By Sadiya Ansari
Thursday, July 5, 2012
The only two hospitals in Waterbury, Conn., are proposing a merger that would subject reproductive health services to Catholic restrictions. Hard times around the country, however, are forcing workarounds and compromises in similar cases.
(WOMENSENEWS)--Tubal ligation may not be available in the new replacement hospital in Waterbury, Conn.
Emergency abortion and contraception could also be dropped.
The hospital merger still faces review by the state's attorney general and commissioner of public health and a public hearing in early fall.
But if it goes through the city of about 110,000, will see its two existing hospitals--the non-profit Waterbury Hospital and the Catholic for-profit Saint Mary's Hospital--become one.
Under an existing agreement, the new hospital--which would be only 10-percent Catholic owned--would adhere to the Ethical and Religious Directives for Catholic Services, rules set by the U.S. Conference of Bishops, based in Washington, D.C.
"There is a lot of concern around the continuation of women's health services in this community," said Teresa Younger, executive director of Connecticut's Permanent Commission on the Status of Women. The Hartford-based agency, a non-partisan arm of the legislature, makes recommendations to guard against gender discrimination. The group hosted a public hearing on the merger on June 11.
Hospital mergers motivated by financial hardship are increasing around the country and at least one major player in acquisitions has broken off its religious ties to ease pre-nuptial difficulties of religious-public unions.
Catholic Healthcare West, the San Francisco-based health system that is fifth largest in the country, ended its affiliation with the Catholic Church in January 2012, changing its name to Dignity Health. It now allows the Catholic and non-Catholic hospitals that it buys to provide services as they see fit.
Younger says the Permanent Commission on the Status of Women is worried about the precedent that Waterbury hospitals could set for the rest of the state. "This is the first for-profit merger between a Catholic hospital and non-Catholic hospital and we need to make sure we do it right and that we don't create a second-class health care system for women in Connecticut or anywhere else."
"Nationwide, Catholic hospitals are at a turning point," said Lois Uttley, director of the non-profit Merger Watch based in New York City. "They are having to think through how to have a religious bishop, while at the same time fulfilling their duty to serve everyone in the mission"
Uttley's pro-choice organization has intervened in over 90 mergers in 34 states in the last 15 years. She says there are many creative solutions for mergers of non-Catholic and Catholic hospitals.
A "sun-setting" clause for instance can provide for the gradual phasing out of Catholic restrictions.
Our Lady of Mercy Hospital in Bronx, N.Y., was permitted to keep Catholic status for three years until it was formally acquired by Montefiore Medical Center in 2008. After the acquisition, the hospital introduced comprehensive reproductive services and underwent a name change to Montefiore North.
Compromises agreed to by the church, however, are getting tougher, said Uttley. "It is difficult sometimes though to bring about those pragmatic solutions because of the increasingly conservative stance of the Catholic bishops."
Judy Tabar is CEO of Planned Parenthood of Southern New England, based in New Haven.
If the merger adopts the Ethical and Religious Directives Tabar fears that women who want tubal ligation after delivery would have to make arrangements to deliver their child in another city.
A report by Dr. Fred Hyde for Community United for Jobs, Healthcare and Opportunity, an advocacy organization in Waterbury, concluded that a merger would result in a loss of choice.
Saint Mary's initiated the deal in March 2011 with a financial partner, LHP Hospital Group, based in Plano, Texas. Waterbury Hospital joined the agreement in August 2011 with the understanding that Catholic directives would be applied to the new hospital. Both hospitals will have 10 percent ownership; LHP will have 80 percent.
Pat Ball, a representative from LHP, would not comment on whether some reproductive services could be imperiled by the deal.
Saint Mary's and Waterbury did not return calls to comment on the proposed reduction in services that Waterbury Hospital currently provides.
Younger, of the Commission on the Status of Women, initially thought a "hospital within a hospital" arrangement would work out for the Waterbury merger, with full reproductive procedures provided in some type of physical enclave.
A similar solution was reached in Kingston, N.Y., in 2009 when Kingston Hospital merged with Catholic-affiliated Benedictine Hospital. Reproductive health services, including abortions, were performed in a center built in Kingston hospital's parking lot that received $4 million from the state. Post-partum tubal ligations were still performed at the non-religious Kingston Hospital.
Younger was disappointed to learn early this year that such a solution was not seen as acceptable by Saint Mary's.
"They are building a replacement hospital and they are seeking state funding for that hospital and I ultimately believe that the state should not be giving any funds to a new hospital that is not going to provide comprehensive health services," she said.
Connecticut Gov. Dannel Malloy, a Democrat, has supported options put forth by the Permanent Commission on the Status of Women. "The governor has been clear all along that he believes the issue of women's health care rights is very, very important," his office said in a recent press statement. "He does not believe the result of this process should be one that in any way reduces the access women now have to health care services."
There is some precedent for governors to avert deals that cut off health services on a religious basis.
Kentucky Gov. Steve Beshear rejected two attempts of a hospital merger among two religious-affiliated hospitals and the state-owned University of Louisville hospital. In December 2011 and January 2012 the merger was rejected on the grounds that it was not in the public interest for a public hospital to become private and lose its ability to deliver reproductive services.
Sadiya Ansari is a Pakistani-Canadian freelance journalist, currently reporting from New York.
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