Maryland Commission on Public Health Finalizes Report

The Maryland Commission on Public Health released its final report this fall, outlining a comprehensive roadmap to modernize the state’s public health infrastructure and strengthen coordination across state and local agencies.

Created in 2023, the Commission was charged with evaluating Maryland’s foundational public health capabilities and developing strategic, actionable recommendations to improve the delivery of services at the state and local levels. Its work included collaboration with universities, public health experts, community partners, and professionals across state and local health departments. Through interviews, surveys, regional listening sessions, and workgroup discussions, the Commission assessed governance structures, data and technology gaps, workforce needs, funding challenges, and barriers to communication and public engagement.

As previously covered by MACo, MACo submitted formal feedback highlighting county priorities, especially regarding funding formulas, state-local coordination, and support for modern public health governance. From MACo’s feedback:

MACo urges the Commission to give special attention to clarifying how local contributions are determined and communicated. Local governments must be able to rely on a predictable, understandable system when crafting their annual budgets, especially when matching requirements can have significant fiscal impacts at the county level. A modernized formula would strengthen the state-county partnership and better position Maryland to respond to the health needs of its residents.

From the final report:

FND-054 Revisit Core Funding Formula

Four comments emphasized the need to modernize Maryland’s core funding formula for LHDs, stressing transparency, predictability, and flexibility tailored to individual county needs. Commenters highlighted Appendix 8: Synopsis of and Commission Response to Substantive Open Comments 131concerns that current funding is often one-size-fits-all and lacks clarity—particularly around local matching contributions, which have caused unexpected financial strains for some counties. There was broad support for involving LHDs in funding decisions through inclusive, multi-sector steering committees, modeled after approaches used in Washington State, to enhance collaboration while maintaining state control over allocations. Additionally, commenters urged that the formula revision consider evolving public health demands, potential regionalization of LHDs, and clearer communication to strengthen the state-county partnership and ensure sustainable budgeting.

The 155-page report represents extensive public engagement, site visits across Maryland, surveys, and expert input collected over nearly two years. Its recommendations are organized around five major priorities critical to strengthening state-local public health capacity:

Strengthening infrastructure (including governance, human resources, and sustainable funding)
Modernizing communication, data systems, and technology
Formalizing and expanding partnerships across agencies and sectors
Better integrating public health and health care delivery
Investing in current and future public health leaders

Read the full report.

At the 2025 MACo Winter Conference Health Officers session, “Navigating Trust and Collaboration: Counties Protecting Public Health Together ,” panelists will explore the strategies for intergovernmental coordination, building multi-sector partnerships, and leveraging coalitions to sustain essential services, protect residents, and strengthen trust in local public health systems.

The 2025 MACo Winter Conference will be held at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, MD, from December 10-12, 2025. This year’s theme is “Local Leadership, Lasting Impact: Shaping What’s Next.” More information can be found on our conference website.