Getting In by Jamie Kirkpatrick

This is not the Musing I had planned to write this week. I’m not even sure it’s the Musing I want to write this week. But it is the Musing I have to write this week. You’ll see why.

For more than twenty years, I was the Director of College Counseling at one of metropolitan Washington’s best independent schools. Since “retiring” (that word always lives within quotes in my mind) from that school a few years ago, I have also worked as an interim college counselor or consultant at four other highly regarded independent schools. My task was always a simple one: to help students and their families navigate the mysterious maze of the college admissions process. In so doing, I’ve seen both elation and disappointment. I’ve watched the pressure of college admissions bring out the best in some people and the worst in others. I’ve been aware of questionable decisions by both families and academic institutions. But until last week, I’ve never seen outright fraud and corruption taint the college admissions process. Am I shocked? No; just bitterly disappointed.

The playing field of the college admissions process has never been completely level. There are a myriad of institutional priorities that come into play when colleges make admissions decisions. There are faculties to pay; buildings to build or to maintain; alumni to please. The ivory tower looms over a highly competitive marketplace and those institutions who do not pay attention to all their various constituencies will ultimately sail over the edge of the world. The football team needs a quarterback. The orchestra needs a bassoonist. Endowments have to grow. A competing institution has a new student union building so we need to break ground for a state-of-the-art science lab. We need more people of color. We need more men. We need more women. You get the picture.

Natural selection will ultimately determine which institutions will thrive and which will fail. College admissions officers are given the Herculean task of identifying those candidates who will best “fit” within their institution’s Board-driven priorities. It’s not easy to build a community year after year, but admissions officers do their best. They look at objective measures of an applicant’s worth—academic performance, rigor of curriculum, and yes, standardized test scores. They also must weigh a variety of subjective measures like leadership potential, commitment to service, legacy, ethnicity, special talents, writing ability, ability to pay, and perhaps most important of all, the ephemeral quality to naturally become a part of, and contribute to, a greater whole.

The doorway to higher education is exceedingly narrow these days and unlikely to get any wider. Some of the most highly competitive colleges and universities now accept fewer than 8% of their highly qualified applicants. Globalization and technology have made the college admissions process more demanding than ever. Students from all over the world apply to American institutions and many of them do not require any financial aid. Paper is a thing of the past: all college applications are submitted electronically now which means (among other things) there are a lot more applicants swimming in the admissions pool. And that’s what drives some people to do unspeakable things.

Parents always want the best for their children, but in the maelstrom of today’s competitive college admissions process, many have lost their way. People of substantial means with imposing reputations now think it’s worth risking it all to get a child into a top-tier school. Pay a specialist to document a specious learning disability allowing for extended time on standardized tests. Find someone to proctor an exam who will look the other way or even correct a test-taker’s answer sheet. Dangle a major gift in front of a prestigious but cash-hungry institution. Bribe a coach. This is a whole new world, one devoid of a moral core or any ethical standards. Sound familiar? Sad!

Colleges and universities must push back. In a recent Op Ed piece in The Baltimore Sun, Washington College President Kurt Landgraf wrote about his institution’s mandate to seek out underserved and underfunded applicants from low-income zip codes for whom a college education will be a life-changing passage. This is right and good but not enough. Colleges also have to drain the swamp, become even more vigilant, and set a clear, transparent, and higher standard in their admissions practices.

I’m not vindictive by nature, but I hope all those people who have become tangled up in this dreadful net go to jail. That admissions process should be a no-brainer.

I’ll be right back.

Jamie Kirkpatrick is a writer and photographer with homes in Chestertown and Bethesda. His work has appeared in the Washington Post, the Baltimore Sun, the Pittsburgh Post-Gazette, the Philadelphia Inquirer, the Washington College Alumni Magazine, and American Cowboy magazine. “A Place to Stand,” a book of photographs and essays about Landon School, was published by the Chester River Press in 2015.  A collection of his essays titled “Musing Right Along” was published in May 2017; a second volume of Musings entitled “I’ll Be Right Back” was released in June 2018.  Jamie’s website is

Profiles in Recovery: Vincent Douglas

It took Vincent Douglas a near-death experience to reevaluate his life and while that event would rock most of us into a self-assessment mode, for Douglas it required a life or death decision: did he want to die as a heroin addict or work toward a life of recovery.

The Spy caught up with the 28-year-old at the A.F. Whitsitt Center’s Recovery in Motion (RIM) 18 months after making his decision to live and talked with us about his pathway to a new life and his dedication as a peer counselor to carry a message of hope to others suffering from addiction.

Reflecting on his past, Douglas says, “I didn’t sign up for the lifestyle I lived. It happened and now I use that as a tool to help others. When I came here, I had nothing, I was nothing, so I had nothing to lose and everything to gain.”

As a peer counselor at RIM, his experience as an addict paired with his own recovery program opens the door for communicating with those suffering from the disease of addiction. Speaking a common language is the centerpiece of establishing trust in a peer recovery environment.

Recovery in Motion (RIM) “Offers a wide range of services that provide our community with the tools to increase their well-being.  Support includes  individual & group counseling, behavioral health education/prevention, peer support and care coordination to assist persons in recovery with behavior and addiction issues.”


This video is approximately 7 minutes in length.  More about A.F. Whitsitt Center in Kent County may be found here.


Mid-Shore Health Future: The Risks of Repealing the ACA on the Shore with Jeananne Sciabarra

On Thursday, Jeananne Sciabarra, Executive Director of Consumer Health First spoke in Kent County about the implications of repealing the Patient Protection and Affordable Act (ACA), also known as “Obamacare.”

Founded in 2006 as the Maryland Women’s Coalition for Health Care Reform, the organization transitioned into CHF in 2016 with the same mission: to work collaboratively to promote health equity through access to comprehensive, high-quality and affordable health care for all Marylanders.

While the impact of repealing and replacing ACA with the currently proposed American Health Care Act (ACHA) would cause profound changes to healthcare nationwide, Sciabarra focused on what Marylanders, and specifically Congressional District, 1 would lose.

Talking about the rollback of Medicaid expansion, Sciabarra said that “the bottom line is that will push back the matching (between state and federal) to 50-50 which is going to make it extremely expensive for Maryland to continue that provision.” She added that on top of that, a block grant per capita system for each person enrolled in Medicaid would force the state to decide who doesn’t get services.

Also, in regard to hospitals, Sciabarra noted that Maryland has a unique rate-setting system that provides services at the same rate anywhere in the state and that during the expansion of Medicaid, uninsured costs went down $311 million between 2013-2015, and that with set amounts or “global budgets” hospitals were incentivized to participate in wellness programs to help people stay healthy and out of the hospital. A rollback of those kinds of programs would have a “catastrophic” effect on people not covered in the health exchange, especially older people.

The district’s uninsured rate has gone from 8.3% to 4.1% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

401,400 individuals in the district who now have health insurance that covers preventative services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover essential preventative services without cost-sharing.

445,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy recession, and coverage of pre-existing health conditions if the ACA is entirely or partially repealed.

15,800 individuals in the district who have purchased high-quality marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

11,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

8400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of healthcare becoming unaffordable is the Republican Congress eliminates cost-sharing reductions.

32,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

This video is approximately nine minutes in length. For more information about Consumer Health First please go here. Sources: US Department of Health and Human Services, Urban Institute, Families USA, The Commonwealth Fund, National Women’s Law Center.

Mid-Shore News: Rural Health WorkGroup Focuses on Health Delivery Transformation

Tasked with studying the healthcare needs for the five counties of the Mid-Shore and offering policy templates to the State, Rural Health Care Delivery Group held their third of seven workshops at Washington College on Monday.

The 32-member committee co-chaired by Deborah Mizeur and Dr. Joseph Ciotola, and attended by health care officials, county and state elected officials and business owners, the workshop sought to clarify the goals and possible implementation of an across-the-board transformation of health care delivery of the mid-Eastern Shore as national health care trends change from total dependence on hospitals a sole provider for health needs.

The work group’s focus is “to examine challenges to health care delivery, including limited availability of health care providers and services; special needs of vulnerable populations; transportation barriers, and the economic impact of closing, partly closing or converting health care facilities and also to identify how the benefits of telehealth and the Maryland all-payer model contract might help in restructuring the delivery of rural health care services. Finally, the study is to develop policy options that address the health care needs of residents and improve the health care delivery system in the five counties.”

Rural Health Care Delivery Workgroup. Co-chairs Joseph Ciotola and Deborah Mizeur at center.

Rural Health Care Delivery Workgroup. Co-chairs Joseph Ciotola and Deborah Mizeur at center.

Addressing the complexity of designing a transformative rural healthcare model for the mid-shore, Deborah Mizeur said that much of the first two meetings were used to orient all committee members to the healthcare landscape. “We have a wide spectrum of membership, from physicians to businessmen and we all need to be on the same page to move forward. I’m energized and encouraged by the progress we’ve made.”

The session began with an overview of Maryland’s progression plan for an All-Payer Model given by Katie Wunderlich, Gov. Hogan’s deputy legislative officer for health care issues. Using slides, Wunderlich walked the group through key strategies, components, and a timeline to frame further work group discussions on how best to create policy platforms to be submitted to the State next October.

One slide, “Rural Health Nationally” stood out as a profound indicator of the need for a systemic change in rural health care delivery. It showed that in urban settings:

  • morbidity rates in females decreased by 10% and in rural areas morbidity rates increased by 40% along with a fivefold increase in opioid and heroin overdoses, doubling of suicides and tripling of deaths due to cirrhosis of the liver, linked to alcohol abuse.
  • At the same time, nationally, “rural hospitals have faced declining margins of 5% annually since 2011, due to shrinking inpatient demand.
  • Nationally, 68 rural hospitals have closed over the last 5 years, and an additional 670 are vulnerable to closure in 2016, up from 280 in 2015.
  • Many Americans living in rural communities rely on their hospital as one of their few sources of health care.

With a declining use of hospitals nationwide due to migration from inpatient care to outpatient care—from hospital-centric to population-centric— the focus is on a continuum of care keeping patients healthy through preventive and primary care services, and out of acute care facilities whenever possible. Refined medical procedures have shortened inpatient stays while outpatient procedure have kept patients out of the hospital altogether.

Wunderlich offered key points to sustaining rural health care with an emphasis on building on the success of the current rate-setting Total Patient Revenue (TPR)—the mechanism replacing Fee-For-Service incentives—and creating a geographic value-based model incentive “to address local accountability for population health and Medicare total cost of care.”

“This is basically putting in rewards for providers, for hospitals, for when they are able to improve their methods,” Wunderlich said.

Wunderlich added that a critical component to addressing rural health care is the transformation of primary care to support care management, care coordination, connections to behavioral health, social services and other resources.

In its fourth year of a five-year plan transforming the state’s health care system, 2017 will include continuing infrastructure development and increased support of high need patients with a 2018 focus on primary care home models, incentive harmonization and developing and organizing geographic and regional efforts.

Deputy secretary for public health at the Department of Health and Mental Hygiene Howard Haft discussed community-based “patient centers” working in tandem with the primary care model as part of the overall transformation needed to meet the needs of the rural population.

“We’re really going to have to transform what we do in primary care, Haft said. “There are insufficient numbers of doctors in the state and certainly a disproportionate number of doctors in rural communities who have to provide more and more care in small intervals. So we must shift from how many people we can see to delivering the best care for every person you can see.”

Patient Centers offer interdisciplinary teams of doctors and specialists who coordinate diagnostics and treatment while taking the stress off overloaded primary physicians. Patient centers would alleviate some of the problems in recruiting new physicians, according to Haft. Many primary physicians are seeing between 35 and 40 patients day. Along with the fact that attracting a physician to a rural area and a lower income model is difficult, Haft sees patient centers as the strengthening of relationships between patient and physician by using coordinated care efforts rather than episodic care visits. This model encourages teamwork between a patient —and his or her willingness to work toward person health goals—physician and other support staff.

The video starts with some of Health Services Cost Review Principal Deputy Director Katie Wunderlich’s overview of the progression plan and is followed by. Dr. Howard Haft, Deputy Secretary for Public Health, DHMH.

The next meeting will be held in March in Annapolis.The Rural Health Care Delivery Plane will be submitted to the State General Assembly in October.

This video is approximately 13 minutes in length  To see slides of each of the presentations, go here. Scroll to the January 9 meeting section.


Recovery: Checking out the Whitsitt Center in Chestertown


Kent County Behavioral Health Staff

Kent County Behavioral Health Staff

Kent County Behavioral Health’s A. F. Whitsitt Center is an inpatient facility in Chestertown offering treatment for adults suffering from chemical dependency and co-occurring disorders.

The Center provides detox and stabilization for people with substance use disorders and/or mental health disorders in a residential setting. The recommended stay is 21 days.

State funded, Behavioral Health Administration, A.F. Whitsitt Center (AFW) has been open since 1983. Additionally, The Governor’s Heroin and Opioid Emergency Task Force recently awarded the Center $800,000 to increase its number of beds from to 40.

The Center’s mission is to offer a better quality of life through substance abuse prevention, intervention, comprehensive treatment and recovery support services for addiction and other mental health issues.

AFW’s Crisis Bed Unit offers short-term detox and stabilization for patients whose primary diagnosis includes mental health problems. The average length of stay is 12-14 days, and upon discharge, patients are supported with a discharge plan that includes case management and introductions to appropriate agencies that can further support their well-being as they transition back into the community.

According to Tim Dove, Director of Outpatient Treatment for Kent County Behavioral Health, a recent increase in available treatment beds has resulted in shorter waiting lists, from 45 days in October 2015 to 14 days at present. There have been some instances in which a referred individual can be admitted on the day the referral was received.

AFW also reaches out to county residents through the Care Coordination/Peer Support Services offered by Kent County Behavioral Health (KCBH) by providing referrals and helping to monitor sober living environments. The AFW Recovery In Motion Center offers a wide variety of support groups as well as computer access for the purpose of employment research, resume writing, and job applications.

KCBH also works with other agencies in the county to address the problems caused by substance abuse. KCBH staff participate in the Rock Hall Town Hall Meeting, provide presentations at Rotary Club meetings, and conduct programs in faith-based communities around the county, including Hope Fellowship, Chestertown Baptist, Emmanuel Church of Pomona, and St. George Church of Worton. They also work closely with the Alano Club, a 12-step recovery organization.

Says Dove, “The Whitsitt Center recognizes the ongoing opioid epidemic and seeks to make treatment more accessible while securing additional funding for the growing number of people seeking recovery.”

AFW initiatives and projects include:

Education and provision of Naloxone in the community
Working with University of Maryland Shore Medical Center at Chestertown to access prompt residential treatment for people who have been revived after an opioid overdose.
Working with Kent County District and Circuit Court in the Post Adjudication Substance Abuse Treatment (PAST) program.
Working with Kent County Detention Center (KCDC) treatment for substance use disorder is provided in the jail. Appropriate referrals for continuing care to facilitate reentry after completing their sentence.
Providing education and administration of Vivitrol, a medication that works in conjunction with counseling and recovery.
KCBH participates in the Kent County DSS multidisciplinary team and contributes to various committees and work groups facilitated by Mid-Shore Behavioral Health.

KCBH employs a wide array of professionals, all of whom have a background in treating people with substance use disorder and / or a mental health disorder. The agency also offers a strong internship program for college? Undergraduate? Graduate? Students pursuing studies in behavioral health and addiction treatment services. These interns, along with volunteers from the community, help KCBH personnel participate in varied church services and activities around the county. Gifts and grant support from public and private entities, including the Town of Chestertown and Kent County Rotary, also support treatment and recovery programs offered by KCBH.


KCBH Outpatient Addictions Staff

KCBH Outpatient Addictions Staff


KCBH Mental Health Outpatient Staff

KCBH Mental Health Outpatient Staff





Recovery: Lethal Marketing and The Royal Court of OxyContin

Again, we keep coming across the message that consumers are merely profit streams in the pharmaceutical world, even if it means endangering and even killing through easier access to opioids.

Unsealed internal documents reveal Abbott Laboratories inappropriate marketing campaign to sell OxyContin. This is only one example of cynical business practices trumping concern for the health of the nation.

Read here




International Overdose Awareness Day Rallies Talbot Treatment Providers

More than a dozen addiction and treatment organizations along with other social service providers met on August 31 at St. Mark’s UM Church in Easton to participate in International Overdose Awareness Day.

The evening offered information about local treatment resources, addiction counseling and grief counseling for those who have tragically lost a loved to an overdose.

Sponsored by Mariah’s Mission Fund of the Mid-Shore Community Foundation and Talbot Partnership for the Prevention of Alcohol and Other Drug Abuse, service providers sought to encourage awareness of the ever growing problem of opioid addiction and drug overdoses in Talbot and neighboring counties.

The event mission statement provided by Talbot Partnership in Easton states that it “is committed to providing a platform to acknowledge the grief felt by families and friends who have lost a loved one to overdose. The purpose is to raise awareness that the tragedy of overdose death is preventable and to share information with people of all ages and walks of life that will help save lives.”

Mariah’s Mission, a foundation to educate and refer treatment and counseling services and support groups, was founded by Valerie and Rick Albee, parents of Mariah Albee, who lost her life from a heroin overdose in 2012.

Currents studies indicate an unabated increase in addiction and overdose globally, with treatment availability for one in ten for the 2.1 million Americans with substance abuse issues related to opioid pain relievers (2012 study), and an estimated 467,000 addicted to heroin, according to the National Institute on Drug Abuse.

Addictions specialists are warning of the increase in fatal overdoses due to the animal tranquilizer carfentanil and fentanyl; a synthetic opioid often added to heroin. Recently, In Cincinnati alone, police and emergency services have responded to between 20 and 30 overdose reports a day.

A 2014 “Substance Abuse in Talbot County” states “heroin abuse is on the rise in Talbot County and throughout the state. The survey monitored whether teens had ever used heroin. Reported abuse by 12th graders increased by 41% and 10th graders rose by 70% compared to 2007.

In Maryland in 2015, there were 1,259 overdose deaths in 2015 —nearly doubled since 2010.

Talbot County’s participation in National Overdose Awareness Day sought to personalize statistics by offering as a centerpiece a memorial service with the names of those who lost their lives to addiction. At evening’s end, after a moment of silence, a lighted paper lantern inscribed with the names of the lost floated up and over the town.

Guest speakers were: Susan Coale, LCSW-C – Clinical Manager of Bereavement Services at Chesapeake Life Center, Addie Eckardt – Maryland State Senator, Michael Flaherty, Ph.D. – National Expert on OD/Clinical Psychologist – Resident Tilghman Island, Joe Gamble – Talbot County Sheriff and John Winslow – Recovery Leadership Program Coordinator of the Maryland chapter of the National Council on Alcoholism & Drug Dependence

Here are a few minutes from the event. A standalone video of Dr. Michael Flaherty appears below.

Photos appearing in the video were taken by Kate Gallagher, UM Shore Regional Health Communication.



For a list of service providers and more about Mariah’s Mission, go here. For more about Talbot Partnership, go here.

Lethal Counterfeit Drugs Hitting US Streets

“Street Lethal” is a term I’m coining for the plethora of counterfeit drugs laced with fentanyl—drug that can be 1000 times more potent than heroin,—currently hitting American streets.

As Salon reports, we are still behind the curve of getting the word out and it should concern all of us.

Read here.

Kent County First in State to Forecast Climate Change Local Impact; Expects 4.5 Foot Sea Rise by 2100

It’s September 2049 and Category 3 Hurricane Able is barreling toward Cape Charles and up the Chesapeake Bay. Winds are clocked at 100 mph. Electricity in Virginia Beach and Norfolk has been knocked out for four hours and reports of extensive flooding, downed trees, and massive structural damage is coming in. Kent County braces for the worst. Emergency services are on alert. Low lying county, state and private roads are already submerged from torrential rains making it impossible to respond to some emergencies. In Chestertown and Rock Hall, marinas are overrun by surge and roads adjacent to rivers and the Bay are beginning to flood.

Since 2016, sea level has risen more than two feet, and the surge projections for the oncoming storm could add as much as an additional 8 feet.

Able would test any preparations Maryland and Kent County had implemented to mitigate the severity of the impending weather threat.

Will the County be ready?

Of course, this is an extreme and hopefully unlikely projection, but the reality is that less severe weather could cause havoc in Kent County as global warming exacerbates the already natural hazards (hurricanes, riverine and coastal flooding, severe storms) with rising sea water, heavier rains, and temperature elevations.

In other words, by 2050, a storm less forceful than Isabel could cause as much or more damage. The threat increases toward the end of the century with a projected 3.7 to 5.7 ft. sea rise. These figures are higher than other global predictions because of a phenomenon called <a href=””>”subsidence”</a>, an ongoing reaction to the Earth’s crust to the retreat of the Laurentian Ice Sheet. It is also noted that these projections are based on current global warming projections and could be adjusted according to any global mitigation.

Those who experienced Isabel in 2003 might remember the sailboat drifting on Cannon Street, submerged cars, and kayakers on Water St. when more than 30 homes were flooded. In Rock Hall the storm surge surpassed the 1933 high water mark, taking with it one hundred properties. It took years to recover.

Thankfully, Kent County has taken the lead in studying the region’s vulnerability to extreme weather.

Last Tuesday a draft report, “Climate Change and Sea Level Rise Adaptation” was presented to the public at the County Commissioner’s Office in Chestertown. Funded by Maryland Department of Natural Resources (DNR), Natural Ocean and Atmospheric Administration (NOAA), Department of Commerce, and prepared by the Eastern Shore Land Conservancy, the report assesses current vulnerabilities, long-term vulnerabilities, hazard consequences and offers mitigation opportunities.

The presentation was made by Kent County Planning and Zoning Director Amy Moredock, Brian Ambrette, coastal resilience specialist at Eastern Shore Land Conservancy, and Ginger Gregg of Kent County Emergency Services

Its three purposes, as described in the Plan’s introduction are: “to augment the Kent County Hazard Mitigation Plan, to inform the Kent County Comprehensive Plan, and to stimulate conversations and improve collaboration across governmental and community stakeholders.”

“Several plans are in place that clearly deal with climate matters,” Moredock said. The 2004 Hazard Mitigation Plan, which identifies historically recurring natural hazards, along with land use ordinances and a Floodplain Plan are all current policies that address aspects of climate change vulnerabilities.

The Floodplain program, updated in 2014 specifically identifies flood zones as areas “subject to the 100-year flood—1% annual chance—determined by FEMA and flood insurance studies, and they include tidal, non-tidal and riverine.”

Ambrette offered an overview of global climate change to address key elements in a dangerous equation— sea rise, warming air and water temperatures, an increase in precipitation, and the geological sinking of the Eastern Shore. Separately and together these elements will likely affect every stratum of life on the Eastern Shore and will require preparedness from overhauling road conditions (tar-based roads melt and or are vulnerable to impassable flooding) to revamping of town water runoff systems.

Ambrette underscored that the county is not in panic mode, but that the twenty-one adaption actions for preparedness and resilience in the report should become part of our government and resident discourse. See page 23 of the report for the complete action recommendations.

<em>The two videos, both ten minutes in length,  offer key highlights to the presentation, along with a pdf of the<a href=”http://Draft_Kent_County_Climate_Change_Vulnerability_Assessment_August_2016 2″> complete report.</a></em>

Don’t Forget: International Overdose Awareness Day August 31

Overdoes Event flyer 1

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