BY JEFF CHUDZINSKINorth Country This Week

CANTON -- St. Lawrence County Legislators once again sounded the alarm as Claxton-Hepburn Medical Center is being dragged through bankruptcy proceedings with North Star Health Alliance, a reorganization process that could see birthing and delivery services cut at Claxton. 

The announcement of the planned closure of the berthing unit drew sharp criticism from elected officials and an outpouring of frustrations by staff and residents alike, however North Star officials appear to remain steadfast in their position to cut the critical services. 

Legislators unanimously sponsored and approved a resolution to call on state and federal lawmakers to find a solution that would spare the services at the facility during the Full Board meeting on Aug. 3. 

During the July 27 Finance Committee meeting, Legislator Jim Reagen addressed concerns, saying the reorganization and bankruptcy process will impact more than 25,000 people in St. Lawrence County as health services remain in dire need of support. 

In particular, the cuts at Claxton will impact not only rural residents surrounding Ogdensburg, but also those who live in the city, he said. 

Reagen said he found the lack of communication "alarming." 

"I've been very disappointed at the lack of communication and transparency over this decision and that's what's causing many of us in this room to take the unusual step of commenting and presenting a resolution like this to the state Department of Health and to our elected representatives," he said.  

He continued, saying it was important that state officials take full measure of the situation and truly assess the impact it would have on residents in the county and surrounding counties as well. 

"I think it's important that as part of the state's review of what they're going to do at Claxton-Hepburn, that they have a long term plan that takes care of the critical health needs of our rural community," he said. 

Though figures have been declining, Reagen said he was concerned that Rochester Regional Health and Canton-Potsdam Hospital would not be able to withstand an influx of more than 100 extra births per year. 

He noted the limited number of providers to meet even the basic OBGYN needs of women in the area, let alone birthing services. 

"What does it mean to people in the rest of the county when the service is removed from the entire county?" he asked. 

Reagen said it wasn't just a matter of the southern portion of the county being impacted, as residents from all over the county travel to Claxton for such services.  

Reagen said the time to act and bring local stakeholders to the table is long past due. 

"It's important for us to send a message and stand up for the rural areas of SLC and put NYS on notice that this idea of reducing healthcare in rural communities is just not acceptable. It is not acceptable to leave pregnant women facing delivery in emergency rooms...to close rural healthcare satellite offices," he said. 

Reagen said many who face severe health problems that require nuclear medicine services are also being forced to travel and wait weeks, if not months, for services that can save lives. 

In the case of potential cancer diagnosis, Reagen said it means the difference between life and death. 

He said the sentiment appears to simply be 'good luck' as patients are told to drive to Watertown, Plattsburgh and Syracuse for such services. 

"Need to speak for the disadvantaged and those who don't have a voice," he said. 

Legislator Rita Curran expanded on his concerns, saying it was crucial to ensure the hospital system was able to provide a service that private businesses cannot afford to or have a mechanism to make possible. 

She said delivery services are not profitable historically, "nor should they be." 

In the case of labor, Curran said women who are beyond four centimeters in dilation are unable to be shipped. 

That means they would be forced to give birth in an emergency room, she said. 

The idea of emergency room births is a dangerous one the hospital cannot afford to undertake, she said. 

Along with the closure of delivery services, Curran said 6,000 to 10,000 residents will also be without primary care providers. 

That could mean delays in crucial referrals, like those needed for mammograms, OBGYN services and cancer testing. 

She said in many cases she saw patients in Syracuse who came to the emergency room due to a lack of primary care help, only to find that they had advanced stage cancer that was untreatable. 

"Oftentimes we would just discharge them to hospice care because it was too late," she said. 

Curran said situations like that could become the norm given proposed cuts and the number of patients impacted.

She said she was also concerned with the number of patients every primary care sees each day, commenting that many providers are struggling to add more mid-level providers to meet the demands.

"That's not how it's supposed to be," she said. 

Curran said the situation is largely a geographic one, which is not acceptable. 

In the case of women who required OBGYN services, Curran said those providers are in short supply as is. In the case of those services, a primary care is unable to undertake the needs of patients. 

"It's important people realize how bad this can be," she said. 

Legislator David Forsythe suggested bringing more local officials to the table as discussions are ongoing. 

He said the local community does not have a voice or a "seat at the table," something that needs to change. 

Forsythe said the financial burden, coupled with the state's concerns about the reorganization, should not override the needs of the people in St. Lawrence County. 

Legislator Margaret Haggard also pointed to proposed cuts at the federal level that will eliminate Medicare and Medicaid for 10-17 million patients. 

Without that insurance, healthcare is not possible for them, she said. 

She said hospitals need patients with good insurance to cover costs with reimbursements, something that is not common in the North Country. 

Haggard also pointed to plans to change requirements for such health insurance, including a work requirement. 

She said in some cases that may not be possible if someone is battling a serious illness. 

"Any woman of child-baring age realizes just how timely getting to a hospital is. There's no rescheduling," she said. 

For Legislator John Burke, the situation is one that should lead to a vote of 'no confidence' in North Star leadership, he said. 

Burke raised concerns about the process and who has empowered North Star officials to undertake the reorganization as they have. 

"Who exactly is empowering them?" he questioned. 

It's a question many have asked publicly in recent weeks with many local officials decrying the lack of local input and transparency coming from North Star, county officials commented. 

Legislator Nicole Terminelli said the situation is North Star simply "taking the easy way out." 

"If they are facing bankruptcy and making cuts, labor and delivery is the easy way out," she said. 

She said labor and delivery services are "a cost, but a necessary one" as a lack of facilities and options are a major deterrent for residents in the region. 

Terminelli questioned how Rochester Regional Health officials felt about the proposal. 

"I'm willing to bet they are hitting the panic button," she said. 

The resolution passed with unanimous support and will be sent to state lawmakers, as well as Representative Elise Stefanik.