(2 of 2)
Encouraged, the hospital last May formally launched Contract for Care, a program aimed at individuals who fall just above the federal poverty level--$1,138 a month for a family of three. So far, a dozen patients have enrolled. Nancy Cameron Dickinson, 49, whose family income was less than $16,000 last year, weeded the hospital's garden beds and helped with landscaping to pay $800 she owed after Fallopian-tube surgery. Scott Smith, 29, an uninsured ski instructor, painted the ambulance bays to pay the $5,300 surgical bill he incurred after breaking his leg in a ski accident. A local florist is working off $275 she owed for a colonoscopy by providing a bouquet for the lobby each week. A 39-year-old housewife whose family racked up more than $2,000 in family emergency-room visits paid her final $220 by donating a handmade baby quilt.
Dr. David Dixon, a surgeon in Farmington, thinks the program will encourage more people to seek medical help before they need acute care. "This is a fee-for-service with a different currency," he says. "Hospitals tend to concentrate on patients inside the building and not accept responsibility for the wellness of the entire community."
Maine attorneys and advocates for the poor have reacted skeptically to the program. Christopher St. John, executive director of the Maine Center for Economic Policy, says asking poor working families to take on another job is an imposition. "These families need every ounce of their effort to pay for rent and food," he says. "An extra job could be the straw that breaks the camel's back." Others fear that if the IRS rules the labor is revenue, some people may lose some of their Medicaid, food stamps or earned-income tax credit. To avoid that problem, hospital attorneys insisted that the program be voluntary. No money changes hands. A task not completed is the hospital's loss.
Would the program work elsewhere? "It can work anywhere," says Batt, who came to the region from Denver, where he ran a 565-bed hospital. "It's a way to help patients help themselves." O'Leary puts it this way: "It gives you a good feeling that you aren't a charity case."