Health group hones pri­or­i­ties

Kent County News - - NEWS - By DO­RIAN MITCHELL dmitchell@thekent­coun­

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

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