Project costs are estimated at $11.6 million for the 12-bed hospital
October 14, 2009 -- Columbia County residents may not have to wait much longer to find out if they’re getting a new hospital.
A certificate of need application for the 12-bed acute care facility is under consideration by the Department of Human Services’ Office of Community Health and Health Planning. A decision is expected on Oct. 22.
Residents voted in Nov. 2004 to form a new taxing district and levy a 38-cent-per-thousand assessed value tax – which was instituted in 2005 -- to build the hospital.
Now, the Columbia County Public Health District has a web site
and floor plan – designed to be expandable and LEED certified – and a proposed construction site – 35311 Millard Road in St. Helens, near the intersection of Millard Road and US Highway 30.
Legacy Health System, which already manages an urgent care clinic in St. Helens, would run the new facility. If the certificate of need is approved, construction will likely go forward in 2010. If not, the health district can appeal the decision.
Several analysts are working on the project, said Jana Fussell, certificate of need coordinator for DHS, but the final decision will be made by Grant Higginson, administrator for the Office of Community Health and Health Planning. A feasibility study conducted in 2003 and updated this year estimates the total cost of the project – including construction, land and medical equipment – at $11.6 million.
The question on many locals’ lips – at a Sept. 28 meeting at St. Helens High School, and in the local press – is whether the hospital would survive after it’s opened, and how closely it resembles the project they approved five years ago. Voters approved a critical care facility – and, due to a change in critical access designation, this hospital won’t be.
Past closures not forgotten
The project is haunted by the memory of the St. Helens Hospital and Health Center, which closed in 1990 due to bankruptcy.
“Small taxing districts like ours cannot afford this,” said Larry Karnoski, who described himself at the Sept. 28 meeting as a lifelong resident of Columbia County.
The previous hospital was a 90-bed critical care facility that employed 123 people, all of whom were laid off when the hospital closed. At the time, the hospital was more than $11 million in debt.
A handful of other small hospitals around the state shut their doors in 1989 and 1990 after posting major financial losses, including the 27-bed Rinehart Memorial Hospital in Wheeler, the 57-bed Eugene Hospital in Eugene and the 26-bed Malheur Memorial Hospital in Nyssa.
The closures were attributed to several different factors: inadequate Medicare reimbursement rates, low occupancy of hospital beds, high numbers of indigent and uninsured patients, shortages of physicians to channel patients to the hospital and an inability to invest in modern equipment.
Questions about Medicare reimbursement and physician recruitment remain – with concerns about the latter coming from the county’s medical community.
Dr. Janet Kelly, a family practice physician in St. Helens, said she has been trying to recruit additional physicians to her practice for five years – and has yet to succeed. “It takes doctors to admit somebody to a hospital,” she said. “I haven’t read how that’s going to be addressed and that concerns me.”
Dr. Christopher Ritchie, a doctor at Legacy’s Urgent Care Clinic – located in the former hospital facility – said the existence of a hospital alone won’t necessarily make it easier to recruit doctors. Half the counties in Oregon, he said, have doctor shortages – and many of those already have hospitals. What Columbia County really needs, he said, is increased access to primary care physicians.
Not exactly what voters approved
Initially, voters approved a critical care facility, but the facility currently under review is acute care, treating minor injuries and illnesses 24/7, and sending more serious cases to larger hospitals in Portland.
In addition, Kaiser Permanente patients could not receive care for anything but life-threatening emergencies at the new facility – and most life-threatening cases would not be seen at the hospital.
Still, Brian Burright, division chief of Columbia River Fire and Rescue, said at least one-third of patients currently being transported to Portland by Emergency Medical Services would be eligible to be seen at the proposed facility.
“I’ve never seen a new hospital such as this,” Fussell said. While she said there’s a trend toward smaller hospitals and toward 24/7 acute care, a facility with this one’s size and specific breadth of coverage is still unusual.
Pam Powell, the hospital project coordinator for the health department, said the hospital, while controversial, is the result of a grass-roots community effort – and it has plenty of local support. “The main question we hear is, ‘When will you be open?’"
Organizations endorsing the hospital project include the Columbia River Fire & Rescue Board, the Columbia Emergency Planning Association, and professional and volunteer firefighters’ organizations in St. Helens, Rainier and Scappoose.
In 2004, a hospital in St. Helens would have qualified as a critical access facility – a federal designation cost-based Medicare reimbursement for remotely located hospitals. But in 2006, the federal definition of “critical access” changed, and St. Helens is now too close to Portland to qualify as a CAH facility. According to the hospital website’s FAQ, however, the board intends to apply for CAH status after the hospital is opened.