Healthcare Solutions: A Collaborative Approach  

Al Hammond • May 30, 2018

Big changes are potentially coming to healthcare in the 5 Mid-Shore counties -- Caroline, Kent, Queen Ann, Talbot, and Worcester counties, the area served by the University of Maryland Shore Regional Health network. Legislation passed by the Assembly and just signed by the governor establishes a Mid-Shore Collaborative—a formal regional partnership of health systems, health providers, county health officers and other officials, including a health consumer from each county. Over the next year and a half, the collaborative is to design a new Rural Health system, focusing both on improving traditional healthcare (which mostly means illness care and the fate of small community hospitals) and on improving population health (which primarily means preventive and behavioral health). The collaborative is also designed to align the new system with Maryland’s Medicare Waiver—an agreement with the federal government that is unique to Maryland and that allows the state to experiment with new ways to deliver healthcare and new ways to pay for it. It’s a big assignment, and a lot will depend on the commitment and open-mindedness of the individuals chosen to serve on the collaborative. Interested individuals—especially local health providers and consumers—are now being invited to volunteer.

For Kent County specifically, another piece of legislation requires an audit of health services at Chestertown Hospital, to ensure that Shore Regional Health is living up to its commitment to maintain the full level of promised services through at least 2022.

In addition, other potential ideas being discussed that could improve health outcomes include:


  • Community Health Centers that could serve as a one-stop shop for health services and better coordinate care.
  • Telehealth services that would enable remote access to doctors and other health professionals—easing the chronic shortage of doctors and specialists in rural Maryland.
  • Mobile health units with expanded services that could help overcome the lack of public transportation to reach doctors, hospitals, and pharmacies. Another approach might be an Uber-like on-call health transport system—partially subsidized by state hospital systems—to take people where they need to go to meet health needs.
  • In-home care services, provided by lay health workers and nurses that follow explicit protocols, gather patient health data on mobile devices, and are overseen by doctors. Such in-home care services could improve early diagnosis and provide preventive and behavior health services, potentially greatly lowering the overall cost of healthcare by keeping people out of hospitals.
  • An expanded community schools healthcare system for children of all ages, providing vaccinations and regular medical, dental, and vision checkups via nurses and visiting specialists.

What will emerge from the collaborative process and other discussions is unclear. Nonetheless, the next couple of years offers both a chance for major improvements and for citizens to participate in shaping those changes.


Common Sense for the Eastern Shore

By John Christie September 23, 2025
In a case concerning the proper standards employed by Immigration and Customs Enforcement (ICE) when detaining people suspected of being in the United States illegally, the ideologically split Supreme Court — acting on the 23rd emergency request filed since January 20 — handed another win to the Trump administration. Noem v. Perdomo (September 8, 2025). Lower federal courts had approved a temporary injunction to prevent roving patrols of armed and masked ICE officers from detaining people without satisfying the Constitution’s reasonable suspicion requirement. The Court’s majority — as it has too often — offered no explanation for its decision to vacate the injunction. Justice Sotomayor wrote a dissent, joined by Justices Kagan and Jackson. The result would appear to allow all Latinos, U.S. citizens or not, who work at low-wage jobs to be seized at any time, taken from their workplace, and held until they provide proof of their legal status to ICE agents’ satisfaction. --------------------------------------------------------- Launching “Operation At Large” in early June, the government conducted large immigration enforcement raids in Los Angeles and its surrounding counties. During the raids, teams of armed and masked agents pulled up to car washes, tow yards, farms, and parks and seized individuals on sight, often before asking a single question. As discussed in an earlier Common Sense article (August 12, 2025), a California federal District Court found that these raids were part of a pattern of conduct by the ICE agents that likely violated the Fourth Amendment requirement that any detention be premised upon facts that reasonably warrant the suspicion that the individual may be illegally in the country. Based on the evidence before it, the court found that the government was stopping individuals based solely on one or more of four factors: (1) their apparent race or ethnicity; (2) whether they spoke Spanish or English with an accent; (3) the type of location where they were found (such as a car wash or bus stop); and (4) the type of job they appeared to work. Concluding that stops based on any one of these four factors alone, or even when taken together, could not satisfy the Fourth Amendment’s requirement of reasonable suspicion, the District Court temporarily enjoined the government from continuing its pattern of unlawful mass arrests while it decided if longer-term relief was appropriate. The District Court stated, the ICE “officers cannot rely solely on generalizations that, if accepted, would cast suspicion on large segments of the law-abiding population.” The Ninth Circuit Court of Appeals refused to interfere, noting that the government did not dispute that these detentive stops had been based solely on the four enumerated factors and did not challenge the District Court’s findings that those stops were part of a pattern of conduct that has apparent official approval. In the context of the Central District of California, the four factors, even when considered together, describe only a broad profile and do not demonstrate sufficient “reasonable suspicion” for any particular stop. The Trump administration sought emergency relief from the Supreme Court and on September 8, it received the relief it sought, thereby allowing continued stops based upon any one of these four factors alone. The votes of at least five justices would have been required for such an outcome but only one of those justices, Justice Kavanaugh, explained his vote. Kavanaugh asserted that the “high prevalence” of undocumented immigrants on the Central District would make it inevitable that immigration officers would target any Latino person, or any person speaking Spanish or any person in a low wage job. However, nearly 47% of the Central District’s population identifies as Hispanic or Latino. For that reason, as explained by Justice Sotomayor in her dissent, the Fourth Amendment prohibits exactly what the government is attempting to do here: seize individuals based solely on a set of facts that would embrace a very large category of presumably innocent people. The four factors are no more indicative of illegal presence than of legal presence and surely in no way reflect the kind of individualized inquiry the Fourth Amendment demands. In deciding such an issue, the Court typically must also “explore the relative harms to both sides, as well as the interests of the public at large.” The government’s sole argument on this score was that the injunction “chills [its] enforcement efforts.” However, the injunction does not prevent the government from enforcing its immigration laws, provided it stops individuals based on additional facts on top of any one of all the four factors listed. Moreover, the on-the-ground reality appears to contradict the administration’s and Justice Kavanaugh’s claim of a chilling effect. Since the issuance of the injunction, Secretary of Homeland Security Kristi Noem has called the district judge an “idiot” and vowed that “none of [the government’s] operations are going to change.” ICE’s chief patrol agent in the Central District has stated that his division will “turn and burn” and “go even harder now,” and has posted videos on social media touting his agents’ continued efforts “chasing, cuffing, and deporting” people at car washes. Balanced against the “chilling effect” claim, it is the people of Los Angeles and the Central District who will suffer. As characterized by Justice Sotomayor in her dissent, “countless people in the Los Angelos area have been grabbed, thrown to the ground, and handcuffed simply because of their looks, their accents, and the fact that they make a living by doing manual labor.” Nor are undocumented immigrants the only ones harmed by the government’s conduct. United States citizens are also being seized, taken from their jobs, and prevented from working to support themselves and their families. As stated by Justice Sotomayor, the Fourth Amendment protects every individual’s constitutional right to be “free from arbitrary interference by law officers.” In her opinion, the Court’s decision is “unconscionably irreconcilable” with our nation’s constitutional guarantees. John Christie was for many years a senior partner in a large Washington, D.C. law firm. He specialized in anti-trust litigation and developed a keen interest in the U.S. Supreme Court about which he lectures and writes. 
By Jan Plotczyk September 23, 2025
We, the People, like our system of government. At least in the abstract. We like its checks and balances. We like its oversight. We like how the Founding Fathers created a system to prevent any one branch of government from wielding too much power. But we’ve never had a president who wanted to be a dictator and who has convinced Congress and the Supreme Court to give him carte blanche to carry out an extreme right-wing agenda. The results of four recent polls illustrate how Americans feel about the state of our three branches of government and the theory of checks and balances right now. (Links to the polls are at the end of this article.) Voters overwhelmingly support our system of checks and balances. Large majorities of voters feel that democracy is strengthened by congressional oversight (78%), judicial review (70%), and congressional power of the purse (68%).
By Jan Plotczyk September 23, 2025
Health insurance premiums for nearly 300,000 Marylanders will increase dramatically next year because of the Trump/GOP One Big Beautiful Bill Act signed into law in July. Our Congressman, Maryland District 1 Rep. Andrew P. Harris voted for that bill. Who will this affect? People who buy individual health insurance plans through Maryland’s Affordable Care Act Marketplace. How much will the increase be? 13.4% on average; policy holders will pay hundreds more for health insurance in 2026. Why is the increase happening? Federal tax credits that help keep costs down for low- to middle-income Marylanders are scheduled to expire at the end of 2025. The Maryland General Assembly approved funding this year, but it only partially covers the 13.4% increase. An estimated increase of 6.5% in medical and pharmaceutical costs also contributes to the rate hike. Why are the tax credits ending? The enhanced health insurance premium tax credits provided by the American Rescue Plan and Inflation Reduction Act will expire on December 31, 2025. The tax credits were not extended in the Trump/GOP OBBBA. What is the likely outcome? People who can no longer afford their plans will drop their insurance. Can anything be done? As part of negotiations to prevent a government shutdown on Oct 1, Democrats are pushing to preserve health care programs , including the permanent restoration of the federal tax credits and reversal of Medicaid cuts in OBBBA. Reactions in Maryland: “Under this new federal administration, Washington has shirked its duty to help middle-class Americans and families in poverty get affordable health care. Congress should act without delay to avoid these federal tax credits being ripped away from hardworking families,” said Maryland Gov. Wes Moore . “In Maryland, we will continue to do everything in our power to keep costs low for families and preserve access to affordable care.” “This can still be fixed,” said Vincent DeMarco, president of the Maryland Health Care for All coalition. “If Congress fails, it will hurt Marylanders.” Jan Plotczyk spent 25 years as a survey and education statistician with the federal government, at the Census Bureau and the National Center for Education Statistics. She retired to Rock Hall. 
By Gren Whitman September 23, 2025
(With apologies to the Rev. Martin Niemoller) First Trump came for undocumented immigrants, and I did not speak out because I was a citizen from birth. Then Trump swept up citizens in their immigration raids, and I did not speak out because my skin is not brown. Then Trump came for several white-shoe law firms in NYC and the District, and I did not speak out because I’m not an attorney. Then Trump came for Goldman Sachs, and I did not speak out because I’m not an economist. Then Trump halted collective bargaining for most federal workers across two dozen agencies, and I did not speak out because I’m no longer in a union. Then Trump came for Columbia, Penn, Brown, Princeton, Cornell, Northwestern, UCLA, Duke, UVa, and UMaine, and I did not speak out because I am no longer a student. (I did speak out as a Harvard grad.) Then Trump came for the Centers for Disease Control and Prevention, the Bureau of Labor Statistics, the Federal Reserve Board, and the Federal Emergency Management Agency, and I did not speak out because these federal agencies lacked spines. Then Trump came for Los Angeles with U.S. Marines and California National Guard, and I did not speak out because I’m not an Angelino. Then Trump came for the District of Columbia, but I had nothing to do with that city and said nothing. Then Trump threatened to come for Chicago, New York, and Baltimore, but ran into stiff resistance from Democratic mayors and governors and decided instead to come for Memphis, and I did not speak out. Then Trump came for Federal Reserve’s Lisa Cook, and I did not speak out because she’s fighting back in court and will likely win. Then Trump came for NPR and PBS, and I did not speak out because my news is from other sources. Then Trump came for New Jersey’s state’s Democratic governor and attorney general over immigration policies, and I did not speak out because I wasn’t directly affected. Then Trump came for a Wisconsin judge for allegedly obstructing ICE, and I did not speak out because Wisconsin’s a long way from the Eastern Shore. Then Trump came for former Special Prosecutor Jack Smith, and I did not speak out because if there was anyone on the planet who can take care of himself, it’s Smith. Then Trump came for NY AG Leticia James and Manhattan DA Alvin Bragg, and I did not speak out because they’re also fully capable of resisting threats and imprecations from Trump and his thugs. Then Trump came for Stephen Colbert and Jimmy Kimmel and I did not speak out because the other shoes — Seth Meyers, John Oliver, Jimmy Fallon, and John Stewart — have yet to drop. Then Trump promised to target “radical left lunatics,” and I did not speak out because, really, this is too nutty to be taken seriously, isn’t it? Then Trump threatened to “go after the NGO network that foments, facilitates and engages in violence,” and I did not speak out because, again, so very difficult to take seriously. Then Trump sued the NY Times for defamation, and I did not speak out because I believed his suit would be summarily tossed (as it was). Then Trump came for me and there was no one left to speak for me. As a community organizer, journalist, administrator, project planner/manager, and consultant, Gren Whitman has led neighborhood, umbrella, public interest, and political committees and groups, and worked for civil rights and anti-war organizations. 
By Jan Plotczyk September 23, 2025
To combat confusion and misinformation from the federal government, the Maryland Department of Health has taken the following steps to protect vaccine access for Marylanders: Issued new, clear recommendations for respiratory vaccines for individuals based on science Issued a statewide standing order giving all Marylanders access to the covid-19 vaccine Joined the bipartisan Northeast Public Health Collaborative to protect public health and access to vaccines The recommendations are for covid-19, RSV, and flu vaccines and follow science-based guidance issued by the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and American Academy of Family Physicians. The clear, understandable recommendations were adopted to replace the confusing and restrictive federal standards that are being issued by the Trump administration. In a clear departure from federal guidelines, MDH makes the following recommendations: Covid-19 vaccination is for: All children 6 months–2 years Children 2 years–18 years old who are at risk All adults RSV immunization is for: Infants under 8 months Children 8-19 months with risk factors Anyone pregnant People 50-74 who are at risk People over 75 Flu vaccine is for: Everyone older than 6 months Adults older than 50 years should get higher dose
By CSES Staff September 23, 2025
Construction on the Revolution Wind project off the coast of Rhode Island is back on after U.S. District Judge Royce Lamberth blocked the Trump administration’s most recent attempt to shut it down. The project is already 80% complete and will soon provide 704 megawatts of clean power to Rhode Island and Connecticut. Its supply chain spans 34 states, with shipyards in Louisiana and New England, steel production in New York, cable manufacturing in South Carolina, and hundreds of union jobs in Providence. This is proof that offshore wind is about more than turbines. It’s about jobs, investment, and energy independence. This matters here at home. Just as with his other stunts, Trump’s lawsuits against wind power projects in Maryland and Delaware are on track to fail. That means offshore construction for US Wind is still slated to begin in 2029, and the Eastern Shore will be at the center of it. Here’s what’s on the line: Rebuilding and expanding the deteriorating 45-year-old pier in West Ocean City into a modern operations and maintenance facility, complete with dredging guaranteed for 30 years. That project alone will support about 100 full-time local jobs. US Wind has also committed $20 million to the Fishing Community Resilience Fund, with $13.5 million dedicated to Maryland fishermen for offloading, ice services, harbor maintenance, and seafood marketing. The project will create nearly 2,700 jobs a year over seven years, power 718,000 homes with clean energy, and bring $815 million in investments to Maryland, with more than 50 companies already contracted. At Sparrows Point in Baltimore, US Wind is partnering with Haizea Wind Group to build a 100-acre monopile factory. At Wagner’s Point, Hellenic Cables is setting up a new undersea cable plant. These are well-paying, union-backed jobs that strengthen Maryland’s manufacturing base. For our Eastern Shore community, it means opportunity. US Wind has partnered with the Lower Shore Workforce Alliance, which received $700,000 from Maryland Works for Wind, to train the next generation of local workers. Our community college is already structuring its trades curriculum around offshore wind. These are careers for the future, right here at home. The project also sets a new standard for environmental protection. Turbines will be spaced to minimize migration impacts. Lights will remain off unless aircraft are nearby, thanks to aircraft detection lighting systems. Construction will be monitored with bubble curtains, acoustic listening for whales, and strict shutdown zones to protect marine life. These are the reasons that groups like the National Audubon Society, American Bird Conservancy, National Wildlife Federation, Interfaith Partners for the Chesapeake, and Greenpeace all support this project. In total, US Wind’s Maryland project will deliver two gigawatts of clean power — the equivalent of two nuclear plants and enough to serve about a quarter of Maryland homes. Four phases, 114 turbines, four offshore substations, and a record of decision already in hand from the federal Bureau of Ocean Energy Management. The fight is far from over, but the momentum is on our side. Trump and 1st District Rep. Andrew P. Harris can waste our tax dollars in court, but they can’t stop progress. Offshore wind is how we build good jobs, reduce bills, protect our Shore, and power a cleaner future, and is worth every ounce of the fight.
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