County presents an­nual health care re­port card

Times-Record - - News - By ABBY AN­DREWS aan­drews@car­o­line­times­record.com

DEN­TON — Caro­line County has greatly in­creased health care ac­cess for its res­i­dents over the past year, but more much-needed im­prove­ments are on the way, as the county ad­dresses sev­eral key in­di­ca­tors of over­all health in which it still lags.

Those achieve­ments and plans for the fu­ture were pre­sented Tues­day, Dec. 6, at an an­nual progress re­view.

“Maybe we’re step­ping into the fu­ture,” said Caro­line County Com­mis­sion Pres­i­dent Wil­bur Le­ven­good. “It’s been dark here a right good while.”

Dr. Le­land Spencer, Caro­line County health of­fi­cer, opened the pre­sen­ta­tion by re­view­ing statis­tics com­piled by the Uni­ver­sity of Wis­con­sin’s Pop­u­la­tion Health In­sti­tute.

Re­gard­ing qual­ity of life and length of life, Le­land said, re­searchers found Caro­line County ranked 23rd out of 24 ju­ris­dic­tions in Mary­land, ahead of only Bal­ti­more City.

The main fac­tor driv­ing down Caro­line’s rank­ing was its rate of pre­ma­ture deaths, Spencer said.

Bal­ti­more City’s high rate of pre­ma­ture deaths can be at­trib­uted to the num­ber of homi­cides, Spencer said, but in Caro­line County, those deaths are mostly caused by res­i­dents’ health be­hav­iors and a lack of clin­i­cal care.

Adults and ado­les­cents both smoke at a high rate in Caro­line County, Spencer said. Caro­line’s lung can­cer rate is 25 per­cent above the na­tional av­er­age.

Adults also have a high rate of obe­sity and in­ac­tiv­ity, Spencer said, con­tribut­ing to the rate of chronic dis­eases, heart dis­ease and strokes in the county, which lead to many pre­ma­ture deaths.

Caro­line County is No. 1 in the state for ac­ci­den­tal deaths, Spencer said, many of which are caused by ve­hi­cle col­li­sions. Half of those fa­tal col­li­sions were re­lated to al­co­hol use. There is also a high rate of drug over­dose deaths, he said. On the other side of the equa­tion is the dearth of clin­i­cal care. Spencer said Caro­line County has the worst ac­cess in the state, par­tic­u­larly lack­ing pri­mary care physi­cians and men­tal health and ad­dic­tion care providers.

Its res­i­dents record an ex­ces­sive num­ber of pre­ventable hospi­tal stays, dou­ble the state av­er­age, be­cause they do not seek treat­ment for a chronic dis­ease un­til it gets so bad they have to go to a hospi­tal, Spencer said.

As a re­sult, Caro­line County’s av­er­age life ex­pectancy is 76 years, four fewer than the statewide av­er­age, Spencer said.

But progress is be­ing made to ad­dress those short­falls, Spencer said.

“Caro­line is do­ing a tremen­dous job work­ing to­gether,” Spencer said. “Strate­gic plan­ning is in the works for all is­sues, seek­ing com­plex so­lu­tions to com­plex prob­lems.”

Spencer said in the 10 years he has worked for the Caro­line County Health De­part­ment, the strate­gies im­ple­mented to im­prove res­i­dents’ health have grown.

“The prob­lems are big, but I think we’ve laid the foun­da­tion to see big changes down the road,” Spencer said.

Rep­re­sen­ta­tives of sev­eral of the part­ners who are work­ing to im­prove health care ac­cess, in­clud­ing Shore Re­gional Health, Chop­tank Com­mu­nity Health Sys­tem, Com­pass Re­gional Hospice and the Caro­line Drug and Al­co­hol Abuse Coun­cil, spoke about their re­spec­tive or­ga­ni­za­tions’ progress over the past year, and plans for the com­ing ones.

Kath­leen McGrath, re­gional di­rec­tor of out­reach and busi­ness de­vel­op­ment for Shore Re­gional Health, said in the past year, the health sys­tem has opened the first ur­gent care cen­ter in Caro­line County, ChoiceOne Ur­gent Care in Den­ton.

Shore Re­gional Health has also strength­ened part­ner­ships to im­prove tran­si­tional care for pa­tients af­ter they leave the hospi­tal, to re­duce emer­gency de­part­ment vis­its and avoid­able hospi­tal ad­mis­sions; to pro­vide bet­ter ser­vices for se­nior cit­i­zens and peo­ple with dis­abil­i­ties; and to bet­ter ad­dress be­hav­ioral health needs, McGrath said.

In 2016, the fourth of five $120,000 grants from Shore Re­gional Health was pre­sented to the Caro­line County com­mis­sion­ers, McGrath said, to main­tain its emer­gency trans­porta­tion fleet, since the county does not have an emer­gency de­part­ment.

In 2018, Shore Re­gional Health will open a new Den­ton med­i­cal of­fice, McGrath said. The 50,000-square foot, two-story build­ing, at the in­ter­sec­tion of state Route 404 and Deep Shore Road, will of­fer fam­ily medicine, di­ag­nos­tic imag­ing and lab ser­vices, a pad for a mo­bile CT scan­ner, spe­cialty providers, an ed­u­ca­tional suite, re­ha­bil­i­ta­tion, a be­hav­ioral health “bridge” clinic, home health care and dial­y­sis.

Dr. Jonathan Moss, chief med­i­cal of­fi­cer for Chop­tank Com­mu­nity Health Sys­tem, said the sys­tem, which has pro­vided med­i­cal and den­tal care in Caro­line County for 36 years, hired sev­eral new providers for all three of its county cen­ters in 2016, in­clud­ing fam­ily physi­cians, nurse prac­ti­tion­ers, li­censed clin­i­cal so­cial worker coun­selors and pe­di­a­tri­cians.

Su­san John­son, vice pres­i­dent of qual­ity and pop­u­la­tion health, said Chop­tank now has two nurse care co­or­di­na­tors and will soon im­ple­ment a new soft­ware sys­tem that will al­low it to track pa­tients across the health sys­tem and bet­ter de­velop in­di­vid­ual care plans for them.

Al­li­son Wood, mar­ket­ing co­or­di­na­tor for Com­pass Re­gional Hospice, said the Queen Anne’s County-based hospice provider went re­gional two years ago, and now pro­vides ser­vices in Kent and Caro­line coun­ties.

In Caro­line County, the re­gional provider col­lab­o­rated with the Caro­line Hospice Foun­da­tion to re­open the three-bed hospice house in Den­ton, which Wood said has been heav­ily used.

In ad­di­tion to hospice care in nurs­ing homes, the Den­ton hospice house and pa­tients’ own homes, Wood said, Com­pass pro­vides grief sup­port pro­grams for fam­i­lies, in­clud­ing one specif­i­cally for chil­dren.

Dave Wha­ley, of the Caro­line Hospice Foun­da­tion, said the ser­vices pro­vided in the Den­ton hospice house are paid for 100 per­cent by do­na­tions to the Caro­line Hospice Foun­da­tion.

Wha­ley said use of the house in its first year ex­ceeded pro­jec­tions by 35 to 40 per­cent; it cost the foun­da­tion $388,000 to pay for the pro­fes­sional ser­vices pro­vided by Com­pass, foun­da­tion salaries and up­keep on the house.

The Caro­line Hospice Foun­da­tion does not re­ceive any lo­cal, state or fed­eral money, Wha­ley said. It runs 100 per­cent on do­na­tions and fundrais­ers.

Holly Ire­land, ex­ec­u­tive di­rec­tor of Mid-Shore Be­hav­ioral Health, said the Caro­line Drug and Al­co­hol Abuse Coun­cil’s mis­sion is to con­tin­u­ally im­prove the net­work of care re­sources for sub­stance use dis­or­ders in Caro­line County.

Ire­land said the coun­cil has part­nered with the Caro­line County Health De­part­ment, law en­force­ment, the Caro­line County Board of Ed­u­ca­tion, faith-based or­ga­ni­za­tions, the county gov­ern­ment and the Caro­line County De­part­ment of So­cial Ser­vices.

Among its pri­or­i­ties are re­duc­ing the avail­abil­ity of al­co­hol to mi­nors, re­duc­ing the avail­abil­ity of opi­oids and re­lated over­dose deaths and mak­ing med­i­cal-as­sisted opi­oid treat­ments more widely avail­able, Ire­land said.

The plan to achieve those goals, Ire­land said, in­cludes pro­mot­ing ac­cess to be­hav­ioral health care; in­creas­ing the ed­u­ca­tion, train­ing and size of the care provider work­force; us­ing data and tech­nol­ogy to eval­u­ate and im­prove ser­vices; and in­creas­ing pub­lic aware­ness and sup­port for be­hav­ioral health needs and ser­vices avail­able.

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