What is HCLHIC? – June 13, 2017 Podcast

Hello! Welcome to our 5th Collaboration Mindset program brought to you by AAA Physical Therapy - awarded Patient's Choice Winner for 2016 with Open Care located in Columbia, MD (voted as Best City to live in last year) - and with Dragon digital radio at Howard Community College. 

Again, as a friendly reminder, we are streaming live every Friday at 530PM and Sunday at 930AM.  You may also easily download our podcasts when you want to listen to our program any day / any time / anywhere! We are also going to showcase this program in our YouTube site so just kindly search for AAA Physical Therapy there and feel free to share and like our videos on our channel!

Being that this program is about collaboration, where we have interviewed so far, a lawyer, a Tony Clark, in discussing what to do with auto accidents and how physical therapy can help with such injuries. Dr. Javier Colon and Dr. Nelson about collaborating with doctors in terms of rehabilitation with patients and with their telemedicine program. And Professor Brukiewa for the Physical Therapy Assistant program here at Howard Community College. Where we discussed in how PT should be chosen as one of the first options in working with pain management and other rehabilitation processes.

As always, we are blessed with guests who are leaders in both the public and private sectors. Today, we are happy to have Ms. Kelly Kessler, who is the director of the Howard County Local Health Improvement Coalition (HCLIC). Kelly’s previous professional roles have included serving most recently as a community health director for common Maryland. Ms. Kessler has also served as assistant director of health promotion for the University of Maryland and the Vice President for program services of the American Lung Association of Maryland. Ms. Kessler earned her BS in school of health education from the University of Maryland and earned her Masters’ degree in community health education from Towson University in 2002. Kelly is a 16-year cancer survivor and an active volunteer for the leukemia and lymphoma society supporting newly diagnosed individuals. Kelly enjoys spending time with her family and friends and resides in Howard County with her husband and three children.  

Now, we always hear about people or should I say our hero’s or inspiration, who have triumphed over cancer and we find this really cool that we have one right now as our guest, so welcome Ms. Kessler to our collaboration mindset program!

Ms. Kessler: Thank you! I’m very happy to be here!

Manuel: Alright, then let’s get to it. So, what is the local health improvement coalition, or to shorten it LHIC), and its main objectives?

Ms. Kessler: We are a collaborative group of about 220 individual members representing about 60 to 70 organizations that live, work, serve, or play here in Howard County, Maryland. Our primary goal or vision is that all residents of Howard County will have access to health care and health outcomes that will be equitable for everyone. We really work to achieve health equity in Howard County. We look at areas where not everyone is perhaps benefiting from the wonderful resources we have in the County and we try to fill those gaps. We try to ensure that everyone has access to health, has access to the tools they need to live long strong healthy lives and stay here and continue to grow here in Howard County.

Manuel: Wonderful, thank you! So, you mentioned this is a low known treasure...so for us not to do a treasure hunt necessarily, and just make things easier. You mentioned organizations, but your part of a government. So, who can actually join and/or participate here?

Ms. Kessler: So, what’s exciting and I know you may have people who don’t necessarily reside in Howard County. Every community in Maryland has a local health improvement coalition or actually a coalition that’s mandated by the state of Maryland. So, in Howard County we’re very fortunate that our office, our coalition is supported in partnership and funded by the HC health department. It’s also co-chaired by Dr. Maura Rossman our health officer, and Mr. Stephen Snelgrove, the president of HC general hospital. Anyone in the community is welcome and invited to consider learning more, joining the coalition. Some individuals really enjoy being a member and just kind of staying in touch to hear what’s going on. Some individuals really want to participate in the coalition and roll up their sleeves and do activities and be engaged on a different level. There’s a place and a space for everyone depending on what their interest is. In HC, you can easily find us. Our website is www.HCLHIC.org, so Howard County LHIC.org and you can also use that same HCLHIC to follow us on twitter or to follow us on Facebook. One of the great things that we do is to really try to just make people aware of the activities that are taking place in our community for anyone to get involved. Our membership includes everyone from medical providers to individual community members. We have a growing number of individuals who are retired who have raised their families here in HC, who have worked here and the surrounding community, and really are just looking for different ways to give back and use their energy in now newfound time in their retirement. We have members who represent the faith communities, we have members who represent governmental organizations, the schools, we’re really interested in engaging with the members of service organizations, fraternities, sororities, other groups that might be passionate or have a passion around health and are really looking to engage with others in the community around things that are important to them.

Manuel: So, again it’s community members and also the private sectors and also parts of the government you mentioned in terms of HGH being a part of it, but why should community members and other organizations be part of this then?

Ms. Kessler: Really community members and businesses that are here in Howard County, we’re your coalition! We’re your voice, we’re here to try to fill gaps and meet needs for all of the same people. So, for a business, a small business owner, I’ll use real estate as an example. Part of the allure of HC is that we are a wonderful community to live in and we prioritize things. When you can say and you can be very in tune and very much speak to your clients about what is going on around wellness, health issues, and access to care in your community. It not only provides you as a resident as a business owner in the community with education and networking opportunity, but it also provides you with a better way to communicate to people that you’re trying to serve. So, if you’re serving a client who’s looking to move to HC and maybe something they’re worried about leaving their old community is well my old community had great bike paths. Well I’m well aware because I’m a part of the healthy weight work group that not only does HC have a priority of being a walkable/bike able community, but I can also tell you because I’m familiar with or I’ve networked with who you can contact. I can tell you about resources for bike pathway apps, so you can download the How do I get around the CA bike paths. It’ll help you even to do your job better.

Manuel:  What is a short term strategic plan with LHIC?

Ms. Kessler: So, I probably will talk a little about the short term and the long-term plans quite honestly. Every 2 years, the coalition meets to establish its priorities and we pick 2 years because of the time spent working on certain initiatives, it takes time, energy, and effort to secure commitment and engage things like engaging individuals and organizations. I would say that one of our short-term goals is really looking to make sure that people know we’re here, making sure people are aware, and making sure people can feel comfortable utilizing us. I may not know where all the walks that are that’re going on in HC, I may not know where all the resources for behavioral health are, but I know that HCLHIC will help connect me. So, one of our short-term goals is to increase our recognition as a convener or connector that we can help our HC residents find the answers that they need or find the resources they need. On a long-term level, we have identified four priority areas in our coalition that we are working on. We work a lot on reducing obesity in our county, that includes increasing physical activity, it includes working around people that are at a healthy weight already, keeping them at a healthy weight. For those who are obese, working to help them to lose weight and to be in better health that way, so healthy weight is one of our main focal areas. We also look at healthy aging. HC is a population of an aging community. So many folks as we’re celebrating the 50th anniversary of Columbia, it still seems so young, but at the same time those people who were sort of the original Columbia families are looking at a different type of aging in HC. And they’re looking at how do I make my home more accessible, what do I need to think about planning for my future, I’m looking for retirement now, what do I wish I had known in my 20’s that I am now trying to deal with. So, we look at healthy aging around helping everyone plan for their future. Behavioral health in our county as well as many other counties in the state and nationally, we are faced with an opioid epidemic. So, our coalition has made behavioral health a priority, not just in dealing with addiction related emergencies. The opioid epidemic certainly is a crisis that we’re addressing, but we also look at mental health in our community and we look at suicide prevention in our community. I would say that everyone in HC in some way, shape, or form has been touched by mental health issues or circumstances and certainly we work to give priority and really to reduce the stigma around talking about those things because there are many resources and there are supports for assistance, so really trying to break down the barriers to getting people to talk about those things. Lastly, we have a priority around access to care. Initially, access to care, our coalition, our goals had a lot to do with enrolling people for health insurance. Certainly, there are a lot of questions that exist right now in respects to coverage and what will coverage mean. What we focus on a lot, regardless of having health insurance or not, what are the barriers, other barriers that people are facing to care. We talk about something we refer to as social determinants of health. There are a lot of things that affect our health that may have nothing to do directly with our health insurance per say, it might be transportation. Whether or not I have health insurance, if I can’t get to the doctor I have a concern, that’s a barrier. Economics, finances, I may know because I’ve been educated that I need to have a regular annual physical or that my children need to have regular dental screenings, but if I’m an hourly employee and I can’t take off work or I’m at risk of losing my job if I take time away, or other factors and we look to go and address those things. Food security, we have many residents in HC, many more then people probably believe or would recognize that really do rely on support from the HC food bank or rely on support from other organizations. The school system just announced this summer for example that they will have four sites that will remain open and provide lunches and meals while the schools are closed for the summer because we have so many children that do rely on free/reduced lunch. So, our access to care group is really focused on addressing other barriers to care. We certainly do address health insurance, we look at making sure people know how to access health care, how to enroll, that they can come and they can access the door to health care to help have questions answered if they need insurance, if they have questions about Medicare or Medicaid, we try to connect them with the right folks, but we also look at those other barriers. So, I think those are really our long-term objectives and to address those four main areas in our community.

Manuel: Wow! For the listeners, we were part of some of the events that they just did in terms of financial planning and it’s really helpful to have those. I know you were also handing out the yellow packets, what’s inside of those yellow packets again?

Ms. Kessler: So we were very fortunate our coalition, our priority around financial and legal planning, we were the recipients, we were one of three counties in the state actually that received a grant through the department of health in partnership with the Alzheimer’s association to conduct education and so through that we were able to fund, we’re calling them sort of a planning for the future kit so to speak, which is really providing a checklist and tools for individuals to think about things that we need to think about in planning for the future. Sometimes people get caught up in thoughts. They think specifically about the future i.e. if I’m sick or dying. Those are very important, naming a healthcare agent, having conversations about your end of life wishes, those are incredibly important, but we also want people to think about do I have an estate plan, have I thought about where I want to live when I’m older, have I thought about who might take care of me if I can’t take care of myself, have I thought about finances, have I met with a financial planner. Sometimes you think, I’ve even thought this to myself sometimes, if I don’t have any money for anything I want to plan, but the reality is I have 3 children. Whether or not I have no money in my checking account or if I have a lot of money in my checking account, I have an estate and I actually do need an estate plan. A lot of people don’t really realize that when we think about future planning, we get so caught up in focusing in one area of future planning, we don’t think about the bigger picture, so that’s something that we really try to do and are trying to do with the kids who have fortunately received a grant to help move that forward.

Manuel: And obviously that’s whether you’re 20 years old or 70 years old

Ms. Kessler: Exactly, its’s never too early or too late. I actually just had a conversation with my 18-year old and we were talking about job opportunities and I suggested to him that he needed to look at certain types of positions. I said well you know in some positions you can already start investing in retirement. He said I’m 18, why do I need to think about retirement, I said well you know when you’re an adult and you’re paying for me because I didn’t think about that when I was 18, you’ll know why you needed to think about that when you were 18. So, you’re never too young or too old to be thinking about your future.

Manuel: Wonderful! You also mentioned earlier, again, private organizations are a part of it and obviously us being a physical therapy practice, how do you think about PT could be involved and help a little bit more with these strategic plans of LHIC?

Ms. Kessler: Well, definitely I think PT is a key discipline really in respects to the coalition across the gamut. In our interaction, AAA has definitely been apart and worked very closely with us in healthy aging activities. PT is certainly a resource and a tool that can be utilized with the ageing community to help them stay in their homes longer, age in their homes longer and be healthier longer, so I think that there’s certainly a ton of opportunity for that, but even across looking at behavioral health. Right now, one of the biggest crises that we have in our community is around the opioid epidemic. What we find are that a lot of people are first exposed or experiencing opioid use through pain management, pain medication, and knowing that PT and some of the work that goes into that in a way of helping people manage chronic pain or chronic health conditions that way. It’s certainly something engaging people like yourself in understanding the bigger context and the fight so to speak around that in that sort of the global issues around that. Then, becoming or entrusting our coalition members to be sort of carriers of that message. So, when you leave a meeting and we’ve talked about what’s going on and statewide new resources. What could you potentially add to your own website, taking that forward and carrying it into your practice and carrying it forward into your field. That’s the best way to affect positive change, so if you’re PT and our partnership I think is a great example, but I would say that on a model level for other practitioners and other disciplines, not necessarily clinical even, that same thing is true and that’s what we would hope to see in our membership and collaborative efforts.

Manuel: Thank you for bringing that up with the opioid situation that we’re having here and again in relation to behavioral health. So, to those listeners who may not necessarily be aware exactly, what’s an opioid then?

Ms. Kessler: Opioids are basically drugs that are derived from opium. In some cases, there are prescription types of opioids, so you may have oxycodone, there’s a wide range of those type of medications that are prescribed for pain management. But then there are also a wide variety and there are all kinds of street names for others, but we would be talking about heroin and other drugs of that type. So, what we have seen in our community and in surrounding communities is that drugs are actually being combined and mixed together and some very dangerous combinations of drugs are seen increased in fentanyl use and other such drugs, the thing with opioids is it kind of like our healthy aging work group, it covers the entire span. The opioid epidemic really covers the entire span, it’s something that someone really can become addicted or be exposed to opioids in many ways. You have children who are dealing with chronic, for example for a child who might be going through treatment for chemotherapy who might be given opioids for pain management all the way up until they’re an adult and even in end of life pain management and then you have, I don’t want to use the term, but you have the more street version and people are exposed in a wide variety of ways to that. What we’re seeing is that again, a rise in really dangerous combinations and I think across the board, people are really looking to make changes to how those drugs are prescribed, how are we monitoring and controlling pain from the clinical level and then from the community perspective, trying to empower community members to handle and be familiar with what can they do in a situation where it might be someone’s home or something along those lines. One example is we have a very robust overdose response prevention program and overdose response program. Anyone in HC can actually receive a free training at the health department and they actually receive free naloxone which is the lifesaving medication that can reverse the effects of an opioid overdose. They receive training on how to put together the device, how to administer the drug, and by empowering community members to be in that situation and also letting people know we do have a good Samaritan law. Sometimes people recognize that someone might be in a crisis, but they’re afraid that there’s drugs in the house or I don’t want to call. They’re afraid of getting that person in trouble or getting themselves in trouble. Good Samaritan law: help first, and that’s something we really do work at to try and put out in the community. On the LHIC website, www.HCLHIC.org , there is an area behavioral health resources and there’s a number of informational pieces, video clips, PSA messages, resources where you can connect for information if you’re a community resident and you are passionate about this issue and you just want to share information, there’s a lot of information and resources you can share on your own social media and so we encourage you to visit that and also help us carry that forward. If you’re interested in overdose response training programs, that information is listed in our community calendar. You can certainly always reach out to us at that website as well, and we can connect you with us.

Manuel: I just recently got that certificate/card to go ahead and do that!

Ms. Kessler: It’s a really easy training! It’s very interesting and it’s actually a real service to the community. When you’ve gone through the overdose response training program, should you need to administer the drug, you can take your certificate into any pharmacy and they will resupply you with a standing order, so you don’t have to go back and take the training again. So, if it means saving someone’s life then it’s worth an hour of anyone’s time.

Manuel: No doubt! And obviously the more we share what this training is about, providing more education of the abuse going on whether it’s legal or illegal drugs, if you may. And speaking of social media, I know you mentioned websites with all these different programs. I know there’s a survey out there about opioid

Ms. Kessler: Yeah! The health department was working with the University of Maryland and I’m actually not sure, I believe the survey may have closed recently or might be closing soon. To gain information around what people actually know or don’t know about opioids in the community, it’s kind of interesting because you know, we also talk about stigma in mental health, but the same is true with addiction and sort of the stigma of around well…it’s heroin vs. it’s oxycodone. There are some very well-known individuals who have shared their stories candidly around how easily they became addicted to things and how you know it isn’t, there is no sort of, any idea you have of a stereotypical addict, just throw it away because the stereotypical addict could be your next-door neighbor, it could be your child, it could be you. There isn’t a you know, if I were to describe to you what this addict looked like, there is none of that. We have families in our community that are just like any one of us who have lost children to overdose or who have lost a loved one to overdose. I have a friend who recently lost, it was actually their ex-husband, but recently lost someone very close to them and their pathway to addiction started as someone who dealt with chronic pain and progressed. This individual was only in their early 40’s, so I mean it can affect any one of us. We just have to throw away those stereotypes and all of us empower ourselves with the education around the issue.

Manuel: On that note, I know you mentioned that opioids are meant to help with pain. If you don’t mind, discussing a little bit further, how would physical therapy be able to help curve this epidemic that’s happening, if you may?

Ms. Kessler: You know I’m certainly not the expert on PT, but what I can say is anything that we can do to prevent injury or to treat injury in ways that kind of allow us other opportunities besides just prescribing something that may not necessarily be addressing the source of the pain or maybe just dulling the pain. With PT, many individuals who have really benefited learning how to do the proper techniques, the proper stretching techniques, that have rehabbed from an injury in proper supervised ways, without then reinjuring themselves or needing to be on medication longer than initially after a surgery or something like that. So, I think there is a lot of opportunity within that sort of discipline to really be looking at alternative ways to help people address pain and more to the point to prevent continued pain.

Manuel: Exactly, and not be drug dependent. To those listeners out there, everything that Ms. Kessler identified, feel free to listen to our first podcast and our fourth podcast in that we discuss the importance of PT and working with pain, so you don’t have to be drug dependent. Again, as Ms. Kessler identified, if you’re masking the pain with these drugs, you’re not necessarily addressing the problem and that’s where addiction could lead to and would lead to that specific path that we’re all trying to avoid.

Alright wonderful! Well is there anything else you would like to add regarding HCLHIC or any other initiatives?

Ms. Kessler: First, I would just like to start again by thanking you for inviting us to share about the HCLHIC and I think what I would love to say and just encourage people to do is to become involved. We are your community coalition! Anyone is welcome to come to the meetings and to attend. We have the schedule, we do keep the schedule up to date on the community calendar that’s available on our website. You can certainly reach out to us and we’re always happy to share with you a little bit more about what’s going on. We have people who come check out the meetings, we have some people who really want to get involved with those specific activities, so we invite you to be involved however you see fit and we just encourage you to follow us on Facebook and twitter, its @HCLHIC.org and again same website, so we look forward to hopefully having some new folks interested in joining with us!

Manuel: Yes, feel free to go and join, everyone! Again, and if you’re asking where all your tax dollars are going, this is another way for you to be more informed of what we’re doing with these programs and how we can go ahead and get better. In terms of maintaining that status of being the best city to live in, but if other cities would be able to go ahead and follow whatever it is that we’re doing here, why not? And again, we need everybody’s help here in order to contribute.

Ok, so for our next program, we will have our Physical Therapist, Mrs. Nina Evangelista! We have been discussing the importance of the rule of PT and rehabilitation. However, at AAA Physical Therapy, we’re expanding our rehabilitation program after patients complete their physical therapy treatment. As discussed in our previous program with the physical therapy assistant here at HCC, the two main goals of physical therapy is pain relief/pain management and to restore normal function and movement where PT should be chosen as one of the first choices when dealing with such problems, as we just discussed regarding the opioid epidemic. Alright everyone, we want to extend and expand our service as regarding maintenance and prevention, fitness, and overall wellness. For example, we plan to incorporate meditation, nutrition and stress management with this program. As I have been an instructor for psychology for almost 2 decades, with my certification in personal training, both Nina and I with the collaboration of other leaders in the wellness field, we will discuss how we are moving into a more holistic approach, in terms of rehabilitation and prevention. We will unveil the name of our health and wellness program in that podcast, so please stay tuned. We also discussed earlier in terms of health insurance and we will also discuss real briefly about what a co-pay is, what a deductible is, and alike, so we’ll clarify those things too.

As always, we appreciate you listening, downloading and sharing our program to your loved ones. For AAA Physical Therapy and with Dragon Digital Radio at Howard Community College This is Manuel your host, we’re signing off for now and we look forward to having you join us for our next program, thank you!