Getting There in Time: Emergency Medical Services (EMS)

Tom Timberman • October 5, 2018

Access to health care—and especially to specialized medical services—is more difficult in rural areas of the U.S., such as the Eastern Shore of Maryland. The old county hospital is being replaced by larger emergency rooms (ERs) with facilities for blood and scan testing but not much more. These expanded ERs often have no capacity to birth babies or to provide pre- and post-natal care. Surgeons are similarly scarce. And these medical facilities may not even have beds for seriously ill or injured patients while they wait for a helicopter, an ambulance, or friends and family to take them to a distant regional critical-care hospital.

Recently, a Kent County couple rushed to the reduced-service hospital in Chestertown where the husband was told he needed immediate surgery. Unfortunately, the only surgeon was on vacation. Hours later the husband reached a full-service medical hospital and survived. But it was touch and go and might have had a different outcome.

This new reality makes it even more important that rural communities on Maryland’s Eastern Shore have a first-class EMS capacity to serve them. This requires much more than fast wheels, sirens, and flashing lights.

One critical element is how many EMS personnel are available 24/7 and how many are hard-working, dedicated volunteers rather than paid and highly-trained professionals. An important difference is that volunteers do not have to or may not always be able to show up.

Volunteer or professional, an Emergency Medical Technician’s (EMT’s) training level also counts. There are basically three levels of expertise (Entry, Intermediate & Paramedical) and the certification determines what medical and evaluative services an EMT is authorized to perform, what equipment they can use and what decisions they can make. The kind, condition, and age of the available medical devices also make a big difference. Additionally, rescue personnel must learn many difficult protocols to follow. It is not easy.

Emergency care is also a business. Most counties provide a set percentage of their revenues to support their EMS organizations. However, this amount is seldom enough to pay for the training, equipment, vehicle maintenance, and salaries.

While budgets vary, each EMS organization tallies the number of 911 calls it responds to each year and from that can estimate how much they will need for the upcoming year. With those costs calculated, the emergency service providers can see how much their county-appropriated budgets can support and how much additional money will be needed to fill any gaps. Endowments, grants, and patient billing may pay for some of the services an EMS provides. Bottom line: patients very seldom pay all the expenses of their EMS care. Insurance and taxpayers are the backup providers.

Communities on the Eastern Shore should learn the strengths and weaknesses of their Emergency Medical Response Service organizations and how citizens can step up to help ensure that their EMS is all it can possibly be. The quality of each individual EMS response can literally be a question of life or death.

Common Sense for the Eastern Shore

By CSES Staff September 17, 2025
Easton pastor Daniel Omar Fuentes Espinal, who was detained by federal immigration officials earlier this summer and later released, now has a court date set before a federal immigration judge, according to newly filed records. Fuentes Espinal, 54, has led Iglesia del Nazareno Jesus Te Ama since 2015 and is widely regarded by neighbors and local officials as a respected community leader. In July, he was arrested by U.S. Immigration and Customs Enforcement (ICE), which alleged he overstayed his visa by 25 years after arriving from Honduras. The arrest drew swift reaction from across Maryland. Lawmakers and community members questioned why Fuentes Espinal was detained, noting he had no criminal record. Rep. Glenn Ivey and Sen. Sarah Elfreth reported at the time that his family had not seen him since the arrest, had only limited contact, and feared he would be deported. After weeks of uncertainty, Fuentes Espinal was released on August 15 and reunited with his family. “My family and I are very thankful for all of you,” he said. “I’m very happy to be home with my family and my community. I want to say thank you, thank you, thank you, and God bless everyone.” Friends of the family say he is now working toward legal citizenship, but his case remains unresolved. Federal court records show his first hearing is scheduled for March 31, 2026, in Baltimore. The proceeding, known as a master calendar hearing, marks the initial stage in removal cases. Immigration judges use the session to explain rights and responsibilities to those appearing before the court. According to ICE, if Fuentes Espinal fails to appear, he could be ordered to leave the country. For now, the pastor continues his ministry in Easton, awaiting what is likely to be a lengthy legal process.
By Jan Plotczyk September 17, 2025
On Sept. 11, a group of ultraright House Republicans delivered a letter to House leadership demanding the formation of a select committee on “the money, influence, and power behind the radical left’s assault on America and the rule of law.” Twenty-three reactionary members of Congress signed the letter, including some of the most extreme right-wingers in the House of Representatives. Among the signers is our own First District congressman, Andrew P. Harris, who’s added his voice to the cacophony demanding that something be done about the so-called left-wing threat to America. The letter was composed quickly after last week’s sniper murder of Charlie Kirk, a right-wing podcaster and campus provocateur. It presents a rationalization for investigating the finances of left-wing organizations and persons by blaming them not only for Kirk’s violent death, but for all manner of other problems ills in the country today: Many attacks on “our way of life” Sustained breakdown of law and order Open borders that allow “illegal aliens” to victimize law-abiding Americans Murders of innocent Americans, prominent and unknown alike Assassination attempts of GOP politicians The solution proposed in the letter is to “follow the money” by investigating such persons and groups as George Soros, the Wren Collective, the Southern Poverty Law Center, the U.N., and radicals and organizations suspected of financing the concerted effort to destroy MAGA America. They want to trace the money that, they claim without evidence, funds “the NGOs, donors, media, public officials, and all entities driving this coordinated attack.” But moderate observers and commentators see a broader aim — the end of free speech when the speaker disagrees with the views of the current ruling party. As expressed by Democracy Docket , a digital news platform, “The Trump administration’s rhetoric around Kirk’s murder and its attempt to link it to progressive causes and groups has raised fears it seeks to use the killing as false justification to further crack down on political speech and opposition politics in the U.S.” Harris and the other letter signers have joined a loud and strident chorus of alt-right voices demanding “justice” by dismantling the liberal and left organizations that they claim are fomenting violence. Also on Sept. 11, President Trump told reporters , "We have radical left lunatics out there and we just have to beat the hell out of them." On Sept. 15, Vice President Vance called for the mass doxing of anyone celebrating Kirk’s murder. “Call them out. Hell, call their employer.” A growing number of companies are terminating and suspending employees for posting messages critical of Charlie Kirk on social media. Stephen Miller , Trump’s deputy chief of staff for policy, referred to the Democratic Party as “a vast domestic terror movement” responsible for Kirk’s murder. He said the administration would target those who are “paying for violence.” “With God as my witness, we are going to use every resource we have at the Department of Justice, Homeland Security, and throughout this government to identify, disrupt, dismantle, and destroy these networks and make America safe again for the American people,” Miller vowed in the Oval Office. “I don’t care how — it could be a RICO charge, a conspiracy charge, conspiracy against the United States, insurrection — but we are going to do what it takes to dismantle the organizations and the entities,” he added. The average American realizes that this sort of language is dangerous. A Reuters/Ipsos poll conducted after Kirk’s murder found that most Americans are worried about political violence and partisan divisions: 63% said the way Americans talk about political issues does "a lot" to encourage violence. 79% said people are less tolerant of opposing viewpoints than they were 20 years ago. 66% said they were concerned over the prospect of violence committed against people in their community because of their political beliefs. 71% said that “American society is broken.” Read the right-wingers’ letter and judge it for yourself:
By CSES Staff September 17, 2025
Following a jury trial in Somerset County Circuit Court, Princess Anne Town Commissioner Lionel Frederick was convicted on Sept. 10 of unlawful possession of a firearm and ammunition. A former Town Commission president, Frederick was indicted last April in connection with an October 2024 incident in which investigators alleged he had a shotgun in his home. Because of a 2019 conviction for second-degree assault, considered a crime of violence, Frederick was banned from owning or possessing firearms under Maryland law. During Wednesday’s trial, Frederick — as the sole defense witness — testified he did not realize his earlier conviction barred him from keeping the shotgun. He said the weapon had been purchased legally more than 10 years ago and that he had never been told to surrender it. Prosecutors countered that the restriction was clear. The county State’s Attorney’s office produced a probation order from 2019 that prohibited Frederick from having a gun without court authorization. Frederick questioned the authenticity of his signature on the document, going so far as to suggest, “It’s Somerset County. I wouldn’t put it past this court.” After the three-hour trial, jurors deliberated for 30 minutes before finding Frederick guilty on both counts, one a felony for illegal firearm possession and the other a misdemeanor for possessing ammunition unlawfully. Frederick’s sentencing is scheduled for Oct. 2 before Judge Leah Seaton.
By CSES Staff September 17, 2025
Salisbury Mayor Randy Taylor’s administration has suffered another setback in court after the city failed in its attempt to block developer Mentis from privatizing the downtown parking lot known as Lot 10. In February 2023, the city sold Lot 10 to Mentis with the understanding that the property would remain a municipal lot until the developer was ready to begin construction of its hotel and conference center. This summer, Mentis announced its intent to convert Lot 10 to a private lot and to collect its own parking revenue. Taylor’s administration responded on Aug. 19 by filing for a temporary restraining order and injunction, claiming Mentis had breached its agreement by attempting to take control of the lot without obtaining the necessary permits. The city argued that public access should remain until redevelopment officially began. On Sept. 12, Wicomico Co. Circuit Court Judge Leah Seaton rejected the city’s request, ruling that Salisbury had failed to prove “irreparable harm,” a necessary condition for an injunction. The ruling means that Mentis is now free to collect parking fees from Lot 10, while taxpayers are left footing the bill for a failed legal maneuver. Critics say Taylor misplayed the case Residents and downtown stakeholders have accused the Taylor administration of mishandling the dispute and wasting public money. Rather than negotiating directly with Mentis or resolving the funding agreement for the redevelopment project, the mayor opted for an aggressive legal strategy, which ended in defeat. “This administration keeps charging ahead with lawsuits it cannot win,” one downtown business owner said. “Meanwhile, the city burns through taxpayer dollars, and we’re no closer to seeing real progress on the hotel and conference center.” Developer signals willingness to proceed Mentis officials, for their part, said the project can move forward if the city finalizes the sub-recipient agreement needed to release grant funding. “If we can get the city to move forward with the sub-recipient agreement, and that opens up the grant funding flowing to the project, we will continue to move forward with the hotel and conference center,” said Mentis’ Nick Simpson. Taylor points fingers Pushing back, the mayor argued that the developer needs to secure financing, site plans, and construction approvals before the project can advance — materials that have already been provided to the city. But to many observers, the back-and-forth underscores a larger problem: a stalled project that continues to pit City Hall against its private partners, with little to show for years of promises. A hearing on the remaining disputes is scheduled for December, but critics say the damage has been done. The court ruling leaves Mentis in control of Lot 10’s parking revenue and the city with another legal bill, raising questions about whether Salisbury’s mayor is fighting the right battles and how many more tax increases city residents will endure to pay for these legal battles.
By CSES Staff September 17, 2025
Tenants of a dangerous, code-violating, bat-, rat-, roach-, and mold-infested apartment complex in Prince George’s County will collect an $11.2 million settlement against the owners and operators of the complex. Maryland Attorney General Anthony G. Brown announced the landmark settlement with Heather Hill Apartments after allegations that the property collected rent without a valid license, dodged code inspections, and tried to evict hundreds of tenants. The settlement is the largest restitution ever obtained by the AG’s Consumer Protection Division in a landlord-tenant case. It will provide debt forgiveness, credits, and cash payments to tenants who paid rent while Heather Hill was unlicensed and requires the company to dismiss pending eviction cases tied to that period. “This settlement provides relief for hundreds of Maryland families who were forced to pay rent while some lived in unsafe conditions,” Brown said. “My office will always hold landlords accountable when they put profits over people’s safety.” The company faces three more lawsuits. Broader implications across Maryland While the Heather Hill case is centered in Prince George’s County, housing advocates note that the issues it raises — unlicensed properties, unsafe living conditions, and tenants struggling without recourse — are not confined to one region. On the Eastern Shore, where affordable housing is limited and oversight often inconsistent, tenant advocates have warned of similar problems. Aging multi-family housing in Salisbury, Cambridge, and Crisfield has drawn complaints about weak code enforcement and unsafe conditions. The Heather Hill settlement underscores that the state will step in when landlords fail to comply with licensing laws. For Shore renters, the precedent could mean stronger accountability in local housing markets, which have long marked shortages and rising costs. Connection to statewide reforms The action also comes just days after Gov. Wes Moore signed his Housing Starts Here executive order to accelerate the construction of affordable homes statewide. Together, the order and the Heather Hill settlement reflect a two-pronged strategy: building more housing while holding existing landlords accountable. For Shore communities, where new housing and stronger enforcement are badly needed, the Heather Hill case signals that state officials are paying closer attention to the conditions renters face, not only in the urban core, but across the state.
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By Gren Whitman September 17, 2025
The Maryland Board of Public Works has approved $13 million in grants from the Department of Natural Resources for local governments and land trusts to support community centers, parks, and land conservation projects in 16 counties, including several on the Eastern Shore. In addition to local recreation projects, the board approved $3.2 million in Rural Legacy funding for conservation easements that permanently limit development to protect farms, waterways, and natural habitats. Among the Eastern Shore investments: Talbot County will receive funding for a new softball field at the Home Run Baker Sports Complex. Caroline County is approved to install new playground equipment at Jesse Sutton Memorial Park in Greensboro. Worcester County will receive funds to build new restrooms at Sturgis Park in Snow Hill. The Eastern Shore Land Conservancy will get an award to protect two adjoining properties in Caroline County, covering 220 acres, and safeguarding 7,400 feet of forested stream buffers along tributaries of the Choptank River and preserving scenic views near Preston. In Dorchester County’s Harriet Tubman Rural Legacy Area, the Conservation Fund will secure an easement on a 121-acre farm, preserving historic landscapes along public roads tied to Tubman’s story and protecting valuable agricultural land. “These projects are about building stronger, healthier communities,” Gov. Wes Moore said during the meeting, underscoring the administration’s focus on expanding recreational opportunities and conserving Maryland’s natural resources. The DNR noted that similar projects were approved in counties across Maryland, ranging from new playgrounds and sports facilities to strategic farmland preservation. Officials emphasized that the funding supports immediate community needs and long-term environmental protections. “These grants reflect our dual mission, creating vibrant spaces for Marylanders today while ensuring our land and water resources are protected for generations to come,” DNR Secretary Josh Kurtz said. As a community organizer, journalist, administrator, project planner/manager, and consultant, Gren Whitman has led neighborhood, umbrella, public interest, and political committees and groups, and worked for civil rights and anti-war organizations.
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