288/Maryland Manual

kept. Duties of the Commission were transferred to a Board of Mental Hygiene in 1922, and the State's
five mental institutions were placed under the Department ofWelfare (Chapter 29, Acts of 1922). Wartime
austerity cut back spending on State institutions, and public concern after the war about treatment of the
mentally ill led to creation of the Department of Mental Hygiene in 1949 (Chapter 685, Acts of 1949)
The Department was charged to administer the State's mental institutions, coordinate State activities in
CBYihiBffit KSSa^ and oversee education and training of personnel working in mental institutions.

State Board of Health and Mental Hygiene. Mental health and public health functions became officially
entwined in 1961 under the new Stare Board of Health and Mental Hygiene which assumed responsibility
for: the health interests of Marylanders; State facilities for care of the chronically ill, mentally ill, mentally
retarded, and tuberculous persons; and the medical care program for the indigent and medically indigent.
The two departments, Health and Mental Hygiene, continued to administer programs and facilities as
directed by the new Board (Chapter 841, Acts of 1961).

Department of Health and Mental Hygiene. Through executive reorganization in 1969, the Board and
the two departments were superseded by the Department of Health and Mental Hygiene, which
encompassed not only the programs and facilities inherited from its two predecessors, bur also all the
medical professional licensing boards, the Comprehensive Health Planning Agency, the Commission on
Physical Fitness, the Advisory Board on Hospital Licensing, the Advisory Council on Hospital Construc-
tion, the Radiation Control Advisory Board, the Air Pollution Control Council, the Air Quality Control
Council, and the Juvenile Services Administration (Chapter 77, Acts of 1969). Boards and councils relating
to radiation and air quality, as well as environmental health programs, were transferred to the Department
of the Environment in 1987; the Juvenile Services Administration became an independent agency in 1987
and an executive department in 1988.

The Department of Health and Mental Hygiene has evolved into a complex agency which continues
to protect the physical, mental and social health of Marylanders. Through a comprehensive and accessible
system of health services, the Department promotes health and prevents disease and disability

Many health care programs are, by their nature, public functions and cannot be performed effectively
by the private sector. Prime among these is the responsibility for dealing with epidemiological hazards to
health, such as communicable diseases, and the organization of community efforts to prevent or control
their impact.

Local health departments are the focal point in the delivery of services. Overseen by the Department
of Health and Mental Hygiene, twenty-four local health departments report to the Deputy Secretary for
Public Health Services and have access to all Department officials as well.

The Department also provides or purchases direct care services. These primarily include residential and
outpatient care for the mentally ill; the mentally retarded; the chronically ill, including those with
tuberculosis; the impaired elderly; and persons with addictive conditions. Several health services for the
community as well as comprehensive health care services for the indigene and medically indigent are
provided directly by the Department.

In 1987, the Department was reorganized under deputy secretaries responsible for three distinct
programmatic areas: Operations; Public Health Services; and Policy, Finance, and Regulation.