ALLAGASH, Maine — For more than eight decades, whenever Faye O’Leary Hafford needed medical care or treatment, she was looking at a 60-mile round-trip drive to the nearest health facility.
These days, all the 87-year-old Hafford has to do is walk about 60 feet down the hall from where she volunteers at the library bearing her name in the old Allagash Consolidated School to the offices of the new clinic operated by Full Circle Health Care, LLC, based in Presque Isle.
“We are so far from any hospital [and] 30 miles is a long way to drive,” Hafford said during a recent appointment with clinic director Paula Carson Charette, FNP-C. “It’s been wonderful having them here.”
Hafford was in Charette’s office for some blood work and related testing, something that only months before would have required a half-day trip to the closest medical facility, Northern Maine Medical Center in Fort Kent.
Now, thanks to technology and modern communication methods, the health providers at the Allagash clinic can work with their colleagues at NMMC or any health care facility in Maine to supply needed care for the residents of the tiny village at the mouth of the Allagash River.
The clinic opened its doors this past March and Charette is quick to say it was not a process that happened overnight.
“I started working with Full Circle in 2010 and it was always in my mind to get a health clinic somewhere in the St. John Valley,” she said. “It was needed in such a rural area.”
As it happened, Victoria Grover, PA, not only owns Full Circle Health Care — the only privately owned practice in Aroostook County — she is a tireless advocate for accessible health care.
“I really wanted to try to create a smaller, more flexible, more resilient family practice model,” Grover said. “There is absolutely a place for the larger institutions — we need hospitals — but I am concerned as stresses increase (on the health care system) it will be harder in rural areas to retain good primary care.”
The notion of providing that quality primary care on a personal level is what has driven Grover over the last 30 years in Aroostook County and her philosophy with Full Circle Health Care.
When circumstances left Grover the sole owner and sole full-time provider at Full Circle two years ago, a colleague recommended she bring Charette on board.
“I was concerned she was coming all the way from Fort Kent to work here and that she had that community she wanted to serve,” Grover said. “So when I hired her I said when the time was right I’d try to facilitate her being able to have a health center in the St. John Valley area.”
Neither Grover nor Charette were completely sure what such a clinic would look like, but Grover knew there was language within federal guidelines covering Federally Qualified Health Centers with regards to rural care, reimbursements and the role of physician assistants.
“When I saw rural centers can be owned by PAs I said, ‘Well fancy that,’” Grover said. “Here was a way for me to start a branch [clinic] without having to relinquish control in terms of my vision or philosophy.”
Grover already knew that Charette was well known in the Valley and had a real connection with the residents there.
“I felt she could do it right,” Grover said. “The people of the Allagash were very interested.”
So Grover gave Charette some release time and her blessings to take the ball and run in establishing a full-service health clinic in one of Maine’s smallest communities.
“Something like this is not impossible,” Charette said from her new office in the old school. “You just need determination and stamina.”
Good help is key, too, she added.
Charette found that help in Christine Leslie, a certified nurses aid who grew up in Allagash and, as she said, “Walked into kindergarten on one end of this building and walked out the other end when I graduated from high school.”
The two are a compassionate and formidable force on the front lines of health care in Allagash.
When Charette first came to scout out a location for the clinic, she was greeted with falling ceiling tiles, a leaky roof and what she termed a general look of abandonment in the old school.
But thanks to the efforts of the town’s residents who successfully secured grant funding, the school now has a new roof, freshly painted walls and rooms buzzing with activity from the Faye O’Leary Hafford Library to the suite housing the town’s administrative offices to the old classroom now used by a group of quilters.
“Those women come in every week to work on their quilts,” Charette said. “They even made our curtains for the clinic and one woman made the first hospital ‘Johnny’ for the clinic.”
It’s that kind of community connection Charette believes will make the clinic a success.
It took two years of planning, research and crafting hundreds of pages of a policy manual from scratch, but Charette and Leslie said the work was more than worth it.
“All along the way people from up here have been involved and so they feel a part of it,” Charette said. “Christine knows just about everyone up here and is related to half of them so people often come by to say hi.”
The clinic currently has about two dozen patients signed up and Charette said all residents from Allagash to points east are invited to enroll.
Interested individuals must first come to the clinic where Leslie helps them fill out a medical release form allowing Full Circle access to the patient’s medical records from their current provider.
Once that information is in hand the new patients may make appointments for services including treatment of acute illnesses, management of chronic disease, laboratory work, referrals for specialized tests or X-rays, immunizations, wellness promotion, medication management or health education.
If care is needed beyond what the clinic offers, Charette is able to refer patients to the hospital or specialist of their choosing anywhere in Maine or beyond.
“We will send our patients where we think they will get the best care and where they want to go,” she said.
The blood drawn from Hafford during her recent visit was to be delivered to Full Circle’s lab with results available the next day.
A big part of what will make the clinic a success, according to Charette and Grover, is the ability to share information instantaneously among the clinics and health care providers around the state using electronic and Internet technology.
“I would not have been comfortable with a rural [health] center in Allagash if I did not know I had instantaneous contact,” Grover said. “This way I can read every note and look at every record on the computer and we can communicate back and forth instantly.”
The technology also allows the clinic to access and share patients’ records from providers around the state.
“This is my hometown and to be part of this feels great,” Leslie said. “One of the first patients I saw was one of my old high school teachers.”
In addition, for those residents who are unable to travel to the clinic, Charette and Leslie make in-home visits, a practice dating back to the days of medical house calls.
“I’ve done home visits since 1981 and I will continue to do them,” Grover said. “Why shouldn’t we do this? And why can’t we collaborate and create new systems that will provide safety nets for people?”
Among those safety nets is providing the community-based care that will allow Allagash residents to remain at home in their later years.
“Some of these elderly people here don’t have family around or the ability to travel even to our clinic,” Charette said. “You can see how scary that is for them when they are faced with being alone [and] it feels really good to be the person who can provide them with care and peace of mind.”
Grover said working with other health facilities, such as NMMC in Fort Kent, is a big part of what will allow the Allagash clinic to thrive.
Residents buying into the notion of the clinic in their town is the other part, she added.
“I need the community to step up and say they support it and that they want their health care [in Allagash],” Grover said. “In no way does this diminish Northern Maine Medical Center — we want to work with them [and] we all have to pull together.”
The Full Circle Health Care Allagash Clinic is open Tuesdays-Fridays from 8 a.m. to 4 p.m. and appointments may be made by calling 398-1022.
Correction: An earlier version of this story contained an error. The Full Circle Health Care Allagash Clinic is open Tuesdays-Fridays from 8 a.m. to 4 p.m., not Tuesdays-Thursdays.