The Brookings City Council and Curry Health Network agreed Wednesday to co-sign a letter asking Gov. John Kitzhaber to designate the Brookings Clinic as a remote hospital under the existing hospital's license.

According to City Manager Gary Milliman, the Brookings clinic can obtain federal and state approval, including securing the certificate of need for a hospital with an emergency room, or by getting approval to operate a remote hospital associated with the existing one in Gold Beach, and under its current provider license.

"This is exciting to me," said Mayor Ron Hedenskog. "As long as I can remember we've been working on getting an emergency room in Brookings. Just an emergency room.

"We've never been able to do it," he continued. "It was one of my goals in 2007, and I was shot down by other councilors, and I said I wouldn't bring this up any more. Those councilors are gone, so I brought it up again. Now we're going to get an emergency room, but it has to be associated with a hospital. So what?"

City officials have been working for months to find a way to obtain an emergency room in a city where 2,200 area residents each year are transported to Sutter Coast Hospital in Crescent City for health services. Those patients take with them to California an estimated $68 million for those services, according to Curry Health Network.

"We're in a great position to provide healthcare services throughout the entire county," said Andrew Bair, CEO of Curry Health Network. "We're very excited for the next steps in Gold Beach and also improving services in Brookings."

According to Milliman, having a hospital and emergency room in Brookings will improve the quality of medical care through earlier intervention in serious cases and reduce travel time to other facilities and ambulance and other transportation costs. It will also save lives by improving the accessibility of emergency care services, give access to health care to people in their own community, and enhance economic development.

"Brookings is the largest city in Oregon with no hospital and no emergency department," the letter reads. "All highway routes between Brookings and hospitals in Crescent City and Gold Beach could be considered 'mountainous,' given their terrain and because they are subject to frequent slip-outs, slides and other blockages during winter months.

"A hospital/ER is urgently needed to address the burgeoning health care needs of our community, which is predominantly a retirement community," it continues. "More than one-half of the Curry County population resides in the greater Brookings area, and 29.5 percent of them are age 65 or older - almost twice the state average."

Real estate brokers in the area say the lack of adequate health care is the No. 1 deterrent to attracting new residents and businesses to the area, the letter reads. "Many andhellip; turn away from Brookings after learning about the severely limited access to medical services."

Even though Brookings is not in the hospital district, local leaders are supportive of annexing the city to provide a tax base for the operation of a hospital and emergency department.

Medical care has its supporters.

The letter notes that even tax-averse residents in the health district voted 65-35 percent to fund a $10 million bond to pay for half the costs of a new hospital. The rest is expected to be acquired from a loan.

The clinic in Brookings, which opened in 2011, is self-sustaining, the draft letter reads, but because there is no hospital or emergency department, patients have to be transported by ground to Crescent City or Gold Beach before they can be flown inland to definitive care.

Cal-Ore Life Flight has the capacity to fly out of the Brookings Airport, but because there is no emergency room doctor to stabilize and release them, patients must be driven to Gold Beach or Crescent City and then flown out.

That adds about a half-hour to the travel time to get a patient to Medford. And flying time from Brookings to Medford is two minutes less than it is from Crescent City.

Two minutes is only long if you're a patient in critical care. Care providers work keeping in mind the "golden hour" in which medical treatment is the most effectively to prevent irreversible damage and optimize the chance of survival.

There are precedents available for obtaining critical access hospital status - as officials are discussing at Sutter Coast Hospital - for Brookings, as well, Hedenskog said.

A case study in Kremmling, Colo., a remote town in a mountainous area of the state, was able to split its hospital and offer services in an adjunct facility in Granby, a tourist town and gateway to Rocky Mountain National Park to the east.

"That puts one on the east and west side of (Grand) their county," Hedenskog said. "Why can't Curry County have one in the north and one in the south. The case study shows it can be done. All it takes is a governor's executive order."

Being designated a critical care facility would avail a provider to more Social Security benefits, but limit the number of beds in a facility to 25. Currently, Curry General Hospital has 25 beds and the average use is six beds, Hedenskog said.

Establishing it would take another one to two years.