A Prince George's County task force working on a hospital capacity report moved closer to finalizing a draft after staff reported receiving detailed responses from Adventist Healthcare and partial data from other hospitals.

The staff lead said preliminary analysis projects that roughly half of county residents obtain emergency department care inside Prince George's County and that the other half seek care elsewhere — about 23% in other Maryland jurisdictions and about 27% outside Maryland — highlighting an outflow of patients the report aims to explain.

The report will include added material on the economic role of hospital capacity and a separate section on equity, staff said. "We wanted to include additional information on what does having additional hospital capacity…it's not just about health. It's also an important engine for local economic growth," staff said during the meeting.

Task force members pressed for clearer operational data before publication. Laura Ogle, director of nursing professional development at MedStar Southern Maryland Hospital Center, described how hospitals classify emergency visits by the Emergency Severity Index, a triage tool with levels 1 through 5. "We use the standardized emergency severity index, the ESI levels, and those are levels 1 through 5," Ogle said, adding that low-acuity ESI scores do not always mean a case could safely be treated outside an ED (for example, cases that need imaging).

Jeffrey Rebe, an emergency physician and medical director for Prince George's Fire EMS, described EMS destination practices and said acuity drives ambulance decisions but that EMS generally honors patient requests to be taken to a hospital within about 30 minutes rather than have the patient self-transport. "Our decision is based on the acuity…we do emphasize that if the patient is interested in going to another hospital, within the distance of approximately 30 minutes, we prefer to transport them there," Rebe said.

Staff also reported that Adventist Healthcare is conducting social-determinants-of-health screening for most ED patients; case managers follow up when screening flags social needs. The staff lead noted the Health Services Cost Review Commission (HSCRC) funding model does not currently risk-adjust for social determinants of health, a limitation that could disadvantage hospitals that serve higher-need populations in Prince George's County.

Workforce shortages and retention were a central focus. Jabron Eubanks, a political organizer with 1199 SEIU, urged stronger local incentives and state oversight of hospital spending to increase pay and retain staff. "We have the funds. I think that…the hospital decides how they spend their money, but I think that's why it's important for us to have these recommendations," Eubanks said, urging the task force to press HSCRC and the Maryland Department of Health on oversight and wage issues.

Laura Ogle described several hospital programs intended to improve recruitment and retention, including student nurse externships, partnerships with Prince George's Community College, and transition-to-specialty programs supported by Nursing Support Program (NSP) grant funds. She said her hospital uses annual NSP-supported training allocations (about $30,000) for emergency department transition programs and is launching a patient care technician clinical ladder.

Members also discussed county-level workforce supports. Hospitals can partner with Employ Prince George's for apprenticeship grant funding; task force members said that program can provide up to $5,000 per hired apprentice as a hiring subsidy when hospitals enroll and hire apprentices through Employ Prince George's.

A member recommended soliciting academic expertise to guide policy and strategy on social determinants and local hiring. "Having a workforce that provides care that is reflective of the community is important," a task force member said, recommending input from local academic centers.

Staff listed outstanding data requests: payer mix and uninsured/self-pay counts from HSCRC, more-complete acuity and utilization data from hospital partners, and clarifications with the health department and Fire/EMS on transport practices. Staff said the draft will be emailed to task force members for comment and that the final report will be presented to the County Council and released at a press conference after the hospital inputs are incorporated.

Votes at a glance: members made and seconded a motion to approve the minutes; the motion was recorded in the meeting and seconded, but the transcript did not include a roll-call vote tally or an explicit chair ruling on the vote.

The task force kept "quality of care and perception" on the list of potential report topics pending collection of more evidence about patient decision-making and whether experience or perception drives out-of-county ED use.