With the Baker City birth center officially closed, a federal report recommends county leaders look for ways to get a new birth center. But the short-term challenge of connecting patients with maternity care outside of the county is revealing other gaps in vital services.
The U.S. Public Health Service Commissioned Corps visited Baker County in late August as St. Alphonsus Medical Center was shuttering its maternity ward. St. Alphonsus and its parent company Trinity Health closed the ward despite opposition from staff and the community.
The St. Alphonsus Medical Center in Baker City, Ore. on July 21, 2023.
Antonio Sierra / OPB
The federal report is meant to assess the birth center closure and provide recommendations to “ensure a smooth transition of maternal care services.”
Baker County Commissioner Shane Alderson said the report will be a valuable tool as the county looks to build support for stabilizing and bolstering local maternity care services. With the Baker City birth center closed, the closest maternity ward is 40 miles west at Grande Ronde Hospital in La Grande.
But Alderson said the county is still challenged by helping residents with their imminent maternity care needs while still planning for the future.
“It really is kind of a Herculean task,” he said.
Short-term challenges
The U.S. Public Health Service Commissioned Corps is one of the country’s uniformed services — like the Army, Navy and Coast Guard — that focuses on public health. Oregon U.S. senators Ron Wyden and Jeff Merkley, as well as Gov. Tina Kotek, said they requested the Corps’ services to help Baker County assess the impacts of the maternity ward closure.
The federal report says St. Alphonsus failed in many ways to ensure a smooth transition as it closed its birth center. It says the hospital chain had not updated its home page with information about the birth center closure or included links to a transition plan or information about where people could find maternity services elsewhere.
A St. Alphonsus representative did not return a request for comment.
The report says St. Alphonsus also didn’t provide clear communication with local ambulance providers, including Priority Ambulance and Life Flight.
According to the report, the closure is particularly concerning for Priority Ambulance staff, who worry about transporting maternity patients to a ward 40 miles away during extreme winter conditions, when road conditions are dangerous.
Snowy and icy conditions during the winter have been a prominent concern for Baker County residents. The report notes that the Oregon Department of Transportation closed Interstate 84 — a crucial highway for Eastern Oregon — 29 times between January and June 2023.
But road closures aren’t the only transportation concern, especially for people without cars.
While there is public transportation between Baker City and La Grande, it doesn’t operate 24 hours or on federal holidays. The county’s only taxi service closed at the end of August. Ride-hailing services like Uber or Lyft don’t operate in the county.
St. Luke’s Eastern Oregon Medical Associates in Baker City will continue having obstetricians available to provide pre- and post-natal services. And Grande Ronde staff indicated they were prepared for the increase in patients from Baker County.
But the county is also contending with losing other family services at a critical time. For instance, the report notes the Baker City YMCA is ending its child care program this month. That could add additional financial strain on families in a county where the average cost of child care for two children is $14,000.
Although half of Baker County’s residents live in Baker City, the birth center closure also affects other communities across the county.
The report spotlighted Halfway, a town of 350 in eastern Baker County. Halfway has a clinic with a handful of medical staff, but it does not support birthing services. Beyond Baker City, the closest hospital with maternity care is nearly 90 miles away in Weiser, Idaho. But rather than traverse the area’s winding roads to get there, locals anticipate many patients will have to be flown to Boise to get care.
‘People need all of these services immediately’
The report’s authors said the county should work with the state to replace the St. Alphonsus birth center long-term.
They recommended several options, including bringing in a new organization to lease St. Alphonsus’ unused maternity ward space. The organization could form a health district for a publicly funded birth center.
Baker County Commissioner Shane Alderson said he’s glad the Corps recognized the need for a birth center. But he added that it’s still too early to tell what route the county will go down, since it’s busy dealing with the present-day problem of connecting residents with the remaining maternity services.
“All of these things are moving all at the same time,” he said. “You can’t really stop work on one thing and then go to the next because people need all of these services immediately.”
In a statement, Sen. Ron Wyden thanked the Corps for its work and vowed to continue supporting maternity care in Baker County.
“I’ll use this report that clearly identifies those health risks as well as related economic dangers to stay on the case with Baker County and the entire community to find long-term solutions that fill the void left by St. Alphonsus,” he said.