Lori Dwyer is CEO and President of Penobscot Community Health Care.
“Do the next right thing.”
Somewhere between a slogan and an encouragement, this guideline is common in the recovery community and other places where the options can seem both vast and limited. In the world of public health, this is sometimes a mantra, as we struggle to do more, for more people, with fewer resources.
Maine lawmakers 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 these resources for Maine’s 20 community health centers. LD 1787, currently pending before the Appropriations Committee, would rebase — essentially, recalculate — the reimbursement that health centers receive for treating MaineCare (Medicaid) patients. This is how health centers are supposed to be paid according to federal and state law, but rates have lagged.
While reimbursement has not kept pace with actual costs, the health issues we treat have become increasingly complex even as the number of Medicaid patients increases. Add to that the delayed health care resulting from the pandemic, Maine’s aging population and changing economy, the “Great Resignation”, the worsening epidemic of substance use disorders and illnesses of despair, the epidemic of burnout among healthcare professionals, and the difficulties in recruiting and retaining staff. All of this forces us to do more, with less.
Despite these alarming calculations, community health centers continue to operate. We help lower the cost of health care for everyone in Maine, by providing ongoing primary medical, mental health, dental, and walk-in care that keeps people out of the emergency room, reduces hospitalizations, and length of hospital stays. We operate in public schools, provide care in nursing homes and homebound people, and provide much-needed treatment for people with substance use disorders.
In the case of my organization, we provide shelter and care to homeless people and stimulate the local economy by providing job training and life skills to people with serious mental illness. Our renowned pharmacy and nurse practitioner residencies train the next generation of rural providers.
We do all of this with a very slim margin, and a small adjustment to what Maine reimburses us for MaineCare would make a big difference in our bottom line and improve our ability to provide care to so many people.
The sponsor of the bill, State Senator Ned Claxton, is a retired physician and recognizes the important “safety net” role of community health centers. I hope that all his colleagues at Augusta will follow his knowledgeable example. By approving the bill, they could: ensure continued access to care for Mainers; help reduce the cost of care in the state; and preserve important community resources
Funding for the rebased rates proposed in LD 1787 would help repair the frayed safety net system by investing in community-based primary care. Most Cost – about two-thirds – would be paid for by the federal government. By leveraging these federal dollars, our representatives in Augusta can dramatically improve the health of Mainers.
As we emerge from a pandemic that has wreaked havoc on our collective and individual health, we only ask that the good people representing us all in Augusta do the next right thing. In health care, the results of this decision are almost always good.
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