UM Shore Regional Health’s 2018 Community Health Improvement Report has been published online and is available for viewing at https://www.umms.org/shore/news/2018/um-shore-regional-healths-2018-community-health-improvement-2018.

UM Shore Regional Health’s most recent Community Health Needs Assessment (CHNA), conducted in 2016, identified top health concerns in the region: chronic disease management (obesity, hypertension, diabetes, tobacco use), behavioral health, access to care, cancer, outreach and education (preventive care, screenings, health literacy).These are the same top health concerns and health barriers indicated by the overall Maryland Department of Health and Mental Hygiene State Health Improvement Process (DHMH SHIP) county data.

UM SRH determined that the greatest transformation in population health in the five-county region would be achieved by focusing on chronic disease management, behavioral health and cancer screenings. An implementation plan was developed for each priority, with key activities to improve care coordination and health education in community settings.

As detailed in the new report, the total value of UM Shore Regional Health’s community health improvement initiatives during 2018 exceeds $40 million. According to Ken Kozel, UM SRH president and CEO, and Kathleen McGrath, regional director, Outreach and Community Health, the document “reflects UM Shore Regional Health’s commitment to building community partnerships that help foster better health outside the walls of our hospitals and outpatient facilities, while enhancing access to care and the overall quality of life in the five counties we serve.”

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 2,500 employees, medical staff, board members, and volunteers works with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

More than a year after a controversial end-of-life law went into effect in the District of Columbia, advocacy groups say they are now seeing a higher public response to its efforts to ensure city residents know the law exists.

How many people have used the law will become clearer in an upcoming February report. As of last April, no patient had yet used the law, according news accounts.

The Death with Dignity Act allows mentally capable, terminally ill adults with six months to live to request lethal doses of prescription medication so they can die peacefully and comfortably in their homes or any place where they have been granted permission to do so.

One of the law’s main proponents, Compassion & Choices, has helped the District of Columbia Council advocate for the legislation and educate Washington residents about the new option for patients with terminal illnesses.

The administrative side of the end-of-life process apparently has dissuaded physicians, pharmacists and patients from using the law, but local public service announcements have helped spike interest and attention, Sean Crowley, spokesman for Compassion & Choices, told Capital News Service in an interview.

His group declined to say how many doctors in the District registered to use the law, as it did not have access to such records. But as of last April, only two doctors among the roughly 11,000 doctors in the city had registered to use the law and just one hospital had approved doctors for the practice, according to The Washington Post.

The District of Columbia Department of Health is set to release a detailed report in February on how many patients have utilized lethal drugs and how many physicians have administered them. But to date, no patients have volunteered to go public with their stories.

During September, Compassion & Choices distributed television public service announcements promoting the end-of-life law, featuring prominent Washingtonians Diane Rehm, a former WAMU radio show host, and Dr. Omega Silva, a retired physician.

The announcements, which began Labor Day weekend, aired on various Comcast stations. Compassion & Choices reported that there were 229 visits to the group’s page during September, compared to only 56 for the same month a year ago – a 400 percent increase.

In addition to the District, six states have end-of-life, or physician-assisted dying laws: California, Colorado, Hawaii, Oregon, Vermont and Washington, according to the nonprofit Death with Dignity National Center, based in Portland, Oregon.

Efforts to pass a similar law in Maryland have been unsuccessful.

Since the District’s end-of-life bill was introduced in 2015, organizations such as Right to Life and conservatives in Congress have opposed it and tried to defund it.

Rep. Andy Harris, R-Cockeysville, introduced an amendment in 2017 to defund and repeal the law. The amendment failed to pass the House Appropriations Committee.

Harris, a physician, criticized what he called “the so-called Death With Dignity Act,” saying “most people don’t associate suicide with dignity in any way shape or form.”

“It sends a strong message that regardless of the many types of disease you might have and the many types of treatment that may be available, there is one common pathway that in this case the District would say is perfectly acceptable, it is legal,” he said. “It’s actually to go to a physician and ask if they can participate in your suicide. That doesn’t lead to more choice – that leads to one choice.”

The House will be controlled by the Democrats next month, making the prospects for repealing the District bill more remote.

In any case, Crowley said that “lawmakers from outside the District should not dictate to district lawmakers what laws they should pass for their local constituents.”

“Other states would never allow lawmakers from outside their state dictate what their states can do,” he said. “Why should they be allowed to dictate in D.C.?”

Since its founding as the seat of the federal government, the District of Columbia has not had voting representation in Congress, although it has some limited autonomy. Even so, Congress has the power to review and repeal District laws.

“That Congress thinks it should substitute its judgment for the judgment of the residents of the District of Columbia is odious enough,” said Councilmember Mary Cheh, who sponsored the end-of-life bill. “That it would presume to substitute its judgment for the judgment of people who are dying is unconscionable. Such an action is fundamentally undemocratic and it should not stand.”

By Morgan Caplan

As we complete a week dedicated to the awareness of suicide, it is important to review this manifestation of mental illness and what the community and we, family, friends and mental health professionals, can do to address this crisis.

Statistically, it is staggering that suicide is the 3rd Leading cause of death in 15 to 24 year-olds and the 6th leading cause of death in 5 to 14 year-olds according to data from the American Academy of Child and Adolescent Psychiatry (AACAP, Facts for Families, 2013). Center for Disease Control data from 2005 indicated that among 15 – 24 year-olds, suicide accounts for 12.9% of all deaths annually.

This is particularly a concern for high school students who, in a study by Eaton et al in 2006, indicated at 16.9% of all high school students seriously considered suicide in the previous twelve months before the study. Additionally, there are significant cultural differences. The same study documented that Hispanic female high school students reported a higher percentage of suicide attempts than their non-Hispanic peers.

These statistics, however overwhelming, are only overshadowed by the unrelenting pain suicide inflicts on surviving family and friends. Some professionals contend that suicide cannot be prevented but mitigated by focusing on providing alternative choices to desperate situations. That providing those in emotional distress with more appropriate choices to manage their feelings and instead of self harm, utilize different coping skills when overwhelmed.

To that end, open discussion about suicidal behavior and feelings as well as providing alternatives to self harm, are the goal of therapy and community support.
Providing tools to children and their families including crisis lines, access to mental health services and other professional support is key.

Recognition of potential risk factors that indicate emotional distress and could lead to suicidal thoughts or behavior is everyone’s responsibility.
Potential risk factors, described by AACAP (2004), include:

Prior suicide attempts
Substance Abuse
Change in sleeping/eating habits
Withdrawal from family and friends
Unusual neglect of personal appearance
Violent, rebellious behavior
Loss of interest in pleasurable activities
More severe psychiatric symptoms (psychosis)
Complain of feeling “bad” or “rotten” inside
Put his or her “affairs in order”
Verbalize suicidal thoughts or feelings

Underlying mental illness, lack of family and social support as well as limited coping skills also play a pivotal role in suicidal behavior.

How can we, as family, friends and community, help?
Some basic interventions include:
Take threats seriously; notify police or mental health professionals
Be suspicious when there are serious psychiatric symptoms or substance abuse issues
Keep lines of communication open
Seek professional support

Eastern Shore Psychological Services (ESPS) has therapists in all the Talbot County schools working hand in hand with the school guidance counselors ready to help.
ESPS offers mental health, substance abuse and wellness services for all ages. For those seeking mental health services, ESPS offers “same day access” appointments Monday – Thursday at 8 AM at their office at 29520 Canvasback Drive.  For more information, please contact the Clinic at 410-822-5007.

Laurence Pezor, MD is the Chief Medical Officer at Child and Adolescent Psychiatrist with Eastern Shore Psychological Services.

As many as 260,000 Maryland residents could see higher premiums or lose their health care coverage altogether because of pre-existing medical conditions, age or gender under a new Trump administration legal strategy, state Democrats warned on Tuesday.

Rep. Elijah Cummings, D-Baltimore, along with other Democratic members of the Maryland congressional delegation and state Attorney General Brian Frosh attacked the Trump administration for refusing to protect Americans guaranteed the right to health insurance under the Affordable Care Act.

The protections, the Democrats argued, are of the utmost importance and won’t be invalidated without a legal fight.

“We’re better than that,” Cummings said. “We’re a better country than that.”

In June, Attorney General Jeff Sessions wrote in a letter to House Speaker Paul Ryan, R-Wisc., that the Justice Department would not defend key provisions of the health care law, a regular target of attacks by President Donald Trump and repeal efforts by congressional Republicans.

Cummings released a report by the Democratic staff of the House Oversight and Government Reform Committee that detailed potential impacts of such a policy on Marylanders. Frosh is among more than a dozen attorneys general challenging Sessions’s decision in federal court.

“Even more troubling, they did not offer any alternative,” Cummings said at a press conference.

He was flanked by Frosh, Maryland Sens. Ben Cardin and Chris Van Hollen, and Reps. Dutch Ruppersberger of Timonium and John Sarbanes of Towson. All are Democrats.

Trump has largely moved to defund the ACA since taking office, scaling back federal funding from $62.5 million in 2016 to just $10 million this year.

But Health and Human Services Secretary Alex Azar has challenged attacks on Trump’s handling of the health care law.

“The president trying to sabotage the (Affordable Care Act) is proving better at managing it than the president who wrote the law,” Azar said during a Sept. 27 speech in Nashville, The Washington Examiner reported.

Under the new Trump policy, 167,000 Marylanders with pre-existing conditions could lose coverage or face hikes in premiums, the Democrats’ study estimated. Of those, 79,000 have such severe pre-existing conditions that insurance carriers could deny them any coverage.

Up to 160,000 Maryland women could be charged more than men for the same health care coverage, the report said. Such discrimination was barred by the health care law.

In addition, up to 108,000 older Maryland residents could be charged more, according to the report.

Maryland workers in higher-risk occupations also could lose protections: 19,000 construction workers, 9,700 shipping clerks and 4,800 emergency medical technicians.

“Defending the Affordable Care Act will affect the lives of Marylanders and people all over this country,” Cardin said. “It’s critically important that the American people understand what’s at stake when the president does not defend the Affordable Care Act.”

A Kaiser Family Foundation poll released in September showed that 50 percent of adults held a favorable view of the ACA. Forty percent held an unfavorable view. Another Kaiser poll found that 75 percent of people polled said it was “very important” that the ACA’s protections for people with pre-existing conditions ensuring guaranteed coverage remains law.

“When the Trump Administration decided not to defend the law … they’ve given a green light to all those who want to undo that protection through the courts,” Van Hollen said.

Trump, who said during his campaign that he wanted to put somebody on the Supreme Court who would help overturn the ACA, has done just that in nominating Brett Kavanaugh. In 2011, Kavanaugh was the dissenter in a 2-1 federal appeals court ruling on the constitutionality of the ACA’s individual mandate provision.

Cummings said the administration’s hostility to the health care law has caused unease even among government attorneys.

“Their actions are so indefensible,” Cummings said, “that three of four career attorneys representing the government withdrew from the case rather than sign their names on the brief. One attorney even resigned.”

Joel McElvain and two other lawyers withdrew from the case this summer; he later resigned. All three worked on a lawsuit brought by Texas and other Republican-led states that challenges the constitutionality of the ACA and is likely to find its way to the Supreme Court.

by Jared Goldstein

Pictured is The Pam Ortiz Band, who will provide two benefit concerts this year as For All Seasons Suicide Prevention Campaign comes to Chestertown for the first time.

According to the Center for Disease Control (CDC) every 13 minutes someone dies by suicide and for every suicide, 25 suicide attempts are made. This fall, to help create awareness about this community mental health issue, For All Seasons is sponsoring its Annual NO MATTER WHAT . . . YOU MATTER Suicide Prevention Campaign, with two concerts in Chestertown this month.

To benefit the Campaign, The Pam Ortiz Band are holding concerts on both Saturday, September 29 at 7 p.m. and Sunday, September 30 at 3 p.m. at Robert Ortiz Studios at 207C S. Cross Street in Chestertown. Tickets cost $25 per person and can be reserved at ortizconcert.eventbrite.com or bought at the door. Chester River Wine and Cheese Co. will be selling wine and mini-cheese boards beginning at 6 p.m. on Saturday night. All proceeds will benefit For All Seasons suicide prevention efforts.

According to For All Seasons’ board member Pam Ortiz, “Harry Chapin used to say he played one night for himself and one night for the other guy. In that spirit, we will be doing the two shows to benefit our friends and neighbors served by For All Seasons, a behavioral health and rape crisis center serving the five Mid-Shore counties. These events will kick off the organization’s suicide prevention initiative, No Matter What…You Matter, in Chestertown.”

The Pam Ortiz Band includes Pam on vocals, Pam’s husband, Bob Ortiz, on percussion and guitar; Ford Schumann on guitar; Nevin Dawson on viola and violin; and Philip Dutton on piano and keyboards. The band has been performing in this configuration since 2012. In 2017 the group hosted a seven-concert series, Songs for Our Future, to packed houses. Each show raised funds for an organization that supported an important right or vulnerable group of people.

Monika Mraz, Director of Development at For All Seasons, comments, “We are thrilled to have the support of The Pam Ortiz Band as we promote awareness about suicide prevention in Kent County. This is a real issue in our communities on the Shore and we hope to enhance the community’s understanding of the issue, while providing some valuable tips in how to prevent suicide with our friends and family members.”

Suicide does not discriminate, affecting people of all genders, ages, and ethnicities. Many different factors may contribute to someone making a suicide attempt. For All Seasons hopes that by discussing the signs and symptoms associated with suicide that it can raise awareness about the issue in our community. Because family and friends are often the first to recognize the warning signs of suicide, they can be critical to helping an individual find treatment with a provider who specializes in diagnosing and treating mental health conditions.

According to the Center for Disease Control (CDC), for every suicide, 25 suicide attempts are made. For All Seasons wants people to know that If they think a friend or family member is considering suicide, they should reach out and start a conversation. Talking openly about suicidal thoughts and feelings can save a life. The following are three steps to help people begin the conversation:

1) Ask directly – “Are you having suicidal thoughts?” – Let them know you care.
2) Stay and Listen – Let them share their thoughts and feelings.
3) Get help – Connect them with a friend, family member or a therapist at For All Seasons.

Beth Anne Langrell, Executive Director of For All Seasons, comments, “For All Seasons hopes through this campaign to create an ongoing dialogue with agencies about this growing issue in our communities. We want people to know that no matter what, they do matter.”

For All Seasons provides Trauma Certified Individual, Family, and Group Therapy; Child, Adolescent, and Adult Psychiatry; and Crisis and Advocacy Services for Child, Adolescent, and Adult Victims of Sexual Assault, Rape and Trauma. If you or someone you know needs help, call 410-822-1018 for a same-day crisis appointment.

Throughout the year, For All Seasons brings awareness to the community about such issues as suicide, sexual assault, trauma, and mental health needs.
Follow For All Seasons on Facebook to find out how to get involved. For further information, call Monika Mraz at 410-822-1018, email mmraz@forallseasonsinc.org or visit forallseasonsinc.org/youmatter.

 The concerts will be held on Saturday, September 29 at 7 p.m. and Sunday, September 30 at 3 p.m. at Robert Ortiz Studios at 207C S. Cross Street in Chestertown. Tickets cost $25 per person and Chester River Wine and Cheese Co. will be selling wine and mini-cheese boards beginning at 6 p.m. on Saturday night. All proceeds will benefit For All Seasons suicide prevention efforts.

United Way releases surprising data on their 2018 Maryland ALICE Project which identifies households that have incomes above the Federal Poverty Level but struggle to afford basic household necessities. That finding is true for both Kent County and the rest of the state. 

The report, which uses 2016 data, shows that in Maryland 825,433 households or 38% could not afford basic needs such as housing, childcare, food, transportation, healthcare, and a smartphone. These statistics indicate an increase of three percent from last year’s report. Low-wage jobs, half of all jobs paying less than $20 per hour, and an increase in “gig” and contractual work all contribute to decreased financial stability for working households.

The ALICE Project utilizes standardized measurements to calculate the cost of a bare-bones household budget in each county in each state and quantifies the number of households that cannot afford even that. It includes Household Survival Budgets which have increased steadily, reaching $69,672 for a family of four (two adults with one infant and one preschooler) and $26,052 for a single adult in 2016. These conclusions are an alternative to FPL guidelines, which underestimates the number of struggling families as it does not accurately reflect current, local costs of living.

“At United Way of Kent County, the ALICE findings have reinforced our commitment to addressing the issues stressed in our Community Needs Assessment,” said Glenn Wilson, Board President, United Way of Kent County. “This updated research underscores our findings and highlights the issues that need more attention here and how to provide services to this vulnerable population.”

Following is the Kent County breakdown of Household Survival Budgets and percentage of households living below the ALICE Threshold:

“ALICE isn’t going away,” said Franklin Baker, president and CEO of United Way of Central Maryland “and as this latest report shows, the numbers are only increasing. We must continue to work together to help remove barriers in areas such as housing, transportation, and childcare that prevent so many of our citizens from leading a stable, secure life. Stronger, stable working families mean stronger, stable communities. And that’s something that United Way, our donors, volunteers, staff and partners fight for every day.”

The United Ways of Maryland join more than 540 United Ways in 18 states that are working to better understand ALICE’s struggles. The research will be used to stimulate meaningful discussion, attract new partners and ultimately inform strategies for positive change.

For more information on the ALICE report please go here

University of Maryland Shore Medical Center at Easton is featured among the Maryland hospitals recently ranked in U.S. News & World Report’s annual report on best hospitals nationwide. The Easton hospital was ranked second among the best hospitals on the Eastern Shore of Maryland and among the top 15 hospitals in the State of Maryland. The U.S. News ranking also gave special recognition to UM Shore Medical Center at Easton’s programs for patients with chronic obstructive pulmonary disease (COPD), heart failure and hip replacement received special recognition for high quality care.

“There are so many people who deserve credit for this excellent recognition – our team members, our physicians and advanced practice providers, our volunteers and our devoted community supporters,” says Ken Kozel, president and CEO of UM Shore Regional Health. “On behalf of the Board of UM Shore Regional Health and our senior leadership, I’m very pleased to express our appreciation for the outstanding teamwork that is helping us achieve our Vision, to Be The Region’s Leader in Patient Centered Health Care.”

Issued annually during the month of August, the U.S. News Best Hospitals nationwide analysis reviews 5,000 hospitals’ performance in both adult and pediatric clinical specialties, procedures and conditions. Scores are based on several factors, including survival, patient safety, nurse staffing and more. Hospitals are ranked nationally in specialties from cancer to urology and rated in common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. Hospitals are also ranked regionally within states and major metro areas.

Public Information Session July 31 to Share Proposed New State-of-the-Art Medical Campus in Cambridge, Offering 24/7 Emergency Care, Surgery Center, and Comprehensive Outpatient Services to Meet Dorchester Health Needs

Representing a significant step in a process that began more than two years ago, University of Maryland Shore Regional Health (UM SRH) has filed applications with the Maryland Health Care Commission (MHCC) seeking approval to transform and enhance the health care services offered in Dorchester County.

The filing, called a Request for Certificate of Need Exemption, describes plans to replace UM Shore Medical Center at Dorchester with a new state-of-the-art health care campus offering services including 24/7 emergency care and short-stay observation care, with proposed outpatient surgery center, diagnostic services, outpatient specialty medical care, chronic disease management services, telemedicine and enhanced outpatient behavioral health programs and services.

A free public information session is scheduled Tuesday, July 31, 6:30 p.m. to 8:30 p.m., at Cambridge-South Dorchester High School, to share the proposed plans for this new medical campus with a Freestanding Medical Facility (FMF), to be known as University of Maryland Shore Medical Center at Cambridge.

Aerial view of the proposed UM Shore Regional Health medical campus in Dorchester (design may be subject to change.)

The proposed medical campus is planned to be located approximately one mile from the current hospital, in Cambridge Marketplace, at Ocean Gateway (Route 50) and Woods Road. This location provides enhanced access to public transportation and ambulances and provides for an adjacent helipad for air transports.

Over the past two years, UM SRH discussed the changing health care environment with Dorchester County physicians, elected officials, Emergency Medical Services, public health and other health care partners, and community business leaders.  With their support for the possible conversion of the aged hospital in Dorchester to an FMF, and the  relocation of inpatient medical-surgical and behavioral health beds to nearby University of Maryland Shore Medical Center at Easton,  the discussions expanded to the wider Dorchester community through a series of community listening sessions around the County in 2017.  With positive feedback from these conversations, the Boards of University of Maryland Medical System (UMMS) and UM SRH moved forward with more detailed plans, leading to this month’s applications.

The proposed timeline for the opening of the new UM Shore Medical Center at Cambridge and the relocation of acute care inpatient beds to Easton is mid-2021, depending upon both State approval and funding.

With regulatory approvals, this new model of care will enhance the hospital’s ability to ensure services are available, keeping residents healthy in their community and reducing unnecessary inpatient admissions and emergency room visits.  This model also allows for the potential to provide ambulatory surgical care and intensive outpatient behavioral health treatment.

Plans for the sale and ultimate redevelopment of the existing hospital site, located on approximately 14 acres of Choptank River waterfront, took a step forward in May when the City of Cambridge and Dorchester County created a Memorandum of Understanding creating an entity, Cambridge Waterfront Development, Inc. (CWDI), designed to purchase the property, prepare it for development and negotiate its sale by 2021. A second step occurred in early June, as UM SRH CEO Ken Kozel, Cambridge Mayor Victoria Jackson-Stanley, and Dorchester County Council President Ricky Travers signed a Letter of Intent for continued negotiations leading to the future sale of the hospital property to CWDI when health care services transfer to Cambridge Marketplace.

SUMMARY: Proposed UM Shore Medical Center at Cambridge

Approximately 40,000 square foot state-of-the-art Freestanding Medical Facility (FMF), open 24/7/365, to include:

• 18 private emergency treatment rooms serving all ages
• 2 bed resuscitation/critical care suite, serving all ages
• 3 behavioral health rooms
• 10 private short stay observation beds
• Telemedicine capabilities for Emergency Department patient specialist consultation
• State-of-the-art diagnostic/treatment equipment and technology
• Diagnostic services to support emergency care, including CT, MRI, ultrasound and X-ray
• Laboratory services, 24/7
• Helipad for air transport

SUMMARY: Proposed Services- UM Shore Medical Pavilion at Cambridge

Approximately 50,000 square foot, two story facility housing diagnostic, treatment, community education and support services, including:

• Outpatient services/providers in specialties such as cardiology, diabetes/endocrinology, ENT (ear, nose, throat, allergy), gastroenterology, general surgery, gynecology, obstetrics (prenatal care), orthopedics, outpatient behavioral health, outpatient medical oncology, pediatrics and urology
• Ambulatory Surgery Center (1 OR and 1 procedure room)
• Outpatient rehabilitation services, including The Balance Center
• Cardio-pulmonary rehabilitation
• Fully integrated telemedicine services for specialist access
• Community health education hub

About University of Maryland Shore Regional Health

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 2,600 employees, medical staff, board members and volunteers work with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together. For more information, visit www.UMShoreRegional.org.

About the University of Maryland Medical System

The University of Maryland Medical System (UMMS) is a university-based regional health care system focused on serving the health care needs of Maryland, bringing innovation, discovery and research to the care we provide and educating the state’s future physician and health care professionals through our partnership with the University of Maryland School of Medicine and the UM Schools of Nursing, Pharmacy, Social Work and Dentistry in Baltimore.  As one of the largest private employers in the State, the health system’s 25,000 employees and 4,000 affiliated physicians provide primary and specialty care in more than 150 locations and at 14 hospitals.  UMMS’ flagship academic campus, the University of Maryland Medical Center in Baltimore, is recognized regionally and nationally for excellence and innovation in specialized care.  Our acute care and specialty rehabilitation hospitals serve urban, suburban and rural communities and are located in 13 counties across the State. In addition, UMMS operates health insurance plans serving Medicare and Medicaid members. For more information, visit www.umms.org.