The community health needs assessment begun in the Penquis and Moosehead regions in August is scheduled to be completed by the end of December. A report to the public should be available in January 1999.

The needs assessment was conducted by the Edmund Muskie School of Public Service at the University of Southern Maine, with local help from Mayo Regional Hospital and the North Country Healthy Communities Coalition in Greenville.

It was designed to paint a true picture of the local population's health needs, and to give residents a say in the development of their healthcare system.

The assessment included 600 household telephone surveys of residents from Dexter to Rockwood. Other components were interviews with healthcare providers, focus groups with specific segments of the population teens, the elderly, community leaders, social service providers and others -- and public goal-setting meeting in Dover-Foxcroft and Greenville on Nov. 16 and 17. Muskie School researchers have also analyzed health data available through state agencies.

Once the needs assessment report is completed and its findings shared with the public, local community steering committees in the Penquis and Moosehead regions will begin to use that information to craft an improve health care system that is responsive to community needs.

Community involvement at that point is critical to the effort's success.

"The process is designed to engage the community in decision making," said William Altman, research associate at USM's Muskie School.

An open house will be held at Regional Hospital's new occupational Therapy Clinic on Wednesday, Jan. 6, from 6:30-7:30.

The clinic is located in the Mayo Street School Annex on Mayo Street in Dover-Foxcroft, up the hill behind the county courthouse. Look for directional signs located at entrance and inside the door.

Occupational therapy was added as a new service of Mayo's physical Therapy Department in August, with the hiring of Laura Goulet, OTR/L.

It is hoped the open house will provide an opportunity for past and current patients, students, parents, caregivers and the general public to meet the therapists from Mayo, ask questions, and see the Occupational Therapy Clinic.

The new unit, commonly referred to as a CAT scan, will replace a mobile CT scanner service shared by Mayo Regional, Millinocket Regional Hospital and Penobscot Valley Hospital in Lincoln.

The mobile service is contained in a large, white truck commonly seen parked in front of Mayo Regional. Not only will that vehicle no longer be visible outside the hospital once the fixed-base unit is installed, but Mayo's interior is also undergoing a transformation in order to accommodate the new equipment.

The fixed-base scanner is being located in first floor space formerly occupied by administrative offices and the chapel. The administrative suite has already been relocated to the hospital's second floor, while the chapel has moved down the first floor hall closer to the main lobby.

The CT scanner renovation project will also allow Mayo to create a private waiting area on the first floor for laboratory and radiology outpatients.

That waiting room will be situated adjacent to the CT scanner and across the hallway from what will be the new entrance to Mayo's laboratory. The lab entrance and phlebotomy room, where patient blood and urine samples are taken, is now located off the hospital's main lobby. It will be moved around the comer and down the hallway.

Chief Executive Officer Ralph Gabarro said the new waiting area will address a long-standing concern over issues of privacy and confidentiality in the hospital's main lobby.

Mayo Regional has shared the mobile CT scanner with the Lincoln and Millinocket hospitals for six years, but decided to buy its own, fixed-base unit in order to improve the quality of scans, increase accessibility for patients and meet rising activity levels.

Mayo's Radiology Department provided 927 CT scans during the 1998 fiscal year. With the availability of full-time CT service for area residents, that figure is expected to rise to 1,200 scans in 1999.

The new scanner also has spiral capabilities, providing Mayo with technology identical to that available at Bangor hospitals.

The cost of the CT scanner and necesary renovations has been budgeted at $659,220.

The equipment, manufactured by General Electric, was delivered in early Decemeber. Renovations started in November, with E.W. Littlefield, Inc. of Hartland as general contractor.

Gabarro said the project is on schedule, with the equipment scheduled to be installed and operational by January 1.

Computerized Tomography is a diagnostic imaging technique designed to show detailed images of structures in a selected plane of tissue.

GUILFORD EXPANSION Construction of an addition to the Guilford medical building begain Aug. 31 (right photo), and the expanded structure was closed in during the fall (top photo). When the work is finished in January, the building will house two physician practices - Guilford Associates and Norumbega Medical Specialists.

A 1997 study disclosed that 10 percent of Maine's children, about 34,000 in all, did not have health insurance. Eighty-five percent of those children come from low income, working families.

Under the "Campaign for Coverage" - an initiative involving the Maine Hospital Association and the state Department of Human Services - Mayo and local physician offices will help enroll eligible children into the expanded Medicaid program and into "Cub Care," a subsidized insurance program. That assistance will be provided free of charge.

Through the Campaign for Coverage, hospitals will identify recently hospitalized uninsured children and then provide their parents with eligibility information and guidance on how to enroll in the state's expanded programs.

These efforts follow the passage of a law earlier this year that added healthcare insurance coverage to about 20,000 Maine children, mostly by expanding Medicaid eligibility.

Under the newly expanded Maine Medicaid program, the income limit is now 150 percent of the federal poverty level, up from 133 percent. In a family of four, children age I to 18 are eligible if the family's income does not exceed $2,057 per month.

Under the Cub Care program, the income limit expands to 185 percent of the federal poverty level, although families must be willing to pay a monthly premium of between $5$30, depending on family size and income.

Families interested in information and enrollment forms for the expanded Medicaid and Cub Care programs may contact Mayo Regional at 564-8401, ext. 306.

The rate hike halved the increase approved in both 1997 and 1998, when Mayo rates rose by 6%.

"We were conservative in our approach and our goal was to minimize any rate increase to the community," said Chief Executive Officer Ralph Gabarro. "This is a budget that has a solid integrity. We can now move forward in a very constructive way to meet our community's needs."

Mayo's 1999 budget projects operating revenues of $15,099,243 and expenses of $14,434,040. It will provide an operating margin of $665,203, or 4.6%.

The net income or bottom line after including non-operating income is expected to be $754,030. Net income is reinvested back into the hospital to fund depreciation.

Medicare and Medicaid payments combine to equal 58.5% of Mayo's revenue, by payer.

Chief Financial Officer Dennis Allen said the budget anticipates no significant change in use of hospital services. The budget assumes an average daily census of 15.9 patients, with an average length of stay of 3.5 days.

Operating expenses are predicted to rise by 5%, or $640,169. That comes primarily in the area of wages and benefits, which account for 7 1 % of the total expense increase.

Mayo employees are eligible to receive wage increases of up to 3% in 1999. The hospital is also raising its employment level to 215 full-time equivalent workers, an increase of seven positions. Mayo Regional employs a total of 260 people, including part-timers and per them employees, making it the largest employer in Dover-Foxcroft.

HAD 4 directors also authorized a 1999 hospital capital equipment budget of $2,123,41 1, a figure that includes two big-ticket items originally budgeted for 1998: a new computer system ($750,000) and a fixed-based CT scanner ($659,000). Those two items alone account for $1.4 million of the total $2.1 million capital budget.

Other major capital equipment expenditures include an ambulance remount ($60,000), a radiology laser printer ($54,000) and a new telephone system ($50,000).

The hospital also enlarged its rear employee parking lot on Dwelley Avenue, a move that opened up parking spaces for patients nearer the hospital and the Medical Office Building.