The Maine Department of Health and Human Services has rescinded the Certificate of Need condition that would have required the St. Andrews Urgent Care Center in Boothbay Harbor to remain open 24 hours a day for a period of at least 18 months.
The 24-hour condition was originally set in the department’s May 29 CON decision, but DHHS agreed, at the request of MaineHealth, to reconsider the condition before implementing it. A reconsideration public hearing was held in Boothbay Harbor on Aug. 11.
For Lincoln County Healthcare, the decision was a welcome one.
"We deeply appreciate Commissioner Mayhew's willingness to reexamine the conditions of her CON approval and her decision to rescind the condition requiring an additional 12 hours of urgent care service delivery at the St. Andrews Campus," LincolnHealth President Jim Donovan said on Monday.
"Over the summer months we worked closely with individuals and organizations throughout the county developing a shared vision for our organization and the health of our communities,” LincolnHealth Board Chair Jeff Curtis said. “Commissioner Mayhew’s decision means our precious resources will continue to be invested in services and facilities that our communities not only want, but will use."
However, for the many locally who fought against the St. Andrews ER closure and testified in support of the 24 hour urgent care facility, Mayhew’s reversal was a disappointment.
“We are dismayed that Mary Mayhew has backed down on her requirement to provide 24-hour urgent care service to the year round and seasonal residents on the Boothbay peninsula,” Health and Wellness Foundation President Patty Seybold wrote in an email, “We believe that the lack of 24-hour care has profoundly negative humanitarian and economic repercussions for our community.”
In the final DHHS decision letter dated Nov. 21, Commissioner Mary Mayhew said MaineHealth “presented new information that demonstrated that requiring the operation of an urgent care center would not lower costs or improve access or efficiency for the system of healthcare in the region.”
Mayhew also agreed with MaineHealth that the Boothbay Region Health and Wellness Foundation’s recommendation to use a different staffing model at the urgent care would be unlikely to improve the facility’s finances or the quality of healthcare.
“The applicant demonstrated that utilizing mid-level providers and fewer staff (members) would likely have little positive financial impact and that any minor savings would not offset the lesser scope and quality of care,” Mayhew wrote, and added “the CON cannot dictate how an applicant staffs a service beyond requiring that it meet the minimum standards for licensure and certification.”
Mayhew concluded that expanding the urgent care’s hours would improve access for about 800 patients but “the existing emergency department in Damariscotta has the capacity to serve these patients, and there is not a need for two EDs in the region.”
"We strongly believe we have maintained accessible, high-quality emergency and urgent care services for everyone in Lincoln county,” Donovan said. “We are pleased to report that more patients were treated at the St. Andrews Urgent Care Center during its 8 a.m. to 8 p.m. hours of operation last year than the entire previous year when it was open as a 24 hour-per-day emergency department. We believe the significant price reductions for these services is a factor."
Seybold said she hoped resolution of the CON question will spur LincolnHealth to replace beds lost when St. Andrews and Miles Memorial Hospitals were merged.
“We hope this (Mayhew’s decision) means that LincolnHealth will now finally submit its application for a Certificate of Need for additional skilled nursing beds on our peninsula ASAP! We need those beds!”