Commissioners on the Island Hospital Board and commissioners for two other Skagit County hospitals will announce Wednesday, August 29 which hospital all three will partner with. The decision had been expected August 14.
The decision affects Orcas Island residents especially as Island Hospital oversees the medical care on the island.
PeaceHealth is one of the healthcare systems the three hospitals are considering. Concerns have been raised by many citizens, healthcare providers and others about restrictions to healthcare by PeaceHealth due to the Bishops Ethical and Religious Directives. A statement on PeaceHealth's website states the organization complies with the directives.
Recently the Washington State Department of Health has been reviewing its criteria for certificate of need program. The following letters, two of which were submitted to the DOH during that process (the Planned Parenthood letter and the Death with Dignity volunteer's letter) - are posted below.
Three letters - one signed by 60 members of the clergy, one by Planned Parenthood and one by a Death with Dignity volunteer were submitted to the state Department of Health on August 5. All three are posted below.
Comprehensive information is available on San Juan Island/Seattle resident Monica Harrington's Catholicwatch.org website.
A list of stories published on San Juan Islander can be easily accessed here.
Letter signed by 60 members of the clergy to Governor Jay Inslee, the State Attorney General, the University of Washington Board of Regents, and others
09 August 2013
We write as a collective group of faith community leaders who wish to express our deep concerns regarding both past and proposed hospital mergers in Washington State. Joining with many other voices, we wish to firmly state our desire that all residents of our state are able to access a full and complete range of health care services, including all safe, legal and medically appropriate health care options.
Proposed mergers, strategic collaborations, or comingled relationships between publicly funded hospitals and religious institutions raise some deep concerns for us that full health care options may not be available in these facilities once merged. When religious based health care institutions are under the dictate of one specific church and its leaders, patients are permitted only those services which are deemed acceptable to that one faith tradition.
Ours is a pluralistic society which welcomes many faith traditions and belief systems. When only one voice or one church determines what is allowed within a hospital setting, we have reached a very narrow and selective approach to patient care. Washington is a progressive state that has enshrined into law certain guarantees for its citizens, including the Reproductive Privacy Act, the Death with Dignity Act, and Marriage Equality. Any denial of those lawful rights would be a violation of these voter approved measures.
We affirm our strong position that the constitution of Washington State is clear when it states, “No public money or property shall be appropriated for or applied to any religious worship, exercise or instruction, or the support of any religious establishment.” We are aware that both the Governor of the State of Washington and the Attorney General have expressed serious reservations regarding these several proposed mergers of public hospitals with Peace Health. In the spirit of caution and in respect for the many other religious voices who have written this letter to you, we ask that you enter a period of waiting before any decision. It is our faithful conviction that the denial of any safe, legal and medically appropriate service would not be in the best interest of any patient, any health care facility, or the people of Washington.
Rev. Dee Eisenhauer
Rev. Eric Kaminetzky
Rev. Dr. Donald Schmidt
Rev. Barbara ten Hove
And 56 Other Ministers and Rabbis in Western Washington
Department of Health Certificate of Need hearing August 5, 2013
Comments by Edward James Moody PhD
Thank you for the opportunity to offer comments today. I am a client support volunteer with Compassion & Choices of Washington. I visit with clients and their families to discuss their end of life options, including the option of aid in dying. I don't push people in any direction-their choices are their own. But if they decide they want to use Washington's Death with Dignity law, I help them find cooperating physicians and pharmacists. And regardless of how they choose to go through their dying process, I provide support to the client and family through the time of death.
I have volunteered in Vancouver, Washington over the past many years. We used to have a good handful of doctors in town who were willing to help patients with the Death with Dignity Act. But after the merger between Southwest Washington Medical Center and PeaceHealth, I'm down to one cooperat ing physician in town. My clients at Peacehealth tell me their doctors won't help them. The doctors tell them "I'm so sorry, but I'm not allowed to talk about that."
It is really hard for my clients in Vancouver to use the law. They are usually very sick, within weeks or a month of dying. Travel is tough for them. But with only one cooperating physician in town, I have been driving clients to other doctors in Tacoma or further to meet the two doctor requirement in the law. Some patients are too sick to make the trip. If the Catholic hospitals take over medicine in Olympia and Tacoma, my clients may lose access completely.
I had one client who lived in a rural community, and he was too sick to travel. His cancer was in its end stages-he was swo llen up like a beach ball so I could see his veins through his skin. He was in incredible pain. He had wanted to get a prescription to hasten his death,and Itried to find help for him. But there were no doctors available in his community, and he was too sick to drive. He hadn't had a bowel movement in six days and he was at his wits' end. He shot himself in the head and died.
I feel outraged about how patients suffer when they can't get access to honest information and the serv ices they need. We have a responsibility as a community to take care of our own as they are dying. The merger in Vancouver has really cut people off from information and services, and that's not right. Please do everything you can to make sure patients ca n still get what they need,regardless of who owns the hospital. Thank you.
Edward James Moody PhD
Comments by Planned Parenthood to Janis Sigman, Manager Certificate of Need Program Washington State Department of Health on August 5.
Dear Ms. Sigman,
Planned Parenthood is the nation’s oldest, largest, and most trusted reproductive health care organization in the country, and in Washington we work to protect and advance the reproductive health of individuals, families and communities across the state. On behalf of Planned Parenthood Votes Northwest, I write to provide comments on the Governor’s Directive 13-12 regarding health care mergers.
As a health care provider and patient advocate, ensuring access to the full range of family planning and reproductive health services is our top priority. Accordingly, we have deep concerns about religiously affiliated hospitals’ restricting access to certain kinds of medical care, and we appreciate the opportunity to share our perspective on a problem that is becoming increasingly pervasive in modern health care delivery.
In Washington, just over 40 percent of all acute care hospital beds are owned or controlled by Catholic health systems, and proposed transactions involving secular and religiously-affiliated health systems could push that rate closer to 50 percent, threatening local access to comprehensive health care for women. Across the state, patients seeking medical information and treatment are encountering health care restrictions based on institutional religious doctrine, and reproductive health care services – including birth control, sterilization, abortion, and infertility services – are the type of care most frequently banned.
In particular, many religiously sponsored hospitals restrict the services they provide, despite a growing conflict between these hospitals and the diverse communities they serve. Moreover, religious hospitals have consolidated into large regional and national health systems that wield considerable market power.
These health systems are acquiring non-religious community hospitals and physician practice groups at an alarming rate, and these entities are subsequently all subject to the same extreme religious restrictions. In some instances, hospitals prohibit physicians from even making referrals for reproductive health services. Finding an appropriate response to this matter is more urgent than ever – in the past fifteen years, never have so many religious/secular hospital mergers been active in one state as in Washington.
In many public hospital districts, these mergers mean that health care access is limited to only one facility, and patients have no other convenient choice for hospital care. Patients may also be restricted in where they can seek care because of managed care rules requiring members to use “in-network” hospitals. When patients have but one convenient choice for hospital care, they frequently only learn about the restrictions in a religious hospital once they are in emergency need of such care.
Public hospital districts serve residents who have the right to expect that a tax-supported health care facility will not deny them legal and medically appropriate health services. Medical care that is restricted by conservative religious doctrine undermines patients' rights to informed consent and interferes with their ability to obtain a full range of health care services. Health care refusals like these hurt all patients, but they fall most heavily on women, the LGBT community, and the poor.
Religiously-affiliated hospitals are restricting women’s access to abortion care, contraception, and other reproductive health services across the state, and lesbian, gay, bisexual and transgender individuals are also at risk of the denial of all manner of medical care because of bigotry based on sexual orientation and gender identity. These denials can come with refusals to refer patients to helpful providers and refusals to provide medically accurate information about a patient’s options.
Additionally, low-income women are disproportionately affected by religious health care restrictions because they tend to be more dependent on hospitals and hospital outpatient clinics for “safety net” health care. Rural women are also especially affected, because when services are unavailable due to a conflict with a hospital’s religious doctrine, they may not have an easily accessible alternative provider of health care.
Monopolies are created when hospital entities merge in rural or under-served areas, and that frequently results in inflated costs for patients. For example, research from staff at Mount Baker Planned Parenthood shows that while the average cost for a vaginal delivery performed at Island Hospital in Anacortes is between $7,117-$8,454, PeaceHealth charges between $10,886-$19,738. Moreover, they found that Skagit Valley Hospital in Mount Vernon charges between $10,867-$18,659 for a C-section, compared to PeaceHealth’s charges of $22,148- $34,357.
The problem isn’t limited to in-patient hospital care. In March of 2012, PeaceHealth administrators informed one of our affiliates, Mount Baker Planned Parenthood (MBPP), that they would like to discontinue lab services for our patients at the request of the bishop (PeaceHealth processes lab tests to (1) determine ectopic pregnancy, (2) conduct semen analysis for vasectomy patients, and (3) determine best treatment for wounds). While they did offer two “work-around” options, we declined them because they were financially unsustainable for MBPP and put our patients at risk. Under the duress of a great deal of public scrutiny, for the moment PeaceHealth has stated they will continue to provide lab services as they explore solutions that will work for the bishop.
We take this threat very seriously, as PeaceHealth has terminated lab services for Planned Parenthood in Eugene at the request of the bishop, and a Catholic-affiliated lab in Spokane has terminated services for another Washington affiliate, Planned Parenthood of Greater Washington and North Idaho (PPGWNI). Without competition, PeaceHealth is the only hospital in MBPP’s service area that is currently purchasing labs.
Hospital mergers are often intended to improve coordination of patient care and increase system efficiencies. But where mergers involve religious health care corporations, safeguards are needed to ensure health care decisions are based solely on medically accepted standards of care and the law, not religious directives.
All hospitals have a responsibility to make sure the community has access to the health care services they need, including a full range of reproductive health care. We ask that the Washington Department of Health do everything in its power to ensure that public hospital district residents can access all of the health care services that best medical practice would dictate, without restrictions based on religion. While we respect religious freedom, a patient’s best medical interests must always be the paramount duty of a hospital and all of its providers.
Thank you for the opportunity to provide input. We welcome any opportunity to further discuss this issue.
Jennifer M. Allen
Public Policy Director, Planned Parenthood Votes Northwest
Links to other letters submitted at the Rule-making Workshop