July 28, 2013

Boothbay region 'full of fear' as hospital closing looms

MaineHealth officials call it the best path forward, but a community with many older residents worries about having no ER nearby.

By Colin Woodard cwoodard@pressherald.com
Staff Writer

(Continued from page 1)

Today's poll: Hospital closing

Do you agree with Lincoln County Health Care's decision to close St. Andrews Hospital?

Yes

No

View Results

click image to enlarge

On Oct. 1, St. Andrews in Boothbay Harbor will cease to be a hospital.

John Ewing/Staff Photographer

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Additional Photos Below

"It has made a lot of people very angry," says retired nurse's aide Helen Farnham, who helped found the local ambulance service in 1975. "Home prices are going to go down, and property taxes are going to go up."

Over the past two decades, the Boothbay region has attracted large numbers of retirees, many of whom bought with the knowledge that a hospital was close at hand. This helped make Lincoln County the oldest in the state, with a median age of 48.1 years in 2010, compared with 42.7 for all of Maine and 37.2 for the United States as a whole. On Southport, the median age is 60, meaning half the island's 600 people are older than that.

The sense of betrayal many feel here is augmented by the fact that many thought their hospital had been protected from closure under the original 1996 partnership agreement with MaineHealth. St. Andrews was the first to join the hospital network apart from its founding flagship, Maine Medical Center, and benefited from shared procurement, loan collateral, and insurance pricing with its much larger partner.

The local board took care to ensure that the agreement would give it control of the endowment and would commit MaineHealth "to maintain at a minimum emergency services, outpatient health care services and appropriate home health and long-term care services in the Boothbay Harbor region" unless the St. Andrews board decided they were "no longer necessary and appropriate."

"We were acutely aware of who we were dealing with and the relative power of each entity, so we were trying to protect St. Andrews from exactly the situation we are facing at this time," says Boothbay Harbor attorney Tom Berry, who was on the board at the time. "We wanted to make sure they couldn't just scoop up the endowment and move everything to Damariscotta."

But in 2007, St. Andrews' local board signed another agreement, this one to effectively merge with Miles Memorial in Damariscotta, creating Lincln County Health Care. While the hospitals retained their separate legal identities, for practical purposes St. Andrews lost its independence. LCHC, Miles and St. Andrews have since had boards with identical compositions, meet simultaneously and share the same minutes. A majority of board members are either from the Damariscotta area or are employees of LCHC, which has led some in the Boothbay area to charge that their community's interests were underrepresented when the board, behind closed doors, decided to suspend general surgery, acute care and, ultimately, the emergency room.

"People in this community feel this big corporate machine came in here and somehow underhandedly ended up with the gift Dr. Gregory gave this town," says Good. "They've taken equipment out of here, dismantled the place and stripped it."

ER NO LONGER SAFE?

Nothing could be further from the truth, says emergency room physician Mark Fourre, LCHC's chief medical officer and a board member, who formerly headed the St. Andrews emergency department. The changes, wrenching though they may be, are both desirable and vitally necessary, he says.

Over the past six years, Fourre notes, emergency room visits to St. Andrews have fallen by 20 percent. "When you get down to that kind of volume, you end up with a skeletal crew, with a single nurse and a single physician," he says. "If you get somebody who is critically injured or ill, they need a team to care for them, and at St. Andrews we can't assemble that team. But 20 minutes away (at Miles) there's an ER with physicians and a pediatrician and surgeons."

"In my opinion," he adds, "arriving at an ER that doesn't have the people or supplies they need to effectively run a resuscitation on a critically ill person or individual -- that's more of a risk than 15 extra minutes in an ambulance."

(Continued on page 3)

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Additional Photos

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Hairdresser Jane Good of Southport Island talks about the proposed closure of St. Andrews Hospital in Boothbay Harbor with summer resident Walter Weil. Good's salon has become an epicenter of support for keeping the hospital alive in the community.

John Ewing/Staff Photographer

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James Donovan, CEO of Lincoln County Health Care, supports the emergency room’s closure at St. Andrews Hospital in Boothbay Harbor. “For many years now, the 24/7 St. Andrews emergency department hasn’t been busy enough to sustain itself,” Donovan says.

John Ewing/Staff Photographer

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George McEvoy of Boothbay Harbor, photographed in Portland last week, opposes the pending loss of St. Andrews Hospital, where he has had positive experiences with its medical care. McEvoy says Lincoln County Health Care didn’t want the Boothbay Harbor hospital to succeed.

Gabe Souza/Staff Photographer

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William Caron, CEO of MaineHealth: “We are changing the way care is being provided on the (Boothbay) peninsula, and it’s going to be the best care in the state of Maine when we’re done.”

John Patriquin/Staff Photographer

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After Oct. 1, the nonprofit Boothbay Region Ambulance Service will take emergency patients from the Boothbay peninsula to Miles Memorial Hospital in Damariscotta, a 30-minute drive from downtown Boothbay Harbor, above, and 40 minutes from the southern tip of Southport or Ocean Point in Boothbay.

John Ewing/Staff Photographer

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Signs of community support for St. Andrews pepper the landscape in the Boothbay region. In largely symbolic referendums held in four towns – Boothbay Harbor, Boothbay, Edgecomb and Southport – this year, 86 percent of the region’s residents opposed the emergency room closure.

John Ewing/Staff Photographer



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Today's poll: Hospital closing

Do you agree with Lincoln County Health Care's decision to close St. Andrews Hospital?

Yes

No

View Results