Mayo officials looking at merger with Northern Light Health

DOVER-FOXCROFT — With total operating expenses having surpassed net patient revenue for more than half a decade, Mayo Regional Hospital officials and its governing HAD 4 board of directors have been looking at options for the long-term future of the West Main Street facility. A possibility being explored is for Mayo Regional Hospital to become part of Eastern Maine Health System — which at the start of the month took on the new name Northern Light Health — and hospital officials were present at the Oct. 22 Dover-Foxcroft selectmen’s meeting to discuss the potential change.

In a letter to Town Manager Jack Clukey, HAD 4 board officers wrote that Mayo Regional Hospital’s year after year financial losses are not sustainable and its future success depends on strategically aligning with a strong, integrated healthcare system.

“We have proposed integration with Eastern Maine Health System — they are Northern Light Health,” Mayo Regional Hospital President & CEO Marie Vienneau said. “We were told we were probably not going to remain a viable hospital after time.”

Nearly three years ago the HAD 4 directors voted to seek a larger system partner. Requests for proposals were made and bids came in from Eastern Maine Health System and Covenant, parent company to St. Joseph Hospital in Bangor. Interviews were conducted and the directors voted to pursue an agreement with what is now Northern Light Health.

The letter gives several reasons for the decision. Mayo Regional Hospital patients would have more access to specialty practices and rural clinics with a partner with whom staff already have long-term, respectful, clinical relationships; Northern Light Health has experience operating two critical access hospitals in the region with C.A. Dean in Greenville and Sebasticook Valley Health in Pittsfield; Mayo Regional Hospital, C.A. Dean and Eastern Maine Medical Center (EMMC) in Bangor would create a strong alliance that presents opportunities to efficiently and effectively provide state of the art care in the region;

Mayo Regional Hospital would have the capability to handle many procedures which are currently referred to EMMC, thereby freeing up capacity in Bangor; Northern Light Health/Eastern Maine Health System and Mayo Regional Hospital have a rich history of working together such as the oncology unit in Dover-Foxcroft; and Mayo Regional Hospital would have access to all Northern Light Health services including recruitment, day-to-day financial management services, employee benefits, legal compliance, and more.

“We don’t believe we should be spending our money competing with each other,” Vienneau said, saying instead better healthcare could be offered to the region through partnerships.

“Technically it would be a merger,” she said. Mayo Regional Hospital could merge into a new Northern Light Health entity, as opposed to being dissolved.

“We are really already in the same market as Eastern Maine Health System and it really doesn’t help to be competitive,” Select Vice Chair Cindy Freeman Cyr said.

“It is emotional to think of losing our hospital, but we know we need to operate with our heads and our hearts,” she said.

“I think the board feels we will not lose our local control,” Vienneau said. “The point of this is to keep as many services in your local hospital and still have your local hospital.”

Speaking of the timeline, the hospital CEO said HAD 4 officials have been working on the proposal for several years. “We are now at a point where we are here educating the communities,” she said. Vienneau said the directors were scheduled to take another vote on moving forward Wednesday, Oct. 24, unless there are still unanswered questions.

In late December legislation would need to be filed, as the hospital district charter contains language allowing for the facility closure but not a merger. Vienneau said the Maine Legislature’s health and human services committee would need to take this up and state certification and approval from the attorney general are both needed.

“Then your local board needs to take a vote,” she said. Vienneau said under an aggressive schedule the merger could be complete by the spring, but next fall is also a possibility.

Right now there are 19 HAD 4 directors and the new board could have between 11 and 19 members. “We would still have representation from the region,” the CEO said.

Director of Emergency Medical Services (EMS) Brian Mullis was asked about the impact on ambulance services.

“I really think from an EMS perspective, this will be a seamless transition,” Mullis said. “I think this will probably strengthen our service in Dover-Foxcroft.”

Vienneau referred to Northern Light Health as a “hub and spoke” hospital model. She said patients from Greenville would be able to come to Mayo Regional Hospital rather than head to Bangor, as EMMC often is full or near capacity and this hospital could instead serve the most critical.

“That is the vision why we are valuable to them as a hospital,” she said.

A community forum on the proposal is being planning for the evening of Tuesday, Nov. 27 at the Dover-Foxcroft Congregational Church.

When asked Vienneau said, “the proposed name is Northern Light Mayo Hospital.”

In other business, the selectmen held a public hearing on the special town meeting referendum ballot for the Nov. 6 election when residents will be asked to enact a land use ordinance and ordinances concerning mega projects: transportation corridors, and mega projects: large-scale water extraction.

“It’s been quite an effort and I think it really feels good to all of us to have something to bring before the town,” consultant Gwen Hilton, who worked with the land use ordinance committee for about two years, said.

“The reason there are three ordinances is the ordinance committee felt it was best for the townspeople to vote on each one separately,” Hilton said.

She said the first article asks about “repealing your existing land use ordinance and replacing it with a brand new land use ordinance.” She said the new document builds upon the existing ordinance and its foundation is the comprehensive plan.

“I would say for most homeowners and small businesses you won’t notice a change, day to day,” Hilton said. “It regulates land uses based on their size and potential impacts.”

She said the permitting process for small projects has been streamlined, as some only need approval of the code enforcement officer.

“We created several new industrial districts,” Hilton said about another change in the proposed land use ordinance. The districts are located by Pleasant River Lumber, the transfer station, and the airport/business park. She said the commercial district on West Main Street has been expanded by several parcels and a few lots have been added to the downtown.

Hilton said the other two articles concern mega projects that “could potentially have a lot of impact on the municipality.” She said the ordinances provide a more thorough review process through the planning board and “there would be extensive public input and review.”

“What passing them does is give you some strong legal guidelines no matter what you decide,” she added.

Selectman and land use ordinance committee member Steve Grammont compared using the mega project ordinances to the late 1980s and early 1990s when superstores looked to build in small communities and these towns had no legal provisions to stop or allow construction.

“An entity cannot come into this town and proceed without all their permits,” Grammont said, saying under the ordinances a construction firm cannot have a permit in Dover-Foxcroft unless having gained formal approval from other towns that may be part of the project.

“They cannot do anything in this town until everything is greenlighted in all other towns and forms of government,” he said.

“I really want to thank the folks who worked on this, it’s been a really long time and I know there’s been many, many, many meetings,” Freeman Cyr said