St. Mary’s hospital seeks state funds to cover part of its financial deficit, fund new program

AUGUSTA — St. Mary’s Regional Medical Center is seeking $10 million from the state to help cover its behavioral health services’ deficit and roll out a new program.

Hospital officials spoke in favor of L.D. 2105 during a public hearing Wednesday before the Health and Human Services Committee in Augusta.

The bill was presented by Sen. Peggy Rotundo, D-Lewiston.

St. Mary’s Regional Medical Center has had significant operating losses in the past few years, with its behavioral health program experiencing the most financial losses, President Cindy Segar-Miller said at the hearing. The hospital estimates it lost just over $10 million in its behavioral health care services in 2023.

If the hospital is not granted the one-time funding request, it will likely end some or many services, putting all of its behavioral health services in jeopardy, she said. “Our bandwidth is very narrow and we have huge demands.”

Asked if $10 million will be enough in the face of the financial deficit the hospital has faced every year for the past few years, she said, “We have undertaken a rigorous operations approach as to how we can continue to operate in this footprint.”

If granted the money, the hospital will also use it to start a new day program to provide behavioral services to adults and adolescents with mental health and substance use issues, Segar-Miller said.

St. Mary’s Regional Medical Center, seen in June 2021 from above Sabattus Street in Lewiston, is asking the state for a $10 million infusion of cash to cover a shortfall in its behavioral health care services. Russ Dillingham/Sun Journal file

More services are needed for patients who are between outpatient and inpatient services, Sally Cooper, St. Mary’s chief of behavioral medicine, said in a submitted statement to the committee. The behavioral health emergency department is often over capacity and the hospital’s inpatient adult mental health and adolescent services and chemical dependency units are full.

The program would include partial hospital care or intensive outpatient care, she wrote. There is an absence of lower-level care providers in the hospital’s service area that can meet the needs of chronically acute patients.

“Often patients move from the most acute level of care in the hospital to minimal outpatient services, without opportunity for a gradual transition to a lower level of supportive care as is most appropriate in these circumstances,” she said in her written testimony.

The lack of day program services the hospital is proposing, or similar services, results in a delay in discharges from the hospital, creating a backlog of patients in the hospital’s behavioral health emergency department, she said. “Often, there are more than 10 patients in the behavioral health emergency department waiting for inpatient treatment,” she said in her written testimony.

Segar-Miller estimates that the day program would serve 500 patients annually, she said. It would easily serve people in Androscoggin, Oxford and Sagadahoc counties.

Mental health care providers are facing unprecedented challenges amid the pandemic[/mtm-related-link]

Department of Health and Human Services Commissioner Jeanne Lambrew submitted written testimony against the request, though she did not speak at the public hearing. She called it a “special payment” and as a general policy principle the department does not support those types of payments to a single facility, without giving it to all similar facilities, according to her written testimony.

“The department continues to work with stakeholders toward broad hospital payment reform, and strongly believes that this proposal is not an appropriate vehicle for addressing a single hospital’s financial problems,” she wrote.

The payment methodologies the department uses ensures that tax dollars go toward rates that are equitable and adequate to care and costs, she said. Starting last July, the department implemented new methods and rates for inpatient psychiatric and substance use disorder reimbursements to hospitals, and it expects that St. Mary’s will get higher reimbursements during this coming state fiscal year.

“Based on the most recent claims data, the department estimated that St. Mary’s would receive an additional $7 million in reimbursement for state fiscal year 2024,” she wrote. “In addition, the department is in the process of broader inpatient and outpatient hospital rate reform which will provide additional investment to hospitals in fiscal year 2025.”

Despite the recent increase in MaineCare behavioral health hospital rates, they are not enough to cover St. Mary’s financial losses, Segar-Miler said.

Patients from across the state go to St. Mary’s Behavioral Emergency Department and its inpatient detox unit, Rotundo said. People from 10 of Maine’s 16 counties are served through its behavioral health inpatient units for children and adults.

The hospital is looking for policy solutions to keep the public safer and identify individuals who are mentally ill enough to harm others, she said.

That, coupled with continued efforts to address the fallout from pandemic isolation, are increasing the need for many different types of mental health services. Existing mental health resources, including St. Mary’s services, should be reinforced, Rotundo said.

“St. Mary’s is staffed with dedicated professionals who do excellent work,” she said. “Let’s prioritize keeping this facility funded so it can continue to work on the front lines of this crisis.

Since the Oct. 25 mass shooting in Lewiston, during which 18 people were killed at two locations, the need for child and adolescent mental health services has increased, said Douglas Smith, chief medical officer and vice president of medical affairs at St. Mary’s.

Lewiston police Lt. Derrick Laurent submitted written testimony in support of the funding, saying officers regularly take patients to St. Mary’s behavioral health emergency room for various reasons.

In recent years, it has become common to bring a patient to the hospital only to find that rooms and waiting areas are full, he wrote. Despite this, hospital staff do not refuse to find a spot for a person in need.

The hospital first approached Rotundo about its financial deficit before the Oct. 25 mass shooting, Rotundo said.

Committee members asked a few questions of some who spoke in favor of the bill during the roughly 30-minute hearing.

Segar-Miller ended her testimony by impressing on committee members the importance of the funding in ensuring the hospital continues its level of services into the future.

“We want to be able to continue to fulfill our mission for the next 135 years and we’re struggling,” she said. “So, we really implore you to consider this very important move at a very important time where we are at a tipping point working diligently every day to continue to provide these services that are so necessary.”

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