With the St. Andrews Hospital emergency room closing delayed for six months, the hospital task force has decided to take a little more time to produce its alternative healthcare plan for the peninsula. 

On Wednesday, Jan. 2, Rep. Bruce MacDonald (D-Boothbay) said the iVantage consultant’s report, originally expected by January 1, would not be available for a couple more weeks.

“With the extension, we figured we would take the extra couple of weeks to produce a quality product,” MacDonald said. 

Task force members agreed with this approach although Boothbay Selectman Chuck Cunningham was clear that the report should be completed before the end of the month.

MacDonald said his draft bill to create a hospital administrative district for the Boothbay Region was being reviewed internally by legislative staff. He said the bill had not yet been formally submitted and there was still time to decide whether to proceed with this legislative proposal. 

MacDonald’s proposal would create a hospital district that operates like other municipal districts, e.g., Boothbay Region Water District, with elected trustees and the ability to raise funds through taxation. The legislation would not directly change ownership or governance of St. Andrews Hospital.

Most of the weekly task force meeting was devoted to discussing the Boothbay Region Ambulance Service. BRAS Chair Robert Ham said the ambulance service’s final budget will be presented to its board on Thursday, Jan. 3 for approval. 

Once approved, BRAS will present its budget and subsidy requests to Boothbay, Boothbay Harbor and Southport for inclusion in 2013-14 town budgets.

Ham said the ambulance service’s proposed budget is astronomically high, but represented the bare bones needed to provide emergency services once the ER closes. He said each town’s subsidy under the proposed budget is likely to be about three times higher than this year. 

The two primary factors driving the budget increase are the need for a paid crew 24 hours a day to respond to emergencies and the loss of about $200,000 in revenues currently made on transfers of patients from St. Andrews Hospital. 

Operations Manager Scott Lash said it was not possible to predict how much revenue BRAS may earn from patient transfers from Miles Memorial Hospital in the future. “If we do a lot of transfers out of Miles, then the subsidy request would go down,” Lash said. Due to this uncertainty, Ham said he hoped town subsidies could be disbursed, and adjusted, over the course of the year rather than upfront. 

Ham and Lash said legal questions about whether Lincoln County Healthcare can offset some of these additional local ambulance costs have not yet been answered. 

Safe harbor laws prevent any monetary transfer or action that could be considered a kickback or enticement and govern Medicare reimbursements (about 80 percent of BRAS revenues).

Lash said BRAS will not directly accept funds from Lincoln County Healthcare but will ask whether the healthcare organization can provide compensation to the towns for higher ambulance costs. 

BRAS has engaged an attorney and will seek a formal opinion from the federal government. Boothbay Town Manager Jim Chaousis said there have been no discussions between the task force and the healthcare organization about direct compensation to towns to date.

At Southport Selectman Smith Climo’s suggestion, the task force will now meet on the first and third Tuesdays of the month, instead of weekly. 

The task force is scheduled to meet with Lincoln County Healthcare and MaineHealth representatives again next week in closed session.

Sue Mello can be reached at 844-4629 or sumello@boothbayregister.com.