HEALTH CARE


[photo, Medical and Chirugical Faculty of Maryland, Baltimore, Maryland]
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    Medical and Chirurgical Faculty of Maryland, Baltimore, Maryland, April 2001. Photo by Diane F. Evartt.



    Health care represents a $17.0 billion industry in Maryland with per capita spending on health care reaching nearly $3,316 in 1998. The Maryland Health Care Commission seeks to control hospital and other health care related costs. The Commission also evaluates the quality of services provided by private Health Maintenance Organizations (HMOs).

    Medicare is the federal government's health insurance program for Americans 65-years old or older and for those with certain disabilties.


    LOCAL HEALTH DEPARTMENTS

    Local health departments in each Maryland county and Baltimore City are overseen by the Community Health Administration of the Department of Health and Mental Hygiene. The local health department administers and enforces State, county and municipal health laws, regulations, and programs. Public health programs tailored to community needs provide preventive care; immunizations; health education; drug and alcohol abuse counseling; and rabies and communicable disease prevention. Information about these and all other health-related state programs may be found by contacting local health departments.


    MEDICAID

    The Medical Assistance Program, known as Medicaid, provides health insurance for low-income and needy people. Maryland and the federal government jointly fund Medicaid. The program is overseen in Maryland by the Medical Assistance Program of the Department of Health and Mental Hygiene, and on the federal level by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services. During FY1999, Medicaid covered health care for a total of 484,842 people (10.7% of State's population) with expenditures of $2.7 billion, half funded by the State.

    Eligibility for Medicaid is determined by local departments of social services. To apply for Medicaid assistance, Maryland residents visit their county or city department of social services. There, they are interviewed and submit an application. Generally, those who are either older than age 65, under age 21, disabled, blind, or caring for a child whose parent is unemployed, sick, or deceased are eligible for benefits.

    As of March 2000, approximately 70% of qualifying Medicaid recipients are required to join one of eight State-regulated Managed Care Organizations. Exceptions are made for those who receive long-term care, certain mentally fragile children, or for the mentally handicapped, among others.

    HEALTHCHOICE

    HealthChoice is the program that places Medicaid recipients into Managed Care Organizations (MCOs). These organizations provide group insurance that covers medical services at select hospitals and clinics participating in HealthChoice and are responsible for meeting nearly all of the recipients' medical needs, except for mental health services and other specific care. Mental health services are provided by the Specialty Mental Health System, which is administered by the Mental Hygiene Administration.

    A variety of major programs are offered through HealthChoice. Local health departments identify and enroll Medicaid recipients with special needs or disabilities (such as diabetes, homelessness, alcoholism, or drug addiction) into appropriate programs. One-on-one assistance is available for those who require it.

    Additional State-sponsored services include infant and reproductive care through the Center for Maternal and Child Health, nutritional assistance offered by Women, Infants and Children (WIC) Program, and medical care for children through the Maryland Children's Health Program.

    To investigate and mediate disputes, health departments act through the Ombudsmen Program to handle enrollees' complaints. Concerns also may be addressed through the HealthChoice Enrollee Action Line at 1-800-284-4510.

    The Rare and Expensive Case Management Program and the Stop Loss Case Management Program focus on patient needs and expenses that are not covered by Managed Care Organizations.

    PHARMACY ASSISTANCE

    Initiated in 1978, the Pharmacy Assistance Program helps pay for prescriptions, insulin, and certain medical supplies for low-income individuals who are not eligible for Medicaid. The Program is entirely State-funded. During Fiscal Year 1999, Pharmacy Assistance each month helped an average of 25,008 persons at an annual cost of $37.3 million.


    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, Nursing, 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 facility for trauma management. In Bethesda is the National Institutes of Health of the U.S. Department of Health and Human Services.


    PERSONNEL (LICENSED)

    1998 1999
    Acupuncturists 480 570
    Chiropractors 546 616
    Counselors, Professional 1,800 1,922
    Dental Hygienists 2,512 3,129
    Dentists 5,405 3,277
    Dieticians 1,260 825
    Morticians 843 884
    Nurses, Practical 8,358 7,500
    Nurses, Registered 48,276 45,000
    Physicians 21,000 21,967


    FACILITIES (LICENSED OR CERTIFIED)

    1999 2002
    Adult Day Care Centers 80 77
    Ambulatory Surgical Centers 255 317
    Assisted Living Programs 300 1,800
    Birthing Centers 5 5
    Developmental Disability Programs 2,158
    Home Health Agencies 67 58
    Hospice Programs 38 34
    Hospitals 73 71
    Laboratories 4,000 4,000
    Mental Health Community Treatment Programs 541
    Nursing Homes (comprehensive care) 258
    Outpatient Physical Therapy 129 165
    Outpatient Rehabilitation Centers 12 18
    Residential Service Agencies 214 327
    Residential Treatment Centers 14 14
    Substance Abuse Treatment Programs 253 300
    (MONITORED FOR QUALITY ASSURANCE)
    Health Maintenance Organizations (HMOs)
    13 10

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