DEPARTMENT OF HEALTH & MENTAL HYGIENE

FUNCTIONS

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OFFICE OF SECRETARY

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

Herbert R. O'Conor State Office Building, 201 West Preston St., Baltimore, Maryland, December 2000. Photo by Diane F. Evartt.

Reporting to the Secretary, four deputy secretaries each have a specific area of responsibility: Behavioral Health and Disabilities; Health Care Financing; Operations; and Public Health Services.

The Office of Secretary oversees eight offices: Communications; Constituent Services; Diversity and Inclusion; Equal Opportunity Programs; Governmental Affairs; Health Care Quality; the Inspector General; and Minority Health and Health Disparities. The Office also is aided by the Work Group on Cancer Clusters and Environmental Causes of Cancer; the State Child Fatality Review Team; the Long-Term Care Reform Work Group; the Morbidity, Mortality, and Quality Review Committee; and the Advisory Board on Prescription-Drug Monitoring.

WORK GROUP ON CANCER CLUSTERS & ENVIRONMENTAL CAUSES OF CANCER
With the Department of the Environment, the Department of Health and Mental Hygiene convened the Work Group on Cancer Clusters and Environmental Causes of Cancer in July 2013 (Chapters 248 & 249, Acts of 2013). The Work Group is to examine issues concerning the investigation of possible cancer clusters and possible environmental causes of cancer in Maryland, including: how cancer clusters are identified and researched; how State and federal agencies communicate about their research into cancer clusters; and whether more information about such research should be made public.

By June 30, 2014, the Department is to report the Work Group's recommendations to the Governor and General Assembly.

STATE CHILD FATALITY REVIEW TEAM
The State Child Fatality Review Team formed within the Department of Health and Mental Hygiene in September 1999 (Chapters 355 & 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 departments of health, law enforcement, medical examiners, and social services (Code Health-General Article, secs. 5-701 through 5-709).

LONG-TERM CARE REFORM WORK GROUP
In June 2009, the Long-Term Care Reform Work Group was authorized (Chapters 308 & 371, Acts of 2009). The Work Group reviews current long-term care plans and best practices, both in Maryland and in other states. To change how Medicaid provides extended care services, the Work Group considers the feasibility of creating a long-term care program that meets the differing needs for care of seniors, and adults with disabilities.

MORBIDITY, MORTALITY, & QUALITY REVIEW COMMITTEE
The Morbidity, Mortality, and Quality Review Committee was authorized in October 2008 (Chapter 664, Acts of 2008). The Committee conducts confidential and anonymous case reviews of morbidity and mortality associated with pregnancy, childbirth, infancy, and early childhood. From those reviews, the Committee develops and implements interventions to improve the system of care for pregnancy, childbirth, infancy, and early childhood (Code Health-General Article, sec. 18-107).

ADVISORY BOARD ON PRESCRIPTION-DRUG MONITORING
In October 2011, the Advisory Board on Prescription-Drug Monitoring was created (Chapter 166, Acts of 2011). The Board makes recommendations to the Secretary of Health and Mental Hygiene on how to design and implement the Prescription Drug Monitoring Program within the Alcohol and Drug Abuse Administration. Initial recommendations cover regulations, legislation, and funding for the Program.

Providing oversight of the Program, the Board reports annually to the Governor and General Assembly (Code Health-General Article, secs. 21-2A-01 through 21-2A-10).

OFFICE OF COMMUNICATIONS

The Office directs public affairs of the Department and coordinates them with Departmental officials, local health officers, and the Governor's Office. The Office of Communications also arranges special events and disseminates employee information.

OFFICE OF DIVERSITY & INCLUSION

OFFICE OF EQUAL OPPORTUNITY PROGRAMS

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.

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 HEALTH CARE QUALITY

The Office of Health Care Quality started 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, it was renamed 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. The Office received its present name in September 1999, then moved under Regulatory Programs in August 2005, and under the Office of Secretary in November 2009.

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. These include: adult daycare centers; ambulatory surgical facilities; assisted-living programs; birthing centers; developmental disabilities programs; dialysis centers; group homes; health maintenance organizations (HMOs); home health agencies; hospice programs, hospitals; independent physical therapists; major medical equipment; medical laboratories; mental health programs; nursing homes and rehabilitation centers; prison hospitals; residential service agencies; residential treatment centers; substance abuse programs; and other miscellaneous programs. To regulate these institutions and programs, the Office conducts more than 10,000 inspections yearly.

For all health facilities participating in the Medical Assistance Program (Medicaid) and Medicare, the Office is responsible for inspection and certification recommendations. Administrative actions against facilities that violate State rules and regulations are initiated by the Office.

The Office consists of Policy and Administration and two divisions: Federal Programs, and State Programs. Also asisting the Office is the Abuser Registry Work Group.

ABUSER REGISTRY WORK GROUP
Originally convened by the Office of Health Care Quality following the 2012 legislative session, the Abuser Registry Work Group was reconvened in June 2013 (Chapters 239 & 606, Acts of 2013).

The Work Group is to review the work of the previous work group; monitor any implementation of its recommendations; and recommend changes to existing laws and regulations necessary to prevent abuse and neglect of patients in health care settings.

Authorization for the Work Group ends June 30, 2014.

POLICY & ADMINISTRATION
For the Office of Health Care Quality, Policy and Administration develops policy, operational procedures, regulations, budgets, and legislation. Administration also oversees the Health Maintenance Organization (HMO) and Hospital Licensure Program.

HMO & HOSPITAL LICENSURE PROGRAM
The HMO and Hospital Licensure Program evaluates all hospitals, and investigates and responds to consumer complaints. The Program 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).

NURSING HOME TECHNICAL ASSISTANCE UNIT
The Nursing Home Technical Assistance Unit within the Office of Health Care Quality was authorized in October 2000 (Chapter 217, Acts of 2000). The Unit supports compliance with quality assurance for nursing home care. The Unit also is to establish a list of approved medical automated systems (Code Health-General Article, sec. 19-1412).

FEDERAL PROGRAMS DIVISION
The Federal Programs Division originated as the Long-Term Care Program within the Licensing and Certification Administration 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. In 2001, it was renamed Federal Programs.

This division is responsible for licensure of adult medical daycare, ambulatory care facilities, laboratories, and nursing homes.

Ambulatory Care Program. This 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.

Laboratory Program. Within the Office of Health Care Quality, the 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.

STATE PROGRAMS DIVISION
Functions of State Programs 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. That program reorganized as the Developmental Disabilities, Substance Abuse and Community Mental Health Program in 1997, and became State Programs in 2001.

State Programs oversees licensure of assisted-living facilities, developmental disabilities facilities, and mental health programs. This office also certifies substance abuse programs. It 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. The 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.

OFFICE OF INSPECTOR GENERAL

The Office oversees two divisions: Audits, and Program Integrity.

AUDITS DIVISION
The Audits Division investigates allegations of fraud, waste, and abuse in Medicaid, Medicare, and other departmental programs, as well as violations of the Department's Code of Conduct. Training in corporate compliance policies also is provided by the Division. The Division conducts internal and external audits, and Medicaid internal audits, as well as overseeing the Institutional Review Board.

INSTITUTIONAL REVIEW BOARD
The Institutional Review Board was created by the Department of Health and Mental Hygiene in 1977. Formerly under the Community Health Administration, the Board transferred to the Office of Inspector General in January 2004.

Research that uses human subjects is reviewed by the Board to ensure that the rights, safety, and dignity of those involved are protected. The review process is mandated as a condition of federal funding.

PROGRAM INTEGRITY DIVISION
The Program Integrity Division investigates potential recipient fraud in Medicaid and other programs, and reviews provider records.

OFFICE OF MINORITY HEALTH & HEALTH DISPARITIES

In October 2004, the Office of Minority Health and Health Disparities was established within the Office of Secretary (Chapters 319 & 443, Acts of 2004; Code Health-General Article, Subtitle 10). The Office advocates for improvements in minority health care. Also, the Office oversees the Cigarette Restitution Fund Program.

For the Secretary of Health and Mental Hygiene, the Office assists in developing priorities for State health programs, services, and resources to address disparities. It also recommends changes in State laws and regulations to expedite delivery of health services to minorities.

With public and private organizations and institutions, the Office works to find funding, administer grants, establish programs, and conduct research to reduce and eliminate racial or ethnic health care disparities in Maryland. Emphasizing habits of health care and preventive health measures, the Office also works to educate the public and reach underserved minorities.

CIGARETTE RESTITUTION FUND PROGRAM
In July 2000, the Cigarette Restitution Fund Program began. With $1 billion of the State's tobacco settlement money committed over ten years, the Program works with academic institutions, county health departments, medical facilities, and community-based organizations to implement programs that reduce tobacco use by Maryland citizens, and reduce cancer-related illnesses and deaths.

The Program conducts baseline and annual studies of cancer incidences and mortality. The findings are evaluated and monitored to determine the Program's effectiveness in controlling cancer and ending smoking.

To stop smoking, the Cigarette Restitution Fund Program works to establish local health coalitions that help health officers identify, support, and initiate smoking cessation programs. Media campaigns are developed to counteract tobacco industry advertising and promote healthy behavior.

With Maryland's top research institutions, the Program instigates cancer research and encourages clinical trials. The Program also supports community-based services for those who are uninsured or underinsured.

REGULATORY PROGRAMS

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 nineteen licensing and regulatory boards:

State Acupuncture Board
State Board of Examiners for Audiologists, Hearing Aid Dispensers, & Speech-Language Pathologists
State Board for Certification of Residential Child-Care Program Administrators
State Board of Chiropractic Examiners
State Board of Professional Counselors & Therapists
State Board of Dental Examiners
State Board of Dietetic Practice
State Board of Environmental Health Specialists
State Board of Morticians & Funeral Directors
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 Physicians
State Board of Podiatric Medical Examiners
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). To protect consumers, the Board licenses persons wishing to practice acupuncture in Maryland. Further, the Board registers auricular detoxification specialists and certifies persons performing acupuncture on animals. The Board provides information about the licensure procedure, fees, continuing education requirements, and new trends in acupuncture and Oriental medicine to both applicants for licenses and the public. Consumers may make inquiries to the Board regarding licensed acupuncturists and also file complaints.

Seven members constitute the Board. They are appointed to four-year terms by the Governor. Authorization for the Board extends to July 1, 2025 (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.

Thirteen members constitute the Board. They are 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, 2016 (Code Health Occupations Article, secs. 2-101 through 2-502).

STATE BOARD FOR CERTIFICATION OF RESIDENTIAL CHILD-CARE PROGRAM PROFESSIONALS

In October 2004, the State Board for Certification of Residential Child-Care Program Administrators was established (Chapter 438, Acts of 2004). In October 2008, it was restructured as the State Board for Certification of Residential Child-Care Program Professionals (Chapter 218, Acts of 2008).

Since October 2007, administrators of residential child-care programs have been required to be certified by the Board. By October 1, 2015, residential and child youth care practitioners also are required to be certified by the Board (Chapter 583, Acts of 2010).

Residential child-care programs provide 24-hour per day care within a structured set of services and activities designed to achieve specific objectives for the children, including provision of food, clothing, shelter, education, social services, health, mental health, recreation, or any combination of these.

The Board's twelve members are appointed to four-year terms. The Governor appoints six members with Senate advice and consent, and the Secretary of Health and Mental Hygiene appoints two. One each is appointed by the Secretary of Human Resources, the Secretary of Juvenile Services, the State Superintendent of Schools, and the Children's Cabinet.

Authorization for the Board extends to July 1, 2024 (Code Health Occupations Article, sec. 20-501).

STATE BOARD OF CHIROPRACTIC & MASSAGE THERAPY EXAMINERS

In 1920, the State Board of Chiropractic Examiners formed (Chapter 666, Acts of 1920). In October 2008, it was restructured under its present name (Chapters 242 & 243, Acts of 2008).

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 or massage therapy 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 eleven 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, 2022 (Chapter 133, Acts of 2010; Code Health Occupations Article, secs. 3-201 through 3-602).

STATE BOARD OF PROFESSIONAL COUNSELORS & THERAPISTS

The State Board of Professional Counselors and Therapists originated in 1985 as the State Board of Examiners of Professional Counselors (Chapter 734, Acts of 1985). The Board adopted its present name in October 2000 (Chapter 358, Acts of 2000), and was reorganized in October 2008 (Chapter 505, Acts of 2008). The Board licenses professional counselors and therapists, and regulates their 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). In 2008, three more categories were added: graduate alcohol and drug counselor; graduate marriage and family therapist; and graduate professional counselor (Chapter 505, Acts of 2008). These new categories allow an individual to practice counseling under the supervision of a licensed counselor or therapist if they have completed all other requirements for licensure but still need the 2,000 hours of supervised experience.

With the advice of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's thirteen members to four-year terms. Authorization for the Board continues until July 1, 2019 (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 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 sixteen 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, 2021 (Code Health Occupations Article, secs. 4-101 through 4-702).

STATE BOARD OF DIETETIC PRACTICE

To protect the public by setting standards for the practice of dietetics in Maryland, the State Board of Dietetic Practice was authorized in 1985 (Chapter 773, Acts of 1985). The Board licenses dietitians and nutritionists in Maryland, sets standards for the practice of dietetics, and develops and enforces regulations. 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, 2025 (Code Health Occupations Article, secs. 5-101 through 5-502).

STATE BOARD OF ENVIRONMENTAL HEALTH SPECIALISTS

The State Board of Environmental Health Specialists licenses qualified applicants as registered environmental health specialists. The Board also issues certificates of eligibility to applicants awaiting examination. Environmental health specialists are concerned with environmental effects on public health. They promote environmental health and maintain it by securing compliance with public health laws and regulations. They inspect and investigate the manufacture, preparation, handling, distribution, or sale of food and milk; water supply and treatment; wastewater treatment and disposal; solid waste management and disposal; vector control; insect and rodent control; air quality; noise control; product safety; recreational sanitation; and institutional and residential sanitation.

Upon recommendation of the Secretary of Health and Mental Hygiene and with Senate advice and consent, the Governor appoints the Board's nine members to four-year terms. Authorization for the Board continues until July 1, 2017 (Code Health Occupations Article, secs. 21-201 through 21-206).

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 & FUNERAL DIRECTORS

The State Board of Morticians and Funeral Directors 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 became the State Board of Morticians in 1981 (Chapter 8, Acts of 1981). The Board received its present name in October 2007 (Chapters 185 & 186, Acts of 2007), and reorganized in 2008 (Chapter 583, Acts of 2008).

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 eleven members to four-year terms. Authorization for the Board continues until July 1, 2017 (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 thirteen members for four-year terms. Two members are consumers appointed with Senate advice and consent. Authorization for the Board continues until July 1, 2023 (Chapter 621, Acts of 2012; Code Health Occupations Article, secs. 8-101 through 8-802).

CERTIFIED NURSING ASSISTANT ADVISORY COMMITTEE
Since 1999, the Certified 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.

The Committee's fifteen members are appointed to four-year terms by the State Board of Nursing (Code Health Occupations Article, sec. 8-6A-13).

ELECTROLOGY PRACTICE COMMITTEE
In 1978, the Electrology Practice Committee began as the State Board of Electrologists (Chapter 851, Acts of 1978). On July 1, 2003, it moved under the State Board of Nursing and assumed its current name (Chapter 422, Acts of 2003). The Committee adopts and revises standards of electrology practice for registered electrologists and prescribes standards for educational programs leading to licensure. It examines and licenses qualified applicants. The Committee 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.

The Committee consists of five members appointed to four-year terms by the State Board of Nursing. Authorization for the Board continues until July 1, 2023 (Chapter 573, Acts of 2011; Code Health Occupations Article, secs. 8-6B-01 through 8-6B-29).

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 Physicians. Members serve three-year terms (Code Health Occupations Article, sec. 8-503).

NURSE PRACTITIONER PEER REVIEW COMMITTEE
In 1981, the Nurse Practitioner Peer Review Committee was organized. 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.

REHABILITATION COMMITTEE no. 1
REHABILITATION COMMITTEE no. 2
As a nonpunitive alternative to the disciplinary process of the State Board of Nursing, the Rehabilitation Committee was authorized in 1988 (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. To handle the volume of nurses referred to the Program, a second committee was established in 1992.

The State Board of Nursing selects each committee's six members. Three are licensed registered nurses with expertise in the field of chemical dependency or psychiatric nursing. One member is a registered nurse, who has demonstrated expertise in pain management; one 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

Authorized 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.

Fourteen members constitute the Board. They are appointed to four-year terms by the Governor upon recommendation of the Secretary of Health and Mental Hygiene. A representative of the Office of Health Care Quality serves ex officio. The Governor names the chair and vice-chair. The Board appoints the executive director, who is confirmed by the Secretary. Authorization for the Board continues until July 1, 2017 (Chapter 24, Acts of 2011; 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.

With the advice of the Secretary of Health and Mental Hygiene, the Governor appoints the Board's seven members to four-year terms. The Board selects the Executive Director. Authorization for the Board continues until July 1, 2025 (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, 2023 (Chapter 236, Acts of 2010; 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.

Annually, the State Board of Pharmacy meets with the State Board of Physicians and the State Board of Nursing to determine what vaccines may be administered by pharmacists and to develop and review regulations for administering such vaccines (Chapter 304, Acts of 2009).

By April 1, 2014, a facility or practitioner that performs sterile compounding or distributes sterile drug products in Maryland must have a permit from the Board (Chapter 397, Acts of 2013).

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, 2023 (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, 2022 (Code Health Occupations Article, secs. 13-101 through 13-502).

STATE BOARD OF PHYSICIANS

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 in Maryland (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 Board reformed in 2003 as the State Board of Physicians (Chapter 252, Acts of 2003).

The State Board of Physicians 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 or licenses seven categories of allied health practitioners, including physician assistants, respiratory care practitioners, medical radiation technologists, nuclear medical technologists, polysomniographic technologists, radiation therapists, and radiologist assistants. 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.

Two disciplinary panels, each consisting of eleven Board members, work to resolve allegations which would require disciplinary action against a licensed physician or an allied health professional (Chapter 401, Acts of 2013).

Composed of twenty-two members, the Board is appointed by the Governor with Senate advice and consent to four-year terms. The Governor names the chair to a two-year term. Authorization for the Board continues until July 1, 2018 (Chapter 681, Acts of 2012; Chapter 401, Acts of 2013; Code Health Occupations Article, secs. 14-101 through 15-502).

ATHLETIC TRAINER ADVISORY COMMITTEE
Since October 1, 2011, a person must be licensed by the State Board of Physicians to act as an athletic trainer in Maryland (Chapters 529 & 530, Acts of 2009).

Authorized in October 2009, the Athletic Trainer Advisory Committee develops and makes recommendations to the State Board of Physicians concerning licensure of athletic trainers. The Committee advises the Board on regulations for the practice of athletic training, continuing education requirements, and evaluation and treatment protocols.

The Committee's eleven members are appointed by the State Board of Physicians to three-year terms. Every two years, the Committee elects a chair. Authorization for the Committee extends to July 1, 2018 (Code Health Occupations Article, secs. 14-5D-01 through 14-5D-20).

PERFUSION ADVISORY COMMITTEE
In October 2012, the Perfusion Advisory Committee was established under the State Board of Physicians (Chapter 588, Acts of 2011). The Committee is to develop and recommend regulations, a code of ethics, standards of care, and continuing education requirements for the practice of perfusion in Maryland. A perfusionist operates and monitors equipment which performs the functions of a patient's heart and lungs, usually during open-heart surgery.

By October 1, 2013, individuals must be licensed to practice perfusion in Maryland.

The Committee's seven members are appointed to three-year terms by the State Board of Physicians. Every two years, the Committee selects a chair. Authorization for the Committee extends to July 1, 2018 (Code Health Occupations Article, secs. 14-5E-06 through 14-5E-25).

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 (now the State Board of Physicians) in 1988 (Chapter 109, Acts of 1988).

The Committee recommends to the State Board of Physicians, 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 Physicians. 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 Physicians. Authorization for the Committee expires July 1, 2018 (Code Health Occupations Article, secs. 15-101 through 15-502).

POLYSOMNOGRAPHY PROFESSIONAL STANDARDS COMMITTEE
Since October 2006, the State Board of Physicians has licensed and regulated the practice of polysomnography, the monitoring and recording of physiological data during sleep for purposes of diagnosing and treating sleep disorders (Chapter 595, Acts of 2006). At that time, the Polysomnography Professional Standards Committee was created to make recommendations to the State Board of Physicians on how to regulate the profession of polysomnography, and develop a code of ethics, standards of care, and licensure requirements (Code Health Occupations Article, secs. 14-5C-05 through 14-5C-07).

The State Board of Physicians appoints the Committee's seven members to three-year terms. Authorization for the Committee continues until July 1, 2018 (Chapter 401, Acts of 2013).

RADIATION THERAPY, RADIOGRAPHY, NUCLEAR MEDICINE TECHNOLOGY ADVISORY , & RADIOLOGY ASSISTANCE COMMITTEE
The Radiation Therapy, Radiography, Nuclear Medicine Technology Advisory, and Radiology Assistance Committee began in 1990 as the Medical Radiation and Nuclear Medical Technology Advisory Committee. In 2002, it became the Radiation Oncology/Therapy, Medical Radiation, and Nuclear Medicine Technology Advisory Committee (Chapter 373, Acts of 2002). In October 2008, the Committee adopted its present name (Chapter 328, Acts of 2008).

The Committee reviews and makes recommendations to the State Board of Physicians on all applications for licensing of nuclear medical technologists, radiation therapists, radiographers, and radiologist assistants. To the Board, the Committee also recommends the approval, modification, or disapproval of applications for licensure. In addition, the Committee recommends to the Board regulations governing such practice (Code Health Occupations Article, secs. 14-5B-05 through 14-5B-21).

Appointed to three-year terms by the State Board of Physicians, ten members constitute the Committee. Authorization for the Committee extends to July 1, 2018 (Chapter 401, Acts of 2013).

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 Physicians 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.

The Committee's seven members are appointed to three-year terms by the State Board of Physicians. Every two years the Committee elects a chair. Authorization for the Committee extends to July 1, 2018 (Code Health Occupations Article, secs. 14-5A-01 through 14-5A-24).

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).

In Maryland, the practice of podiatry 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, 2022 (Chapter 419, Acts of 2011; Code Health Occupations Article, secs. 16-101 through 16-602).

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.

Nine members compose the Board. They are 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, 2023 (Chapter 574, Acts of 2011; 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 twelve members are appointed by the Governor to four-year terms. Two are consumers appointed on recommendation of the Secretary of Health and Mental Hygiene with Senate advice and consent. The Board appoints the Executive Director. Authorization for the Board continues until July 1, 2024 (Code Health Occupations Article, secs. 19-201 through 19-502).

MARYLAND COMMUNITY HEALTH RESOURCES COMMISSION

The Maryland Community Health Resources Commission was established in July 2005 (Chapter 280, Acts of 2005). To improve access to health-care for those who are under insured and those without any insurance, the Commission will award operating and information technology grants to community clinics which meet Commission-determined criteria as community health resources. Using such clinics as the basis for community health care, the Commission will help communities establish integrated health services.

To four-year terms, the Commission's eleven members are appointed by the Governor with Senate advice and consent. The Governor designates the chair. With the Governor's approval, the Commission appoints an executive director.

Authorization for the Commission extends through June 30, 2015 (Chapters 624 & 625, Acts of 2008; Code Health-General Article, secs. 19-2101 through 19-2111).

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.

To evaluate the quality and performance of health maintenance organizations (HMOs) operating in Maryland, the Commission has developed a system based on clinical standards and a consumer survey. Each fall since October 1997, an annual report is issued enabling employers and employees to compare the quality of care and services provided by Maryland HMOs and make informed choices about health care plans.

In July 2006, the Commission organized its work under five centers: Health Care Financing and Health Policy; Health Information Technology; Hospital Services; Information Services and Analysis; and Long-Term and Community-Based Services.

In September 2008, the Center for Health Care Financing and Health Policy began enrolling participants in the Health Insurance Partnership, which assists small businesses in providing health insurance to their employees (Chapter 7, Acts of 2007 Special Session).

With Senate advice and consent, the Governor appoints the Commission's fifteen members to four-year terms. The Governor also names the chair. The Executive Director is appointed by the Commission with the Governor's approval (Code Health-General Article, secs. 19-101 through 19-227).

CLINICAL ADVISORY GROUP ON CARDIAC SURGERY & PERCUTANEOUS CORONARY INTERVENTION SERVICES
The Clinical Advisory Group on Cardiac Surgery and Percutaneous Coronary Intervention Services was convened by the Maryland Health Care Commission in July 2012 (Chapter 418, Acts of 2012). The Group, consisting both of Maryland and out-of-State experts, is to provide guidance to the Commission in setting new standards in surgical and nonsurgical hospitals for performance of percutaneous coronary intervention services and cardiac surgery.

HOSPITAL PERFORMANCE EVALUATION GUIDE ADVISORY COMMITTEE
The Hospital Performance Guide Steering Committee originated in January 2000 as the Hospital and Ambulatory Surgical-Facility Report-Card Steering Committee within the Maryland Health Care Commission. The Committee devised a system to evaluate the performance of hospital and ambulatory surgical facilities which was implemented by July 2001 (Chapter 657, Acts of 1999). In 2004, certain functions of the Committee were organized as the Hospital Evaluation Guide Steering Committee, which was renamed the Hospital Performance Evaluation Guide Advisory Committee in July 2006.

STATE HEALTH SERVICES COST REVIEW COMMISSION

In 1971, the State Health Services Cost Review Commission was mandated 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).

BEHAVIORAL HEALTH & DISABILITIES

Organized in July 2008, Behavioral Health and Disabilities is headed by a Deputy Secretary responsible for three administrations: Alcohol and Drug Abuse; Developmental Disabilities; and Mental Hygiene. The office is aided by the Community Services Reimbursement Rate Commission, and the Mortality and Quality Review Committee.

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). Its purpose is to contain hospital costs, maintain fairness in hospital payment, provide for financial access to hospital care, and report on how hospitals operate in the State.

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. In doing so, 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 in 1999 formed two advisory groups: the Developmental Disabilities Administration Technical Advisory Group, and the Mental Hygiene Administration Technical Advisory Group.

Seven members comprise the Commission. They are appointed to three-year terms by the Governor with Senate advice and consent.

Authorization for the Commission extends through September 30, 2016 (Chapter 401, Acts of 2005; Chapters 572 & 573, Acts of 2008; Chapter 94, Acts of 2011; Code Health-General Article, secs. 13-801 through 13-810).

MORTALITY & QUALITY REVIEW COMMITTEE
Within the Department of Health and Mental Hygiene, the Mortality and Quality Review Committee was initiated in October 2000 as the Mortality Review Committee (Chapter 470, Acts of 2000). It reformed as the Mortality and Quality Review Committee in July 2006 (Chapter 268, Acts of 2006; Code Health-General Article, secs. 5-801 through 5-803).

The Committee is concerned with the death of any person with developmental disabilities who, at the time of death, resided in or was receiving services from any program or facility licensed or operated by the Developmental Disabilities Administration, or operated by waiver. After the Office of Health Care Quality reviews each such death, the Office reports to the Committee which, in turn, examines the Office report. Annually, the Committee prepares a public summary report.

Appointed by the Secretary of Health and Mental Hygiene, the Committee has eighteen members (Code Health-General Article, secs. 5-801 through 5-810). Authorization for the Committee extends through December 31, 2022 (Chapters 340 & 341, Acts of 2012).

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). It was placed under Behavioral Health and Disabilities in July 2008.

The Administration develops and regulates programs to prevent and treat the misuse of alcohol and drugs. Education, training, and research on substance abuse is conducted by the Administration, which also provides substance abuse grants to local health departments and private providers, such as hospitals and nonprofit organizations in Maryland.

Functions of the Alcohol and Drug Abuse Administration are carried out by Statewide Projects, and five divisions: Information Technology; Management Services; Quality Assurance; Recovery-Oriented System of Care; and Research.

INFORMATION TECHNOLOGY DIVISION

The Division collects, processes, and reports statistical information related to 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. The Administration's website is maintained by the Division, which also publishes reports and newsletters.

MANAGEMENT SERVICES DIVISION

This division is responsible for Federal Block Grants; Fiscal Services Section; and Grants Section.

GRANTS SECTION
The Grants Section began as the Grants Management Division. In 1994, it became Administration and Grants Management, and Grants and Contract Management Division in 1998. It reformed as the Grants and Contracts Management Section in 2001, and the Grants Section in January 2011.

This section awards and monitors Administration monies for substance abuse treatment and prevention. Grants are received by local health departments, government agencies and private companies. As the Administration's fiscal agent, the Section works closely with the Fiscal Services Administration, and with the Program Cost and Analysis Division of the Budget Management Office of the Department.

QUALITY ASSURANCE DIVISION

Substance abuse prevention and treatment services funded by the Administration are evaluated by the Division for quality, effectiveness, and compliance with regulations. With the data collected by its compliance units, the Division helps plan for service expansion and enhancements, as well as regulatory actions and legislative initiatives. The Division also investigates regulatory violations and recommends corrective actions. In addition, the Division is responsible for promulgating and updating those regulations concerning addiction services found in the Code of Maryland Regulations (COMAR).

RECOVERY-ORIENTED SYSTEM OF CARE DIVISION

REGIONAL SERVICES
Regional Services formed as the Regional Field Services Division. Renamed the Treatment and Field Services Division in 1994, and as the Treatment Services Section in 1998, it combined with the Prevention Services Section to form Regional Services in 2002. In January 2011, Regional Services moved from the Community Services Division to the Recovery-Oriented System of Care Division.

To coordinate addiction treatment services, Regional Services serves as liaison between local and State government agencies. To prevent alcohol and drug addiction, Regional Services works with the Office for Children, Youth, and Families; the State Department of Education; the Department of Human Resources; and the Department of Transportation to fund, develop, implement, and monitor government agency strategies.

TECHNOLOGY TRANSFER

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.

RESEARCH DIVISION

PRESCRIPTION-DRUG MONITORING PROGRAM
Under the Research Division, the Prescription-Drug Monitoring Program began in October 2011 (Chapter 166, Acts of 2011). The Program gathers electronic data on the prescribing of certain drugs to prevent them from being diverted to nonmedical uses.

The Program's Technical Advisory Committee reviews requests for information from the Program's database, and determines whether to release information to law-enforcement or licensing agencies, monitoring programs in other states, or other units in the Department.

STATEWIDE PROJECTS

Local public and private programs that develop services for adolescents, women, women with infants and children, and pregnant women are assisted and monitored by Statewide Projects.

JUSTICE SERVICES
In 1987, Justice Services began as the Criminal Justice Division under the former Addictions Services Administration. Later, it became the Criminal Justice Section, and in 2004 Justice Services under the Community Services Division.

Justice Services coordinates all evaluations of criminal defendants for drug and alcohol abuse, and all commitments for evaluation or treatment made by circuit courts and district courts (Code Health-General Article, secs. 8-505 through 8-507). It also coordinates all education and treatment for those convicted of driving while intoxicated (DWI). Justice Services works closely with the Division of Parole and Probation, the Division of Correction, the Administrative Office of the Courts, the Motor Vehicle Administration, and local health departments.

DEVELOPMENTAL DISABILITIES ADMINISTRATION

The Developmental Disabilities Administration started 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). It was placed under Behavioral Health and Disabilities in July 2008.

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 intellectual disabilites, 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.

Residential facilities are operated by the Administration which also funds community-based services, such as 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 two facilities: Holly Center, and Potomac Center. A citizens advisory board for each facility also serves the Administration. Reporting directly to the Director is the Sykesville Secure Evaluation and Therapeutic Treatment (SETT) Unit.

SYKESVILLE SECURE EVALUATION & THERAPEUTIC TREATMENT UNIT
Muncie Building, Springfield Hospital Center, Sykesville, MD 21784

When Rosewood Center closed in July 2009, those residents at Rosewood committed there by the courts as developmentally disabled adults either incompetent to stand trial or found not criminally responsible for their crimes were transferred to the Sykesville Secure Evaluation and Therapeutic Treatment Unit. The Unit is a secure commitment program with a capacity for up to twenty individuals.

CENTRAL MARYLAND REGION

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.

Since June 2011, the Center has had a licensed capacity of 150 inpatient residents. Residential and training services are offered to individuals with intellectual disabilites 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). Further, the Center coordinates and assists day programs and group homes for individuals with intellectual disabilities.

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

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 intellectual disabilites 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.

MENTAL HYGIENE ADMINISTRATION

HEALTH CARE FINANCING

In 1975, Health Care Financing began 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. The deputy secretariat reorganized as Health Care Financing in December 1999.

Health Care Financing administers Maryland's five medical care programs: Family Planning; Kidney Disease; Maryland Children's Health Program; Maryland Pharmacy Program; and Medical Assistance (Medicaid & HealthChoice).

The principal health regulatory functions of the Department are overseen by Health Care Financing which also 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.

For the Secretary of Health and Mental Hygiene, the Deputy Secretary for Health Care Financing develops recommendations 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 three offices: Eligibility Services; Health Services; and Systems, Operations, and Pharmacy. Health Care Financing also is assisted by the Maryland Medicaid Advisory Committee and two administrations: Finance; and Planning.

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. The Committee 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 (Code Health-General Article, sec. 15-101 through 15-103).

MARYLAND CHILDREN'S HEALTH PROGRAM
The Maryland Children's Health Program was created in 1998 as the Children and Families Health Care Program (Chapter 110, Acts of 1998). Effective July 1, 2001, it adopted its current name (Chapters 15 and 16, Acts of 2000). The Program provides complete health coverage for children and pregnant women who are not eligible for Medicaid, are uninsured, and whose family income is at or below 200% of the federal poverty level. Health care is provided by managed care organizations through HealthChoice.

MEDICAL ASSISTANCE PROGRAM (MEDICAID)
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: Eligibility Services; Health Services; and Systems, Operations, and Pharmacy.

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

OFFICE OF ELIGIBILITY SERVICES

The Office of Eligibility Services originated as part of the Office of Operations, Eligibility, and Pharmacy (under Health Care Financing). It was established as a separate Office of Eligibility in July 2007. In September 2007, it became the Office of Eligibility Services.

Through statewide outreach efforts, the Office of Eligibility Services ensures that eligible Marylanders receive the Medical Assistance benefits for which they are eligible. The Office provides benefit information, enrollment assistance, and problem resolution. Further, the Office develops and implements eligibility policy, and provides training to staff in local health departments.

Under the Office are Eligibility Determination and Eligibility Policy. Two divisions, Beneficiary Enrollment and Call Center, and Recipient Eligibility Programs, report directly to the Executive Director.

DIVISION OF BENEFICIARY ENROLLMENT & CALL CENTER
In December 1999, the Division of Beneficiary Enrollment and Call Center was created as the Beneficiary Services Division, and reorganized under its present name in 2003. It oversees the HealthChoice Program.

HealthChoice Program. This program was initiated 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.

DIVISION OF RECIPIENT ELIGIBILITY PROGRAMS
The Division of Recipient Eligibility Programs began as the Division of Programs and Liaison. Renamed the Division of Eligibility Services in 1989, it reorganized as Recipient Eligibility Programs in November 1993, and reformed as the Division of Recipient Eligibility Programs in November 2005.

Systems and procedures are the responsibility of the Division to 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.

Buy-In Programs for Medicare (Parts A & B). Under the these programs, 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 DETERMINATION

Home and Community-Based Waiver programs are administered by Eligibility Determination. Waivers allow persons to receive Medical Assistance benefits in a community setting, at home, or in assisted-living facilities. Waivers include: the Waiver for Older Adults; Living at Home Maryland Community Choices Waiver; Waiver for Children with Autism Spectrum Disorder; Model Waiver for Disabled Children; Waiver for Individuals with Developmental Disabilities; and the Home and Community-Based Services Model Waiver for Adults with Traumatic Brain Injury.

For children in residential treatment centers and institutions providing mental health services, Eligibility Determination also determines and maintains Medical Assistance eligibility.

ELIGIBILITY POLICY

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 Services.

HEALTHCHOICE & ACUTE CARE ADMINISTRATION

ACUTE CARE
Acute Care organized in November 2005. It oversees three divisions: Children's Services; Dental, Clinics and Laboratory Services; and Hospital Services.

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

DIVISION OF HOSPITAL SERVICES
The Division of Hospital Services was established in July 1979 as the Division of Acute Care. It became the Division of Medical Services in October 1997, the Division of Pharmacy and Clinic Services in January 2000, the Division of Hospital and Physician Services in June 2003, the Division of Hospital and Professional Services in November 2005, and received its current name in January 2011.

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; and Residential Treatment Centers.

MANAGED CARE
Managed Care formed in January 2000 as Provider Management and adopted its present name in November 2005. It oversees three divisions: HealthChoice Customer Relations; HealthChoice Management and Quality Assurance; and Outreach and Care Coordination.

DIVISION OF HEALTHCHOICE MANAGEMENT & QUALITY ASSURANCE
In July 1987, the Division of HealthChoice Management and Quality Assurance began as the Division of Primary Care, became the Division of Managed Care in October 1997, and the Division of HealthChoice Management in January 2000. That division merged with the Division of Managed Care Quality Assurance in April 2002 to become the Division of HealthChoice Management and Quality Assurance.

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 OUTREACH & CARE COORDINATION
The Division of Outreach and Care Coordination started in May 1998 as the Division of Outreach and Women's Services, became the Division of Outreach and Assistance in January 2000, and received its current name in July 2000.

LONG-TERM CARE & COMMUNITY SUPPORT SERVICES ADMINISTRATION

COMMUNITY INTEGRATION PROGRAMS
Community Integration Programs began in January 2000 as Access, Quality, and Program Integrity and restructured as Nursing and Community Programs in July 2004. In January 2011, it further reorganized as Community Integration Programs. It oversees two divisions: Community Support Services; and Living at Home Waiver.

NURSING & WAIVER SERVICES
Nursing and Waiver Services began as Long-Term Care and Waiver Services and adopted its present name in January 2011. It oversees three divisions: Evaluation and Quality Review; Nursing Services; and Waiver Programs.

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).

NURSING HOMES & COMMUNITY LONG-TERM CARE
Formed in November 2005 as Long-Term Care Financing, Nursing Homes and Community Long-Term Care adopted its present name in January 2011. It is responsible for two divisions: Community Long-Term Care; and Long-Term Care Services.

DIVISION OF COMMUNITY LONG-TERM CARE
The Division of Community Long-Term Care 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 LONG-TERM CARE SERVICES
In July 1979, the Division of Long-Term Care Services formed. It became the Division of Institutional Long-Term Care Services in January 2000, and returned to its original name in 2006. 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.

OFFICE OF SYSTEMS, OPERATIONS, & PHARMACY

The Office of Systems, Operations, and Pharmacy originated 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, the Office of Operations and Eligibility, Medical Care Programs. Renamed the Office of Operations, Eligibility, and Pharmacy in 2004, it adopted its current name in July 2007, when the eligibility functions became a separate office.

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). From 1999 to July 2007, the Office was responsible for eligibility determination and policy.

The Office includes the Kidney Disease Program, the Maryland Pharmacy Program, and the Systems and Operations Administration.

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

KIDNEY DISEASE PROGRAM
Formed in 1971, the Kidney Disease 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. Formerly under the Office of Eligibility Services, the Program transferred to the Office of Systems, Operations, and Pharmacy in August 2008.

MARYLAND PHARMACY PROGRAM

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).

The Pharmacy Discount Program allows income-eligible Medicare recipients to purchase prescription drugs priced at 65% of the Medicaid price.

SYSTEMS & OPERATIONS ADMINISTRATION

PROGRAM OPERATIONS
Program Operations is responsible for six divisions: Adjustments and Payment Auditing; Claims Processing; Long-Term Care Problem Resolution; Medical Assistance Recoveries; Provider Relations; and Provider Services.

DIVISION OF CLAIMS PROCESSING
The Division of Claims Processing was first named the Division of Invoice Processing and adopted 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.

TECHNICAL SYSTEMS
Under Technical Systems are two divisions: Medicaid Information Systems; and Systems and 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.

OPERATIONS

Operations supports the Department through expenditure control, personnel management, data processing and information technology, general services, grants administration, and capital construction.

Under Operations are two administrations: Budget Revenue; and Fiscal Services. Operations also is responsible for six offices: Appointments and Executive Nominations; Capital Planning, Budgeting, and Engineering Services; Human Resources; Information Technology; Procurement and Support Services; and Regulation and Policy Coordination. In addition, Operations is assisted by the Volunteer Services Division.

OFFICE OF APPOINTMENTS & EXECUTIVE NOMINATIONS
Formerly under Business and Regulatory Services, the Office of Appointments and Executive Nominations was placed under Operations in 1997. It transferred to the Office of Public Relations and Governmental Affairs in 2005 and back to Operations in December 2008.

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 CAPITAL PLANNING, BUDGETING, & ENGINEERING SERVICES
The Office of Capital Planning, Budgeting, and Engineering Services started as the Office of Planning and Policy Management, became the Office of Planning and Capital Financing in 1994, and adopted its present name in August 2006.

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.

MAINTENANCE ENGINEERING SERVICES
Formerly under the General Services Administration, Maintenance Engineering Services moved to the Office of Planning and Capital Financing in January 2006 as the Division of Engineering and Maintenance. It adopted its present name in August 2006.

Maintenance Engineering Services oversees environmental, air quality and asbestos projects in Department facilities. It also reviews plans for every health care facility designed and constructed in Maryland.

OFFICE OF HUMAN RESOURCES
Herbert R. O'Conor State Office Building, 201 West Preston St., 1st floor, Baltimore, MD 21201 - 2399

The Office of Human Resources was first the Office of Personnel Management and became the Personnel Services Administration in 1988. On May 1, 2004, the Administration reformed as the Office of Human Resources. For the Department, the Office provides personnel services and training.

Under the Office are units for Personnel Information Systems, Risk Management and five divisions: Administration; Employee Relations; Employment; Recruitment and Selection; and Training Services.

OFFICE OF INFORMATION TECHNOLOGY
By 1967, the Office Information Technology originated as the Division of Data Processing under the Bureau of Analysis and Records. By 1973, the Division was placed under the Office of General Administration. As Data Systems, the unit reorganized by 1977 as part of the Office of Service Operations. As the Division of Data Processing in 1981, it came under the Fiscal and Support Operations Administration. By 1983, the Division became part of the Information Systems Administration, renamed the Information Services Administration in 1985. As Information Services, the division joined the Program Systems and Operations Administration in November 1993. By July 1997, Information Services reorganized as the Information Resources Management Administration. In January 2011, the Administration restructured as the Office of Information Technology

The Office devises information-processing strategies and implements the policy, procedures, and controls required for automation programs. The Office also provides security, systems analysis, programming and data communications, and training and computer operation services for the Department's information systems throughout the State. These systems inlcude the Electronic Vital Records System (EVRS); the Hospital Management Information System (HMIS); the National Electronic Disease Surveillance System (NEDSS); and the Medicaid Management Information System II (MMIS II). The Department's wide area network connects to local health departments, hospitals, and health clinics with over 9,000 user connections across the State.

Under the Office are four divisions: Administrative Operations; Applications; Computer Operations; and Infrastructure and Network.

OFFICE OF PROCUREMENT & SUPPORT SERVICES
The Office of Procurement and Support Services was established as the Office of Contract Policy, Management, and Procurement under Operations in December 2001 and adopted its present name in April 2006.

The Office develops policies, procedures, and standards that govern how the Department procures and manages contracts, and ensures that those policies and procedures are disseminated and adhered to throughout the Department. Upon request, the Office serves in an advisory capacity to programs and directly delivers procurement services for programs not certified to process or approve their own procurements. The Office also provides legal advice on procurement issues and serves as the repository and clearinghouse for procurement and contract management information within the Department.

SUPPORT SERVICES
Formerly under the General Services Administration, Support Services originated as the Division of Central Services. The Division moved to the Office of Contract Policy, Management, and Procurement in January 2006 and reformed as Support Services in January 2008.

Support Services manages the Central Warehouse, building services, fleet management, forms management, inventory control, life safety, security, and telecommunications.

OFFICE OF REGULATION & POLICY COORDINATION
The Office of Regulation and Policy Coordination began as the Office of Regulations Coordination and adopted its present name in August 2006.

A central clearinghouse for health regulations is provided by the Office. Here, regulations are drafted, amended, reviewed, and revised. The Office establishes internal policy and procedures, and 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 patients in the community. The Chief serves as liaison to the Department's Council of Auxiliaries, a private, nonprofit service organization.

BUDGET REVENUE ADMINISTRATION

The Budget Revenue Administration began as the Financial Planning Administration and became the Budget Management Office in 1997. In March 2004, it moved from Operations to the Chief Financial Officer within the Office of Secretary. As the Financial Management Administration, it moved to Operations in June 2007, and reorganized under its present name in November 2008.

The Administration monitors and controls all Department financial affairs, including liaison with the Department of Budget and Management and the General Assembly. It also oversees budget preparation and review, expenditure management, funding enhancement, rate setting, cost analysis, and fiscal policy.

Administration functions are carried out by the Budget Management Office, and the Cost Accounting and Reimbursements Division.

PUBLIC HEALTH SERVICES

FAMILY HEALTH ADMINISTRATION

INFECTIOUS DISEASE & ENVIRONMENTAL HEALTH ADMINISTRATION

LOCAL HEALTH DEPARTMENTS

LABORATORIES ADMINISTRATION

OFFICE OF CHIEF MEDICAL EXAMINER

OFFICE OF PREPAREDNESS & RESPONSE

STATE ANATOMY BOARD

Maryland Constitutional Offices & Agencies
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Maryland Executive Commissions, Committees, Task Forces, & Advisory Boards
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