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Community Based Care Team Changes Lives of the Most Chronically Ill in Howard County

Officials from the Howard County Health Department, Healthy Howard, Inc. and the Horizon Foundation, today announced the formation of an innovative partnership created to target healthcare services to those most in need and to reduce the costs associated with delivering those services. Using existing community data, the Howard County Health Department will target residents with the greatest healthcare needs and deploy the Community Based Care Team (CBCT) members to assist those individuals in accessing more impactful, effective, and efficient medical services, reducing barriers to care, and promoting health factors that can reduce chronic diseases. Health Officer Dr. Maura Rossman notes “Establishing an integrated and cost effective public health and primary care delivery model is a continuation of the Health Department’s goal to create a model public health community within Howard County, Maryland. This initiative is a crucial step in that process.”

The Community Based Care Team (CBCT) consists of nurses, community health workers and a program manager. The program, which began in January 2014, focuses on reducing hospitalizations and delivering the right care, at the right time, at the right location, for those who need it most. The CBCT also assists patients with connecting to the primary care provider, understanding their treatment plan and empowers them to better manage their overall health. "Part of creating a model public health community means embracing innovation to figure out the most effective and efficient way to deliver care. I am thrilled that we have forged a partnership that allows us to remain on the cutting edge of best practices, provide excellent care and reduce cost and utilization. I can't wait to see the results of this exciting initiative," said County Executive Ken Ulman. Clients for the program are identified through referrals from Howard County General Hospital. Once enrolled, the patients become clients of the CBCT and assistance formally begins upon discharge from the hospital. On average CBCT staff will assist clients for approximately 90 days. The pilot program will run for the next three years.


Department of Health and Mental Hygeine Warns of Deadly Drug Combination

Maryland’s Office of the Chief Medical Examiner (OCME) reports an increase in the number of deaths linked to a potent and deadly batch of heroin that is tainted with fentanyl, a powerful synthetic opioid, Maryland Departmentof Health and Mental Hygeine (DHMH) announced on January 31, 2014. According to OCME data, between September 2013 and January 31, 2014, at least 37 Maryland deaths were caused by the lethal drug combination. The fentanyl/heroin deaths represent approximately 12 percent of 318 overdose deaths during the same time period. This represents the preliminary total of overdose deaths for the period between September 2013 and January 2014.

"DHMH is reaching out to local behavioral health providers to ensure that they are fully informed about this dangerous and deadly trend,” said Dr. Gayle Jordan Randolph, Deputy Secretary for DHMH Behavioral Health Services. “We will support the local authorities as they adapt their overdose prevention plans in response to this deadly trend." According to the federal Centers for Disease Control and Prevention (CDC), fentanyl is estimated to be 80 times more powerful than morphine and hundreds of times more potent than heroin. The presence of fentanyl dramatically increases the risk of an overdose death.

“Deaths due to the deadly heroin mixture appear to be widespread in Maryland and not localized to any specific area,” says Dr. David Fowler, Chief Medical Examiner for the State. “We have also seen overdose deaths due to fentanyl mixed with cocaine.”

Fentanyl-related deaths have been reported from Western Maryland to the Eastern Shore, and throughout Central Maryland. Recent reports indicate that heroin-fentanyl overdose deaths have also been seen in Washington State, Pennsylvania, Rhode Island, and along the I-95 corridor. The location of an overdose death does not necessarily indicate the source of a drug.

COUNTY  NUMBER OF DEATHS 
Anne Arundel 4
Baltimore City 10
Baltimore County 5
Calvert 2
Carroll 1
Charles 1
Frederick 2
Howard 2
Prince George 5
Queen Anne 1
Somerset 1
Washington 2
Wicomico 1
TOTAL  37 
*The deaths are widespread across the state and may not be representative of the source of the drugs.
*Fentanyl is an opioid many times stronger than heroin. Pharmaceutical fentanyl is typically used in the treatment of severe, chronic pain (often related to cancer) and is available in multiple formulations (transdermal patch, lozenge, sublingual tablet).
*The fentanyl involved in many of these deaths is packaged in powder form in combination with heroin or cocaine, indicating the possibility of illicit manufacture rather than diversion from the healthcare system. *The combination may be sold to the user as a strong version of heroin. As the person using the drug is unaware of its potency, overdose is a heightened risk.
*Alcohol and Drug Abuse Administration encourages treatment programs to incorporate overdose prevention training into intake and discharge protocols.
*In the event of an overdose, 1) call 911, 2) perform rescue breathing until help arrives, and 3) administer naloxone (Narcan®) when available! 

Resources:
Opioid Overdose Prevention Toolkit  - SAMHSA (Substance Abuse and Mental Health Services Administration)

Overdose Prevention Plans - DHMH

(credit: DHMH Press Release January 31, 2014) 


Prevention of Accidental Infant Deaths is Reason Behind Maryland’s Ban on Sale of Crib Bumper Pads

The ban on the sale of crib bumper pads is part of an ongoing public health effort to educate parents about safe sleep practices for babies. The ban applies to crib bumpers that are made of non-mesh type material, rest directly above the mattress along the length of each of the interior sides of the crib.

What are the Safe Sleep Practices for Baby?

The ABC's of Safe Sleep

A - ALONE  

B - on their BACK  

C - in a CRIB  (WITHOUT any blankets, pillows, fluffy toys, crib bumpers or stuffed animals)

More Resources: 


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