Get Into Mental Health

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Mental Health Awareness Week is Oct. 1-7, 2017. Each year, the first full week in October provides an opportunity to fight stigma, provide support, educate the public, and advocate for equal care.

One in five adults experiences mental illness problems every year, and 50 percent of chronic mental illness begins by age 14. Although many people today understand that mental illness is a medical condition, individuals and families affected by mental illness are still often subjected to stigma and discrimination.

This year the National Alliance on Mental Illness (NAMI) is calling on everyone to get “Into Mental Health” and replace stigma with hope.

Locally, NAMI Kent & Queen Anne’s (the newest affiliate of NAMI Maryland) is now offering the NAMI Family Support Group program on the first and third Monday in Centreville, and the first and third Tuesday in Chestertown, from 7 to 8:30 p.m.

In addition, as part of Mental Health Awareness week, National Depression Screening Day will be held Thursday Oct. 5. Organizations around the world are encouraged to offer free, anonymous questionnaires that can help individuals identify potential signs of depression. Learn more at www.mentalhealthscreening.org/programs/ndsd.

“We are calling on everyone to join NAMI and replace stigma with hope by pledging to be #stigmaFree,” said Lainie Surette, steering committee co-chair of NAMI Kent & Queen Anne’s.

To take the #StignaFree pledge, visit www.NAMI.org/stigmafree. NAMI offers information about mental illness conditions, symptoms and treatment at www.NAMI.org or through its HelpLine at (800) 550-NAMI (6264).

For more information about the Kent and Queen Anne’s Support Groups call (443)480-0565.

To Counter Opioid Epidemic Leads State Panel to Revisit “Recovery Schools

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A fire led to the eventual end of Phoenix — a groundbreaking Maryland public school program for children with addiction that closed in 2012 — but the state could see institutions like it rise again from the ashes.

Recent spikes in the Maryland heroin and opioid epidemic have triggered calls for substantial changes in education systems statewide, and a state work group is weighing the return of recovery schools after a Sept. 7 meeting.

For Kevin Burnes, 47, of Gaithersburg, Maryland, attending a recovery school separate from his hometown high school was life-changing.

Burnes said in a public letter that he began to experiment with drugs and alcohol at age 10, and his addiction to alcohol quickly escalated to PCP. He found himself homeless and was admitted into a psychiatric institute, he wrote.

However, after finding Phoenix, a recovery program for secondary school students with addiction, and attending for two years, his whole life turned around.

“What I can tell you is that this program undeniably saved my life,” said Burnes, now a full-time musician living in Frederick, Maryland. “The largest part of Phoenix’s success was due to the fact that everyone was involved. It was a community effort. It’s a community issue.”

State legislation that passed this year — known as the Start Talking Maryland Act — came into effect in July and directed schools in Maryland to take precautionary measures against opioid exposure and abuse. It also established the work group.

The panel is charged with evaluating and developing behavioral and substance abuse disorder programs and reporting their findings to the General Assembly, according to a state fiscal analysis.

The legislation additionally requires:

–To store naloxone in schools and train school personnel in the drug’s administration
–Public schools to expand existing programs to include drug addiction and prevention education
–Local boards of education or health departments to hire a county or regional community action official to develop these programs
–The governor to include $3 million in the fiscal 2019 budget for the Maryland State Department of Education for these policies
–Schools of higher education that receive state funding to establish these similar policies and instruction in substance use disorders in certain institutions

The Phoenix program and similar secondary schools that followed it were created specifically for students in recovery from substance use disorder or dependency, according to the Association of Recovery Schools.

“What we’ve known anecdotally for a while, we are starting to finally see with data. These high schools have positive effects on preventing and reducing adolescent alcohol and drug use as well as supporting the abstinence of kids post-treatment and seeing a positive impact on academics,” Dr. Andrew Finch, Vanderbilt University researcher and co-founder of the Association of Recovery Schools told the University of Maryland’s Capital News Service.

The first of its kind in the United States, the original Phoenix I school opened in 1979 as an alternative program in Montgomery County, Maryland, that provided both an education and a positive peer culture centered on recovery. Phoenix II followed, also in Montgomery County.

Since then, about 40 schools have opened nationwide, according to Finch, but none remain in the state of Maryland.

“It was amazing the support that the students gave to each other. We would have weekly community meetings where they would praise each other for their commitment, but if they weren’t working toward sobriety these kids were the first ones to rat on each other,” Izzy Kovach, a former Phoenix teacher told the University of Maryland’s Capital News Service. “It was a real sense of family…”

Critical to the Phoenix schools were outdoor challenges, said Mike Bucci, a former Phoenix teacher for 20 years, in a report. Along with regular days of classes and support groups, students would go from climbing 930-foot sandstone cliffs at Seneca Rocks, West Virginia, to biking the 184-mile length of the C&O Canal to sailing the waters of the Chesapeake Bay.

“These trips helped form lifelong bonds along with an ‘I can’ attitude,” Bucci wrote.

The Phoenix schools at their largest enrolled about 50 students each at a time, according to a state report.

After years of successful work, the Phoenix schools began to lose their spark. Tragedy struck in 2001 when the Phoenix II school burned down.

However, instead of remaining a standalone recovery school, Phoenix II continued on as an in-school program, and eventually Phoenix I followed, according to Kovach.

“The program lost its validity with this model (with students back in traditional high schools). The students knew it, the parents knew it, and eventually key staff left because they also saw it was ineffective,” Kovach said.

Eventually, enrollment dwindled down to only three students and the Phoenix program closed its doors in 2012, according to a report compiled by a community advocacy group Phoenix Rising: Maryland Recovery School Advocates.

Five years later, with the rise in drug use throughout the state, talk of bringing back recovery school programs have reemerged.

“Whenever you have a program where there aren’t many of them, like recovery schools, people just don’t don’t think of them as an option. But, it is slowly changing and it’s even starting to be picked up by the media,” Finch said.

The epidemic is gathering attention and resources in Maryland — Gov. Larry Hogan declared a state of emergency from March 1 to April 30 and committed an additional $50 million over five years to help with prevention.

From 2014 to 2017, the number of opioid-related deaths reported in Maryland between Jan. 1 and March 31 more than doubled — taking the death toll up to 473, according to state health department data. Since then, the work group has begun to look at these numbers and is beginning to discuss various models for these new recovery programs.

Lisa Lowe, director of the Heroin Action Coalition advocacy group, said she fears that the work group will not be able to understand how to move in the right direction without having students, parents or teachers with lived experience contributing.

“Instead of just guessing what’s going to work, why not ask the people who are living it?” Lowe said.

The work group has considered either creating a regional recovery school or bringing the recovery programs into already existing schools — both models in which Burnes, Lowe and many others are not in favor.

Lowe said students in recovery need to get away from “people, places and things,” a common phrase that is used in 12-step programs. With a regional school or an in-school program, Lowe said, it is more difficult to maintain after-school programming and local peer support groups, and it will bring recovering students back to where their problems started.

The start-up costs for Year 1 for one recovery school are estimated to range from approximately $2,258,891 to $2,473,891 depending on whether the school is operated only for Montgomery County students or as a regional recovery school, and again should enroll about 50 students age 14 through 21 years (or Grades 8 through 12), according to a state report.

“The overdoses are not occurring as much at the high school level, but that’s where they start. They start in high school and they start in middle school. We have to get the program in place so that we don’t have the deaths later on,” said Kovach, the former Phoenix teacher.

Rachelle Gardner, the co-founder of Hope Academy, a recovery charter high school in Indiana, said that these recovery schools are needed all over the country to help battle this substance abuse crisis.

“Addiction is addiction, when you walk into a 12-step meeting you’re in a room of addicts. You have to treat the addict in itself and we have to meet everybody where they’re at regardless of their drug of choice,” Gardner said.

The workgroup is continuing to develop their ideas for recovery schools and are expected to present their findings to the State Board of Education on Oct. 24.

By Georgia Slater

Pink Polar Bear Golf Tourney Raises $2,550 for the Women’s Center

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Pink Polar Bear Tournament participants paused for a group photo after coming in from the links at Chestertown Yacht and Country Club.

The sixth annual Pink Polar Bear Golf Tournament, held August 6 at the Chester River Yacht & Country Club, raised $2,550 to benefit patient care in the Eleanor & Ethel Leh Women’s Center at UM Shore Medical Center at Chestertown.

According to tournament co-chair Gwinn Derricott, who also is a hospital volunteer, 66 members and guests of the club, which is located just outside Chestertown, participated in this year’s event. “Everyone says that this is the most fun tournament they play in because of the format and the camaraderie,” Derricott said. “We’ve come a long way from a group of nine and 18-hole lady golfers and we’re looking forward to many more tournaments.”

Jane Hukill, tournament co-chair and also a hospital volunteer said, “We call it the Pink Polar Bear tournament because early on, it was explained to us that finding breast cancer can be like trying to find a polar bear in a blizzard.  When we saw the capabilities of the tomosynthesis in mammography, we had to do our part to support the continued availability of this technology in Chestertown.”

Kelly Bottomley, regional manager, Imaging, for UM Shore Regional Health, said that mammography is the medical “gold standard” to identify breast cancer. The Eleanor & Ethel Leh Women’s Center, which opened in October 2013, was the first facility on the Delmarva Peninsula to offer 3-D digital mammography with tomosynthesis, which can identify breast cancer at the earliest possible stage; in 2016, the Center performed 2,643 mammograms.

“On behalf of both the staff of the Leh Women’s Center and the patients who come to us for treatment, I am humbled to thank everyone who helped make the Pink Polar Bear tournament such a great success this year as in the past – in fact, their support grows larger every year. Their generosity and commitment is making a positive difference for women’s health here in Kent County and beyond, and we are proud to have them as part of our family of care,” Bottomley stated.

The Leh Center also offers bone density testing. A plastic surgeon is on site at the Center two days a week for breast surgery, reconstruction, consultation and other services.

Save Our Hospital Group Responds to Workgroup Report

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Leaders of the Save Our Hospital group and other concerned citizens have sent a letter about recommendations of the Maryland Rural Health Workgroup’s in the draft report on the future of the Chestertown hospital. The letter cites a number of potential problems with the report, especially as its recommendations would affect Kent County residents. Signers include a number of doctors, the mayor of Chestertown and two town council members, the president of Washington College, the director of Heron Point and board members of the hospital foundation along with other business and community leaders.

The hospital,  a branch of University of Maryland Medical System, has been the focus of community concerns since UMMS acquired it in 2007. While the UM Shore Regional Health board, the immediate parent facility, has committed to keeping the hospital open through 2022, its future beyond that date remains uncertain, Many community members interpret recent staff cuts and other reductions in services as preliminaries to downsizing the facility with an eye to closing it shortly after 2022.

The Rural Health Workgroup is in the final stages of writing its report, which the legislators will then turn into law.  The final report will be presented at the last full workgroup meeting, Sept. 28 in Annapolis.

Here is the Save Our Hospital letter as submitted.

To:        Members of the Rural Health Workgroup and staff of the Maryland Health Care Commission

From: Leadership, Save Our Hospital physicians and citizens group

Date:    August 10, 2017

Re:        Concerns about the draft recommendations  

Dear Workgroup Members and Staff:

As members of the physician-led Kent and northern Queen Anne’s community volunteer group Save Our Hospital, we write to share our reaction to the draft recommendations discussed at the July 25 meeting of the Rural Health Workgroup.

We are grateful to the Health Care Commission staff and the Workgroup members, especially chairs Deborah Mizeur and Joseph Ciatola, for the time and thought they have dedicated to the process of rethinking and redesigning a health-care delivery plan that works for rural communities like ours.

We wholeheartedly endorse the majority of the recommendations, which concern greater coordination and clustering of health-related services, providing in-home or close-to-home care for patients, incentives for attracting and retaining physicians and other health-care professionals, reducing re-admission rates, avoiding unnecessary visits to emergency rooms, and exploiting the power of telemedicine and other innovations to increase timely access to the highest quality diagnostic and treatment expertise.

But we have serious concerns.

Since our original 2015 meetings (which sparked Maryland’s General Assembly and the State Secretary of Health and Mental Hygiene to create your Workgroup), the Save the Hospital citizens group has continued to focus on the viability and vitality of the acute care hospital in Chestertown, now part of University of Maryland Medical System’s Shore Regional Health System. Most of our concerns for the Workgroup recommendations therefore revolve around the concept of the special Rural Community Hospital. That designation is outlined on page 11 of the draft recommendations under item 10: “Create a special hospital designation for Rural Communities.”

While we applaud the creation of a new category of hospital if it will help ensure the continued financial success of our county’s second largest employer, we have specific concerns about the defining characteristics and longevity outlined in the draft recommendations:

Item 10. b. states that the hospital must be “located 35 miles or more from the nearest general acute care hospital.” While we understand that the mileage figure comes from the federal designation for a Critical Access Hospital, it is not a safe measure for rural Maryland communities such as Kent County.  The current hospital in Chestertown is approximately 34 miles from the site of the proposed Easton medical center on Route 50 near the Easton Airport. Thousands of residents, tourists, beach-goers, boaters, students, campers and staffers from marinas, summer camps and environmental education programs in remote parts of Kent County, notably Rock Hall, Betterton, Still Pond Neck and Galena, are 45 to 50 miles or more from the Easton site.

To use the 35-mile figure would be cruel, cynical and dangerous.

We believe a safer criterion would be one based not on mileage but on travel time. That would allow for considerations such as beach traffic on Route 50 and other seasonal issues that lengthen the trip to another hospital.

Item 10. f.  states, “The program would last for five years and would be renewable by agreement of HSCRC and the hospital.” By leaving the renewal option solely up to the hospital board and executives, this clause threatens to put the Chestertown hospital (and any designated Rural Community hospital) right back into the untenable situation that first sparked community outrage and led to the creation of the Rural Health Workgroup in the first place.

A hospital is too important to the health, economy and social wellbeing of a community to be redefined and converted into a lesser facility without vigorous community and legislative debate and input.  The State must require a review process that ensures public discussion and input from the affected hospital’s medical staff and guarantees that the hospital decision makers are hearing and acting on community and physician concerns.  The procedure for altering a Rural Community Hospital’s status should be similar in scope and as rigorous as Maryland’s existing Certificate of Need process for building or significantly altering health-care facilities.

Need for a local hospital board. Another concern is the continued lack of a truly local board to serve as a liaison, watchdog and advocate for our hospital. While the Workgroup’s deliberations and recommendations have invested in the concept of regional and system-wide collaboratives and oversight, we strongly endorse the idea of a community-based board for any rural community hospital or health complex.

Yes, there is a board of directors for the regional health system (in our case, UMMS Shore Regional Health System), but board members from smaller communities will never have a decisive voice on a regional board.  It is, after all, the almost total disregard for our community’s interests and the diminished status of our hospital by the Easton-based regional board that led us to appeal to the General Assembly for respect and attention. Residents will always be more closely connected to, loyal to, and more likely to donate to, a hospital with its own board drawn entirely from neighbors, friends and civic leaders they know and trust.

(Such a local board would give voice to community concerns about hospital policies such as Shore Regional Health’s “white paper” proposal to eliminate the ICU unit and to reduce inpatient beds based on projected rather than recent  patient data.)

“Put some teeth in it.” Given the severity of the physician shortage in rural areas and the pressure and cost of outspending competitors to attract top medical staff, our group suggests building significant incentives and disincentives into any recommendations that will encourage University of Maryland Medical School to develop more family physicians and general practitioners who will train and eventually practice in Kent County and other rural communities. This was a promise—broken immediately and never fulfilled—that UMMS made nine years ago when it was a suitor seeking ownership of the hospital in Chestertown.

Thank you for giving our concerns your serious consideration. The Kent and northern Queen Anne’s community will remain engaged. We are eager to support Senators Middleton and Hershey and Delegates Jacobs, Ghrist and Arentz as they shepherd the Workgroup report through the halls of the General Assembly and into law.  We know that, despite the long road that brought us to this point, we still have a long way to go to ensure that our future includes a robust hospital at the center of a healthy, equitable, prosperous community.

Sincerely,

Save the Hospital Leadership

Dr. Jerry O’Connor

Dr. Wayne Benjamin

Dr. Michael Peimer

Dr. Ona Kareiva

Dr. Susan Ross

Margie Elsberg, SOH Coordinator, past president of Chester River Health Foundation

Kurt Landgraf, President of Washington College

Chris Cerino, Mayor, Town of Chestertown

Garrett Falcone, executive director, Heron Point CCRC

Glenn Wilson, President and CEO of Chesapeake Bank & Trust, President of United Way     of Kent County

Kay MacIntosh, economic development coordinator, Town of Chestertown

And the following citizens in attendance at the August 10 meeting:

(professional or community affiliations provided as known)

Rev. Ellsworth Tolliver, community leader

Marty Stetson, Chestertown Town Council

Linda Kuiper, Chestertown Town Council

Fred Harmon, representing the residents of Heron Point

Leon Irish

Bill Mohan

Shelby Strudwick

Jim Twohy

Charles Lerner, board member, Chester River Health Foundation

Sandra Bjork, board member, Chester River Health Foundation

David Foster, former Chester River Riverkeeper

Nancy Carter

Zane Carter

Beryl Kemp

Michael McDonnell

Stuart Elsberg, past president, For All Seasons

 

 

 

Mainstay Names Carol Colgate Managing Director

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Carol Colgate

When Carol Colgate first attended a concert at the Mainstay, the intimate storefront performing arts center in the waterfront village of Rock Hall,  her initial impression was, “It felt like home.” Today, as the managing director of the friendly and popular live music venue on Main Street, Colgate says that first impression continues, and she would like everyone to feel that they have a home here.

“What I love about the Mainstay is that it grew organically from the time it was founded by Tom McHugh and the core group of original stakeholders, and that the synergy between the music, the audience, the room and the performers has been a natural development. It really is the home of musical magic,” she said, referring to the tagline that accompanies the venue’s logo.

The new managing director position, created in a management reorganization by the Mainstay’s board of directors, is a natural progression for Colgate. She has 30 years of business and arts administrative experience, having worked primarily in theater. Recently, she was a team member in the Kent County production of the new musical, “Red Devil Moon,” where some of her original paintings were featured.

Colgate’s tenure with the Mainstay began as administrative assistant to former executive director Rory Trainor a year ago.  “Rory re-invigorated my love of performance and gave me the opportunity to combine my management skills with imaginative concepts and creativity,” she notes.  All the while, she took on more and more administrative responsibility.

She is enthusiastic to be working with The Mainstay’s very motivated board members on all the operations that keep the venue a vital, thriving part of the local arts scene.  She sees her job as “maintaining the artistic integrity of a long-standing tradition while continuing to grow and expand by keeping our pulse on what’s exciting in the larger community.” Now that the managing director position is filled, Colgate and the board will be hiring staff to work on the programming and marketing for The Mainstay.

Mainstay board president Dan Seikaly says Colgate was a natural fit for The Mainstay.  “For the first 20 years, The Mainstay operated on the energy of Tom McHugh and a few volunteers,” Seikaly noted. “Following Tom’s departure, everyone became aware of the complexity of running a non-profit entertainment venue that presented over 50 concerts a year.  Carol was undaunted and enthusiastic. She learned, adapted or developed methods to grow The Mainstay without losing sight of what made it unique.”

Beyond her demonstrated executive skills, grants management experience and flexible approach to the multi-faceted needs of The Mainstay, Colgate has an innate understanding of the culture that marks the Mainstay’s popularity with its audience and supporters. “Maintaining that culture is important as we continue to move forward with all the creative strengths that bring everyone together,” she said.

UM Shore Regional Health Welcomes New Board Members

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Charles D. “Chip” Macleod

Three local community leaders have recently been appointed to the Board of Directors of University of Maryland Shore Regional Health. Charles “Chip” McLeod and Glenn L. Wilson, both of Chestertown, and Stephen Satchell, of Easton, officially joined the Board in July.

Charles D. “Chip” MacLeod founded MacLeod Law Group, LLC in 2017 with offices in Chestertown and Denton, and a practice representing local governments and related agencies. He is head of the firm’s Local Government Practice Group. He also concentrates in real estate, business and contract law, and serves as general counsel to various non-profit organizations and trade associations. As a registered lobbyist, he advocates for clients before the Maryland General Assembly and Executive branch agencies.

Prior to founding MacLeod Law Group, LLC, MacLeod was a member of Funk & Bolton, P.A. for more than 18 years. He was head of the firm’s Local Government and Real Estate Practice Groups while serving as special counsel to various non-profit organizations and public entities on a broad spectrum of legal matters.

MacLeod also previously served as county administrator of Kent County, Maryland; as a member and chairman of the Board of the former Chester River Health System, Inc.; as a member of the Board of Trustees of the Local Government Insurance Trust (LGIT) and chair of LGIT’s Health Benefits Committee; and associate director of the Maryland Association of Counties. He is a graduate of Washington College and University of Maryland School of Law.

Glenn L. Wilson

Glenn L. Wilson was named president and CEO of Chesapeake Bank & Trust in 2015 after five years as president and CEO of a financial institution in western Pennsylvania that included a $1 billion community bank and $1.8 billion trust company. His career in also banking includes the leadership of Citizens National of Laurel, a top performing bank under Mercantile Bankshares that was later acquired by PNC. He subsequently served PNC as senior credit officer overseeing credit operations in most of Maryland. Other career highlights include serving as past national chairman of the Risk Management Association and as vice-chair of the Pennsylvania Bankers Association and a member of the Federal Reserve Bank of Philadelphia’s Community Institutions Advisory Council.

Wilson’s community involvement has included serving as chair of a local United Way Board in Pennsylvania and as board member for a host of several civic, economic development, and educational organizations. He presently serves as Board chair for the United Way of Kent County and as Board member for Sultana Educational Foundation.

Stephen Satchell is senior vice president and financial advisor for the SRVP Group of Baird Private Wealth Management in Easton. A graduate of Easton High School and Hampden Sydney College, he began his career in finance at Legg Mason in Baltimore in 1992, returning to Easton four years later to focus on wealth management for private clients. He is Series 4,7,63 and 65 registered and is licensed in life, health and long-term care insurance. He presently serves on the St. Johns Foundation Board of Directors and Dave Haslup/Lou Gehrig ASF. His previous Board memberships include the United Fund of Talbot County, Pickering Creek Audubon Center and Talbot Country Club.

Stephen Satchell

Speaking on behalf of the UM SRH Board, John Dillon, chairman, stated: “We are very pleased to have Chip MacLeod, Glenn Wilson and Steve Satchell join us in ensuring that University of Maryland Shore Regional Health will successfully navigate the changing landscape of health care. Their strong personal commitment to the communities we serve, as well as their outstanding professional expertise and accomplishments, make them valuable assets to our efforts going forward.”

In addition to Robert A. Chrencik, CEO, University of Maryland Medical System, and Kenneth Kozel, president and CEO, UM Shore Regional Health, current UM SRH Board members are: from Caroline County, Wayne Howard and Keith McMahan;from Dorchester County, Marlene Feldman, Michael D. Joyce, MD, Richard Loeffler and David Milligan; from Kent County, Myra Butler, Charles B. MacLeod, Charles B. Nolland Glenn L. Wilson; from Queen Anne’s County, Joseph J. Ciotola, MD and Kathleen Deoudes; and from Talbot County, John W. Ashworth,Charles Capute, Art Cecil, John Dillon, Wayne L. Gardner, Sr., Geoffrey F. Oxnam, Stephen Satchell and Thomas Stauch, MD.

“Our board members live and work in our communities. I believe their diverse knowledge and perspectives position us well to achieve our vision of being the region’s leader in patient centered care,” says Kozel.

As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,300 employees, medical staff, board members and volunteers work with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

Telemedicine, Virtual Health Coaches, and Other Wonders: The Future of Health in Kent County, Part 1

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UM Shore Regional Health Center – Chestertown

Small rural hospitals are an endangered species everywhere in the U.S. In Kent County, an intense, citizen-led campaign to save the Chestertown hospital has made progress, but—contrary to recent press reports—the hospital’s fate is still uncertain. Shore Regional Health, part of the University of Maryland Medical  System that provides healthcare to 5 mid-shore counties and which owns and operates the Chestertown facility, has said it would like to maintain in-patient services in Chestertown after 2022, as part of a broader plan to upgrade healthcare on the Eastern Shore.  But doing so will be contingent on legislative or regulatory changes to establish a new reimbursement model for vulnerable rural populations. Whether such legislation is passed is likely to depend on recommendations in the upcoming report of the Maryland Rural Health Study, due this September.  Watch this space for an in-depth report when the recommendations are released.

But the future of the hospital—as a full in-patient facility or as a standalone medical facility with more limited services—is only one of the factors that are likely to shape healthcare in the county in coming years. Moreover, a just-released nationwide assessment of the quality of health—county by county within each state—finds that Kent County has lots of room for improvement. It ranks only 18th (out of 24 Maryland counties) in health outcomes, far behind Talbot (5th) and Queen Annes (7th), and only barely ahead of Caroline and Dorchester.

Healthcare is changing rapidly, driven by both economic pressures (healthcare expenditures make up nearly 20% of the U.S. economy, far above all other industrial countries) and by new technology.  Shore Health’s strategic plan for the Eastern Shore deals with both aspects, but focuses on improving access to care, while also implementing services that can help keep people out of hospitals. Here we profile some technologies and other innovations likely to impact our healthcare in one form or another in coming years, drawing on both local and national examples.

Transport. A big unmet need in Kent County, as in most rural areas, is transport to get people to care.  That could take the form of local transport—to see a doctor, then pick up medicines at a drugstore—or could mean emergency transport by van or helicopter to a distant hospital. One model for local transport could be a kind of “Uber for healthcare” service that would allow people without cars or who can’t safely drive to arrange pickup and transport when they need it with just a phone call or an app. Potentially, a similar service—private but subsidized, or run by a healthcare system or insurer—could also provide transport services to regional hospitals. Will any of these happen? Such services are being started or are under discussion in a few places already, but whether they happen here may depend on local initiatives and some state financing.

Telemedicine and Telehealth. Under the best of circumstances, however, it’s a hassle to drive across the bridge to consult a surgeon or a specialist not found on the Eastern Shore. Suppose instead you could talk to them over a video link from a local facility or, eventually, even from home? As it happens, Shore Regional Health is already gearing up for telemedicine services on the Eastern Shore, in part under a grant from the Maryland Health Care Commission. In April the first patient, a 22-month old boy brought to the emergency room at the Easton Hospital, was linked in minutes to a specialist at the University of Maryland Medical Center in downtown Baltimore—resulting in a diagnosis, immediate treatment, and referrals for followup. “Bridging the gap between the eastern and western shores is a wonderful opportunity that this technology has given us,” says Marc T. Zubrow, MD, vice president of telemedicine for the University of Maryland Medical System. “We will continue to enhance and expand the telemedicine capabilities [to] allow patients to receive the expert care they need without having to leave their local communities and support systems.”

Telehealth refers to broader, non-emergency services at a distance, linking patients at home to doctors or nurses via voice or video or data links. A patient with high blood pressure at risk for stroke, for example, might periodically measure his or her blood pressure at home with a device that transmits the data to be screened automatically by an algorithm and checked periodically by a nurse. Many wearable or in-home sensors capable of monitoring chronic health conditions are now available. Telehealth calls or data streams can also record physical exercise, help patients to improve their nutrition, help a mother decide whether her baby’s fever is high enough to need a doctor’s care, or address other health concerns. The savings in costs and peace of mind could be substantial, and sometimes life-saving.

In-home Care. Some health conditions call for personal contact by a nurse, physical therapist, or health coach. Increasingly, taking care to the patient at home is not only less expensive than institution-based care, but sometimes far more effective—as well as overcoming the necessity to travel and the tendency to put off seeking care.  Surgical aftercare through home visits is now common, in-home infusions or dialysis or massage therapy constitute a growing trend.  Regular visits by a nurse or a health coach, especially for seniors with chronic conditions or for those struggling with opioid and other addictions, are being tested or considered in many places, and there is some evidence that such visits are more effective in helping people adopt healthy behaviors than care in an institutional setting—as well as less expensive. Assistance with non-medical tasks of daily living that are important to maintaining health are now often provided by volunteers, but increasingly such wellness services are being viewed as a part of basic healthcare. In one instance in California, simply inspecting homes of seniors and installing grab bars or stair railings or replacing loose rugs cut the number of falls (and the resulting hospital stays) in half.

The Amazon Dot, a smaller version of the Amazon Echo, can help with daily tasks, make phone calls, answer questions, even remind a person to take medication at a certain time.

A Virtual Health Coach. Millions of people now have an Amazon Echo and its voice-driven intelligent assistant, Alexa, that they use to order new supplies, turn on lights, or play music—just by talking to it.  Now Alexa (and similar voice-based systems from Google and Apple) are starting to be used in healthcare. Alexa can answer questions about your conditions or symptoms or an upcoming doctor’s appointment, remind you to take medicines or order refills, or provide updates on vital signs or pain levels to a remote nurse—all without touching a computer. If you fall, Alexa can call the ambulance. For patients with limited eye sight or who are bed-ridden, Alexa can become a constant companion and a vital link to assistance.

Expert Assistance. Increasingly, large organizations are using artificial intelligence tools to mine large datasets and “learn” how to do things more effectively. So as voice-driven systems interact with millions of patients, asking them about their symptoms—and that data is coupled to the clinical signals provided by in-home sensors for blood pressure, blood sugar, fever, etc.—it’s not very far fetched to imagine that IBM’s Watson or other AI systems may be able to diagnose many health conditions as well as even the most expert doctors—and enable earlier diagnosis and treatment—all without leaving home.

If such things seem hard to imagine, remember that Kent County will soon have the essential infrastructure—near universal access to fast internet connectivity.  Keeping in-patient services at the hospital would be important (and might take some lobbying with lawmakers in Annapolis).  But in the long run, improved access to care through the new tools and services described above, especially for vulnerable populations, may be even more important for the future of health than what kind of local health facility we have.

The Amazon Echo with “Alexa,” your new personal – and maybe even healthcare – assistant.

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Happy Crates! Sends Smiles While Helping to Fight Childhood Cancer

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The Leonards – Derrick, Darren (with Gemma the Giraffe), Mia, Lauren, Matthew

Lauren and Derrick Leonard know what it means to see a child’s smile.

They learned that important lesson when their oldest son, Darren, was diagnosed with a brain tumor shortly after birth. Baby Darren was given only a few months to live. But he’s still here – still very much alive – eight years later.  As Lauren writes, walking the halls of hospitals in the days, months, and then years after that diagnosis, they learned “the true value of a smile.”

As a result of their experience, the Leonards have created Happy Crates, a company dedicated to bringing smiles to children with cancer. The idea is simple: whenever someone buys a “Happy Crate”, a box filled with toys, books, games and other fun items for a child, part of the proceeds goes to send another Happy Crate – free of charge – to a child with cancer. Another portion goes to fighting childhood cancer.  Everyone knows how excited  children can get when they receive a package in the mail – something just for them with their own name on it!  You can order a single Happy Crate or get a six-month subscription with your child receiving a different Happy Crate each month while you get the warm glow of knowing that somewhere another child, one with cancer, is also receiving a Happy Crate. Details are available on the Happy Crates website.

The Leonards – Lauren, Derrick, Darren, their two younger children Mia and Matthew, took part in a ribbon cutting at USA Fulfillment in Chestertown June 29, launching a partnership with the company to ship the crates nationwide. Both sets of grandparents were there. Lauren described the company’s origins and its mission, saying their purpose is to keep fighting and giving children something to bring a smile to their lives.

USA Fullfillment employees turned out in force, all wearing t-shirts with slogan to End Childhood Cancer. VP Jay Stamerro on right with microphone.

Ready, set, go!

And it’s Officially Open!

Chestertown Mayor Chris Cerino and USA Fulfillment vice president Jay Stamerro welcomed the family, their friends and supporters. After the ribbon-cutting ceremony, everyone was invited to come into the USA Fulfillment building for refreshments.  There was a beautiful cake with blue icing, trimmed with blue roses and, in white icing, the words “Happy Crates – Smiles Delivered.  One Step Closer to a Cure, One Smile at a time.”  After the refreshments, everyone went upstairs for a tour of the distribution center where the colorful crates are filled and stored awaiting shipment. Quite a few have already been purchased and shipped since the website went live last week.

A sample of the crates’ contents was on display, along with t-shirts bearing slogans for the fight against cancer. The toys are all from smaller, upscale toy companies, Lauren said.  This is to help ensure that what the child receives is unique, special and not something they may already have in their toy box. So nothing from big box stores.

Sample Happy Crates

Lauren said she worked hard to get t-shirts that had interesting and stylish designs without losing the message.  She said it was hard to find attractive apparel about fighting cancer. The percentage that goes to their mission varies from 20-50%, depending on the item.  The sale of two t-shirts, for example, will support one Happy Crate for a child with cancer.  All items can be bought on the website and help support the Happy Crates mission to bring smiles to kids with cancer while helping the fight to end childhood cancer.

Sample Happy Crates

Mid-Shore Health: The YMCA’s Winning War against Diabetes

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There are a few things that the local health community knows about type 2 diabetes. The first is that it is an epidemic, with close to 28 million Americans already diagnosed facing a lifetime of a disproportionately higher risk of heart attacks, strokes, kidney disease, and a variety of other conditions that often lead to chronic disabilities and death.

The second is that close to 100 million Americans are assumed to be prediabetic. That’s right, about 100 million folks are walking around who could very quickly transition to a condition is experts say is the 7th leading cause of death.

The third is that those whose blood tests indicate a prediabetic condition can dramatically reduce the odds of developing full-blown diabetes by shedding 7% of their weight and committing to some form of exercise for at least 150 minutes a week.

That third fact is what the YMCA of the Chesapeake is now focused on.

Working with adults who are prediabetic, the Y has created year-long classes and support groups throughout the Mid-Shore to slowly and methodically educate their members that their pre-diabetic condition can be controlled or even eliminated with simple, common sense eating and light exercise.

Under the direction of Bridget Wheatley, the YMCA’s Diabetes Prevention Program Director, these outreach efforts are now starting to show some stunning results in the first two years of operations. The three formal classes are running at capacity, and more and more participants are forming informal support groups to maintain personal goals.

The Spy caught up with Bridget and several members of the Y’s support group in Denton a week ago to talk about their experience and the extraordinary sense of well-being that has come with modest changes in lifestyle.

This video is approximately five minutes in length. For more information about the YMCA of the Chesapeake and its Diabetes prevention programs please go here