Howard County Provider Forum Unveils Roadmap to Strengthen Healthcare Access and Improve Patient Outcomes

ELLICOTT CITY, MD – Howard County Executive Calvin Ball today announced the completion and unanimous adoption of the Howard County Provider Forum’s final report, The Starting Line: A Roadmap to Transform Healthcare in Howard County. The completion of this report marks the culmination of a 15-month intensive collaboration between healthcare providers, policymakers, community organizations, and public health leaders, which began back in July 2025 with the signing of an executive order establishing this groundbreaking Forum.

Established by Executive Order 2025-11, the Forum was charged with examining challenges facing Howard County’s healthcare delivery system and identifying practical solutions to improve access to care, strengthen coordination, and enhance patient outcomes. Through seven specialized workgroups, public forums, community listening sessions, and cross-sector collaboration, the Forum combined professional expertise with perspectives from county residents.

The Forum’s final report identifies 65 barriers to effective healthcare delivery and outlines 25 actionable recommendations designed to address the underlying causes of emergency department overcrowding, gaps in primary and behavioral healthcare, workforce shortages, and fragmented patient services.

Community Voices Help Shape the Conversation

Throughout the process, public engagement was an important part of the Forum’s work and commitment to keeping residents’ voices central as next steps are considered. To provide county residents with the opportunity to share their experiences, concerns, and ideas, the Forum hosted multiple public forums and community listening sessions, in which over 300 individuals participated. These conversations allowed the Forum to better understand and gain perspective on the challenges community members face when it comes to obtaining timely, accessible, and coordinated care. Moreover, this community input, combined with healthcare professionals’ expertise and operational experience, helped inform the Forum’s understanding of barriers to care and its recommendations.

A Roadmap for the Future

The report’s recommendations focus on five interconnected priorities:

1. Sustained Collaboration – Establish a permanent Commission on Healthcare Access and Integration to maintain collaboration among healthcare providers, insurers, government agencies and community organizations while advancing the Forum’s recommendations.
2. Improving Access and Navigation – Expand tools such as SmartER, strengthen health literacy, and help residents identify the right care at the right time.
3. Strengthening Care Transitions – Improve coordination between hospitals, primary care providers, and community services to reduce preventable readmissions and ensure patients receive appropriate follow-up care.
4. Connecting Healthcare Systems – Improve information sharing, care coordination, and referral processes among healthcare providers and community partners.
5. Supporting the Healthcare Workforce – Develop sustainable recruitment, training, apprenticeship, and retention strategies to address staffing shortages and strengthen the local healthcare workforce.

Examining the Possibility of a Second Hospital

Recognizing residents’ concerns about emergency department wait times and timely access to hospital care, the Forum conducted a comprehensive evaluation of the feasibility of establishing a second hospital in Howard County.

The decision to establish a new hospital in Maryland is governed by the Maryland Health Care Commission (MHCC) and the state’s Certificate of Need (CON) process, not by Howard County Government. Unfortunately, current state projections do not identify a need for additional general acute care beds in Central Maryland, making MHCC and CON approval for a second hospital in Howard County highly unlikely under present conditions. Additionally, overcoming healthcare workforce shortages, financial requirements, and state cost-containment policies present additional challenges to launching a second hospital in the county.

As a result, the Forum recommends pursuing improvements that can make a difference now, including strengthening existing capacity, expanding community-based care, and addressing the causes of emergency department crowding.

Early Wins Already Making a Difference

While developing its recommendations, the Forum highlighted how collaboration could produce meaningful results without the establishment of a final report. Among the accomplishments these collaborations achieved, include:

• Expanding Healthcare Access for Veterans – All adult urgent care centers in Howard County joined the U.S. Department of Veterans Affairs’ Community Care Network, expanding local care options to the county’s approximately 20,000 veterans.
• Improving Behavioral Health Access – New referral and coordination pathways between general urgent care centers and psychiatric urgent care providers are helping connect residents to appropriate behavioral healthcare while reducing unnecessary emergency department utilization.
• Reducing Hospital Readmissions – A pilot program providing food and transportation assistance to vulnerable patients following hospital discharge demonstrated an approximately 50 percent reduction in the likelihood of readmission.
• Stroke Smart County Designation – Howard County earned recognition as a Stroke Smart county, supported by community education initiatives designed to improve recognition of stroke symptoms and encourage immediate emergency response.
• Stronger Clinical Collaboration – A multi-system quality improvement initiative brought together nearly 30 clinical stakeholders to improve coordination and establish shared protocols addressing infectious disease challenges.

These accomplishments emphasize the Forum’s commitment to identifying problems and developing and implementing solutions.

An Extraordinary Commitment to Collaboration

The establishment of the Forum brought together healthcare executives, physicians, clinicians, emergency medical services representatives, behavioral health professionals, elected officials, human service agencies, insurers, and community partners. Working through seven specialized workgroups, participants contributed their expertise to evaluating challenges and developing recommendations that cross traditional organizational and professional boundaries.

Much of this work took place against a backdrop of rapidly evolving federal and state healthcare policies, growing financial pressures, workforce shortages, and increasing demands on healthcare organizations. Despite these challenges, members committed significant time beyond their regular professional responsibilities, participating in meetings, conducting research, evaluating data, developing recommendations, and building partnerships that will continue beyond the Forum’s formal work.

Ball also recognized the many individuals and organizations who contributed to the Forum’s work, including its appointed members, additional subject matter experts, workgroup participants, support staff, and community partners. Their collective commitment laid the groundwork for continued collaboration and meaningful improvements in healthcare delivery throughout Howard County.

From Recommendations to Action

With unanimous adoption of the Forum’s final report on October 26, 2026, the County will evaluate the recommendations and next steps in collaboration with healthcare and community partners.

Central to the proposed strategy is the creation of a permanent Commission on Healthcare Access and Integration to preserve the relationships established through the Forum and provide ongoing leadership, accountability and coordination as recommendations are prioritized and implemented. Additionally, the report emphasizes that meaningful healthcare transformation will require sustained collaboration, thoughtful investments, and a shared commitment to placing residents at the center of care.

Ball’s Contributions to the County’s Healthcare

• Since taking office, Ball has made significant progress to ease the strain on the county’s healthcare system and improve outcomes, including:
  $200,000 per year in funding for the JHHCMC Behavioral Health Navigators. Patients who interact with this program demonstrate lower levels of utilization.
• $100,000 per year to support multi-visit patients. These are patients who have visited an emergency department more than three times. Since this investment, the Maryland Health Services Cost Review Commission has reported that JHHCMC has the second-lowest multi-visit rate in the state at 17 percent of all patients. The statewide average is 27 percent, and, while broad, this metric suggests that the range of “high utilizer” services at JHHCMC is effective in reducing re-utilization of the emergency department.
• $300,000 for the Mobile Integrated Community Health (MICH). During the three years of this program’s tenure, JHHCMC and the County’s Department of Fire and Rescue Services treated more than 800 patients and saw an 85 percent reduction in 911 calls, 83 percent decrease in inpatient admissions, and 75 percent reduction in emergency department visits.
• $3.2 million for Maternal Health. JHHCMC used the funding to establish a maternal health clinic. It is estimated that more than 200 people avoided the emergency department as a direct result of the Clinic since opening in 2023.
• Contributing $15 million to build a 29-bed observation unit at JHHCMC, which is expected to open for patients in early December following this month’s ribbon cutting.
• $250,000 for a Partnership with the Maryland Hospital Association (MHA). Howard County Government and JHHCMC partnered with MHA to create a discharge hospitality suite. The goal was to help alleviate throughput pressures in JHHCMC’s inpatient bed and emergency department utilization. Opened in July 2024, this suite has served nearly 3,600 patients, reducing time spent in an inpatient bed by nearly 1,015 hours—more than 17 minutes per patient.
• $3 million to support Sheppard Pratt’s Baltimore Washington Campus in Elkridge, which includes a psychiatric walk-in urgent care, and a 16-bed residential crisis facility. Both of these additions provide JHHCMC with additional options to send patients in need of urgent and short-term mental health care.
• The County launched the SmartER Optimization Initiatives, a systemwide navigation tool of alternative healthcare options (e.g., urgent cares) that patients can access across multiple languages.