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Established in 1969, Maryland's Department of Health and Mental Hygiene consolidated numerous agencies charged with protecting the health of Marylanders and caring for mentally ill residents of the state. An early attempt to regulate public health was the 1798 chartering of a group of physicians as the Medical and Chirurgical Faculty of Maryland (Chapter 105, Acts of 1798). The General Assembly authorized them to protect citizens from ignorant medical practitioners and quacks by disseminating medical knowledge and licensing doctors. Even after licensing power was transferred to other bodies, the faculty remained an advocate of improvements in health care facilities and regulation. The Board of Health, created in 1874, advised the legislature and local officials. It offered lectures, collected information on public health, and responded to requests for help from local authorities, but had no power to mitigate nuisances or enforce public health laws (Chapter 200, Acts of 1874). The board was reorganized in 1880 and empowered to establish local boards and to deal with emergencies. In 1910, the board became the advisory and policy setting body for the newly established Department of Health (Chapter 560, Acts of 1910). Provisions for care of the mentally ill came more slowly. The Maryland Hospital was established in 1797 "for the relief of indigent sick persons and for the reception and care of lunatics" (Chapter 102, Acts of 1797), but many of Maryland's mentally ill, as well as the "feeble-minded" and alcoholics, were kept at home or in local jails and almshouses. Private institutions were available to those who could afford them. To prevent abuses, the legislature created the Lunacy Commission in 1886 to inspect all public and private places where the insane were kept (Chapter 487, Acts of 1886). In 1922, the Board of Mental Hygiene assumed the commission's duties, and state mental institutions became part of the Department of Welfare (Chapter 29, Acts of 1922). The Department of Mental Hygiene replaced the board in 1949 (Chapter 685, Acts of 1949). The new department administered state mental institutions, coordinated psychiatric research activities, and oversaw education and training of personnel working in mental institutions. The activities of the Department of Health and the Department of Mental Hygiene came under central review in 1961 with the creation of the Board of Health and Mental Hygiene (Chapter 841, Acts of 1961). The board assumed responsibility for the health interests of Marylanders, state facilities for care of chronically ill, mentally ill, mentally retarded, and tuberculous persons, and medical care programs for the indigent. The two departments continued to administer programs and facilities as directed by the board. Executive reorganization in 1969 resulted in the creation of the Department of Health and Mental Hygiene, which superseded both the board and the departments. The Department of Health and Mental Hygiene encompasses programs and facilities of its predecessor agencies, medical professional licensing boards, the Comprehensive Health Planning Agency, and numerous advisory boards. The department is responsible for dealing with epidemiological hazards to health such as communicable diseases, and organization of efforts to prevent or control their impact. The department also purchases or provides direct care services, including residential and outpatient care for the mentally ill, mentally retarded, chronically ill, impaired elderly, and persons with addictive conditions. Public Health Services is divided into six administrations including aids, mental hygiene, alcohol and drug use, community health surveillance, local and family health, and developmental disabilties. It is headed by a deputy secretary who coordinates the development and implementation of policies, procedures, regulations, and standards to assure delivery of health services. Twenty-four local health departments, the focal points in the delivery of health services, report directly to the deputy secretary. The Advisory Board on Hospital Licensing was established in 1945. The board advises the secretary of health and mental hygiene on standards for hospitals, issuance or denial of hospital licenses, and approval of applications for hospital conversions, alterations, or additions. In 1892, the General Assembly created two boards of medical examiners to license all physicians. One board represented the Medical and Chirurgical Faculty of Maryland; the other represented the Maryland State Homeopathic Society. In 1957, the General Assembly abolished the Homeopathic Board, and all regulation of the practice of medicine passed to a Board of Medical Examiners. In 1988 the board was replaced by the Board of Physician Quality Assurance. The board tests and licenses physicians for legal practice of medicine in Maryland and for certain causes may revoke the license of a physician. The board also regulates the unlicensed practice of medical assistants an technicians. The Medical Discipline Commission was created in 1968 (Chapter 469, Acts of 1968) to handle cases in which discipline of medical professionals was considered. When allegations of grounds for disciplinary or other action were brought to its attention, the commission referred the case to the appropriate local county society or committee of the Medical and Chirurgical Faculty of Maryland for investigation and report. The reports contained recommendations for or against disciplinary procedures. The commission then considered the recommendations. The Medical Discipline Commission was abolished in 1988, and its functions were assigned to the state Board of Physician Quality Assurance (Chapter 109, Acts of 1988). The Board of Nursing originated as the Board of Examiners of Nurses in 1904. It received its present name in 1987. The board regulates the practice of registered nursing, licensed practical nursing, nurse practitioners, nurse midwives, nurse anesthetists, and nurse psychotherapists. The board administers licensure examinations; issues licenses to those who have completed requirements and examinations; evaluates, monitors, and approves nursing education programs; enforces standards of practice; and assesses and evaluates trends in nursing. The board also investigates complaints, conducts hearings, and takes disciplinary action as required. The Division of Medical Services administered the Medical Assistance Program, which provided or purchased home and office, inpatient, outpatient, and nursing home care for the indigent and medically indigent whose eligibility was certified by the Department of Public Welfare. The Council on Medical Care existed from 1945 to 1966. It advised the Department of Health and later the Board of Health and Mental Hygiene on the formulation of state medical care programs. The Board of Morticians was established in 1902 as the Board of Undertakers. In 1937, it was renamed the Board of Funeral Directors and Embalmers. The board received its present name in 1981. Every funeral director and mortician in Maryland must register with and procure a license from the board. The board sets standards for the practice of mortuary science and examines applicants for licensure. The board renews licenses, can suspend or revoke a license, and makes regulations governing mortuary science. The Department of Postmortem Examiners was created in 1939 to replace a decentralized system of local coroners. In 1982, the department was subsumed into the Postmortem Examiners Commission. The commission appoints physicians as deputy medical examiners in each county. They investigate violent and suspicious deaths or deaths unattended by physicians. The deputy medical examiners file with the office of the chief medical examiner reports of all deaths investigated. The Office of Chronic and Rehabilitation Facilities existed as part of the department from 1984 to 1989. It was preceded by the Aged and Chronically Ill Services Administration, and succeeded by the Office of Chronic Disease Prevention. The office oversees chronic disease and comprehensive care rehabilitation facilities. In addition, it is responsible for programs designed to reduce the incidence of chronic diseases, such as cancer. The Preventive Medicine Administration provided and promoted preventive health services to preclude or ameliorate disease and disability. The administration also provided technical and professional assistance and consultation to local health departments. In 1987, the functions were transferred to the Family Health Administration and the Community Health Surveillance Administration. The General Services Administration plans, organizes, and directs four divisions: Central Services, Vital Records, Health Statistics, and Engineering and Maintenance. The administration provides support services for supplies and procurement, space allocation, fleet management, mail, photocopying, building services, and capital construction. Coordination and technical assistance are provided statewide to projects of maintenance and engineering; asbestos identification and abatement; and abatement of polychlorinated biphenyls (PCBs). The Division of Health Statistics began in 1969 as the Center for Health Statistics. It was reorganized and renamed in 1988. The division publishes annual vital statistics and population estimates for the state. To highlight significant trends and findings, the division analyzes and reports annually on the health status of Maryland residents. Early attempts to establish a state system of vital records registration included seventeenth century legislation requiring county court and church registration of births, marriages, and deaths. In 1865, legislation was passed directing clerks of the county circuit courts and Baltimore City Court of Common Pleas to maintain birth and death record books, and individuals and institutions involved with births, deaths, and burials were required to file information with the clerks, who then filed copies with the Secretary of the Senate. Unfortunately, few citizens or institutions complied with the law. In 1898, vital records legislation was passed creating a uniform system of registration for the state. The secretary of the Board of Health was named state registrar of vital statistics, working with local registrars and serving as a central location for filing original birth and death certificates. Baltimore City had established its own program to register births and deaths within its health department earlier in 1875. The city was permitted to maintain its own system until July 1, 1972, when the Division of Vital Records assumed responsiblity for registration. In 1910, the General Assembly reorganized the State Board of Health by renaming it the Department of Health and establishing five bureaus within it, including the Bureau of Vital Statistics. In 1951, the bureau was renamed the Divison of Vital Records, and in 1969, state health and mental hygiene agencies were merged into the Department of Health and Mental Hygiene. Currently, all births, deaths, marriages, and divorces that occur in the state are registered with the Division of Vital Records. The division maintains birth and death records for Baltimore City from January 1, 1875, and for the twenty-three counties from August 1898. It also has marriage certificates from 1951, and divorce decrees from 1961. The Health Resources Planning Commission originated in 1968 as the Comprehensive Health Planning Agency. The agency was reformed as the Maryland Health Planning and Development Agency in 1978 and in 1982 was replaced by the current commission. The commission promotes the development of a health care system that provides quality care at a reasonable cost for all citizens. The commission advocates policies and systems for effective access to services, including acute, long-term, mental health, primary care, and community alternatives. The commission prepares the state health plan and conducts the certificate of need program to assure that institutions meet standards of public need before building or constructing new facilities. The commission coordinates its work with the Health Services Cost Review Commission, established in 1971 to monitor the fiscal affairs of Maryland's hospitals and related institutions. Evaluating the financial resources and requirements of each institution, the review commission assesses the impact of plans and projects on total health care costs to Marylanders. The Mental Hygiene Administration is responsible for the custody, care, and treatment of mentally ill persons, and oversees the state mental hospitals. To improve continuity of care between community and hospital programs, the administration has adopted a regional structure. Assistant directors serve Eastern, Western, Central, and Southern Maryland and the Baltimore metropolitan area. The regional offices implement policies to shorten the length of hospital stays and to improve community mental health programs for the severely ill. In 1910, Crownsville Hospital Center was established as the Hospital for the Negro Insane of Maryland (Chapter 250, Acts of 1910). The hospital opened to patients in 1911 and was renamed Crownsville Hospital Center in 1912. The hospital was desegregated in 1949. The hospital admits mentally ill patients from Anne Arundel, Charles, Calvert and St. Mary's counties as well as some patients from Baltimore City and Prince George's County. The Mental Retardation Administration originated as the Division of Mental Retardation. In 1970 the division was reformed into the Directorate of Mental Retardation from which the Mental Retardation Administration was created in 1971. The administration was reorganized in 1982 as the Mental Retardation and Developmental Disabilities Administration. In 1986, the administration was renamed the Developmental Disabilities Administration. The administration plans, develops, and directs a statewide comprehensive system of services for mentally retarded and developmentally disabled persons and their families. The administration also operates residential facilities and provides funds for purchased care, group homes and apartments, small residential centers, and daytime programs for developmentally disabled persons. Several facilities once used in the treatment of tuberculosis or other chronic diseases were later converted to use for mentally retarded invididuals. The Mount Wilson Hospital, established in 1925, served as a hospital for geriatric and mentally retarded individuals after the decline in the number of tuberculosis cases. The hospital's name was changed to the Thomas Wilson Center in 1981. The Henryton Center was also established for the care of tuberculosis patients in 1922. In 1963, the hospital was transferred to the Department of Mental Hygiene and began to operate a training and habilitation program for severely and profoundly retarded ambulatory adults. The center was closed in 1985. Rosewood Center was established in 1888 as the Asylum and Training School for the Feeble Minded (Chapter 183, Acts of 1888). From 1912 to 1961, it was known as Rosewood State Training School. In 1961, the school became the Rosewood State Hospital. When the departments of health and mental hygiene merged in 1969, the hospital was renamed the Rosewood Center. Rosewood Center provides for the care, education, training, and rehabilitation of mentally retarded persons from all parts of the state. The Miner's Hospital was established in 1912 to provide facilities to miners and their families (Chapter 441, Acts of 1912). It later became a general hospital for the residents of Frostburg and vicinity. See also: Board of Examiners in Optometry. MSA SH79. Board of Funeral Directors and Embalmers. MSA SH81. Board of Health. MSA SH82. Board of Health and Mental Hygiene. MSA SH234. Board of Mental Hygiene. MSA SH39. Board of Undertakers. MSA SH80. Commissioner of Mental Hygiene. MSA SH235. Commisioners for Erecting a Hospital for the Insane. MSA SH27. Department of Health. MSA SH236. Department of Mental Hygiene. MSA SH40. Maryland Hospital. MSA SH26. Maryland Hospital for the Insane. MSA SH29. Spring Grove State Hospital. MSA SH28. State Lunacy Commission. MSA SH31.