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