OBSERVER Photo Katy Schwalbe speaks about the decreasing numbers of hospitals and beds across New York state on Tuesday.

For Katy Schwalbe, the issue regarding whether a new Brooks-TLC Hospital System will be built hits close to her native town. As one of the presenters at the community forum on Tuesday night at the Northern Chautauqua Catholic School, she was born at the current Dunkirk location.

“It’s really exciting for me to come to my home community about what’s going on,” said Schwalbe, who works out of New York City, before getting to the data that spells out why a state-of-the-art facility is so important. In her role during the event, she served as the New York State Nurses Association research presenter.

Schwalbe gave those in attendance the bleak details so many other regions are facing across New York state as well as the rest of rural America. “We have seen a lot of hospitals close and there are a few reasons for this,” she said. “Finances are a huge one. … Other reasons are changes in population .. and also we don’t go to the hospital for the same services we did 20 or 30 years ago.”

From 2000 to 2020, the evolving health-care industry has relied more on outpatient procedures that has led to both fewer facilities and admissions. Across New York state, there are 12.6% fewer beds during that time frame. Chautauqua County, which saw Lakeshore Hospital in Irving close in February of that year, the reduction is 32.3%.

Numbers are just as troubling nationwide. A 2022 report by the American Hospital Association noted the variety of causes that resulted in 136 rural hospital closures from 2010 to 2021, including a record 19 in 2020 alone.

These include many long-standing pressures, such as low reimbursement, staffing shortages, low patient volume and regulatory barriers, as well as the continued financial challenges associated with the COVID-19 pandemic. Additionally, expenses for labor, drugs, supplies and equipment have also increased dramatically, ultimately causing difficulties in maintaining access to care for people in rural communities.

“While many hospitals and health systems are facing unprecedented challenges, those faced in rural America are unique,” said then-AHA President and CEO Rick Pollack. “We must ensure that hospitals have the support and flexibility they need to continue to be providers of critical services and access points for patients and communities.”

One of those models includes a micro hospital, which is what Brooks-TLC has been proposing in recent years. It would include emergency services with 12 bays, 15 medical and surgical beds, four surgical suites and two rooms for procedure, imaging with CT scans, MRI and ultrasound, stat lab services, a pharmacy, support services and a helipad.

The four-story location at 529 Central Ave. in Dunkirk is filled with maintenance issues that add to expenses impacting the bottom line. It’s oversized and antiquated for the shrinking community it serves. Currently, the hospital is licensed to have 65 beds. In reality, there are some days the census — not counting the COVID years — is less than five.

Ken Morris, president and chief executive officer of Brooks-TLC, has been making the case for construction of a new building since his arrival to the area in 2018. Once he joined the administrative team, the wheels were already in motion for the state-of-the-art facility.

Bad planning early on by the board of directors and a global pandemic in 2020 severed the axle so greatly the engine for change could be permanently stalled — putting the future of Brooks in grave danger. Gov. Kathy Hochul may be from Western New York, but she is being far from neighborly when it comes to releasing more than $70 million for a project that has been on the table since March 2016.

That’s led to two major dilemmas facing the north-county community.

First, the natives are getting restless — as was pointed out by Kenny Long, a registered nurse at Brooks-TLC. He’s watching as a new $1.7 billion Buffalo Bills’ stadium is getting built on the backs of taxpayer dollars. “I’m happy the Bills are staying, but (Hochul) couldn’t have taken $70 million of that to give the hospital the money (the state) promised years ago?”

Second — and almost just as importantly — residents here have been exhausted by the fight. No matter how urgent and significant Tuesday’s forum was regarding this region’s future, turnout was disappointing. Only sixty-five people showed up to the event sponsored by some of the strongest unions in the state in the Service Employees International Union 1999 and NYSNA.

It was an underwhelming message to Albany.

There was a time when this region could pack 2,500 into the Williams Center at the State University of New York at Fredonia to fight for a repowering of the Dunkirk generating station that ultimately failed after a lawsuit was filed by competitors giving NRG cold feet while also seeing the state’s effort to move to renewables. Hundreds even turned out in masses to keep the County Home under county ownership.

Morris has put forth a plan to keep the Brooks-TLC operation financially stable with a new facility reducing the annual deficit from $20 million in recent years to $671,000 in 2030. It will take some assistance from Kaleida Health if the site ever comes to fruition.

Inevitably, Hochul holds all the cards when it comes to disbursing state funding. The longer the wait plays out, the slimmer the odds that building happens.

John D’Agostino is the editor of The Post-Journal, OBSERVER and Times Observer in Warren, Pa. Send comments to jdagostino@observertoday.com or call 716-487-1111, ext. 253.