1 week Ago
Dr. Megan Brewer stands in the doorway of an exam room Friday at the B-Street Health Center in Lewiston. The center needs financial help from the community if it is going to survive, Brewer said.
“We need community solutions. We need Mainers helping Mainers.” Andree Kehn/Sun Journal LEWISTON — Community Clinical Services last week announced it was cutting services and a third of its staff amid Maine’s Medicaid budget shortfall and rising uncertainty around federal funding.
With nowhere else to look for money, the organization is now turning to the community for help in sustaining the care it continues to provide at the B-Street Health Center. “We’ve exhausted the federal solutions, we’ve exhausted the state solutions,” Clinical Services Chief Medical Officer Megan Brewer said. “We need community solutions.
We need Mainers helping Mainers. We need this to be a grassroots community movement to save the health care that we provide and to save the community’s future.” Clinical Services leaders on April 2 announced several cuts to services, including the elimination of pediatric dental services in Auburn, impacting 2,000 patients; outpatient counseling and psychiatry services on Campus Avenue in Lewiston, affecting 900 counseling and 500 psychiatric patients; and its school-based health centers in Lewiston and Auburn, impacting 140 patients.
Its pediatrics clinic in Lewiston will be acquired by St. Mary’s Health System. Clinical Services will continue its primary care services and behavioral home health case management services at 57 Birch St.
, along with Dr. Richard Kappelmann’s internal medicine practice in Lewiston. However, the financial viability of those services is bleak.
So Clinical Services CEO Coleen Elias and other staff are appealing to the public for immediate financial help so they do not have to make more cuts to services. “Our mission matters,” Elias said. “What’s the dollar amount that we need to be able to sustain safely through this period of uncertainty? It’s $1 million.
That doesn’t seem like a lot to ask and we have been met with dead ends at every turn, at every call, at every beg.” ‘Heartbreaking’ Community Clinical Services accepts all insurance types, Elias said, but bills people on a sliding-fee scale, with people at 100% of the federal poverty level paying nothing. “We don’t deny care based on insurance status or ability to pay,” she said.
“We’re here to serve the underserved and be a safety net for those that typically are denied care or unable to access care for a myriad of reasons.” Clinical Services Registered Nurse JohnWayne “Duke” Holm, right, talks with Dr. Megan Brewer Friday in the B-Street Health Center in Lewiston.
Andree Kehn/Sun Journal Brewer is Clinical Services’ primary care physician. Some days, she said, she feels more like a therapist as primary care physicians increasingly deal with mental health issues because of a shortage of mental health providers. It puts a strain on providers, she said, and if communities continue to lose providers, it will only get worse in all areas of health care.
As individuals lose options and seek medical care elsewhere, it also strains places like walk-in cares and emergency departments, she said, and eventually impacts the entire community. “It puts more strain on the entirety of the system, the hospitals are not likely to get reimbursed for that care, and so it will affect the health of this entire community regardless of your insurance status,” she said. There is a perception among some in the public that medical services and doctors will always be available, Clinical Services Registered Nurse JohnWayne “Duke” Holm said.
“I think a lot of people take for granted that we have limited resources and it may not always be there,” he said. “And people may not have PCPs (primary care physicians) in the future. I know that sounds pretty extreme but this is something we’ve seen on the horizon for years and COVID really brought that much closer to reality.
And with everything happening now, it’s even more in your face than it ever has been before.” Just two years ago, Clinical Services announced that it was attempting to expand services , using one-time congressionally directed funds of $2.9 million, because demand for its services had increased.
Elias said that demand has not waned but the project has never gotten off the ground. Clinical Services, the only pediatric dental clinic in Androscoggin County that accepted MaineCare, was going to use those funds to expand its pediatric dental clinic, hoping to shrink its 700-patient waitlist. Elias said she needs to re-evaluate what Clinical Services can do with those funds and if they can use them in a different way now that the dental clinic is closing.
“Unfortunately people are left without resources for things that they need and deserve to have in every community,” she said. “It’s heartbreaking.” Capped payments Though Clinical Services is a community clinic, it has a different federal designation than other Maine community health centers, Elias said.
Because of Clinical Services’ historic connection with St. Mary’s Health System, it was designated as a Health Center Program Look-Alike – the only one in Maine, she said. This means it was not entitled to federal funds.
Community health centers typically get federal funds that cover roughly 20% of their operating costs. Before the pandemic, Clinical Services received grant funds from St. Mary’s.
Those were mostly replaced by pandemic relief funds, and when the pandemic funds ended in 2023, St. Mary’s was unable to provide a grant anymore, Elias said. St.
Mary’s did not respond to a request for comment before publication. Clinical Services severed its legal ties to St. Mary’s last summer and applied for $2 million in federal funds.
It had a strong chance of being awarded that funding until things changed within the federal government under President Trump, she said. “The timing of all of this couldn’t have come at a worse time,” she said. With upheaval in the U.
S. Department of Health and Human Services, Elias does not feel confident her clinic will receive any federal funds now, she said. Community Clinical Services CEO Coleen Elias, left, listens to Dr.
Megan Brewer Friday in the B-Street Health Center in Lewiston. Andree Kehn/Sun Journal Paired with the funding deficit in MaineCare, Maine’s Medicaid program, it has made it impossible to predict Clinical Services’ revenue stream, she said. Right now, MaineCare is telling health care providers what they will cover on a week-by-week basis, Elias said.
So far, MaineCare has not capped the health center’s payments, but that will likely happen at some point, she said. While the funding shortfall continues, costs that are normally covered by MaineCare will not be passed onto the patient, and MaineCare patients will not be turned away at any of their health care facilities, Elias said. The health center was already struggling with low MaineCare reimbursement rates that rarely cover the entire cost of services, she said.
“We can’t be expected to provide uncompensated care,” she said. Low-income care provider in Lewiston to layoff 40, cut services Senate Republicans call for MaineCare reforms after blocking budget deal Community Clinical Services splits from St. Mary’s Health System We believe it’s important to offer commenting on certain stories as a benefit to our readers.
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