Time is of the essence as Maryland Health Care Commission will make a decision between Oct 6 - Oct 20, 2019 regarding a proposed change to the future location of the only psychiatric inpatient unit on the Mid-Shore. Please read and Sign this petition opposing the requested Certificate of Need exemption to switch locations of inpatient psychiatric care to Chestertown, Md from Easton, MD in 2021.

Let the Maryland Health Care Commission (MHCC) know that the Psychiatric Inpatient Unit must remain centrally located to the vast majority of the population that it serves.

Read some about this here: https://www.myeasternshoremd.com/dorchester_star/news/application-being-prepped-for-relocation-of-behavioral-health-beds/article_688f3ccf-9f15-5525-b4b4-02dff7335ec3.html

Signing the petition is not enough, in order to insure your voice is heard, contact:

Kevin McDonald, Chief Certificate of Need  kevin.mcdonald@maryland.gov

Ben Steffen, Executive Director, Maryland Health Care Commission ben.steffen@maryland.gov 

Tell them you do not support the granting of a Certificate of Need Exemption because it is not in the public interest and makes health care provision less efficient. (See sample statement below)

University of Maryland Shore Health has requested a Certificate of Need exemption to move critical psychiatric care services from Cambridge and Easton, Maryland to Chestertown, Maryland. This locates a critical service for Talbot, Dorchester, and Caroline Counties between 45 minutes to 2 hours north.

For those curious, the 105 page request for exemption to the current Certificate of Need is linked here. You may have to click one of the PDF's bookmarks to page through it, as it loads very slowly. https://mhcc.maryland.gov/mhcc/pages/hcfs/hcfs_con/documents/Exemptions/con_exemption_dorch_chest_ex012_20190906.pdf

The table to note is Table 1 that shows percentages of admissions by county.

In 2021, Dorchester Hospital, Cambridge, MD will be replaced with a Freestanding Medical Facility- Essentially an ER with observation beds and some other services. Originally, a plan was approved by the Maryland Health Care Commission to move the inpatient psychiatric unit to Easton Hospital's former Pediatric Unit. The inpatient unit could continue to operate as before, but in a new space in Easton, Maryland. The Intensive Outpatient Program (IOP) would also move to Easton Hospital.

Most inpatient health services are already located at Easton Hospital. This location allows easier access to medical consultation in Easton; and is more attractive for recruiting prescribers to work there.  It allows improved service to the same patient population. The state approved this move many months ago. And no opposition to this move was voiced.

However, on Sept 6th the hospital quietly requested a Certificate of Need (CON) exemption to move the inpatient psychiatric unit to Chestertown Hospital instead of Easton. This change would move an important part of the urgent psychiatric care for patients an hour or more away for most of the people it serves. 

Five of the six prescriber's who work at the Dorchester Hospital Inpatient Psychiatry Unit vehemently opposes the move, as well as the vast majority of nurses, social workers, and direct care staff.  

This means all the patients who are admitted to the inpatient psychiatric unit from Easton Hospital ER, and Dorchester's future ER will have to travel 45 minutes or 1.5 hours by ambulance for admission. Additionally the ambulance wait time will likely be several hours (based on the current time it takes for patients to transfer from Chestertown to Cambridge). It is believed that most people in Caroline County use Easton Hospital or Dorchester ER and will have similar issues. 

The move will prevent patient families from readily visiting which is vitally important for family meetings, discharge coordination, and just plain comfort when a loved one is in the hospital. It will degrade the quality of care in patient transition of services.

With the inpatient unit in Easton patients could readily go to mental health IOP and addictions IOP at Easton Hospital while still on the inpatient psychiatric unit facilitating discharge transition. The proposed move to Chestertown would result in zero of the patients on the unit being able to access these critical IOP services.

Chestertown Hospital currently has a census of 7-8 inpatient MEDICAL beds. And would have to find staff to care for an average of 12 psychiatric patients. Attracting qualified staff to a remote and under staffed hospital is a near impossible task.

As per, University of Maryland Medical System's own spokesperson: In 2019, while speaking to the Baltimore Sun, Michael Schwartzberg, Spokesman for UMMS explained how hard it was to fill medical positions at Chestertown Hospital because it is so hard to recruit doctors and other health workers to small towns when people leave. 

Most of the nurses, social workers, and care staff at the psychiatric unit in Cambridge reside in Cambridge or travel from Easton or Salisbury to work in Cambridge. These staff have indicated they will not make the move to Chestertown.

The population centers and the hub of medical care on the mid-shore is in Easton, not Chestertown. The proposed move to Chestertown is a complicated mix of financial and political motivation, not based on patient care considerations or best interest to the community. This proposed change puts psychiatric patient care last.

According to the Dorchester Star, in May, 2019, when speaking to the Chestertown Chamber of Commerce, Kenneth Kozel, Ceo of University of Maryland Shore Health said, “How can we maintain or sustain the viability of that hospital [SIC Chestertown] We could relocate those behavioral health beds to Chestertown permanently. What we would do is provide sustainability to Chestertown.”

Maintaining Chestertown Hospital is a goal unrelated to the current Certificate of Need to provide mental health care services to the Mid-Shore, including management of substance abuse and addictions. 

6.6% of Shore Health inpatient psychiatric patients are from Kent County. 64% of Shore Health inpatient psychiatric patients are from Talbot, Caroline, and Dorchester Counties.

The proposed CON exemption expects the vast majority of patients to receive services 45 min - 2 hours away from home at facility currently under-staffed and under-equipped to handle the average census of the psychiatry unit; and to additionally serve an anticipated increase in patients from Kent County and Queen Anne's County.

However, this sacrifices mental health care services to the majority of those currently served by the inpatient psychiatric service for the sole purpose of maintaining Chestertown’s Medical Services.

While saving Chestertown Hospital is a laudable goal it should not be accomplished by eliminating ready access to inpatient mental health care (including substance abuse treatment) for the vast majority of the Mid-Shore. There is no desire to see current services to Chestertown degraded, but weigh the sustainability of the Chestertown Hospital against the mental health care needs of the ENTIRE mid-shore.

Please let the Maryland Health Care Commission know that you oppose the granting of the Certificate of Need exemption. 

Kevin McDonald, Chief Certificate of Need  kevin.mcdonald@maryland.gov

Ben Steffen, Executive Director, Maryland Health Care Commission ben.steffen@maryland.gov 

Here is a handy template you can use:

Dear, Sir, I am opposed to the granting of an exemption to the current Certificate of Need regarding the location of the only inpatient psychiatric unit on the mid-shore. It is against the public interest to locate the inpatient psychiatric unit in Chestertown, Maryland and will result in a gap in services to an already vulnerable population.

My name is, (your name here), and I am a (Mid-Shore citizen, Mental Health Care Provider, Health Care Provider, family member of a patient, former patient, Mental Health Advocate, concerned citizen, community member) and I oppose the granting of an exemption to the current Certificate of Need. 

Please keep the Psychiatric Inpatient Unit in Easton,

Signed, 

(You)

For additional information email:

KeepPsychiatryUnitInEaston@gmail.com

 

Keep Shore Health inpatient Psychiatry Unit in Easton, MD. Keep critical services local.