County presents annual health care report card
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.