At the meeting Thursday at Piscataquis Community Middle School, hospital officials told the crowd that proposals to significantly shift state hospital policy, spurred by the passage last year of the Dirigo Health plan, are on the horizon, and it is up to those who depend on rural health care to deliver to Augusta their thoughts on how the state should proceed.

"We need your help," said Tom Lizotte, public relations director at Mayo. "We face challenges in the hospital community. This situation we are facing is larger than Mayo or C.A. Dean. It really goes to the core of the future of the Moosehead and Penquis regions."

"We need the community, (and) we need legislators to understand what we are about," said C.A. Dean CEO Geno Murray. "Health care is pushing to point critical in many, many ways."

The Dirigo Health plan moved rapidly from the Governor's office through the Legislature on its way to approval, slowing down only when hospitals raised concerns over a global budget and other aspects meant to rein in health care costs and lower hospital spending.

While concessions were made to hospitals as the bill developed, concerns over how hospital spending will be treated in the next legislative session persist, and talk of regionalism keeps worries afloat that rural hospitals may be closed in an effort to save money. Though the high cost of health care is on everybody's mind, the costs presented by a rural hospital need to be put in a context that includes both economic and community impact, and issues such as quality of care and quality of life, said Mary Mayhew of the MHA.

"It is the passion of what you want for care for your family," Mayhew said, driving home the point that cost-cutting for the sake of cost-cutting may end in a world where the rural population does not have access to the kind of health care they have come to expect.

Mayhew said many of the proposed changes come from "Portland-centric" people with no appreciation for the pressures that distance puts on those who need health care services. If decisions are made solely on money, she said, the system may lose its focus on the patient it is serving.

"Oncology is expensive, but for that reason alone we are going to make people drive long distances after chemotherapy?" she said, adding that further difficulties would be added for those patients who did not have a car, or could not leave work for substantial amounts of time.

With a rapidly aging population needing care -- care that could prevent more serious and expensive attention later on -- and the increasing normalization of procedures like CAT scans and MRIs, it is no time to be cutting back on rural care, Mayhew said. Communities need to decide the level of service they desire, and work to have those opinions considered in the making of new policy, she said.

"That is where communities have to raise their voices and make themselves heard," said Mayhew.Murray and Mayo CEO Ralph Gabarro began the meeting by pledging collaboration between the county's two hospitals, and by touting the their necessity both to the health of the community and the region in general.

Mayo Regional Hospital handles around 1,500 inpatient cases and 184,000 outpatient visits every year, Gabarro said. They have 12,600 emergency room visits and 2,700 ambulance runs every year, he said. Mayo has 390 employees and a $13.5 million payroll, and the hospital spawns around 200 other jobs in the community through purchases and needed services.

C.A. Dean Hospital and Nursing Home has 107 full-time jobs and a payroll of around $4 million, Murray said. There are around 3,000 ER visits a year, Murray said, emphasizing the hospital's role in rural care by adding that paramedics from C.A. Dean have driven 65 miles for a call, and also taken a one hour seaplane flight to access patients.

"We are as rural as it gets," he said. Murray said the hospital considers Greenville a geographically isolated area, with 50 miles to go to the Jackman health care center and 35 miles to Mayo. Together with the school and the town, he said the hospital is part of a three-legged stool.

"If one of those legs gets cut or cracked, we all fall," he said. C.A. Dean and Mayo share nurses, EMS paramedics and other staff, the officials said, and also consult each other with administration issues.

"We have to make sure those relationships continue," said Murray. Meetings will be set up in the future to further discuss the issues as they develop.
"This content originally appeared as a copyrighted article in the Moosehead Messenger and is used here with permission."