Ellicott City Perseveres Post-Flood, County Prepares for Future

A little over a year after a flood devastated Ellicott City, Howard County officials continue to build upon what they’ve learned and plan for the future disasters.

The Baltimore Sun reports on the process the county is taking and progress they are making, including updating the Ellicott City Watershed Master Plan to prepare for future floods:

[Mark] DeLuca [chief of the Department of Public Works’ Bureau of Environmental Services] updated residents on the four projects currently underway to build retention facilities and conveyance improvements in the watershed. The projects are the first wave of 18 project recommendations from the county’s hydrology and hydraulic study, completed this spring.

County officials are also updating emergency operations and community recovery plans, and implementing recommendations for improvement.

While the emergency operations plan is the county’s strategy for utilizing its resources immediately following a disaster like the 2016 flood, [Ryan] Miller [Director of Emergency Management] said the recovery plan picks up where the emergency plan leaves off, and includes strategies for bringing the community back to a “normal” state.

The article notes that officials plan to have the emergency plan finalized in the next few months and the recovery plan by the end of the year. Both plans include about 700 improvements for future responses.

Read The Baltimore Sun for more information.

Learn more about the Ellicott City post-flood recovery efforts at the 2017 MACo Winter Conference session, We’ve Got Your Back: Counties Collaborate

The MACo Winter Conference will be held December 6-8, 2017 at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, Maryland. This year the conference’s theme is “The Power of Partnership.”

Learn more about MACo’s 2017 Winter Conference:

Serving Seniors Supportive Services

Did you know that the MAP Hospital to Home Partnership (H2H) is an innovative initiative which helps counties divert hospital based readmissions by providing access to home and community based services for older adults?

This is but one example of how counties are working to efficiently and effectively administer valuable but limited resources while empowering senior patients to have more control over their care.

At the 2017 MACo Winter Conference learn more about how counties are leveraging public and private partnerships to improve care coordination and achieve better outcomes for their senior residents.

Title: Serving Seniors Supportive Services

Description: Counties provide a diverse array of services and initiatives to assist older adults. These individuals have a wide range of needs: screening for benefits, finding housing, health evaluations, legal resources, and accessing services in their homes and communities are just a few. Counties work efficiently and effectively to administer valuable but limited resources to help address those concerns. In this session learn how counties are leveraging local, state, and national resources as well as forming the necessary partnerships to improve the lives of older adults in their communities.


  • Joanne Williams, Director, Baltimore County Department of Aging
  • Linda Willis, Chief of Aging and Disability Services, Cecil County
  • Morgan Deweese, Aging and Disability Resource Manager, Cecil County

Moderator: The Honorable Sheree Sample-Hughes, Maryland House of Delegates

Date/Time: Wednesday, December 6, 2017; 3:00 pm – 4:00 pm

The MACo Winter Conference will be held December 6-8, 2017 at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, Maryland. This year the conference’s theme is “The Power of Partnership.”

Learn more about MACo’s 2017 Winter Conference:

Senator Cardin Holds Round Table with Maryland Business Leaders

Senator Ben Cardin discussed critical issues — taxes, healthcare, infrastructure — being debated in Congress that have are impacting Maryland’s business and residents at a round table held at the Maryland Chamber of Commerce on Friday, November 17.

Senator Cardin discusses taxes, healthcare, infrastructure, transportation priorities and more at business round table.

Senator Cardin discusses taxes, healthcare, infrastructure, transportation priorities and more at business round table.The Senator emphasized his commitment to addressing key priorities for Maryland including:

  • FBI – working on finding a path forward for moving the FBI to Prince George’s County.
  • Protecting Federal and Military Installations in Maryland – ensuring they receive the resources and support they need. There was not a round of BRAC this year but one may be coming in another year or so.
  • CSX/Howard Street Tunnel – addressing the issues with the tunnel is essential to its long-term viability and talks continue with CSX financial officers and CEOs.

Q&A with the round table participants centered a lot on their frustrations with the state of the national health care laws and rising premiums, but also involved lengthy discussions on taxes, cyber security, and small business procurement issues.


Harford Council Considers Ambulance Fee Bill

The Harford County Council is considering a bill introduced by County Executive Glassman to set fees on county-owned ambulance services equal to those under Medicare.

The Baltimore Sun reports:

The legislation also provides for such charges to increase or decrease in step with applicable Medicare charges fluctuations. If there is no comparable Medicare charge for the service provided, the county’s director of emergency services and treasurer would set the fee.

If the patient transported is not covered by insurance – or the insurance does not cover the service provided, the legislation gives the emergency services director and treasurer authority to waive the charge.

The bill also provides waiver authority to the director of emergency services and treasurer for cases in which the patient or the service being provided is not covered by insurance.

The article notes that the bill is one part of a plan by the County Executive’s office to move towards a county paid and county controlled ambulance system.

For more information read the full article in The Baltimore Sun.

Related coverage from Conduit Street:

Harford Launches New Emergency Medical Standards Advisory Board

Study: Opioid Addiction Medication Equally Effective, Factors to Consider

New study from The Lancet finds naltrexone (Vivitrol) comparably effective as buprenorphine (Suboxone), providing more treatment options for patients. Providers should continue to consider all factors when considering which treatment to use.

There are a few different medication-assisted treatments available to help treat opioid addiction — old guards such as methadone and buprenorphine (Suboxone), and new comers such as naltrexone (Vivitrol). A recent study sought to compare the effectiveness of the old and new options, specifically naloxone and buprenorphine.

The results: both were similarly effective but factors such as the initial hurdles to starting the medications, the way they  work, costs, and treatment processes should be considered when deciding which treatment to use for a patient.

Vox reports:

For the first time, a new study in The Lancet, sponsored by the National Institute on Drug Abuse (NIDA), compared the effectiveness of naltrexone with buprenorphine. The results were both promising and disappointing. While naltrexone is as effective as buprenorphine once treatment begins, it is also significantly more difficult to actually start naltrexone because it requires an extensive detox period — which can span more than a week — that buprenorphine does not.

The good news, though, is that buprenorphine and naltrexone were similarly effective once patients got over the initial hurdle. For naltrexone, the opioid relapse rate was about 52 percent. For buprenorphine, it was 56 percent. These were statistically similar, with no difference between men and women. Other measures, such as opioid-negative urine samples, opioid-abstinent days, and overdoses, did not differ between naltrexone and buprenorphine.

The Vox article explains in detail how the report showed that while both medications are ultimately effective in treating opioid addiction, there are differences between the two medications that factor into how good a fit each would be as an option for a particular individual.

It concluded that multiple treatment paths and treatment options are needed to ensure patient’s needs and treatments are effectively being met. For the right patient Naltreoxone is as effective as the medication-assisted treatment options.

Different options are needed. As Humphreys told me, “In the rest of medicine, we accept that there are multiple treatment paths and that patient preference matters.” The same should be true for addiction. After all, even though buprenorphine is still considered the gold standard for addiction care, the Lancet study found it still had an average relapse rate above 50 percent. It’s clear that buprenorphine doesn’t serve all patients and that other options are needed.

For more information:

A new study found a big problem with a popular opioid addiction medication (Vox)

Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial (The Lancet)

Treatment Placements, Drug Courts, and More Raised at Oversight Board Meeting

The Department of Health revamps court ordered mental health and substance abuse treatment placement procedures; The State’s Attorneys’ raise concerns about Drug Courts and RICO; and Justice Reinvestment Act (JRA) implementation work continues.

The Justice Reinvestment Oversight Board (JROB) held a quarterly meeting on Wednesday, November 15 in Annapolis.

Officials from the Maryland Department of Health provided an update on the overhaul of their processes for court ordered mental competency treatment (under Title 3) and court ordered substance use disorder evaluation and placements (under 8-505 and 8-507).

The Department has been working on increasing capacity for the mental health treatment beds and reorganizing their internal structure for managing the court ordered placements. Notably they have 95 new beds in the works, reduced the waitlist backlog from about 50 in June to 11 as of this week, and have created a centralized admissions office to serve as the single point of contact for processing all the court orders for evaluation to treatment services for mental health or substance abuse issues.

In regards to the 8-505/8-507 substance use disorder placements the Department shared that they have the bed capacity, but have identified the hold ups within the system that have caused placement delays. As a result they have adjusted their processes, communications, and training to help meet the JRA requirement of placing the court involved individuals into community facilities within 21 days of the court order. The Department is also working to improve the delivery of substance use disorder services to non-court involved individuals.

JRA implementation updates were also provided from the Division of Parole and Probation, the Judiciary, County Jails, and the Department of Public Safety and Corrections on topics ranging from restitution, employee and stakeholder training, data collection, and inmate education and certification.

Representatives from the Maryland State’s Attorneys’ Association testified to the JROB about their concerns with the details of Act. They primarily raised issue with: (1) the negative impacts on specialty courts, specifically drug courts; and (2) the difficulties prosecuting cases under the RICO provisions.

The attorneys’ asserted that lengthy jail sentences help motivate offenders to participate in drug court. The reduced sentences in the Act for certain crimes makes some offenders ineligible for the more intensive and longer drug court programs, and also makes drug courts less attractive of an option overall given that the standard sentencing is now less severe. They would like to see specialty courts exempt from the JRA. Additionally the state’s attorneys are finding it harder to prosecute cases under the new RICO laws and would like to see the state adopt the federal RICO model.

The 25 member board, chaired by Judge Daniel M. Long, is charged with overseeing the implementation of the Justice Reinvestment Act (SB 1005), the law passed during the 2016 outlining comprehensive state criminal justice reform. Duties include collecting and analyzing data, creating performance measures, and making recommendations for reinvestment of savings. The board meets quarterly.

For more information about the JROB visit the GOCCP website.

Prior coverage from Conduit Street:

Justice Reinvestment Oversight Board Gears Up For Act’s Implementation

Justice Reinvestment Oversight Board Briefed on Opioids, Implementation

Breaking the Mold: Foster Care Collaborations That Work!

Did you know there are over 4,000 children within the foster care system in Maryland?

All 23 counties and Baltimore City provide foster care programs for these children but they don’t do it alone. As the proverb goes, “It takes a village.”

At the 2017 MACo Winter Conference session, Breaking the Mold: Foster Care Collaborations That Work!, learn how counties are forming innovative partnerships to deliver the best programs for children in foster care.

Breaking the Mold: Foster Care Collaborations That Work!

Description: Foster care programs operate in all Maryland counties to help provide short- and long-term care and support services to children who are unable to live at home, or who are without a home altogether. There are a range of reasons that children end up in foster care and each child presents a unique set of challenges, considerations, and capabilities. Counties work diligently to provide a safe and nurturing environment in the community for these children to help them transcend their circumstances and reach their full potential. In this session, learn how counties are launching innovative partnerships with public and private entities to ensure the best possible outcomes for children entering, living in, or aging out of the foster care system.


  • Deborah S. Harburger, Clinical Instructor, The Institute for Innovation & Implementation, University of Maryland School of Social Work
  • Dina Daly-Director, Caroline County Department of Social Services
  • Linda Webb, Director, Talbot County Department of Social Services
  • Shalita O’Neal, Foster Youth Ombudsman for the Department of Human Services

Moderator: The Honorable C.T. Wilson, Maryland House of Delegates

Date/Time: Thursday, December 7, 2017; 2:00 pm – 3:00 pm

The MACo Winter Conference will be held December 6-8, 2017 at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, Maryland. This year the conference’s theme is “The Power of Partnership.”

Learn more about MACo’s 2017 Winter Conference:

City Health Commissioner Urges Federal Help on Naloxone Costs

Baltimore City Health Commissioner Dr. Leana Wen discussed the significant cost increase for naloxone amid national crisis in opioid overdose deaths and urged federal help. The spike in costs has led the City to ration the naloxone it has.  WBAL reports:

Baltimore Health Commissioner Dr. Leana Wen said that it doesn’t make sense that the generic version has  increased at the time of a public health emergency. Wen says there is a greater need for Naxolone or Narcan because of the powerful synthetic opioid fentanyl and the number of people dying as a result of that drug use.

Wen said wished that the president would have called the situation across the country a national state of emergency to release the federal dollars urgently needed to help local governments. President Donald Trump last month called the epidemic a public health emergency, which opened up far less funding.

Visit WBAL to learn more.

Learn how to administer naloxone to help reverse an opioid overdose at the 2017 MACo Winter Conference. The training sessions, Learn to Save a Life, sponsored by the Maryland Association of County Health Officers (MACHO) will be held Wednesday, December 6 from  4:15 pm – 5:15 pm and Thursday, December 7 from 12:45 pm – 1:45 pm.

The MACo Winter Conference will be held December 6-8, 2017 at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, Maryland. This year the conference’s theme is “The Power of Partnership.”

Learn more about MACo’s 2017 Winter Conference:

Learn How to Incorporate ‘Health in All Policies’ at #MACoCon

Some of the greatest challenges counties face involve treating, managing, and improving the health of their communities. Health challenges are often entangled in a web of social, economic, and environmental factors which have a significant impact on the opportunities or hurdles that arise as governments try to improve the health of their citizens.

An innovative nationwide initiative, Health in All Policies (HiAP), aims to change the old siloed approach to improving health outcomes by encouraging government agencies to collaborate and incorporate health considerations into all policy decisions — transportation, housing, education — that they are making.

At the 2017 MACo Winter Conference learn more about how counties are incorporating HiAP to tackle complex health challenges and improve the health of their communities.

Title: Health in All Policies

Description: Communities across the country are adopting the use of a Health in All Policies (HiAP) approach to improving the health of individuals and populations. HiAP is a collaborative approach, usually led by local public health departments, that integrates health considerations into policy discussions and policy decisions across all sectors of a community to improve population health. Panelists will provide an overview of the tenets and principles of HiAP, describe how this approach is being used to improve educational attainment, housing, transportation, and neighborhood safety, while also improving health outcomes, and discuss how the approach can be used in local jurisdictions. In this session, learn how counties are building community-based partnerships and strengthening strategies to incorporate public health practices in all policies.


  • Bridget Kerner, National Association of County and City Health Officials (NACCHO)
  • Robert Stephens, Health Officer, Garrett County

Moderator: The Honorable Addie Eckardt, Maryland Senate

Date/Time: Thursday, December 7, 2017; 3:30 pm – 4:30 pm

The MACo Winter Conference will be held December 6-8, 2017 at the Hyatt Regency Chesapeake Bay Hotel in Cambridge, Maryland. This year the conference’s theme is “The Power of Partnership.”

Learn more about MACo’s 2017 Winter Conference:


‘Apprenticeship Maryland’ Stories of Success, Potential for Expansion

Secretary Kelly Schulz discussed the success of the Department of Labor, Licensing, and Regulation’s Apprenticeship Maryland program at an event in Hagerstown.

Apprenticeship Maryland is currently being piloted in public schools in Washington and Frederick counties as a means of exposing children to skilled trades. Schulz shared the possibility of expanding the program statewide and to new industries.

The Herald-Mail reports:

The two-year pilots will conclude with the end of this school year, and state officials will have to determine what to do going forward, she said.

Traditionally, apprenticeships have been linked to skilled trades, such as the courses offered through the Barr Construction Institute at the Associated Builders and Contractors Cumberland Valley Chapter in Hagerstown, she said.

“Why would we not pick up where we left off with the building trades and bring that to our other industries?” she asked.

The article continues with Schulz explaining that while schools have focused on preparing kids for college they have lacked on the career readiness piece that Apprenticeship Maryland seeks to improve. Tweaks to the program have already allowed for more help to the schools and employers. The Secretary notes that while the pilots are still being evaluated, it is already evident that flexibility will be key should the program be expanded statewide.