TAKING STRATEGIES TO RESIDENTIAL FACILITIES, COMMUNITY-BASED ORGANIZATIONS TO HELP FRONTLINE STAFF DO THE WORK DIFFERENTLY TO HELP YOUNG PEOPLE HEAL FROM TRAUMA AND CHANGE THEIR BEHAVIORS AND NOW I'M BACK.

>> Jeff: NOW THAT YOU ARE BACK YOU'VE MADE AN IMMEDIATE CHANGE IN THE ELECTRONIC MONITORING PROGRAM.

WHAT IS CHANGING?

>> ELECTRONIC MONITORING IS SUCH AN IMPORTANT PART OF OUR OVERALL CONTINUUM OF CARE FOR YOUNG PEOPLE.

IT ALLOWS YOUNG PEOPLE TO BE IN THE COMMUNITY WITH AN ADDED LEVEL OF SUPERVISION.

AND MOST OF OUR YOUNG PEOPLE WHO ARE ON THAT PROGRAM DO VERY WELL.

BUT AS I DUG INTO THE DATA AND TOOK A STRONG LOOK AT OUR OPERATIONS, WE NOTICED THERE WERE A POPULATION OF YOUNG PEOPLE WHO WERE NOT DOING WELL IN THE PROGRAM, FALLING THROUGH THE CRACKS WHO WERE REOFFENDING WHILE ON THAT ELECTRONIC MONITORING.

SO IT HIGHLIGHTED WE HAD TO DO SOMETHING DIFFERENT.

WE WILL USE DETENTION WHEN A YOUNG PERSON IS BROUGHT BACK TO OUR ATTENTION IF THEY ARE ALLEGED TO HAVE REOFFENDED WHILE ON THE ELECTRONIC MONITORING PROGRAM.

BUT WE WANT TO DO MORE THAN USE DETENTION AS OUR RESPONSE.

WE'RE ENSURING OUR FRONTLINE WORKERS WHO ARE OVERSEEING AT THAT TIME PROGRAM ARE GETTING COACHING AND TRAINING TO HELP DISRUPT SITUATIONS WHEN THEY OCCUR IN THE COMMUNITY SO WE CAN HELP BRING YOUNG PEOPLE INTO COMPLIANCE.

WE ARE GOING TO ENSURE THE DETENTION WORKERS ARE IN THE COURTROOM SO WHEN THE PERSON GOES TO COURT THE NEXT DAY EVERYONE IN THE COURTROOM HAS THE BEST INFORMATION THE MOST UP-TO-DATE INFORMATION ON HOW THE YOUTH WAS REALLY COMPLIANT ON AT THAT TIME PROGRAM.

AND WE'RE ALSO GOING TO MAKE SURE WE'RE CONNECTING YOUNG PEOPLE TO COMMUNITY-BASED SUPPORTS SO THEY CAN BE SUCCESSFUL IF RETURNED TO THE PROGRAM.

>> Jeff: WHAT PEOPLE ACROSS MARYLAND SEE ON THE NEWS ALL THE TIME, IS REALLY A CONSTANT STREAM OF STORIES ARE JUVENILE OFFENDERS, CARJACKINGS, ARMED ROBBERIES, SHOOTING AND SO FORTH.

LAST NIGHT AHEAD OF OUR TAPING TIME THERE WERE INCIDENTS INVOLVING GUNFIRE INVOLVING JUVENILES IN BOTH BALTIMORE COUNTY AND MONTGOMERY COUNTY.

ARE WE OVEROVERALL DEALING WITH THIS PROBLEM EFFECTIVELY?

>> THERE'S ALWAYS ROOM FOR IMPROVEMENT.

AND, I THINK, WHAT WE'RE SEEING IN OUR COMMUNITIES IS THERE IS ROOM FOR IMPROVEMENT.

AGAIN MOST OF OUR YOUNG PEOPLE BROUGHT TO OUR ATTENTION PLACED ON PROBATION OR LONG-TERM TREATMENT ARE DOING WELL AND GETTING CONNECTED TO THE INTERVENTIONS AND SUPPORTS THEY NEED TO BE CONNECTED TO IN ORDER TO BE SUCCESSFUL AND REACH THEIR GOALS.

BUT THERE IS A SMALL POPULATION OF YOUNG PEOPLE THAT ARE CONTINUING TO HAVE A SIGNIFICANT IMPACT ON COMMUNITY SAFETY, A SIGNIFICANT IMPACT ON PEOPLE AND VICTIMS.

AND WE WANT TO MAKE SURE WITH THAT POPULATION WE ARE REALLY HYPER FOCUSED ON ENSURING WE ARE DOING THE RIGHT THINGS CONNECTING THOSE YOUNG PEOPLE TO THE RIGHT RESOURCES WHETHER OR NOT IT'S LONG-TERM TREATMENT IN A RESIDENTIAL FACILITY OR WE ARE CONNECTING THEM TO THE RIGHT HIGH LEVEL COMMUNITY-BASED SUPPORTS TO HELP DISRUPT THOSE INCIDENTS FROM HAPPENING AGAIN.

>> Jeff: IS THERE ANYTHING ELSE YOU'RE PLANNING TO CHANGE FROM YOUR PREDECESSOR'S TENURE?

>> I THINK WE ARE GOING TO SEE A LOT OF CHANGES AWE DIG INTO OUR OPERATIONS.

BUT WE ARE LOOKING ARE WE GETTING WHAT WE WANT OUT OF OUR DAY-TO-DAY OPERATIONS?

ARE WE DELIVE DELIVERING WHAT WE NEED TO YOUNG PEOPLE AND BEING A TRUE PARTNER HELPING PUBLIC SAFETY IN OUR COMMUNITIES?

AND IN DOING SO WE ARE GOING TO FOCUS ON OUR FRONT END OF THE SYSTEM ENSURING WHEN WE HAVE THAT FIRST INITIAL CONTACT WITH YOUNG PEOPLE, WE'RE USING THAT MOMENT TO DO AN ASSESSMENT, TO CONNECT THE YOUNG PERSON AND THE FAMILY TO SUPPORTS TO REDUCE THE LIKELIHOOD OF FUTURE OFFENDING.

AND WE'RE ALSO GOING TO FOCUS AT THE DEEPER END OF OUR SYSTEM.

OUR FACILITIES, OUR TREATMENT PROGRAMS, TO ENSURE THOSE FACILITIES AND TREATMENT PROGRAMS ARE DELIVERING TO YOUNG PEOPLE THE TYPE OF INTERVENTIONS THAT THEY NEED.

SO THAT WHEN THEY RETURN HOME WE DON'T SEE THE REPEAT OFFENDING.

>> Jeff: ARE THE FACILITIES YOU ARE TALKING ABOUT WHAT USED TO BE CALLED REFORM SCHOOLS?

AND HOW DO THEY WORK NOW?

>> I THINK YES, THEY USED TO BE CALLED REFORM WILL SCHOOLS.

THEY HAVE GONE THROUGH DIVOTRATIONS OVER TIME.

BUT WHAT WE DO KNOW AND THE SCIENCE WHAT WE KNOW ABOUT ADOLESCENTS DEVELOPMENT ALL YOUNG PEOPLE HAVE CAPACITY TO CHANGE, CAPACITY TO HEAL FROM THE TRAUMA THEY HAVE EXPERIENCED AND WE CAN DO THINGS TO HELP THEM BE SUCCESSFUL WHEN THEY RETURN TO COMMUNITY.

SO WE LOOK AT THOSE FACILITIES, ESPECIALLY OUR LONG-TERM TREATMENT FACILITIES, AS A WAY TO REHABILITATE, TO HELP YOUNG PEOPLE PROVIDE THE RIGHT INDIVIDUALIZED TREATMENT SO THEY ARE EMPOWERED TO CHANGE THEIR BEHAVIORS WHEN THEY RETURN.

>> Jeff: YOU KNOW, THE PENDULUM IN POLITICS SWINGS BACK AND FORTH ON A LOT OF TOPICS BUT I CANNOT THINK OF ANYTHING THAT HAS SWUNG MORE DRAMATICALLY THAN JUVENILE JUSTICE.

30 YEARS AGO MARYLAND WENT TO A BOOTCAMP MODEL UNDER BISHOP ROBINSON AND GOVERNOR SCHAEFER.

THAT WAS HARSH.

AND THEN UNDER YOUR PREDECESSOR IT SEEMED TO HAVE GONE TO LET'S CALL IT A MORE RELAXED MODEL.

WHAT IS THE OPTIMUM PLACE ON THAT SPECTRUM.

WHERE SHOULD WE BE?

>> WE SHOULD BE WHERE WE NEED TO BE TO GET OUR YOUNG PEOPLE WHAT THEY NEED.

WE HAVE TO TAKE A HARD LOOK AT OUR POPULATION WHO WE ARE SERVING.

AND IDENTIFYING THEIR NEEDS AND MANY OF OUR YOUNG PEOPLE ARE COMING IN WITH A DIVERSE SET OF NEEDS AND CHALLENGES.

BUT OUR SYSTEM HAS TO BE EQUIPPED AND DESIGNED TO BE ABLE TO ADDRESS THOSE CHALLENGES AND ADDRESS THOSE NEEDS REGARDLESS OF WHAT WE CALL IT, IF WE OPERATE DAY-TO-DAY WITH THAT MINDSET THEN WE'RE GOING TO BE ABLE TO EQUIP YOUNG PEOPLE TO BE SUCCESSFUL WHEN THEY RETURN.

>> Jeff: WHAT IS THE CENSUS LIKE, THE COUNT OF IN THE PRISON SYSTEM THE COUNT OF PRISONERS IN JUVENILE JUSTICE IT COULD BE CALLED THE COUNT OF RESIDENTS, I GUESS.

THE AND HOW DOES IT COMPARE TO WHERE WE WERE 10 OR 20 YEARS AGO?

>> IF WE LOOK BACK 10, 20 YEARS AGO WE HAVE LESS YOUNG PEOPLE IN OUR SYSTEM, LESS YOUNG PEOPLE IN OUR FACILITIES.

BUT IF WE LOOK IN THE SHORT-TERM WE HAVE MORE YOUNG PEOPLE IN OUR DETENTION FACILITIES AND LONG-TERM TREATMENT FACILITIES THAN WE DID OVER THE COVID PANDEMIC TIME.

AND AS WE SEE THOSE POPULATIONS CHANGE, WE REALLY NEED TO LOOK AT WHAT THOSE YOUNG PEOPLE NEED.

WE'RE SERVING AN OLDER POPULATION THAN WE DID PROBABLY FIVE, 10 YEARS AGO.

SO WE NEED TO BE ABLE TO ADDRESS THAT POPULATION SHIFT OUR PROGRAMMING AND WHAT WE'RE DELIVERING TO REALLY MEET THE NEEDS OF AN OLDER POPULATION.

>> Jeff: YOU KNOW, WHEN YOU TALK TO PROSECUTORS AROUND THE STATE WHO HAVE BEEN CRITICAL OF THE DEPARTMENT DEALINGS WITH THE DEPARTMENT, THEY SEEM TO AGREE WITH THE IDEA THAT NOTHING WHEN YOU ARE DEALING WITH TEENAGERS, UNDER 18, IT SHOULDN'T BE PUNITIVE.

IT SHOULD BE RESTORATIVE.

BUT AT THE SAME TIME, DO YOU THINK THERE NEEDS TO BE SOME LEVEL OF DETERRENCE FOR A YOUNG PERSON WITH A GUN WHO MAYBE SEES NO PENALTY AT ALL FOR GOING OUT AND CARJACKING SOMEBODY?

>> A SYSTEM THAT IS BASED IN REHABILITATION ONE NOT BASED IN PUNITIVE MEASURES OR ONE THAT IS BASED IN RESTORATIVE PRACTICES AND SKILL BUILDING DOES NOT MEAN WE OPERATE A SYSTEM THAT IS VOID OF ACCOUNTABILITY.

WE HAVE TO HAVE A LEVEL OF ACCOUNTABILITY SO AS WE DELIVER THOSE INTERVENTIONS TO YOUNG PEOPLE, THAT THEY ARE ENGAGED AND THAT WE ARE HOLDING THEM ACCOUNTABLE TO RECEIVE THE TREATMENT WE ARE DELIVERING.

>> Jeff: AND THE GREATEST VICTORY HERE WOULD BE TO NOT HAVE ANYBODY COMING INTO YOUR SYSTEM, TO NOT HAVE PEOPLE WHO IN THEIR YOUNG, SHORT LIVES HAVE WOUND UP ON A BAD PATH.

WHAT IS THE ANSWER THERE?

>> I MEAN THAT IS THE GOAL.

WE'D LOVE TO GET TO A PLACE WHERE WE HAVE PUT IN THE RIGHT TYPE OF STRATEGIES, WE WORKED OURSELVES OUT OF JOBS THAT IS PROBABLY NOT LIKELY IN THE SHORT-TERM.

SO WE HAVE TO MAKE SURE THAT WHAT WE ARE DOING, IS ANSWERING TO THE NEEDS OF OUR YOUNG PEOPLE, ANSWERING TO THE NEEDS OF OUR FAMILIES AND ANSWERING TO THE NEEDS OF COMMUNITY.

>> Jeff: YOU ARE THE ACTING SECRETARY, THE GOVERNOR WILL NOMINATE YOU FOR THE FULL-TIME POSITION THAT WILL MEAN A HEARING IN THE SENATE WHERE A LOT OF THESE ISSUES WILL BE BROUGHT UP.

THAT WON'T HAPPEN UNTIL NEXT JANUARY WHEN THE LEGISLATURE COMES BACK?

>> THAT'S RIGHT.

WHEN THE GENERAL ASSEMBLY RECONVENES IN JANUARY, 2026 I WILL HAVE THE OPPORTUNITY TO GO THROUGH THE CONFIRMATION PROCESS, TALK WITH THE MEMBERS OF THE GENERAL ASSEMBLY, ANSWER THEIR QUESTIONS AND HOPEFULLY AT THE END OF THE DAY, RECEIVE THEIR VOTE OF APPROVAL AND TAKE THIS POSITION PERMANENTLY.

>> Jeff: BETSY FOX TOLENTINO, IS RUNNING JUVENILE SERVICES IN MARYLAND WE APPRECIATE YOUR TIME.

THANK YOU VERY MUCH.

>> THANK YOU SO MUCH.

[♪♪] >> JOINING ME IS AVA PERLIN, SHE IS JUST 17 YEARS OLD AND AMONG HER ACCOMPLISHMENTS SHE IS A PUBLISHED AUTHOR.

HER BOOK, "ONE IN A MILLIEON" IS ABOUT HER SISTER, HER LITTLE SISTER MILLIE IS THAT RIGHT?

>> YES.

>> TELL ME ABOUT THE STORY AND WHY YOU DECIDED TO WRITE THIS ABOUT YOUR SISTER AND WHO ISN'T INTENDED FOR.

>> I GO TO SCHOOL IN OWENS MILLS AND EVERY YEAR THE JUNIOR CLASS TAKES ON OUR PASSION PROJECT WHERE WE HAVE FREE RANGE TO CREATE A PROJECT ABOUT SOMETHING WE ARE PASSIONATE ABOUT.

WHEN I HEARD ABOUT THE PROJECT I KNEW I WANTED TO DO SOMETHING ABOUT MY SISTER MILLIE AND DISABILITY ADVOCACY AND INCLUSION.

SO I TALKED TO MY TEACHER, AND WE CAME UP WITH THE IDEA TO WRITE A CHILDREN'S BOOK SPECIFICALLY TARGETED TOWARDS SIBLINGS OF KIDS WITH DOWN'S SYNDROME THAT IS WHO I AM AND MY STORY AND I CAN SPEAK TO AND I WOULD HAVE WANTED WHEN I WAS YOUNGER IN NAVIGATING GOING TO SCHOOL WITH MY SISTER, MILLIE.

MANY PEOPLE HAVEN'T INTERACTED WITH PEOPLE WITH DOWN'S SYNDROME SO THERE WAS A LOT OF CURIOSITY AND THIS BOOK WOULD HAVE BEEN HELPFUL FOR ME.

THAT IS WHAT I WANTED TO CREATE.

>> A LOT OF KIDS SEEM TO GET THE MESSAGE ABOUT NOT BULLYING.

YOUR BOOK IS ABOUT THE SUBTLE WAYS IN WHICH KIDS MIGHT EXCLUDE PEOPLE WHO ARE DIFFERENT THAN THEM, RIGHT, OR MAKE THEM FEEL DIFFERENT?

>> RIGHT.

SO I REALLY WANTED SOMETHING ESPECIALLY WITH MILLIE WE'VE NEVER HAD ANY INCIDENTS WHERE THERE HAVE BEEN STEREOTYPICAL BULLYING.

BUT I DID NOTICE KIDS WERE INTIMIDATED AND SCARED BECAUSE THEY HAD NEVER INTERACTED WITH SOMEONE WITH DOWN'S SYNDROME.

THE BEST THING I COULD DO WAS TO TEACH OTHER PEOPLE AND THAT IS WHAT I WANT THIS BOOK TO DO AS WELL.

>> IN THE BOOK YOU TALK ABOUT MILLIE LOVES TO SING.

>> YES.

THAT'S VERY MUCH A TRUE STORY MILLIE LOVES TO SING AND DANCE AND ESPECIALLY WHEN WE WERE YOUNGER THAT CAME WITH A LITTLE BIT OF EMBARRASSMENT FOR ME, BECAUSE WE WERE OFTEN THE CENTER OF ATTENTION WITH THAT.

SHE WAS LOUD AND SHE WAS HAPPY AND THAT STANDS OUT.

THAT'S VERY MUCH A REAL STORY.

AND I WANTED TO TEACH OTHER PEOPLE THAT WE DON'T NEED TO BE EMBARRASSED AND ALSO THAT A LITTLE BIT OF EMBARRASSMENT IS OKAY.

IT'S HARD TO BE THE CENTER OF ATTENTION AND HARD WHEN PEOPLE DON'T KNOW WHO SOMEONE IS OR WHY THEY ACT THE WAY THEY DO.

THAT IS ANOTHER THING I WANTED TO TOUCH ON IT'S OKAY TO FEEL EMBARRASSED OR INSECURE.

BUT AT THE END OF THE DAY, WE ARE WHO WE ARE AND INCLUSION AND KINDNESS ARE IMPORTANT ABOVE ALL ELSE.

>> I LOVE THAT.

NOW, ONE THING TO SHARE YOUR STORY WITH YOUR CLASS OR YOUR SCHOOL, BUT HOW DID YOU END UP GET TO GO PUBLISHED?

THAT IS REMARKABLE?

>> I PRESENT TO DO TO MY SCHOOL AND I WAS INVITED TO THE LOWER SCHOOL, THE AGE RANGE OF KIDS I HAD WRITTEN THIS BOOK FOR AND I GOT POSITIVE FEEDBACK AND TEACHERS AFTER THAT CAME UP TO ME AND ASKED WHERE THEY COULD BUY A COPY WE DECIDED MAYBE THE STORY AND THIS MESSAGE IS NEEDED IN A BROADER SENSE.

SO I USED KINDLE DIRECT PUBLISHING AMAZON'S PUBLISHING PROGRAM AND I SUBMITTED BY BOOK AND IT WENT OUT FOR REVIEW AND IT WAS EVENTUALLY ACCEPTED AND PUBLISHED ON JUNE 1.

>> HOW HAS REACTION BEEN AND WHAT DOES MILLIE THINK OF IT?

>> THE REACTION HAS BEEN OVERWHELMING POSITIVE.

WE'VE HEARD FROM PEOPLE WE KNOW AND PEOPLE WE DON'T KNOW THAT SAY THIS STORY IS NEEDED OUT THERE AND I THINK THAT OUR FAVORITE PIECE OF FEEDBACK IS WHEN PEOPLE SAY THEY ARE GOING TO BRING IT INTO THEIR CLASSROOMS TO TEACH THEIR STUDENTS AND GIVE IT TO SOMEONE AS A BABY SHOWER PRESENT THAT JUST SHOWS THAT THIS BOOK -- THE MESSAGE IS NEEDED THAT INCLUSION NEEDS TO BE TAUGHT AND MILLIE'S HAD A FUN REACTION TO IT.

SHE IS MORE HUMBLE IN THE SENSE I DON'T KNOW IF SHE LOVES BEING THE CENTER OF ATTENTION BUT SHE DOES TELL PEOPLE ABOUT THE BOOK.

SHE IS PROUD THERE IS A STORY ABOUT HER.

>> DO YOU WANT TO WRITE MORE BOOKS?

>> I DON'T THINK SO.

ALTHOUGH I DID WRITE THIS BOOK, WRITING ISN'T MY PASSION.

IT IS I'M MORE INTERESTED IN SCIENCE AND MATH AND FASCINATED ABOUT THE SCIENTIFIC SIDE OF DOWN'S SYNDROME, THE GENETICS REALM OF IT.

I PLAN TO PURSUE A CAREER WITHIN THE DOWN'S SYNDROME BUBBLE IT PROBABLY WON'T BE MORE WRITING.

>> AVA PERLIN, THE BOOK IS "ONE IN A MILLIEON" YOU CAN BUY IT ON AMAZON.

IT IS A BEAUTIFUL BOOK ABOUT ACCEPTANCE AND THE BEAUTY OF DIFFERENCES.

THANKS SO MUCH.

>> THANK YOU SO MUCH.

>> Jeff: NOW A NEW ALLIANCE OF HEALTHCARE GROUPS IS FORMED TO DRY TO ADDRESS A DECADE LONG PROBLEM MARYLAND'S WORST IN THE NATION EMERGENCY ROOM WAITING TIMES WE SPOKE WITH ANNA PALMISANO DIRECTOR OF MARYLANDERS FOR PATIENT RIGHTS.

THANK YOU FOR JOINING US.

LET'S START WITH THE PROBLEM HERE.

WHAT IS HAPPENING IN MARYLAND'S EMERGENCY DEPARTMENTS?

>> WELL, JEFF, FOR THE LAST DECADE, MRYLAND PATIENTS HAVE SUFFERED THE LONGEST AVERAGE ER WAIT TIME OUT OF 50 STATES.

CURRENTLY WELL OVER FOUR HOURS.

SOMETIMES LASTING 24 HOURS FOR EMERGENCY.

AND THIS IS SHAMEFUL FOR A STATE THAT'S FIFTH IN PER CAPITA INCOME.

MARYLAND PATIENTS LACK RELIABLE ACCESS TO TIMELY CARE.

SOME PATIENTS ARE DRIVING TO TO OTHER STATES TO GET THEIR EMERGENCY CARE.

INCLUDING A GROUP RETIREMENT VILLAGE WHO HAVE IDENTIFIED DESIGNATED DRIVERS TO TAKE THEM ACROSS THE BRIDGE TO GET THERE.

THIS IS A VERY APPALLING SITUATION.

AND I'D LIKE TO ADD, LONG WAIT TIMES ARE MORE THAN AN INCONVENIENCE FOR EMERGENCY PATIENTS.

THERE'S MEASURABLE INCREASE IN RISK.

IN FACT, THERE ARE STUDIES PUBLISHED BY THE BRITISH MEDICAL JOURNAL THAT CITED AN INCREASE IN PATIENT MORTALITY OF 13% FOR EVERY ADDITIONAL HOUR THAT YOU WAIT IN THE ER.

SO.

>> Jeff: I'LL ADMIT TO NOT BEING A DISINTERESTED SPECTATOR I'VE HAD PERSONAL EXPERIENCE SITTING WITH A COUPLE RELATIVES IN DIFFERENT EMERGENCY DEPARTMENTS OVER THE PAST COUPLE OF YEARS.

AND ONE CASE, IT WAS A SERIOUS MATTER IT'S WORKED OUT OKAY.

BUT THE PATIENT ARRIVED BY AMBULANCE, WOUND UP BEING ADMITTED FOR NEARLY A WEEK WAS 10 HOURS SITTING IN THE WAITING ROOM OVERNIGHT.

AND IT WASN'T LIKE IT WAS THE MIDDLE OF THE PANDEMIC AND THINGS WERE CRAZY.

IT WAS NORMAL TIMES.

AND JUST AN INCREDIBLE WAIT.

AND IT SEEMS LIKE INSTEAD OF GETTING BETTER, THIS PROBLEM IS ACTUALLY GETTING WORSE.

>> IT IS; INDEED.

AND I THINK IT HAS TOUCHED JUST ABOUT EVERYONE IN MARYLAND IN THE PAST YEAR, IF YOU HAVEN'T GONE TO THE ER, I BET SOMEONE IN YOUR FAMILY YOUR NEIGHBOR, A FRIEND, IT REALLY HAS TOUCHED EVERYONE.

AND YOU KNOW, I OFTEN HEAR THIS MYTH THAT OH, ALL THESE PATIENTS, THEY ARE COMING IN THEY DON'T NEED THE ER AND THEY ARE OVERWHELMING THE ER.

WELL, IT TURNS OUT FROM MY STUDIES THAT 90% OF THE STATES HAVE MORE ER VISITS THAN MARYLAND.

SO THAT'S SIMPLY NOT TRUE.

WE DON'T HAVE AS MANY PEOPLE TRYING TO GET IN THE ER BECAUSE THEY KNOW HOW LONG THE WAIT IS.

>> Jeff: TELL ME ABOUT YOUR NEW ORGANIZATION.

>> YEAH.

WELL, I'M THE DIRECTOR OF MARYLANDERS FOR PATIENT RIGHTS.

MY DOCTORATE IS MICROBIOLOGY AND WE HAVE 23 PATIENT ADVOCACY MEMBERS OF OUR COALITION.

COLLECTIVELY OVER A MILLION MARYLANDERS, BIG GROUPS LIKE AARP AND N.A.A.C.P., CASA, AND MANY MORE, IN ADDITION, WE'RE ALSO PARTNERING WITH HEALTHCARE UNIONS, THE MEDICAL SOCIETY, ADVOCATES LIKE PROGRESSIVE MARYLAND AND WE HAVE FORMED A PATIENT WORKER COLLABORATIVE.

PATIENTS WANT TO PARTNER WITH WORKERS BECAUSE THIS IS ISSUE IS IMPORTANT TO EVERYONE, PATIENTS AND HEALTHCARE WORKERS.

>> Jeff: TELL ME WHAT YOUR GROUP'S PROPOSED SOLUTION IS?

>> WELL, AS I MENTIONED, OUR GROUP HAS OVER A MILLION MARYLANDERS, INCLUDING THE PATIENT RIGHTS ADVOCATES, IT HAS THE MEDICAL SOCIETY, HEALTHCARE WORKER UNIONS IT IS A VAST GROUP OF PEOPLE.

OUR ONLY OPPOSITION HAS BEEN THE MARYLAND HOSPITAL ASSOCIATION WHICH IS A LOBBYING GROUP FOR HOSPITAL EXECUTIVES.

WE HAVE FOUND THROUGH OUR STUDIES, THE ROOT CAUSE OF THE LONG WAITS IS THAT ER'S ARE CONSTANTLY UNDERSTAFFED.

OVERWHELMED ER'S MEDICAL STAFF TRYING TO PROVIDE THE BEST CARE THAT THEY CAN BUT IT'S NOT ADEQUATE FOR THE PATIENT LOADS.

ESPECIALLY DURING THE SURGES THAT CONSIDER EVERY FALL WITH FLU, RSV AND COVID.

>> Jeff: WHAT ARE THE OTHER POSSIBILITIES?

IT COULD BE STAFFING, IT COULD BE SIZE OF THE FACILITIES, IT COULD BE THE NUMBER OF FACILITIES.

HAVE YOU CONSIDERED ALL THAT?

>> WELL, FROM MY RESEARCH, REALLY, STAFFING COMES OUT ON TOP ALL THE TIME.

THE SECOND VERY FACTOR WOULD BE BED AVAILABILITY, BUT THAT IS STARTING TO BE ADDRESSED IN OUR STATE.

BUT WE ARE 45TH IN THE NATION FOR STAFFED BEDS.

SO WE DO NOT HAVE ENOUGH STAFF TO GO AROUND FOR THE BEDS THAT ARE AVAILABLE.

>> Jeff: LEGISLATURE HAS A STUDY ONGOING I BELIEVE.

WHAT DO WE KNOW ABOUT THAT?

>> CURRENTLY, THERE IS AN ER WAIT TIME COMMISSION BEING LED BY HSCRC, HEALTH SERVICES COST REVIEW COMMISSION.

AND THEY ARE LOOKING AT THE ENTIRE HEALTHCARE SYSTEM, WHICH SHOULD TAKE SOMETIME INSTEAD OF FOCUSING ON THE PROBLEM.

AND THEY ALSO FEEL THAT THEY WANT TO GET MORE PEOPLE GOING TO PRIMARY CARE.

WHICH IS HARD, BECAUSE PRIMARY CARE DOCTORS ARE GETTING TO BE FEW AND FAR BETWEEN AS WE MARYLANDERS ARE AGING, HAVE MULTIPLE ACUITIES, MULTIPLE PRESCRIPTIONS THAT CAN INTERACT.

THEY HAVE BEEN GOING ON FOR A COUPLE YEARS AND I HAVE NOT SEEN LIGHT COME OUT OF THAT.

>> Jeff: EVERYBODY DENIES THIS, BUT I SUSPEC THIS MIGHT HAVE AT LEAST A LITTLE BIT TO DO WITH THE EXPERIMENTAL PAYMENT SYSTEM THAT FUNDS HOSPITALS IN MARYLAND WHERE THEY ESSENTIALLY HAVE A DISINCENTIVE TO TREAT ADDITIONAL PATIENTS.

IS THAT POSSIBLE THAT BECAUSE OF THE WAY THEY ARE PAID, PROVIDING BAD EMERGENCY CARE MIGHT BE GOOD FOR THE BOTTOM LINE?

>> WELL, I HAVE STUDIED THIS.

IT IS A GREAT QUESTION, JEFF.

AND I FOUND NO RELATIONSHIP BETWEEN THIS CONTINUING INCREASE IN ER WAIT TIME AND THE TOTAL COST OF CARE MODEL WHICH NOW HAS A NEW NAME OTHER STATES ARE GOING TO HAVE TO DO THAT AS WELL.

AND YOU LOOK AT THE GLOBAL BUDGETS AND YOU CAN SEE THEY SAY OUR MARGINS ARE SO NARROW BUT THEY ARE HEAVY ON EXECUTIVE SOME MAKEUP TO $14 MILLION A YEAR.

AND THAT'S 200 TIMES MORE THAN THE AVERAGE HEALTHCARE WORKER MAKES.

SO I HAVE TROUBLE WHEN PEOPLE THINK THAT OH, WE JUST DON'T HAVE ENOUGH MONEY.

MONEY IS THERE TO BE REPURPOSED.

>> Jeff: I DON'T KNOW IF YOU'VE BEEN IN THIS SITUATION, BUT WHAT DO YOU HEAR FROM PEOPLE ABOUT HOW SOMEBODY CAN SUCCESSFULLY GET EMERGENCY CARE?

IF SOMEBODY BREAKS THEIR ARM AND IT'S PAST THE CAPACITY OF URGENT CARE, WHAT DO YOU DO?

DO YOU DRIVE TO DELAWARE?

IS THERE ANY ADVICE THAT WOULD HELP SOMEBODY?

>> YOU KNOW, THAT IS A VERY TOUGH QUESTION.

I THINK THERE ARE CERTAIN TIMES OF DAY THAT IT'S EASIER TO GET HELP LIKE MORNINGS.

BUT YOU CAN'T TIME YOUR EMERGENCY.

YOU CAN'T PLAN ON HAVING YOUR EMERGENCY AT A TIME WHEN YOU MIGHT HAVE A CHANCE TO GET IN.

IT IS A HARD QUESTION.

I ASK MYSELF AS I GET OLDER I WANT TO HAVE MY LOCAL HOSPITAL PROPERLY STAFFED.

AND I KNOW I DON'T HAVE THAT.

DRIVING TO OTHER STATES IF IT'S CONVENIENT, PEOPLE CAN DO THAT.

BUT FOR A LOT OF PEOPLE IT'S NOT.

WE NEED TO FIX THIS.

THIS IS A FIXABLE PROBLEM.

>> Jeff: THERE ISN'T A WEBSITE WHERE YOU CAN LOOK UP THE THREE NEAREST HOSPITALS AND THEIR CURRENT WAIT TIME IS X.

>> YOU KNOW, THERE ARE OCCASIONALLY SOME WEBSITES LIKE THAT.

BUT THE DATA ARE NOT ACCURATE, I WILL BE HONEST.

>> Jeff: BEFORE WE GO, IN COMPLAINING ABOUT EMERGENCY DEPARTMENTS I WANT TO MAKE CLEAR THAT WE ARE NOT COMPLAINING ABOUT THE PEOPLE WHO WORK THERE.

TO DO THESE JOBS ARE THE PRESSURE, THE STRESS INCREDIBLE BODY OF KNOWLEDGE YOU NEED TO BE A PROVIDER OF AT ANY LEVEL IN THE SITUATION, THESE ARE REALLY IMPRESSIVE PEOPLE DOING REALLY HARD WORK.

>> ABSOLUTELY.

AND THE ER IS SO STRESSFUL BUT IT'S HARD TO RETAIN HIGHLY QUALIFIED WORKERS WHEN THEY ARE OVERSTRESSED, UNDERSTAFFED, AND UNDERPAID.

>> Jeff: OUR THANKS TO ANNA PALMISANO AND THAT IS "STATE CIRCLE" FOR THIS WEEK.

THANK YOU FOR WATCHING.

WE'LL SEE YOU BACK HERE MONDAY EVENING AT 7:00 P.M. FOR "DIRECT CONNECTION".

[♪♪]