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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

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