Staff Shortage at Kent Center Blamed on Low Wages and Stress

As Maryland’s minimum wage rises to $15 by 2025 so do concerns that direct support staff serving Maryland’s developmentally disabled will make a career change to McDonald’s, where working the drive-thru pays almost the same.

“Support staff wear many hats” and the work is stressful, said Kent Center’s Executive Director Karine Ireland at a legislative breakfast on June 28 to commemorate nearly 50 years of serving clients in Kent County. “The staff needs increased training and increased pay.”

Kent Center President Randy Cooper takes a moment with a Kent Center client, June 28, 2019

Low wages continue to plague recruitment and retention, which caregiver organizations in Maryland have called a “crisis.” They say starting wages must exceed the minimum wage by a wider margin than currently exists to recruit and retain a workforce.

There are over 200 organizations in Maryland like Kent Center that serve 25,000 developmentally disabled; they rely almost exclusively on Medicaid and state dollars that flow through the Maryland Developmental Disabilities Administration to pay support staff.

A third of new DDA support staff in the state quit after six months and nearly half resign after one year. The attrition is the result of high stress and low wages, according to the Maryland Association of Community Services, a group that advocates for caregiver organizations. Courtney Williams, administration director for Kent Center, said their retention rate was close to the state average.

Ireland said all support staff require emergency medical training and certification to administer medications. They also undergo extensive training in conflict resolution and mentoring — in order to provide the job coaching and life skills clients need to integrate into the community.

The breakfast included a tour of the facility on Scheeler Road where job readiness and mentoring programs are run. There are currently 12 clients employed in the community with the help of the center’s Supported Employment Services.

Delegates. Jay Jacobs, R-Kent, and Steve Arentz, R-Queen Anne’s, attended the breakfast and blamed the rising minimum wage on the chronic staff shortages in DDA funded facilities.

“A $15 minimum wage actually hurt this place, it didn’t help it at all,” Jacobs said. “That $15 may sound good in the outside world but it actually harmed the workers in the pay scales.”

Arentz and Jacobs voted against the $15 wage hike that passed in Annapolis this year.

But caregiver organizations lobbied in Annapolis for “the fight for $15” and asked for a 7% bump in DDA’s budget. The legislature cut the request back to 3.5% for 2020 and 4% for years 2021-2026.

As the minimum wage rises, entry-level workers in 2025 will make about 60 cents more than new hires at McDonald’s, the difference could be even less if the burger chain is paying more than the minimum wage by then. See figure 1.

The average starting wage in DDA facilities is $10.50 to 11.00. The Kent Center’s starting wage is $10.66 — just 56 cents above the current minimum wage, a gap of just 5%.

The staff turnover over at the Kent Center is 22%, which is slightly lower than the state average of 25%. The center needs 50 more recruits by February to run programs at the facility and staff 14 full-time residences in the community. The center currently has 150 support staff for roughly 80 clients.

In 2006 the reimbursement rate was 69% above the state minimum wage; this year the gap has narrowed to 19%. But new employees are actually paid much closer to the minimum wage because providers, mostly community nonprofits, must reward employees with tenure at a higher wage to maintain retention.

Figure 1. Maryland Association of Community Services

The state tried to address the gap in the Minimum Wage Act of 2014 and tied the reimbursement rate to the minimum wage. The Act came with a mandate that set the reimbursement rate to a level above the state’s minimum wage in order to attract and maintain the workforce.

“The current rate is not enough when you can [start] at Giant earning $12.35,” said Laura Howell, executive director of Maryland Association of Community Services in brief phone interview. She said the vacancy rate was compromising the safety of staff and clients in facilities like the Kent Center.

Ireland spoke of one success story at the center where a client landed a better paying job than the support staff who trained him. Williams said there were other instances where staffers quit after learning they could earn more where their former clients had found work.

The workforce shortage has also raised concerns among aging parents whose children rely on the Kent Center.

“If I’m not there or my husband is not there, someone has to be,” said Linda Cades, whose 40-year-old son has relied on the Kent Center for 20 years. “We need to get good people to do this. We need to know that our kids are safe because they are extremely vulnerable.”

She said the center provided the socialization her son needed to know people with and without disabilities. Her son was also able to perform work, participating in the contract mailing and shredding services the center offers.

In their 70s, Cades said she and her husband worry about their son’s care after they pass on.

“I need to know that when I’m not here to run interference he’s going to be OK, in a place where people care about him,” she said. “Wages have been so low over the years that it extremely difficult to recruit, train and retain people.” She said the staff vacancies were putting greater burdens on the existing staff doing “very difficult work” for as low as $21,000 a year.

The Kent Center receives 99% of its revenue from DDA. Only 1% comes from private donations, said Kent Center Chairman Randy Cooper. He is also the founder of Radcliffe Corporate Services in Chestertown.

Cooper said a $500 donation earns a $250 tax credit on the Maryland tax return.

Channel Marker Cuts Ribbon on Regional Wellness Center

Channel Marker, Inc. has completed the final phase of its renovations of its 19,000-square foot Regional Wellness Center on Glebe Park Drive in Easton. The organization’s ribbon cutting celebrates the completion of a $2 million Capital Campaign to provide integrated services to people with severe and persistent mental illness in Talbot, Caroline and Dorchester counties.

Senator Addie Eckardt; Tolbert Rowe, Volunteer Executive Director of Channel Marker Foundation; Cathy Cassell, Channel Marker Program Director; Len Foxwell, Chief of Staff for Maryland Comptroller Peter Franchot; and Danielle Williams, Clinical Coordinator, in the Channel Marker’s new fitness gym

The new building consolidates the administration and client programs, previously situated in rented properties and houses a dedicated medical wing for a Registered Nurse, Nurse Practitioner Consultant, and Psychiatrist. The program section of the new building offers two lounges for social activities – one for transition age youth (ages 18-25) and one for adults, a computer lab with work stations, a large teaching kitchen and pantry, a dining area, two large group activity rooms, and a fitness gym with exercise equipment. As visitors enter the building, they are greeted with a view of a lush courtyard, complete with a pond and garden, around which the building was constructed.

Johnny Mautz, Senator Addie Eckardt, John McQuaid, President of the Channel Marker Board of Directors; Debbye Jackson, Executive Director of Channel Marker, and Ryan Snow from Governor Larry Hogan’s office.

Chad Hill, Liz Freedlander, Development Director; and Scott Warner of Rural Maryland Council.

Debbye Jackson, Executive Director of Channel Marker, commented, “Our plans are to offer a wide variety of group activities in the new facility for all of our clients. Many Caroline and Dorchester county clients now receive services from their psychiatrist and therapist at the Regional Wellness Center. The organization also recently rebranded its public image, with a new focus on wellness for our clients.”

According to Jackson, who has been with Channel Marker for 34 years, Channel Marker, Inc. opened its doors in 1982, operating out of donated space in churches. Over time, the organization embarked on a campaign to build facilities to have a permanent place in communities in Talbot, Caroline and Dorchester counties. Channel Marker serves approximately 400 people annually, almost 50% of whom are under the age of 21. Channel Marker’s services increase social and problem-solving skills, job readiness, illness management, and substance abuse recovery. Services are provided in day and residential settings in all three counties of the Mid Shore by a dedicated staff of nearly 60 people who have a personal and caring relationships with the individuals who live with organic brain disease through no fault of their own.

During the activities to put the final touches on the client program spaces, in preparation for the building’s ribbon cutting, one client asked a staff member, “When the party is over, will this all be taken away from us?” Hearing that everything was for the permanent use of the clients, he replied, “Then this must be my birthday!”

Ceci Nobel, Debbye Jackson, Executive Director of Channel Marker; and Marti Reed in the new fitness gym.

Funding for Channel Marker’s work in the community primarily comes from Medicaid and the State of Maryland.  Support from generous members of the community and private foundations underwrites uncompensated costs for programs that are vital to clients’ well-being. A community of donors including government, private foundations and individuals participated in the completion of the recent Capital Campaign.

Donor Nancy Klein of Oxford commented, “Our foundation was pleased to contribute to Channel Marker’s Capital Campaign. Its mission to serve very vulnerable members of our community matches our philanthropic interests.”

Among the other donors to the Campaign are The Harry and Jeannette Weinberg Foundation, The Michael and Nancy Klein Foundation, Bruce and Sandra Hammonds, Maxine Whalen Millar, The Whalen Company and Craig A. Wanner in memory of Ronald J. Wanner, Dr. David Hill and the Hill Family, The George B. Todd Fund of the Mid-Shore Community Foundation, The Reynolds/Cristiano and Ferree Funds of the Mid-Shore Community Foundation, Wayne and Terri Cole and Win Transport, Amy’s Army, Tom and Cathy Hill, The Schulman Foundation, The Robert and Ruth St. John Foundation, John and Debra McQuaid, Phoebe Reynolds, C. Tolbert and Jeanne Rowe, The Van Strum Foundation, and anonymous friends.

According to Tolbert Rowe, Volunteer Executive Director of Channel Marker Foundation, completion of Channel Marker’s Capital Campaign, “Opening New Doors to Wellness,” has enabled the organization to repay the Foundation’s loan to purchase and renovate the building. He added, “The Foundation is excited about our next project to improve services to youth in Caroline County, having just purchased the former Hospice House in Denton for this purpose.”

For further information or to tour the new Channel Marker facility in Easton, contact Debbye Jackson, Executive Director of Channel Marker, at 410-822-4619 or visit

Kids Grieve Too: Talbot Kids Grief Camp with Becky DeMattia

When Chestertown’s Becky DeMattia, Talbot Hospice’s bereavement coordinator, talks about providing support for children who grieve, it might seem odd at first to hear her talk about interjecting fun as part of that effort. But as you begin to understand that kids work through bereavement very differently from adults,  it becomes much more clear how important a camp environment might be for a child struggling with the loss of a parent or another loved one.

As Becky tells us in our Spy interview, this is the reason that Talbot Hospice has just started Talbot Kids Grief Camp. This special children’s bereavement camp is designed for any youth, ages 6-12, who have experienced that kind of loss. This two-day camp will be held May 18-19, 2019, at the Talbot County Agricultural Center, and there is space for 35 participants. Each child attends the camp at no cost, to learn how to cope with the complex feelings of grief.

The goal is to provide an opportunity for children to process their losses in a healthy, peer supported environment via a curriculum of activities and therapeutic practices designed to teach children about themselves, and the grief they are experiencing. Together campers will discover ways to cope, realize they are a valuable member of the group and work together to overcome challenges ahead. The camp will also provide grief education, support, and resources to parents and families and help strengthen the family unit as they process the loss together.

We spent some time with Becky at the Hospice office in Easton last week.

For more information about Talbot Kids Grief Camp please contact Becky DeMattia at 410-822-6681 or


Talbot Hospice to Launch Camp Courageous

Talbot Hospice is pleased to announce Camp Courageous, a new children’s bereavement camp designed for any youth, ages 6-12, who have experienced the loss of a loved one. This two-day camp will be held May 18-19, 2019, at the Talbot County Agricultural Center, and there is space for 35 participants. Each child attends the camp at no cost, to learn how to cope with the complex feelings of grief.

The goal of the camp is to provide an opportunity for children to process their losses in a healthy, peer supported environment via a curriculum of activities and therapeutic practices designed to teach children about themselves, and the grief they are experiencing. Together campers will discover ways to cope, realize they are a valuable member of the group and work together to overcome challenges ahead.  The camp will also provide grief education, support, and resources to parents and families and help strengthen the family unit as they process the loss together.

Talbot Hospice Bereavement Coordinator Becky DeMattia will lead the camp along with other specially trained staff and volunteers. “We have planned a number of activities that will help children work through some of the feelings they experience surrounding the loss of someone significant in their lives,” said DeMattia. “We want children to feel safe expressing their feelings, to have some fun while together, and hopefully walk away feeling lighter and understanding how to use newly found coping skills.”

At Camp Courageous, children will laugh, cry, talk together about their losses, share emotions, and learn healthy ways to deal with the feelings that accompany grief. Camp Courageous is offered free of charge, thanks in part to a generous donation from the Bryan Brothers Foundation. Talbot Hospice and Camp Courageous rely on the generosity of the community to provide a safe place for children to grieve.

For more information about Camp Courageous, please contact Becky DeMattia at 410-822-6681 or


Media Contact:

Caron James, Director Marketing & Communications



Mid-Shore Health: Compass Regional Hospice Adds Palliative Care

Since 1985, Compass Regional Hospice has been serving the Mid-Shore of Maryland with perhaps one of the most challenging moments for human beings; the management of the end of one’s life.

Through their extensive coverage in Caroline, Kent, and Queen Anne’s Counties, Compass has developed a well-deserved reputation for exceptional in-patient care for those in need as well as an extensive commitment to in-home support for those with a life expectancy of six months or less.

But like any institution with a special mission, the board and staff of Compass knew that something important was missing from their long list of services. A few years ago, after an extensive strategic planning process, the organization concluded that to serve their communities, a palliative care program must also be added.

Palliative care is entirely different from hospice care. It is an interdisciplinary approach to care for people with life-limiting illnesses rather than a terminal condition. Those benefiting from this specialized approach are provided relief from the symptoms, pain, physical stress, and mental stress at any stage of a chronic illness with remarkable improvements in quality of life.

To understand more about the significant change at Compass, the Spy sat down with Compass’s executive director, Heather Guerieri and the organized newly appointed medical director, to understand what this means for the communities they serve.

This video is approximately eight minutes in length. For more information about Compass Regional Hospice please go here.

Maryland House passes Drug-aided Death Bill

The Maryland House on Thursday passed a measure that would give terminally ill patients six months from death the option to end their lives by taking prescribed lethal medication.

House bill 399, or the End-of-Life Option Act, received 74 votes for and 66 against in an impassioned chamber session.

Individuals are required to consent three times to death. “Lethal injection, mercy killing or euthanasia,” would not be legal under the legislation, according to the bill’s analysis. There would be criminal penalties for people who coerce others into ending their lives.
The debate began with some tension, but soon cooled off, as personal anecdotes of experiences with death or near-death brought tears to the eyes of members of the chamber.

Democratic and Republican delegates opposed the bill, saying they had religious and moral objections, and detailing how important each day alive was to many of their relatives who died from terminal illnesses.

“Because I am a believer,” God should be answered to, not nurses or doctors, Delegate Jay Walker, D-Prince George’s, said. “Give my Lord the opportunity of a miracle.”

“Doctors take an oath, the Hippocratic oath, to do no harm,” Delegate Haven Shoemaker, R-Carroll, told Capital News Service.

“We’re encouraging (physicians) to contravene that oath,” Shoemaker said.

“Think about vulnerable populations” who could be taken advantage of by this legislation, said House Minority Leader Nicholaus Kipke, R-Anne Arundel. “Less than 5 percent of the poor receive hospice care at the end of life.”

If many people begin ending their lives prematurely, “we wouldn’t look for a cure,” to their diseases, said Minority Whip Kathy Szeliga, R-Baltimore and Harford counties.

Delegate Cheryl Glenn, D-Baltimore, spoke of her sister who died of a terminal illness.

She would not have made peace with her only son if she had ended her life early, Glenn said. “We don’t know what tomorrow will hold.”

Democratic supporters argued that individuals deserve the right and option to choose when they die.

Delegate Shane Pendergrass, D-Howard, lead sponsor of the legislation, told the stories of two people who fought breast and brain cancer.

Knowing the medication to end your life is there gives comfort and control to an individual who is suffering, Pendergrass said.

Delegate Eric Luedtke, D-Montgomery, said he had three family members attempt suicide, and spoke of his mother who tried to end her life from the pain of her cancer.

“Despite my personal hatred for suicide, I began to ask myself what right I had as a government official, and even as her son, to dictate to her how her life should end,” Luedtke said.

Individuals can already choose to not be resuscitated and be taken off a feeding tube, Delegate Elizabeth Proctor, D-Charles and Prince George’s, said. The bill just gives people at the end of life another option, Proctor said.

Delegate Sandy Bartlett, D-Anne Arundel, told her story of anguish following mastectomies for breast cancer.

Deciding to end one’s life is up to “her, and her choice only,” Bartlett said, speaking of herself.

The bill “does not impose beliefs on anyone,” said Delegate Terri Hill, D-Baltimore and Howard counties, a physician. “I expect that the positions we’ve taken have been thoughtful and spiritually guided.”

The chamber was silent following the final vote.

Now that the legislation has passed the House, an identical bill must pass the Senate, and then must not be vetoed by Gov. Larry Hogan, R, to become law.

“I’m going to give a lot of heartful and thoughtful consideration,” to the act, Hogan said in February.

California, Colorado, Hawaii, Oregon, Vermont and Washington, as well as the District of Columbia, have legalized physician-assisted suicide, and Montana has no law prohibiting it.

Seventy-two percent of Americans would support ending a terminally ill patient’s life, according to a 2018 Gallup poll.

The legislation, originally titled the “Richard E. Israel and Roger ‘Pip” Moyer Death with Dignity Act,” was first presented to the General Assembly in 2015.

Israel and Moyer were former members of Annapolis government, and both died in 2015 from Parkinson’s disease.

Pendergrass said after years of supporting the bill, it is “just a remarkable moment” to see the vote of passage for this legislation.

She attributed the bills’ success to testimony she heard and has repeated many times: “Everyone is one bad death away from supporting this bill.”

By David Jahng

Talbot County Has a Heart for Cardiac Care

Jeff Dawson, age 56 from Frederick, MD, a manager with the Environmental Protection Agency (EPA), was trying to relax and de-stress from work by hunting with some friends in Talbot County on December 27, 2018. He had been coming to the area for four years to hunt with Rennie Gay of Tidewater Guide Service. The hunting party had broken for lunch at the Amish Market in Easton, when Dawson fell out of his seat, suffering from a cardiac arrest.

Fortunately, Easton Police Sergeant Pat Sally was nearby and started CPR within a minute. An AED from Sally’s police car was then used to provide an electrical shock to Dawson’s heart. Talbot Paramedics and the Easton Volunteer Fire Department responded to the scene. Dr. Thomas Chiccone, Medical Director for Talbot County Emergency Medical Services (EMS), just happened to be on a ride-along on the ambulance to assist with Dawson’s care.

Dawson was taken to University of MD Shore Regional Health (UMSRH) in Easton where he underwent immediate heart catheterization and PCI or angioplasty by Dr. Jeffrey Etherton, who placed a stent in the artery of Dawson’s heart where earlier, plaque had broken off, causing a blockage to the artery and cardiac arrest. He was discharged from UMSRH on January 1 and started cardiac rehabilitation in Frederick in mid-January.

Dawson, who is now recuperating at home in Frederick, comments, “I was luckier being at that location than at my own home, where it would have taken more time to get the help I needed. My friends in Frederick tell me they want to take me to Vegas because of my luck.”

According to Clay Stamp, Director of Talbot County Department of Emergency Services and Assistant County Manager, the number of cardiac calls is increasing in Talbot County. He comments, “Talbot County has a rich history in staying current with staffing and technology as it relates to our increasingly aging population with cardiac issues. We have been able to provide a continuum of care through the partnership between the Talbot County government, UMSRH, and the Talbot Paramedic Foundation. Together, we have been able to put the pieces in place to effectively save lives.”

Gary Jones, Regional Director Cardiovascular Services, UMSRH, was one of a group of five firefighters, Basic Life Support providers, and cardiac rescue technicians in Talbot County who recognized the need for Advanced Life Support services in Talbot County while working in the field in the early 1980s. In 1983, this group of five took training and worked as volunteer ALS providers out of the Easton Fire Department. As the need in Talbot County grew for ALS providers, the number of people trained grew and eventually the ALS Service changed from a volunteer to a paid service provided through Talbot County Emergency Services. UMSRH committed to providing a place for the training to occur, utilizing the Emergency Department for training, providing medical oversight, as well as ongoing continuing education for paramedics. Currently, paramedics across the Shore are trained at Chesapeake College with clinical rotations at UMSRH.

Photo: L-R with Life Pack 15 are Paramedic Brian Micheliche, Paramedic Jason Leaman, Dr. Thomas Chiccone, Medical Director for Talbot County Emergency Medical Services; Brian LeCates, Deputy Director of Talbot County Department of Emergency Services; Ken Kozel, President and CEO of UMSRH; Clay Stamp, Director of Talbot County Department of Emergency Services and Assistant County Manager; and Paramedic Keith Dulin. Absent from the photo are Gary Jones, Regional Director of Cardiovascular Services, UMSRH; Wayne Dyott, President of the Talbot Paramedic Foundation; and UMSRH interventional cardiologists, Dr. Jeffrey Etherton, and Dr. Gabriel Sardi.

In 2009, the program became part of the Talbot County Department of Emergency Services, which encompasses the 911 Center, Emergency Medical Services, and Emergency Management. “The county’s focus on mitigating and assisting with the treatment of sudden cardiac arrest has focused on community training, paramedic training, 911 Dispatch, and keeping abreast of new technology and techniques,” adds Brian LeCates, Deputy Director of Talbot County Department of Emergency Services.

LeCates adds, “Talbot County pays to train its paramedics and to date has 29 paid paramedics and 15 paid EMTs. This enables the county to have one paramedic and one EMT, at a minimum, on each ambulance at each location in the county, as well as a supervisor on duty 24/7. The five stations in Talbot County include Easton Volunteer Fire Department, Easton Airport, St. Michaels Volunteer Fire Department, Tilghman Volunteer Fire Department, and Trappe Volunteer Fire Department.”

Each February, Talbot County Department of Emergency Services provides its Annual CPR Marathon, providing free CPR and AED training to the public. The event usually draws 200 to 300 people. This year the event is on February 27, from 9 a.m. to 6 p.m. at the Talbot County Community Center in Easton. LeCates states, “The goal of the marathon is to train bystanders so that they can start CPR before trained professionals arrive. It can mean the difference between life and death in the field.”

AED training is also provided that day for any site which has a public access AED. There are approximately 230 AEDs throughout Talbot County in such locations as schools, police cars, businesses, churches, and public spaces. Over the years, AEDs have saved lives at Lowes, the YMCA, the Tidewater Inn, and recently at the Amish Market in Easton. These devices were funded by The Talbot Paramedic Foundation, which just celebrated its 30th anniversary.

The Talbot Paramedic Foundation funded the purchase of AEDs 18 years ago to be used for public access. The AEDs are maintained by Talbot County Department of Emergency Services. Because many of the AEDs are no longer serviceable by the manufacturer, the organization needs to raise $100,000 to replace a portion of them. The plan is to phase the new AEDs in over a period of time. The Foundation’s purchase of the AEDs reduces the cost for users to less than half the actual cost of $1000 each. With underwriting from the Talbot Paramedic Foundation, Talbot County Department of Emergency Services also trains individuals at sites which have AEDs. Sites pay $200 annually for maintenance of their units and a portion of their annual training.

Wayne Dyott, President of the Talbot Paramedic Foundation, explains, “Our organization was originally founded by the same staff who provided ALS in the county. Once the Talbot County government started funding salaries and some of the equipment needed for paramedics, the Talbot Paramedic Foundation supplemented the funds to support the purchase of additional equipment, such as AEDs, Life Packs, and video laryngoscopy, and to provide training for paramedics. Our mission as a nonprofit organization is to help maintain paramedic services at the highest level needed in Talbot County.”

Talbot County received national recognition for their AED Program, “Operation Save Heart,” at the International Fire Chiefs’ Association meeting in Las Vegas, NV as one of the largest rural AED communities in the nation. About six years ago, the Foundation provided upgraded equipment for paramedics, purchasing Life Pack 15. This equipment provides a monitor, a defibrillator, a pulse oximeter, and end-tidal capnography – all industry standard equipment used to handle cardiac events in the field. The units cost $36,000 each and Talbot County needs six of them for its paramedic units. Talbot County government purchased half of the Life Packs and the Talbot Paramedic Foundation purchased the other half. Talbot Paramedic Foundation works with local civic and philanthropic organizations to raise the necessary funds.

Talbot County Emergency Medical Services is always looking for ways to improve the outcomes for cardiac arrest victims. Talbot County’s 911 dispatchers give pre-arrival CPR and AED instructions to callers who call in cardiac arrests, encouraging them to administer CPR and look for an AED if they are in a public building. Talbot County DES Command Staff attended the Maryland Resuscitation Academy in May of 2013 to learn High-Performance CPR, now the industry and State of Maryland standard for resuscitation. In September 2013, paramedics began using the Lucas CPR devices, which allow them to administer High-Performance CPR through a device, enabling them to start other interventions such as IVs, medication administration, and airway management. According to LeCates, “We have seen a spike in survival rates by using this more effective CPR.”

Information is also transmitted differently today. Over the past six years, paramedics have been able to transmit EKGs to hospital Emergency Departments. These general technology improvements help determine next steps for the hospital’s cardiac catheterization lab. In 1991, Dr. Scott Friedman and Gary Jones established diagnostic heart catheterization services and pacemaker defibrillator implant services at UMSRH. At this point in time, patients requiring acute coronary interventions were transferred to the University of Maryland in Baltimore or Peninsula Regional Medical Center in Salisbury for treatment. For a select number of a subset of heart attacks delays in transferring patients were impacting the outcomes for heart attack victims and paramedics were getting tied up with transporting patients to these centers, UMSRH decided to seek Cardiac Interventional Center designation in order to do primary and elective angioplasty in Easton. Jones comments, “Time is muscle, meaning the longer the delay, the greater the possibility of heart muscle damage.”

UMSRH applied to become a Cardiac Interventional Center (CIC) through MIEMSS and recruited two interventional cardiologists, Dr. Jeffrey Etherton, and Dr. Gabriel Sardi, and hired additional cardiac catheterization lab staff, doing elective angioplasties in 2017. In 2018, UMSRH was designated as a CIC and today, paramedics take patients to Easton for interventional services. This past year, in addition to over 300 elective angioplasties, the CIC treated over 70 primary angioplasty patients – a significant increase over the 50 patients they projected – and the demand is increasing every day. UMSRH now has three cardiac catheterization teams and this past year, there were 163 activations of the call team.

Jones comments, “We are very proud of these results. The “door to balloon” target time nationally is 90 minutes. At UMSRH, the CIC can do it 60 minutes or less over 95 percent of the time.  There have been numerous examples where people have had a cardiac arrest in the field, received bystander CPR, received ALS by Emergency Medical Services, and then been transported to UMSRH CIC and patients have walked out of the hospital just like Jeff Dawson. And, like Dawson, patients in our area can receive Cardiac Rehab at our Centers in Easton, Dorchester, and Chestertown following their intervention.”

He adds, “From very humble beginnings, we have developed a sophisticated model of care for the continuum of care here for cardiac patients in Talbot County. It’s a real partnership between government, private funders and the hospital. When all the pieces come together as they have and it works effectively, it’s pretty gratifying.”

Dawson reflects on his experience, “I am super grateful to everyone who cared for me in Talbot County. It’s a debt I can never fully repay. I will try and live a life that’s worth living. It’s a second chance to keep working on things that improve people’s lives.”

UM Shore Regional Health Publishes 2018 Community Benefits Report Online

UM Shore Regional Health’s 2018 Community Health Improvement Report has been published online and is available for viewing at

UM Shore Regional Health’s most recent Community Health Needs Assessment (CHNA), conducted in 2016, identified top health concerns in the region: chronic disease management (obesity, hypertension, diabetes, tobacco use), behavioral health, access to care, cancer, outreach and education (preventive care, screenings, health literacy).These are the same top health concerns and health barriers indicated by the overall Maryland Department of Health and Mental Hygiene State Health Improvement Process (DHMH SHIP) county data.

UM SRH determined that the greatest transformation in population health in the five-county region would be achieved by focusing on chronic disease management, behavioral health and cancer screenings. An implementation plan was developed for each priority, with key activities to improve care coordination and health education in community settings.

As detailed in the new report, the total value of UM Shore Regional Health’s community health improvement initiatives during 2018 exceeds $40 million. According to Ken Kozel, UM SRH president and CEO, and Kathleen McGrath, regional director, Outreach and Community Health, the document “reflects UM Shore Regional Health’s commitment to building community partnerships that help foster better health outside the walls of our hospitals and outpatient facilities, while enhancing access to care and the overall quality of life in the five counties we serve.”

As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s, and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,500 employees, medical staff, board members, and volunteers works with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

Death with Dignity: DC Residents Learning about New End-of-Life Law

More than a year after a controversial end-of-life law went into effect in the District of Columbia, advocacy groups say they are now seeing a higher public response to its efforts to ensure city residents know the law exists.

How many people have used the law will become clearer in an upcoming February report. As of last April, no patient had yet used the law, according news accounts.

The Death with Dignity Act allows mentally capable, terminally ill adults with six months to live to request lethal doses of prescription medication so they can die peacefully and comfortably in their homes or any place where they have been granted permission to do so.

One of the law’s main proponents, Compassion & Choices, has helped the District of Columbia Council advocate for the legislation and educate Washington residents about the new option for patients with terminal illnesses.

The administrative side of the end-of-life process apparently has dissuaded physicians, pharmacists and patients from using the law, but local public service announcements have helped spike interest and attention, Sean Crowley, spokesman for Compassion & Choices, told Capital News Service in an interview.

His group declined to say how many doctors in the District registered to use the law, as it did not have access to such records. But as of last April, only two doctors among the roughly 11,000 doctors in the city had registered to use the law and just one hospital had approved doctors for the practice, according to The Washington Post.

The District of Columbia Department of Health is set to release a detailed report in February on how many patients have utilized lethal drugs and how many physicians have administered them. But to date, no patients have volunteered to go public with their stories.

During September, Compassion & Choices distributed television public service announcements promoting the end-of-life law, featuring prominent Washingtonians Diane Rehm, a former WAMU radio show host, and Dr. Omega Silva, a retired physician.

The announcements, which began Labor Day weekend, aired on various Comcast stations. Compassion & Choices reported that there were 229 visits to the group’s page during September, compared to only 56 for the same month a year ago – a 400 percent increase.

In addition to the District, six states have end-of-life, or physician-assisted dying laws: California, Colorado, Hawaii, Oregon, Vermont and Washington, according to the nonprofit Death with Dignity National Center, based in Portland, Oregon.

Efforts to pass a similar law in Maryland have been unsuccessful.

Since the District’s end-of-life bill was introduced in 2015, organizations such as Right to Life and conservatives in Congress have opposed it and tried to defund it.

Rep. Andy Harris, R-Cockeysville, introduced an amendment in 2017 to defund and repeal the law. The amendment failed to pass the House Appropriations Committee.

Harris, a physician, criticized what he called “the so-called Death With Dignity Act,” saying “most people don’t associate suicide with dignity in any way shape or form.”

“It sends a strong message that regardless of the many types of disease you might have and the many types of treatment that may be available, there is one common pathway that in this case the District would say is perfectly acceptable, it is legal,” he said. “It’s actually to go to a physician and ask if they can participate in your suicide. That doesn’t lead to more choice – that leads to one choice.”

The House will be controlled by the Democrats next month, making the prospects for repealing the District bill more remote.

In any case, Crowley said that “lawmakers from outside the District should not dictate to district lawmakers what laws they should pass for their local constituents.”

“Other states would never allow lawmakers from outside their state dictate what their states can do,” he said. “Why should they be allowed to dictate in D.C.?”

Since its founding as the seat of the federal government, the District of Columbia has not had voting representation in Congress, although it has some limited autonomy. Even so, Congress has the power to review and repeal District laws.

“That Congress thinks it should substitute its judgment for the judgment of the residents of the District of Columbia is odious enough,” said Councilmember Mary Cheh, who sponsored the end-of-life bill. “That it would presume to substitute its judgment for the judgment of people who are dying is unconscionable. Such an action is fundamentally undemocratic and it should not stand.”

By Morgan Caplan

Mid-Shore Health: The Goal of Control at the End of Life

There is little doubt that one of the paramount issues for those facing the last phase of their lives is one of control. From such things as pain management to document the end of life wishes with family members, the patient is eager to control as much of the process as possible.

And one of their primary allies in maintaining that control is working with their local hospice as early as possible. That is the central message we received when talking to Talbot Hospice’s medical director, Mary DeShields, and its executive director, Vivian Dodge when talking to the Spy the other day.

With the national average hospice care period lasting only two to three weeks, the options and time for solid planning are minimal. That is why Mary and Vivian are strong advocates for patients and families to enter into hospice care almost immediately after a terminal diagnosis, which allows up to six months for them to prepare appropriately and guarantee the most comfortable end of life strategies possible.

This long-range approach also applies to palliative care which takes of those between acute care and end of life care. This stage for those with a chronic illness this is likely to result in death also requires a multidisciplinary management approach that, like hospice, is directed around the wishes of the patient and dramatically improve their day-to-day quality of life.

That is the primary reason that Talbot Hospice has been taking steps this year to strengthen their palliative care role with a new initiative to work more closely with community physicians and their patients.  By adding the local hospice team, both doctors and those under their care can greatly benefit patients with symptoms, and the emotional side of these serious chronic conditions.

The Spy sat down with Mary and Vivian at Talbot Hospice last week for a brief discussion of these issues.

This video is approximately seven minutes in length. For more information about Talbot Hospice please go here

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