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Reducing Preventable Hospitalizations

Yesterday, as part of our ongoing ‘Governing for Results’ series, I had the privilege of touring the Center for Clinical Resources, part of the Western Maryland Health System. I met dedicated health care providers on the tour and we talked about the steps we’re taking to reduce preventable hospitalizations and create a stronger, healthier Maryland.

Hospital visits represent one of the most preventable public health challenges facing our State and the nation. While every person should have access to critical care at hospitals, we’re working to keep more people healthy and reduce the number and length of hospital stays, which in turn reduces costs for families and our health care system.

The O’Malley-Brown Administration set a goal to reduce the rate of preventable hospitalizations by 10 percent by 2015. In 2012, we exceeded that goal, driving down preventable hospitalizations in Maryland by 11.9 percent.

We’ve driven down preventable hospitalizations by investing in innovative ways to reduce costs, improve care, and cover all Marylanders.

Governor and CRC Staff

In 2009, we took one of many key steps to address this issue with the development of Maryland’s Health Information Exchange. The Chesapeake Regional Information System (CRISP) connects Maryland’s physicians, hospitals, and labs with real-time information ensuring continuity of care for all patients. CRISP sends roughly 10,000 notifications a month to physicians when their patients are admitted, discharged, or transferred to any hospital in Maryland.

The Western Maryland Health System is just one example of the way in which health care providers are working to keep more Marylanders healthy.  In July 2010, WMHS became one of 10 hospitals to participate in a demonstration project for the Total Patient Revenue model offered by the Maryland Health Services Cost Review Commission. In the four years since starting Total Patient Review, inpatient admissions have been driven down 32 percent, while readmissions within 30 days have been driven down 46 percent over the last two years.

Additionally, the Center for Clinical Resources at WMHS now centralizes services to support patients with chronic health conditions, such as diabetes, heart failure, and COPD. With the support of the Allegany County Health Department and the Maryland Health Care Commission, the Center’s efforts have produced approximately $1.4 million in savings for chronic heart failure and diabetic patients. And in 2014, the federal Centers for Medicare & Medicaid Services (CMS) approved Maryland’s all-payer rate-setting system which will improve patient care and reduce health care costs. Uwe Reinhardt, a health care economist at Princeton University, said,This is without any question the boldest proposal in the United States in the last half century to grab the problem of cost growth by the horns.

We believe that there is no such thing as a spare Marylander, and improving health care in Maryland means recognizing the promise, value, and potential of every human life. Together, we can ensure that every Marylander can improve their health and spend fewer days in hospitals.

To learn more about the O’Malley-Brown Administration’s innovative policy efforts and investments in new data platforms that have led to lower costs, better health outcomes, and improved patient care, please read the Governor’s recently released white paper: A Prescription for Innovation: Maryland’s Data-Driven Approach to Containing Costs and Advancing Health.


Protecting Maryland’s Blue Crabs

I say, “Maryland.”

You say, “Crabs.”

Few things dial up an instant connection to our home state like a pile of steamed crabs, hot to the touch and dusted with Old Bay, spread across a table covered with brown paper. Surrounded by friends and family with the Orioles game providing the soundtrack—you could be somewhere else, but why would you want to be?

steamed blue crabsWe often take for granted our next bushel of crabs and the one after that, just as our parents and grandparents did.

We shouldn’t. Harsh winter weather, coastal currents and natural predators can threaten the health of the blue crab population. To be sure, conditions can change as quickly as the striped bass bite in early fall. Good crab harvest years, such as 2012, are sometimes followed by poor seasons marked by scarcity and high prices.

The Maryland Natural Resources Police have launched a campaign – Don’t Get Pinched – to target crabbers who don’t play by the rules. The enforcement effort is being embraced by our partners at the Virginia Marine Resources Commission and the Potomac River Fisheries Commission, as we stand together to protect and manage these resources using the best available science.

NRP’s game plan follows the one established last year to protect another Bay keystone species – oysters. Surveillance, undercover operations, night vision equipment, saturation patrols and the Maritime Law Enforcement Information Network (MLEIN) are all being employed. Officers will be on the lookout for undersized crabs, overharvesting, recreational crabbers keeping female crabs, and crab pots that are not registered.

Rest assured we are not looking to ruin anyone’s outing or dinner plans. We are working to ensure the health of our fishery, the livelihoods of honest, law-abiding watermen and the enjoyment of our citizens.

Despite harvest being within the safe range for the last six years, the 2014 spawning age female crab abundance was just below the minimum safe level and the last two juvenile population surveys were not as robust as we would have liked. With this, awareness and enforcement efforts such as Don’t Get Pinched are necessary now more than ever.

The signature species of the Chesapeake Bay and its tributaries will keep its treasured place in our heritage only if we protect it. So, enjoy Maryland’s delicious blue crab and the rest of your summer… but don’t get pinched.

Joe Gill, Secretary
Maryland Department of Natural Resources


A Healthier, Safer Maryland

Yesterday, I visited the Annapolis Police Department as part of our ‘Governing for Results’ tour to highlight the formation of the Overdose Prevention Council and the steps we’re taking to reduce substance use disorder in our communities.

In Maryland, we value the wellness of our citizens and the safety of our communities above all else, which is why we’re working together to reduce drug-related deaths.

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In June, I signed an executive order establishing the Overdose Prevention Council to advise and assist State agencies in this effort. The Department of Health and Mental Hygiene and the Maryland State Police have launched a new initiative to equip Maryland State Troopers with naloxone, a life-saving medication that can safely and effectively reverse opioid overdoses. And earlier this year, I signed the Good Samaritan Law, which provides immunity for a person who assists someone experiencing a drug or alcohol overdose from criminal prosecution.

We’re also working on several data initiatives to better understand this epidemic, and all Maryland counties and Baltimore City have submitted local overdose prevention plans to DHMH.

The O’Malley-Brown Administration set a goal to expand services for substance use disorder by 25 percent from FY2008 to the end of FY2012, and in 2012, we met our goal, having increased the number of patients in State-funded substance use treatment programs by 26 percent. We followed that success by setting a new goal to reduce overdose deaths by 20 percent by 2015 – one of my Administration’s 16 strategic goals. But our work isn’t finished until we drive the number of overdose deaths down to zero.

In Maryland, we believe in moving forward and working together. Learn how you can help save lives in your community by visiting Maryland Department of Health and Mental Hygiene’s website.

Together, we can move forward and build a healthier, safer One Maryland.


A Better Prepared Maryland

Last week, I made a second call on our Maryland FiRST statewide radio communications system to mark the successful implementation of the system’s expansion to the Eastern Shore. The State’s first-ever statewide radio communications system puts first responders on the entire Eastern Shore and parts of Central Maryland on the same radio channel so they can communicate more effectively and better coordinate resources in the event of an emergency. These emergency personnel are responsible for 55 percent of our population and key critical infrastructure sites, including the northern I-95 corridor, Port of Baltimore, and BWI-Thurgood Marshall Airport. By 2017, the Maryland FiRST system will serve all of our state’s citizens, from Ocean City to Oakland.

Keeping Marylanders safe and secure is the most sacred responsibility of our government, and the Maryland FiRST system is helping to ensure that we carry out that responsibility efficiently and effectively.

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We’ve also invested in ESSENCE (Electronic Surveillance System for the Early Notification of Community-Based Epidemics), a web-based system designed for early detection of disease outbreaks. Every hospital in the state uses this system to protect Marylanders from infectious disease outbreaks and public health emergencies.

And we’ve increased traffic management video feeds available to our first responders from 266 feeds in 2009 to 1,657 video feeds now available, an expansion of over 520 percent.

These innovative investments are essential in helping us meet Maryland’s homeland security goals as part of the O’Malley-Brown Administration’s 16 strategic goals.

When Marylanders unite to achieve our goals, we are unstoppable. Together, we can continue to build on our homeland security successes as we work to create a more secure One Maryland.

Click here to view a video of Governor O’Malley’s second call on the Maryland FiRST system.


RedOwl Analytics: Doing the Things that Work

This week I visited RedOwl Analytics, a homegrown Baltimore company with 25 employees that turns big data into smart solutions for other businesses and organizations. Last year, judges selected RedOwl as the best business in the IT category at Maryland’s 2013 InvestMaryland Challenge, awarding the company $100,000 to help them grow. Here in Maryland we know that early investments spur innovation and create jobs, and with the help of InvestMaryland, RedOwl hopes to double their workforce over the next few years.

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Progress is a choice. Job creation is a choice. And the economy grows from the middle up and the middle out, not from the top down. That’s why, in the wake of the Great Recession, the O’Malley-Brown administration has focused on helping small businesses like RedOwl in the fight to recover all the jobs lost during the downturn. We set a goal to recover those jobs by the end of FY2014, and in April this year, we surpassed it.

The progress we’ve made, we’ve made by choosing to do the things that work; investing in education and infrastructure, and building innovative, common platforms for business success like InvestMaryland. Since May 2013, Maryland has created 22,100 jobs, with 83% (18,300) of those jobs in the private sector. And our unemployment rate is nearly 10% lower than the national average.

RedOwl Analytics is just the tip of the iceberg. The company is just one of the growing businesses in Maryland that has led the U.S. Chamber of Commerce to name Maryland #1 in the nation for entrepreneurship and innovation for three consecutive years and #1 in the nation for STEM jobs.

And even though we’ve surpassed our goal to restore jobs lost, we must continue to invest in the things that work as we look to the future. Together, we will build a stronger One Maryland.

Click here to view a video of Governor O’Malley’s visit to RedOwl Analytics.


Our Shared Belief in Dignity

June is LGBT Pride month, an opportunity for us to reaffirm our commitment to celebrating and protecting the dignity of every individual in Maryland.

As Marylanders, we believe that love is an unalienable right. We believe that the way forward is always to be found through greater respect for the equal rights of all of our friends, families, and neighbors. The common thread running through all our efforts together in Maryland is the thread of human dignity, our shared belief in the dignity of work, the dignity of faith, the dignity of family, the dignity of every single person.

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In 2012, I signed the Civil Marriage Protection Act into law. The Act protects the dignity of every individual in Maryland by allowing same-sex couples to get a government-issued marriage license, while including important provisions to ensure fair protection for religious institutions.

When the act was brought before voters, we became the first state in the nation to uphold same-sex marriage at the ballot box. Clergy and faith-based leaders, community leaders, civic organizations, civil rights groups, and citizens of all backgrounds from across our State came together as one, ensuring that Maryland protected individual civil marriage rights and religious freedom equally.

We are One Maryland, and all of us, at the end of the day, want the same thing for our children: to live in a loving, stable, committed home recognized and protected equally under the law.

Soon after taking office, we expanded the definition of protected classes to include “gender identity and expression” under the state’s Code of Fair Employment practices. Earlier this year, I had the pleasure of signing another victory for inclusion and openness in our State. The Fairness for All Marylanders Act ensures that everyone, regardless of gender identity, is protected from discrimination under the law. Because of the Act, we are one step closer today to creating the open, respectful, inclusive world that we want for all of our children.

Marylanders stand on the side of fairness and progress, and we will keep moving forward together. Join in on the celebration and learn more about Maryland’s LGBT community at Baltimore Pride 2014, a wonderful weekend of exhibitions, vendors, and performances taking place June 13 through 15.


Celebrating our Shared Heritage

This June, we celebrate the first Immigrant Heritage Month, an opportunity to reflect on the rich immigrant tradition that has long fueled our nation’s enterprising spirit. It’s that spirit that continues to bring millions from around the world to our shores today.

With the help of partners and advocates, we passed the DREAM Act to educate more of our children and help keep some of the world’s best and brightest minds living, working and innovating in our state. The DREAM Act gives students access to in-state tuition rates, regardless of their parents’ immigration status, provided they pay state taxes, graduate from a Maryland high school, and commit to legalizing their status as soon as they are eligible.

Despite a challenge to the law in the 2012 general elections, Marylanders of all racial, ethnic and cultural backgrounds came together  to defend the DREAM Act at the ballot box, reaffirming our state’s guiding belief in the dignity of every individual. Expanding opportunity to a greater number of people, regardless of where their parents or grandparents happen to have been born, will only create more jobs and continue to drive our Innovation Economy forward.

Casa De Maryland Justice Awards Night Reception

Last year, I also signed the Maryland Highway Safety Act into law to make Maryland roads safer. The Act allows undocumented immigrants in Maryland to obtain a driver’s license through the MVA, provided that they have paid taxes in Maryland for at least the two previous years.

Undocumented immigrants previously driving illegally now have the chance to learn the rules of the road, pass Maryland’s driving test and become licensed, insured drivers. And Maryland residents have responded, applying for more than 48,000 new or renewed driver’s licenses, ID cards or learner’s permits and obtaining them since the program went into effect in January.

As a result, I ordered scaled back compliance with Secure Communities program at Central Booking in Baltimore City because it was no longer clear to me that the program was still primarily focused on protecting public safety. Instead, it only broke family ties unnecessarily and eroded our community’s trust in law enforcement.

Here in Maryland, we also understand that our economy does better when we’re all doing better. That’s why in 2008, we established the Maryland Council on New Americans to tackle challenges to citizenship and better equip highly qualified workers to enter the workforce, and start new businesses. Today, we’ve not only increased awards in state contracts to Hispanic businesses by 133%, we also have the lowest unemployment rate for Latino workers in the nation.

This is what we’re fighting to create here in Maryland, a stronger economy with a human purpose. Join us all in celebrating and creating opportunities for our One Maryland’s greatest strength: the skills, talent, and creativity of our diverse people. I encourage you to become a part of the celebration online at Welcome.us.


Manufacturing a Stronger, More Sustainable Future

This week, I had the opportunity to address a group of over 200 Maryland manufacturers on the topic of energy efficiency– and the great strides we’re making together as a State to reduce greenhouse gas emissions, boost renewable energy, and drive down energy consumption. This group of innovators is at the forefront of an era of breathtaking change; they’re leading the way, helping us to accelerate the innovation curve so we can strengthen and grow our green economy.

It’s all about how we live, and fuel ourselves, on a planet with finite resources — and our collective moral imperative to take action, embrace market trends, and mold a better, more sustainable future for the next generation.

Energy Forum

Climate change is transforming our planet in ways that continue to evolve. This past Monday, we took a critical step toward combating this growing threat when President Obama announced new regulations that go after a principal driver of climate change — carbon emissions. Hailed as one of the boldest policy initiatives on climate change in decades, the President’s proposal empowers states to fight carbon dioxide pollution in a way that best suits their regions. I commend the President for his resolute leadership.

This follows a model that we’ve used here in Maryland. More than seven years ago we joined 9 other states (currently 8 states after New Jersey exited) in the Northeast to form the Regional Greenhouse Gas Initiative. Since that time, we’ve come to realize that this would serve as the blueprint for addressing the monumental effects of climate change.

All of this speaks to our commitment to govern in a fundamentally different way: setting goals, measuring performance, hitting deadlines, and getting results. Many of our 16 strategic goals in Maryland focus on sustainability. Among them are our goals (1) to reduce electricity consumption 15 percent by 2015, (2) to increase Maryland’s in-State renewable generation to 20 percent by 2022, and (3) to reduce Maryland’s greenhouse gas emissions 25 percent by 2020.

By making the better choice to take real action, we now rank in the top ten states for energy efficiency, up from our 47th place showing seven years ago. Baltimore is ranked by Ford Motor Company as one of the top 25 most electric vehicle ready cities America. With this work, we’re changing our energy grid for the better and we now have the 6th highest concentration of green, family-sustaining jobs along with the fastest rate of green job growth in the nation. These are tangible outcomes that demonstrate the important progress we’ve made to protect the land we love.

Here in Maryland, we believe in setting goals, measuring progress and delivering results. The time for action is here; the good news is that we finally have the tools we need to really make a difference.


Celebrating Maryland Green Schools

This has been a productive year for our state’s teachers and students in environmental education and today we honor our progress while looking to the future. Earlier today, I joined students and educators at the Maryland Association for Environmental and Outdoor Education’s Green School Youth Summit, held in Sandy Point State Park.

This event gave us the opportunity to congratulate 58 new Maryland Green Schools, 73 schools that have been recertified to maintain their green status, and the 3 schools that have achieved the Sustained Green School Award. Since 1999, 468 Maryland schools have received the Maryland Green Flag, making our State a leader in sustainability by incorporating green practices into the classroom and tackling environmental projects in their communities and neighborhoods.

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The green culture that educators, parents, staff, and community partners are establishing in our schools provides students with a pathway to college and future career success, while working to fulfill Maryland’s Environmental Literacy graduation requirement. Our graduation requirement is the first of its kind in the nation and an important step in ensuring that our students become savvy, healthy and productive members of our evolving green economy.

One example of this work in action: In 2013, we launched Explore and Restore your SchoolShed, through which teachers use local streams and creeks as outdoor classrooms, and connect hands-on learning to disciplines beyond science, such as language arts or social studies. Students learn about water quality and the importance of healthy streams, as well as the ways their own actions can improve their local environment. More than 100 schools are now participating across the State, and more schools are encouraged to join.

The O’Malley-Brown Administration is further inspiring young Marylanders to join efforts to protect our state’s abundant natural resources through the Stream Restoration Challenge. This program gives thousands of students the opportunity to plant trees all across the state, helping improve water quality. Additionally, over the past five years, the Governor’s Conservation Job Corps has graduated 1,800 at-risk youth from a summer employment program at Maryland State Parks, teaching invaluable green job skills and instilling a life-long appreciation of nature.

While we have accomplished much, there is still much to be done. We must continue to push for a healthier Chesapeake Bay, restoring Maryland’s most important natural resource by curbing harmful run-off and upgrading wastewater treatment plants. We must also work to reduce greenhouse gas emissions and promote in-state renewable energy sources, creating jobs and strengthening our economy while protecting Maryland’s environment for future generations.

By taking advantage of these resources now, we can continue to enrich programs and help our young citizens grow their knowledge and stewardship ethic. Together, we are ensuring that the leaders of tomorrow are attaining the knowledge they need today — both in the classroom and in the community — to address the challenges of our ever-changing world.

Congratulations to today’s honorees and thank you to all of the Maryland Green Schools for working to make our One Maryland a greener, healthier, more sustainable state.


Lowering Hospital Bills by Reducing Uncompensated Care

The Affordable Care Act (ACA) ushered in a number of important reforms: insurance companies can no longer deny care to someone because of a preexisting condition; they can’t drop someone if he or she gets sick; and children can now stay on their parents’ plan until age 26. The Affordable Care Act was also designed to expand access to affordable and quality health coverage, and to reduce the significant cost-shifting that drove up health care costs pre-ACA.

Before the ACA, people who didn’t have insurance—and who couldn’t afford to pay out-of-pocket—would show up to hospitals for care. Hospitals would then shift the huge costs they incurred from providing uncompensated care onto the rest of us via higher bills. As more people are insured because of the ACA, fewer people without insurance will show up to the hospital in need of care. Reducing uncompensated care will mean fewer costs that have to be passed on to everyone else, and that will mean lower hospital bills.

We know that more than 330,000 Marylanders have enrolled in coverage since January 1 (exceeding our goal of 260,000). We received some early data in March to show that uncompensated care already was on the decline in Maryland. And yesterday, we received even more data: for the first quarter of 2014, hospitals saw 62% fewer charity cases and 24% fewer self-pay cases, compared to the first quarter of 2013.

Maryland’s unique system of setting hospital rates means that less uncompensated care translates directly into lower hospital bills. Officials on the rate setting commission said they plan to take 1% off of their planned rate adjustment in July because of a reduction in uncompensated care. There is now optimism that rates could be driven down even farther.

Tom Mullen, the widely respected CEO of Mercy Medical Center, summed the news up this way to the Baltimore Sun: “It’s very positive. Having more people covered is good. In Maryland, everyone benefits.”

Joshua M. Sharfstein, MD, Secretary
Department of Health & Mental Hygiene