Heath care commission public hearing in Caroline County
DENTON — Caroline County residents spoke at a public hearing Tuesday, June 13, about strengths and weaknesses of existing health care access in the county, and what they would like to see in the future.
The hearing, hosted by the Rural Health Care Delivery Work Group, was the final of five such public hearings — one in each Mid-Shore county — held over the past few weeks.
The work group will use input gathered at the hearings to make recommendations to the Maryland Health Care Commission and state legislators for improving health and well-being on the Mid-Shore and in a rural areas around the state, said Dr. Ben Steffen, executive director of the Maryland Health Care Commission.
“This is the start of a process,” Steffen said. “At the end of the work group, we won’t have a full solution yet, but ideas.”
At the Caroline County meeting, held at Denton Elementar y School, residents spoke about the strength of the partnerships between many agencies and departments within the county, but a lack of resources.
Ryan Todd, emergency medical services division chief for the Caroline County Department of Emergency Ser vices, said emergency transportation is a challenge, due to both the location of emergency departments — all outside the county, as opposed to one central emergency department within it — and Caroline’s geography, a tall, skinny county bisected by the Choptank River.
Todd said he understands Caroline County does not have the population to support a hospital, but he would like to see a freestanding emergency facility that can hold patients for observation.
He said the county also needs transportation alternatives for people who cannot drive themselves to routine doctor appointments, but also cannot call a taxi or an Uber. Instead, Todd said, those patients have to wait until they have an emergency, to call 911.
Todd praised Choptank Community Health System and University of Maryland Shore Regional Health for strides in increasing patients’ case management, but said more needs to be done.
“We need everyone to bring (patients’) information together to provide more global treatment,” Todd said.
Recruiting and retaining skilled EMS workers is also a challenge in Caroline County, Todd said, as many entry-level employees use the county as a training ground before accepting jobs with neighboring jurisdictions that can pay more.
Dr. Derek Simmons, director of student services for Caroline County Public Schools, said the many partnerships within the county are admirable, but they can also stretch ever yone thin.
Simmons pointed out Caroline County is the only county in Maryland with a wellness center in each of its public schools, thanks to a partnership with Choptank Community Health, which has increased behavioral health services for students, but more is needed.
“Studies show traumatic childhood experiences can lead to longterm health issues later in life if they don’t have support,” Simmons said, including drug addiction, which ties into the opioid abuse epidemic.
A move to a fee-for-services model has made it even more difficult for lower income students to access those services, Simmons said, though providers Corsica River Mental Health Services and For All Seasons have been able to procure some grants to cover fees for some students.
“Behavioral health care is preventative care,” Simmons said. “There aren’t a lot of behavioral health providers in the area even if we had the money to hire them, but we would make room for them in the schools if we could get them. It would help the access issue a lot if they were in schools.”
David Rosario Torres, who said he used to work as a community outreach worker with the state’s Wellmobile, providing mobile health care, said a lack of providers is a problem.
He said he called Choptank Health earlier that day out of curiosity, to see how long the wait would be for a new patient to make an appointment. He said he was told three months.
“If someone had the flu, they would have to call 911,” Torres said.
Sue Simmons, director of the Caroline County Department of Recreation and Parks, said she was concerned about the number of people who work two or three low-wage jobs yet are still unable to afford health insurance.
“Federal reform could add to that shortfall,” Simmons said.
Simmons said the community spaces, like a recently-opened park in Marydel, provided by her department give people a place to be well as a community.
“Inmates (with the work release program) who have helped maintain the new park in Marydel have said (the park) would’ve been a better diversion if it’d been there when they were growing up,” Simmons said. “Built environment matters. It’s not more important than access to providers but it’s part of it.”
Simmons said stress and trauma are a big risk factor for health issues, as people search for ways to disengage and numb themselves, often turning to drugs.
More residents spoke about a need for more specialists on the Eastern Shore, and better behavioral health and transportation services.
Dr. Joseph Ciotola, Queen Anne’s County health officer and a member of the Rural Health Care Delivery Work Group, closed the hearing by saying the group has been working on its recommendations for nine months, and he is “ready to deliver that baby.”
“We are looking at this from an innovative standpoint to provide quality, effective health care across the board,” Ciotola said.
The Mar yland Health Care Commission is still accepting public comment by email. To provide comments, send email to Erin Dorrien, chief of government and public affairs, at firstname.lastname@example.org; or to Kathy Ruben, center for health care facilities planning and development, at email@example.com.
Send written comments to the Maryland Health Care Commission, 4160 Patterson Ave., Baltimore MD 21215.