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The objectives of this audit were to determine whether the Maryland Department of Health and Mental Hygiene (State agency) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus area designated in the cooperative agreements and whether the State agency has established controls and procedures to monitor sub-recipientsí expenditures of Centers for Disease Control and Prevention funds. We found that the State agency generally accounted for Program funds in accordance with the terms and conditions of the cooperative agreements and applicable departmental regulations and guidelines. Specifically, the State agency recorded, summarized and reported transactions by specific focus area. The State agency had a system to track and monitor sub-recipient activities; such as, application and award processes, grant conditions, ongoing fiscal activities, and reporting. In addition, the State agency was planning to add reviews of Program funds to current audits performed on sub-recipients.