Sen. Ron Wyden, D-Ore., talks with Baker City residents following a town hall meeting on Sunday, June 25.

Officials from Saint Alphonsus Medical System wrote in a letter to Sen. Ron Wyden that they need nine nurses from a federal program, three more than a local campaign has offered, to operate the birth center at the Baker City hospital beyond Aug. 26.

The Aug. 10 letter was a response to questions Wyden had submitted two days earlier.

Wyden has been urging Saint Alphonsus to keep the birth center open for at least six months.

In an Aug. 14 letter to Saint Alphonsus, Wyden, Sen. Jeff Merkley and Oregon Gov. Tina Kotek wrote that hospital officials’ Aug. 10 letter “provides written confirmation of the gigantic gap in commitment between the Baker County community, for whom we are advocating, and an institution that’s supposed to be providing health care for those Oregonians.”

“Simply put, the community deserves better,” the senators and governor wrote. “In the face of St. Alphonsus’ response, the community now understands it’s on its own.”

They wrote in the letter that they are working with the U.S. Department of Health and Human Services to “secure federal resources to help in the community’s transition” from Saint Alphonsus to another potential option for local maternity care.

The federal agency will assess how many workers are needed for obstetrics care locally, “identify transition plans and resources for families expecting babies after August 26, and assist the community in identifying models of delivering safe obstetrics after St. Alphonsus walks away from local maternity care,” Wyden, Merkley and Kotek wrote.

The federal team is slated to report on its progress by Aug. 31.

In addition, Wyden, Merkley and Kotek are asking Saint Alphonsus to donate the equipment from its birth center to Baker County rather than selling items, and to provide the federal team non-proprietary information related to the birth center.

“We are making these requests because Baker County can no longer count on St. Alphonsus after 126 years to provide maternity services,” the officials wrote.

Hospital officials announced June 22 that the birth center, the only such facility in Baker County, would close July 30.

That prompted widespread concern among local residents, particularly pregnant women who were expecting to deliver their babies at the Baker City hospital.

More than 300 people attended Wyden’s previously scheduled town hall in Baker City on June 25.

Saint Alphonsus officials said in late July that the birth center would remain open for four more weeks, through Aug. 26.

In the meantime, an effort involving Wyden, Merkley, Baker County commissioners and other officials, and Kotek, has arranged to bring six nurses from a federal program to work in the Baker City birth center.

But in the Aug. 10 letter to Wyden, hospital officials wrote that they need nine nurses, not six.

If the federal government commits to bringing nine nurses to Baker City, “we will reevaluate the decision to close,” according to the letter, which is from Dina Ellwanger, hospital president, Odette Bolano, CEO for the West Region of Trinity Health, the Michigan company that owns the hospital, Mike Ballantyne, board chair for Saint Alphonsus Health System, and Mike Slubowski, CEO for Trinity Health.

In the Aug. 14 letter, Wyden, Merkley and Kotek contrast the local, state and federal effort — “this Eastern Oregon community has moved mountains to find a solution” — with what they deem Saint Alphonsus’ reluctance to work with the local campaign.

“Instead, the goalposts kept moving and the story kept changing about what St. Alphonsus actually needs to keep the maternity center open so that safe access to labor and delivery services can be maintained,” they wrote. “This is completely unacceptable, and the community deserves better.”

A joint statement from Wyden, Merkley and Kotek also criticized Saint Alphonsus, stating that “St. Alphonsus seems resolute in slamming the doors shut on women and families needing obstetrics care in Baker County.”

The statement also mentions the federal team that will assess the local obstetrics care needs.

“We will not rest until the expectant parents and families of Baker City have access to the safe maternal health care they deserve,” Wyden, Merkley and Kotek wrote.

Shane Alderson, chairman of the Baker County Board of Commissioners, who have committed to spending about $500,000 in federal COVID-19 aid to bring six federal nurses to Baker City temporarily, said he’s disappointed by the Saint Alphonsus administrators’ claim that nine nurses are needed.

Alderson said he’s gratified, though, that the federal team will assess the community’s needs for maternity services.

How many nurses?

In their Aug. 10 letter to Wyden, Saint Alphonsus officials explained why they need nine nurses, not six, to continue operating the birth center beyond Aug. 26.

“We continue to dialogue with employed Saint Alphonsus Baker City OB nurses and agency nurses around a willingness to continue for an additional five months; however, commitment is not there. At this point, we would need 9 new nurses to continue to keep the unit open.”

Wyden, in his Aug. 8 letter, asked Saint Alphonsus about the difference in salary between nurses in Baker City compared with Grande Ronde Hospital in La Grande.

The Saint Alphonsus officials didn’t answer the question, writing that the nurses are paid based on their union contract.

Endowment proposed to help pregnant women

In their Aug. 10 letter to Wyden, Saint Alphonsus officials offered to contribute $100,000 to an endowment fund, operated by Baker County, that would help pay for transportation and lodging for women who have to travel outside Baker City to delivery their babies.

Reasons for closing birth center

In their Aug. 10 letter to Wyden, Saint Alphonsus administrators reiterated the issues that prompted them to announce the birth center closure — a lack of nurses and declining birth numbers at the Baker City hospital.

The latter trend — the total births for calendar 2022 was 100, the fewest since 2003, when there were also 100 deliveries — has contributed to nurse shortage, according to Saint Alphonsus.

“Due to low volumes, OB nurses working in Baker City are unable to practice their desired specialty at a frequency that ensures their competency and provides fulfillment,” the administrators wrote. “As a result, they are often unsatisfied with their work, and some have sought employment elsewhere.”

The administrators also wrote to Wyden that “OB nurses have not been willing to cross train in other areas of the hospital when there are no patients in the OB unit.”

Some of the nurses, however, cite other reasons for leaving.

They said the closure of the intensive care unit at the Baker City hospital in January 2023 left them uncertain about the birth center’s future.

Nurses also mentioned the resignation that month of Sommer Sargent, the birth center supervisor, as contributing to declining morale among obstetrics nurses.

Saint Alphonsus administrators, in their letter to Wyden, wrote that after half of the birth center nurses left earlier this year, the hospital had to rely more heavily on temporary traveling nurses.

“Even though highly paid, these temporary agency nurses have become increasingly difficult to recruit and retain because there is a national shortage of nurses, and OB nurses have little interest in practicing at facilities with low numbers of deliveries,” the administrators wrote.

Then, in June, the Oregon Board of Nursing told Saint Alphonsus that one traveling nurse could no longer practice.

“Unable to identify additional nurses, and to ensure the safety of our patients, the decision to announce closure was made,” the administrators wrote to Wyden. “During the notice time, our leadership team worked tirelessly to bring in nurses from our other Saint Alphonsus facilities in Ontario, Nampa, and Boise to fill the growing number of unfilled shifts.”

The administrators wrote that Saint Alphonsus will spend $143,666 to keep the birth center open through Aug. 26.