DEPARTMENT OF HEALTH & MENTAL HYGIENE

PUBLIC HEALTH SERVICES

Herbert R. O'Conor State Office Building, 201 West Preston St., Baltimore, Maryland, March 2004. Photo by Diane F. Evartt.

To ensure that basic public health services are provided in all parts of Maryland, the Deputy Secretary for Public Health Services oversees the local health departments in each county and Baltimore City. Under 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.

CHIEF OF STAFF

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.

To provide advice on technical issues, the Commission has formed two advisory groups: the Developmental Disabilities Administration Technical Advisory Group, and the Mental Hygiene Administration Technical Advisory Group.

The Commission's seven members are appointed to three-year terms by the Governor with Senate advice and consent. Authorization for the Commission was extended through September 30, 2011 (Chapter 401, Acts of 2005; Chapters 572 & 573, Acts of 2008; Code Health-General Article, secs. 13-801 through 13-810).

HEALTH & HUMAN SERVICES REFERRAL BOARD
In October 2004, the Health and Human Services Referral Board was organized under Public Health Services (Chapter 390, Acts of 2004). The Board is to oversee the establishment of a single-source information and referral phone number for health and human services statewide, beginning with four pilot programs.

With Senate advice and consent, the Governor appoints the Board's seventeen members to four-year terms. The Governor also names the chair (Code Health-General Article, secs. 24-1101 through 24-1105).

FAMILY HEALTH ADMINISTRATION

In 1987, the Family Health Administration originated under its current name. The Local Health Administration and the Family Health Administration merged in 1989 to form the Local and Family Health Administration. In January 1997, it became the Community and Public Health Administration. That agency in July 2001 divided into the Family Health Administration and the Community Health Administration.

The Family Health Administration works to prevent and control chronic diseases; prevent injuries; provide public health information; and promote healthy behaviors in Marylanders. Further, it strives to ensure that quality health care services are available, especially for at-risk and vulnerable people.

Under the Administration are Deer's Head Center and Western Maryland Center. The Administration also is responsible for the Center for Cancer Surveillance and Control; the Center for Health Promotion, Education, and Tobacco Use Prevention; and the Center for Maternal and Child Health. In addition, the Administration oversees five offices: Chronic Disease Prevention; Genetics and Children with Special Health Care Needs; Health Policy and Planning; Oral Health; and Women, Infants and Children Food Program.

DEER'S HEAD CENTER

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

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 60 licensed hospital beds and 63 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.

CENTER FOR CANCER SURVEILLANCE & 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.

CENTER FOR HEALTH PROMOTION, EDUCATION, & TOBACCO USE PREVENTION

In November 1993, the Center for Health Promotion, Education, and Tobacco Use Prevention formed from the Division of Health Education as the Office of Health Promotion, Education, and Tobacco Use Prevention. It was renamed the Office of Health Promotion, Education, and Tobacco Control in 1997, and adopted its present name by 2004.

300 West Preston St., Baltimore, Maryland, December 2000. Photo by Diane F. Evartt.

Maryland Arthritis Project. Funded for two years by the federal Centers for Disease Control and Prevention, this Project began in September 1999. It is setting up a surveillance system to collect epidemiological data on arthritis and related rheumatic conditions; formulating the Maryland State Arthritis Plan; and working to expand the role of the State Advisory Council on Arthritis and Related Diseases.

Maryland Kids in Safety Seats Program. To ensure children's safety as passengers in vehicles, this program began in 1980. It educates the public about what State law requires for child safety seats and restraints, and how to properly install and use them. A newsletter containing product information on child safety seats, product recalls, safety tips, instructions on proper installation, and related issues is published by the Program. To offer low-income families access to child safety seats, the Program also coordinates loaner programs statewide.

Tobacco Use Prevention Program. This program funds local school districts and health departments in their tobacco use prevention and cessation efforts. It support media campaigns on clean indoor air and smoke-free environments and other community programs that educate the public about tobacco use.

CENTER FOR MATERNAL & CHILD HEALTH

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 became part of the Community and Public Health Administration in 1997 and joined the Family Health Administration in July 2001.

In 1922, the Office of Maternal Health and Family Planning originated 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. As part of the Community and Public Health Administration since 1997, it transferred to the Family Health Administration in July 2001.

Since the merger of the Office of Children's Health with the Office of Maternal Health and Family Planning, the Center for Maternal and Child Health has worked 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.

For children whose chronic illnesses or disabling conditions interfere with normal growth and development, the Center helps families plan and obtain specialized medical and rehabilitative care. 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).

A joint federal, State and local program called Children's Medical Services, formerly Crippled Children's Services, is administered by the Center. While State funding for services to crippled children dates to at least 1922, the program has operated in Maryland since 1937 (Code Health-General Article, sec. 15-125).

Under the Center are Adolescent and Child Health; Community Initiatives and Partnerships; Family Planning and Reproductive Health; and Maternal and Perinatal Health.

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

In 1946, the Maryland State School Health Council was formed 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 CHRONIC DISEASE PREVENTION

The Office of Chronic Disease Prevention organized in the 1960s as the Regional Medical Program and later became the Adult Health Program. When the Local and Family Health Administration formed in 1989, the Program reformed under it as the Office of Chronic Disease Prevention. The Office transferred to the Community and Public Health Administration in 1997, and became the Office of Chronic Disease Prevention and Public Health Residency Program under the Family Health Administration in 2000. It combined with the Office of Injury and Disability Prevention to form the Center for Preventive Health Services in May 2003. In June 2008, the Center was renamed again the Office of Chronic Disease Prevention.

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.

The Council advises the Department on implementation of the Arthritis Prevention and Control Program, which was created in October 2002 (Chapter 215, Acts of 2002). In establishing the Program, the General Assembly considered the fact that arthritis is the leading cause of disability in the United States, affecting nearly one out of every six people. Through the Program, the Council trains teachers, and health-care professionals and providers about how to prevent and control arthritis. The Council also educates consumers about the importance of early diagnosis of arthritis, its causes and prevention.

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 names the chair. Members serve four-year terms (Code Health-General Article, secs. 13-505 through 13-509).

STATE ADVISORY COUNCIL ON HEART DISEASE & STROKE
The State Advisory Council on Heart Disease and Stroke 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 as the State Advisory Council on High Blood Pressure and Related Cardiovascular Risk Factors 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. The Council reorganized as the State Advisory Council on Heart Disease and Stroke in 2001 (Chapter 238, Acts of 2001).

Guidelines to manage and treat heart disease and stroke are established by the Council. To detect, prevent, and treat these conditions, the Council also develops and promotes educational programs targeted for those at high-risk and for geographic areas with high incidences of heart disease and stroke.

Educational programs on the prevention, early detection, and treatment of heart disease and stroke in Maryland are developed and promoted by the Council.

The Council's twenty-four members are appointed by the Governor to four-year terms (Code Health-General Article, secs. 13-201 through 13-206).

MARYLAND COMMISSION FOR MEN'S HEALTH
In October 2006, the Maryland Commission on Men's Health was established (Chapter 442, Acts of 2006). The Commission is to develop ways to: raise public awareness of men's health needs; encourage men to participate in healthy behaviors; educate men on the benefits of regular medical checkups; and reduce disparities in rates of specific diseases among minorities and underserved populations. Further, the Commission will assess the status of Maryland men's health, with specific attention to prostate and testicular cancer, oral cancer, cardiovascular disease, depression, and diabetes. To attain its goals, the Commission will organize community workshops; monitor applicable State and federal policy and legislation; and recommned services, assistance, and necessary policy changes.

Of the Commission's twelve members, the Governor appoints four, as do the Senate President and House Speaker. Authorization for the Commission extends through September 30, 2010.

STATE ADVISORY COUNCIL ON PHYSICAL FITNESS
In 1963, the State Advisory Council on Physical Fitness began as the State Commission on Physical Fitness (Chapter 606, Acts of 1963). The Commission 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).

STATE BOARD OF SPINAL CORD INJURY RESEARCH
In July 2000, the State Board of Spinal Cord Injury Research was authorized (Chapter 512, Acts of 2000). Due to lack of funding, the Board did not meet from October 2004 to July 2006. At that time, it resumed its work of reviewing grant applications for spinal cord research.

OFFICE OF ORAL HEALTH

The Office of Oral Health focuses on improving the oral health of Marylanders and increasing their access to oral health care. The Office develops educational materials, including brochures on oral cancer, brushing and flossing techniques, healthy eating habits, and a children's guide to healthy oral habits. The Office also grants local health departments funds to develop oral health education and prevention programs and for community water fluoridation. To increase the number of dentists serving in Dental Health Professional Shortage Areas, the Office works with the University of Maryland Dental School.

Under the Office are the Maryland Dental-Care Loan Assistance Repayment Program and the Oral Cancer Prevention Pilot Program. The Office also is served by the Oral Health Advisory Committee.

ORAL HEALTH ADVISORY COMMITTEE
The Oral Health Advisory Committee was created in May 1998 to address concerns about access to oral health care for Marylanders in HealthChoice. In 2000, the Committee was asked to recommend to the Secretary of Health and Mental Hygiene strategies for reducing the oral cancer mortality rate in Maryland (Chapter 307, Acts of 2000).

OFFICE FOR GENETICS & CHILDREN WITH SPECIAL HEALTH CARE NEEDS

In 1964, the first programs of the Office for Genetics and Children with Special Health Care Needs were initiated. These programs were assigned to the Division of Hereditary Disorders in 1973. Reorganized as the Office of Hereditary Disorders in 1990, the Office was placed under Family Health Services and Primary Care in 1997, and received its present name in March 2000. The Office has functioned under the Family Health Administration since July 2001.

The Office works to improve the early identification of children with special health care needs through newborn screening for metabolic diseases, sicle cell disease, chronic diseases, birth defects, hearing loss, and developmental problems. The Office coordinates 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 Birth Defects Reporting and Information System (BDRIS) is maintained by the Office. The System collects data and provides 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. The Office also ensures that children receive timely specialized medical care and family support services.

STATE ADVISORY COUNCIL ON HEREDITARY & CONGENITAL DISORDERS
In 1973, the State Advisory Council on Hereditary and Congenital Disorders formed 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, and in July 2001 as the Family 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).

INFANT HEARING PROGRAM
The Infant Hearing Program was established as the Program to Identify Hearing-Impaired Infants 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 moved under the Community and Public Health Services Administration in 1997. The Program was placed under the Office of Hereditary Disorders in 1998. Reformed as the Universal Newborn-Hearing Screening Program in 1999, it moved under the Office for Genetics and Children with Special Health Care Needs in 2000 (Code Health-General Article, sec. 13-602; Chapter 127, Acts of 1999). The Program became part of the Family Health Administration in July 2001.

The Program provides early identification and follow-up of hearing-impaired infants and infants who are at risk of developing a hearing impairment. Since 1999, the Program has been required to help develop protocols for the universal screening of newborns' hearing (Chapter 127, Acts of 1999).

ADVISORY COUNCIL ON UNIVERSAL NEWBORN-HEARING SCREENING PROGRAM
In 1985, the Advisory Council on Universal Newborn-Hearing Screening Program began as the Advisory Council for Program to Identify Hearing-Impaired Infants (Chapter 402, Acts of 1985). It was renamed the Advisory Council on Universal Newborn-Hearing Screening Program in 1999 (Chapter 127, Acts of 1999).

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 to four-year terms (Code Health-General Article, secs. 13-601 through 13-605).

OFFICE OF HEALTH POLICY & PLANNING

The Office provides policy analysis, comprehensive strategic planning, and scientific program analysis for the Family Health Administration. Since July 2006, the Office also is responsible for statewide access to primary health care services and promoting availability of health services in rural areas. It staffs and coordinates the departmentwide Healthy Maryland Project 2010, and is preparing the Health Improvement Plan (a component of the Project).

Core Public Health Services Funding Program. The Office also administers this program to provide matching State funds to local health departments for vital programs, such as communicable disease control, maternal and child health services, and environmental health.

OFFICE OF WOMEN, INFANTS & CHILDREN FOOD PROGRAM

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, the Community and Public Health Administration in 1997, and again the Family Health Administration in July 2001.

Maryland Special Supplemental Food Program for Women, Infants, and Children (WIC). The Program offers health and nutrition services, including supplemental foods, to pregnant, postpartum and breast-feeding women; infants up to one year of age; and children until 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 (P.L. 95-627).

INFECTIOUS DISEASE & ENVIRONMENTAL HEALTH ADMINISTRATION

The Infectious Disease and Environmental Health Administration is responsible for environmental health programs, food control services, HIV care services, infectious disease prevention and reporting, outbreak response, and regulatory programs.

In July 2009, the Infectious Disease and Environmental Health Administration formed from the merger of the AIDS Administration and the Community Health Administration.

500 North Calvert St., Baltimore, Maryland, February 2004. Photo by Diane F. Evartt.

The other component forming the Infectious Disease and Environmental Health Administration was the Community Health Administration. It originated 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 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 as the Community and Public Health Administration. That administration divided into the Community Health Administration and the Family Health Administration in July 2001. Functions of the Community Health Administration transferred in July 2009 to the Infectious Disease and Environmental Health Administration.

The Infectious Disease and Environmental Health Administration is organized under four offices: Environmental Health and Food Protection; Finance and Operations; Infectious Disease Epidemiology and Outbreak Response; and Infectious Disease Prevention and Care Services.

OFFICE OF ENVIRONMENTAL HEALTH & FOOD PROTECTION

CENTER FOR ENVIRONMENTAL HEALTH COORDINATION
In 1998, the Office of Environment Health Coordination and Regulatory Affairs was created as the Office of Environmental Health Coordination within the Community and Public Health Administration. In November 2005, it reorganized as the Office of Environmental Health Coordination and Regulatory Affairs under the Community Health Administration. Under its present name, the Office transferred to the Infectious Disease and Environmental Health Administration in July 2009. When environmental issues may impact public health, the Office coordinates its work with the Department of the Environment and local environmental offices.

The Office oversees the Office of Environmental Public Health Tracking, and the Preventive Medicine Residency Program.

OFFICE OF FOOD PROTECTION & CONSUMER HEALTH SERVICES
6 St. Paul St., Baltimore, MD 21202

The Office of Food Protection and Consumer Health 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, joined the Community Health Administration in July 2001, and the Infectious Disease and Environmental Health Administration in July 2009.

By eliminating or minimizing exposure to or consumption of unsafe commodities and substances, the Office prevents disease, disability, and death. It 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 is responsible for the Office of Administrative Services, the Office of Emergency Response, and four centers: Community Health Services; Food Processing; Milk Control; and Retail Food, Plan, and Process Review. The Youth Camp Safety Advisory Council assists the Office.

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

In 1986, he Youth Camp Safety Advisory Council was created (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).

CENTER FOR MILK CONTROL
The Center for Milk Control began as the Division of Milk Control and was restructured under its present name in August 2009. To ensure that Marylanders have a safe supply of milk and dairy products, the Center licenses and inspects dairy farms, milk processing plants, frozen dessert manufacturers, bulk milk receiving and transfer stations, and wholesale distribution facilities that handle Grade A milk products. Further, the Center licenses and certifies dairy farm inspectors; licenses and evaluates bulk milk haulers and samplers; and licenses milk transportation companies operating in Maryland. For dairy products produced in Maryland, the Center issues certificates for exports. The Center also investigates all complaints and enforces all laws relating to production and shipment of milk and dairy products (Code Health-General Article, secs. 21-401 through 21-436).

OFFICE OF INFECTIOUS DISEASE PREVENTION & CARE SERVICES

CENTER FOR HIV CARE SERVICES
In 1989, the Division of AIDS Services, Planning, and Development formed within the AIDS Administration. The Division became the Center for AIDS Services, Planning, and Development in 1994. It reorganized in 1997 as the Center for HIV Patient Services, and became the Center for HIV Health Services in 2001. Also in 2001, the Center for HIV Client Services was formed to operate programs to fund medication for eligible persons. In December 2006, that Center combined with the Center for HIV Client Services to form the Center for HIV Care Services. It joined the Infectious Disease and Environmental Health Administration in July 2009.

Clinical activities for the diagnosis and evaluation of patients with AIDS are funded by the Administration. The Administration also directly operates drug assistance and insurance assistance programs for those living with HIV/AIDS. 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 Center administers the federal Ryan White CARE Act Program. Through this and other federal and State programs, the Center assures that Marylanders living with or affected by HIV/AIDS have access to primary medical care, case management and dental care, as well as to other support services. Funds are awarded to local health departments, other government agencies, community and hospital-based health care facilities, and community organizations to provide these services. For housing assistance and related supportive services for individuals with HIV/AIDS, the Center also administers funds from the Housing Opportunities for Persons with AIDS (HOPWA) Program of the U.S. Department of Housing and Urban Development.

Through the Maryland AIDS Drug Assistance Program, the Center funds specified medications in the treatment of HIV and AIDS patients throughout Maryland. The Center also administers two health insurance programs: Maryland AIDS Drug Assistance Program-Plus (MADAP-Plus), and the Maryland AIDS Insurance Assistance Program (MAIAP).

CENTER FOR PREVENTION, EDUCATION, & TRAINING
The Center for Prevention, Education, and Training began in 1991 as the Division of Professional Education and Health Services. The Division formed within the AIDS Administration by merging 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 as the Center for Education and Training. In July 2004, it restructured under its present name, and in July 2009 transferred to the Infectious Disease and Environmental Health Administration.

In 1997, when the Center for Quality Assessment and Improvement was abolished, 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 Prevention, 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.

Under the Center for Prevention, Education, and Training are three divisions: Capacity Building and Training; Health Communications, Public Information, and Prevention for HIV Positive Persons (PHIPP); and Local Prevention and Provider Education.

DIVISION OF LOCAL PREVENTION & PROVIDER EDUCATION
The Division of Local Prevention and Provider Education first formed as the Division of HIV Counseling and Testing Services within the AIDS Administration. Renamed Division of Local Prevention Services, it was placed under the Center for AIDS Education (later the Center for Prevention Programs). The Division transferred in 1997 to the Center for Education and Training, and reorganized as the Division of Local Prevention and Provider Education. In July 2004, the Center reformed as the Center for Prevention, Education, and Training and, in July 2009, the Division was made part of the Infectious Disease and Environmental Health Administration.

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 EPIDEMIOLOGY & HEALTH SERVICES RESEARCH
The Center for Epidemiology and Health Services Research started as the Center for AIDS Epidemiology within the AIDS Administration 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 to form the Center for Epidemiology and Health Services Research. It joined the Infectious Disease and Environmental Health Administration in July 2009.

Through case surveillance, epidemiologic investigations, and seroprevalence and other studies, the Center determines the impact of the AIDS/HIV epidemic on Maryland's residents, institutions, and government. 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.

OFFICE OF EPIDEMIOLOGY & DISEASE CONTROL
Herbert R. O'Conor State Office Building, 201 West Preston St., Baltimore, MD 21201 - 2399

The Office of Epidemiology and Disease Control began under the Community Health Surveillance and Laboratories Administration. That administration became the Community and Public Health Administration in 1997, the Community Health Administration in July 2001, and reformed as the Infectious Disease and Environmental Health Administration in July 2009. 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.

Four centers are overseen by the Office: Clinical Epidemiology; Community Epidemiology; Immunization; and Veterinary Public Health.

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 Laboratories Administration has broad responsibilities for laboratory testing to help physicians and health officials prevent, diagnose, and control human diseases. It 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 Administration 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 two regional laboratories, Laboratories oversees the Office of Laboratory Emergency Preparedness and Response as well as Regulatory and Administrative Programs, and Scientific Programs.

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; Health-General Article, sec. 17-217).

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

OFFICE OF LABORATORY EMERGENCY PREPAREDNESS & RESPONSE
In July 2002, the Office of Laboratory Emergency Preparedness and Response was created within the Laboratories Administration as the Laboratory Bioterrorism Office. It was reorganized under its present name in November 2004. The Office develops procedures, trains staff, and coordinates State efforts to prepare for and respond to a bioterrorism attack. The Office also oversees the Biological Agents Registry.

BIOLOGICAL AGENTS REGISTRY
Since October 2002, the Biological Agents Registry has been authorized to monitor persons in Maryland who possess, maintain, or transfer certain biological agents. These biological agents could include microorganisms, fungi, and other toxins.

The Registry is in charge of a system of safeguards requiring individuals who possess, maintain, or transfer biological agents to comply with the federal regulations on transferring these agents. The Registry also alerts proper authorities of unauthorized possession, or attempted possession of biological agents. In addition, during investigations, the Registry is maintained for the use of federal law enforcement agencies, and the Centers for Disease Control and Prevention (Chapter 361, Acts of 2002; Code Health-General Article, secs. 17-601 through 17-605).

REGULATORY & ADMINISTRATIVE PROGRAMS

DIVISION OF DRUG CONTROL
4201 Patterson Ave., 4th floor, Baltimore, MD 21215 - 2299

In 1951, the Division of Drug Control originated 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 Office became part of the Laboratories Administration in 1997 and resumed its original name in November 2004.

The Division 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 Criminal Law Article, secs. 5-101 through 5-505). Division programs focus on physicians, dentists, veterinarians, pharmacists, manufacturers, distributors, pharmacies, and nonpharmacy establishments.

SCIENTIFIC PROGRAMS

ENVIRONMENTAL CHEMISTRY DIVISION
To help monitor and enforce environmental and consumer product safety laws, the Environmental Chemistry Division tests air, beverages, drugs, drinking water, foods, pharmaceuticals, sediments, sludges, soils, wastewater, and local flora and fauna. Tests are conducted to detect potentially toxic pollutants, such as pesticides, radioactivity, metals, and organic and inorganic compounds. For consumer safety, products are tested for tampering, characterization, and nutritional labeling.

ENVIRONMENTAL MICROBIOLOGY DIVISION
The Environmental Microbiology Division tests for disease-causing microorganisms in drinking water, swimming water, sewage treatment water, foods, shellfish and shellfish waters, and dairy products. Also, the Division certifies laboratories to test water, shellfish, and dairy products.

MOLECULAR BIOLOGY DIVISION
In the Molecular Biology Division, testing is carried out for HIV, rabies, West Nile virus, and other pathogens.

Five sections perform the Division's work: Molecular Diagnostics; Molecular Epidemiology; Molecular Imaging and Analysis; DNA Sequencing; and Rabies Zoonosis.

NEWBORN & CHILDHOOD SCREENING DIVISION
For every baby born in Maryland, the Newborn and Childhood Screening Division offers testing for numerous hereditary disorders. These include biotinidase deficiency; congenital adrenal hyperplasis; galactosemia; homocystinuria; maple syrup urine disease (MSUD); neonatal hypothyroidism; phenylketonuria (PKU); sickle cell anemia and other hemoglobinopathies; and tyrosinemia. As part of the State's Lead Poisoning Prevention Program, the Division also tests children's blood for elevated lead levels and environmental samples for lead contamination.

PUBLIC HEALTH MICROBIOLOGY DIVISION
The Public Health Microbiology Division began as the Division of Diagnostic and Public Health Microbiology and assumed its current name in November 2004. The Division provides diagnostic services, including processing patient specimens, recovering and identifying infectious agents, and assisting physicians in delivering proper antimicrobial therapy. For Maryland health care providers and institutions, the Division indentifies and confirms microbial agents: enteric and diarrheal; foodborne, fungal; gonococcal; parasitic; pertussis; and tuberculosis. These agents cause various diseases.

Four sections comprise the Division: Bacteriology; Mycobacteriology; Mycology; and Parisitology.

VIROLOGY & IMMUNOLOGY DIVISION
To detect viral and certain bacterial agents that cause diseases in humans, the Virology and Immunology Division conducts serological assays to determine the effectiveness of vaccines for hepatitis, measles, mumps, polio, rubella, and varicella. The Division conducts surveillance testing for sexually transmitted diseases; does cell culture isolations for epidemiological studies of respiratory virus outbreaks; and analyzes animal-borne agents, such as Hantaviruses, Lyme disease, rabies, and arboviruses, including encephalitis.

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 to the Center for the Study of the Health Effects of Fire 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.

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

TOXICOLOGY

OFFICE OF PREPAREDNESS & RESPONSE

The Office of Preparedness and Response plans for rapid mobilization of public health personnel, and ensures that they are organized, trained, and equipped for all types of hazards. The Office coordinates the Maryland Professional Volunteer Corps, trained health care professionals who provide emergency care during catastrophic events. The Office also is responsible for the Department's Emergency Management Team. On-call 24 hours a day, the Team responds to any health emergency such as a natural disaster, or act of bioterrorism.

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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