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Lori Dwyer is president and CEO of Penobscot Community Health Care.
This is a message I never wanted to write.
Penobscot Community Health Care’s financial future is at serious risk. Without a capital infusion in the very near term, we will be forced to make choices to curtail services and locations. Access to care will suffer for the people who depend on us most. While we intend to keep our doors open, stabilizing requires help we cannot secure on our own.
For the roughly 50,000 patients we serve, the nearly 720 people who work here and the local vendors and businesses who depend on us as a customer and an employer in this region, this isn’t an abstraction. In 2025, our acute dental services in Bangor handled more than 2,600 emergency visits — cases that would otherwise have landed in expensive hospital emergency rooms. Our primary care work keeps people out of the ER, too.
If just 10% of our patients lost access to care and a quarter of them ended up in an ER instead, that’s roughly 1,500 additional visits and an estimated $1.1 million in costs to the system. At 50% displacement, that figure climbs to about $11.2 million a year. These aren’t worst-case scare numbers — they’re a conservative underestimate of what happens when a safety-net provider this size is destabilized.
But the real cost isn’t measured in emergency room math. Penobscot Community Health Care serves families on MaineCare, seniors on Medicare, children in foster care and people without insurance. For them, risk to Penobscot Community Health Care means losing the only healthcare they have.
This didn’t happen overnight, and it isn’t the result of one single decision. Federal and state funding has been delayed, underfunded or cut. Millions of earned dollars were not distributed to Penobscot Community Health Care by a former Accountable Care Organization partner. The financial toll of pandemic-era provider turnover lingers. Costs have skyrocketed, while reimbursement for preventive care lags way below the cost of care.
Each pressure on its own might be survivable. Together, they’ve become a crisis.
We haven’t waited to act or ignored the signs. For many years, Penobscot Community Health Care has methodically reduced costs and made difficult choices — workforce reductions, position eliminations, transferring Hope House shelter to Preble Street, closing the Winterport practice, and eliminating podiatry, chiropractic, X-ray, and walk-in services elsewhere.
We are preparing for every contingency, including Chapter 11 restructuring if our turnaround efforts fall short. While this is a tool that has its purpose and keeps an organization operating while it works through obligations, Chapter 11 is an expensive, time-consuming last resort that should be avoided at all costs.
Even as we’ve cut, we haven’t stopped showing up where Maine needs us most: on the front lines of the regional HIV outbreak, in Jackman, in behavioral health and school-based health centers, in primary care access, and in a Bangor dental practice that serves nearly 6,000 patients, plus a new one in Belfast opened because the need was too great to ignore.
Now we need Maine to show up for us. As the state’s largest federally qualified health center, Penobscot Community Health Care exists to serve everyone, regardless of their ability to pay. To continue, an infusion of roughly $3 million in the next 30 to 60 days is necessary and can bridge us through this immediate crisis.
We have spent four years attending meetings, writing emails, delivering testimony, touring with state policymakers and leaders, and making the case for primary care investment. What’s missing now isn’t understanding — it’s a coordinated, urgent commitment, together with our leaders to act on it.
We have weeks, not months, to get this right. If we don’t, the cost won’t be measured only in dollars. It will be measured in the health of tens of thousands of Mainers who, in many cases, will lose their only source of care.