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What does 'Code Blue' mean in Baltimore, and who is responsible for declaring it?

As snow approached Baltimore over the weekend, some residents wondered why the city’s health department had not yet issued a Code Blue alert, expressing concern about the homeless population.

Interim health Commissioner Mary Beth Haller did declare “Code Blue Extreme Cold” alert for Saturday night through Sunday — but the program is not actually tied to emergency shelters like it once was.

The Baltimore City Health Department initiated the Code Blue program in 2002, as a tool to prevent hypothermia deaths among the city’s homeless.

When the program started, a “Code Blue” alert meant the city opened an emergency shelter. A bus picked up homeless people and brought them to the emergency shelter, where they received a blanket, cot and hot meal.

When Mayor Catherine Pugh took office, she updated the policy for the city’s emergency shelters to open any time the temperature dips below freezing, rather than waiting until a “Code Blue” alert to be issued.

Today, emergency shelter is handled through the Mayor’s Office of Human Services, which activates “winter shelter status” on nights 32 degrees or below. Should the city’s existing shelters fill up on these nights, the city will transport homeless individuals to overflow shelters, where they will receive dinner and breakfast and access to shower and laundry services.

Individuals can access real-time information on the MOHS website, or call 311, 211 or Baltimore Crisis Response (410-433-5175) to find out whether it is a winter shelter night and how to access shelter.

The criteria for “Code Blue” nights have fluctuated over the years. At first, Code Blue nights would be declared when the temperature fell below 20 degrees, or 25 degrees with precipitation and sustained winds of 15 mph. In 2005, the policy dropped any reference to wind and allowed some leeway for going a bit over 32 degrees if there was also rain or snow.

Currently, the health commissioner can declare a code blue when temperatures including wind chill are expected to be 13 degrees or lower, or when “other conditions are severe enough to present a threat to the life of health of Baltimore residents.”

Although the program is no longer tied to emergency shelters, a “Code Blue Extreme Cold” alert does trigger some responses from the city, according to the health department’s website. For example, outreach workers encourage homeless people to take shelter and a Salvation Army canteen will provide hot drinks. Additionally, says spokeswoman Mona Rock, the department conducts outreach efforts to let people know about dangers that extreme weather can pose.

Baltimore Sun reporter Lillian Reed contributed to this article.

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