Morgan Starkweather, a pediatric occupational therapist who was suspended from June to July, acknowledges supporters after speaking at a rally on July 14 in Portland. MaineHealth Care at Home nurses and clinicians and their union supporters are calling for removal of the MHCAH management team after delivering a no-confidence petition. But top officials of MHCAH are standing by the supervisors’ decision to fire two nurses. Michele McDonald/Staff Editor

Officials of an at-home care division of MaineHealth are voicing support for its clinical leadership team in the wake of a no-confidence vote by staff.

In an interview Thursday, MaineHealth Care at Home President Patsy Aprile and board of trustees member Patrice Camire said management is upholding supervisors’ decision to fire two nurses for issues concerning the quality of patient care. Moreover, officials do not plan to comply with staff demands to remove members of the clinical leadership.

“There’s a vote of confidence from the board,” Camire said. “There’s no question in our mind that we know that leadership is there to provide safe patient care and that is their focus.”

But MHCAH officials haven’t yet explicitly informed staff members of that decision. Aprile said she has offered staff members time to bring up concerns in meetings. But she has not addressed the no-confidence vote head on – nor does she plan to.

In part, that is because the issues involve confidential information governed by privacy laws and disciplinary-action policies, Aprile said. But it’s also because MHCAH management believes it has solved the quality of care concern and is ready to focus on the future, she said.

“The whole reason why we’re doing this is because we’re so committed to quality of care. So (we are) nipping this in the bud and moving on as an agency,” Aprile said.


In response, the union representing nurses and other clinicians within MHCAH is gathering community support to try and compel MaineHealth to satisfy their demands. Local president MaryBeth Gagne said the union has so far collected around 500 signatures from community members, other Maine unions, patients and their family members.

“We need (the current clinical leadership team) to be gone, to have new management put in place that understand the running of the agency,” she said.


Gagne and Karen McNally were pediatric nurses fired in early July. Both women had been at MHCAH for over 30 years. They were among six pediatric providers who were suspended in mid-June because of concerns about inadequate patient care.

That disciplinary action led 65 of 70 nurses, social workers, pathologists, administrators, and occupational and physical therapists with the Maine State Nurses Association union at MHCAH to issue a vote of no confidence in three members of the clinical leadership team: Heather Lomax, Jennifer Morin and Amanda Kunkel.

Staff members rallied on July 14 and called on MaineHealth officials to reinstate Gagne and McNally and to remove the three members of the leadership team. They said the firings were merely the final straws after years of issues with the clinical leadership team concerning communication, scheduling, work culture and resources. Those disagreements, the nurses and clinicians say, have led to a decline in health care quality and long patient waitlists, harmed employee morale, and fostered what they consider a toxic work environment.


Aprile and Camire disagree with that assessment. They said they firmly believe that the vote of no confidence was solely motivated by the firing of the nurses. They see the vote, rally and call to action as a union “tactic.”

Todd Ricker, with the Maine State Nurses Association, is not denying that.

“When management treats workers unfairly, yes, we will absolutely use every tactic we have to defend those members and help them to win justice,” Ricker said. “When our members are injured by discipline and discharge without just cause, we absolutely take action to support those members.”


There is disagreement about the root of the dispute.

Three clinicians separately said they were told by supervisors that they were suspended because of a Department of Health and Human Services investigation into their work “due to allegations of provision of inadequate care,” said Morgan Starkweather, a pediatric occupational therapist who was suspended from June to July.


Starkweather said that when she was reinstated, DHHS told her the investigation was into a pediatric patient’s at-home caregiver – so despite what she had been told, the investigation had nothing to do with her at all.

Aprile and Camire, however, appeared exasperated by those claims in an interview with the Press Herald.

“It’s so off-base, I can’t even respond to that,” Aprile said.

DHHS did not respond to a request for comment in time for publication.

Nurses and clinicians say there has been a decline in health care quality, which they blame on the arrival of the new clinical leadership team two years ago.

But Aprile and the trustees say the supervisors have solved what was a one-off problem by firing the two nurses.



While Gagne is not currently employed by MHCAH, she is still serving as the local union president and steward for MHCAH staff members.

“And they’re very frustrated. They don’t understand why, with MaineHealth especially because we sent the vote of no confidence to (CEO) Andy Mueller and just got no response,” Gagne said.

The Maine State Nurses Association is also advocating for Gagne and McNally through the grievance process mandated in MHCAH’s union contract. If management denies the grievance in a series of meetings, the union can then escalate the process to arbitration, where a neutral third party would determine the future of Gagne and McNally’s careers at MHCAH.

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