Some safeguards for a hospital in Dover-Foxcroft

Gov. Mills recently signed LD 1708 into law, clearing the way for the next steps in a merger between Hospital Administrative District #4 and Northern Light Health. Recent articles in the Bangor Daily News and copied to the Piscataquis Observer contained headlines such as “Piscataquis County Lawmaker Wants More Local Control Over Dover-Foxcroft Hospital Merger” and copy such as “Stearns proposed several amendments that would have given the thirteen communities more say over the happens (sic) to the hospital after the merger.”

My single proposed amendment to LD 1708 had nothing to do with “local control” but would have merely placed in statute some safeguards to ensure that standard fiduciary procedures were followed and that the citizens of the district would have an opportunity to keep a hospital in Dover-Foxcroft should something happen down the road.

Rep. Paul Stearns,
R-Guilford

First, it would have required an independent audit at the time of the merger and, if there were any funds in savings or the checkbook remaining after all HAD #4 debts were paid, those monies would be distributed back to the towns in the District.

Secondly, it included language that, should Northern Light Health or any successor decide to discontinue operating Mayo Hospital at a “critical access” level that the towns would have the opportunity to have their facility back if they wished to take it.

Thirdly, it removed the emergency preamble, which would have meant that the law would have taken affect 90 days after the governor has signed it, rather than immediately.

Last November, immediately following the election, legislators from the HAD #4 towns were invited to meet with the district officials. The HAD #4 Board of Directors had recently voted 15-3 to proceed with the merger, and the idea was that one of us would submit legislation to change the district charter and clear the way for a merger. The three Republican legislators, Rep. Foster, Sen. Davis and myself, were reluctant to champion such legislation and then have to explain to constituents in arrears what had been done. Instead we suggested, strongly, that at a minimum the HAD #4 board and administration hold public forums to explain to the people why the merger was necessary and in everyone’s best interest. This was not something that the officials and their counsel were interested in, nor did they feel that it was necessary.

A few weeks later we were invited to meet again. Upon our arrival, this meeting turned out to be with the executive board and we heard a presentation from an attorney hired by the board explaining why input from the local voters was not necessary. Again, the three Republicans were not sold, and again we requested public forums and input.

This simmered along for weeks, with informal dialogue back and forth in search of a satisfactory way forward.

There was extreme urgency on behalf of representatives from both the HAD and Northern light that legislation be passed during the first session of the 129th Legislature. This led to the submission and passage of LD 1553 which required the district to hold four public forums and for each town to then take an “advisory” vote on the merger. Note: This is precisely what we had asked them to do all along. This type of data would allow us to explain to fellow legislators that we were indeed representing the wishes of the people of the district.

The forums were held, and the votes were overwhelmingly in favor of the merger. Employees of HAD #4 were forbidden to speak out against the merger, but this was part of the agreement that the HAD #4 Board of Directors had signed onto.

As we prepared final legislation, LD 1708, we were told that HAD #4 had $13.7 million (plus or minus)) in an investment account and $9 million in debt, along with another million dollar line of credit. Rep. Foster came up with an idea to take one million dollars of the peoples’ money and invest it in a local trust, overseen by a local board. A portion of the interest on this fund would be used for healthcare initiatives in the 13 HAD 4 towns. This certainly would fit in with the mission of Northern Light Health. We approached Northern Light with this idea and received a letter back saying that it would not be possible, and, in fact, that the merger was going to amount to an $8 million loss to Northern Light.

This is where the idea for my amendment was hatched. One entity was telling us that there would be a $3.7 million positive balance, and the other entity was telling us that there was an $8 million deficit. That is an $11.7 million difference in estimates. This led me to craft the “independent audit” portion of my amendment. This should have caused no problem, as one would assume that an audit would be standard procedure when a quasi-municipal entity ceases to exist. It also would have been quite simple for the HAD #4 board to dedicate any funds to various capital improvement projects needed at Mayo, thus having little to no balance between cash and debt at the time of transfer.

The impetus behind the merger, from the perspective of local HAD officials and most board members, is that “we must do this or risk losing the hospital.” Northern Light Health officials have stated repeatedly that there is no intent to ever close Mayo hospital, and I believe them. That is why the second part of my amendment — the part that would have given HAD #4 citizens the option of getting their hospital back if it were ever to be closed, didn’t seem to me to be an onerous addition to the statute.

The amendment was presented at a work session of the State and Local Government Joint Committee, and when I presented it I was very clear that these were merely safeguards, and in no way intended to slow the passage of legislation. Northern Light officials were not available to attend a scheduled meeting prior to the final work session on LD 1708, and as promised I pulled my amendment and the legislation passed.

The proposed amendment merely would have accounted for local dollars and assured that Mayo Hospital would never cease to exist if the citizens of HAD didn’t want it to.