1/30/2013 2:00:00 PM Consultants Call For St. Andrews To Keep Emergency Department
By Dominik Lobkowicz
A critical access hospital is viable on the Boothbay peninsula and Lincoln County Healthcare should keep the emergency department at St. Andrews Hospital open, according to a 36-page report released Jan. 23.
"Specific data along with assumptions about a very uncertain future demonstrate there is no compelling reason to close the Emergency Department," according to the document.
Consulting firms iVantage Health Analytics and the Gabarro Group, which produced the report, were hired by the St. Andrews Task Force to look into the needs and opportunities for a hospital in the Boothbay area.
Lincoln County Healthcare's proposal to close the emergency department at St. Andrews Hospital in April 2013 was approved by the MaineHealth board of trustees last August. In early December, LCH agreed to postpone the closure until Oct. 1.
According to the consultants' report, Lincoln County Healthcare's analysis of the loss of critical access hospital status at St. Andrews failed to stress or mention several "significant financial implications." Those implications include: loss of $1.5 million in Critical Access Hospital revenue per year, loss of $250,00 for skilled nursing care associated with the hospital status, loss of $1,342,859 from direct and indirect job losses, and an estimated $400,000 in pre-hospital EMS costs, which ultimately fall upon area taxpayers.
The report calls for LCH to continue providing 24/7 emergency room services, reestablish outpatient surgery, invest in telemedicine, establish a geriatric center, and restore patient clinics, among other actions.
The elimination of inpatient services, specialty clinics, oncology services, and surgical services at St. Andrews all contributed to the loss of volume and market share LCH used as justification for closing the emergency department, according to the report.
LCH did not consider the effects of the closure on the Boothbay region, including negative effects on property values and the region's ability to attract retirees to the area based on its proximity to a local hospital, according to the report.
"Up until now I thought we couldn't dispute the facts presented by Lincoln County Healthcare and Maine Health," said Smith Climo, according to the task force's Jan. 23 press release. Climo is a Southport Island selectman and a member of the task force.
"I'm proud and excited with the report from iVantage. I hope that this will lead to constructive dialogue with the hospital," he said.
"We are attempting to preserve a community resource and provide the best healthcare for our community," said Valerie Augustine, according to the release. Augustine is a Boothbay Harbor selectman and task force member.
"I'm optimistic that continued conversations with the task force, Lincoln County Health, and MaineHealth will come to the best healthcare options for our community," Augustine said.
Jim Donovan, president of Lincoln County Healthcare, Miles Memorial Hospital, and St. Andrews Hospital, said the members of the Lincoln County Healthcare board of trustees have all received copies of the report and will next meet on Thursday, Jan. 31.
Speaking only for himself, on Jan. 25 Donovan said nothing in the report has changed his mind of the closure of the emergency department at St. Andrews.
"There's nothing new in there for me; there's nothing in there that I didn't know or didn't think about," Donovan said.
LCH's vision for healthcare in the Boothbay region starts with primary care physicians' offices and the urgent care center planned for St. Andrews, and includes a comprehensive array of outpatient services, such as laboratory, radiology and occupational therapy services, Donovan said.
"Those are services that the community really needs and really uses," Donovan said. "That's where the future is in small communities across the state and across the country."
While LCH is working on building those services in a sustainable and affordable way, they'll also be working with the community on the transition, Donovan said.
"This is where we've made some progress with the task force, we believe...helping them understand the forces in healthcare that we're dealing with that lead us to the decision that we made and lead us down the path that we're following now," Donovan said.
The consultants' full report is available in Boothbay's town office and on its website, www.townofboothbay.org.