Gov. Mark Dayton's administration expressed "serious concerns" Monday over Mayo Clinic's plan to remove key inpatient and obstetrics services from its hospital in Albert Lea, a plan that has triggered sustained opposition by civic leaders in the southern Minnesota city.

While Mayo has maintained for months that the hospital realignment is necessary for physician recruitment and economic survival, the Rochester-based clinic system has received stiff resistance from community leaders, who have won the support of Albert Lea's City Council and school board, U.S. Rep. Tim Walz, and now the governor.

"We have serious concerns about Mayo Clinic's decision to reduce services at their Albert Lea hospital, and how this decision will impact the community," Dayton said in a statement with Lt. Gov. Tina Smith.

The dispute revolves around Mayo's plans to consolidate its Albert Lea and Austin hospitals, which are 23 miles apart. Austin would provide labor and delivery, inpatient surgeries and intensive care, while Albert Lea would provide inpatient chemical dependency and mental health care.

Both campuses would maintain full lines of outpatient surgeries and clinic services — which Mayo leaders have argued is the majority of modern health care anyway.

"The changes we're making are intended to keep both the Albert Lea and Austin campuses viable and available to current and future generations of patients," a Mayo spokesman said in a written statement Monday.

Dayton's intervention is significant considering he has oversight of millions of dollars in state funds going to Rochester for the Destination Medical Center project, which Mayo leaders had sought so their flagship hospital could remain competitive in the global health care market. Smith chairs the corporate board overseeing the Destination project.

The governor's statement did not ask Mayo to drop the plan, only that it "engage the public in an open discussion about the impact of its business decisions on people."

Leaders in Albert Lea hailed the support. They've argued that Mayo's plan would make Albert Lea one of the largest Midwest cities without a full-service hospital. Walz recently called the move a gut punch to Albert Lea, a community of 18,000 people selected in 2009 to be a Blue Zone model for reforming and improving community health.

"Our state leaders have recognized something wrong is going on," said Mariah Lynne, an Albert Lea businesswoman leading the Save Our Hospital campaign.

Minnesota Attorney General Lori Swanson and the state health commissioner were in Albert Lea Monday to hear more about the community's opposition.

Mayo leaders responded to criticisms Monday by noting that they have taken steps to connect with community leaders and hear their concerns. A proposed change in response to those concerns includes maintaining short-stay hospital rooms in Albert Lea for patients who need extended observation after surgeries or emergency care.

Small and rural hospitals nationwide have been halting specialty services such as obstetrics in response to financial pressures and declining deliveries. The University of Minnesota recently reported a 9 percent decline between 2004 and 2014 in rural U.S. counties with hospitals that provide obstetrics services.

Consolidation is happening in urban areas as well. Allina Health engaged in a similar plan recently with Mercy Hospital in Coon Rapids and Unity Hospital in Fridley — with the former gaining all baby deliveries and the latter taking on all inpatient mental health care.

Community leaders in Albert Lea argue that Mayo's proposed swap is unfair because deliveries are generally more profitable and result in high patient satisfaction ratings, while inpatient mental health care is reimbursed by insurers at low rates.

Mayo has faced criticism in other communities where it has taken over hospitals. Three years ago, leaders in Fairmont accused Mayo of weakening their hospital and transferring too many patients to Mankato. Earlier this year, leaders in Lake City challenged Mayo's control of their hospital after it stopped scheduling baby deliveries and lost key physicians.

Jeremy Olson • 612-673-7744