Maine Health Center Chases Funding

Closing the Jackman Region Health Center, which provides hospital services to a rural area the size of R.I., isn't an option residents want to consider


ERIN RHODA, Kennebec Journal | | Wednesday, January 25, 2012

JACKMAN, Maine -- With the health and well-being of residents on the line, community members are redesigning the funding structure of their hospital in an effort to keep it running.

The pursuit of federal funding, however, is an enormous task that will take at least a year of effort, collaboration between local, state and federal agencies, hundreds of hours of volunteer work by dozens of residents, and about $130,000 in grant money and in-kind labor.

The Jackman Region Health Center provides regular hospital services to a rural area the size of Rhode Island, so closing it entirely is not an option residents want to consider. Who would remain in an area or move a business to a place with no nearby health care?

Reaching the next nearest hospital, Charles A. Dean Memorial Hospital & Nursing Home, in Greenville takes an hour, while getting to Redington-Fairview General Hospital in Skowhegan takes an hour and a half.

It's two hours to MaineGeneral Medical Center in Waterville.

"Really, it's 75 miles to Skowhegan and 100 miles to Waterville. So if we don't keep what we have up here, that's what it would entail, people traveling that distance to get what we're giving now," said Alan Duplessis, a Jackman resident who is chairman of both the health center's board and the new steering committee planning the center's future.

Even though the health center provides a 24-hour urgent care department, doctor's office, ambulance service and nursing home to a large area, Jackman and the surrounding unorganized territories have such low population densities that there aren't enough patients to keep the health center in the black.

As a division of MaineGeneral Health, the health center operates with up to half a million dollars of deficit each year, said Nona Boyink, senior vice president at MaineGeneral Health. The parent corporation pays off a portion of the deficit each year, and the local community contributes by fundraising.

"There really isn't a way, in a community that size, that the physician practice part of the health center can break even," Boyink said.

Jackman has about 700 people, while Moose River Plantation has about 200.

In the year preceding June 30, the Jackman Region Health Center saw 2,346 doctor's office visits, 459 urgent care visits and 197 ambulance runs, according to MaineGeneral Health. Its nursing home has about 13 people, with 18 beds available.

But even running at bare-bones cost, with 33 full- and part-time employees that often fill multiple roles, the health center could support twice as many patients, Boyink said.

With no indication of an increasing population -- Jackman actually lost one-quarter of its population between 1990 and 2009, according to the U.S. Census Bureau -- a local group of volunteers is preparing for the day when it can apply for the health center to be federally funded.

The planning process to potentially become what's called a federally qualified health center is in itself a challenge.

"It's an enormous undertaking, but it's an enormous community," Bill Primmerman said, referring to residents' dedication.

Primmerman is project director of the Greater Somerset Public Health Collaborative, which is facilitating the Jackman group's $80,000 planning grant, awarded by the U.S. Department of Health and Human Services' Health Resources and Services Administration as part of the Affordable Care Act.

The local group will use the money in the coming months to devise a long-range plan for the health center. Redington-Fairview General Hospital in Skowhegan is lending its help by acting as the fiscal agent for the grant.

"To experience Jackman is to really experience a community that works together, and they have worked together to keep their school as a community and they're working together now to keep their health care. This is just one of those communities that you know can do this," Primmerman said.

Becoming federally qualified would mean the health center is eligible for funding to stabilize the current shortfall.

As a federally qualified health center, it would also receive full reimbursements from Medicaid and Medicare. It currently does not get reimbursed to cost.

The planning committee, which began work this fall, will complete all the background work necessary to have a successful application with the federal government, Primmerman said. The federal funding is not available every year, however, and it's still unknown if there will be a call for applications this year.

In the coming months, the Jackman group will structure a potential plan for the medical services residents need and likely form a nonprofit organization with a board of directors in order to accept the hoped-for federal money.

They will also decide whether to remain an independent health center or become part of a network of health centers, such as the Health Reach Community Health Centers, which has 11 clinics throughout Maine.

The planning process kicked off on Nov. 30 with a public forum attended by 43 people. The committee meets once a month and is looking for several more residents to help, Duplessis said.

The town is also looking to its Congressional delegation for assistance.

Ed Gilman, communications director for U.S. Rep. Mike Michaud, D-2nd District, said the role of Congress in this instance is to fund the U.S. Department of Health and Human Services, which hands down the funding for qualified health centers.

"What we're trying to do is just help in any way that we can," Gilman said.

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