Since artist Amy Ray returned to her beloved hometown of Eastport three years ago, she and her husband, Mike Stewart, have gotten everything they wanted: a quaint seaside home, two downtown shops and a vibrant arts scene.
What Ray didn’t get was a dentist, at least not without a lengthy hassle.
Ray wanted to go to the dentist at Eastport Health Care, where she receives primary care, but was told it would take a long time — at least four years.
“It turned out I had a pretty bad abscess,” Ray said. She was able to visit a private dentist, “but only because I pulled the strings.”
Ray said she doesn’t blame the health center. When she returns after many years, she sees how much Eastport has grown and understands the pressure it puts on medical providers.
According to the most recent census data, Washington County, like most of the state, saw its population grow, adding about 450 new residents over the past four years. Three percent of that increase occurred in Eastport, which now has 1,321 full-time residents, 133 more than in 2020.
While the number seems small, it doesn’t tell the whole story about the added strain on Eastport’s limited resources, including health care.
During the summer months there is a flow of tourists, vacationers and summer residents, many of whom require healthcare. Although a trendy artist community, Eastport has a poverty rate of about 15 percent and a median household income of just $51,669, according to census data.
About 10% of residents do not have health insurance and there are not enough healthcare providers.
Eastport, like all communities in the county, is classified by the federal Health Resources & Services Administration as being in a Health Professional Shortage Area (HPSA), meaning there is a shortage of primary, dental or mental health providers – or all above.
Eastport Health Care, which already serves approximately 5,400 patients, is acutely aware of the growing demand and is rapidly expanding its services and presence in Down East Maine. Last year, the nonprofit built a 10,000-square-foot facility on Dublin Street in Machias to replace an outdated and cramped building on Fremont Street that previously housed EHC services.
Now, with an influx of nearly $6 million in state and federal grants, EHC is expanding once again. The federally supported community health center recently purchased a 2.8-acre parcel next to the IGA store on Washington Street in Eastport, around the corner from its existing offices, and plans to build a medical facility larger than the one in Machias.
“We are the oldest county in the oldest state in the country, and we have unacceptable rates of chronic disease, suicide and addiction,” said Ellen Krajewski, CEO of Eeastport Health Care. “All this makes the work of community health centers and hospitals very important.”
Krajewski, who moved to Eastport from Vermont in 2018 to take on the CEO role, said patient numbers have grown 33% over the past five years.
She said the Eastport expansion will more than double the size of the current building, the Rowland B. French Medical Center at 30 Boynton St., which was built in 1978.
Once financing is secured, the design phase will begin, Krajewski said. She expects the facility will have two floors and be between 13,000 and 17,000 square feet. It is larger than the Machias center and should allow for a wider range of services.
All services at the Boynton Street location, including dental care, primary care, behavioral health and diabetes care, will move to the new facility.
The additional space will accommodate additional dental professionals and primary care providers, and enhanced spaces for behavioral health services, as well as an expanded diabetes center.
Krajewski said the new building should provide a more comfortable space for patients and caregivers, which she hopes will lead to a higher level of care and attract new staff.
With 35 providers in Eastport and approximately another 25 in Machias, Krawjeski says EHC is optimistic about workforce growth at both locations, despite workforce shortages in the region due to a limited pool, retired professionals and difficulties in attracting providers to the remote, rural community.
EHC is already having success with recruitment and is bringing in a number of new healthcare providers at both locations, including a new medical director, Dr. Robert Phares. He was recruited from West Virginia to replace Dr. Cynthia Sammis, who retired last year.
Down East Community Hospital, which operates a hospital in Machias and a sister hospital in Calais, also provides primary care across five locations. In a statement to The Maine Monitor, Down East CEO Steve Lail said that while he sometimes competes with EHC for providers, patients and funding, he welcomes the expansion.
“We have a good working relationship with EHC, and they refer many of their patients to DECH for specialty care, imaging, etc.,” Lail said. “Increasing access to… primary care is good for the entire community.”
The EHC project is financed with a mix of subsidies. The largest – $5 million – was led by Senator Susan Collins’ office.
“It is critical that Mainers in every part of the state have access to the medical services they need,” Collins said in a statement to The Maine Monitor. “This funding would support the continued expansion of Eastport Health Care, increasing and improving the quality of a range of healthcare services offered to Eastport and the surrounding rural communities.”
The bill that included the grant was approved by the Senate Appropriations Committee last July, but the allocation awaits a final budget from Congress, which is being negotiated, said Phoebe Ferraiolo, Collins’ deputy communications director.
Another $281,400 came from an Emergency Rural Healthcare Grant from the U.S. Department of Agriculture’s Rural Development Agency in Maine. Rhiannon Hampson, state director of the department, said the Eastport Community Health Center project is more than a one-time investment.
“It’s not about lottery winners, like, ‘Oh, wasn’t that community lucky because they took advantage of that grant,'” Hampson says. “It’s actually happening all over the state. It’s happening all over the country. It’s part of this whole movement of investing in rural health care centers.”
The project also received state funding from a Maine Thrive Grant. The $500,000 forgivable loan financed the purchase of the property and will help with other project costs.
Krawjewsi said the community health center’s mission is the same as it was in the 1970s, when Eastport leaders first envisioned a public health model: to provide Washington County with quality behavioral, dental and primary care services, regardless of a patient’s ability to pay. .
As a federally qualified community health center that receives federal funding to offset reduced revenue, EHC is required to price services on a sliding scale based on household income. EHC is one of six such health centers serving Washington County – in Milbridge, Harrington, Lubec, Eastport, Calais, Princeton and the East Grand region bordering Aroostook County.
Indian Health Services clinics also provide primary and other health care services to Passamaquoddy Tribe members in Pleasant Point and Indian Township, where community needs ranging from diabetes to substance abuse are also increasing.
“Even if all health care centers double, triple, quadruple access to care, we still can’t move the needle because the situation nationwide is truly desperate,” said Jesse Bean, director of health at Pleasant Point Health Center.
In 2023, the county’s community health centers received a total of $6,236,471 in funding from the Health Resources & Services Administration. The agency awards grants to rural health centers to help meet the needs of often impoverished communities.
Some community health centers, such as EHC, have designated staff members who work with patients to address a variety of barriers people face in accessing health care, including food insecurity, housing inequality and a lack of reliable transportation .
Employees arrange rides for appointments, help patients apply for MaineCare and low-income housing, and connect patients to numerous community resources such as food banks.
“We as health centers are stepping up to best serve not only our patients, but also the community,” Krajewski said. “We form the safety net, together with our hospital partner.”
Blizzard will target southern Maine on Tuesday