement, rate setting, cost analysis, and fiscal policy. Administration functions are carried out by two divisions: Budget Analysis; and Program Costs and Analysis.

FISCAL SERVICES ADMINISTRATION

By 1923, functions of the Fiscal Services Administration were organizedunder the Bureau of Personnel and Accounts, which was responsible for fiscal administration of the Department of Health. The Administration analyzes and provides fiscal, accounting and contracting services for the statewide operation of major Department programs and health care facilities. The Administration develops systems, policies, and procedures for the Department's fiscal management in coordination with regulatory or control agencies, the General Assembly, and the federal government.

Under the Administration are five divisions: Auditing; Contracts; Financial Management Information System (FMIS) and Telecommunications; General Accounting; and Reimbursements.

GENERAL SERVICES ADMINISTRATION

The General Services Administration was created as the Office of General Administration by 1973. Renamed the General Administrative Services Administration by 1983, it received its current name by 1985.

Support services for supplies and procurement, space allocation, fleet management, mail, photocopying, building services, and capital construction are provided by the General Services Administration. Coordination and technical assistance are provided statewide to maintenance and engineering projects; asbestos identification and abatement; and abatement of polychlorinated biphenyls (PCBs), which are toxic chemicals found in insulating oils for electric transformers and switch gear.

The Administration directs two divisions: Central Services, and Engineering and Maintenance.

INFORMATION RESOURCES MANAGEMENT ADMINISTRATION

The Administration devises information-processing strategies and implements the policy, procedures, and controls required for automation programs. The Administration also provides systems analysis, programming and data communications, and training and computer operation services for the Department's information systems throughout the State.

Under the Administration are four divisions: Computer Operations; Information Technology Support; Information Systems; and Policy, Planning, and Administration.

PERSONNEL SERVICES ADMINISTRATION

The Personnel Services Administration originated as the Office of Personnel Management and received its present name in 1988. The Administration provides personnel services and training for the Department.

Under the Administration are eight divisions: Administrative Services; Classification and Compensation; Employer/Employee Relations; Employment Services; Payroll and Timekeeping; Recruitment and Examination; Testing Services; and Training Services.

VITAL STATISTICS ADMINISTRATION

In November 1998, the Vital Statistics Administration formedfrom divisions formerly under the General Services Administration. At that time, the Division of Health Statistics and the Division of Vital Records were placed under the Administration.

The Administration is responsible for two divisions: Health Statistics, and Vital Records.

DIVISION OF HEALTH STATISTICS

Annually, the Division of Health Statistics publishes vital statistics and population estimates for the State. To highlight significant trends and findings, the Division analyzes and reports annually on the health status of Maryland residents. It provides statistical analysis and advice to programs on studies and systems development. The Division publishes annual and special reports on these topics.

DIVISION OF VITAL RECORDS

The Division of Vital Records organized in 1910 as the Bureau of Vital Statistics under the State Department of Health (Chapter 560, Acts of 1910). In 1951, it reformed as the Division of Vital Records and Statistics and, in 1967, as the Division of Vital Records under the Bureau of Analysis and Records. In 1969, the Division was placed under the Center for Health Statistics. In 1988, the Division was separated from Health Statistics.

The Division provides copies of certified birth, death, and marriage certificates. All births, deaths, marriages, and divorces that occur in the State are registered. Copies of birth, death and marriage records are issued to authorized persons for a fee of $6.00 per copy (checks to be made payable to Department of Health and Mental Hygiene).

Birth and Death Records. The Division has birth and death records for Baltimore City from January 1, 1875, and for the twenty-three counties of Maryland from August 1898. The information also is available from the State Archives.

Marriage and Divorce Records. State marriage registration began on June 1, 1951, and divorce registration began in June 1961. Copies of marriage records prior to June 1951 and of all divorce records may be obtained from the Circuit Court clerk in the county where the marriage or divorce occurred, or from the State Archives.

PUBLIC HEALTH SERVICES

Public Health Services was established in 1987. The Deputy Secretary for Public Health Services is responsible for the Office of Chief Medical Examiner and six administrations: AIDS; Alcohol and Drug Abuse; Community and Public Health; Developmental Disabilities; Laboratories; and Mental Hygiene. Public Health Services is aided by the Community Services Reimbursement Rate Commission.

COMMUNITY SERVICES REIMBURSEMENT RATE COMMISSION
In 1996, the Community Services Reimbursement Rate Commission formed as an independent unit that functions within the Department of Health and Mental Hygiene (Chapter 593, Acts of 1996). The Commission assesses the adequacy of reimbursement rates paid to community-based agencies or programs that serve individuals with developmental or psychiatric disabilities and are funded by the Developmental Disabilities Administration or the Mental Hygiene Administration. The Commission considers: the needs of service recipients; quality of service; State and federal regulations; staff turnover; staff qualifications; and solvency of providers. The Commission compares salaries and benefits in the private sector to those paid by the State. It evaluates the efficiency of the State's methods of reimbursing providers, and how much uncompensated care is being provided. In reporting its findings, the Commission may recommend changes in law or regulation.

The Commission's seven members are appointed to three-year terms by the Governor with Senate advice and consent. Authorization for the Commission continues until September 30, 2002 (Code Health - General Article, secs. 13-801 through 13-810).

AIDS ADMINISTRATION

Created in 1987 as the AIDS Control Administration, the Administration received its current name in 1988. The AIDS Administration educates the public and health care professionals about Acquired Immune Deficiency Syndrome (AIDS) and the human immuno-deficiency virus (HIV). It monitors the disease in Maryland, and provides services for persons with AIDS or infected with HIV. The Administration consults and coordinates its work with twenty-four local health departments. Each local health department has counseling and testing sites that offer free tests and consultations.

The AIDS Administration funds clinical activities for the diagnosis and evaluation of patients with AIDS. It also administers grants to community organizations for gay and minority outreach efforts.

The Administration is organized under two main functions: Epidemiology and Research, and HIV Services.

EPIDEMIOLOGY & RESEARCH

CENTER FOR EPIDEMIOLOGY & HEALTH SERVICES RESEARCH
The Center for Epidemiology and Health Services Research started as the Center for AIDS Epidemiology and became the Center for AIDS Epidemiology and Analysis in 1997. It reorganized as the Center for Epidemiology and Health Research in 1998, and later that year combined with the Center for Health Data under its present name.

Through case surveillance, epidemiologic investigations, and seroprevalence and other studies, the Center determines the impact of the AIDS/HIV epidemic in Maryland. Data and information derived from studies are used by the Center and other organizations to design programs for prevention and health care, and support requests for federal funds.

HIV SERVICES

CENTER FOR EDUCATION & TRAINING
The Center for Education and Training began in 1991 as the Division of Professional Education and Health Services. The Division formed by merging the functions of the Division of Provider Education and Training with the Division of Patient Care Services. In 1994, the Division of Professional Education and Health Services reorganized as the Center for Professional Education and Patient Services and, in 1997, received its present name.

When the Center for Quality Assessment and Improvement was abolished in 1997, most of its functions were assigned to the Center for Education and Training. Among these functions are the evaluation of the results of preventive care, early intervention, and treatment provided by the AIDS Administration; and the setting of high standards of clinical performance for State and federally funded HIV and AIDS services.

The Center for Education and Training educates health-care professionals about HIV and treats persons who are HIV infected. HIV diagnostic evaluation units where a person with HIV disease can be assessed by health-care professionals are funded by the Center. Staff consult with the patient's health-care provider to help that provider meet the patient's complex medical needs. The Center also operates the Maryland AIDS Drug Assistance Program which covers the cost of specified drugs for eligible persons.

Under the Center for Education and Training are three divisions: Health Communication; Local Prevention Services; and Training.

DIVISION OF LOCAL PREVENTION SERVICES
The Division of Local Prevention Services first formed as the Division of HIV Counseling and Testing Services. In 1996, it was placed under the Center for AIDS Education (later the Center for Prevention Programs) and adopted its name. The Division later transferred to the Center for Education and Training.

At no charge, the Division provides HIV health education and counseling, as well as voluntary HIV antibody testing to any Marylander. Efforts are made selectively to test, counsel, and refer for treatment and other services those individuals who practice behaviors that put them at risk for HIV infection.

Services are provided by funding local health departments to operate 54 sites throughout Maryland for HIV counseling and testing services. All local health departments also provide programs for sexually transmitted disease. These programs offer HIV-risk assessment, counseling, and testing to their clients.

CENTER FOR HIV PATIENT SERVICES
The Center for HIV Patient Services was established in 1989 as the Division of AIDS Services, Planning, and Development. The Division became the Center for AIDS Services, Planning, and Development in 1994. It reorganized in 1997 as the Center for HIV Patient Services.

The Center develops resources to meet the needs of AIDS/HIV patients and analyzes cost data on the treatment of HIV. In Maryland, the Center administers the Ryan White CARE Act program, which is federally funded (P.L. 101-381). Through this and other federal programs, the Center helps support HIV services throughout the State.

CENTER FOR PREVENTION PROGRAMS
The Center for Prevention Programs also is known as the Maryland Center for AIDS-Related Educational Services (MDCARES). It began in 1987 as the Center for AIDS Education and received its present name in 1997. The Center develops, implements, and oversees programs designed to interrupt transmission of the AIDS/HIV infection. Prevention efforts help both the general population and individuals and communities at high risk of AIDS/HIV disease. The Center also is responsible for the AIDS hotline.

ALCOHOL & DRUG ABUSE ADMINISTRATION

The Alcohol and Drug Abuse Administration started as two separate agencies: one concerned with alcoholism and the other with addiction to narcotics. Formed in 1969, the Drug Abuse Authority was succeeded in 1971 by the Drug Abuse Administration (Chapter 404, Acts of 1969; Chapter 29, Acts of 1971). The Division of Alcoholism Control of the former Mental Health Administration became the Alcoholism Control Administration in 1976 (Chapter 746, Acts of 1976). By departmental reorganization in 1987, the Drug Abuse Administration and the Alcoholism Control Administration merged to become the Addictions Services Administration. In 1988, the Administration received its present name (Chapter 758, Acts of 1988; Code Health - General Article, Title 8).

Functions of the Alcohol and Drug Abuse Administration are carried out by four main units: Criminal Justice/Policy and Program Development/Special Populations; Grants and Contracts Management and Administration; Management Information, Continuous Quality Improvement, and Office of Education and Training for Addiction Services; and Prevention and Treatment. The Administration also is served by the Alcohol and Drug Abuse Treatment Research Advisory Committee.

ALCOHOL & DRUG ABUSE TREATMENT RESEARCH ADVISORY COMMITTEE
In 1990, the Alcohol and Drug Abuse Treatment Research Advisory Committee was created (Chapter 580, Acts of 1990). The Committee develops methodology for evaluating the effectiveness of treatment programs. The Committee also advises the Alcohol and Drug Abuse Administration on regulations needed for research on the effectiveness of treatment programs (Code Health - General Article, sec. 8-402).

CRIMINAL JUSTICE/POLICY & PROGRAM DEVELOPMENT/SPECIAL POPULATIONS

POLICY & PROGRAM DEVELOPMENT DIVISION
The Policy and Program Development Division originated as the Policy, Planning, and Development Division and received its current name in 1994. Administration policies, rules, and regulations governing alcohol and drug abuse treatment are formulated by the Division. The Division provides technical assistance to all methadone programs, oversees their compliance with State and federal regulations, and monitors private methadone programs. It also monitors treatment of pregnant addicts and compiles quarterly statistics on their admissions, retentions, and deliveries. In addition, the Division serves as liaison to the Federal Center for Substance Abuse Treatment.

SPECIAL POPULATIONS DIVISION
The Special Populations Division organized in Fiscal Year 1985 as a project of the Alcoholism Control Administration. It continued under the Special Projects Division when the Addictions Services Administration formed in 1987. The following year, it organized into the Youth, Adolescents, and Family Division. In 1993, The Division became the Children, Youth, and Families Division and in 1995 received its present name.

For adolescents addicted to drugs or alcohol, and for their families, the Special Populations Division develops, monitors, and funds assessment and treatment services. Youths under age 18 or, if eligible for Medical Assistance, under age 21, and their families may secure help locally. Services include screening; clinical assessment; drug and alcohol education, and counseling; clinical intervention; case management; residential treatment and long-term continuing care; intensive outpatient and day treatment; and family therapy. Teenagers are referred by local schools, departments of social services, or offices of juvenile services for treatment. The Division also assists and monitors local public and private programs developing services for women, women with infants and children, and pregnant women.

GRANTS & CONTRACTS MANAGEMENT & ADMINISTRATION

SOCIAL SECURITY INCOME DRUG & ALCOHOL PROJECT
Federally funded, the Social Security Income Drug and Alcohol Project certifies that Social Security recipients comply with federal eligibility standards. These require that all Social Security recipients with alcohol or drug abuse noted on their records be referred, where appropriate, to substance abuse programs and be monitored. The Social Security Administration refers to the Project persons over age 18 whose primary disability is substance abuse. The Project, in turn, refers the person to vocational rehabilitation for continued treatment and services.

MANAGEMENT INFORMATION SERVICES, CONTINUOUS QUALITY IMPROVEMENT & COMMUNICATIONS & OFFICE OF EDUCATION & TRAINING FOR ADDICTION SERVICES

OFFICE OF EDUCATION & TRAINING FOR ADDICTION SERVICES
Created in 1976, the Office of Education and Training for Addiction Services educates and trains public and private agency personnel who treat addicts and work to prevent addiction. The Office also helps devise curriculum and evaluates college and university courses on how to treat and prevent addiction.

MANAGEMENT INFORMATION SERVICES DIVISION
The Management Information Services Division develops and maintains agency data systems; reports and analyzes trends and patterns in alcohol and drug abuse, and assessment of treatment programs; and assists other divisions with data, research, and computerized information systems. All certified providers of public and private treatment and DWI assessors report monthly data to the Division.

PREVENTION & TREATMENT SERVICES

PREVENTION SERVICES DIVISION & RADAR NETWORK CENTER
The Prevention Services Division and Radar Network Center funds, develops, implements, and monitors strategies to prevent alcohol and drug addiction. The Division works with the Office for Children, Youth, and Families; the State Department of Education; the Department of Human Resources; and the Department of Transportation.

TREATMENT SERVICES DIVISION
The Treatment Services Division organized as the Regional Field Services Division. Renamed the Treatment and Field Services Division in 1994, it received its present name in 1998. To coordinate addiction treatment services, the Division serves as liaison between local and State government agencies.

COMMUNITY & PUBLIC HEALTH ADMINISTRATION

The Community and Public Health Administration originated from two agencies. The first formed in 1969 as the Local Health Services Administration. By 1973, it reorganized as the Local Health and Professional Support Services Administration and, by 1977, as the Local Health Administration. The second agency was the Family Health Administration, created in 1987. The Local Health Administration and the Family Health Administration merged in 1989 to form the Local and Family Health Administration. In January 1997, the Administration reformed under its present name.

To ensure that basic public health services are provided in all parts of Maryland, the Community and Public Health Administration oversees the local health departments in each county and Baltimore City. Under the direction of a local health officer, each local health department provides these services and administers and enforces State and local health laws and regulations in its jurisdiction. Programs meet the public health needs of the community and provide services not offered by the private sector. The local health officer is appointed jointly by the Secretary of Health and Mental Hygiene and the local governing body.

Under the Administration are Maryland's local health departments and four main teams: Administrative, Policy and Management Support; Consumer Health and Facility Services; Family Health Services and Primary Care; and Prevention and Disease Control.

LOCAL HEALTH DEPARTMENTS

Today, local health departments in Maryland's twenty-three counties and Baltimore City are overseen by the Community and Public Health Administration.

ADMINISTRATIVE, POLICY & MANAGEMENT SUPPORT

OFFICE OF MANAGEMENT SERVICES
The Office of Management Services formed in 1991 to consolidate administrative and fiscal functions of the Local and Family Health Administration (now the Community and Public Health Administration). In 1997, the Office was placed under Administrative, Policy and Management Suppport. The Office is responsible for budget preparation, grants management, personnel, accounts payable, legislation, and regulations.

OFFICE OF PUBLIC HEALTH ASSESSMENT
The Office of Public Health Assessment began in 1991 as the Office of Planning, Evaluation, and Program Development within the Local and Family Health Administration. The Administration was renamed the Community and Public Health Administration in 1997.

For the Administration and local health departments, the Office provides computer, planning, statistical and epidemiologic advice. The Office also conducts disease surveillance to help plan programs, devise policy, and determine research needs.

In cooperation with the U.S. Centers for Disease Control, the Office conducts the Maryland Behavioral Risk Factor Survey. It manages the voluntary Abortion Surveillance System and conducts on-site reviews of local health departments. The Office also directs the writing, review, and use of annual local health department plans; develops and monitors Operational Plan objectives for the Community and Public Health Administration; and publishes annually the Local and Family Health Surveillance Data Book. In addition, the Office designs personal computer systems for tracking high risk infants; and provides special analyzes for programs, such as Data-based Intervention Grants, Sample Size Requirements, and the Needs Assessments required by the federal Social Security law governing Maternal and Child Health Block Grants (Title V, sec. 501).

FAMILY HEALTH SERVICES & PRIMARY CARE

CENTER FOR MATERNAL & CHILD HEALTH
201 West Preston St.
Baltimore, MD 21201 - 2399

The Center for Maternal and Child Health formed in January 2000 with the merger of the Office of Children's Health and the Office of Maternal Health and Family Planning.

The Office of Children's Health had been known as the Office of Child Health Services since 1989 when it was made part of the Local and Family Health Administration. In 1993, the Office became the Office of Child Health. In 1994, the Office of Child Health and the Office of Children's Medical Services merged to form the Office of Child Health and Children's Medical Services. Renamed the Office of Children's Health in 1995, it has been part of the Community and Public Health Administration since 1997.

The Office of Maternal Health and Family Planning originated in 1922 as the Bureau of Maternal and Child Health and Services to Crippled Children. The Bureau had become the Division of Maternal and Child Health under the Bureau of Preventive Medicine by 1951, under the Bureau of Preventive Medical Services by 1967, and under the Preventive Medicine Administration in 1969. The Division was renamed the Office of Maternal Health, Family Planning, and Hereditary Disorders by 1985. As the Office of Maternal and Child Health it was placed under the Family Health Administration in 1987. The Office joined the Local and Family Health Administration in 1989 and was renamed the Office of Maternal Health and Family Planning in 1990. It also has been part of the Community and Public Health Administration since 1997.

The Center for Maternal and Child Health works to improve the health of women of childbearing age and their babies. With federal and State funds, the Center directs prenatal care and family planning services offered by local health departments and others. The Center also administers special grants to improve the reproductive health of adolescents and introduce new contraceptive techniques into the public health system.

For basic preventive services to safeguard the health of children, the Center administers State and federal funding to the local health department in each county and Baltimore City. These services include immunizations; screening for lead poisoning, vision, hearing and scoliosis; and counseling in basic nutrition. The Center also administers special grants, such as the grant to the University System of Maryland relating to sudden infant death syndrome (SIDS), or grants to Eastern Shore counties for preventive dental care for children. In addition, the Center offers training, consultation, and technical assistance to local health departments and the private sector.

The Center administers a joint federal, State and local program formerly called Crippled Children's Services, now Children's Medical Services, that has operated in Maryland since 1937 (Code Health - General Article, sec. 15-125). State funding for services to crippled children dates to at least 1922.

The Center helps families plan and obtain specialized medical and rehabilitative care for children whose chronic illnesses or disabling conditions interfere with normal growth and development. These conditions include cerebral palsy, orofacial anomalies, speech and language problems, spina bifida, heart disease and defects, hearing impairment, cystic fibrosis, chronic otitis media, chronic renal disease, and epilepsy. Many other diagnoses qualify a child to receive services if financial eligibility requirements also are met (Code of Maryland Regulations - COMAR 10.22.08.05B).

MARYLAND STATE SCHOOL HEALTH COUNCIL
c/o Baltimore County Health Department
One Investment Place, 11th floor
Towson, MD 21204 - 4125

The Maryland State School Health Council was formed in 1946 by the State Department of Health and the State Department of Education. Reorganized in 1966, the Council advises the Department of Health and Mental Hygiene and the State Department of Education on the school health program. The Council helps develop and maintain programs to provide a healthful school environment, health and safety instruction, and school health services. It also serves as a forum for the two State departments, their local counterparts, and other groups concerned with the health of school-age children.

The Council includes two representatives appointed by each of the twenty-four local health and education departments. The Executive Board consists of five members elected by the Council and representatives of health and education agencies; State and local associations; and education organizations.

OFFICE OF HEREDITARY DISORDERS
201 West Preston St.
Baltimore, MD 21201 - 2399

The first programs of the Office of Hereditary Disorders were initiated in 1964. Formed in 1973, the Division of Hereditary Disorders reorganized as the Office of Hereditary Disorders in 1990. It was placed under Family Health Services and Primary Care in 1997.

The Office works to reduce the morbidity and mortality caused by genetic disorders and birth defects. The newborn screening program coordinated by the Office provides alpha-fetoprotein (AFP) testing to pregnant women; screens nearly every newborn baby in Maryland for birth defects; treats genetic metabolic diseases and hemoglobin disorders, including sickle cell disease; and provides clinical services for other genetic disorders. The Office also maintains a reporting and information system on genetic disorders and birth defects to collect data and give information to parents of children with disorders and defects. Educational programs on genetics and genetic services are offered by the Office to health professionals, educators, and the general public.

PROGRAM TO IDENTIFY HEARING-IMPAIRED INFANTS
The Program to Identify Hearing-Impaired Infants was established under the Developmental Disabilities Administration in 1985 (Chapter 402, Acts of 1985). In 1990, the Program transferred to the Office of Children's Medical Services and, in 1992, to the Office of Children's Health within the Local and Family Health Administration. In 1995, the Program became part of the Office of Child Health, which has been under the Community and Public Health Services Administration since 1997. The Program was placed under the Office of Hereditary Disorders in 1998. Since 1999, the Program has been required to help develop protocols for the universal screening of newborns' hearing (Chapter 127, Acts of 1999).

The Program provides early identification and follow-up of hearing-impaired infants and infants who are at risk of developing a hearing impairment.

ADVISORY COUNCIL FOR PROGRAM TO IDENTIFY HEARING-IMPAIRED INFANTS
tIn 1985, the Advisory Council for Program to Identify Hearing-Impaired Infants started (Chapter 402, Acts of 1985). The Council advises the Department of Health and Mental Hygiene on implementing the Program and on educational programs for families, professionals, and the public. The Council also reviews Program materials distributed by the Department.

The Council consists of eleven members appointed by the Secretary of Health and Mental Hygiene (Code Health - General Article, secs. 13-601 through 13-605).

OFFICE OF PRIMARY CARE SERVICES
The Office of Primary Care Services formed within the Local and Family Health Administration in July 1994. Under the Community and Public Health Administration since 1997, the Office assures that basic health care is available to all Maryland residents regardless of their ability to pay.

The Office works through five programs: the Primary Care Cooperative Agreement; the Office of Rural Health; Physician Loan-Repayment Program; Primary Care for the Medically Indigent Program; and the Maryland Statewide Home-Health Agency.

OFFICE OF WOMEN, INFANTS & CHILDREN FOOD PROGRAM
201 West Preston St.
Baltimore, MD 21201 - 2399

Created by the Department in 1985, the Office of Women, Infants and Children Food Program joined the Family Health Administration in 1987. That administration was renamed the Local and Family Health Administration in 1989 and became the Community and Public Health Administration in 1997.

The Office administers the Maryland Special Supplemental Food Program for Women, Infants, and Children (WIC) under federal law (P.L. 95-627). The Program offers health and nutrition services, including supplemental foods, to pregnant, postpartum and breast-feeding women; infants to one year of age; and children to their fifth birthday. To be eligible, an individual also must meet income requirements and be at nutritional risk.

Funded by the U.S. Department of Agriculture, the Program is administered by the Office of Women, Infants and Children Food Program through grants to eighteen local agencies that serve the entire State. Each local agency determines recipient eligibility, prescribes individualized food packages, provides nutrition education, prepares required records and reports, and issues food instruments (negotiable checks used in exchange for approved foods). The Office ensures that Maryland's program accords with federal requirements.

CONSUMER HEALTH & FACILITY SERVICES

Consumer Health and Facility Services started as the Office of Food and Product Health. It was renamed the Office of Food Protection and Consumer Health Services in 1988 under the Community Health Surveillance and Laboratories Administration. In 1997, it reorganized as Consumer Health and Facility Services under the Community and Public Health Administration.

By eliminating or minimizing exposure to or consumption of unsafe commodities and substances, the Office prevents disease, disability, and death. The Office controls the manufacture, distribution, and sale of milk, food, and consumer products. In addition, it establishes and enforces regulations regarding campgrounds and youth camps, migratory labor camps, mobile home parks, outdoor music festivals, and swimming pools.

The Office supervises Deer's Head Center, Western Maryland Center, the Public Health Residency Program, and two offices: Environmental Health Coordination, and Food Protection and Product Safety. It is aided by the Youth Camp Safety Advisory Council.

YOUTH CAMP SAFETY ADVISORY COUNCIL
c/o Office of Food Protection & Product Safety
3431 Benson Ave.
Baltimore, MD 21227

The Youth Camp Safety Advisory Council was created in 1986 (Chapter 116, Acts of 1986). The Council helps the Department of Health and Mental Hygiene develop and review regulations for certifying youth camps. These regulations cover fire and safety standards; medical services; personnel screening procedures; refuse collection and disposal; safety; sanitation; sewage disposal; and water supplies; and reporting systems for fatalities, serious illnesses, or accidents. All youth camps in Maryland must comply with these regulations.

The Council's eleven members are appointed to three-year terms by the Governor with the advice of the Secretary of Health and Mental Hygiene and Senate advice and consent (Code Health - General Article, secs. 14-401 through 14-411).

DEER'S HEAD CENTER
P. O. Box 2018
Emerson Ave.
Salisbury, MD 21802 - 2018

Authorized in 1945, Deer's Head Center was established in 1950 (Chapter 994, Acts of 1945). It is a regional facility for chronically ill and elderly adults in need of medical and rehabilitation services or general medical care for chronic disease or terminal illness. The Center also operates a kidney dialysis facility for area residents.

The Center provides the services of a chronic disease hospital (including a small hospice service) and a comprehensive care facility, as well as outpatient and end-stage kidney dialysis, and outpatient rehabilitation therapy. The licensed capacity for the Center is 188 hospital beds and 33 comprehensive care beds (Code Health - General Article, sec. 19-502).

CITIZENS ADVISORY BOARD
Upon recommendation of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's seven members to four-year terms.

WESTERN MARYLAND CENTER
1500 Pennsylvania Ave.
Hagerstown, MD 21740
(301) 791-4410

Western Maryland Center began as Western Maryland State Hospital. Authorized in 1952, the Hospital opened in 1957 (Chapter 53, Acts of 1952).

The Center provides chronic or rehabilitation hospital care, and comprehensive or nursing home care. The Center also offers adult day care; end-stage kidney dialysis; and physical, occupational, and speech rehabilitation to outpatients. It has 117 licensed hospital beds and 58 licensed comprehensive care beds (Code Health - General Article, sec. 19-502).

CITIZENS ADVISORY BOARD
The Board's seven members are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

PREVENTION & DISEASE CONTROL

MARYLAND CANCER REGISTRY
The Maryland Cancer Registry was initiated in July 1982. It is an incidence-based electronic database containing demographic, diagnostic and treatment data on Maryland residents and those nonresidents who are diagnosed or treated in Maryland (Code Health - General Article, sec. 18-204). Formerly under the Department of the Environment, the Registry transferred to the Department of Health and Mental Hygiene in 1991. Under contractual agreement with the Department of Health and Mental Hygiene, the Registry is operated by Tri-Analytics, Inc., of Bel Air, Maryland.

MARYLAND CANCER REGISTRY ADVISORY COMMITTEE
Following the establishment of the Maryland Cancer Registry in July 1982, the Maryland Cancer Registry Advisory Committee was created. The Committee advises the State Council on Cancer Control on the operation of the Registry.

STATE ADVISORY COUNCIL ON ARTHRITIS & RELATED DISEASES
The State Advisory Council on Arthritis and Related Diseases started as the State Commission on Arthritis and Related Diseases in 1985 (Chapter 250, Acts of 1985). The Council received its present name and was placed under the Local and Family Health Administration in 1992 (Chapter 71, Acts of 1992). In 1997, the Administration became the Community and Public Health Administration.

To improve the quality of life for arthritic individuals and their families, the Council coordinates the activities of public and private agencies, medical schools, and related professional groups. The Council recommends ways to limit costs associated with arthritis prevention and treatment, and vocational training, as well as to improve services. The Council also develops and coordinates programs for vocational rehabilitation and industry to help arthritic individuals remain productive in the work force.

Through studies and proposals, the Council devises a State program of education and applied research in gerontology and geriatrics. The development of a strategic plan of patient education throughout Maryland is coordinated by the Council. The plan involves State and local health departments, private agencies, pharmaceutical companies, medical schools, and professional organizations.

The Council's fifteen members are appointed by the Governor, who designates the chair. Members serve four-year terms (Code Health - General Article, secs. 13-501 through 13-506).

STATE ADVISORY COUNCIL ON HEREDITARY & CONGENITAL DISORDERS
The State Advisory Council on Hereditary and Congenital Disorders formed in 1973 as the Commission on Hereditary Disorders (Chapter 695, Acts of 1973). It became the State Commission on Hereditary and Congenital Disorders in 1986 (Chapter 740, Acts of 1986). Renamed the State Advisory Council on Hereditary and Congenital Disorders, it was placed under the Local and Family Health Administration in 1992 (Chapter 71, Acts of 1992). In 1997, the Administration reformed as the Community and Public Health Administration.

Information on the treatment of hereditary and congenital disorders in Maryland is gathered and disseminated by the Council. It also establishes and promulgates rules, regulations, and standards for the detection and management of these disorders. On a continuous basis, it evaluates the need for and efficiency of relevant State programs. For the public and providers of health services, the Council also institutes and supervises educational programs and counseling on hereditary and congenital disorders, their treatment and prevention.

The Council is composed of eleven voting members and five nonvoting members. Those voting serve four-year terms. They include nine members appointed by the Governor, one senator named by the Senate President, and one delegate chosen by the House Speaker. The nonvoting members are appointed by the Secretary of Health and Mental Hygiene (Code Health - General Article, secs. 13-103 through 13-109).

STATE ADVISORY COUNCIL ON HIGH BLOOD PRESSURE & RELATED CARDIOVASCULAR RISK FACTORS
The State Advisory Council on High Blood Pressure and Related Cardiovascular Risk Factors originated as the Commission on High Blood Pressure in 1976 (Chapter 792, Acts of 1976). It became the State Commission on High Blood Pressure and Related Cardiovascular Risk Factors in 1986 (Chapter 486, Acts of 1986). In 1992, it reorganized under its present name and was placed under the Local and Family Health Administration (Chapter 71, Acts of 1992). The Administration became the Community and Public Health Administration in 1997.

Guidelines to manage and treat high blood pressure and related cardiovascular risk factors are established by the Council. To prevent and treat these conditions, the Council also develops and promotes educational programs.

The Council's sixteen members are appointed by the Governor to four-year terms. Consumer members are named with Senate advice and consent (Code Health - General Article, secs. 13-201 through 13-206).

STATE ADVISORY COUNCIL ON PHYSICAL FITNESS
The State Advisory Council on Physical Fitness began as the State Commission on Physical Fitness in 1963 (Chapter 606, Acts of 1963). The Council reorganized in 1992 by its present name under the Local and Family Health Administration (Chapter 71, Acts of 1992). The Administration became the Community and Public Health Administration in 1997.

The Council works to protect and improve the physical fitness of Marylanders. It disseminates information about physical fitness, and collects and assembles information from State agencies. To further its work, the Council maintains liaison with the State Department of Education, local boards of education, private and parochial schools, and local physical fitness commissions.

With the advice of the Secretary of Health and Mental Hygiene, the Governor appoints the Council's twenty-five members. Members serve four-year terms. The Governor names the chair. The Secretary of Health and Mental Hygiene appoints the executive director.

In each county and Baltimore City, the Governor may appoint a local advisory council of from fifteen to twenty-five members. The Secretary of Health and Mental Hygiene names each local council chair (Code Health - General Article, secs. 13-401 through 13-412).

OFFICE OF CHRONIC DISEASE PREVENTION
201 West Preston St.
Baltimore, MD 21201 - 2399

The Office of Chronic Disease Prevention organized in the 1960s as the Regional Medical Program which later became the Adult Health Program. When the Local and Family Health Administration formed in 1989, the Program reorganized under it as the Office of Chronic Disease Prevention. The Office has been part of the Community and Public Health Administration since 1997.

The Office reduces the risk factors for chronic diseases and injuries and the complications of diabetes; assures tests for early detection and, if appropriate, diagnosis and treatment of disease. The Office also provides information to the public on rehabilitative services, treatment options for breast cancer, and breast reconstruction.

Under the Office are four divisions: Cancer Control; Cardiovascular Health and Nutrition; Diabetes Control; and Injury and Disability Prevention and Rehabilitation.

OFFICE OF EPIDEMIOLOGY & DISEASE CONTROL
201 West Preston St.
Baltimore, MD 21201 - 2399

The Office of Epidemiology and Disease Control began under the Community Health Surveillance and Laboratories Administration which became the Community and Public Health Administration in 1997. The Office works to control all communicable diseases affecting people in Maryland. The Office strives to contain hard-to-control diseases, such as hepatitis, influenza, sexually-transmitted diseases, and rabies. It also works to control acute communicable diseases, tuberculosis, nosocomial infections, and animal-borne diseases transmittable to humans. In addition, the Office supervises health programs for refugees and migrants.

The Office oversees four centers: Clinical Epidemiology; Community Epidemiology; Immunization; and Veterinary Public Health.

OFFICE OF HEALTH PROMOTION, EDUCATION, & TOBACCO CONTROL
300 West Preston St.
Baltimore, MD 21201

In November 1993, the Office of Health Promotion, Education, and Tobacco Control formed from the Division of Health Educationas the Office of Health Promotion, Education, and Tobacco Use Prevention. It received its present name in 1997.

The Office is responsible for five programs: Health in Pregnancy, a smoking cessation program; Maryland Kids in Safety Seats (Maryland KISS); Migrant Health; Planned Approach to Community Health (PATCH); and Tobacco Use Prevention.

OFFICE OF INJURY PREVENTION

CLEARINGHOUSE FOR REHABILITATION & TECHNOLOGY INFORMATION
The Clearinghouse for Rehabilitation and Technology Information began in 1984 as the Rehabilitation Information Service under the Office of Chronic and Rehabilitation Facilities (Chapter 416, Acts of 1984). In 1990, when the Service received federal funds through the Technology Assistance Program of the Office for Individuals with Disabilities, it assumed its current name. In 1991, the Clearinghouse was placed under the Office of Chronic Disease Prevention and, in 1995, under the Office of Children's Health.

Information on rehabilitation services is provided by the Clearinghouse to persons who have suffered amputation, stroke, spinal cord injury, or head trauma. The Service also responds to the needs of other disabled individuals and helps providers locate needed services. Inquiries are accepted from anywhere in Maryland (Code Health - General Article, sec. 20-108).

DEVELOPMENTAL DISABILITIES ADMINISTRATION

The Developmental Disabilities Administration originated in 1966 as the Division of Mental Retardation within the Bureau of Preventive Medical Services of the Office of Medical Care Services. In 1970, the Division reformed into a Directorate of Mental Retardation from which the Mental Retardation Administration was created in 1971. The Administration reorganized in 1982 as the Mental Retardation and Developmental Disabilities Administration (Chapter 430, Acts of 1982). In 1986, the Administration received its present name (Chapter 637, Acts of 1986).

For persons with developmental disabilities and their families, the Developmental Disabilities Administration plans, develops, and directs a statewide system of services. Among the services are programs for individuals with mental retardation, cerebral palsy, spina bifida, epilepsy, and severe communicative disorders. The Administration coordinates its work with other government, voluntary and private health, education and welfare agencies.

The Administration operates residential facilities and also provides funds for purchased care, group homes and apartments, small residential centers, and daytime programs for developmentally disabled persons. In addition, the Administration funds Children's Summer Programs, Family and Individual Support Services, and Supported Employment Programs. Regional offices initiate, coordinate, and evaluate local programs (Code Health - General Article, secs. 7-101 through 7-1201).

The Administration operates four facilities: Brandenburg Center, Holly Center, Potomac Center, and Rosewood Center. The Community Services Advisory Commission and four citizens advisory boards also serve the Administration.

COMMUNITY SERVICES ADVISORY COMMISSION
The Community Services Advisory Commission was created within the Developmental Disabilities Administration in 1986 (Chapter 797, Acts of 1986). Annually, the Commission updates a five-year plan to improve community services and programs for persons with developmental disabilities. The plan includes alternative ways and means to finance and expand services and programs.

The Commission has thirteen members. Seven are appointed by the Governor. One represents the State Department of Education. One is a state senator appointed by the Senate President, and one is a delegate appointed by the House Speaker (Code Health - General Article, sec. 7-204).

CENTRAL MARYLAND REGION

ROSEWOOD CENTER
Rosewood Lane
Owings Mills, MD 21117

Rosewood Center was established in 1888 as the Asylum and Training School for the Feeble Minded of the State of Maryland (Chapter 183, Acts of 1888). The Asylum and Training School first admitted children in 1889. From 1912 to 1961, it was known as Rosewood State Training School. In 1961, the School became Rosewood State Hospital (Chapter 89, Acts of 1961). When the State Department of Health merged with the Department of Mental Hygiene in 1969, the Hospital was renamed Rosewood Center.

The Center provides for the care, education, training, and habilitation of persons with mental retardation from Anne Arundel, Baltimore, Harford and Howard counties and Baltimore City. Specialized services to manage behavior also are available. Rosewood is funded to serve a daily average of 290 residents (Code Health - General Article, sec. 7-305).

CITIZENS ADVISORY BOARD
The Board's seven members are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

EASTERN SHORE REGION

HOLLY CENTER
P. O. Box 2358
Snow Hill Road (Route 12)
Salisbury, MD 21801 - 2358

In 1968, the Holly Center began as the Regional Mental Retardation Center - Eastern Shore (Chapter 435, Acts of 1968). It was renamed the Holly Center in 1973.

The Center is funded to serve a daily average of 196 residents. Residential and training services are offered to individuals with mental retardation and their families residing in the nine counties of the Eastern Shore. Education, training, and habilitation services and programs are provided both in the Center and the community (Code Health - General Article, sec. 7-305).

CITIZENS ADVISORY BOARD
The seven members of the Board are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

SOUTHERN MARYLAND REGION

WESTERN MARYLAND REGION

BRANDENBURG CENTER
P. O. Box 1722
Country Club Road
Cumberland, MD 21502 - 1722

Opened in 1978 as the Thomas B. Finan Center - Mental Retardation Unit, the Center came to be known as Western Maryland II. In 1981, the Center was renamed in memory of Joseph D. Brandenburg, a Cumberland resident who distinguished himself through years of service to persons with mental retardation.

Brandenburg Center is a multipurpose health facility serving the residential needs of individuals with mental retardation in Western Maryland from Garrett to Carroll counties. It is located on the grounds of the Thomas B. Finan Hospital Center. Brandenburg Center provides occupational, physical, speech and hearing therapies; social services; and medical supervision for its clients. It habilitates clients so they may return to the community. The Center is funded for a daily average of 68 people. (Code Health - General Article, sec. 7-305).

CITIZENS ADVISORY BOARD
The Governor, upon recommendation of the Secretary of Health and Mental Hygiene, appoints the Board's seven members to four-year terms.

POTOMAC CENTER
1380 Marshall St.
Hagerstown, MD 21740

The Potomac Center originated in 1978 as Western Maryland I - Mental Retardation Center. It became the Potomac Center in 1981.

The Center serves as a residence for persons with mental retardation in Western Maryland from Garrett to Carroll counties (Code Health - General Article, sec. 7-305). It provides habilitative services to expedite the return of clients to a less restrictive environment.

Persons of all ages and at all levels of retardation are served by the Center. It is funded to serve a daily average of 117 people.

CITIZENS ADVISORY BOARD
The Governor, upon recommendation of the Secretary of Health and Mental Hygiene, appoints the Board's seven members to four-year terms.

LABORATORIES ADMINISTRATION

The Laboratories Administration was formed by the Department as the Community Health Surveillance and Laboratories Administration in 1987 and received its present name in January 1997. The Administration is responsible for the Office of Drug Control; and Laboratories.

OFFICE OF DRUG CONTROL

In 1951, the Office originated as the Division of Drug Control within the Bureau of Environmental Hygiene. Later transferred to the Office of Licensing and Certification, the Division of Drug Control reorganized in 1987 as the Office of Drug Control and joined the Community Health Surveillance and Laboratories Administration. The Administration was renamed the Community and Public Health Administration in 1997.

The Office enforces the Controlled Dangerous Substance Act and ensures the availability of drugs for legitimate medical and scientific purposes while working to prevent drug abuse (Code 1957, Art. 27, secs. 276-302). Office programs focus on physicians, dentists, veterinarians, pharmacists, manufacturers, distributors, pharmacies, and nonpharmacy establishments.

LABORATORIES

Formerly the Laboratories Administration, Laboratories became part of the Community Health Surveillance and Laboratories Administration in 1987. The Administration was renamed the Community and Public Health Administration in 1997.

The Office has broad responsibilities for laboratory testing to help physicians and health officials prevent, diagnose, and control human diseases. The Office performs examinations in connection with the enforcement of State health laws, and the chemical, microbiological, and radiological surveillance of the environment related to foods, waters, sewage, air, pharmaceuticals, and hazardous wastes. Laboratory tests are conducted to support State occupational safety and health regulations and to enforce pure food and drug laws.

To ensure the quality of laboratory services, the Office develops standards and regulations for medical laboratories, tissue banks, and physician office laboratories. It also certifies and periodically inspects laboratories that examine water and dairy products for shipment out of Maryland.

In addition to a central laboratory in Baltimore and three branch laboratories, the Office oversees six divisions: Administrative and Support Systems; Environmental Chemistry; Microbiology; Newborn and Childhood Screening; Quality Assurance, Safety, and Training; and Virology and Immunology.

LABORATORY ADVISORY COMMITTEE
Authorized in 1989, the Laboratory Advisory Committee advises the Secretary of Health and Mental Hygiene on matters relating to medical laboratories (Chapter 330, Acts of 1989).

The Secretary of Health and Mental Hygiene appoints Committee members to two-year terms and names the chair.

MENTAL HYGIENE ADMINISTRATION

The Mental Hygiene Administration originated in 1886 as the State Lunacy Commission (Chapter 487, Acts of 1886). The Commission inspected public and private institutions for the insane and advised their boards of managers. In 1922, the Commission was replaced by the Board of Mental Hygiene (Chapter 29, Acts of 1922). The Board, in turn, was superseded by the Department of Mental Hygiene in 1949 (Chapter 685, Acts of 1949). Not only was the Board of Mental Hygiene abolished in 1949, but so also were the separate governing boards of the State mental hospitals. In that year, the Department of Mental Hygiene became responsible for the custody, care, and treatment of mentally ill persons. The Department of Mental Hygiene became part of the Department of Health and Mental Hygiene in 1969 and subsequently reorganized as the Mental Hygiene Administration (Chapter 77, Acts of 1969).

Eight psychiatric hospitals are overseen by the Administration:

Walter P. Carter Center (Baltimore City)
Crownsville Hospital Center (Anne Arundel County)
Eastern Shore Hospital Center (Dorchester County)
Thomas B. Finan Hospital Center (Allegany County)
Clifton T. Perkins Hospital Center (Howard County)
Spring Grove Hospital Center (Baltimore County)
Springfield Hospital Center (Carroll County)
Upper Shore Community Mental Health Center (Kent County)

The Administration also is responsible for the Maryland Psychiatric Research Center, and three residential treatment centers for youth:

Regional Institute for Children & Adolescents - Baltimore
Regional Institute for Children & Adolescents - Rockville
Regional Institute for Children & Adolescents - Southern Maryland

The Director of Mental Hygiene heads the Administration. Certified in psychiatry by the American Board of Psychiatry and Neurology, the Director is appointed by the Secretary of Health and Mental Hygiene. With the approval of the Secretary of Health and Mental Hygiene, the Director of Mental Hygiene is empowered to make State grants-in-aid to further community mental health services (Chapter 125, Acts of 1966). The Director supervises programs receiving these grants-in-aid (Code Health - General Article, secs. 10-101 through 10-1203). Local mental health advisory committees also are authorized for each county and Baltimore City (Code Health - General Article, secs. 10-308 through 10-312).

MARYLAND ADVISORY COUNCIL ON MENTAL HYGIENE
In 1976, the Maryland Advisory Council on Mental Hygiene was created (Chapter 746, Acts of 1976). It advises the Mental Hygiene Administration on the social, economic and medical problems of mental hygiene.

The Council's eighteen members are appointed by the Governor for three-year terms (Code Health - General Article, secs. 10-301 through 10-305).

WALTER P. CARTER CENTER

The Walter P. Carter Center first offered community mental health services to Baltimore City residents in 1967. Now, these services include inpatient and outpatient care, partial hospitalization, and emergency services. Psychiatric emergency service for area residents is available twenty-four hours a day, seven days a week. Consultation and education services are provided to community agencies (Code Health - General Article, sec. 10-406).

The Center also maintains three units at other sites that provide treatment for adults, adolescents, and children: Benson Avenue Outpatient Clinic, Carruthers Clinic, and Cherry Hill Clinic.

CITIZENS ADVISORY BOARD
The Board's seven members are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

CROWNSVILLE HOSPITAL CENTER

Crownsville Hospital Center originated as the Hospital for the Negro Insane of Maryland in 1910 (Chapter 250, Acts of 1910). The Hospital opened to patients in 1911 and was renamed Crownsville State Hospital in 1912 (Chapter 187, Acts of 1912). It desegregated in 1949 (Chapter 685, Acts of 1949).

Patients with mental illness from Anne Arundel, Calvert, Charles, St. Mary's and Prince George's counties are admitted by the Center. The facility is funded for a daily average of 297 patients (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
Appointed by the Governor upon recommendation of the Secretary of Health and Mental Hygiene, the Board's eleven members serve four-year terms (Code Health - General Article, sec. 10-411).

EASTERN SHORE HOSPITAL CENTER

Eastern Shore Hospital Center began in 1912 as Eastern Shore State Hospital (Chapter 187, Acts of 1912). The Hospital admitted its first patients in 1915.

The Center cares for patients with mental illness who reside on the lower Eastern Shore. The facility is funded for a daily average of 80 patients (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
The Governor appoints the Board's eleven members to four-year terms upon recommendation of the Secretary of Health and Mental Hygiene.

THOMAS B. FINAN HOSPITAL CENTER

Opened in October 1978, the Thomas B. Finan Hospital Center is a multi-purpose psychiatric facility which serves Allegany, Frederick, Garrett and Washington county residents of all ages with mental illnesses (Code Health - General Article, sec. 10-406). Services extend as well to youth from Carroll, Howard and Montgomery counties.

The Center is staffed to accommodate and treat 72 adult and 24 geriatric patients, and 23 adolescents in small, 25-bed cottages. It also includes three cottages that house treatment programs for addicts. These are operated by the Allegany County Health Department. The one-cottage Massie Unit, licensed by the Department of Health and Mental Hygiene to the County Health Department, treats adults who abuse drugs and alcohol. The two-cottage Jackson Unit, licensed by the Department of Juvenile Justice to the County Health Department, treats juveniles with substance abuse problems or children in need of supervision. Another cottage is leased to Archway Station, Inc., as a 16-bed rehabilitation apartment complex. Also on the grounds of the Finan Center, the Joseph D. Brandenburg Center serves persons with mental retardation through programs of the Developmental Disabilities Administration.

CITIZENS ADVISORY BOARD
Upon recommendation of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's seven members to four-year terms.

CLIFTON T. PERKINS HOSPITAL CENTER

The Clifton T. Perkins Hospital Center is the State's only maximum security hospital. Formally established in 1959 as Maximum Security Hospital, it was placed under the Department of Mental Hygiene. In April 1960, the Hospital was renamed to honor Dr. Clifton T. Perkins, Commissioner of Mental Hygiene from 1950 to 1959 (Chapter 814, Acts of 1959). Dr. Perkins had planned and defined the function of the Hospital but died before it opened early in 1960.

Patients referred by the courts of Maryland for pretrial psychiatric evaluation are treated by the Center. It is a residence for individual offenders who have been found not guilty by reason of insanity. The Center also serves as a hospital for prisoners who become mentally ill and require involuntary psychiatric hospitalization. Prisoners are committed to the Center for an indefinite length of time and only can be released upon the authorization of a judge. From other State psychiatric hospitals, the Center also accepts patients whose illness requires maximum security treatment for a period of time. The Center is funded to serve a daily average of 250 patients (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
The Board's seven members are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

MARYLAND PSYCHIATRIC RESEARCH CENTER

Opened in 1968, the Maryland Psychiatric Research Center is located on the grounds of Spring Grove Hospital Center (Chapter 558, Acts of 1967). The University of Maryland, Baltimore, operates the Research Center under an agreement with the Department of Health and Mental Hygiene.

The Center conducts a program of basic and applied interdisciplinary research on mental illness. It trains graduate and postgraduate students in psychiatric and behavioral sciences research (Code Health - General Article, secs. 10-417 through 10-429).

EXECUTIVE BOARD
The Executive Board for the Maryland Psychiatric Research Center consists of five ex officio members (Code Health - General Article, secs. 10-419 through 10-422).

TECHNICAL REVIEW COMMITTEE
The Technical Review Committee for the Maryland Psychiatric Research Center consists of eleven members. Six are named by the Executive Board and three serve ex officio (Code Health - General Article, secs. 10-426 through 10-429).

SPRING GROVE HOSPITAL CENTER

Spring Grove Hospital Center is the oldest hospital for the mentally ill in Maryland, and the third oldest in the United States. It was established in 1797 as the Maryland Hospital at Monument Street and Broadway in Baltimore City (Chapter 102, Acts of 1797). In 1872, the Hospital moved to Catonsville as the Maryland Hospital for the Insane. It was renamed Spring Grove State Hospital in 1912 (Chapter 187, Acts of 1912).

With an average daily population of 340 patients in FY1999, the Center admits patients from Baltimore and Harford counties (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
The Board's nine members are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene (Code Health - General Article, sec. 10-411).

SPRINGFIELD HOSPITAL CENTER

Springfield Hospital Center formed in 1894 as the Second Hospital for the Insane of the State of Maryland (Chapter 231, Acts of 1894). The Hospital opened for patients in 1896. It was renamed Springfield State Hospital in 1900 (Chapter 70, Acts of 1900).

The Center admits patients from Baltimore City and Carroll, Howard and Montgomery counties. The Center is the largest State facility for the care of persons with mental illness. In FY1999, its daily average was 375 patients (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
The Governor, upon recommendation of the Secretary of Health and Mental Hygiene, appoints the seven members of the Board to four-year terms.

UPPER SHORE COMMUNITY MENTAL HEALTH CENTER

Opened in 1982, the Upper Shore Community Mental Health Center is a multipurpose mental health hospital. It serves a daily average of 43 patients and provides psychiatric services for eligible persons, 16 years of age and older, from Caroline, Cecil, Kent, Queen Anne's and Talbot counties. The Center also holds a 15-bed juvenile detention center and a 20-bed intermediate care unit for alcoholics over the age of 18 (Code Health - General Article, sec. 10-406).

CITIZENS ADVISORY BOARD
The Governor appoints the Board's seven members to four-year terms upon recommendation of the Secretary of Health and Mental Hygiene (Code Health - General Article, sec. 10-411).

CHILD & ADOLESCENT SERVICES

REGIONAL INSTITUTE FOR CHILDREN & ADOLESCENTS - BALTIMORE
605 South Chapel Gate Lane
Baltimore, MD 21229

The Regional Institute for Children and Adolescents - Baltimore opened in 1958. Formerly on the grounds of Rosewood State Hospital in Baltimore County, the Institute moved to southwest Baltimore, near the U.S. National Cemetery, in the early 1970s.

Serving Baltimore City and Anne Arundel and Baltimore counties, the Institute provides intensive inpatient and outpatient psychiatric care for youths with serious emotional illnesses. The Institute is funded for a daily average of 37 residential patients and 50 day patients.

CITIZENS ADVISORY BOARD
Upon recommendation of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's seven members to four-year terms.

REGIONAL INSTITUTE FOR CHILDREN & ADOLESCENTS - ROCKVILLE
15000 Broschart Road
Rockville, MD 20850

In 1980, the Regional Institute for Children and Adolescents - Rockville received its first patients. It provides treatment for youths with emotional handicaps from Frederick, Howard, Montgomery, Prince George's and Washington counties. It offers an intensive diagnostic and treatment unit, and residential and day treatment. Educational services are provided by the Montgomery County Department of Education. The Institute is funded to serve an average daily population of 45 young people in residence and 90 children between the ages of 5 and 18 in day treatment.

CITIZENS ADVISORY BOARD
The seven-member Board is appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene.

REGIONAL INSTITUTE FOR CHILDREN & ADOLESCENTS - SOUTHERN MARYLAND
P. O. Box 369
9400 Surratts Road
Clinton, MD 20735 - 0369

The Regional Institute opened as Cheltenham Center in 1976. Then, it was funded by a State grant from the Department of Health and Mental Hygiene through the Prince George's County Health Department. In 1982, the Center became a State institution renamed the Regional Institute for Children and Adolescents - Prince George's County (Chapter 891, Acts of 1982). Since 1989, it has been known as the Regional Institute for Children and Adolescents - Southern Maryland. The Institute serves boys and girls with serious emotional disturbances. They are ages 12 to 18 years old, from Calvert, Charles, Prince George's and St. Mary's counties.

Youth reside at the Institute for an average of eight months. Some day students receive therapy and schooling at the Institute but live at home. The Institute, in FY1999, served a daily average of 29 youths, including students referred by the court for evaluation and young people who receive day treatment.

CITIZENS ADVISORY BOARD
Appointed by the Governor upon recommendation of the Secretary of Health and Mental Hygiene, the Board has eleven members who serve four-year terms (Code Health - General Article, sec. 10-411).

OFFICE OF CHIEF MEDICAL EXAMINER

The Office of Chief Medical Examiner oversees a network of local deputy medical examiners and forensic investigators who investigate violent and suspicious deaths, and deaths unattended by physicians. These duties had been the responsibility first of local sheriffs, and then of local coroners from 1666 to the end of the nineteenth century. Then, they were assumed by justices of the peace. In 1939, these functions were assigned to deputy medical examiners (Chapter 369, Acts of 1939).

With the State Postmortem Examiners Commission, the Chief Medical Examiner appoints physicians as deputy medical examiners and forensic investigators in each county. The deputy medical examiners file with the Office of Chief Medical Examiner reports of all deaths investigated. Records of the Office are open for inspection to the family of the deceased and are acceptable in court as evidence of the facts contained.

The Chief Medical Examiner performs autopsies and provides the local state's attorney with copies of records concerning any death which requires further investigation. Appointed by the State Postmortem Examiners Commission, the Chief Medical Examiner oversees Administration, Autopsy Services, Statewide Services, Toxicology, and the Center for the Study of Health Effects of Fire.

STATE POSTMORTEM EXAMINERS COMMISSION
Created in 1939, the Department of Postmortem Examiners replaced a decentralized system of local coroners (Chapter 69, Acts of 1939). In 1982, the Department was subsumed into the State Postmortem Examiners Commission (Chapter 21, Acts of 1982).

The State Postmortem Examiners Commission is composed of four ex officio members and a representative of the Department of Health and Mental Hygiene selected by the Secretary of Health and Mental Hygiene. The Commission appoints all professional personnel (Code Health - General Article, secs. 5-301 through 5-312).

CENTER FOR THE STUDY OF HEALTH EFFECTS OF FIRE
111 Penn St., 3rd floor
Baltimore, MD 21201

The Center for the Study of the Health Effects of Fire was created in 1988 (Chapter 185, Acts of 1988). The Center studies the health effects of exposure to fire; gathers and analyzes data on fire-related injury or death; and maintains both a registry of persons who suffer fire-related injury or death, and a computerized database concerning injuries and health effects of fire. For information routinely collected about fires, the Center is a repository. Information collected by the Center and intended for use in research, however, is confidential and not discoverable or admissible as evidence in a civil or criminal action to determine cause of death or liability for injury or death.

Pilot studies on issues or factors affecting injuries from or the health effects of fire are funded by the Center which also applies for federal or private research grants to investigate such issues. In addition, the Center communicates with national scientific data bases on toxicology, chemistry, epidemiology, and related scientific disciplines; collaborates with agencies, such as the National Bureau of Standards, that are involved in programs related to health effects of fire; and promotes interest in fire-related issues at educational institutions in Maryland (Code Health - General Article, secs. 18-701 through 18-711).

ADVISORY COUNCIL TO THE CENTER FOR THE STUDY OF HEALTH EFFECTS OF FIRE
The Advisory Council reviews the work of the Center for the Study of Health Effects of Fire. The Council also advises the Director concerning the scientific evaluation of information collected by the Center and helps the Center set research priorities.

With Senate advice and consent, the Secretary of Health and Mental Hygiene appoints the Council's seven members to five-year terms (Code Health - General Article, secs. 18-706 through 18-710).

STATE ANATOMY BOARD

Authorized in 1947, the State Anatomy Board was organized in 1949 (Chapter 669, Acts of 1947). The Board's purpose is to ensure the proper distribution of cadavers to qualified hospitals, medical schools, and other agencies engaged in medical education and research. Bodies are distributed equitably to the anatomy department of each medical school in Maryland. The Board also carries out the legal provisions regulating Consent to Post Mortem Examination (Chapter 315, Acts of 1961) and the Anatomical Gift Act (Chapter 467, Acts of 1968).

The Board consists of two representatives from each of the departments of anatomy of medical schools in the State of Maryland and one representative of the Department of Anatomy of the University of Maryland School of Dentistry. Members of the Board are designated by the administrative officers of each school (Code Health - General Article, secs. 5-401 through 5-409).

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