Baker County looks ahead as St. Alphonsus birth center nears end

Whatever the future of childbirth looks like in Baker County, St. Alphonsus Medical Center is setting itself up for a much smaller role.

St. Alphonsus and its parent company, Trinity Health, announced in June it was closing its birth center. Although the closing date was originally set for the end of July, St. Alphonsus agreed to extend its lifespan by four weeks under pressure from local, state and federal officials.

The extension runs through Saturday and local officials don’t expect any more reprieves from St. Alphonsus. As the deadline approaches, government officials tasked with sustaining maternity care in Baker are starting to share their frustrations with St. Alphonsus publicly.

“Baker County has worked closely with the community to protect and preserve maternity care for moms and newborns, but unfortunately St. Alphonsus didn’t match the community’s can-do and innovative approach,” U.S. Sen. Ron Wyden, D-Oregon, said in a statement. “That’s frustrating, and the focus now must be ensuring St. Alphonsus cooperates fully with the federal healthcare team working to provide answers on what is needed so Eastern Oregon families can get the safe maternity care they need and deserve.”

St. Alphonsus pushes back against scrutiny

Public comments from St. Alphonsus and Trinity have been rare since they made their June announcement. But they were more willing to explain the decision in correspondence with Wyden.

In an Aug. 10 letter, hospital administrators reiterated their reasons for shutting down the maternity ward. Deliveries at the Baker City facility are falling from an average of 128 per year to an estimated 75 in the past fiscal year. According to the letter’s authors, birth center nurses were both unsatisfied with the lower work volume and unwilling to work in other hospital departments when there were no patients at the center.

The administrators told Wyden that they were increasingly relying on temporary nurses to fill vacancies in their staff, and when one of those nurses was disqualified from practicing by the state, St. Alphonsus made the decision to close the maternity ward.

The group said they were able to extend the birth center’s lifespan by four weeks by hiring six temporary nurses, but it would take more than that to get them to consider staying open for longer.

“If the federal government identifies 9 (obstetrics)-trained US Public Health Service Commissioned Corps. Nurses willing to commit for six months, we will reevaluate our decision to close,” they wrote.

St. Alphonsus and Trinity officials said they would also be willing to contribute $100,000 to an endowment that would provide money for transportation and lodging costs for Baker County patients who now need to travel to a different hospital for birth center services. The closest birth center to Baker City is at Grande Ronde Hospital in La Grande, more than 40 miles away.

Wyden, along with Sen. Jeff Merkley, D-Oregon, and Gov. Tina Kotek, remained unmoved by St. Alphonsus’ explanations.

Writing a joint letter to St. Alphonsus Eastern Oregon President Dina Ellwanger on Aug. 14, the trio compared the investments they helped coordinate with the money put in by the hospital.

Wyden helped secure $500,000 to extend maternity services in the county in addition to various resource and service commitments from the state of Oregon, local businesses like Beef Northwest Feeders and Treasure Valley Community College to help address short-term and long-term gaps in care.

They calculated that between St. Alphonsus’ planned contribution to the endowment and the cost of keeping the birth center open for four weeks, the hospital had only committed $240,000 toward the transition, “less than $2,000 for each of the 126 years it’s been in the community.” They accused St. Alphonsus of continually moving the goalposts and changing its story about the resources the hospital needed to keep its maternity ward open.

“Simply put, the community deserves better,” they wrote. “In the face of St. Alphonsus’ response, the community now understands it’s on its own. And we intend to work with them to find short-term fixes and a long-term response that ensures families expecting babies do not suffer.”

St. Alphonsus bypassed the senators and governor for its next letter, which was an open letter sent to OPB and addressed to the “Baker Community.”

“We typically don’t respond to false statements meant to grab headlines,” Ellwanger and Trinity West Region President Odette Bolano wrote. “However, when our Mission and commitment to caring are questioned, we are compelled to set the record straight.”

St. Alphonsus’ prior comments about the birth center nurses had been “grossly misrepresented by some,” they wrote. Ellwanger and Bolano did not blame nurses for the hospital’s closure. Instead they said they were “incredibly grateful for their service.”

Further into the letter, the pair wrote that the hospital closing its birth center was not “financially driven,” but also noted that the birth center had operated at a loss of $5.3 million over the past 10 years. All of the red ink was “an example of our commitment to providing care,” they wrote.

At the end of the letter, Ellwanger and Bolano reminded readers that other services like emergency care, orthopedics and physical therapy would still be offered in Baker City. The birth center might be gone soon, but the hospital will remain.

Preparing for the aftermath

With no further extensions from St. Alphonsus in sight, government officials are starting to look ahead.

In the Aug. 14 letter, the senators and governor write that the U.S. Department of Health and Human Services is assigning a team of rural hospital experts to assess the situation and come up with both short-term and long-term solutions for Baker County. This team is expected to deliver a report by Aug. 31.

Baker County Commissioner Shane Alderson said the county’s public health officers will help the federal government connected with local health care leaders while they compile their report. While he’s looking forward to getting a set of fact-based recommendations, Alderson said the community will eventually need a new birth center.

“There’s some on one side that say that we’re an aging community and another side saying this is a good community to raise your children in,” he said. “I think that overall, the long term goal will have to be to bring not only maternal services to Baker County, but increase what we provide our citizens because I think we’ll see the population continue to grow.”

The loss of the birth center is personal for Alderson because he and his wife are expecting a child. He said their plan is to stay with family while delivering the baby in Idaho.

“I can see the hardship that this is going to bring to families that don’t have as many resources as my wife and I do,” he said. “It’s so hard, I understand these families are in a hard place right now.”

Parents across the county are worried about how it could affect their pregnancies or their ability to have more children. Until the local, state and federal government comes up with a solution, locals will have to look outside Baker County to find answers.