NEWS UPDATE FROM STATE REPRESENTATIVE DAVID GOMBERG: Some Non-Legislative Thoughts

By Representative David Gomberg, House District 10

Dear Friends and Neighbors,

I thought I’d offer readers a legislative break this week and turn to news I’m seeing outside the Capitol.

Earlier this year, I wrote about our coastal hospitals and the financial challenges faced by Samaritan Health Services (SHS), a non-profit, integrated delivery healthcare system consisting of five hospitals in Corvallis, Newport, Lincoln City, Albany and Lebanon. Samaritan is one of the 10 largest non-profit employers in the State of Oregon with nearly 7,000 employees and volunteers.

An article in the Lincoln Chronicle (formerly Yachats News) provides some insight into our health care environment and the economics of hospital care. Samaritan Pacific Communities Hospital in Newport and Samaritan North Lincoln Hospital in Lincoln City are financial bright spots in the five-hospital system. The two local hospitals don’t keep their profits, however. The Samaritan system’s finances are pooled, with profits from some facilities and services covering money-losing services or going into reserves for capital projects.

The system’s two big hospitals, Good Samaritan Regional Medical Center in Corvallis and Samaritan Albany General Hospital, typically lose money or break even. The Corvallis hospital has reported operating losses totaling $8 million for the first half of this year, on top of losses totaling $54 million the previous two years. Profits from the system’s three smaller hospitals – Samaritan Pacific in Newport, Samaritan North Lincoln Hospital in Lincoln City, and Samaritan Lebanon Community Hospital, have covered those losses.

Samaritan Pacific Communities Hospital and Samaritan North Lincoln Hospital are helping cover losses throughout Samaritan Health Services five-hospital system.

The Newport hospital’s financial performance has been strong for many years. Samaritan Pacific, with 25 beds, made a profit of $23 million in 2023. North Lincoln Hospital, which has 16 beds, made $2 million in 2023.

I’m writing about our hospitals again because I’m hearing concerns that Samaritan is considering cost-saving measures that could affect patient care and service availability across our district. For example, if – and I emphasize IF – birthing services are eliminated in Lincoln City, women going into labor may have to travel to Newport or Salem. Emergency support that requires anesthesia or surgery may require transport to another hospital.

I reached out to Samaritan Health Services, and they assured me the public will be able to participate in ongoing discussions.

“SHS, like so many hospitals in Oregon and across the country, have faced many challenges post-COVID ranging from talent acquisition to seeing sicker patients to financial challenges. In 2024, SHS developed and implemented cost-savings measures that helped move them toward sustainability. Although these efforts are helping, the health care environment landscape continues to shift and SHS needs to shift with it.”

“Groups of Samaritan clinicians and administrators have been meeting to brainstorm ideas on how to continue to serve our communities while being responsible stewards of our resources. No decisions have been made as of yet. As new ideas and strategies are formed, SHS is committed to engaging with local communities including SHS’ local boards first and leadership groups like medical directors and managers, to review and refine our approach. SHS will advance this work deliberately and carefully over the next few months. If decisions are made to advance any new approaches, there will be planned time for additional discussion including welcoming community input and thoughts regarding the impact and viability of such proposals prior to any decisions regarding implementation.“

“SHS’ mission of building healthier communities together is paramount to our thinking as we strive to find solutions that provide the highest quality care to our communities.”

I’m proud of our two new hospitals in Lincoln City and Newport. I’m proud of the communities that helped build them, the people who work there, and the service they provide. Our two hospitals in Lincoln County, with 1,000 employees, try to provide the best short and long-term medical care possible in an economically disadvantaged rural area of the Oregon coast.

But I am also cognizant that coastal residents who need health support often have to go to the Valley to get it.

Overall, Oregon hospitals are facing problems with increasing costs and declining reimbursements.

The South Coast’s largest hospital, Bay Area Hospital in Coos Bay, is struggling.

At the same time, three of the state’s largest hospitals reported large losses in 2024: Providence Portland ($86.2 million), Legacy Emanuel ($85.6 million), and Salem Hospital ($50.8 million). Collectively, Oregon’s 60 hospitals made just $50.5 million in 2024, about one-tenth of their average profitability in the decade prior to the pandemic.

In a report last week, the Hospital Association of Oregon, an industry trade group, painted a bleak picture. The reports show that post-COVID revenues are rising as business picks up at most Oregon hospital systems. But costs, especially pay for practitioners and nurses, are also up sharply. As a result, many Oregon hospitals’ expenses continue to outstrip operating revenues. You can read specifics about each of our largest health providers here.

Reimbursement rates from all types of insurers — Medicare, Medicaid, or commercial insurers — are lagging.

Hospitals want increased reimbursement rates for low-income patients on the Oregon Health Plan (OHP), which covers roughly a quarter of Oregonians. OHP, Oregon’s version of Medicaid, is funded by federal and state taxes and controlled by federal and state officials and regional insurers. At many Oregon hospitals, from a quarter to a third or more of patients are on the OHP.

Oregon policymakers and health care leaders still need to address two other problems: how to increase the supply of health care workers, and how to create more post-hospital care facilities, such as rehabilitation or nursing facilities.

Once a patient is medically fit to be discharged from a hospital, the insurer cuts its reimbursement rates, even if the patient must remain at the hospital, occupying a hospital bed, simply because there is no space available at a rehabilitation facility. The large number of patients who are waiting for discharge but have no place to go, either because there are no beds in less acute medical facilities or no suitable accommodations at home, drives costs up. The hospital association says the cost of holding those patients beyond their discharge dates totaled $324 million in 2024.

Healthcare is complicated, sometimes elusive, increasingly expensive, and absolutely consequential to those of us living across the 10^th Legislative District. I’m no expert. But these changes and challenges mean I need to learn more, and fast! Across our part of Oregon, a third of our residents are over 65. In Lincoln County, 25% of patients are on Oregon’s Medicaid program for low-income residents, and 50% are on Medicare for the disabled or retired.

As the 2025 legislative session unfolds, questions about hospital mergers, reimbursements, staffing and federal support continue.

With the deadline for most policy bills behind us, and budget decisions waiting for a revenue forecast in two weeks, some legislators are describing early May as a slower time in our fast-paced legislative process. Not so in my office!

We have been focused in recent sessions on infrastructure funding – a fancy term for getting money for necessary stuff like water, sewer, ports, and parks. Most of us in Salem believe the available funds detailed in the looming revenue forecast will be flat or even decline. I’m watching tariffs, federal layoffs, funding cuts, and the volatile stock market, and I just can’t see how any of that will improve the Oregon economy in the coming year. At the same time, much of our infrastructure money comes from bonds financed through the Oregon Lottery. That money will be available, and competition is expected to be fierce!

I often say that small towns can’t afford big projects and need state or federal help to cover costs. Hundreds of proposals submitted paperwork for Capital Construction funding. The next step in the process will be a public hearing where applicants take turns to pitch their priorities in just 90 seconds. It is high stakes and high drama.

Our office works with each applicant from our district to make sure they understand the paperwork and the process. Sometimes we help craft their script. I told some folks this week that their appearance will not increase their odds of receiving money. But not appearing will definitely diminish them.

The Capital Construction hearing is likely scheduled for May 9 at 1 pm.

Back in 2023, I voted to expand self-service gasoline in Oregon. The change was carefully crafted to ensure full service was available to those who wanted or needed it and at the same price as self-serve. Stations are required to have at least one person available to pump fuel for anyone asking for full-service.

Most stations comply with these requirements. But two years after self-service became the norm, I’m frustrated to increasingly see stations not providing a full-service option. Self-service isn’t hard for most of us. But that isn’t the point. Some people do have problems pumping their own. Some prefer not to. And sometimes the weather is so daunting, you’d rather have the help. The law says that help must be available.

Learn more about full and self-service options here.

I recently stopped at a local station and saw a disabled man get out of his car, hop to the pump on his one leg, and fill his tank after waiting several minutes for help. He left before I could offer assistance, so I went inside the station and found three employees chatting at the cash register….

What this station needs to understand is that it risks fines and possibly a lawsuit.

All gas stations are subject to the Americans with Disabilities Act (ADA) and Oregon law, which requires equal access to fuel for people with disabilities. Any gas station with an attendant or other employee on duty must provide refueling assistance to customers with disabilities.

The Oregon State Fire Marshal’s Office is responsible for monitoring compliance with the state’s self-serve gas law and receiving complaints. This office can also apply civil penalties for violations. Contact them at ask.osfm@osfm.oregon.gov or 503-378-3473.

Again, the law allows self-service in Oregon’s 16 most populous counties. It requires that no more than half of the pumps at any service station be self-serve, and that at least one gas station employee in those communities be available at all times to pump gas. Stations cannot charge more for full-service.

In 20 less populated counties, self-serve gas is allowed at all hours. These counties include Baker, Clatsop, Crook, Curry, Gilliam, Grant, Harney, Hood River, Jefferson, Klamath, Lake, Malheur, Morrow, Sherman, Tillamook, Umatilla, Union, Wallowa, Wasco, and Wheeler.

As busy as the legislative week was in Salem, the weekend at home seemed even busier!

Friday morning, I was in Salem for a Ways and Means Committee meeting. From there, I drove to Eddyville for the groundbreaking of a new East Lincoln County Fire Hall. Back in 2021, I worked to secure $4 million in funding for this critical resource, and I was pleased, at long last, to see work start. Certainly, it is important to shift emergency services out of the tsunami zone so they can be active and engaged when the “Big One” arrives. But I also observed that we have changed Highway 20 from a slow, twisty, dangerous highway into a straight, fast, dangerous highway. Accidents occur too often. Relocating emergency response to Eddyville will reduce response times and certainly save lives.

Friday evening, I was pleased to MC the Grand Welcome Piano Benefit at the Lincoln City Cultural Center. The goal was to raise funds and complete the purchase of a new grand piano to replace the original instrument that had been declared “musically dead.” A lively crowd was on hand to see – or hear – the wonderful new Yamaha C3 and listen to a variety of jazz and classical performances. The generous crowd must have been impressed because the mission was accomplished, and the piano is now wholly owned and paid for by the LCCC.

Early Saturday, I drove to Philomath for the monthly Benton County Legislative Breakfast with commissioners, mayors and councilors, department heads, educators, and OSU. These are regular gatherings to update local leaders on the session, and I was pleased to join Senator Sara Gelser-Blouin and Representative Sarah Finger McDonald there. Afterward, I traversed Highway 20 to Newport in time for the Loyalty Days Parade. This is the parade season kick-off with more parades to follow in Waldport, Philomath, and on July Fourth, with a choice between Yachats and Gleneden Beach. Usually, I ride my small bicycle in these pageants, but this year in Newport, I opted to share a ride with Mayor Jan Kaplan. Saturday evening, I returned to the Cultural Center in Lincoln City for the Grand Bazaar fundraiser.

I’m back in Salem today and with new responsibilities to help review the behemoth ODOT budget, looking for reductions and efficiencies.

As gasoline taxes decline, Oregon is considering a series of revenue-raising ideas. Those include increasing gas taxes, charging electric vehicles for the miles they drive, and increasing registration fees. During difficult economic times, none of those options are attractive. But they may be necessary to maintain road safety.

Before we increase taxes, the legislature needs to look at how to reduce costs. House Republicans have proposed several “belt-tightening” ideas that would cut funding for mass transit and for repairs and upgrades to bike, pedestrian, and rail infrastructure, or efforts to make projects socially equitable and climate-friendly. Another suggestion would lease out 70,000 square feet of office space in the ODOT Salem headquarters.

Some of these proposals are worth looking at. Others are easy suggestions, but not particularly good ideas. I’m looking for hard answers to tough budget questions and will be spending days and nights in the coming weeks to find efficiencies before we consider higher costs for you.

I hope and trust your coming weeks will be more fun!