As CEO, Dwyer has led a series of dramatic changes at the federally qualified health center. She talks with Mainebiz about how the pandemic has “forced and accelerated innovation,” and some of the further changes ahead.
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Lori Dwyer is CEO of Bangor-based Penobscot Community Health Care, which has patients in Penobscot, Somerset and Waldo counties. In the past year, the nonprofit has worked on increasing access to rural Maine residents and launching a variety of innovative programs that include expanded telehealth, a pilot program to allow paramedics to perform emergency services usually reserved for doctors, the addition of the East Coast’s first dental therapist to perform some services previously reserved for dentists, and more. PCHC was recently awarded $10 million out of the $41 million the state allotted to federally qualified community health centers to expand COVID-19 care and access.
Mainebiz: PCHC has had a lot going on recently — is there a common thread?
Lori Dwyer: Yes. The pandemic, though tragic, gave us the gift of forced and accelerated innovation, demanding that we hold people at the center of our design process and work to improve accessibility for everyone, not just those with computers and smartphones. It accelerated our work to get customized, affordable and convenient health care to people when they need it, in a way that works for them — via telehealth, in person, telephone, email, text. It demanded improved communication, space reconfiguration, and a new array of tools that will continue to improve care and communication in the long term.
MB: How did PCHC get the East Coast’s first dental therapist and why is it a big deal?
LD: We are always looking for ways to improve health care — to build or tweak models of care with the goal of improving that care and access, especially in rural or rural-adjacent communities, and for those least able to access health care. Dental therapists check all the boxes by expanding access to basic oral care while reducing costs. We were introduced to this model more than a decade ago and knew it had the potential to transform dental care in Maine. So, we lobbied for the necessary legislative changes, worked with schools on curriculum for this new dental provider role, worked with the licensing board, and started our search. It has taken many years, and we’re thrilled to be here. We hope our dental therapist — who is now practicing — will be the first of many in Maine.
MB: How has PCHC and its patients fared in general in the past year?
LD: Our teams are tired, but we have drawn on a well of resilience we never knew existed. We also drank a lot of coffee, learned how to collaborate more efficiently, adapted to personal and family stress, communicated in new ways and kept ourselves grounded in our mission as a social justice organization. We found energy in our mission. Our patients adapted alongside us, but, unfortunately, in spite of outreach and assurances it was safe, many deferred care for chronic diseases and have suffered setbacks and exacerbations as a result. Our staff work every day to address this unfortunate backlog.
MB: What are the challenges to PCHC’s vaccine program?
LD: Navigating disparate federal and state guidance, inconsistent applications of policy related to where and how vaccines can be delivered and to whom, widespread anti-vax misinformation, supply chain logistics and having sufficient staff and capacity to bring vaccines to patients rather than asking patients to come to us. Our primary goal is to get the vaccine to marginalized communities and those who cannot access mass vax sites — hard but vitally important work.
MB: Anything new on the horizon?
LD: We have multiple projects! We’re addressing staff and provider burnout and have programs to encourage joy in work; some new interprofessional models of care informed by the pandemic; expanding medication-assisted treatment for opioid use disorder; we’re focusing on harm reduction and reducing overdose deaths and supporting the startup of low-barrier treatment models at sister community health centers in Maine. We’re expanding our telehealth and mental health services, ramping up our new pediatric obesity service and breaking ground on an expansion of our practice in Belfast.