Brattleboro considers tax-funded help for hospital birthing center as state urged to act

A memo was presented outlining a possible one-time municipal contribution somewhere between $100,000 and $1 million.

Brattleboro leaders are looking at whether town residents should be asked to help keep Brattleboro Memorial Hospital’s birthing center open, even as a coalition of medical organizations presses the state to raise Medicaid payments instead.

The five-member Selectboard voted unanimously Tuesday night to examine a special Town Meeting that could be held as soon as September. Town Manager John Potter presented a memo outlining a possible one-time municipal contribution somewhere between $100,000 and $1 million, though no specific amount has been set. Selectboard Chair Oscar Heller said the concept being discussed would be a special assessment rather than an added cost built into future budgets.

Any local tax increase would come on top of growing concern about the hospital’s finances. Brattleboro Memorial Hospital said July 1 that it could shut down obstetric services within six to nine months if it cannot offset an expected $4.8 million loss in the unit this fiscal year. The hospital is also facing a projected $14.5 million overall budget deficit after recent leadership turmoil.

On Wednesday, the hospital said its birthing center’s problems reflect broader pressures on rural hospitals, including low reimbursement for obstetric care, fewer births and higher expenses. It said the situation calls for both short-term help and longer-term policy changes.

Meanwhile, seven medical groups representing 3,000 Vermont clinicians have asked Gov. Phil Scott and the Agency of Human Services to act quickly by increasing Medicaid reimbursement for obstetric services to match what is paid for other primary care. The groups said Medicaid covers nearly half of births in Windham County, a share above the statewide average of 36.9%. The state said Tuesday afternoon that it had received the letter but had not yet responded.

Brattleboro Memorial Hospital is the only Vermont hospital offering obstetrical services in Windham and Windsor counties. The nearest alternatives are in New Hampshire, at Cheshire Medical Center in Keene and Dartmouth Hitchcock Medical Center in Lebanon.

The hospital said Wednesday that it appreciated the selectboard’s willingness to consider municipal support and that it continues to seek a wider solution involving state aid, philanthropy and other funding sources.

Not everyone at Tuesday’s meeting supported the idea of raising taxes for the hospital. Some residents said the hospital itself had acknowledged that one-time grants would not solve the underlying funding gap. Others argued that Brattleboro has major needs of its own, including infrastructure repairs and expensive replacements for the public works garage and public swimming pool.

Former Selectboard Chair Dick DeGray said the town should first study the issue more carefully and suggested that the debate had become emotional rather than practical. Real estate agent Susan Bellville urged officials to seek contributions from the 21 other towns in Vermont, New Hampshire and Massachusetts that use the facility.

Residents’ unease over local taxes has been building for some time. Last year, Brattleboro rejected a municipal budget for the first time in Town Meeting history, turning down an initial $25 million plan that would have raised taxes 12.1%. This spring, voters approved the current budget only after a lower-tax alternative was also considered, resulting in a 6.3% increase.

The selectboard has not yet announced another meeting on the hospital issue, though members said they could return to the topic as soon as next week.