In this subtitle the following words have the meanings indicated. “Administrative Component” means the component of the Program established under § 13–1119 of this subtitle. “Baseline Cancer Study” means the study conducted under § 13–1103 of this subtitle. “Cancer Research Plan” means a plan developed under § 13–1116 of this subtitle. “Cigarette Restitution Fund” means the fund that is established under § 7–317 of the State Finance and Procurement Article. “Community Health Coalition” means a coalition established under § 13–1109(c)(1) or § 13–1115(b)(1) of this subtitle. “Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment” means a plan developed under § 13–1109(c)(2) or § 13–1115(b)(2) of this subtitle. “County” includes Baltimore City. “Education” means information provided to the public regarding the purpose of, availability of, and access to screening programs. “Federally qualified health center” has the meaning stated in 42 U.S.C. § 254b. “Johns Hopkins Institutions” means the Johns Hopkins University and the Johns Hopkins Health System. “Local health officer” means: The head of a county health department; or A person designated by the Department under § 13–1109(g) or § 13–1115(f) of this subtitle. “Local Public Health Cancer Grant” means a grant distributed by the Department to a county under §§ 13–1107 through 13–1113 of this subtitle. “Local Public Health Component” means the component of the Program that is established under § 13–1107 of this subtitle. “Maryland Cancer Registry” means the computerized data system, operated by the Department with the assistance of the Maryland State Council on Cancer Control, that registers cases of cancer that are diagnosed and treated in the State. “Maryland Technology Development Corporation” means the entity that is established under Title 10, Subtitle 4 of the Economic Development Article. “Minority individual” means a woman or an individual of African American, Hispanic, Native American, or Asian descent. “Outreach efforts” means activities that are related to encouraging individuals to seek screening services. “Prevention” means activities relating to early detection, screening, and risk factor reduction. “Program” means the Cancer Prevention, Education, Screening, and Treatment Program that is established under § 13–1102 of this subtitle. “Screening” includes screening, early detection, identification, diagnosis, and outreach efforts associated with screening and early detection programs. “Statewide Academic Health Center” means the University of Maryland Medical Group or the Johns Hopkins Institutions. “Statewide Academic Health Center Cancer Research Grant” means a grant that is distributed under § 13–1116 of this subtitle. “Statewide Academic Health Center Component” means the component established under § 13–1114 of this subtitle. “Statewide Academic Health Center Public Health Grant” means a grant that is distributed under § 13–1115 of this subtitle. “Statewide Academic Health Center Tobacco–Related Diseases Research Grant” means a grant that is distributed under § 13–1017 of this title. “Statewide Public Health Component” means the component of the Program that is established under § 13–1106 of this subtitle. “Surveillance and Evaluation Component” means the component of the Program that is established under § 13–1103 of this subtitle. “Targeted cancer” means a cancer that is identified by the Department under § 13–1102(d) of this subtitle. “Task Force Report” means the report entitled “Report of the Governor’s Task Force to Conquer Cancer” that was issued in December 1999. “Tobacco–related diseases” means cardiovascular disease, chronic pulmonary disease, peripheral vascular disease, stroke, and infant mortality due to low birth weight. “Treatment” includes appropriate access to: Local hospitals, community clinics, physicians, and other health care providers; and Clinical trials, transportation, case management, hospice care, and cancer support groups. “Underinsured individual” means an individual: For whom the appropriate treatment is not adequately covered by private health insurance, Medicaid, Medicare, or the Maryland Children’s Health Program due to out–of–pocket costs, including required copayments, coinsurance, or deductibles; and Who the Department determines does not have the financial means to pay for appropriate treatment. “Uninsured individual” means an individual: For whom the appropriate treatment is not covered by private health insurance, Medicaid, Medicare, or the Maryland Children’s Health Program; and Who the Department determines does not have the financial means to pay for appropriate treatment. “University of Maryland Medical Group” means the University of Maryland Medical System Corporation, the University of Maryland Medical School, and the University of Maryland, Baltimore Campus.

There is a Cancer Prevention, Education, Screening, and Treatment Program in the Department. The purpose of the Program is to coordinate the State’s use of the Cigarette Restitution Fund so as to create a lasting legacy of public health initiatives that reduce mortality and morbidity rates for cancer and tobacco–related diseases in the State and otherwise benefit the health and welfare of the State’s residents. The Program consists of: A Surveillance and Evaluation Component; A Statewide Public Health Component; A Local Public Health Component; A Statewide Academic Health Center Component; and An Administrative Component. To initiate the Program, the Department shall identify the types of cancers that will be targeted under the Program. The Program shall be funded as provided in the State budget with money from the Cigarette Restitution Fund. The Legislative Auditor is authorized to audit the appropriations and expenditures made for the purpose of implementing the Program, including the use of any funds received by a person under any component of the Program. The annual budget bill shall specify the amount of funding that is allocated to each component of the Program. Except as provided in paragraph (3) of this subsection, money that is allocated to a component of the Program in the State budget: May only be expended for the purpose for which it is appropriated; and May not be transferred to any other component in the Program, any other program in the Department, or any unit of State government. Except as provided in subparagraph (ii) of this paragraph, the Department may transfer a maximum of 10% of the total amount of money that is allocated to the Program among the components of the Program if the transfer is specifically authorized in the annual budget bill as enacted. The Department may not transfer funds to the Statewide Academic Health Center Component or the Administrative Component from any other component of the Program. If the Department transfers any money among the components of the Program as authorized under subparagraph (i) of this paragraph, the Department shall report the transfer to the Senate Budget and Taxation Committee, Senate Finance Committee, House Appropriations Committee, and House Health Committee within 60 days after the transfer. The Department may transfer money that is allocated to a component of the Program in the State budget to another program in the Department or another unit of State government if the transfer is specifically authorized by: A provision of this subtitle; or A provision of the annual budget bill as enacted that relates specifically to the transfer of funds from that component. Money that is allocated to a component of the Program in the State budget that remains unspent and unobligated at the end of the applicable fiscal year shall revert to the Cigarette Restitution Fund. Money that reverts to the Cigarette Restitution Fund under paragraph (1) of this subsection shall be used to fund the Program in the fiscal year to which the next annual budget bill relates. The Governor shall include in the next annual budget bill an appropriation for the Program that is at least equal to the amount of money that reverted to the Cigarette Restitution Fund under paragraph (1) of this subsection. No later than January 31 of each year, the Department shall report to the Governor and, subject to § 2–1257 of the State Government Article, Senate Budget and Taxation Committee, Senate Finance Committee, House Appropriations Committee, and House Health Committee: The amount of money that was allocated to each component of the Program during: The prior fiscal year that remained unspent and unobligated at the end of that year; and The current fiscal year that remained unspent and unobligated as of December 31 of the preceding calendar year; and The amount of money that was distributed to a county as a Local Public Health Cancer Grant during: The prior fiscal year that remained unspent and unobligated at the end of that year; and The current fiscal year that remained unspent and unobligated as of December 31 of the preceding calendar year. The Department shall adopt regulations that establish the criteria that the Department will use to determine whether, for the purpose of qualifying as an uninsured individual under § 13–1101(hh) of this subtitle, an individual has the financial means to pay for appropriate treatment.

There is a Surveillance and Evaluation Component in the Program. The purpose of the Surveillance and Evaluation Component is to: Collect, analyze, and monitor data relating to: Targeted cancers; As determined by the Department, nontargeted cancers; and Cancer prevention, education, screening, and treatment programs in the State; Measure and evaluate the results of the Program, including the results of each component of the Program; Conduct the Baseline Cancer Study, as provided under subsections (c) and (d) of this section; and Conduct a Biennial Cancer Study, as provided under § 13-1104 of this subtitle. To initiate the Surveillance and Evaluation Component, the Department shall conduct a comprehensive statewide Baseline Cancer Study as provided in this section. The Department may: Conduct the Baseline Cancer Study or any part of the Study; or Contract with a higher education institution or private entity to conduct the Baseline Cancer Study or any part of the Study. The Baseline Cancer Study shall measure: The number and percentage of individuals who have each targeted cancer, both statewide and in each county; The number and percentage of individuals within each minority population who have each targeted cancer, both statewide and in each county; The mortality rate for each targeted cancer, both statewide and in each county; The mortality rate for different minority populations for each targeted cancer, both statewide and in each county; The number of identifiable cancers with a high incidence in the State for which there are effective methods of: Early detection; and Prevention and treatment after detection; Any aspect of targeted and nontargeted cancers that the Department seeks to measure; and Any other factor that the Department determines to be important for measuring rates of cancers in the State or for evaluating whether the Program meets its objectives. In order to maximize the cost effectiveness of the Baseline Cancer Study, the Department may use data in the Maryland Cancer Registry or provided by other sources, to the extent that these sources provide reliable data relating to the factors listed in subsection (d) of this section. If the Department chooses to have a higher education institution or private entity conduct the Baseline Cancer Study or any part of the Study, the Department shall issue a request for proposal to select the entity that will conduct the Study or the relevant part of the Study. The request for proposal shall require that any methodology or model that is used by the entity to conduct the Baseline Cancer Study or the relevant part of the Study, any data collected under the Study, and any electronic files, codes, and definitions relating to the Study be provided to the State for use in subsequent studies, regardless of whether the studies are conducted by the same entity. The Department may contract with an entity to conduct the Baseline Cancer Study and one or more biennial cancer studies as required under § 13-1104 of this subtitle.

Beginning in fiscal year 2004 and biennially thereafter, the Department shall conduct a Biennial Cancer Study. The Biennial Cancer Study shall: Measure the same factors that are set forth in § 13–1103(d) of this subtitle; and Use the same methodology or model that is used to conduct the Baseline Cancer Study. The Department may: Conduct the Biennial Cancer Study or any part of the Study; or Contract with a higher education institution or private entity to conduct the Biennial Cancer Study or any part of the Study. If the Department chooses to have a higher education institution or private entity conduct the Biennial Cancer Study or any part of the Study, the Department shall issue a request for proposal to select the entity that will conduct the Study or the relevant part of the Study. The Department may contract with an entity to conduct one or more biennial cancer studies or a part of one or more biennial cancer studies. On or before December 31 of each odd numbered fiscal year, beginning in fiscal year 2005, the Department shall submit a report to the Governor and, subject to § 2–1257 of the State Government Article, the General Assembly, on the results of the Biennial Cancer Study.

Before the Department distributes a Local Public Health Cancer Grant to any county under §§ 13-1107 through 13-1113 of this subtitle, the Department shall develop an inventory of publicly funded screening programs that includes information relating to: The number and types of publicly funded screening programs for each targeted cancer, both statewide and in each county, and the number of individuals screened each year in these programs; and The existence of mechanisms to ensure that uninsured individuals receive appropriate treatment for any cancer that is detected in the screening programs identified under item (1) of this section.

There is a Statewide Public Health Component in the Program. The purpose of the Statewide Public Health Component is to maximize the effectiveness of the anti-cancer initiatives in the State by authorizing the Department to take steps to ensure that the Program is implemented in a coordinated and integrated manner throughout the State. Subject to subsection (d) of this section and as necessary to ensure a coordinated and integrated statewide effort to implement cancer prevention, identification, and treatment programs for targeted cancers, the Department may develop and implement statewide anti-cancer initiatives that are consistent with the findings and recommendations of the Task Force Report, including programs that support the implementation of the Local Public Health Component of the Program. If the Department issues a request for proposal, distributes a grant, or enters into a contract as authorized under subsection (c) of this section, the request for proposal, grant, or contract shall state with specificity the objectives and performance criteria that will be used to measure the success of the program to which the request for proposal, grant, or contract relates. The Department may not spend any money that is allocated to the Statewide Public Health Component in the State budget until the Baseline Cancer Study has been completed.

There is a Local Public Health Component in the Program. The purpose of the Local Public Health Component is to maximize the effectiveness of anti–cancer initiatives in the State by empowering local health coalitions to develop and implement cancer prevention, education, screening, and treatment programs in coordination with the Department. Subject to §§ 13–1108 through 13–1113 of this subtitle, the Department may distribute grants to counties for cancer prevention, education, screening, and treatment programs. Except as provided under paragraph (2) of this subsection, the Department may not spend any funds that are allocated to the Local Public Health Component in the State budget until after the Baseline Cancer Study has been completed. Before the Baseline Cancer Study is completed, the Department may distribute a planning grant of not more than $10,000 to each local health department other than the Baltimore City Health Department. Prior to each fiscal year, the Department shall determine the percentage of funds that shall be allocated to cancer screening, diagnosis, and treatment by a county or Statewide Academic Health Center that receives funds under a Local Public Health Cancer Grant.

After the Baseline Cancer Study has been completed and before soliciting applications for Local Public Health Cancer Grants, the Department, in consultation with local health departments, shall: Establish short-term and long-term cancer prevention, education, screening, and treatment goals for each county; Establish other requirements for each county that the Department determines to be necessary to meet the goals established under paragraph (1) of this subsection; and Provide for the distribution of Local Public Health Cancer Grants to eligible counties based on the formula established under subsection (b) of this section. Subject to subsections (c) through (e) of this section and §§ 13-1109 through 13-1113 of this subtitle, the Department shall distribute a Local Public Health Cancer Grant to each county that is equal to the sum of: A base amount of funding as determined by the Department for each county; The product of: One-half of the amount remaining from the allocation to the Local Public Health Component in the State budget after the base amount under item (1) of this subsection is distributed to each county; and The number of individuals in the county who have any of the targeted cancers divided by the number of individuals in the State residing outside of Baltimore City who have any of the targeted cancers; and The product of: One-half of the amount remaining from the allocation to the Local Public Health Component in the State budget after the base amount under item (1) of this subsection is distributed to each county; and The number of individuals in the county who died from any of the targeted cancers during the prior year divided by the number of individuals in the State residing outside of Baltimore City who died from any of the targeted cancers during the prior year. Except as provided in this subsection, Baltimore City is not eligible to receive money from the Department based on the formula established under subsection (b) of this section. Each year, before calculating the amount of money that may be distributed to each county as a Local Public Health Cancer Grant under subsection (b) of this section, the Department shall calculate the amount of money that would have been distributed to each county if Baltimore City were included in the formula. For fiscal year 2007 or any subsequent fiscal year, if the amount of money that would have been distributed to Baltimore City using the formula established under subsection (b) of this section if Baltimore City were included in the formula exceeds 19%, the Department shall transfer the difference between that amount and 19% from the Local Public Health Component to the Statewide Academic Health Center Component. Beginning in fiscal year 2004, the calculations required in subsection (b)(2)(ii) and (3)(ii) of this section of the numbers of individuals having any of the targeted cancers or who died from any of the targeted cancers shall be based on the most recent data averaged over a multiyear period as determined by the Department. The allocation formula calculated in accordance with subsection (b) of this section for fiscal year 2004 shall remain in effect for the following 3 years and thereafter be recalculated every 4th year in accordance with the provisions of this section. The Department may reallocate projected unspent funds awarded to a county to another county as needed during the fiscal year in order to address any unmet county funding needs as determined under § 13–1107 of this subtitle.

Except as provided in § 13–1115(f) of this subtitle, this section does not apply to Baltimore City. Subject to the other provisions of this section, a local health officer may apply to the Department for a Local Public Health Cancer Grant. The amount of a Local Public Health Cancer Grant shall be determined by the Department using the formula that is established under § 13–1108 of this subtitle. Before applying for a Local Public Health Cancer Grant, a local health officer shall: Establish a Community Health Coalition, as provided under § 13–1111 of this subtitle, or identify another coalition approved by the Department; and With the assistance of the coalition established or identified under item (1) of this subsection: Identify all existing cancer prevention, education, screening, and treatment programs that relate to targeted cancers in the county that are publicly funded; Evaluate the effectiveness of the publicly funded programs identified under item (i) of this paragraph; and Develop a Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment that outlines a strategy for meeting the cancer prevention, education, screening, and treatment goals and requirements established for the county under § 13–1108 of this subtitle. A Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment shall: Include a list of the members of the coalition established or identified under subsection (c)(1) of this section and their organizational affiliations; Include the evaluation of any program funded with a Local Public Health Cancer Grant in the prior year; Each year, after the first year of funding, demonstrate that progress has been made toward meeting the cancer prevention, education, screening, and treatment goals established for the county under § 13–1108 of this subtitle; Include a budget plan that provides specific levels of funding for each initiative described in the Plan and an explanation as to how each initiative is expected to help meet the cancer prevention, education, screening, and treatment goals and requirements established for the county under § 13–1108 of this subtitle; Demonstrate that the county has met the base–year funding requirement established under § 13–1112 of this subtitle; Demonstrate that any early detection or screening program that is or will be funded under a Local Public Health Cancer Grant provides necessary treatment or linkages to necessary treatment for uninsured individuals who are diagnosed with a targeted or non–targeted cancer as a result of the screening process; Each year, after the first year of funding, identify all persons who received money under a Local Public Health Cancer Grant in the prior year and state the amount of money that was received by each person under the Grant; Each year, after the first year of funding, state the amount of money that was received by a county under a Local Public Health Cancer Grant in the prior fiscal year that remained unspent and unobligated at the end of that year; Describe how the Plan will help to eliminate the greater incidence of and higher morbidity rates for cancer in minority populations and rural areas, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report; Describe how the Plan will help to increase availability of and access to health care services for uninsured and underinsured individuals and medically underserved populations, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report; Demonstrate that priority consideration was given to persons, including federally qualified health centers, that have demonstrated a commitment to providing cancer prevention, education, screening, and treatment services to uninsured and underinsured individuals in the county and a proven ability to do so; and Contain any data or other information required by the Department. A local health officer who seeks to obtain a Local Public Health Cancer Grant shall apply to the Department by submitting a copy of the county’s Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment for approval. Each year, a local health officer, in consultation with the coalition established or identified under subsection (c)(1) of this section, shall update the Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment. The Department may designate a person other than the head of a county health department to coordinate a county’s cancer prevention, education, screening, and treatment efforts if: The county health department is unwilling to coordinate these efforts; The county health department has been unsuccessful in implementing cancer prevention, education, screening, and treatment initiatives that satisfy performance standards established by the Department; or The county health department lacks sufficient staff or resources to coordinate these efforts. Subject to paragraph (3) of this subsection, the Department shall establish procedures for making a designation under this subsection. If the Department determines that it is necessary to designate a person other than the local health officer to coordinate a county’s cancer prevention, education, screening, and treatment efforts, the Department may designate the Department as the entity that will coordinate the county’s efforts.

The local health officers of two or more counties may join together as a region to apply for a Local Public Health Cancer Grant. The Department may require that two or more counties join together as a region to apply for a Local Public Health Cancer Grant if the Department determines that: It would be cost–effective to fund cancer prevention, education, screening, and treatment programs for targeted cancers on a regional basis; and It would serve the public health interests of the counties to fund cancer prevention, education, screening, and treatment programs for targeted cancers on a regional basis. The amount of a Local Public Health Cancer Grant that is distributed to a region under this section shall be equal to the sum of the Local Public Health Cancer Grants that otherwise would have been distributed to each county under the formula established under § 13–1108 of this subtitle. If the local health officers of two or more counties choose to join together as a region to apply for a Local Public Health Cancer Grant or are required to do so by the Department, the local health officers shall act jointly to: Develop a Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment, as required under § 13–1109(c) of this subtitle; Establish a Community Health Coalition, as provided under § 13–1111 of this subtitle, or identify another coalition approved by the Department; Demonstrate that the base–year funding requirement established under § 13–1112 of this subtitle has been met; and Otherwise satisfy the requirements of §§ 13–1107 through 13–1113 of this subtitle.

The membership of a Community Health Coalition established under § 13-1109(c) of this subtitle shall: Reflect the demographics of the county; and Include representatives of community-based groups, including minority, rural, and medically underserved populations, that, taken together, are familiar with all of the different communities and cultures in the county. In addition to the requirements of paragraph (1) of this subsection, in Baltimore City and in Baltimore, Montgomery, and Prince George’s counties, the Community Health Coalition shall include representatives of the major community hospitals that treat county residents with targeted cancers. In Baltimore, Montgomery, and Prince George’s counties, the local health officer, in consultation with the Department, shall determine whether a hospital is a major community hospital based on the following factors: The number of county residents with targeted cancers who are served by the hospital; Whether the hospital has special expertise in treating targeted cancers; Whether the hospital has demonstrated a commitment to treating uninsured individuals; and The number of research activities conducted by the hospital that relate to targeted cancers and the amount of funding for these activities. In Baltimore City, the University of Maryland Medical Group and the Johns Hopkins Institutions, acting jointly in collaboration with the Baltimore City Health Department, in consultation with the Department, shall determine whether a hospital is a major community hospital based on the factors listed under subparagraph (ii) of this paragraph. The membership of a Community Health Coalition established under § 13–1109(c) of this subtitle may include: Representatives of: A local management board established under Title 8, Subtitle 3 of the Human Services Article; Local hospitals, clinics, physicians, and other health care providers; Local religious organizations; Institutions of higher education; and Hospitals and other entities located outside the county that could enhance the county’s cancer prevention, education, screening, and treatment efforts; and Any other person that the local health officer believes would help the county meet the cancer prevention, education, screening, and treatment goals and requirements established for the county under § 13–1108 of this subtitle.

Except as provided in § 13-1115(f) of this subtitle, this section does not apply in Baltimore City. Before receiving a Local Public Health Cancer Grant, a local health officer shall submit to the Department an inventory of all existing publicly funded cancer prevention, education, screening, and treatment programs that relate to targeted cancers in the county that were identified under § 13-1109(c) of this subtitle. The inventory shall specify the amount of county funds that are being spent on each of the programs included in the inventory. The level of funding specified under subsection (b)(2) of this section shall be the county’s base-year funding for cancer prevention, education, screening, and treatment programs that relate to targeted cancers. A Local Public Health Cancer Grant may not be used to supplant a county’s base-year funding for cancer prevention, education, screening, and treatment programs that relate to targeted cancers. The Department may not distribute a Local Public Health Cancer Grant to a county unless the Department determines that the county will spend, in the applicable fiscal year, at least its base-year funding for cancer prevention, education, screening, and treatment programs that relate to targeted cancers.

The Department shall review a Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment submitted under § 13-1109(e) of this subtitle and determine whether: The Plan addresses the goals and requirements established for the county under § 13-1108 of this subtitle; and All other requirements of §§ 13-1107 through 13-1112 of this subtitle have been met. The Department may not distribute a county’s share of money for a Local Public Health Cancer Grant, as provided under § 13-1108 of this subtitle, if the Department determines that the requirements of subsection (a) of this section have not been met.

There is a Statewide Academic Health Center Component in the Program. The purpose of the Statewide Academic Health Center Component is to maximize the effectiveness of the Program by involving the University of Maryland Medical Group and the Johns Hopkins Institutions in the implementation of the Program. Subject to §§ 13–1115 and 13–1116 of this subtitle, the Department may implement the Statewide Academic Health Center Component by distributing: Statewide Academic Health Center Public Health Grants, as provided under § 13–1115 of this subtitle; and Statewide Academic Health Center Cancer Research Grants, as provided under § 13–1116 of this subtitle. The University of Maryland Medical Group and the Johns Hopkins Institutions shall coordinate their efforts with regard to initiatives that are funded with grants that are distributed under the Statewide Academic Health Center Component to maximize the benefits received from the use of these grant funds and to eliminate unnecessary duplication of efforts.

Subject to the other provisions of this section, the University of Maryland Medical Group and the Johns Hopkins Institutions may each apply for a Statewide Academic Health Center Public Health Grant. For fiscal year 2007 and any subsequent fiscal year, the amount of each Statewide Academic Health Center Public Health Grant that is distributed to the University of Maryland Medical Group or the Johns Hopkins Institutions, respectively, shall be equal to the sum of: At least 9.5% of the total local public health component money distributed under § 13–1108(b) of this subtitle; and One–half of any money that is transferred from the Local Public Health Component to the Statewide Academic Health Center Component under § 13–1108(c) of this subtitle. Before applying for a Statewide Academic Health Center Public Health Grant, the University of Maryland Medical Group and the Johns Hopkins Institutions, acting jointly in collaboration with the Baltimore City Health Department, shall: Establish a Baltimore City Community Health Coalition, as provided under § 13–1111 of this subtitle, or identify another coalition approved by the Department that reflects the demographics of Baltimore City and includes representatives of community–based groups, including minority and medically underserved populations, that, taken together, are familiar with all of the different communities and cultures in Baltimore City; and With the assistance of the coalition established or identified under item (1) of this subsection: Identify all existing cancer prevention, education, screening, and treatment programs that relate to targeted cancers in Baltimore City that are publicly funded; Evaluate the effectiveness of the publicly funded programs identified under item (i) of this paragraph; and Develop a Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment that outlines a strategy for meeting the cancer prevention, education, screening, and treatment goals and requirements established for Baltimore City under § 13–1108 of this subtitle. The Baltimore City Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment shall: Include a list of the members of the coalition established or identified under subsection (b)(1) of this section and their organizational affiliations; Include the evaluation of any program funded with a Statewide Academic Health Center Public Health Grant in the prior year; Each year, after the first year of funding, demonstrate that progress has been made toward meeting the cancer prevention, education, screening, and treatment goals established for Baltimore City under § 13–1108 of this subtitle; Include a budget plan that provides specific levels of funding for each initiative described in the Plan and an explanation as to how each initiative is expected to help meet the cancer prevention, education, screening, and treatment goals and requirements established for Baltimore City under § 13–1108 of this subtitle; Demonstrate that Baltimore City has met the base–year funding requirement established under subsection (h) of this section; Demonstrate that any early detection or screening program that is or will be funded under a Statewide Academic Health Center Public Health Grant provides necessary treatment or linkages to necessary treatment for uninsured individuals who are diagnosed with a targeted and non–targeted cancer as a result of the screening process; State that the Statewide Academic Health Center Public Health Grant will not be used to supplant any existing funding at the University of Maryland Medical Group or the Johns Hopkins Institutions for any cancer prevention, education, screening, or treatment programs that relate to targeted cancers; Each year, after the first year of funding, identify all persons who received money under the Statewide Academic Health Center Public Health Grant in the prior year and state the amount of money that was received by each person under the Grant; Each year, after the first year of funding, state the amount of money that was received by the University of Maryland Medical Group and the Johns Hopkins Institutions under a Statewide Academic Health Center Public Health Grant in the prior fiscal year that remained unspent and unobligated at the end of that year; Describe how the Plan will help to eliminate the greater incidence of and higher morbidity rates for cancer in minority populations, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report; Describe how the Plan will help to increase availability of and access to health care services for uninsured and underinsured individuals and medically underserved populations, with particular emphasis on how the Plan seeks to address the relevant findings and recommendations of the Task Force Report; Demonstrate that priority consideration was given to persons, including federally qualified health centers, that have a demonstrated commitment to providing cancer prevention, education, screening, and treatment services to uninsured and underinsured individuals in the city and a proven ability to do so; and Contain any data or other information required by the Department. To apply for a Statewide Academic Health Center Public Health Grant, the University of Maryland Medical Group and the Johns Hopkins Institutions shall submit to the Department a copy of Baltimore City’s Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment for approval. Each year, the University of Maryland Medical Group and the Johns Hopkins Institutions, acting jointly in collaboration with the Baltimore City Health Department, in consultation with the coalition established or identified under subsection (b)(1) of this section, shall update the Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment. Rather than distributing a Statewide Academic Health Center Public Health Grant to the University of Maryland Medical Group or the Johns Hopkins Institutions under this section, the Department may distribute to the Baltimore City Health Department or another person designated by the Department a Local Public Health Cancer Grant for the purpose of coordinating Baltimore City’s cancer prevention, education, screening, and treatment efforts if: The University of Maryland Medical Group or the Johns Hopkins Institutions are unwilling to coordinate these efforts; The University of Maryland Medical Group or the Johns Hopkins Institutions have been unsuccessful in implementing cancer prevention, education, screening, and treatment initiatives that satisfy performance standards established by the Department; or The University of Maryland Medical Group or the Johns Hopkins Institutions lack sufficient staff or resources to coordinate these efforts. If the Department distributes a Local Public Health Cancer Grant to the Baltimore City Health Department or another person designated by the Department under this subsection rather than distributing a Statewide Academic Health Center Public Health Grant to the University of Maryland Medical Group, the amount of the Grant shall equal the sum of: $2,000,000; and One–half of any money that is transferred from the Local Public Health Component to the Statewide Academic Health Center Component under § 13–1108(c) of this subtitle. If the Department distributes a Local Public Health Cancer Grant to the Baltimore City Health Department or another person designated by the Department under this subsection rather than distributing a Statewide Academic Health Center Public Health Grant to the Johns Hopkins Institutions, the amount of the Grant shall equal the sum of: $2,000,000; and One–half of any money that is transferred from the Local Public Health Component to the Statewide Academic Health Center Component under § 13–1108(c) of this subtitle. The Department shall use money that is allocated to the Statewide Academic Health Center Component in the State budget or transferred to the Statewide Academic Health Center Component under § 13–1108(c) of this subtitle to fund a Local Public Health Cancer Grant that is distributed to the Baltimore City Health Department or another person designated by the Department under this subsection. If the Baltimore City Health Department or another person designated by the Department applies for a Local Public Health Cancer Grant as authorized under this subsection, the Baltimore City Health Department or other person shall comply with the requirements of §§ 13–1107 through 13–1113 of this subtitle. Subject to paragraph (7) of this subsection, the Department shall establish procedures for making a designation under this subsection. If the Department determines that it is necessary to designate a person other than the Baltimore City Health Department to coordinate the city’s cancer prevention, education, screening, and treatment efforts as authorized under this subsection, the Department may designate the Department as the entity that will coordinate the city’s efforts. Before the University of Maryland Medical Group or the Johns Hopkins Institutions may receive a Statewide Academic Health Center Public Health Grant, the Baltimore City Health Department shall submit to the Department an inventory of all existing publicly funded cancer prevention, education, screening, and treatment programs that relate to targeted cancers in Baltimore City that are identified under subsection (b) of this section. The inventory prepared under subparagraph (i) of this paragraph shall specify the amount of funds that are being spent by Baltimore City on each of the programs included in the inventory. The level of funding specified under paragraph (1)(ii) of this subsection shall be Baltimore City’s base–year funding for cancer prevention, education, screening, and treatment programs that relate to targeted cancers. A Statewide Academic Health Center Public Health Grant may not be used to supplant: Baltimore City’s base–year funding for cancer prevention, education, screening, and treatment programs that relate to targeted cancers; or Any existing funding at the University of Maryland Medical Group or the Johns Hopkins Institutions for cancer prevention, education, screening, and treatment programs that relate to targeted cancers. Subject to paragraph (2) of this subsection, the Department may not distribute a Statewide Academic Health Center Public Health Grant under this section until after the Baseline Cancer Study has been completed. Before the Baseline Cancer Study is completed, the Department may use money that is allocated to the Statewide Academic Health Center Component in the State budget to fund a planning grant of not more than $10,000 that may be distributed to and used collectively by the University of Maryland Medical Group, the Johns Hopkins Institutions, and the Baltimore City Health Department. The Department shall review a Comprehensive Plan for Cancer Prevention, Education, Screening, and Treatment submitted under this section and determine whether: The Plan addresses the goals and requirements established for Baltimore City under § 13–1108 of this subtitle; and All other requirements of this section have been met. If the Department determines that the requirements of this section have not been met, the Department may not distribute: A Statewide Academic Health Center Public Health Grant to the University of Maryland Medical Group or the Johns Hopkins Institutions; or A Local Public Health Cancer Grant to the Baltimore City Health Department or another person designated by the Department under subsection (f) of this section.

For each of fiscal years 2011 and 2012: The Governor shall include at least $2,400,000 in the annual budget in appropriations for the Statewide Academic Health Center Cancer Research Grants under this section; and The Grants shall be distributed between the Statewide Academic Health Centers as follows: $2,007,300 to the University of Maryland Medical Group; and $392,700 to the Johns Hopkins Institutions. For fiscal year 2013 and each fiscal year thereafter: The Governor shall include at least $13,000,000 in the annual budget in appropriations for the Statewide Academic Health Center Cancer Research Grants under this section; and The Grants shall be distributed according to historical allocations between the Academic Health Centers. Subject to the other provisions of this section, the Department may distribute Statewide Academic Health Center Cancer Research Grants to the University of Maryland Medical Group and the Johns Hopkins Institutions for the purpose of enhancing cancer research activities that may lead to a cure for a targeted cancer and increasing the rate at which cancer research activities are translated into treatment protocols in the State. Before receiving a Statewide Academic Health Center Cancer Research Grant, an institution shall: Submit a Cancer Research Plan that: Provides a detailed plan as to how the Statewide Academic Health Center Cancer Research Grant will be spent and how it will be used to meet the goals established by the Department; Provides a complete inventory of all cancer research activities relating to targeted cancers that are currently being conducted by the institution, including a breakdown of the types of cancer to which the research relates; Specifies the source and amount of funding for all of the cancer research activities identified under item (ii) of this paragraph; Certifies that the cancer research activities that will be funded by the Statewide Academic Health Center Cancer Research Grant have been endorsed by an independent peer review group that is comprised of experts in the field from outside the institution who will not be involved in the research; Identifies the individuals who make up the independent peer review group; and Includes any other information that is requested by the Department; and Enter into a memorandum of understanding with the Maryland Department of Health, the Department of Commerce, and the Maryland Technology Development Corporation that: Establishes the scope of the State’s ownership or other financial interest in the commercialization and other benefits of the results, products, inventions, and discoveries of cancer research activities funded by a Statewide Academic Health Center Cancer Research Grant; Establishes a plan for expediting the translation of cancer research activities into treatment protocols and clinical trials; and To the extent consistent with federal and State law, reflects the intellectual property policies of the Statewide Academic Health Center. A memorandum of understanding established under subsection (b)(2) of this section may allow for the selection of a higher education institution or private entity to expedite the translation of cancer research activities into treatment protocols and clinical trials. The Department may not distribute a Statewide Academic Health Center Cancer Research Grant unless the Department first determines that: A Cancer Research Plan will help achieve the purpose of the Program; The institution that receives the Grant will not use any part of the Grant to supplant existing cancer research activities or any other type of current expenditure by the institution; The Grant will be used to fund cancer research activities that relate to targeted cancers; The institution has executed a memorandum of understanding as required by subsection (b)(2) of this section; and The institution satisfies any other requirement established by the Department as a condition of receiving the Grant.

There is an Administrative Component in the Program. The purpose of the Administrative Component is to provide the necessary administrative structure in the Department for effective management of the Program. Funds that are allocated to the Administrative Component in the State budget shall be used to cover administrative costs incurred by the Department in administering the Program. Unless otherwise specified in the annual budget bill as enacted, the amount of funds that are allocated to the Administrative Component in the State budget may not exceed 7% of the total amount that is allocated to the Program in the State budget. A county that receives funds under a Local Public Health Cancer Grant, a person who receives funds under a Local Public Health Cancer Grant, a Statewide Academic Health Center that receives money under any of the grants distributed under the Statewide Academic Health Component, and any other person who receives funds under the Program may not use more than 7% of the funds to cover administrative costs.