Planning continues for new health center

Plans for a new health center in Eastport are still moving forward, although they have been delayed, in part because of funding issues caused by federal Medicaid cuts. The proposal to relocate Eastport Health Care (EHC) from its current Boynton Street facility to a new site at the corner of Key Street and County Road had been announced in February 2024, with the possibility of the new building being completed this year. The health center purchased the 2.8-acre vacant lot that adjoins the R&M IGA parking lot in January of that year. EHC had decided to make the move because of space restrictions at its current location and an increasing patient need. The new facility could be more than double the size of the present health center.

According to Ellen Krajewski, CEO of Eastport Health Care, the health center is currently in the process of completing the environmental assessment of the site, as well as the design and schematic phases for the new building. "We will start construction when we have a clear sense of federal Medicaid cuts and their impact on patient care services," she says. "Reimbursement models, reimbursement eligibility and programmatic support and requirements at the federal and state levels are in flux. Our uninsured patient panel will be increasing with these changes as well. We need to understand the impact of all of this on our operations before moving forward."

Back in 2022, a market assessment by Capital Link, a national nonprofit, indicated that 19% of EHC patients were uninsured, 26% used Medicaid, 28% Medicare and 27% private or other third-party insurance. Reimbursement models will be changing with the signing into law, earlier in July, of the One Big Beautiful Bill Act, which will make a 15% cut in Medicaid spending.

As for funding the new facility, in 2024 EHC had received a Congressionally Directed Spending award of $5 million for the building, thanks to U.S. Senator Susan Collins. The health center is presently working with potential funders, including charitable organizations, community development financial institutions and philanthropic individuals, to build a funding profile for the remaining amount needed that will be confirmed once the project design and timeline are finalized.

EHC has now made some modifications in plans for the new facility, including eliminating a back‑up solar initiative that would have saved utility costs and allowed those saved dollars to be put into operations. Also, a built-in food storage and distribution space, as well as a kitchen, are no longer included. "Food donation sources that EHC food distribution services depend on have lost funding and are drying up across the country," Krajewski says. "These are just a few examples of external changes that are impacting our services and space planning."

"These are very challenging and rapidly changing times in health care, both in Maine and across the country, and we must proceed with caution and ensure a focus on our mission," says Krajewski. She notes, though, that EHC will continue to meet the needs of all of the health center's patients. "Access to quality primary care, behavioral health, substance use disorder and dental services remains the EHC board of directors' priority and focus," she says.

Strategic priorities

The EHC board recently reaffirmed its strategic priorities, with the top three being "to position EHC for sustainable and successful patient care delivery; excellence in patient care that is safe, timely, efficient, effective and patient‑centered; and to build a workplace of choice by fostering curiosity, learning, strong communications and trust‑building."

"The primary goal of Eastport Health Care is to provide the residents of Washington County with the very best quality of care and services possible, regardless of ability to pay," Krajewski says. "Leading through listening, learning through partnership and serving through collaboration make us agents of change for better health outcomes in Washington County."

She comments, "As insurance payments, both public and private, limit reimbursement for our services, we must be increasingly careful in managing operations. EHC is committed to providing all of our patients with the same quality care, regardless of how they pay. That means we provide uncompensated care to those who qualify. To continue this, we must manage our dollars carefully."

Noting that EHC's patient care teams are "the hub of what we do," she says that the health center "is leading the way in care management services. We have a team of support staff helping patients manage chronic illnesses, such as high blood pressure and diabetes, beyond the patient‑provider visit." She adds, "Patients love this additional layer of care, and it improves health outcomes. It is also reimbursable care because insurance companies are learning that preventing and managing chronic illness improves health and saves dollars."

While patient numbers continue to increase, with a 33% jump in the number of visits by established patients just in 2022, recruitment of clinical providers is challenging. "While many employees love the region, it is not for everyone, and ensuring a match is tricky. EHC has been successful in recruitment and retention because our clinicians and staff love what they do and where they do it  in Downeast Maine and with EHC," she says.

Among the new staff at the Eastport office is Dr. Bill Richardson, who is planning to stay in the area. Other new staff include John Cassidy, PA‑C, and Lisa Jacobs, PMH‑NP, who cares for EHC patients at both the Eastport and Machias locations remotely. She adds that EHC's Machias facility "continues to thrive with energetic and extremely competent providers and staff."

Expanded facility

The new, larger facility, which will still be named the Rowland B. French Medical Center, will allow for expanded offerings of services, more staff and the ability to see more patients and reduce wait times for becoming a registered patient.

Following the closure of the Eastport Memorial Hospital, the current health center had opened across Boynton Street in 1981, with a 1,980-square-foot expansion in 1987 and a current size of 6,558 square feet. The new facility will have a larger dental center, a community room open to the public, expanded lab capacity and a diabetes center that offers education, patient care and training.

With a great demand for behavioral health services, particularly since the pandemic, and substance use disorder services, and with the closure of EHC's Calais facility, which offered podiatry and behavioral health services, she says that the health center wants to expand both direct and remote access behavioral health services in Eastport. The new facility also will provide space for public health clinics.