Inslee calls for rule change on hospital deals



MOUNT VERNON — Gov. Jay Inslee will not put the brakes on hospital mergers, partnerships and affiliations, he says in a response to the American Civil Liberties and other groups asking him to do so. But that doesn’t mean the state is ignoring the issue.

Inslee’s office doesn’t have the legal authority to issue the six-month moratorium the groups requested a May 21 letter.

Instead, Inslee has directed the state Department of Health to look into the issues raised in a letter the groups sent him, including whether deals between tax-funded and faith-based hospitals could mean religion starts playing a role in public health care.

Such partnerships are being considered by all three hospitals in Skagit County and one in Arlington that works closely with Island and Skagit Valley hospitals.

Some area residents have formed a group, called People for Healthcare Freedom, in part to lobby hospital commissioners not to allow any religiously affiliated potential partner to restrict access to — or discussion of — services such as contraception and Death With Dignity.

People for Healthcare Freedom was one of 10 groups that co-signed the ACLU’s letter to the governor, which also asked for the state to assess the health needs of communities in which hospital partnerships are being proposed.

Inslee also has called for changes to the Department of Health’s Certificate of Need program, which is how hospitals get the state’s blessing to merge or affiliate.

“I believe the (Certificate of Need) rules need to be updated and modernized in light of health care reform and these dynamic changing times,” Inslee wrote. He directed the Department of Health to report to him by Oct. 31 on its progress toward making new rules.

He went on to say the program should look not only at the terms of partnership agreements themselves, but at “the effect of these transactions on the accessibility of health services, cost containment and quality.”

“Access to care is certainly a critical and crucial part of any discussion, and it’s been a part of our discussion since the very beginning,” said Skagit Valley Hospital Commissioner Bruce Lisser. “It’s a complete mystery what’s going to happen because obviously the governor didn’t know or couldn’t figure out what to do, so he’s asking for help to answer these questions.”

Skagit Valley Hospital board President Clark Todd said he did not expect anything in Inslee’s letter to affect the decision-making process his board and the boards of Island and Cascade Valley hospitals are going through in choosing a joint partner.

PeaceHealth, which operates PeaceHealth Southwest Medical Center in Vancouver, Providence/Swedish, UW Medicine and Virginia Mason Medical Center all are vying to be that partner.

United General Hospital Commissioner Chuck Ruhl said he had not seen the governor’s directive and could not comment on it, but mentioned he was “encouraged” the governor had nixed the moratorium request. PeaceHealth, a Catholic nonprofit health care system, is set to start leasing and operating United General by July 2014.

In his directive, dated June 28, Inslee pushed transparency and asked Department of Health staff to look at and make available hospitals’ policies regarding end-of-life care, reproductive services and patient nondiscrimination.

“This is vitally important because, at this time, patients have no way of knowing whether a hospital withholds certain medical procedures based on religious doctrine until they are in the hospital or clinic seeking the service,” People for Healthcare Freedom wrote in an email to its supporters Wednesday.

In his letter to the ACLU, Inslee noted his own uncertainty about whether such restrictions happen.

“Thus far, we have not identified any situations in which Washingtonians have been denied access as a result of these mergers and affiliations,” Inslee wrote. “If you are aware of any such situations, I encourage you to share this information with the Attorney General’s Office or my staff.”