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May 21, 2003
The Hon. John Baldacci Dear Governor Baldacci; We write to you today to comment on your proposed health care reform legislation – the Dirigo Health Care plan. We commend you for taking such a bold step in an effort to contain costs and to use the savings to bring health care insurance coverage to all Mainers. However, we feel strongly that Dirigo – as written – could have a massive, detrimental impact on whole communities through the potential closure of small hospitals, such as Charles A. Dean Memorial Hospital (C.A. Dean) in Greenville. We write to explain our concerns and ask for your help to alleviate what we perceive is an unintended threat to the well-being of our community. The Dirigo Health Care plan would contain the global budget for health care spending by the State of Maine. In ways which are not yet fully understood, the plan would also redirect resources among hospitals. Specifically, the plan would create unique, specialized centers throughout the State's hospital system, limiting or eliminating the duplication of expensive technology and services such as cardiac catheter labs and hyperbolic chambers. The savings from these changes would be used to pay for a health care insurance program for all currently uncovered Mainers. Although this seems to make sense on paper, the geography and the demographics of the State of Maine work against such a scheme. In short, rural Maine needs access to the same basic hospital resources as do people in Bangor, Lewiston, or Portland. If these budget containment measures are implemented, small rural hospitals may go bankrupt in their efforts to continue to offer basic services. Moreover, the realignment of specialized health care centers may result in removing definitive care from rural Mainer's reach. Would you want a family member to have to travel 9 minutes or 90 minutes to reach a hospital when he or she is sick or injured? We believe this is the dilemma many Greenville residents – even if they receive health care insurance coverage for the first time - may be faced with should this plan be implemented. The Town of Greenville has a year-round resident population of just 1,823, but a seasonal population which adds another 1,000 to 1,500 persons each summer and winter. Our economy, as an isolated service center, gateway community, is contingent upon both the service-sector jobs which provide services to visiting tourists, and also a small core industrial sector in the wood products field. Our largest employer is CA Dean Hospital, with a total employee roster of 150 and roughly 85 full time equivalents (FTEs). The estimated median annual income of a FTE at CA Dean is roughly $4,000 to $8,000 more per year than that of the average resident of Piscataquis County. The next largest private employer in Greenville is Moosehead Cedar Log Homes, with approximately 26 FTEs and an estimated average annual income slightly higher than the county-wide median. Clearly, if CA Dean Hospital were to close, there would be a huge void in our local economy. As these professionals would not have any other options for employment in their given fields in Greenville, they would have to consider relocating. As the nearest hospital to CA Dean – Mayo Regional Hospital in Dover-Foxcroft – would be similarly affected by the cost containment measures of the Dirigo Health Care plan, it is very unlikely that Mayo would be able to offer employment to many or any of the professionals departing CA Dean. The next nearest facility (which would likely still be in existence) is Eastern Maine Medical Center (EMMC), which is roughly 1 ½ hours drive from Greenville, one-way in good weather. Commuting this distance would not likely be an option for these professionals: they would depart from our community. How would the Greenville community be affected by the departure of roughly 85 full-time professionals at CA Dean? These roughly 50 households have an estimated total of 40 students in the Greenville schools. This represents approximately 15% of the total student population at Union #60. If each student represents approximately $6,500 worth of funding from the Maine Department of Education, than this student exodus would increase Greenville's local option education costs by $260,000, or $1.75 to the mil rate. Considering that the loss of so many jobs in our community would have an indirect detrimental impact to related businesses (heating oil companies, grocery stores, etc.), others may be forced to relocate for better opportunities. Unaffected families may opt to move as they do not want to live in a community which does not have convenient access to hospital care. Therefore, the 15% student enrollment loss is a very conservative estimate, one which could easily double in a short time. Considering the diminutive size of Union #60 and its isolation from other schools (27 miles one-way to the closest high school), it does not seem feasible to consider downsizing the Greenville Schools or to consolidate our district with another. Indeed, at recent meetings with departing Education Commissioner Duke Albanese and some members of the State Board of Education, Greenville's geographic isolation, as well as its service center status, were both recognized and noted as making Greenville an “exception to the rule” in school consolidation considerations. Yet as an exception, Greenville does continue to look for innovative efficiencies through partnership with other schools, including ATM technology offerings, satellite vocational school options and future wood composites technology apprenticeships. Greenville as a community has recognized for some time now that it needs to grow its year-round population, especially in the demographics of family-aged households, to become vibrant and solvent as a community. We are working to try to attract this demographic by encouraging affordable (middle-income) single-family housing; attracting new, high wage jobs in the wood composites sector; improving the quality and the specialized offerings of our school system; and maintaining a strong, solvent local hospital. We are making strides in all of these fronts with initiatives ranging from our proposed Wood Composites Incubator Center to a strong community literacy program at the Greenville Schools to a proposed single-family housing subdivision which could have been a seasonal housing development. But all of these efforts will be for not if CA Dean Hospital closes, our local school system becomes too expensive to be viable, and it, too is forced to close. The resulting outmigration of middle-aged professionals with young or growing families will be too great to overcome. The loss of potential laborers from our community will have an extreme negative effect on business growth efforts, such as the proposed Pine Tree Enterprise Zones (which Greenville and the rest of Piscataquis County plans to pursue). Indeed, if Greenville proves successful in its plans to secure Pine Tree Enterprise Zone status for its Industrial Park, the level of job growth would never likely exceed to expected job loss from the closure of our hospital. Greenville would lose under this scenario, no matter how many more of its citizens gained access to health care insurance coverage. What we would lose is our community. As leaders in the Greenville community, we urge you to re-work the Dirigo Health Care Plan to find a means to assertively and comprehensively protect the interests of rural Maine. If our concerns are not warranted and our hospital will fare well through this proposal, we very much would like to be shown how this will work. We would be glad to meet with you and/or your staff to further outline our concerns, as well as to help to design favorable alterations as necessary to this bold plan to protect the interests of rural Mainers. Sincerely; | |
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John Simko, Town Manager Town of Greenville Dr. Steve Pound, Superintendent |
Eugene F. Murray, Jr., Interim President Charles A. Dean Hospital & Nursing Home Luke Muzzy, Chairman |
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The Hon. Paul Davis, Senate Minority Leader | |