Underwood Urges Illinois Health Facilities and Services Review Board to Allow McHenry Hospital to Continue to Serve the 14th District

Read the original letter here or republished below.

To the Illinois Health Facilities and Services Review Board:

I write regarding the pending application for exemption to discontinue the 23-bed obstetric care category of service at Northwestern Medicine McHenry Hospital (McHenry Hospital). As the Board reviews this application, I urge you to take into consideration all available data related to the impacts of obstetric service discontinuations to ensure your decision on the exemption application will optimize maternal health outcomes in McHenry County and the surrounding area. The Board's decision must uphold the fundamental principle that every Illinoisan in every community across our state – whether rural, urban, or suburban – needs and deserves access to high-quality maternal health care and robust support during pregnancy, throughout labor and delivery, in the postpartum period, and beyond.

Because federal health program beneficiaries seek care at McHenry Hospital, Northwestern Medicine is a recipient of federal funding through multiple channels, such as direct payments from the Centers for Medicare and Medicaid Services and additional emergency federal funding during the COVID-19 pandemic. As a Member of Congress, it is my responsibility to ensure that recipients of federal funds are using these resources as efficiently as possible, to the greatest possible benefit of our community.

The decision to discontinue obstetric care services at McHenry Hospital comes in the midst of a maternal health crisis impacting Illinoisans and Americans across the country. The United States has the highest pregnancy-related mortality rate of any high-income country and the majority of these deaths are preventable. Black and Native Americans are two to four times more likely to die from pregnancy-related causes than white Americans. Hispanic and Asian American and Pacific Islander (AAPI) people also experience disproportionately high rates of maternal morbidity and mortality. In Illinois, maternal mortality rates are rising and persistent racial and ethnic disparities in outcomes remain. In Illinois, maternal mortality rates are rising and persistent racial and ethnic disparities in outcomes remain.

While the causes of the maternal health crisis are numerous, a significant driver of adverse maternal health outcomes is a lack of access to care. According to the U.S. Health Resources & Services Administration (HRSA), the loss of accessible obstetric services and increased distance to travel to care has been associated with "increased risk of non-indicated induced Cesarean section (which can lead to more complications), postpartum hemorrhage, prolonged hospital stay, and/or postpartum depression."

HRSA's data on maternal health care access and outcomes are consistent with peer-reviewed studies conducted in recent years, which have produced similar findings. One study found that a loss of hospital-based obstetric services is associated with an increase in births in hospitals without obstetric services as well as low prenatal care use. Pregnant patients who go through labor and delivery in hospitals without obstetric services are exposed to a "greater risk of morbidity, mortality, and poor infant outcomes." Low prenatal care use is associated with greater risk of adverse maternal and infant health outcomes as well: pregnant individuals who do not receive prenatal care are three to four times more likely to die from pregnancy-related complications than those who receive care. Furthermore, infants born to mothers who do not receive prenatal care are three times more likely to have a low birthweight and five times more likely to die in infancy than infants born to mothers who receive care.

Given the maternal and infant health risks associated with births in hospitals without obstetric services and low prenatal care use, it is critical that Northwestern Medicine provides detailed information about the steps the health system is taking to ensure pregnant patients are able to deliver their babies in facilities with obstetric services and receive prenatal care consistent with clinical guidelines.

According to Northwestern Medicine, obstetric care currently provided at McHenry Hospital will "transition to Northwestern Medicine Huntley Hospital (Huntley Hospital)" pending regulatory approval. To assess whether patients who would have previously received prenatal care or given birth at McHenry Hospital will be able to access Huntley Hospital without prohibitive barriers, Northwestern Medicine must provide independently verifiable and publicly accessible data demonstrating the projected impacts of the obstetric care services discontinuation at McHenry Hospital on the time and distance that patients will need to travel to get to Huntley Hospital.

These data must be as geographically granular as possible, assessing the impacts of the transition of obstetric care services on patients in each part of McHenry County, western Lake County, and the surrounding area from which people currently seek obstetric care at McHenry Hospital. The data should also be disaggregated by demographic information like race, ethnicity, language, income, family structure, and employment status. Northwestern Medicine must be completely transparent about all the relevant data the health system has collected to justify the discontinuation of obstetric services at McHenry Hospital and ensure the public has access to these data to the fullest extent possible.

Northwestern Medicine must also provide specific and detailed information about the health system's plans to address access barriers for low-income pregnant patients and others lacking reliable transportation options or related challenges. These plans must be developed in coordination with and supported by community members and stakeholders, who have the most in-depth understanding of the effects that the obstetric service discontinuation at McHenry Hospital will have on local residents broadly and on our most vulnerable neighbors specifically.

As you review Northwestern Medicine's application for exemption, I urge you to consider the implications of this decision for the thousands of residents in McHenry County and Lake County who rely on McHenry Hospital as the nearest site for their inpatient health care needs. McHenry Hospital, ranked as one of the best hospitals in Illinois, is an essential part of our community, including for all the pregnant people who receive obstetric care at the facility. The consequences of the decision that the Health Facilities and Services Review Board must make are significant. It is essential that your decision is informed by robust data, complete evidence, and thorough stakeholder engagement.

If you have any questions about the issues I have raised, please do not hesitate to contact my staff at Jack.DiMatteo@mail.house.gov. Thank you for your attention to this matter and for your work to ensure that every Illinois community has access to high-quality health care.

Sincerely,

Congresswoman Lauren Underwood