JACKMAN — The future of Jackman’s Critical Access Integrated Paramedics program looks brighter after nearly two years of uncertainty.
Organizers said they expect the program’s after-hours urgent care services to resume by Sept. 1, 2026.
The program, known as CAIP, recently identified a new physician group to provide telehealth services, according to Jackman Town Manager Richard Petrie, also a paramedic.
The yearslong pause left one of Maine’s most remote communities without the expanded urgent care access the program was designed to provide. Jackman is roughly 50 miles — about an hour’s drive — from the nearest hospital.
Organizers created the CAIP program after the Jackman Community Health Center struggled to maintain 24-hour care due to challenges in recruiting and retaining physicians. The program used specially trained local paramedics to provide after-hours urgent care while consulting emergency physicians through telehealth.
Through additional training with Eastern Maine Community College and clinical rotations at St. Joseph Hospital, paramedics learned to provide services including ultrasounds, splinting and wound care.
The community began exploring the model after MaineGeneral Health stopped providing after-hours medical care in Jackman in 2017, according to the Jackman-Moose River Fire & Rescue Department.
Penobscot Community Health Care later provided after-hours care but indicated that maintaining the service was not financially sustainable long term. That left the community with two options: find a way to fund and provide after-hours care, or lose the service entirely.
In a Feb. 28, 2023, statement, the department said the community chose to develop the CAIP program.
The initiative quickly attracted attention from rural communities across Maine and the country as a possible model for improving health care access in remote areas.
The department also said a representative from Sen. Susan Collins’ office encouraged the community to apply for congressionally directed spending after determining the program met federal funding requirements.
However, organizers paused the program’s after-hours component in fall 2024 after the Centers for Medicare & Medicaid Services, or CMS, responded to a complaint regarding the program’s structure.
CMS determined that the Jackman clinic would need to become a full remote department of St. Joseph Hospital to continue using emergency department physicians from the hospital for telehealth services, according to Petrie.
“This was a cost-prohibitive restriction, which also kept other hospitals from taking the program over,” Petrie said.
Organizers said they spent the next year and a half on efforts to restart the program, though initial attempts to secure federal approval were unsuccessful.
“We have spent the last 18 months working with our federal delegation to get approval from CMS to reinstitute the program, then researching Maine law and finally getting a law change that would allow physicians to delegate practice not only to employees, but also contractors,” Petrie said.
The legal change allowed organizers to search for an independent physician group to provide telehealth services, rather than a hospital-affiliated group. That search ultimately resulted in a solution.
“I am very pleased to report that we have found that group, are finalizing the contract and anticipate having the program up and running again by Sept. 1 at the latest,” Petrie said.
