Seven of eight towns favor Mayo/Northern Light Merger

More than halfway through the process, seven of eight HAD 4 communities have given approval to the proposed merger between Mayo Regional Hospital and Northern Light Health, a statewide system comprised of hospitals across Maine.

The non-binding town meeting votes on the plan have been 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.

Residents of Dover-Foxcroft and Willimantic became the latest towns to approve the plan. As part of the annual town meeting on the morning of April 27, citizens in Dover-Foxcroft approved the plan via a count of 136-7 (about 95 percent raised their hands in favor) at the annual town meeting and that same day a similar question passed 11-8 at a Willimantic special town meeting.

A majority of citizens in Abbot and Monson OKed the proposal via respective special town meeting votes of 23-13 and 20-6 on the evening of April 25.

The Dexter Town Council unanimously approved the plan with councilors’ votes on April 11. In Bradford the tallies were 20 residents in favor and one opposed on April 22 and the next night the measure passed 25-0 in Milo.

Cambridge is the lone community to vote down the merger plan, doing so via a 22-12 count at the first of 12 special town meetings April 20.

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 — such as primary care, inpatient, OB, ER, ambulance and oncology — as key reasons for pursuing the merger.

At several public forums earlier in the month 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. She said the 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.

During the Abbot meeting at the town hall Rep. Norm Higgins, I-Dover-Foxcroft explained 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.

Higgins said the merger proposal calls for a 5-year agreement between Mayo Regional Hospital and Northern Light Health, including a continuation of clinical services for the next half decade. “It’s not a guarantee but it gives us some assurances core services will be here for a 5-year period, after that — like anything with health care — who knows,” he said.

The representative said he and his colleagues asked that four public forums be held across HAD 4 and Davis submitted a bill requiring town meetings be held in the 12 communities with a selectmen’s/town meeting form of government prior to May 7.

“It took a little while longer than we wanted but the governor signed the bill this afternoon,” Higgins said. “Why did we want this bill, in town meeting you have a lot of give and take, two-way conversations,,” he added, saying this discussion does not happen with a referendum. “As legislators we wanted to make sure there are town meetings.”

“The Legislature created HAD 4, the Legislature’s responsible for any charter changes that are going to take place,” Higgins said. “I have a bill in my name, it’s sitting there and won’t be acted upon until we take a look as legislators and see what the overall tenor of towns are.”

He said the HAD 4 charter describes the process for dissolving the district but there is not language for a merger. Higgins said he was involved in the formation of what today is Mayo Regional Hospital over four decades ago and “they never envisioned a merger at the time, I know I didn’t envision a merger at the time.”

When asked, Higgins said the final decision on a charter amendment to allow the merger to happen would be made in Augusta. “It will eventually be the Legislature and it would take a bill to go through the committee process with a public hearing,” he said. Higgins said should the bill proceed out of committee it would go to a vote in the House and Senate.

Abbot Select Chair Mickey Knowles said at previous meetings on the topic Mayo Inpatient and Emergency Department Medical Director Dr. David McDermott has talked about potential merger benefits for patients. “If there was a merger healthcare would be improved so much in this area,” Knowles said.

Dr. McDermott explained by saying a duty of his is recruiting providers and “one of the things we are finding is specialists are sub-specialists, we can’t get a general orthopedist.” Instead these doctors are focusing on specific joints such as shoulders and hips.

As part of Northern Light Health these specialists would be able to travel to Mayo Regional Hospital, Dr. McDermott said.

Not everyone favors the merger.

“I can tell you HAD 4 is pulling the wool over our eyes,” Cambridge Select Chair Michael R. Watson said several days after the Somerset County community’s 22-12 vote against the merger plan. “They have $26,411,877 in liquid assets and they are trying to say they are millions of dollars in debt.”

Watson explained the $26 million could enable the hospital to finance itself for at least six years before there is a need to levy any taxes on the 13 member communities to pay for debt.

“It’s a mess, the board of directors tried to sidestep the charter that brought HAD 4 into existence, they are trying to change without talking to us,” he said, saying after pressure there were the public forums but the closest session to Cambridge was held in Guilford.

“If the citizens of the district wake up and read the facts they will see they are being hoodwinked,” Watson said. “It’s hard for citizens to get the facts, they are getting an opinion.”

Watson said should the merger proceed then the $26 million in liquid assets and about $51 million in hospital real estate would be handed over from the HAD 4 member towns to Northern Light Health. “That’s a lot of money to these little communities,” he said. “We need to hold on to our assets.”

These concerns have been described in a letter Watson sent to the local delegation to Augusta, over a dozen more legislators, Gov. Janet Mills and Attorney General Aaron Frey.

Mayo Vice President of Finance and CFO Nancy Glidden disputed Watson’s statements, saying she and others at the hospital would never specify financials in terms of liquid assets but if this term was used then the only current liquid assets are about $10 million in liability. She said the hospital has about $9 million in long-term debt through the end of March in addition to accounts payable and accrued payroll. Glidden also disagreed with Watson’s figure of $51 million in hospital real estate, saying this would be the purchase value and does not include depreciation which put the real estate at a book value of approximately $16 million.

“The HAD 4 board members and administration, as well as officials from Northern Light, have certainly put a great deal of time and effort into this matter,” Stearns said in a statement. “The informational meetings have been very useful. A decision of this magnitude requires direct input from the voters and we are going to have that soon. I would encourage every citizen to exercise their right to vote.”

The final five communities will be having votes April 29-30 with Atkinson, Guilford, Parkman and Sebec all on Monday evening and the Sangerville special town meeting set for Tuesday evening.

This story was amended on April 30 to include a statement from Mayo hospital official Nancy Glidden.