New rules require hospitals to disclose health care policies

Responding to a directive from Gov. Jay Inslee, the Department of Health enacted new rules, effective Jan. 23, 2014, that bring any change of control of a hospital under the certificate of need process and require hospitals to fully disclose its policies for end of life care and reproductive care.

The new rules are another response to questions raised in 2012 by women's health care activist Monica Harrington and others about the provision of services by Peace Island Medical Center, a Catholic Church-affiliated hospital that receives about $1 million per year from property taxes paid to the San Juan County Public Hospital District.

Harrington believes that the state constitution and state law preclude provision of public funds to a health care institution that restricts access to health care based upon the Ethical and Religious Directives for Catholic Health Care Services issued by the Catholic Church. Some of Harrington contentions were supported by a 2013 Attorney General's opinion issued in response to a request from state Sen. Kevin Ranker (D-Orcas).

The new rules require hospitals to obtain approval under the Certificate of Need process whenever a "change of control" occurs, whether that change is a result of sale, purchase, lease, affiliation, corporate restructuring, merger, and other arrangement. Several previous hospital mergers, such as the acquisition of Swedish Hospital by Providence Health Services, have avoided state oversight by claiming the takeover was an "affiliation," not a takeover.

The rules also require hospitals within 60 days to "submit to the department its policies related to access to care" in the areas of admission, non-discrimination, end of life care and reproductive health care. After review by the DOH, each hospital must post the policies on its web site.

Harrington responded in a written statement, "The rule changes are an important first step, but they don't go far enough, especially given the Catholic institutions' long and now well-documented pattern of obfuscation and secrecy with respect to reproductive and end-of-life issues."

Harrington concluded, "We'll get there because it's the right thing to do and because the central argument of the opposition - that three unelected religious bishops should control health care policy for half the state, even in tax-supported facilities, is dangerous and disrespectful to patients and offensive to the vast majority of Washington voters and taxpayers.  Besides, of course, being unconstitutional."

In a press release issued by the ACLU, Leah Rutman, policy counsel, said, "Significant changes are necessary to make sure that religious restrictions do not limit patients' access to health care. A comprehensive review and revision of state health regulatory programs is needed. The State of Washington has a responsibility to ensure access to best care and medical services for all its residents."

“We appreciate the work that the Governor and the Department of Health have done, but the new disclosure regulations do not go far enough to protect patient access,” said Rachel Berkson, Executive Director of NARAL Pro-Choice Washington. “If we want to address potential gaps in access to care, we need to look for some more solutions.”



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