Residents in the Three Sisters Rural Track Program (RTP) arrived in Madras earlier this month and are immediately helping fill a need in the community by providing care for up to 900 patients a year in local primary care clinics and at St. Charles Madras. Drs. Ben Khalil and Callie Krewson are the first two residents to participate in the program, which is sponsored by Oregon Health & Science University and is the first graduate medical education program in Central Oregon.

“It’s thrilling to see these doctors caring for community members. We have been planning and eagerly awaiting this moment for many years and now it’s here,” said Dr. Jinnell Lewis, RTP director and St. Charles family doctor. “This program is helping us to develop and train providers who will specialize in rural family medicine and also helps us fill a shortage of primary care doctors in the region.”

Residents spend the first year of the program completing advanced training at OHSU before spending two years training and caring for patients in Jefferson County with a focus on rural family medicine. Khalil is caring for patients at Mosaic Community Health, while Krewson is caring for patients at St. Charles Family Clinic in Madras. Both doctors conduct rotations at the hospital and with area specialists where they train in family medicine, family birthing, emergency medicine, behavioral health and hospital medicine. They will also have learning opportunities at the Indian Health Services’ Warm Springs Health and Wellness Center.

"Drs. Krewson and Khalil have hit the ground running and are already enhancing the care of patients in our region,” said Dr. Katie Snyder, clinical medical director for Mosaic’s Madras Health Center and residency program teaching physician. “I look forward to continuing to partner with this critical program and train physicians locally to benefit our community for years to come."

Research has shown that about 55% of physicians stay within a 100-mile radius of their residency site. This means, within 10 years, Three Sisters RTP is estimated to produce more than 20 physicians who would reside in Central Oregon and provide care for 20,000 to 40,000 patients in the region.

Learn more about Three Sisters RTP.

About St. Charles Health System
St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care and specialty clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, nonprofit Oregon corporation and is the largest employer in Central Oregon with more than 5,000 caregivers. In addition, there are more than 400 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

About Mosaic Community Health
Mosaic Community Health is a nonprofit community health center that serves Central Oregonians from all walks of life. Through a network of more than a dozen clinics across the region, we offer integrated health services that address each patient’s medical, dental, behavioral health, nutrition and medication needs. Our care is never influenced by how much money our patients make, what language they speak or the status of their insurance coverage. Mosaic Community Health provides quality care for all. For more information, please visit MosaicCH.org.

St. Charles Health System has awarded more than $85,000 in Community Benefit grants to 27 local organizations in Central Oregon. The grants were awarded to provide basic needs, sponsor local events and as part of St. Charles’ Priority Grant to increase a sense of belonging and reduce loneliness and isolation. Projects supported this year range from providing meals to families in need to creating outdoor spaces for local communities to enjoy.

A local nonprofit organization, CASA of Central Oregon, received $5,000 to expand its Family Find programming. Family Find aims to establish family connections between children in foster care and their relatives by locating long-term, caring, permanent connections and relationships for children and youth in foster care. The goal of this project is not only to find placement resources, but to assist youth in learning more about their familial history and having healthy connections with family members. 

“We are grateful to St. Charles Health System for a grant to support the Family Find program with CASA of Central Oregon,” said Heather Dion, Executive Director for CASA of Central Oregon. “The Family Find program connects children in foster care to their extended family, addressing loneliness and isolation that can sometimes affect youth in foster care. This work will help Central Oregon's most vulnerable children by giving them belonging within their extended family.”

Learn more about St. Charles Community Benefit program by clicking here.

At St. Charles, we are concerned about the escalating total costs of insurance and out of pocket expenses faced by our patients, by our employees, by our business community and by taxpayers. 

Health care is simply too expensive.

For the past several years, St. Charles leaders have asked insurance companies to work with us on proposals that address our ongoing concerns related to delays in patient care, denials for treatments and administrative burdens on our care teams. Our goal is to find common ground with insurers to address inefficiencies and wasteful processes within our overly complicated payment systems that add to costs for everyone – especially our patients.

We’ve made strides and found common ground in most of these conversations, but not all. That is why the insurance companies that are contracted with the health system change from time to time. If you are curious where your coverage currently stands, I recommend reaching out to your insurance company first. You can also check this page on our website.

While health care costs continue to rise, hospitals and stand-alone clinics struggle to maintain financial viability. In 2024, 45% of Oregon’s community hospitals lost money. In other parts of the state, we are seeing medical practices and hospitals attempting to consolidate, looking for out-of-state investors, laying off staff, cutting programs and services, all in an effort to ward off closure.

Those aren’t good options for any community but are especially concerning for a region like Central Oregon where the population is growing rapidly, particularly among seniors, and alternative options may be hundreds of miles away. The net result for our community is a widening gap between demand and supply of services which most of us experience as difficulty finding providers and longer wait times for essential services. In order to meet this gap and growing need, we need to reinvest in our people, facilities and services. To do so (and to counter reimbursements from insurance companies and government programs that have not kept up with inflation), we have negotiated above average rate increases from insurance companies a few times in recent years.

This necessary approach has allowed our workforce to grow, our staff vacancy rate to decrease while we are actively making physical upgrades to our hospitals and clinics, however, there is still more that needs to be accomplished. And, as highlighted in our 2024 Annual Report, we’re taking action to preserve, expand and improve access to care in the communities we serve with a strong focus on keeping care local.

Ultimately, St. Charles is committed to providing essential health care services in Central Oregon for years to come. To do that, we have to make good on another commitment: To grow sustainably by remaining strong financially. Without the latter, the former becomes much more difficult, if not impossible.

Thank you, as always, for reading, and for your interest in St. Charles – your local, nonprofit health care system. 

Sincerely,
Steve

Pictured above, from left, are Athletes Without Limits board member Ian Conyers, Dr. Sondra Marshall, and Athletes Without Limits co-founders Julie and Barry Holman.

Before an athlete with an intellectual developmental disorder (IDD) competes in the Paralympics — or any major international competition — they must first be declared eligible for the event by a group of assessors with expertise in IDDs.

The assessor for the United States — Dr. Sondra Marshall — lives in Bend. She is a licensed psychologist and the director of St. Charles’ PEDAL Clinic, a specialty service for children and youth with special health care needs. And in her spare time, she is the U.S. National Eligibility Officer for Athletes Without Limits (AWL), an organization that supports athletes with IDDs who want to compete at the highest level of sport.

Practically speaking, that means Marshall reviews the documentation of every athlete who comes to AWL in search of a pathway to elite sports competition, including the Paralympics. Her role is vital to ensuring that those events are fair and that all athletes are competing on a level playing field.

“My job is to make sure athletes who want to compete in elite parasports meet their eligibility requirements,” Marshall said. “Athletes Without Limits manages eligibility for athletes with IDDs, and I’m the one looking at each athlete’s documentation to support their participation.”

AWL’s co-founders, Julie and Barry Holman, live in Bend, and Marshall joined the organization in 2017. In her first year, she reviewed the documentation for around a dozen athletes.

This year, she’s already up to about 250 — which is reflective of a widespread push to increase access to parasports for people with IDDs.

“There’s been a groundswell of energy around this issue and organizations are taking notice and the athletes are owning it. They have a voice and they’re using it to say, ‘We want full inclusion. We want to participate at this level,’” Marshall said. “In the past, we just hadn’t met a critical threshold of interest, but everything’s coming together.”

In mid-September, the International Olympic and Paralympic committees will host a training program in the Dominican Republic to address the need for increased inclusion of athletes with IDDs in the Paralympics. Representatives from 34 countries across the Americas will attend, and Marshall will be part of the U.S. Olympic contingency to serve as an expert consultant, providing other countries with insights, information and tools they need to help IDD athletes reach their goals.

Over the past eight years, Marshall has traveled to places like France and Mexico to support athletes in international competitions and meet with psychologists from other countries. She also served as a consultant at the United States Golf Association’s National Adaptive Golf Championship, held in July at Woodmont Country Club in Maryland. The September trip, however, is significant in that the Olympic and Paralympic governing bodies of the Americas are coming together to discuss increasing both inclusion of IDD athletes, as well as the number of sports on the international stage in which they can compete.

Marshall, who has dedicated her professional career to those with neurodevelopmental conditions such as IDD, is especially excited about the opportunity because she strongly believes that access to sport and high-level competition should be available to all.

“For anyone, this is good for the mind, good for the body, good for your sense of self — all those things,” she said.

“But it’s also just a human right to be able to participate,” Marshall continued. “I think it’s just a human quality to look around and want to gauge who we are relative to who’s around us. That’s true for all people, regardless of their intellectual or physical ability.”

You can see that quality in the growth of her workload with AWL: More awareness and more inclusion means more athletes seeking the benefits that come with participation in elite competition. 

“In my role here at St. Charles, our patient population at the PEDAL clinic falls under this umbrella,” she said. “So this population is my passion, and I’m proud of the work we’re doing for the athletes themselves but also the IDD community as a whole.”

St. Charles Prineville has been named one of the top 100 critical access hospitals in the country, according to a survey conducted by The Chartis Center for Rural Health, an advisory firm focused on improving health care in rural communities.

The Prineville hospital is one of only two in Oregon to receive the recognition, along with Grande Ronde Hospital in La Grande. The top 100 list, which comes out annually, honors outstanding performance among the nation’s rural hospitals based on an assessment of publicly available data related to quality, patient perspectives, financial results and more.

“There are nearly 1,400 critical access hospitals across the United States, so to be designated as one of the 100 best is a tremendous honor,” said Todd Shields, hospital administrator for St. Charles’ Prineville and Madras hospitals.

“More than anything, it’s a reflection of the caregivers across the St. Charles organization who work hard every day to make St. Charles Prineville a great place to both provide and receive care,” he said. “They are skilled, compassionate and committed to serving the residents of Crook County and the region, who truly benefit from the hospital’s connection to the health system.”

The complex methodology used by Chartis analyzes data from the past five years that is pulled from a variety of sources maintained by the U.S. Centers for Medicare & Medicaid Services (CMS). Chartis then feeds that data into an algorithm, which determines the top 100.

Prineville’s strong performance is based on several different factors, said Amber La, a quality improvement analyst for St. Charles. Of particular note were:

• Patient experience and perspective. Coming out of the COVID-19 pandemic, leaders in Prineville focused on implementing programs to improve patient experience at the hospital, including increased visits to patient rooms, upgraded hospitality services and a procedure to ensure safe patient hand-off at the bedside.
• Quality and safety. In recent years, Prineville has experienced a very low incidence of patient infections, patient falls and hospital-acquired pressure injuries thanks to several initiatives, including regular reviews of safety concerns, process improvements to enhance quality of care and a renewed focus on hand hygiene.
• Keeping care local. A continued focus on increasing the hospital’s capacity and reducing barriers to care for local residents has resulted in a decrease in the number of transfers from Prineville to another facility. A major investment in training for nurses in 2023 has upped the level of care available at the hospital, allowing Crook County residents to get the care they need closer to home.

“We set some high targets and then we were able to achieve them and sustain them,” said Kimberli Munn, chief nursing officer for Prineville. “I think ultimately, we received this award because we provided high-quality care to Prineville and Crook County. That’s what we’re here to do, and we’re proud to be recognized for it.”

St. Charles Health System is announcing plans to open a Community Pharmacy in Prineville to help to preserve access to local pharmacy services in Crook County. St. Charles is acquiring the current Clinic Pharmacy operating near St. Charles Prineville, with the transition slated to take place later this fall.

“We are excited to announce this news to our community, as we work to maintain access to this critical health need for the region. While the name of the pharmacy is changing, the service and stability offered will remain the same and we know that’s important for our community members,” said Todd Shields, Vice President Hospital Administrator for Prineville.

Clinic Pharmacy owner Sean Phothiyane has long been committed to serving the residents of Crook County and says that’s why he thinks this change will benefit the community long term.

“I really appreciate the opportunity to create a permanent stable future for this pharmacy and the patients it serves. St. Charles is going to continue the legacy we’ve built here. And I’m happy to share that this will be a seamless transition for community members with existing prescriptions. We are working together so that the new St. Charles pharmacy will automatically be able to continue to fill needed medications with zero interruption of services,” said Phothiyane.

This is the second Community Pharmacy St. Charles has opened this year, after opening a pharmacy in Madras in June. St. Charles Chief Pharmacy Officer Michael Powell explains that this is part of a larger commitment the health system is making to prescription access and keeping care local.

“We are continuing to see pharmacies across the nation, state and region closing their doors and our goal is to ensure access for the communities we serve,” said Powell. “We know that when people don’t have access to necessary medications, it increases their risk for hospitalization and poor health outcomes. And we believe no one in Central Oregon should go without needed medications.”

The new St. Charles Community Pharmacy in Prineville will open later this fall at 198 NE Combs Flat Road in Prineville. Additional details, including hours of operation, will be updated as the transition approaches.

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This summer, St. Charles launched a new ambassador program to give high school students in Jefferson and Crook counties hands-on hospital experience through clinical shadowing and support.

Two incoming seniors were selected for the program: Emily Pineda, a student at Madras High School (pictured above left) and Shirley Anderson, a student at Crook County High School (pictured above right).

“I signed up for this program because I’m interested in nursing and it’s been an amazing experience,” said Pineda, St. Charles Madras ambassador. “On my very first day, I got to witness a birth in the Family Birthing Center and it helped me realize that’s the kind of nursing I want to do. This program is a great way to figure out what area of health care you’re passionate about.”

Anderson, the St. Charles Prineville ambassador, is also excited about her experience with the program.

“I’ve always been interested in a career in health care, so getting to see what actually goes on in a hospital has been such a great opportunity,” she said. “I especially love working with pediatric speech therapy — it’s something I found an interest in after exploring that department through this program. Each week I shadow a different department and get hands-on experience. It’s been such a great experience to learn from actual health care professionals.”

The new program is organized and funded through the Cascades East Area Health Education Center program, East Cascade Works and Youth Compass Program.

Jeri Young’s office at St. Charles’ Bend hospital is an unexpected blend of common, neutral-colored work supplies — folders, computer monitors, a stapler — and shelves stuffed with colorful toys and books for kids.

Young is one of the health system’s three child life specialists, whose job, broadly speaking, is to help kids cope with challenging health care experiences through play, self-expression activities and age-appropriate medical education. So, for example, Young might meet with a child and their family to discuss an upcoming procedure, practice stress-relieving techniques and facilitate communication with the clinical care team.

Tools of the trade include toys, and Young is excited about a new one she has on her shelf: A LEGO® MRI Scanner — three of them, actually — designed specifically by LEGO® to help children cope with the uncertainty of having a Magnetic Resonance Imaging (MRI) scan.

Measuring about 10 inches long, 5 inches wide and 4 inches tall when constructed, the kit provides a remarkably detailed replica of the MRI experience, including a waiting room, a space for MRI techs and their computers, and an MRI machine that swings open to provide a peek inside.

It’s a major upgrade from the tools Young has used in the past, including children’s books about the MRI process and a toy CT scanner that looks kind of like an MRI scanner, but not exactly.

“We have kids who we’re asking to lay still for up to an hour or longer, and that’s really challenging,” said Young, pictured above with a kit. “Some kids are scared, and most have a lot of questions: What’s going to happen? How does it work? Will it be noisy? Why do I have to be alone? We can show them pictures, but it just doesn’t have the same effect as giving them something they can manipulate.” 

Indeed, the LEGO scanner was developed “with a child-centered focus” and “is a means for clinicians to facilitate both role play and dialogue so that the child feels safe and can build confidence and resilience before the actual journey, in turn reducing stress and anxiety,” according to the company’s website. “Play motivates the child’s natural curiosity and openness to try new, sometimes difficult, experiences.”

Scott Waite saw that effect firsthand. In May, he walked into St. Charles’ Bend hospital for his daughter’s MRI, braced for what he expected to be a tough day.

Avalyn, 7, had had an MRI several months before at a different facility, and it was “a very traumatic experience,” Waite said.

“She came out of the scanner sweating profusely. She cried the whole time. And the pictures were blurry, so the doctor asked for a second one,” he said. “When we told her she’d have to do it again, she was so nervous. And we were nervous, too.”

Shortly after arriving, the family was met by Young, who had the LEGO scanner in hand. Young said she sometimes meets with up to a half-dozen children getting an MRI in a day.

“She started making jokes with Avalyn and talking to her stuffed animal and just generally doing things to take her mind off what she was there for,” Waite said.

“And Avalyn loved the LEGO model. She played with it, and Jeri explained all the parts and how it works and all kinds of things. It was wonderful,” he continued. “By the time she was headed back for the procedure, she was smiling and so much more comfortable.”

Young has been trying to acquire a LEGO MRI scanner for about three years, but they were hard to find for a long time, she said. (“They’re wildly popular in our profession,” Young said.) Then, earlier this year, she noticed they were being offered on the website of the Starlight Children’s Foundation, an organization that supports hospitalized kids by providing toys, games, movies and more to hundreds of hospitals across the country.

She signed up for a kit, and Starlight asked if she’d be willing to share feedback on its impact.

“I messaged them right back: ‘You bet I will. I’ll do whatever it takes,’” she said. “When the first one arrived, I went down to show the nurses and techs and anesthesiologists who work with the MRI — they might’ve been more excited about it than the kids.”

The kit’s attention to detail — the moveable parts, the insides of the machine and so on — encourages extended play, which leads to important conversations with both children and their families. (“Many of the parents haven’t ever had an MRI either,” Young said.) Those conversations give her an opportunity to probe for stress points, to identify and correct misperceptions, and to convey to kids the importance of staying still during the procedure.

Calmer, more informed patients, of course, make St. Charles caregivers’ jobs easier and usually result in better scans.

“It’s just so important to have something that kids can manipulate, because that’s how they learn — by playing and touching and feeling and being in control,” Young said. “It’s been incredible to watch their reaction, and to see them be like, ‘Oh, I’ve got this. It’s easy.’”

Parents can have that reaction too, said Avalyn’s dad, Scott Waite.

“It was so refreshing not having to do it alone. It gave us a chance to step back and take a breath and process and go, ‘She’s going to be OK,” he said.

“And it was so reassuring to see her smiling before the procedure instead of shaking like she was the first time,” he continued. “When I asked Avalyn what she remembered about Jeri, she said, ‘She helped me not be scared.’”