Health group hones priorities
CHESTERTOWN — The state workgroup studying health care delivery in rural areas was in Chestertown May 24, holding an afternoon meeting at Washington College before listening to public comments at a hearing later that evening.
How to successfully establish a cross-jurisdictional planning council, better link rural county residents to existing health resources and further enhance how care is implemented were among the priorities discussed by the Maryland Health Care Commission’s Rural Health Care Delivery Plan Workgroup.
This was the workgroup’s fifth meeting. The group is responsible for developing a plan that meets the health care needs of the five MidShore counties.
The panel included health care representatives, elected officials and business owners from different counties. The session was led by workgroup chairmen Deborah Mizeur, owner of Apotheosis Herbs in Chestertown, and Dr. Joseph Ciotola of the Queen Anne’s County health and emergency services departments.
“Today, as they say, we will be drilling into the weeds of it all,” Ciotola said.
Luisa Franzini, a member of the University of Maryland School of Public Health research team, gave a presentation on the results of stakeholder and focus group interviews. Both were conducted in communities across the five counties and the participants ranged from health care professionals to residents.
Results showed people preferring their own primary care physician — or more personal relationships between doctors and patients — over a hospital and the desire to have a council of both citizens and experts to oversee rural health care needs.
Respondents also thought it important to find ways to improve how mental and behavioral health issues are treated and how to better provide care for vulnerable populations such as the very young and the elderly.
“The status quo cannot continue as is. Residents and stakeholders are interested in an immediate action plan that has their input,” Franzini said. “For it to work, how rural health is implemented will require innovative and flexible strategies.”
Another component of the study showed each county’s main concern regarding health care. For Kent County, it was enhancing University of Maryland Shore Medical Center at Chestertown’s inpatient bed services, particularly for elderly patients and creating a community advisory board.
Legislation from last year’s General Assembly mandated that Shore Medical Center will retain inpatient beds until 2020, with Shore Regional Health extending that to 2022.
“Outreach also is needed, because there has been a very rocky relationship with the community that needs to be repaired,” Franzini said.
Other aspects of the study revolved around what can be done to attract both health care providers and professionals to rural areas and economic development, in terms of bringing “economic engines” to the MidShore.
“There is a growing understanding that each community cannot have every type of health care,” Franzini said. “Experiences reflect that planning for health service needs should incor- porate the unique nature of each locale and its population needs.”
After the presentation, Mizeur and Ciotola went over recommendations from the workgroup’s advisory boards. Like the feedback from the study, one of the boards’ main recommendations was establishing a regional health planning council.
“It really allows rural areas to tailor for themselves, with input from the community and providers, their own idea of what rural health care should look like,” Mizeur said.
Most of the panel agreed with the concept of such a council. Some had questions, like how to best pool each county’s resources — such as the health departments — together, who would serve on the council and what degree of authority it would have.
“Our health planning council has been effective because it brings a lot of creative ideas together,” Garrett County Memorial Hospital President and CEO Mark Boucot said. “It actually doesn’t have any authority. The only thing it has is to develop its own creativity by pulling constituents together.”
He said through collaboration, the council has received several grants to be used toward further planning for community health.
Another issue was transportation and how it can be improved to serve those in rural settings. Possible solutions were expanding mobile integrated health care resources and better coordinating the efforts of emergency medical services and community health workers.
Shore Regional Health President and CEO Ken Kozel said emergency medical services are “well appreciated” on the Mid-Shore. He singled out Queen Anne’s County’s expanded EMS division for praise and suggested other counties offer similar services.
“We have great faith and belief in this program. We see it as a benefit to the system and to the community,” Kozel said.
Other recommendations included the enhancement of behavioral health services in communities, the expansion of home health services and offering rural scholarships to medical students as a means of recruitment.
Gene Ransom, president of the state’s medical society and a former Queen Anne’s County commissioner, suggested there be a recommendation to combat substance abuse and addiction, particularly for the use of opiates.
Mizeur said she was not only “heartened” by the involvement of those at the May 24 meeting, but also glad to see such a response from the community on the future of rural health.
“I’m heartened to see citizens are this involved and engaged about this process,” she said. “I’m heartened to see that what they are saying has great alignment with what we’re talking about here.”
The workgroup held a public hearing on the delivery plan later that night.
Another public hearing will be held from 6 to 8 p.m. Thursday, June 1, at the Hurlock Volunteer Fire Company in Dorchester County.
The next Rural Health Care Delivery Plan Workgroup meeting is set for July and will be held at Chesapeake College in Wye Mills. The group meets every eight weeks, until the Rural Health Care Delivery Plan is due to the General Assembly in October.
Maryland Rural Health Care Delivery Plan Workgroup co-chairman Deborah Mizeur discusses a recommendation to better deliver rural health care while co-chairman Joseph Ciotola listens during a May 24 meeting at Washington College. PHOTO BY DORIAN MITCHELL