FILE - In this June 8, 2018 file photo, Baltimore Mayor Catherine Pugh addresses a gathering during the annual meeting of the U.S. Conference of Mayors in Boston. Pugh on Monday, March 18, 2019, stepped down from the University of Maryland Medical System’s board of directors, days after it came to light that the hospital network had for years purchased her self-published children’s books. Board positions are unpaid, but The Baltimore Sun reported last week that around a third of the board received compensation through the UMMS network's contracts with their businesses. The newspaper revealed that Pugh failed to fully disclose a $500,000 business relationship she began with the 11-hospital network in 2011.(AP Photo/Charles Krupa, File)

BALTIMORE (AP) — A search is underway in Maryland for "Healthy Holly" — not a fugitive or a missing citizen, but a self-published children's book series authored by Baltimore Mayor Catherine Pugh and sold for half a million dollars to a health care system whose board of directors she sat on for nearly two decades.

Since 2011, Pugh received $500,000 selling her illustrated books to the University of Maryland Medical System, a $4 billion hospital network that's one of the largest private employers in the state. Since the arrangement was exposed by The Baltimore Sun earlier this month, she's stepped down from the volunteer board and returned her most recent payment of $100,000 for the hard-to-find books. She also defended her actions and portrayed press inquiries as a "witch hunt."

A Democrat who became mayor in 2016 and represented some of Baltimore's poorest areas in the state's Senate before that, Pugh is the public face of the still-unfolding debacle. But the Baltimore mayor — who served on the UMMS board since 2001 and once sat on a state Senate committee that funded the major health network — is hardly the only influential Marylander connected to the board or the medical system facing questions.

One-third of the UMMS board members received compensation through the medical system's arrangements with their businesses, a revelation that Gov. Larry Hogan has called "appalling." Two other members of the board also resigned, and four others went on voluntary leave while the system reviews governance practices. The president and CEO of the University of Maryland Medical System has recently been sent on a temporary leave of absence.

Maryland Comptroller Peter Franchot said Tuesday that an independent audit is urgent to understand how many "self-dealing" arrangements there have been over the years. In Pugh's case, there needs to be a thorough examination of whether a product was actually delivered, he said.

"I describe it as juvenile, this arrangement where she was providing or not providing books — no receipts, no contracts, no procurement. It was simply a $500,000 gift to her from the University of Maryland Medical System," Franchot asserted in a phone interview.

The slim "Healthy Holly" books, sharing tips on nutrition and exercise, were meant to be distributed to schools and daycares. However, the Sun has reported that 50,000 copies are unaccounted for, leading to widespread speculation that a good chunk were never printed in the first place. In recent days, fewer than 9,000 copies were tracked down collecting dust in a warehouse of Baltimore's school district, which has described Pugh's children's books as "unsolicited" donations. The city library system, daycare programs and booksellers can't find copies. "Healthy Holly: Exercising is Fun" is unavailable on Amazon, where the only reviews for the book are entries of people savaging Pugh's ties with UMMS.

In a written statement, Pugh has defended her lucrative book deal with UMMS, saying it started as a passion project.

"I recall passing the time by thumbing through the first book before an UMMS meeting. One my colleagues loved it and thought it would help advance children's health," she said in a recent statement.

Pugh has since cancelled all public appearances and her spokespeople say she was hospitalized over the weekend with pneumonia. They say she will address the matter more once her health improves.

Criticism of UMMS and of Pugh — who faces a 2020 Democratic primary for re-election in a city dominated by a single party's political machine — has been intense. The Washington Post's editorial board asserted the UMMS had a "get-rich-quick program" for many of its board members, with Pugh's involvement painted as an egregious case of "political sleaze."

Meanwhile, UMMS and Pugh have not provided clarity on the whereabouts of the 100,000 copies of the "Healthy Holly" series books or definitive proof they were published and distributed. A spokeswoman for the university-based health network says their communications team was "working hard on all of the inquiries." The medical system had classified the "Healthy Holly" purchases as grants in federal filings.

Some critics say the various statements made by Pugh and others regarding the arrangements with UMMS board members are absurd on so many levels that it's hard to know where to begin.

"Whatever Pugh does, she is going to be operating under a very, very big cloud for a long time," said Donald Norris, professor emeritus of public policy at the University of Maryland Baltimore County. "This is an unethical lapse of humongous proportions — $500,000 worth."

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