Labor And Delivery Center At Johnson Memorial Hospital To Stay Closed

STAFFORD, CT — Johnson Memorial Hospital will be allowed to keep its labor and delivery center closed but must now fund a study by an independent group to explore a stand-alone outpatient service option.

That study will determine if the out-patient facility is feasible or that it can't be done. The latter would force the hospital to go back to in-patient offerings.

The decision angered at least one lawmaker — State Sen. Jeff Gordon — who said he was "not happy at all with the process and outcome."

The Connecticut Office of Health Strategy Thursday said that it has reached an agreement with JMH and parent Trinity Health designed to "prioritize maternal and infant health and study the need for a new birthing center in the hospital's service area." The OHS issued a "proposed" final decision in January denying the hospital’s certificate of need application requesting to terminate labor and delivery services. Johnson Memorial Hospital opposed that proposed decision and OHS heard oral arguments on the matter in March.

OHS officials said they have "worked collaboratively with" officials from Johnson Memorial Hospital and Trinity Health of New England since March to reach an agreement regarding labor and delivery services.

Here's the summary offered by OHS Commissioner Deidre Gifford:

"We are committed to prioritizing appropriate community access to high quality, affordable maternal and infant health services. This agreement permits termination of labor and delivery services at the hospital but holds Johnson Memorial Hospital accountable to the community they serve and to the state of Connecticut for maintaining access to all levels of maternal and infant health care. If an independent analysis indicates that a free-standing birthing center in the area is viable, then Johnson Memorial will need to ensure that one is built.”

The agreed settlement requires the hospital to take several additional measures to "ensure access to labor and delivery services and maintain prenatal and post-partum care in the community." The agreement requires JMH to:

• Engage an independent third party to assess the need for and feasibility of establishing a birthing center in the hospital’s service area
• Support the establishment of a birthing center and coordination of care with that center, should those services be identified as needed and feasible
• Maintain all prenatal, postpartum and wraparound services and staffing levels currently provided by the hospital including lactation consulting and patient and infant wellness, as well as provide support with access to supplemental resources including SNAP/WIC and the Diaper Bank
• Advise all pregnant patients in the hospital’s service area of the birthing options available to them
• Provide emergent and non-emergent transportation to "any birthing person and their support person" to any hospital of their choosing with a 50-mile radius for labor and delivery services at no cost to the patient or support person
• Provide emergency deliveries in the Johnson Memorial Hospital Emergency Department when necessary
• Support continued recruitment and professional development of certified nurse midwives in outpatient venues and commit to establishing a doula training and certification program should the Department of Public Health establish criteria for the certification of doulas in the next five years
• Support the establishment of a birthing center and coordination of care with that center should those services be identified as needed and feasible

The agreement also requires Johnson Memorial Hospital to report aggregate data on outpatient prenatal services and pregnant patients presenting at the hospital in active labor annually and maintain a community member representing the interests of women on a Community Advisory Council.

Said Gordon, "I was made aware today on short notice of OHS's negotiated settlement agreement with Johnson Memorial Hospital about not re-opening inpatient labor and delivery. I am reading through the detailed agreement that was just made public. I have spoken with Dr. Gifford of OHS. I am reaching out to town officials, fellow legislators, and the hospital leadership.

"As a doctor and state senator, I've fought to preserve Johnson Memorial Hospital’s labor and delivery services in our region. These services are vital to expectant mothers and families who cannot otherwise access this care or easily be transported elsewhere in emergencies. These were key points of concern that I previously raised. I am disappointed by the negotiated settlement and that the public, town officials, and legislators were not included in the decision-making process.

"I will continue to do what I can to ensure that appropriate and timely services are provided, including what must be done to bring about a standalone birthing center in the region per the settlement agreement, or if the hospital must re-open labor and delivery if a birthing center cannot be created."

The JMH closing is just the latest blow to those expecting in the region. Windham Hospital stopped servicing births in 2020 and, a decade earlier, a state-of-the-art and practically new birthing center was closed at Rockville General Hospital.

Said state Rep. Tammy Niccio:

"The closure of Johnson Memorial Hospital's labor and delivery unit is a massive loss to families
in our community, especially in rural areas where access to essential healthcare is already
limited. This decision prioritizes cost-cutting over the well-being of expectant mothers
and newborns who will now have to drive farther to receive critical care at the most important
time. And I would really like to know, why was an agreement that will create a void in patient
services finalized without input from lawmakers, outside health experts, or the public, who will
be impacted by this decision? We have to continue to fight to preserve access to these critical
services, ensuring families in our towns can receive the quality care they need close to home and
I have multiple questions about how this agreement was reached."

The full agreement with Trinity and JMH has been posted to the Office of Health Strategy Certificate of Need Portal under docket number 22-32612-CON.

According to the OHS, Johnson Memorial Hospital separately faces a civil penalty (under docket 21-32486-CON). The OHS issued the Notice of Civil Penalty on June 29, 2022 citing the hospital's failure to resume labor and delivery services, despite the expiration of a temporary waiver granted during the COVID-19 pandemic.

The OHS issued a proposed final decision for a civil penalty of $153,000 on Feb. 14, 2024, and heard oral argument from Johnson Memorial Hospital on May 29, 2024. The Civil Penalty docket is still pending, and the agreed settlement does not alter the status of that docket, according to the OHS.