AUGUSTA — Legislation drafted to allocate a one-time stopgap payment to a financially crippled Jackman health facility was voted out of the Health and Human Services Committee unanimously during a work session Friday in Augusta.

The need for an influx of funding to the Jackman Community Health Center became urgent in June 2017 when MaineGeneral Health announced they no longer could afford to operate at the health center and pulled their overnight and weekend emergency services from the rural tourist town. MaineGeneral, which operated a nursing home at the center, and Penobscot Community Health Care, of which the Jackman facility is a part, had been pooling their resources to keep it open at night.

Penobscot has implemented an on-call system for nighttime and weekends so that a nurse, physician’s assistant and doctor could be available at the center if a patient were in need of immediate care; but without MaineGeneral’s funding, the operation of the on-call service is not sustainable and the roughly 800 Jackman residents and residents from the surrounding Moose River region eventually would have to travel either 75 miles to Skowhegan or 50 miles to Greenville in order to receive emergency care.

The $150,000 that would go to the center if the Legislature passes the bill would be tied directly to the center’s budget and would cover the $250,000 shortfall that will be incurred to provide on-call services to the region over the fiscal year until a long-term solution can be devised.

As was mentioned in an earlier public hearing by Rep. Chad Grignon, R-Athens, a sponsor of the bill and Jackman’s elected representative, Jackman’s status as a destination for outdoor recreation has added to the urgency of the funding situation. Thousands of tourists go to the area, which is just a few miles from the Canadian border, to snowmobile, hunt, fish and ride all-terrain vehicles. In recent months, several snowmobile and ATV accidents have been reported in the region.

In addition, Grignon said, a large number of people in the area work in the forestry industry, which can be one of the most dangerous jobs out there.

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At Friday’s work session, Lori Dwyer, the president of PCHC, and Jackman Selectman Alan Duplessis went before the committee to offer testimony on the center’s need for the funding.

Dwyer told the committee that although the original sum sought was almost a half million dollars, since the last public hearing there has been discussion on the level of funding that actually was needed. In that time, they successfully raised $100,000 from the community and are continuing to raise funds privately and seek grants. With that in mind, Dwyer said, they would now be asking for a one-time allocation of $150,000 to cover the rest of the financial shortfall. PCHC would receive that money and would earmark it solely for the Jackman facility for the fiscal year.

At the initial hearing, committee members voiced apprehension about giving stopgap funding to single entities because of the precedent it can set and that there might be similar communities with the same need, but Dwyer assured the committee Friday that measures are being taken not only to find a way for the Jackman facility to succeed in offering urgent and emergency care as a rural and federally qualified health center, but to study and find solutions to the systemic and statewide problems of rural health care centers that are struggling financially.

Many facilities such as Jackman’s use a sliding scale when they bill patients, which means they not always are charging as much as it costs to treat a patient, which in turn causes the facility to lose money. Duplessis explained in an interview with the Morning Sentinel last month that the sliding-scale billing is part of being a federally qualified health center, which the town agreed to when it achieved that status.

Duplessis also said U.S. Sens. Susan Collins and Angus King put in a request to the Health Resources and Services Administration, or HRSA, an agency of the U.S. Department of Health and Human Services, to alter the way the facility bills patients

But Dwyer said PCHC already is looking for different ways to model reimbursement. For example, it recently was awarded a catalyzing rural health care grant from Maine Health Access Foundation to work with stakeholders to assess the current community need and then develop a new health care delivery model for the Moose River region.

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Additionally, Dwyer said, the agency was working with staff members from King’s and Collins’ offices to come up with long-term solutions for rural health centers. She mentioned a possible pilot program that Jackman could pursue in which it would try different reimbursement methods but did not go into specific details about what that would look like or how it would work. She did say that similar programs have been tried in one or two other locations but haven’t quite caught on.

Dwyer said PCHC also is talking to HRSA about a common-sense solution to a loophole that disqualifies the Jackman facility from qualifying for certain federal health care funding.

Democratic Rep. Dale Denno said he was concerned about allocating funding to one community when the problem is systemic, but applauded Dwyer and Duplessis on the work that’s been done to identify possible solutions to the statewide problem.

“This has been a heartbreaking situation,” Denno said. “The rural health care system in Maine is under siege. Communities can die if its infrastructure dies.”

He said he is going to support the stopgap measure and hopes the Legislature will look at the larger problem much harder, adding that he believes the expansion of Medicaid will help rural hospitals and health centers fund services.

After the work session, Bradlee Farrin, R-Norridgewock, who represents part of Madison, Norridgewock and Solon and is a co-sponsor of the bill, said he thinks the Legislature probably will take up the bill for a vote next week.

Emily Higginbotham — 861-9239

ehigginbotham@centralmaine.com

Twitter: @EmilyHigg


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