Jackie Fournier, co-director of the Nurse Practitioner fellowship program for Maine Center for Palliative Medicine, stands Thursday in St. Mary’s Regional Medical Center’s ICU where she works as a nurse practitioner consultant for Maine Center for Palliative Medicine, which is an offering of Androscoggin Home Health + Hospice. Andree Kehn/Sun Journal
LEWISTON — A nurse practitioner fellowship program in palliative care at Lewiston-based Androscoggin Home Healthcare + Hospice will be able to continue another year and add a second fellow thanks to over $230,000 in federal funding secured by U.S. Sen. Angus King.
The funding was part of the massive $1.7 trillion omnibus appropriations bill for fiscal year 2023 approved by Congress in late December. Maine’s congressional delegation — Sens. King and Susan Collins and Reps. Chellie Pingree and Jared Golden — secured over $6.5 million for health care-related projects in Androscoggin, Franklin and Oxford counties.
King said in an interview Thursday that Androscoggin Home Healthcare approached his office with the proposal to continue funding the program. The omnibus bill that passed in December was the second time the U.S. Senate Appropriations Committee accepted congressionally directed spending requests. Senators make these requests on behalf of government entities — typically towns — and nonprofit organizations, King said.
“We thought that this was a really good project given the population, the demographics and the need,” he said.
Palliative care is an interdisciplinary specialty of medicine focused on providing support for people with serious and life-threatening illnesses, the organization’s chief medical officer, Dr. Vance Brown, said Thursday.
“And they oftentimes have really advanced symptoms — weakness, fatigue, pain, shortness of breath — and this is really the specialty that concentrates on helping support them and clarify some of their goals and clarify some of the issues related to end-of-life planning,” Vance said.
“(It’s about) making sure that we kind of stay on track collectively as a health care system and helping honor those goals and helping the patient drive what’s important to them.”
King said it’s “no secret” that Maine is the oldest state in the nation. The median age in Maine is 44.7 years old, which is nearly six years older than the median age for the entire country, according to the 2020 Census.
“Hospice and palliative care, sadly, is a reality and a necessity,” King said, but there aren’t enough providers to meet the need.
There are only five certified palliative care providers for every 100,000 Maine residents, according to data provided by Androscoggin Home Healthcare + Hospice.
“Sadly, it’s an expending need as people age and approach end-of-life issues,” King said. “And keeping people in their homes as long as possible is always better — better for them, better for the family.”
The nurse practitioner program, housed within the Maine Center for Palliative Medicine, a division of Androscoggin Home Healthcare + Hospice, is in its first year. Sen. Collins secured $150,000 in the omnibus bill passed in March 2022 to begin the program. The program’s first fellow, Katie Frend, started last summer, Brown said.
With this additional funding, Androscoggin Home Healthcare + Hospice will be able to offer the program a second year and with two fellows, who begin on July 1, Jackie Fournier, a palliative care nurse practitioner with Androscoggin Home Healthcare + Hospice, said.
Fournier helped design the program and serves as its co-director with Nastasha Stitham, who is also a nurse practitioner at the Maine Center for Palliative Medicine.
When Fournier and others began drafting the program a couple of years ago, there were only seven or eight palliative care fellowships for nurse practitioners across the country, Brown said. In Maine, there are two fellowship programs for physicians but at the time, none for nurse practitioners.
“Nurse practitioners — because they all started as nurses and I think because of that are, you know, super hard-wired and naturally really patient oriented, and obviously have fantastic medical backgrounds and many of them are superb communicators right of the bat — they’re really, really fantastic at this work,” he said.
Androscoggin Home Healthcare’s program is geared toward gaining experience at community and rural practices, as opposed to in large university settings, Brown said. The fellows rotate through a number of clinical settings, including at St. Mary’s Regional Medical Center and Central Maine Medical Center, Androscoggin’s Hospice House and through their home hospice program.
“End of life is a terribly difficult time, obviously, for everyone involved. The patient, clearly, but the family as well. And it’s comforting to have professional support,” King said.
“… It’s sort of difficult to use the term ‘quality of life’ for someone who’s dying, but what you’re really talking about is quality of life at the end — trying as best we can to make the last days, weeks and months of someone’s life as comfortable as possible for them, and as comforting as possible for their family. And that’s why I think this is one of those projects where the impact will be very direct and very meaningful to families and patients.”
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