are overseen by the Local and Family Health Ad-
ministration of the Department of Health and
Mental Hygiene. The local health department ad-
ministers and enforces State, county and municipal
health laws and regulations. Public health programs
tailored to community needs provide preventive
care, immunizations, health education, drug and
alcohol abuse counseling, and rabies and commu-
nicable disease prevention.

Renowned Health-care Institutions. In Baltimore
are The Johns Hopkins Hospital and The Johns
Hopkins University Medical School, the University
of Maryland Schools of Dentistry, Medicine, Nurs-
ing, and Pharmacy, and the private University of
Maryland Medical System, which serves as the
primary teaching hospital for the University of
Maryland School of Medicine and includes the R
Adams Cowley Shock Trauma Center, a regional
faulicy for trauma management. In Bethesda is the
National Institutes of Health.

Medicaid. The Department of Health and Mental
Hygiene is responsible for the Medical Assistance
Program (Medicaid) providing health care for eligible
low-income Maryland residents. Funded by federal
and State government, Medicaid provides hospital
inpatient and outpatient services, physician and nurse-
midwife services, laboratory and X-ray services, nurs-
ing faculty services, home health care for adults, family
planning, early and periodic screening, diagnosis and
treatment for children, transportation, federally quali-
fied health center and rural health clinic services, and
some nurse practitioner services. Maryland also pro-
vides certain options: adult dental care, vision, podia-
try and clinic care, pharmacy, medical supplies and
equipment, health maintenance organization mem-
bership, medical day care, personal care, services for
persons age 65 and over in institutions for mental
diseases, inpatient psychiatric services for persons un-
der age 21, intermediate care facilities for the mentally
retarded, and other treatments. Dunng FY 1993,
Medicaid covered health care for a monthly average
of 433,805 people (8.8% of State's population) with
expenditures of $l.9 billion (53% State funded).

Pharmacy Assistance. This State-funded program
helps low income individuals who are not eligible
for Medicaid pay for prescriptions, insulin, and
certain medical supplies. During Fiscal Year 1993,
Pharmacy Assistance each month helped an average
28,600 persons at a cost of $13.7 million

Nurses, Registered 45,000
Physicians 21,450
Nurses, Practical 9,000
Dentists 3,824
Dental Hygienists 1,961
Dietitians 1,590
Counselors, Professional 1,462

Licensed Facilities, 1994
Alcohol/ Drug Abuse Programs, Community 372
Ambulatory Surgical Centers 102
Birth Centers, Freestanding 4
Day Care for Elderly 55
Developmental Disabilites
Programs, Community 3,455
Domiciliary Care Homes, Licensed 89
Domiciliary Care Homes, Registered 869
Health Maintenance Organizations (HMOs) 19
Home Health Agencies 124
Hospice Programs 41
Hospitals (acute, psychiatric, chronic, special) 82
Laboratories, Clinical 370
Laboratories in Physician Offices 2,219
Mental Health Programs, Community 285
Mental Retardation Centers, State (residential) 5
Nursing Homes (comprehensive care) 231
Outpatient Rehabilitation Centers 296
Renal Dialysis Units, End Stage 66
Residential Service Agencies 77
Residential Treatment Centers/ Therapeutic
Group Homes 13

HIGHWAYS

The National Road, begun in Cumberland in 1806, was
the nation's chief route west for many years. As U.S.
Route 40, it remains a principal east-west artery today in
a State highway network with over 16,000 lane miles of
interstate, primary and secondary roads and over 2,000
bridges. Each year, the State Highway Administration
designs and constructs new roads, and operates, main
tains, widens, and improves existing highways at an
average cost of $590 million a year. To alert motorists to
traffic congestion, incidents, and detours, the Admini-
stration operates a low-frequency radio station (560
AM) On most major urban highways, maximum speed
limit is 55 miles per hour. On some rural highways, it
changed to 65 miles per hour in 1995.

Interstate Highways: I-68, 1-70, I-83, I-95, I-97,
I-270, and U.S. 50. Two circular highways or beltways
loop around Baltimore (I-695) and Washington, DC
(I-495), connecting major routes. Maryland's inter-
state system links to the Port of Baltimore, and to
Dulles, National and Baltimore/ Washington Interna-
tional Airports. One of Maryland's newest interstates,
I-68, opened in 1991. It provides an alternate route
for westbound truckers and brings the Appalachian
culture of Western Maryland closer to vacationers.

Tolls. Most Maryland highways are toll-free. Tolls are
collected, however, on the John F. Kennedy Memorial
Highway (part of I-95, northbound toll). They also
are collected for two tunnels—Baltimore Harbor
Tunnel (I-895), and Fort McHenry Tunnel (also part
of I-95), and four bridges—Thomas J. Hatem Bridge
(part of U.S. 40, one-way toll) at Perryville, the two
Chesapeake Bay Bridges (eastbound toll) in Anne
Arundel County, and the Governor Harry W. Nice
Bridge in Charles County (northbound toll).