Citizens in HAD 4 to vote on proposed Mayo merger

MILO — Mayo Regional Hospital officials and area legislators told community members April 18 that the region’s citizens will be able to participate in the decision-making process for the proposed merger between the hospital in Dover-Foxcroft and Northern Light Health, a statewide system comprised of hospitals across Maine.

Non-binding town meeting votes on the plan are scheduled across a dozen HAD 4 communities from April 20-30 to help area legislators make a decision on submitting a bill to amend the hospital district charter to pave the way for a merger. More information is at https://mayohospitalfacts.org/.

About 50 people gathered at the Penquis Valley School for the fourth of four public forums on the merger heard Rep. Norman Higgins, I-Dover-Foxcroft say that he, Reps. Paul Stearns, R-Guilford and Steven Foster, R-Dexter and Sen. Paul Davis, R-Sangerville started meeting with Mayo Regional Hospital officials in November as well as meeting with other legislators in Augusta.

Observer photo/Stuart Hedstrom
COMMUNITY FORUM ON FUTURE OF MAYO — Mayo Regional Hospital President & CEO Marie Vienneau opens a community forum on the proposed merger between the hospital and Northern Light Health April 18 at the Penquis Valley School in Milo. At the panel with Vienneau are, from left, HAD 4 Board Chair Amanda Thomas, forum moderator Chris Winstead, Mayo Inpatient and Emergency Department Director Dr. David McDermott and hospital Vice President of Finance and CFO Nancy Glidden. Through the end of the month HAD 4 member towns will be making advisory votes on the merger to help area legislators make a decision on the plan.

“It will take legislation to enact this merger, I think everyone has come to that conclusion,” Higgins said. He said the delegation would like to see three things including a greater assurance that services that would still be provided in the region post-merger, “we wanted Mayo to conduct public meetings,” and “we believe since this district was formed by a vote of these communities this vote should be at town meeting where debate takes place.”

“As legislators we’ve been reluctant to submit legislation for the merger until we know what the public opinions are,” Higgins said. “Because it is your hospital we want to be respectful of your opinions and help instruct us in the direction we want to proceed.”

The four legislators were present and said they support improving public healthcare. “I think it is important to think what healthcare will look like for all of us the next 10-15-years,” Higgins said.

Davis said a bill has been submitted in Augusta requiring the HAD 4 communities hold town meetings to provide advisory opinions, and a vote on the bill is set for April 22. “We don’t feel comfortable at all doing this without the people telling us what they want,” he said.

“I think for us legislators we are going to need a significantly positive vote to put any legislation forward,” Davis said. When asked, the state senator said he was unsure of how the voting data would be weighed by the legislators.

“We’re interested in looking at the broad spectrum of the 13 towns,” Higgins said. “There are a number of factors that we will look at and then we will make a value judgement at that point.”

He mentioned the previous week the Dexter Town Council gave its approval to the plan on behalf of the community. How this result by the seven councilors will provide guidance along with the decisions, made potentially by dozens of attendees, at a dozen special town meetings is something the legislators will still need to consider.

“The charter calls for a vote in each town but it only pertains to dissolving, it says nothing about a merger,” Davis said.

Language pertaining to a merger would need to be added to the HAD 4 charter and any amendments would need to be passed in the Legislature. The town votes will help the legislative delegation determine whether or not to submit legislation to change the HAD 4 charter to pave the way for the merger.

“We are only working on a bill that requires towns to have a vote,” Foster said. “Then, depending on the result, we will look at what we are going to do and there will be another bill going through to change the charter.”

With the exception of Dexter with its town council, all the HAD 4 member communities have a selectmen/town meeting form of government and the bill is asking that citizens make a decision on the merger through a town meeting vote.

Dover-Foxcroft has its annual town meeting on Saturday morning, April 27 so this item was added to the warrant, while the other 11 communities will hold special town meetings to make a decision. Each will be able to decide at the meeting whether to make the vote by a show of hands or via written ballot.

“The second bill only happens after this first bill takes place,” Northern Light Health Deputy General Counsel George Eaton said.

In February directors of HAD 4, the quasi-municipal entity that owns and oversees the hospital, voted 15-3 to proceed toward a merger agreement. Last month Northern Light directors unanimously approved the merger. Those involved have cited finances and a continuation of services as key reasons for pursuing the merger.

HAD 4 Board Chair Amanda Thomas of Guilford said the district is the last of its kind in Maine, founded in 1974 by the Legislature with 11 member communities and now at 13 with the addition of Dexter and Milo. Thomas said the board of directors has 19 members representing each of the 13 towns.

Thomas said the directors’ planning board first addressed the possibility of some kind of merger and in late 2015 requests for proposals were sent out. Two proposals came in, one from Covenant Health — which oversees St. Joseph Hospital in Bangor — and the other from Northern Light (Eastern Maine Healthcare Systems at the time). In July 2016 the directors unanimously voted to sign a letter of intent and in March 2017 they signed an interim affiliation agreement.

“Most alarming to us is the closing of 102 rural hospitals [nationally] since 2010, including three in Maine,” Thomas said. “We believe in order for Mayo to continue to provide high quality care for our region we must merge with a larger organization.”

Mayo Vice President of Finance and CFO Nancy Glidden said the hospital has been experiencing operating losses since 2010 and over the last three years the deficit has averaged $1.6 million annually. “We have been very public in talking about our operating losses these last few years,” she said.

Glidden said Mayo Regional Hospital has incurred an operating loss of about $1.5 million through the first five months of the fiscal year and this could project to about $4 million by year’s end.

“We are continuing our process because we believe this merger would have a positive impact on us,” she said.

Glidden said being part of a larger healthcare system would help Mayo Regional Hospital recoop more costs through Medicare and Medicaid and insurance negotiations as well as attracting medical providers.

“There is downward pressure on markets and as a single hospital we are not able to negotiate a market position,” she said. “Our costs we think could be more manageable in a larger system. We would not be competing with (Northern Light) for providers, we would be participating with them.”

“We are in Milo, I don’t have to speak to you what it means to lose your local healthcare or your healthcare options,” Mayo Inpatient and Emergency Department Medical Director Dr. David McDermott said, as the community once had a hospital prior to joining HAD 4.

He said already Mayo shares a number of services with Northern Light, including oncology, surgical podiatry, OB-GYN, radiology, and psychiatry. “We are working with them collaboratively for the area,” Dr. McDermott said.

He mentioned, as an example of post-merger services, a patient in Greenville suffering an acute appendicitis could come to Dover-Foxcroft for the procedure rather than traveling twice as far to Bangor.

“We have done a lot of things collaboratively with Northern Light Health and I would say this is the next step,” he said.

“I would say the vast majority of the physicians are in favor of this,” Dr. McDermott said, mentioning many feel that without the merger the range of services may not be able to continue. “We all want to have hospital and a thriving community.”

“If we don’t do anything there is no guarantee we will have a hospital in five years,” said HAD 4 Board Treasurer D. Jensen Bissell of Milo. “We think this is the best option for healthcare.”