Thursday, October 1, 2026 | St. Lawrence County, NY
BY JIMMY LAWTONNorth Country This WeekOGDENSBURG — More than 300 residents packed the auditorium at Ogdensburg Free Academy Wednesday night, delivering a simple but overwhelming message to state officials and North Star Health Alliance leaders.
Don't close labor and delivery services at Claxton-Hepburn Medical Campus.
The public hearing, required by the New York State Department of Health, centered on North Star's proposal to eliminate labor and delivery services and the nuclear medicine department at Claxton-Hepburn Medical Center while permanently closing primary care clinics in Heuvelton, Hammond, Madrid and Waddington as the organization works through Chapter 11 bankruptcy.
While many of the speakers focused on the point that children and mothers will almost certainly die if North Star moves forward with the decision and that lives can’t be weighed against the bottom line, they also raised tangible questions about NSHA’s ability to ensure continuity of care.
Healthcare workers at neighboring hospitals in Potsdam and Carthage raised real concerns about their own healthcare facilities to take on any additional capacity, noting that their own labor and delivery units were already at capacity.
With the nearest birthing center more than 30 miles away, many questioned how people without transportation in Ogdensburg’s urban setting would make the trip. Similar questions were raised about members of the Amish community who come to Ogdensburg in desperation.
Questions were raised about the county’s ability to fill a new demand on emergency transports in the area. Local volunteer emergency medical services have been critically understaffed in recent years as local EMS squads and fire departments struggle to find volunteers.
Medical professionals at the hearing said that in obstetrics minutes and seconds can mean the difference between the life and death of mothers and children. They said that ending the service line would leave women vulnerable.
Some speakers questioned the alleged $3 million annual loss cited by NSHA alliance, sharing anecdotes about not receiving bills for services for more than two years.
Current obstetrician Dr. Farkad Balaya challenged the financial analysis presented by North Star, saying obstetrics generates revenue across multiple departments including laboratory, imaging and gynecology.
He told officials the solution is to expand the services and get more people through the door, which he said he could make happen.
"You are not just losing OB patients," he said. "You're losing future GYN patients."
Balaya also questioned whether the hospital's financial picture accurately reflects service revenue, noting longstanding billing issues acknowledged by hospital leadership.
During the hearing, residents repeatedly questioned why patients had gone months or even years without receiving bills for medical services.
The hearing followed a rally organized by members of the New York State Nurses Association outside the school, where nurses, elected officials and residents urged state officials to reject the proposed closures before hundreds moved inside for nearly three hours of testimony.
Of the dozens of speakers who addressed hospital officials and Department of Health representatives, virtually every public comment opposed the proposed cuts.
North Star’s take
North Star Interim CEO Andy Manzer acknowledged the emotional nature of the proposals, telling attendees the organization understands the importance of rural healthcare but faces financial realities it can no longer ignore.
North Star filed for Chapter 11 bankruptcy protection in February and has since undertaken extensive restructuring efforts intended to stabilize the organization.
"We are finding traction and do have a path forward to make sure healthcare stays in Ogdensburg, stays in Carthage and stays viable in the North Country," Manzer said. "But we have a lot of work left to do."
He said the proposed reductions are part of efforts to eliminate years of operating losses while preserving as much healthcare as possible.
According to North Star Chief Operating Officer Jerian Odell, labor and delivery operated at nearly a $3 million annual loss while averaging fewer than 10 births per month during 2025.
Odell said maintaining safe obstetrical services requires 24-hour staffing by physicians, nurses, anesthesia providers and pediatric support regardless of the number of deliveries.
She also cited an annual operating loss of more than $800,000 in nuclear medicine following the departure of the hospital's lone technologist and unsuccessful recruitment efforts.
The Waddington and Madrid primary care clinics together lose approximately $400,000 annually, Odell said, while Heuvelton and Hammond have already experienced years of reduced or suspended services because providers could not be recruited.
She said labor and delivery services would remain open while the Department of Health reviews the proposal and that North Star is working with Canton-Potsdam Hospital and other regional providers to develop patient transition plans should the closure ultimately be approved.
Hospital officials said emergency department staff would receive additional obstetrical training and emergency protocols would be developed for women arriving in labor after any closure.
Those assurances did little to ease concerns among healthcare workers, physicians and residents.
Lives over dollars
Speaker after speaker questioned how women experiencing obstetrical emergencies could safely travel 30 to 50 miles on rural North Country roads, particularly during winter weather.
Retired nurse and former EMS provider Robert Bromley warned emergency department staff cannot replace experienced obstetrical teams.
"You can have the training," Bromley said, "but if you don't practice those skills on a regular basis, you're not as adept."
Jessica Thornton, a surgical nurse and local NYSNA leader, said the proposal ignores the realities of obstetrical emergencies.
"When hospital leadership states that patients can simply drive to Watertown or Potsdam, they are demonstrating a lethal detachment from clinical reality," Thorin said.
She described catastrophic complications such as placental abruption and prolapsed umbilical cord, saying mothers and babies often have only minutes before permanent injury or death.
"You cannot perform an emergency C-section in the back of a moving ambulance on black ice," she said.
Longtime labor and delivery nurse Snow Harper Moulton argued declining birth numbers reflected administrative decisions rather than community demand.
She testified that staff repeatedly warned previous hospital leadership patients were being turned away, appointments delayed and limits placed on deliveries long before the current financial crisis.
"Our concerns have felt unheard," Moulton said.
Retired certified registered nurse anesthetist Bob Smith delivered one of the evening's most passionate appeals, telling state officials that obstetrical emergencies often come down to minutes.
Smith, who spent most of his career working in Claxton-Hepburn's operating rooms, said he had witnessed numerous emergency cesarean sections where immediate surgical intervention saved the lives of mothers and babies.
"If they had to spend another five minutes without our help, they'd be dead," Smith said. "You cannot rationalize a budget item over life."
He said removing labor and delivery services would force healthcare workers to watch preventable tragedies unfold while denying women in the North Country the same access to emergency care afforded to other patients.
St. Lawrence County Legislator Rita Curran, a healthcare professional with decades of emergency medicine experience, echoed those concerns, recalling emergency deliveries in hospital parking lots, hallways and elevators throughout her career.
Curran praised Claxton-Hepburn's labor and delivery nurses for responding immediately whenever emergency department staff required assistance and said patient care must remain the priority.
"We can figure out somehow how to staff these units, how to find this money," Curran said. "But we can't explain to people's families why we allowed their mothers to bleed out and die in an ambulance, or why your kid didn't make it."
Former Claxton-Hepburn Chief Medical Officer Dr. Adam Jarrett also urged the state to reject the proposal, arguing financially successful rural hospitals grow services rather than eliminate them.
"We did that by adding programs, not by cutting them," Jarrett said.
He warned that eliminating primary care clinics would further weaken the hospital by reducing patient referrals while stressing that profitable service lines should subsidize essential departments like obstetrics.
Manzer acknowledged the organization continues to face significant revenue cycle problems and said rebuilding billing and collections remains among North Star's highest priorities.
"We still have a $50 million gap to get to break even," Manzer said, noting the organization has already implemented roughly $34 million in annualized financial improvements.
He also defended recent management restructuring, saying millions of dollars in executive compensation have already been eliminated and company vehicles previously provided to administrators have been removed.
Capacity concerns
Aaron O’Neill, a nurse at Canton-Potsdam Hospital and a member of the union’s executive committee, raised concerns about whether the hospital has the capacity to absorb additional labor and delivery patients.
“I just want to let the community know that if you go to our labor and delivery unit, you will find that most of the rooms are filled with two couplets each. So there are four people in every room. How do you think we can absorb these patients? It’s functionally not possible,” O’Neill said during the public hearing.
O’Neill questioned whether North Star Alliance had consulted with hospital leadership before making its decision.
“I wonder if North Star Alliance has spoken to our COO or any of our people to see if we can actually absorb these people before they’ve made this decision. I can’t see a world where that’s a possibility,” he said.
O’Neill also pointed to unfinished expansion plans at the hospital, saying a fourth-floor area that was previously identified for maternity services remains incomplete.
“Last I went up there, there’s no drywall. HVAC is still exposed. There’s no movement at all,” he said, adding that there are rumors the space could instead be converted for additional medical-surgical services.
“In our labor meetings that we have for the union, all of our operational shortcomings come from a lack of square footage,” O’Neill said. “At this time, as a CPH nurse, I can report that we cannot absorb these new patients.”
Emily Etheridge, a nurse at Samaritan Medical Center raised concerns about the potential impact of an influx of patients on Samaritan’s capacity.
“I’m here not only representing my fellow Northern New Yorkers, but also my NYSNA fellow nurses,” Etheridge said during the public hearing. “As a Samaritan nurse, I have grave concerns about the influx of patients we may be receiving.”
Etheridge, who works as a case manager, said she has firsthand knowledge of the hospital’s daily capacity challenges and questioned whether Samaritan would be able to accommodate additional patients.
“You’ve said it yourself in your transition plan. One of the hospitals that is to be receiving your patients is Samaritan,” she said. “I know on a daily basis what our bed census looks like, and I can say that several days a week we are in surge protocol, meaning we don’t have the beds for the patients in the ER who are admitted and holding, waiting for somewhere to go.”
Etheridge urged the state Department of Health to consider the potential impact on patient care.
“I genuinely think that Samaritan is not going to be able to handle the influx of these patients, and I am urging the Department of Health to genuinely consider the risk that these patients are going to be put in,” she said.
Calls for denial
Elected officials from across the region urged the Department of Health to deny the closure request.
Among attendees were Assemblyman Scott Gray, Sen. Mark Walczyk, Madrid Town Supervisor Kevin Finnegan, Waddington Mayor Michael Zagrobelny, Gouverneur Mayor Ron McDougall and multiple members of city council including Mayor Michael Tooley, Dan Skamperle, Donna Trimm and Jennifer Stevenson.
County Legislators David Forsythe, Jim Reagen, Rita Curran and Joseph Lightfoot were also in attendance.
Ogdensburg Deputy Mayor Jennifer Stevenson said the loss of healthcare services would further accelerate population decline and make the city less attractive to families and employers.
City Councilor Dan Skamperle called the proposal "unconscionable," arguing rural poverty and transportation challenges make comparisons to urban healthcare unrealistic.
"This should not be based on money," Skamperle said. "It should be based upon the stories that we're hearing tonight."
County Legislator Jim Reagen said the area has already seen closures of maternity and delivery services in Gouverneur and Massena.
"Now, they've come for us,” he said.
Other speakers raised concerns about increased strain on emergency medical services, neighboring hospitals already operating at or above capacity, the impact on Amish and low-income families lacking transportation, and the long-term viability of attracting young families to the region.
Throughout the evening, Manzer acknowledged many of the concerns raised by residents and said no final decision has been made.
"There is not a silver bullet to solve this problem," he said.
The Department of Health will now review testimony from Wednesday's hearing along with written public comments before deciding whether to approve or deny North Star's closure plan. Written comments will be accepted through Aug. 5 before the state begins evaluating the hospital's formal closure proposal, a process expected to take approximately 90 to 120 days.
Those interested in providing comment can do so at communityfeedback@nshany.org or by mail to North Star Health Alliance, Attn: Administration, 214 King St., Suite C, Ogdensburg, NY 13669.
