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 3)

Today's poll: Hospital closing

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

Yes

No

View Results

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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

For private insurers, Miles is by far the most expensive of Maine's 24 smaller hospitals, according to a January study prepared for the state Office of Employee Health & Benefits, with 2011 pricing more than 27 percent higher than the statewide average. St. Andrews was the next most expensive at 17 percent above average.

"We have been struggling to sort out how to keep the greatest level of service we can in Lincoln County, so that people don't have to come to Portland or Mid Coast," Caron explains. "St. Andrews' emergency room is not the last point of discussion we're going to have there. We have other services that are being challenged."

The critical-access designation -- which requires Miles not have more than 25 beds -- has given that hospital breathing room. "This critical access thing took a lot of the pressure off, and I can't sit here now and tell you how long that's going to sustain it, but it's going to sustain it for a while," Caron says.

THE AMBULANCE ARGUMENT

But the new arrangement will increase pressure on an entity that is not part of MaineHealth: the nonprofit Boothbay Region Ambulance Service, whose operations are subsidized by the region's taxpayers.

Instead of a short drive to St. Andrews, ambulances will need to get patients to Miles, a 30-minute drive from downtown Boothbay Harbor, 40 minutes from the southern tip of Southport or Ocean Point in Boothbay. There is only one proper road off the peninsula -- Route 27 -- which is subject to summertime traffic congestion and winter weather.

Emergency patients are typically brought to St. Andrews, stabilized and then transferred to Miles or a larger hospital for further treatment. LCHC argues they are better served by being stabilized by the ambulance crew while en route to a fully staffed hospital.

"You will be stabilized in the back of that ambulance -- they have the capability to do that," says Donovan, who notes LCHC is helping the ambulance service install iPads so doctors can talk face to face with paramedics and patients. "Ambulances these days are really four-wheeled intensive care units."

The operations director of the ambulance service, Scott Lash, isn't so sure. "We're talking about a fully functioning emergency department shutting down, and they're turning around and saying, 'Just look at the ambulance; they'll bridge the gap,"' Lash says. "That's a huge expectation."

Lash is also concerned that his service will be stretched thin, both in terms of resources and in reaching people quickly when they call 911. At present, Lash says, his crews can respond to a call, deliver someone to St. Andrews and be available for another call in as little as 30 to 40 minutes. This allows them to cover the peninsula, even in summer, with their fleet of three active ambulances, although it's not uncommon to have all three on the road simultaneously.

But Lash expects that "turnaround time" will jump to between an hour and 1:50 to get people to Miles, even without traffic or weather complications. The result? "We'll be throwing caution to the wind," he says. "If you're one of the first to call 911, you're in luck. If you're not, you may be waiting for an ambulance to come from Wiscasset or Damariscotta."

The ambulance service's expenses will also go up, both because crews will be out longer and traveling farther, and because they will be making fewer billable trips transferring stabilized patients on from St. Andrews to a larger hospital. The service estimates local taxpayers will have to increase the subsidy they pay from just over $80,000 to more than $400,000 annually. LCHC has pledged a one-year gift of $250,000 to the towns to help defray the costs.

(Continued on page 5)

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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