BAKER CITY — U.S. Sen. Ron Wyden, D-Oregon, prompted in part by the August 2023 closure of the birthing center at Saint Alphonsus Medical Center-Baker City, has introduced draft legislation intended to maintain maternity services in rural hospitals.

The Keeping Obstetrics Local Act would boost Medicaid payments for some rural hospitals and add supplemental federal aid for hospitals that had an annual average of fewer than 300 births over the previous three years.

Saint Alphonsus in Baker City averaged far fewer than 300 births per year — about 125 annually from 2000-2020.

Wyden, Oregon’s senior U.S. senator, discussed the draft legislation during a press briefing the morning of June 17.

Wyden, chairman of the Senate Finance Committee, also talked about the increasing risk of “maternity deserts,” including Baker County, during a committee hearing on May 16 in Washington, D.C.

A summary for the Keeping Obstetrics Local Act that Wyden’s office’s provided states that “Hospital maternity units are closing at an alarming rate, and Americans in rural and medically underserved areas are bearing the brunt of this crisis. Closures of rural labor and delivery units force expectant mothers to travel long distances outside of their community to receive perinatal care, lead to more births outside of a hospital setting, and result in higher rates of preterm deliveries.”

The summary states that from 2011 to 2021, a total of 267 rural hospitals stopped delivering babies, roughly 25% of rural hospitals.

“The epidemic of hospital closures of maternity centers is produced by several overlapping challenges, including the high fixed operating costs of these units, low volumes of births, and difficulties in attracting and retaining OB-trained clinic staff, all of which is exacerbated by inadequate reimbursement for labor and delivery services.”

During the press briefing, Wyden said the bill has 16 cosponsors, all Democrats, but that he hopes the legislation will be bipartisan.

The senator repeated criticism he made last year, including during a town hall meeting in Baker City in late June, less than a week after Saint Alphonsus officials announced that the birthing center would close.

The hospital is owned by Trinity Health Systems, which is based in Michigan and is the sixth-largest hospital company in the nation.

Wyden said the closure in Baker City was a “big splash of cold water” in the faces of community residents.

“It left the families in Baker City in an incredibly precarious position,” he said.

His bill, among other things, would require hospitals planning to close their obstetrics units to submit a report to federal, state and local agencies at least 90 days prior to the closure, listing the projected adverse effects of the closure.

Although the bill is designed to stave off future closures, Wyden said he hopes the prospect of additional federal dollars for rural hospitals, such as Baker City’s, would persuade Saint Alphonsus officials to consider reopening the birthing center.

“For over 100 years there has been a very positive partnership between the hospital and the community,” he said.

Wyden acknowledged that hospitals are reacting to “stark economic realities.” He said the bill is designed to help struggling hospitals deal with the financial challenges by increasing federal aid.

Saint Alphonsus officials attributed the closure of the Baker City birthing center to the difficulty in finding qualified nurses, a problem Wyden noted in the summary for the Keeping Obstetrics Local Act.

He described maternity services as “essential.”

“We can’t just sit by and let these communities become sacrifice zones,” Wyden said.

The proposal has been endorsed by the American College of Nurse-Midwives, America’s Essential Hospitals, Catholic Hospital Association, Community Catalyst, Families USA, Hospital Association of Oregon, National Partnership for Women & Families, National Rural Health Association, and the Oregon Perinatal Collaborative.

Daniel Grigg, CEO of Wallowa Memorial Hospital in Enterprise, called the draft legislation “an important step towards protecting access to maternity care in rural Oregon and across the country. This bill will support rural families and communities by boosting reimbursement for labor and delivery services and providing payments to hospitals with low-birth volumes. Senator Wyden cares deeply and understands the important role hospitals play in rural maternal health. We are grateful to have his support during this critical time.”