BAKER CITY — Sen. Ron Wyden had what he called a “productive” conversation with executives from Saint Alphonsus Health System on Tuesday morning, Aug. 1 about the future of the birth center at the Baker City hospital.

Wyden, Oregon’s senior U.S. senator, said he pointed out during the meeting that Baker County commissioners voted on July 28 to spend up to $350,000 from the county’s federal COVID-19 aid to help pay to bring six obstetrics nurses to Baker City for six to 12 months.

That addresses the issue — a nurse shortage — that hospital officials cited as the main reason for their plan to close the birth center July 30.

“The money is now available” to bolster the nursing staff, Wyden said in a phone interview with the Baker City Herald on Tuesday afternoon.

Saint Alphonsus, however, has yet to commit to keeping the birth center open for more than four weeks after July 30, the initial closure date that officials announced on June 22.

That would keep the birth center open through Aug. 26.

In response to a question from the Herald about whether Saint Alphonsus, given the local effort to secure nurses for at least six months, had agreed to operate the birth center beyond four weeks, Mark Snider, media, public relations and digital strategy coordinator for Saint Alphonsus Health System, wrote on Monday, July 31: “At this time, we have no additional comments regarding the closure of the Obstetrics unit at Saint Alphonsus Medical Center – Baker City.”

Wyden has called for the birth center to stay open for at least six months, through Jan. 31, 2024.

County commissioners have urged Saint Alphonsus to operate the birth center for at least an additional year, through July 2024.

Wyden said Saint Alphonsus’ commitment to operate the birth center for four weeks is a “positive development,” but he said he reiterated, in his conversation with hospital executives, that the community needs at least six months to work toward a potential long-term solution that will ensure mothers can deliver their babies in Baker City.

The nearest maternity ward is at Grande Ronde Hospital in La Grande, 43 miles away via Interstate 84, which in the past several winters has closed for multiple hours more than half a dozen times due to wintry weather and crashes.

Saint Alphonsus Medical Center in Ontario is 70 miles away, also via I-84.

Shane Alderson, chairman of the Baker County Board of Commissioners, said on Tuesday afternoon that he spoke with Saint Alphonsus officials earlier that day, a separate conversation from Wyden’s.

Alderson said he asked hospital administrators for a commitment to operate the birth center for more than four weeks, but that they declined to do so.

“I do appreciate the hospital giving us breathing room to work on this,” Alderson said, referring to the four-week extension.

But a longer commitment of at least six months would help with the effort, at the local, state and federal level, to craft a long-term solution, he said.

It’s not clear, though, how the community could offer maternity services if Saint Alphonsus closes the birth center. Doctors from St. Luke’s Clinic/Eastern Oregon Medical Associates in Baker City, who deliver babies at the hospital, said recently that it’s not feasible to open a new birth center there. A birth center must have an operating room available in case of emergencies.

Looking ahead

Wyden, who is chairman of the Senate Finance Committee, said he is looking into other ways to potentially keep the Baker City birth center open and also to address more general financial challenges for hospitals in rural areas such as Baker County.

One idea is to have Congress increase the reimbursement rate from Medicaid, the federal health insurance program for lower-income residents, for maternity care in hospitals such as Baker City’s with small and declining birth rates.

Although Saint Alphonsus officials haven’t cited financial shortfalls as a reason for closing the birth center, the hospital’s total revenue dipped by 12.7% in 2022 compared to the previous year, from $40,832,000 in 2021 to $35,632,000 in 2022, according to data from the Oregon Health Authority.

The operating margin — revenue minus expenses — went from a surplus of $2,832,000 in 2021 to a negative $1,660,000 in 2022. That’s the biggest deficit since 2016, when it was $1,200,000, and the biggest in at least 15 years.

The hospital’s “bad debt” — money that patients were billed but did not pay — was the highest in nearly a decade in 2022, at $1,217,000. That was the biggest amount of bad debt since 2013, when it was $1,413,000. The highest annual figure in the past 15 years was $2,603,000, in 2009.

According to state records, about 57% of women who gave birth at the Baker City hospital between 2015-17 had health insurance through Medicaid or the Oregon Health Plan. Baker County’s average household income, about $48,000 in 2021, is the sixth-lowest among Oregon’s 36 counties, and about 30% below the state average.

Wyden also touted Treasure Valley Community College’s decision to revamp its nurse training program to increase the number of obstetrics nurses potentially available in the region.

‘Amazing’ response from community

Wyden, who coincidentally had scheduled a public town hall in Baker City on June 25, three days after Saint Alphonsus announced the birth center closure, said he was stunned by local residents’ response to the announcement.

More than 300 people, including several pregnant women and mothers with newborns, attended the town hall.

Wyden said the turnout, which was considerably larger than is typical for such events here, showed him immediately how vital the birth center is.

“It was an amazing kind of effort,” he said.

If the community hadn’t mobilized support so quickly and widely, he said, the birth center would have closed as scheduled on July 30.

“I can’t say enough good things” about the local response, Wyden said.