Persons requiring in-patient psychiatric services will now have to travel an hour north to Fort Kent or approximately three hours south to Bangor, following The Aroostook Medical Center’s announcement May 7 that its Fort Fairfield facility would be closed.
The closure was based on two factors: the declining number of patients being treated in-house at any given time and the costs involved in keeping the facility operational. The closure will not affect out-patient services offered at the same location. While in-patient numbers have dropped, out-patient figures are on the increase.
“Changes are going to occur in mental health services and the general hospital division, said David Peterson, president and CEO of TAMC. “The quality of patient care offered is foremost in our minds. We’ve spent a number of months evaluating those services and came to the determination that if we can’t do it (offer services) the best way possible, then it won’t be done.”
After much discussion on the matter, the decision was made by the Board of Trustees on May 3 to close the in-patient unit no later than June 30 of this year, as well as the New Roads program by the same date.
The impact of the decision, according to Peterson, “re-positions TAMC to meet overall patient needs in a challenging and changing health care environment and clarifies aspects of (TAMC’s) Facilities Master Planning.”
Bill Calhoun, senior vice president and chief operating officer, explained what services would be affected and how TAMC planned to care for patients in the future. Of the three services offered in Fort Fairfield, two will be phased out as of the end of June.
“In-patient psychiatric care is intended for the patient at risk of harming himself or others. Of the 16 beds we have available, typically 5-6 are in use at any given time. Offering care on a 24-hour basis, under the direction of a psychiatrist, requires staff around the clock for observation, assessment, treatment and therapy,” said Calhoun, adding that such round-the-clock care is costly in light of the dropping number of patients requiring such treatment.
New Roads provides intensive out-patient treatment. Calhoun explained that the program is designed for, “patients who present no imminent potential for harm to themselves or others. Patients are typically seen three times a week for up to three hours each session, supervised by a licensed health professional.”
The third area involves outpatient mental health services.
“These are clients that show no imminent risk to themselves or others. Traditional treatment ranges from medication management (15-20 minute sessions) to psychotherapy (50-minute sessions). These cases are handled by two psychiatrists and four mid-level providers,” said Calhoun.
Because of its location, concerns arose regarding additional medical needs of the patients.
“The in-patient unit is isolated from an acute-medical facility. Some of the patients require acute, medically complex supervision. Patients admitted also pose the highest risk to self and others,” said Calhoun, adding that patients often have to wait for a on-call doctor to arrive to address issues that arise.
The lack of psychiatrists also factored into the closure. Dr. Alfred Bergman, who had served at the facility until recently, left for Acadia Hospital in March of this year.
As the number of in-patient cases have dropped, the facility has seen an increase in out-patient cases. In light of that information, officials made the decision, based on the best interest of the patients, to keep the out-patient aspect operational while closing the in-patient division and New Roads Program.
Approximately 25 of the 30 or so staff currently working at the Fort Fairfield facility will lose their jobs as of next month. Some will be able to fill other positions through TAMC, as they become available, said Peterson. With the notification of the impending closure, others have been in contact with similar facilities in the state inquiring about positions elsewhere.
“Dieticians, housecleaning staff, nurses – as positions come open at TAMC, they’ll be considered to fill them. Some staff have contacted other facilities about possible openings,” said Peterson.
The closure means a considerable savings to TAMC, according to Bruce Sandstrom, senior vice president and chief financial officer with TAMC.
“Mental health services are losing $700,000 yearly,” said Sandstrom, due in part to patients who are covered by government-funded health care programs that don’t sufficiently cover expenses or have no coverage at all. “On average, we’re collecting 43 cents on the dollar for what we charge. It’s a difficult area to survive financially with declining volume. We had $2.6 million in net revenue as opposed to the $3.3 million to provide services (last year).”
By closing the Fort unit, TAMC would reduce its losses by approximately $300,000 annually.
With the closure, patients needing in-patient care will have at least two options, according to Peterson.
“There’s a facility in Fort Kent that’s currently operating at 60 percent capacity. They can take additional patients. Or patients can go to Bangor for care,” said Peterson.
Options for the building, located at 23 High Street, are now being considered. Built in 1951, Peterson indicated upgrades may be required, depending on what the facility will be used for in the future. Outpatient services will continued to be offered at the site, with no plans to close the building at this point.
“We have a responsibility to look at the quality of service, accessibility. Sometimes the best response is to find other places to get that care. We’re looking at different ways to deliver care. We don’t want to diminish the quality of mental health care, we’re just looking at ways to provide it differently,” said Peterson.