Freeborn County commissioners pressed Mayo Clinic Health System leaders for answers Tuesday about the transition of services underway in Albert Lea and Austin.

Raising concerns about the consolidation of the birthing unit to the Austin campus, transportation for seniors and others without vehicles who have to travel to Austin for inpatient care, and the cost of overnight stays in observation beds on the Albert Lea campus, the commissioners voiced displeasure about many of the changes that have already taken place or are set to change in the coming years.

“I’ve been wanting to say this for a long time, and I’m just going to say it,” 1st District Commissioner Glen Mathiason said. “Common sense tells me that if one of these two places had to cease inpatient hospital care, it certainly should have been Austin and not Albert Lea.”

Mathiason said he represents people outside of Albert Lea in the county who have to travel further to receive health care services.

“I just wish somebody would be honest and tell me why that decision was made,” he said. “I’ve got my feelings why it was made … it really hurts this community.”

Sumit Bhagra, medical director of Mayo Clinic Health System in Albert Lea and Austin; and Kristin Johnson, associate administrator for Mayo Clinic Health System in Albert Lea and Austin, presented an update on the transition of services and answered questions from the commissioners. Mark Ciota, CEO of Mayo Clinic Health System in Albert Lea and Austin, was unable to attend because of a full surgical schedule.

Commissioner Dan Belshan discussed transportation concerns, including whether Mayo would cover ambulance costs from the Albert Lea campus to the Austin campus.

Bhagra said the cost would be covered by the health system.

Belshan also questioned whether there would be shuttles available for people without transportation who needed to get to Austin for family members or appointments.

Johnson said they are assessing the need, and there should be more on that issue in the future.

Belshan went on to ask whether the hospital observation beds that are expected to be in place at the Albert Lea campus would be covered like a regular hospital bed by Medicare.

Johnson said this was not a black and white answer and depends on what the patient needs and how long he or she is in observation care. 

Board Chairman Chris Shoff questioned the cost per night in an observation bed, and Johnson again said this would depend on the level of care needed. Shoff said in April that cost was $1,200.

According to the Medicare.gov website, Medicare Part A covers inpatient hospital stays but would not cover a night in observation unless the doctor writes an order to admit the patient as inpatient. The observation services, classified as outpatient, would only be covered by Medicare Part B.

Belshan asked Bhagra and Johnson if they could think of another hospital in Minnesota that serves an area as large as the Albert Lea hospital that doesn’t have birthing services.

“I just feel like we’re so isolated, I feel like we really got the short-end of the stick — hospital beds are leaving, can’t have children here, we need a workforce,” Belshan said.

He questioned whether young families would want to come to Albert Lea without some of the services that are being moved to Austin.

Johnson said many OB/GYN nursing staff and physicians have been difficult to recruit, and the health system will be able to do a better job moving forward by consolidating and having the births in one unit instead of staffing two facilities.

Bhagra said the combined census for Albert Lea and Austin locations is five deliveries per day, and a new graduate wants to stay busy, maintain their skills and see complex cases.

“I want to believe you, but I look at Mankato, New Ulm, St. Peter — they all have hospitals, I believe.” Belshan said. “Mankato and St. Peter, they’re closer together than Albert Lea and Austin.”

He said he thinks keeping a birthing center in Albert Lea would solve 80 percent of the angst with the public.

“When you tell us no more babies, it’s like pulling the rug out,” he said. “You’d be heroes if you guys changed that.”

Shoff said there is research that shows the longer distance a mother has to go to receive care, the higher risk of maternal mortality and asked what the contingency was for mothers who would have to travel further distances to deliver their babies.

Bhagra said the emergency room staff in Albert Lea and Austin are trained to help in situations where a mother would stop at an emergency room in case of inclement weather and noted that many patients have planned C-sections or natural deliveries.

Commissioner Jim Nelson questioned why the birth center couldn’t be in Albert Lea.

Bhagra said to have a standalone OB site without the backup of services available at a hospital site doesn’t work toward patient safety.

The presentation and question-and-answer session went approximately 45 minutes.

Prior to answering questions, Bhagra said the health system has faced challenges in recruiting providers and has sought to battle these challenges with sign-on bonuses, “excellent” salary and benefits, and relocation assistance to help spouses find new employment.

The health system has hired 22 new providers this year. Of those providers, 16 will either have sole or shared responsibility in Albert Lea. Eleven will practice in both Albert Lea and Austin — six will work only in Austin and five will work only in Albert Lea. Three new pediatricians have been hired, along with additional staff for urgent care.

A new MRI and CT scanner valued at $3 million has been installed at the Albert Lea facility that minimizes radiation exposure. The health system has remodeled the Cancer Center and upgraded the cooling system in the campus to make it more energy efficient.

“It is a strong statement for commitment to keep the facilities up to date to provide room for future remodeling expansion,” Bhagra said.

The Naeve Foundation contributed to the Cancer Center upgrades and to observation beds.

The inpatient psychiatric services unit will move to Albert Lea this fall. Renovations have been estimated at over $2 million.

Construction will begin on the birth center in Austin in 2019.

“Looking ahead, I see Albert Lea/Austin as providing complimentary services to the entire region,” Bhagra said.

He noted both facilities provide specialized services — Albert Lea has dialysis services, a hyperbaric oxygen chamber, rehabilitation at Health Reach and the Cancer Center, to name a few.

The Mayo representatives left the meeting after the commissioner questions concluded, prior to the public forum time of the meeting, when three people spoke about the presentation.

Resident Carol Smith asked of the babies delivered in Albert Lea, how many of those needed special care. She also emphasized the importance of family being able to be with their loved ones while in ICU.

“It just doesn’t make sense to be dropping these services,” she said.

Brad Arends, chairman of the Save Our Healthcare organization, thanked the commissioners for hosting the discussion and for asking the Mayo representatives what he called “piercing” questions.

Arends asked the commissioners to also ask questions about the cost of services, noting people in south central and southeastern Minnesota pay significantly higher for routine services, and this ultimately impacts employer costs.