In this new century, a financial crisis has been developing for rural hospitals and medical practices. Costs for all services have gone up rapidly. Expensive new technology has been developed that has brought great advances in both treatment and diagnosis. But that technology is usually beyond the means of smaller hospitals and offices. At the same time, the population in rural areas is both decreasing and aging as many younger people grow up and head off to metropolitan areas to find jobs and an exciting new life.

Then along came 2008 and the Great Recession. The effects on medical services in general and hospitals in particular were quickly felt. In 2010, across America three rural hospitals closed; the rate of closures has steadily increased since. In 2015 alone, 16 hospitals in rural areas closed. Between 2010 and 2019, a total of 97 rural hospitals have shuttered their doors. Many others have cut services. Many will no longer deliver babies. The hospital in Chestertown is one such.

Since being acquired by the University of Maryland Medical System (UMMS) in 2008, the hospital in Chestertown has discontinued or cut services and staff in several departments. UMMS also now owns the hospitals in Cambridge and Easton as well as the Queenstown Emergency Center and several other smaller medical clinics on the Eastern Shore. This is part of another national trend of acquisitions and mergers often followed by reduced services and closures in the newly acquired medical organizations. Thus control of rural medical services has tended to move away from the local community to more distant urban centers. Hospitals and medical practices that were originally started, owned, and operated by local groups—town councils, doctors, churches, or other civic organizations—are now controlled from afar.

There are currently 4 bills, introduced by Senator Stephen Hershey (R, District 36, Kent, Queen Anne's, Cecil, and Caroline Counties) before the Maryland Senate that deal with rural health care and could help to keep local hospitals and other medical services open and to lower their costs. Should these be passed and turn out to be helpful for rural medical services, they could serve as a model for other hospitals—on the Eastern Shore and beyond.

• SB 1010 would assess service cuts at the hospital in Chestertown.

• SB 1018 would establish the Chestertown Rural Health Care Delivery Innovations Pilot Program to promote innovative solutions for a sustainable future for inpatient care in rural areas.

• SB 1028 would establish the Rural Health Care Scholarship and Grant Program to increase the availability of primary health care in rural areas of the State.

• SB 1029 would establish a program to recruit Nurse Practitioners and Physician Assistants in rural areas of the State.

For more information, and the complete text of the bills, see http://bit.ly/2WagerS

Hearings will already have been held on this legislation by press time, but you can write a letter in support here: http://bit.ly/2TKDRdG

All you have to do is enter a few pieces of information, many in the form of checkboxes. A customized letter to Gov. Hogan and Senator Delores G. Kelley (member of the Senate Finance Committee) will be generated from your responses. A representative of Save the Hospital will print and mail a copy of your letter. Easy peasy!