Lori Dwyer is the CEO and president of Penobscot Community Health Care.
“Do the next right thing.”
Somewhere between a catchphrase and an encouragement, that directive is common in the recovery community and in other places where options can seem both vast and limited. In the public health world, it’s sometimes a mantra, as we struggle to do more, for ever more people, with fewer resources.
Legislators in Maine have the opportunity to do the next right thing for the health of all Mainers by including a measure in the pending budget bill to increase those resources for Maine’s 20 community health centers. LD 1787, now pending before the Appropriations Committee, would rebase — essentially, re-calculate — the reimbursement health centers receive for treating MaineCare (Medicaid) patients. This is how health centers are supposed to be paid per state and federal law, but rates have fallen behind.
While reimbursement has failed to keep up with actual costs, the health issues we treat have become more and more complex, even as the number of Medicaid patients increases. Add to that the deferred healthcare resulting from the pandemic, Maine’s aging demographic and changing economy, the “Great Resignation,” the worsening epidemic of substance use disorder and diseases of despair, the epidemic of burnout among healthcare professionals, and the difficulties recruiting and retaining staff. All this compels us to do more, with less.
Despite this alarming math, community health centers keep on keeping on. We help drive down the cost of health care for all Mainers, by providing the ongoing primary medical, mental health, dental and walk-in care that keeps people out of emergency rooms, reduces hospitalizations and length of hospital stays. We operate in public schools, provide care in nursing homes and to the homebound, and offer critically needed treatment to people with substance use disorder.
In the case of my organization, we provide shelter and care for the unhoused and boost the local economy by providing vocational training and life skills to folks with serious mental illness. Our celebrated pharmacy and nurse practitioner residencies train the next generation of rural providers.
We do it all on a razor-thin margin, and a small adjustment in what Maine reimburses us for MaineCare would make a big difference to our bottom line and improve our ability to provide care for so many.
The bill’s sponsor, state Sen. Ned Claxton, is a retired physician and recognizes the important “safety-net” role of community health centers. I hope all his colleagues in Augusta will follow his well-informed lead. By approving the bill, they could: Ensure continued access to care for Mainers; help drive down the cost of care in the state; and preserve important community resources
Funding the rebased rates proposed in LD 1787 would help mend the frayed safety net system by investing in community based primary care. Most of the cost – about two-thirds — would be paid for by the federal government. By leveraging these federal dollars, our representatives in Augusta can significantly improve the health of Mainers.
As we emerge from a pandemic that has taken its toll on our collective and individual health, we ask only that the good people who represent all of us in Augusta do the next right thing. In health care, the outcomes to that decision are almost always good.