The successful design and practice of an environmental health and safety program in an institutional setting is a comprehensive undertaking. It involves the coordination and integration of a broad range of people, both professional and nonprofessional, and their diverse and complimentary resources and skills. The institution is in effect a small community and therefore contains the numerous environmental, community health, social, emotional, and psychological problems attributed to or found in any small community. In addition, a considerable number of people congregate in a limited amount of space. The typical institution continues to grow in size and complexity. The budget of the institution and means of financing have become problems, because costs rise as new techniques and equipment are developed and as medical inflation continues to grow sharply.