Just as surely as the tide rises and falls, there is yet another chapter in the St. Andrews Hospital saga. The Boothbay Region Health & Wellness Foundation wants the community to understand the real ebb and flow of where we are today. There is a lot of flotsam and jetsam on the beach.

Commissioner Mary Mayhew, in response to a request from LincolnHealth, granted two Certificates of Need: one for the actions taken in 2007 to combine the two hospitals, St. Andrews and Miles Memorial, under the leadership of a newly created Lincoln County Healthcare; and another for the plan to reorganize the management structure in 2013. Having heard the voice of the community, the commissioner said “I specifically acknowledge the comments contained in the record ... regarding the provision of urgent care in the area. I have determined that the ordinary economic development of healthcare for the Boothbay region would be adversely affected and this specific application would have to be denied if the applicant who provided acute emergency care was not required to maintain an appropriate urgent care presence. The commenters have made this need clear and I have approved including a condition requiring 24/7 urgent care services.”

In recent letters to the editor of the Boothbay Register, the chairman of the board of trustees and the medical director of LincolnHealth have each made interesting comments regarding 24-hour urgent care. We are pleased to hear from Dr. Mark Fourre that “since October of 2013, the St. Andrews Campus has provided urgent care services to hundreds of patients 12 hours a day, every day.” Jeff Curtis, on the other hand, presents historic statistics from the emergency room era of St. Andrews: “with an average of only two patients a night, we could not guarantee the highest quality of care in the middle of the night to patients with life-threatening conditions.”

Let's be very clear about this. The hundreds of people who are using the urgent care facility from 8 a.m. to 8 p.m. are not presenting “life-threatening conditions.” As Commissioner Mayhew suggests, why not run it 24/7 for three years and then look at the numbers. Let’s not confuse the issue with old ER statistics, which have nothing to do with urgent care.

LincolnHealth would lead the public to believe that if they are forced to provide 24/7 urgent care, they will not be able to afford the necessary skilled nursing beds — therefore they have filed for reconsideration of the commissioner's condition requiring 24/7 urgent care.

That hearing has nothing to do with the skilled nursing beds — it only has to do with 24/7 urgent care. But still LincolnHealth is urging its employees and the community to attend a public hearing to help convince the commissioner to reconsider her ruling and they are throwing the skilled beds issue into the mix, and this is what is muddying the waters.

Keep in mind that the commissioner has the final say here, and she may not grant such a hearing. If she does not grant a hearing, the 24/7 urgent care must be up and running by August 27, 90 days from her original ruling.

LincolnHealth has said that they will be filing a letter of intent with DHHS, notifying the department that they intend to file for a Certificate of Need for 10-12 skilled nursing beds at St. Andrews Village. This is an entirely different Certificate of Need and will have its own hearing.

We agree with Jeff Curtis and Dr. Mark Fourre that we can “work together for common goals” and we will do that with the beds. However, the community’s testimony for the two certificates of need for which the 24/7 urgent care is a condition was strong and true. We spoke about the loss of our ER, about the increased cost of ambulance services, and about the loss of beds on the peninsula. Those issues are still true. The commissioner’s response to our testimony is very clear: 24-7 urgent care. DHHS wants all of the people in our community to be safe and to have access to care, both year-round and summer residents.