THIS PROGRAM IS MADE BY MPT TO SERVE ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

[♪♪] LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

♪♪] >> JEFF: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION."

WE BEGIN TONIGHT WITH WHAT YOU NEED TO KNOW ABOUT REAL ID.

THAT IS THE ENHANCED DRIVER'S LICENSE THAT TRAVELERS WILL NEED TO PRESENT AT AIRPORTS SECURITY.

WE SPOKE WITH MVA ADMINISTRATOR CHRISSY NIZER.

THANK YOU FOR JOINING US.

LET'S START AT THE 10,000-FOOT LEVEL ON THIS.

WHAT DO MARYLANDERS NEED TO KNOW ABOUT REAL ID?

>> SO REAL ID IS A REQUIREMENT THAT WENT IN OFF THE TRAGIC EVENTS OF 9/11 TO ENSURE WE ARE CONFIRMING THE IDENTITY OF THE INDIVIDUAL WHEN ISSUING THAT DRIVER'S LICENSE OR AT THAT TIME ID CARD.

THE GREAT NEWS FOR MARYLAND RESIDENTS IS THAT WE ARE 99% REAL ID COMPLIANT AND THAT MEANS OUR RESIDENTS HAVE TAKEN THE ACTION TO BRING IN THE REQUIRED DOCUMENTS TO GET THAT NEW LICENSE WITH THE STAR ON IT.

AS OF MAY 7TH IT WILL BE A REQUIREMENT GOING THROUGH TSA CHECKPOINTS THANK YOU WILL BE LOOKING FOR THAT REAL ID COMPLIANT CREDENTIAL OR A PASSPORT OR A DOCUMENT THAT THEY DEEMED ACCEPTABLE FOR FEDERAL PURPOSES.

>> Jeff: MARYLANDERS HAVE 99% COMPLIANCE NOT BECAUSE WE ARE NOT A STATE FULL OF PROCRASTINATORS BUT BECAUSE YOU MADE US DO IT, RIGHT?

>> WE HAVE BEEN WORKING ON REAL ID FOR MANY YEARS AND REACH OUT TO CUSTOMERS AT NUMEROUS OPPORTUNITIES.

ASKING THEM TO COME BACK AND IN PRESENT DOCUMENTS AND SO WE HAVE BEEN VERY ACTIVE IN OUR PUBLIC EDUCATION CAMPAIGN ATTENDING MORE THAN 200 COMMUNITY EVENTS.

BUT WE THANK MARYLAND RESIDENTS FOR BEING RESPONSIVE.

THEY HAVE MET THE CALL AND PROVIDED THOSE DOCUMENTS WHICH IS GREAT NEWS WE DON'T HAVE A SURGE AS MANY STATES ARE EXPERIENCING LONG LINES AND PEOPLE COMING IN TO GET THAT REAL ID BEFORE THE MAY 7TH DEADLINE.

>> Jeff: I SAW NEW JERSEY COMPARED TO MARYLAD'S 99% I BELIEVE THEY ARE AT 17% IS THAT EVEN POSSIBLE?

>> SOME STATES ARE COMPLETELY OPTIONAL AND DID NOT IMPLEMENT REAL ID UNTIL LATE IN THE GAME.

THEY ARE STRUGGLING AT THIS POINT TO GET CUSTOMERS TO COME IN OR CUSTOMERS ARE TRYING TO COME IN AND THEY CAN'T MAKE THAT HAPPEN.

POLICYMAKERS IN MARYLAND STARTED EARLY WE STARTED COLLECTING THOSE DOCUMENTS FROM CUSTOMERS.

STARTED ISSUING THAT PRODUCT WITH A STAR IN 2018.

REALLY IT SHOWS ITS FRUIT AT THIS POINT.

THEY WERE COMING TO THE COMPLIANCE DEADLINE.

IT'S IMPORTANT FOR MARYLAND RESIDENTS AND THOSE AROUND THE WASHINGTON D.C. AREA TO KNOW IT'S NOT JUST TSA CHECKPOINTS IT'S FEDERAL FACILITIES.

MAYBE YOU ARE GOING TO A MILITARY INSTALLATION OR A FEDERAL COURTHOUSE THEY ARE ALSO GOING TO BE LOOKING FOR THAT REAL ID COMPLIANT PRODUCT.

A REMINDER THERE AS WELL.

>> Jeff: TELL ME ABOUT THE STAR ON THE DRIVER'S LICENSE THAT IS WHAT THIS IS ALL ABOUT.

AND I DISTANT MEMORY OF SOME STARS MISTAKENLY BEING GIVEN OUT AT SOME POINT.

IS THAT ALL BEHIND US?

>> IT IS.

SO THE REAL ID STARS ON THE RIGHT HAND CORNER OF YOUR LICENSE THERE'S OTHER INFORMATION IN THE BARCODE LICENSE SAYING IT'S REAL ID COMPLIANT THAT IS WHAT EVERYBODY IS GOING TO BE LOOKING FOR THAT MAY 7TH DEADLINE TO MAKE SURE YOU ARE COMPLIANT WITH REAL ID.

YOU MIGHT BE REMEMBERING THAT DHS CHANGED RULES WHEN WE STARTED ISSUING THE PRODUCT WITH THE STAR.

WE INVITED CUSTOMERS TO VISIT US ANOTHER TIME AND PROVIDE THOSE DOCUMENTS.

AND THAT'S WHERE I WANT TO THANK OUR MARYLAND RESIDENTS FOR BEING SO RESPONSIVE AS WELL AS OUR GREAT CUSTOMERS FOR PROVIDING THAT CUSTOMER SERVICE EVEN WITH EXTRA HOURS AND IF YOU REMEMBER WE OPENED ADDITIONAL LOCATIONS TO MAKE IT AS VENTS AS WE POSSIBLY COULD.

>> Jeff: IF SOMEBODY DOESN'T REMEMBER DOING THIS AND I DON'T REMEMBER DOING THIS, YOU CAN GO TO THE MVA WEBSITE ON THE MAIN PAGE THERE IS A LINK TO A PLACE WHERE YOU CAN TYPE IN YOUR LICENSE NUMBER AND CHECK.

>> THAT'S EXACTLY RIGHT.

SO WE HAVE A REAL ID LOOK UP TOOL AND WE HAVE YOUR MVA ACCOUNT AND FOR THE LISTENERS WHO DON'T HAVE ONE, SIGN UP BECAUSE NOT ONLY CAN YOU FIND OUT IF YOU ARE REAL ID COMPLIANT YOU HAVE ACCESS TO ELECTRONIC TRANSACTIONS AND SEE NOTICES MAYBE YOU MISPLACED YOUR RENEWAL NOTICE.

EVERYTHING IS THERE SECURELY AND CONVENIENTLY FOR YOU ANYTIME THROUGHOUT THE DAY.

SIGN UP FOR THE ACCOUNT AND YOU CAN CONFIRM THAT REAL ID STATUS.

>> Jeff: TO CLARIFY WHAT IT IS AND WHAT IT IS NOT, IT IS NOT A PROOF OF CITIZENSHIP.

IT IS KIND OF MAYBE AN ENHANCED FORM OF IDENTIFICATION, THOUGH.

AM I DRAWING THE LINE IN THE RIGHT PLACE THERE?

>> THAT IS ACCURATE.

THERE ARE VARIOUS STATUSES ELIGIBLE FOR A REAL ID UNDER THE FEDERAL LAW AND FEDERAL REGULATIONS.

THAT INCLUDES INDIVIDUALS WHO ARE CITIZENS, THAT INCLUDES INDIVIDUALS WITH PERMANENT LAWFUL STATUS AND CITIZENS WITH TEMPORARY LAWFUL STATUS.

YOUR LICENSE OR ID CARD WILL BE ISSUED WITH THE LENTSD OF YOUR LAWFUL STAY.

THOSE WILL NOT BE EIGHT YEARS WITH THE FULL MARYLAND LICENSE IT MAYBE TWO OR THREE YEARS DEPENDING HOW LONG THAT STAY%IS.

úALL THAT SPELLED OUT BY THE FEDERAL GOVERNMENT.

WE ARE DOING ELECTRONIC VERIFICATIONS OF BOTH THE SOCIAL SECURITY NUMBER AS WELL AS ANY IMMIGRATION STATUS DOCUMENTS.

>> Jeff: AND I ALSO SAW THAT YOU HAVE A CERTAIN NUMBER OF MVA OFFICES THAT HAVE ACCESS TO BIRTH CERTIFICATES IS THAT RIGHT?

>> THAT IS RIGHT.

A FEW YEARS AGO AS WE THOUGHT ABOUT REAL ID IMPLEMENTATION AND HOW DO WE CONTINUE TO DO THIS WITH PREMIER CUSTOMER SERVICE IN MIND, WE PASSED A LAW TO ALLOW MVA TO ISSUE BIRTH CERTIFICATES FOR THOSE INDIVIDUALS BORN IN MARYLAND BUT MAKE IT CONVENIENT IF YOU ARE COMING TO GET THE REAL ID COULDN'T FIND YOUR BIRTH CERTIFICATE.

WE DON'T CHARGE ANY ADDITIONAL FEE ONLY THE FEE FOR THE CERTIFICATE.

YOU WALKOUT WITH THAT IN YOUR HANDS TO USE FOR OTHER PURPOSES AND COMPLETE THAT REAL ID TRANSACTION.

IT'S ABOUT THAT SEAMLESS INTERACTION WITH GOVERNMENT.

WE ALSO OFFER TSA PRECHECK IF YOU ARE PLYING MANY OF OUR BRANCH OFFICES OFFER THAT SERVICE AS WELL.

WE'RE TRYING TO HAVE THAT ONE STOP SHOP APPROACH TO GOVERNMENT TO MAKE IT AS VENTS AS POSSIBLE FOR OUR CUSTOMERS.

>> Jeff: DID YOU CHARGE FOR THIS PROCESS?

OTHER STATES ESPECIALLY IN THE CRUSH OF PEOPLE THAT THEY ARE SEEING NOW HAVE A FEE FOR IT.

AND IF THE NUMBER WAS ZERO, IT STILL TOOK A LOT OF EXTRA WORK FOR THE MVA.

DO YOU KNOW WHAT THE OVERALL COST WAS?

>> SO MANY OF THE THINGS SOME WE ARE ALREADY DOING AND SOME WE WORKED INTO OUR IMPLEMENTATION PLAN WE DIDN'T INCREASE THE COST PER YEAR OF THE LICENSE AS PART OF THE REAL ID IMPLEMENTATION.

WE DID MOVE YOU MIGHT REMEMBER FROM A FIVE-YEAR LICENSE TO AN EIGHT-YEAR LICENSE THAT GAVE US EFFICIENCIES BECAUSE WEREN'T COMING IN AS FREQUENTLY.

THERE WERE COSTINGS AND NEW THINGS WE HAD TO DO.

BUT THE REALITY IS THAT THE MOTOR VEHICLE COMMUNITY WAS LOOKING AT THESE ISSUES BEFORE 9/11.

THERE IS A FEDERAL REAL ID LAW BUT WE ARE ENHANCING OUR PROCESSES AND TRYING TO MAKE SURE OUR PRODUCTS ARE AS SECURE AS POSSIBLE.

YOU KNOW HOW VALUABLE THAT LICENSE IS IN THE WRONG HANDS SO WE HAVE TO MAKE SURE OUR SECURITY FEATURES ARE REGULARLY REFRESHED.

WE LOOK FOR THE BEST TECHNIQUES TO MAKE IT AS DIFFICULT AS POSSIBLE FOR FRAUDSTERS TO REPLICATE OUR LICENSES.

>> Jeff: IF SOMEBODY OUT THERE IS SOMEHOW IN THE 1%, NOT THE 1% YOU WANT TO BE IN, BUT THE 1% THAT DOESN'T HAVE THE STAR ON THE LICENSE AND THEY NEED IT FOR SOME REASON, YOU ARE NOT HAVING ANY SORT OF BACKLOG LIKE OTHER STATES?

>> NOT AT ALL.

IN FACT, YOU CAN GENERALLY GET A SAME-DAY APPOINTMENT IN MOST OF OUR BRANCH OFFICES STATE-WIDE.

IF NOT THE SAME DAY, AT A TIME THAT IS CONVENIENT FOR YOU.

YOU CAN CAN TAKE ADVANTAGE OF THAT AND OUR WAIT TIMES ARE FIVE MINUTES STATE-WIDE SO WE ARE VERY PROUD OF THE PREMIER CUSTOMER SERVICE WE'RE OFFERING TO OUR CUSTOMERS.

MEETING THIS FEDERAL REQUIREMENT AND DOING SO IN A WAY THAT IS CUSTOMER FRIENDLY IS OUR GOAL.

WE DO RECOGNIZE ANYTIME THERE IS A DEADLINE THERE'S ANXIOUSNESS ABOUT IT.

BUT SOMETHING TO THINK ABOUT FOR THE NEXT TIME YOU ARE FLYING AND BUILD IT INTO YOUR PLANS IF YOU ARE IN THAT 1%.

>> Jeff: TELL ME ABOUT THAT FIVE-MINIMUM?

>> YEAH, WE'VE WORKED REALLY HARD.

OBVIOUSLY WE HAVE APPOINTMENTS BASED SYSTEM THAT WE SEE OUR CUSTOMERS IN.

FIVE MINUTES AVERAGE IS WHERE WE ARE AND WHERE WE WERE LAST YEAR AND PROUD OF THAT RATE.

WE WANT THE EXPERIENCE TO BE THE SAME WHETHER IT IS IN WESTERN MARYLAND OR SOUTHERN MARYLAND OR METROPOLITAN BRANCHES IN BALTIMORE OR DC AREA.

WE WANT YOU TO HAVE THAT GREAT CUSTOMER SERVICE EXPERIENCE WE'VE WORKED HARD AND IMPLEMENTED A NEW IT SYSTEM SEVERAL YEARS AGO AND DONE A LOT OF THINGS TO EMPOWER OUR EMPLOYEES TO ASSIST THE CUSTOMER IN THE BEST WAY POSSIBLE.

>> Jeff: LAST THING ON THE REAL ID SUBJECT, I'VE READ PROBABLY NOT HERE BUT OTHER PLACES SOME ON-LINE SCAMS ARE POPPING UP WHERE YOU ARE SUPPOSED TO UPLOAD YOUR INFORMATION YOUR DOCUMENTS TO SOME WEBSITE.

THAT'S JUST IDENTITY THEFT, RIGHT?

YOU WANT PEOPLE TO BRING THE DOCUMENTS PHYSICALLY TO YOU.

>> I'M GLAD YOU BROUGHT THAT UP.

PEOPLE GET TEXT MESSAGES OR E-MAILS AND IT IS A SCAM TO GET YOUR CONFIDENTIAL INFORMATION.

PLEASE DO NOT PROVIDE DOCUMENTS THAT WAY.

DO NOT PROVIDE YOUR SOCIAL SECURITY NUMBER OR DRIVER'S LICENSE NUMBER.

AS YOU SAID REAL ID REQUIRES US TO PHYSICALLY SEE THE DOCUMENT AND THE SECURITY FEATURES AND SCAN IT IN.

THE WEBSITES THAT MAY SAY UPLOAD YOUR DOCUMENTS IT IS NOT SOMETHING WE WOULD ASK YOU TO DO.

REFRAIN FROM THAT AND THERE ARE SO MANY SCAMS WE TRY TO WARN OUR CUSTOMERS ABOUT.

>> Jeff: IN A SENTENCE OR TWO SUMMER DRIVING SEASON ALMOST UPON US WHAT DO YOU WANT MARYLAND DRIVERS TO KNOW?

>> I WOULD ASK ALL OF OUR DRIVERS TO BE SAFE AND LOOK OUT FOR EACH OTHER.

OUR GOAL IS VISION ZERO IN MARYLAND.

WE WANT EVERYBODY TO GET SOME SAFELY.

SLOW DOWN.

BUCKEL UP.

NEVER DRIVE IMPAIRED.

LOOK OUT FOR OUR VULNERABLE ROADWAY USERS A LOT OF MOTORCYCLES OUT THERE, AND BICYCLES OUT THERE AND AND PEDESTRIANS THEY SHARE THE ROAD AND WE ALL GET HOME SAFELY AND THAT IS WHAT WE WANT TO HAVE NOT HAVE FAMILIES DEVASTATED BY THE LOSS OF A LOVED ONE ON OUR ROADWAYS.

>> Jeff: ABSOLUTELY.

CHRISSY NIZER THE LONG TIME HEAD OF THE MARYLAND MVA.

WE APPRECIATE YOUR TIME THANK YOU VERY MUCH.

>> THANK YOU FOR HAVING ME.

[♪♪] >> Jeff: ON THE BOOK BEAT WE ARE JOINED BY MEDICAL Dr. AND FORMER LEGISLATOR DAN MORHAIM, DELEGATE Dr. DAN IT'S GREAT TO HAVE YOU BACK ON MPT.

>> ALWAYS GOOD TO BE WITH YOU, JEFF, THANK YOU.

>> Jeff: YOU HAVE CONTRIBUTED A CHAPTER BY A BOOK IMPROVING DIES PUBLISHED BY THE HOSPICE FOUNDATION AND THIS BROAD SUBJECT HAS LONG BEEN IMPORTANT TO YOU?

>> IT SHOULD BE IMPORTANT TO EVERYBODY BECAUSE DESPITE ALL THE ADVANCES IN HEALTHCARE THE DEATH RATE IS STILL THE SAME ONE PER PERSON.

WE ARE ALL GOING TO DEAL WITH FOR OURSELVES AND OUR LOVED ONES WE MIGHT AS WELL DO IT WITH INTELLIGENCE AND FORESIGHT AND TAKING ADVANTAGES OF THE TOOLS AVAILABLE.

WE CANNOT DO ANYTHING ABOUT DEATH BUT WE CAN DO A LOT ABOUT IMPROVING DYING.

>> Jeff: I HEARD SOMEBODY SAYING LIFE ITSELF IS FATAL UNFORTUNATELY.

WHAT WOULD YOU SAY THE OVERALL OBJECTIVE OF THE BOOK IS?

>> THE OVERALL OBJECTIVE OF THE BOOK IS TO RIDE PEOPLE WITH A NEW SET OF TOOLS THAT CAN HELP THEM DEAL WITH VERY LIKELY INEVITABLE EVENT.

SOME PEOPLE DIE SUDDENLY IN A CAR ACCIDENT.

OVER TIME.

WE ARE THE FIRST GENERATION IN HUMAN HISTORY THAT SOME SAY HOW, WHEN AND WHERE WE DIE.

I GET THIS IS A TOPIC PEOPLE DON'T WANT TO DEAL WITH.

YOU RUN THE OTHER DIRECTION IT WAS NOT EASY CAMPAIGNING FOR OFFICE SAYING I WANT TO TALK ABOUT THIS ISSUE AND YOUR DEATH AND DON'T FORGET TO VOTE FOR ME.

IT IS SOMETHING WE CAN ACTUALLY DO BETTER WITH AND MAKE IT MORE FAMILY CENTERED, HOLISTIC AND ACCORDING TO YOUR OWN PERSONAL SENSE OF VALUES WHICH MAYBE DIFFERENT FROM PERSON TO PERSON.

>> Jeff: YOUR CHAPTER IS TITLED THE POWER OF ADVANCED CARE PLANNING.

ARE WE TALKING ABOUT ADVANCED DIRECTIVES?

>> YES, WE ARE.

THEY ARE FREE LEGAL FORMS AND HAVE AROUND SINCE 1991 AND THEY ARE AVAILABLE FROM MANY SOURCES IN MARYLAND STATE ATTORNEY GENERAL'S OFFICE, DEPARTMENT THE HEALTH, MY DIRECTIVES.COM FREE AND ON-LINE.

FIVE WISHES, AARP.

IF YOU HAVE A FAITH BASED ORIENTATION THERE'S FAITH BASED ADVANCED DIRECTIVES BUT NOT ENOUGH OF US COMPLETE THEM.

ER DOCTORS I WAS CALLED TO SEE PATIENTS IN EXTREMISTS AND WE DIDN'T KNOW WHO TO TALK TO AND WHAT THEIR WISHES WERE.

FOR THE LACK OF COMPLETING FREE PAPERWORK WHICH IS AVAILABLE, MY DIRECTIVES NAME AND PASSWORD THE THINGS WE ARE ALL USED TO WE ARE NOT RESPECTING PEOPLE'S WISHES.

AND WHATEVER THEY ARE, IS APPROPRIATE FOR THEM.

IT'S NOT FOR ME AS A PHYSICIAN TO IMPOSE THEM.

I WANT TO KNOW WHAT PATIENTS WANT AND WHO I SPEAK TO IF THEY CAN'T SPEAK FOR THEMSELVES.

>> Jeff: HOW OFTEN IN THAT EMERGENCY ROOM SETTING DID IT GO WELL?

DID THE PERSON'S WISHES AS PUT DOWN ON PAPER MAKE IT TO THE CORRECT MEDICAL PEOPLE SO THAT THE WISHES WERE RESPECTED?

HOW OFTEN WAS IT THE OPPOSITE?

EITHER THEY HADN'T PUT IT ON PAPER OR NOBODY COULD FIND THE PAPER?

>> WELL, SOME OF BOTH.

OVERWHELMINGLY NOT ENOUGH.

THIS IS A THREE-STEP PROCESS.

PEOPLE HAVE TO COMPLETE THEIR OWN.

YOU DONTD ANEED A LAWYER OR ANYBODY ONLY YOU CAN DO YOURS.

PEOPLE OVER THE AGE OF 18 ADULTS.

WHEN OUR KIDS TURNED 18 WE GAVE THEM THE DIRECTIVE TO COMPLETE.

EVERYBODY OUGHT TO COMPLETE IT AND UPDATE IT AS YOUR HEALTH AND CIRCUMSTANCES SPIRITUAL ORIENTATION, RELATIONSHIPS CHANGE.

AND THEN IT HAS TO BE AVAILABLE.

NOT HIDDEN IN A FILING CABINET AND THERE IS A SYSTEM IN THE STATED THAT THAT IS STILL IN PROGRESS.

AND THIRD CLINICIANS NEED TO LEARN TO HONOR THEM AND WE ARE NOT SEEING IT ENOUGH.

ON THE OTHER HAND THERE HAVE BEEN TIMES FOR LACK OF ADVANCED DIRECTIVES I'VE SEEN FAMILIES GOING INTO CONFLICT THAT LASTED FOR GENERATIONS AND I'VE SEEN WITH THE PRESENCE OF ADVANCED DIRECTIVES FAMILIES COME TOGETHER THAT WERE IN CONFLICT BECAUSE THEY KNEW WHAT THE PERSON WANTED.

IT DOESN'T WORK PERFECTLY EVERY TIME.

IT IS NOT A FIX ALL.

BUT IT SHIFTS LIKELIHOOD TO YOUR DYING EXPERIENCE BEING ONE THAT YOU WANT.

AND MOST PEOPLE I WOULD ASK YOU AND THE AUDIENCE WHEN THE INCOME FOR YOU WHERE WOULD YOU LIKE TO BE WHO IS AROUND YOU AND WHAT IS GOING ON.

>> Jeff: I WONDER DESPITE OUR DIFFERENCES IN BACKGROUND AND IN EXPERIENCES AND RELIGION, IF MOST PEOPLE ESPECIALLY LATER IN LIFE WOULD FEEL ABOUT THE SAME WAY THAT I DON'T WANT TO BE KEPT AROUND IN A COMA FOR A DECADE OR I DON'T WANT TO HAVE SUPER PAINFUL MEDICAL PROCEDURES THAT AREN'T ACTUALLY GOING TO EXTEND MY LIFE BUT THE THING I WONDER, AND MAYBE YOU'VE THOUGHT ABOUT THIS WHEN WE GET THERE TO THE EDGE OF THE ABYSS DO WE THEN THINK ABOUT IT DIFFERENTLY AND ALL RIGHT, I'LL LET YOU DO THAT WHATEVER PROCEDURE YOU'RE THINKING ABOUT DOCTOR?

>> WELL, IF YOU ARE AWAKE AND LETTER MAKING YOUR DECISIONS YOU CAN MAKE THAT CHOICE.

MOST PEOPLE DON'T.

THE SITUATION IN ADVANCED DIRECTIVES COMES UP WHEN YOU CAN'T.

HOPEFULLY YOU'VE HAD A CONVERSATION WITH THE PERSON YOU DESIGNATED AS YOUR HEALTHCARE DECISION MAKER TO REFLECT YOUR VIEWS WHATEVER THOSE MAY BE.

MY JOB IS TO TRY TO FIND OUT WHAT THE VIEWS ARE AND TO RESPECT THEM.

>> Jeff: BOOK IS PUBLISHED BY THE HOSPICE FOUNDATION.

GIVE US YOUR THOUGHTS ON THAT WORLD.

I DON'T BELIEVE THAT IS YOUR SPECIALTY, BUT IN TERMS OF END OF LIFE CARE, THEY HELP A LOT OF PEOPLE.

>> THEY HELP A LOT OF PEOPLE IN WAYS THAT WE DON'T OFTEN THINK OF THEY DO ANOTHER THAN COMING IN AND GIVING PEOPLE MEDICINE.

THEY WILL HELP FAMILIES TAKE CARE OF THE PATIENT SO THEY KNOW HOW TO TURN THEM AND MOVE THEM AND TAKE CARE OF THEIR HYGIENE.

THEY KNOW HOW TO KEEP PEOPLE ENTERTAINED.

I WANT CONTROL OF THE REMOTE I WANT TO BE TAKEN OUTSIDE AS MUCH AS POSSIBLE.

SHOW ME THE OUTSIDE.

HERE IS PEOPLE I WOULD LIKE TO VISIT.

WE ARE AWKWARD IN OUR FEATURE, JEFF DIDN'T CALL ME.

WE WERE FRIENDS AND YOU ARE THINKING DAN HASN'T REACHED OUT.

SO THIS SAYS, I LIST PEOPLE I WOULD LIKE THEM IF THEY ARE WILLING TO COME AND SPEND TIME WITH ME WHEN I AM ON MY DEATH BED.

YOU CAN DO LOTS OF THINGS WITHIN THE ADVANCED DIRECTIVE FORM BEYOND THE STRAIGHT UP MEDICAL CARE.

MINE SAYS ORGAN DONATION.

I REVAMPED THE LAWS IN 2009 AS A STATE LEGISLATOR MY ADVANCED DIRECTIVE SAYS TAKE ANY ORGANS THAT WILL DO ANYBODY GOOD.

THAT IS MY DECISION.

>> Jeff: I ADMIRE PEOPLE IN THE HOSPICE CARE YOUR WORK IN THE EMERGENCY DEPARTMENT HAS BEEN I'M SURE THAT IS SUPER STRESSFUL.

REWARDING.

SOME COMES IN WITH A BROKEN ARM AND YOU CAN FIX IT OR GIVE SOMEBODY ANTIBIOTICS WORKING IN HOSPICE CARE THE REWARDS ARE A LITTLE BIT DIFFERENT I WOULD THINK?

>> THEY ARE BUT IT TAKES A KIND OF SPECIAL PEOPLE WHO ARE REALLY LOVING AND TALENTED AND SKILLED AND TRAINED AND PROFESSIONAL TO DEAL WITH IT.

I THINK IF YOU TALK TO THEM THEY WILL TELL YOU STORIES HOW THEY HELPED FAMILIES GET THROUGH A DIFFICULT TIME IN A WAY THAT WAS HOLISTIC, FAMILY-CENTERED, VALUE-DRIVEN AND RESPECTFUL AND SUPPORTIVE OF THE ENTIRE PROCESS.

SO HATS OFF TO THE HOSPICE PEOPLE.

BY THE WAY WE ARE ENTITLED TO SIX MONTHS OF HOSPICE CARE THE AVERAGE LENGTH OF STAY IN HOSPICE IS TWO WEEKS.

WE ARE NOT TALKING FULL ADVANTAGE THERE IS A TENDENCY LET'S WAIT UNTIL YOU ARE NEAR THE END TO CALL HOSPICE.

CALL HOSPICE EARLY AND CHECK OUT THERE'S DIFFERENT HOSPICES YOU MAY FIND ONE.

DO THAT WHEN YOU ARE WELL OR THE EARLY PART OF A DISEASE DON'T WAIT UNTIL THE END AND THROWING IN THE TOWEL NOW LET'S CALL HOSPICE CALL EARLY BECAUSE SIX MONTHS OF CARE CAN BE VERY HELPFUL.

>> Jeff: BACK TO THE ADVANCED DIRECTIVES WE ESTABLISHED YOU DON'T NEED A LAWYER FOR THIS.

IF SOMEBODY SHOULD TALK TO SOMEONE AND IT COULD BE A LAWYER, ESPECIALLY ELDERCARE LAWYER WHO HAS SEEN A LOST THIS OR HOPEFULLY THEY HAVE A FAMILY PHYSICIAN WHO WOULD YOU SUGGEST HAVING THE CONVERSATION WITH?

>> WELL, WE ACTUALLY DID A STUDY ON THIS AND THE ANSWER IS OVERWHELMING IMPLEMENT PEOPLE WANT TO TALK TO A CLINICIAN.

THERE IS A STUDY ON THE FACULTY AT JOHNS HOPKINS.

WHEREVER YOU WANT TO GET THE INFORMATION.

SO MUCH IS AVAILABLE ON-LINE.

BUT YOU ALSO WANT TO HAVE THAT CONVERSATION WITH THE PERSONS OR PERSONS WHO ARE GOING TO BE YOUR DECISION MAKERS IF YOU NOT AROUND FUNCTIONALLY TO MAKE THE DECISION.

THERE IS A VARIETY OF SOURCES THAT YOU CAN ACCESS.

ONE OF THE THINGS I LIKE ABOUT MY DIRECTIVES IT GIVES YOU THOSE CHOICES.

FOR ME, I LIKE SPEAKING PERSONALLY.

BECAUSE THIS IS NOT AN ABSTRACTION IT IS PEA MY WIFE FIRST AND IF SHE IS NOT AROUND THREE ADULT CHILDREN I HAVE IN MY ADVANCED DIRECTIVE CONTACT MY GOOD LONG TIME FRIEND FROM MEDICAL SCHOOL NOT THAT HE WILL MAKE DECISIONS BUT HE WANT HIM TO CHECK THE MEDICAL BOXES HAVE BEEN PROPERLY DONE.

THAT CAN VARY.

I WOULD PICK YOU YOU COULD PICK ME IT DOESN'T HAVE TO BE FAMILY OR RELATIVE.

IT CAN BE SOMEBODY YOU TRUST AND THERE ARE PEOPLE WHO WILL CHOOSE THEIR NEXT-DOOR NEIGHBOR WHO KNOWS THEM BETTER THAN A FAMILY MEMBER.

>> Jeff: THE BOOK IS CALLED IMPROVING DYING.

HOW ELSE, DAN, CAN WE NOBODY WANTS TO TALK ABOUT THIS STUFF, BUT I UNDERSTAND WE NEED TO HAVE THE CONVERSATION.

HOW ELSE CAN WE IMPROVE DYING?

>> LET ME MAKE TWO POINTS THIS IS ABOUT EMPOWERMENT.

MUCH OF THE HEALTHCARE SYSTEM WE ARE ABOVEETED AROUND THE PATIENTS ONE THING OR ANOTHER DIRECTS US.

YOU HAVE THE OPPORTUNITY TO TAKE INCREASE THE LIKELIHOOD NOT GUARANTEE INCREASE THE LIKE LAY HOOD OF SOME CONTROL AND I NEED TO BRING UP MONEY.

WE CAN'T TALK ABOUT MONEY WITHOUT HEALTHCARE.

IF PEOPLE COMPLETE ADVANCED DIRECTIVES BECAUSE MOST PEOPLE DON'T CHOOSE I WANT TO DIE IN THE INTENSIVE CARE UNIT, CALL 911 AND SEND THEM TO MY HOUSE.

MOST OF US DON'T CHOOSE THAT.

EVERY DEATH DOESN'T HAPPEN IN INTENSIVE CARE BUT HAPPEN -- DOESN'T HAPPEN IN A HOSPITAL OR HOSPICE FACILITY OR NOT IN A FACILITY BUT AT HOME.

MOST PEOPLE I'VE DONE THOUSANDS OF THESE TALKS AND OVERWHELMINGLY PEOPLE SAY SOME VERSION OF I WANT TO DIE AT HOME LIKE QUEEN ELIZABETH DID.

THEN YOU SAVE A GREAT DEAL OF MONEY.

WE SAVE MONEY IN HEALTHCARE BY MAKING THINGS MORE COMPLICATED AND REFUSING AND DENYING SERVICES.

HERE YOU HAVE A CHANCE TO SAVE HUGE AMOUNTS OF MONEY BILLIONS OF DOLLARS, BECAUSE PEOPLE WILL MAKE RATIONAL CHOICES AND MOST PEOPLE WILL CHOOSE I WANT REASONABLE AMOUNTS OF HEALTHCARE TO A CERTAIN POINT BUT WHEN IT STOPS BEING HELPFUL AND HURTFUL I DON'T WANT IT AND IT SAVES A LOT OF MONEY.

>>Jeff: THE BOOK IS IMPROVING DYING.

PUBLISHED BY THE HOSPICE FOUNDATION.

JOINING US Dr. DAN MORHAIM.

Dr. DAN WE APPRECIATE YOUR TIME.

THANK YOU, SIR.

>> THANK YOU.

>> Jeff: NEW TECHNOLOGY IS PROMISING BETTER EFFICIENCY IN RECYCLING AS NANCY AMATA REPORTS >> RIGHT NOW AS OF NOW THE SHREDDER HAS A FAULT.

>> WITH SWIPES OF TABLET THE EMPLOYEE IS ABLE TO CONTROL ALL OF THE OPERATING MACHINES AT THE NEW RECYCLING FACILITY IN ELK RIDGE.

THE GRANDS OPENING OF THE RECYCLING FACILITY SERVING HOWARD ANNE ARUNDEL, FREDERICK AND CARROLL COUNTIES, AS WELL AS BALTIMORE CITY, WASHINGTON D.C. AND PARTS OF VIRGINIA, MARKS A NEW ERA IN ADVANCED TECHNOLOGY AND AUTOMATION.

>> EVERYTHING IS ABOUT LEVERAGES TECHNOLOGY TO MAKE OUR EMPLOYEES' JOBS EASIER.

>> THE CHIEF SUSTAINABILITY OFFICER.

>> WE REALLY HELPED OUR EMPLOYEES GET UPSKILLED AS WE BRING THE TECHNOLOGY INTO THESE FACILITIES.

>> THE WM RECYCLING FACILITY IS CAPABLE OF PROCESSING MORE THAN 250 TONS OF MATERIAL A YEAR OR 65 TONS OF MATERIAL AN HOUR.

>> THIS NEW TECHNOLOGY IT HELPS PULL OUT MORE MATERIAL FROM WHAT GOES IN THE RECYCLING BIN AND WE'RE ABLE TO REDUCE THE AMOUNT OF MATERIAL THAT IS GOING TO LANDFILLS BUT BETTER YET, THE MATERIAL THAT WE PULL OUT, IT GOES TO THE NEXT BEST LIFE.

IF YOU THINK ABOUT A WATER BOTTLE, A WATER BOTTLE COULD GET TURNED INTO OUR EMPLOYEES' UNIFORMS TOMORROW.

>> THE BALLISTIC SEPARATORS AND THEY SORT MATERIAL WITH A SERIES OF PADDLES AND AIR JETS.

>> CHRIS IS THE SUSTAINABLE GROWTH AREA DIRECTOR AND SHOWED US HOW EMPLOYEE CAN WATCH WHAT IS BEING SORTED THROUGH 22 OPTICAL SCANNERS.

>> THOSE MACHINES HAVE THE ABILITY TO PICK A THOUSAND PIECES OF ITEMS PER MINUTE AND WE CAN CUSTOMIZE THEM TO PICK UP PAPER, PLASTICS, UVC WHATEVER WE'RE TRYING TO SORT.

>> THE UPGRADE AND INVESTMENT IN INTELLIGENT SORTING TECHNOLOGY IS PAYING OFF.

>> WE'RE SEEING OURRIES DUE DROP IT'S LESS TRASH AND SEEING THE QUALITY OF THE BALES THAT WE ARE PRODUCING FOR OUR CUSTOMERS BE MUCH HIGHER QUALITY AS WELL.

>> BEYOND THE TECHNOLOGY HE SAYS CONSUMERS CAN DO THEIR PART BY BECOMING MORE KNOWLEDGEABLE ABOUT WHAT CAN AND CANNOT BE RECYCLED.

THE BIG NO?

>> FOOD WASTE, WET MATERIAL, STRAIGHT ON RECYCLING BOTTLES, CANS AND PLASTICS, TUBS, JARS NO FOOD WASTE OR WET MATERIAL.

>> Jeff: THANK YOU NANCY.

THAT IS "DIRECT CONNECTION" AND WE'RE BACK FRIDAY WITH "STATE CIRCLE" THE LATEST ON MARYLAND POLITICS FRIDAY EVENING AT 7:00 P.M.

FOLLOW US ON SOCIAL MEDIA@MPT NEWS.

FOR ALL OF US AT MPT THANK YOU FOR WATCHING "DIRECT CONNECTION".

AND HAVE A GOOD NIGHT.

[♪♪]