Why is Legacy Health filing a waiver to seek approval to close the Family Birth Center?

Did Legacy try to find other doctors to keep the Family Birth Center operating?

Is there any way to keep the Mount Hood Family Birth Center operating?

What is the State of Oregon's role in this process?

When will the Oregon Health Authority make a decision on the waiver?

Did the community donate money to build the Mount Hood Family Birth Center?

Where will East County patients deliver their babies?

What happens if a pregnant patient arrives with an emergency situation?

Will the diverse populations served by Mount Hood’s Family Birth Center be able to receive quality and equitable care?

How will Randall Children’s Hospital meet the needs of diverse patient populations who live in East County?

What is Legacy doing to address racial disparities in maternal mortality?

What women’s services will Mount Hood offer?

What other options for delivery are there for pregnant people in the area?

Who seeks care at Mount Hood and its Family Birth Center?

How many babies are born at Mount Hood each year ?

What does this mean for health care in Gresham and East County?

Is there capacity at Randall to serve patients from East County?

How do I learn more about the Family Birth Center at Randall Children’s Hospital?

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Frequently Asked Questions & Answers

Why is Legacy Health filing a waiver to seek approval to close the Family Birth Center?

• Legacy did not plan to file a waiver with the Oregon Health Authority to close the Family Birth Center. Our goal was to transition the center to a new care model that continues to deliver safe, quality care in a new, financially viable model.

• In the aftermath of the pandemic, hospitals nationwide are facing a financial crisis driven by rising costs, short staffing and patient backlogs.

• At Legacy Health, we have had an unsustainable trend of operating losses that requires us to take urgent action.

• As we reviewed our operations across our six hospitals, the Mount Hood Family Birth Center stood out because of its low volume of births coupled with an unusually high-cost care model that required 24/7 staffing by an obstetrics doctor.

• 24/7 staffing with obstetrics doctors is generally employed at high-volume birth centers with at least 1,500 annual births.

• Mount Hood is a low-volume birth center with 700 to 1,000 births per year since 2017.

• Among the general service Family Birth Centers in the Portland-Vancouver-Salem region with a 24/7 obstetrics care model, Mount Hood was the smallest in terms of the number of annual births. The next smallest was more than double the size of Mount Hood in annual births.

• Over the past several months, Legacy and our doctors at the Family Birth Center evaluated other approaches to our model of care.

• Unfortunately, we could not identify a model that met all the criteria for Legacy and our providers.

• While we evaluated other approaches, we saw an unanticipated number of staffing vacancies and voluntary departures at the Family Birth Center.

• As a result, we had to make the difficult decision to file a waiver with the Oregon Health Authority to request their approval to close the Family Birth Center.

Did Legacy try to find other doctors to keep the Family Birth Center operating?

• Yes. We explored all options to keep the Family Birth Center in operation.

• We explored the possibility of hiring temporary doctors, known as locums. However, the cost, timing and availability of recruiting and onboarding locums would not have made it possible to keep the center open within a safe, financially viable care model.

Is there any way to keep the Mount Hood Family Birth Center operating?

• Unfortunately, we currently do not have any options to keep delivery services operating at the Family Birth Center. 

What is the State of Oregon’s role in this process?

• The Oregon Health Authority oversees the licensing of hospitals.

• We filed a waiver request with the Oregon Health Authority on March 6 to seek the state’s review of our plan to close the Family Birth Center.

• On March 13, the Oregon Health Authority sent Legacy a request for additional information.

• On March 17, Legacy submitted responses to the Oregon Health Authority’s questions.

When will the Oregon Health Authority make a decision on the waiver?

• We expect that the Oregon Health Authority will need several weeks to complete its review.

• After March 17, we will have no new elective admissions at the Mount Hood Family Birth Center.

• We will essentially operate on divert status for labor and delivery while the Oregon Health Authority is reviewing our waiver request.

• All scheduled deliveries will move to the Family Birth Center at Randall Children’s Hospital at Legacy Emanuel.

• Pregnant people who arrive at Legacy Mount Hood with a pregnancy-related care need will be seen by a provider and then transferred to Randall Children’s for further care.

Did the community donate money to build the Mount Hood Family Birth Center?

• Legacy, like other nonprofit organizations, conducts fundraising campaigns to support investments made by the organization to build or expand services.

• There was a fundraising campaign in the early to mid-1990s to provide an opportunity for donors to make contributions in support of the Family Birth Center.

Where will East County patients deliver their babies?

• After March 17, Legacy’s labor and delivery services for East County patients will be available at the Family Birth Center at Randall Children’s Hospital in North Portland.

• That means that all pregnant patients with the Legacy Medical Group Mount Hood Women’s Health clinic can deliver at the Family Birth Center of Randall Children’s Hospital.

What happens if a pregnant patient arrives with an emergency situation?

• Pregnant patients who arrive at Mount Hood with an emergency situation related to their pregnancy will be evaluated by our care teams and stabilized so they can be safely transferred to Randall or another hospital with a labor and delivery unit.

• Pregnant people seeking care for a non-pregnancy-related concern will be treated at Mount Hood’s emergency department.

Will the diverse populations served by Mount Hood’s Family Birth Center be able to receive quality and equitable care?

• Yes, East County residents will continue to have access to quality and equitable care, but it will look a bit different.

• Across our system of 14,000 employees, eight hospitals and 70 clinics, Legacy is on a journey to deliver equitable care for diverse patient populations. Some departments and locations are more advanced in the journey than others.

• Through education, training and process improvements, we are addressing workforce diversity challenges and racial disparities in care.

• We are continuing our work to recruit and retain a workforce that represents the ethnic and racial diversity of our community to deliver culturally competent care.

How will Randall Children’s Hospital meet the needs of diverse patient populations who live in East County? 

• Randall Children’s Hospital and the Emanuel Medical Center campus, where it is located, have served patients representing diverse racial/ethnic groups, family types, immigration statuses, and income levels for decades.

• Randall specializes in low-risk and high-risk pregnancies.

• The Randall birth center and women’s health services on the Emanuel campus offer more bilingual caregivers and on-site Spanish interpreters than any other hospital campus in the Legacy system.

• We are working now with our staff and community partners to inform and educate the diverse populations we serve about the changes at Mount Hood. 

What is Legacy doing to address racial disparities in maternal mortality? 

• The most effective way to decrease racial disparities in maternal mortality is to have a standardized approach to obstetric care to quickly identify and treat high-risk complications.

• Clinical and non-clinical leaders are being educated about all the areas in the care continuum where racial bias is impacting maternal mortality so interventions and trainings can be appropriately implemented.

• Leaders in Women’s Services and the DEI department are working with grant writers to implement evidence-based trainings for care teams to see and stop bias and the inconsistent application of standards of care for patients of color. 

What women’s services will Mount Hood offer?

• While Mount Hood will stop delivering babies, we will continue to offer outpatient women’s health services at Mount Hood.

• That means pregnant people will continue to receive care in their community at Mount Hood before and after their delivery, also known as prenatal and postnatal. That care will be provided by Legacy’s midwives and obstetrics and gynecology doctors.

• We will work with East County providers to ensure outpatient care for babies and children is established in East County clinics.

• We will expand Legacy Medical Group gynecology services, such as annual women’s visits, and gynecology surgery, such as hysterectomy.

• We will also establish high-risk pregnancy outpatient care on our campus, also known as maternal fetal medicine.

What other options for delivery are there for pregnant people in the area?

• Pregnant people in East County have access to five birth centers within a 30-minute drive from Mount Hood: OHSU Adventist Health Portland, Providence Portland Medical Center, Providence Willamette Falls, Kaiser Sunnyside Medical Center and Randall Children’s Hospital at Legacy Emanuel.

• About 85% of all births for East County residents already take place at one of these five hospitals.

• Legacy also continues to offer women’s services across our hospitals and clinics, including the state-of-the-art Family Birth Center at Randall Children’s Hospital that opened in 2021

Who seeks care at Mount Hood and its Family Birth Center? 

• Mount Hood, a community hospital, serves a population of about 275,000 people who live in the east metro area communities. Its service area includes Boring, Estacada, Fairview, Gresham, Sandy, Troutdale, Wood Village. 

• Among the east metro population, about 65% are white, 8% are Asian and 5% are Black. About 17% identify their ethnicity as Hispanic.

• What’s important to know about is that 85% of babies born to pregnant people living in this service area deliver at a hospital other than Mount Hood, according to data captured by Apprise Health Insights, a subsidiary of the Oregon Association of Hospitals and Health Systems.

• In 2022, the racial demographics among patients at the Mount Hood Family Birth Center are: 61% white, 7% Black or African American and 5% Asian. About 23% identify their ethnicity as Hispanic. 

How many babies are born at Mount Hood each year? 

• About 750 babies were born at Mount Hood in 2021, the most recent complete year when data are available. The total number of births at Mount Hood fell 17% from 2019 to 2021.

• Mount Hood has the lowest number of annual births among the 10 general service Family Birth Centers in the Portland-Vancouver-Salem region that offer 24/7 staffing by obstetrics doctors.

• Mount Hood has about one-third of the number of births compared to the average among the other nine birth centers who offer 24/7 staffing by obstetrics doctors. 

What does this mean for health care in Gresham and East County?  

•  Legacy Health is committed to serving our communities in East County. Most of Mount Hood Medical Center’s staff, providers and leaders are members of this community.

• We will continue to invest at Legacy Mount Hood Medical Center to serve the unique characteristics of our community where the 45 and older population is expected to grow fastest.

• In addition to our commitment to provide essential obstetric and gynecologic care to our community, we will focus on cancer treatment, cardiology, gastroenterology, musculoskeletal, neurosurgical, primary care and robotic surgeries.  

Is there capacity at Randall to serve patients from East County? 

• Yes. Randall Children’s Hospital at Legacy Emanuel has capacity to welcome East County families to deliver their babies. Randall is Oregon’s most complete, state-of-the-art Family Birth Center.

• Randall offers a team of medical experts to handle any situation, from low-risk pregnancies to high-risk births and has the highest designated neonatal intensive care unit in Oregon and Southwest Washington.

• Randall’s diverse workforce and team of providers are also well prepared to provide culturally competent care for East County’s diverse population. They employ more staff who are approved through Legacy’s Bilingual Competency Program and have two on-site Spanish interpreters. 

• At Randall’s Family Birth Center, we have hired 18 additional nurses and tech staff who start in March and April to support the expected increase in deliveries.

How do I learn more about the Family Birth Center at Randall Children’s Hospital?

• You learn more on the Randall Family Birth Center website.

• You can register for an in-person tour of Randall’s Family Birth Center now on our website.