The three newest commissioners for San Juan County Public Hospital District No.1 ran their campaigns promoting Planned Parenthood and at the district’s Feb. 22 meeting, they made good on that promise — sort of.
“This is not a motion to contract with Planned Parenthood, it’s a motion to draft a contract,” said board chairman Bill Williams before the vote. He, Barbara Sharp and Monica Harrington were voted onto the commission in 2015.
In a 3-2 vote, the resolution passed to use some of the $50,000 subsidy reduction to draft a contract with the Mount Baker Planned Parenthood’s Friday Harbor location. The draft will include the services to fund at Planned Parenthood, their costs and the length of the contract.
The resolution states that Sharp and Harrington will draft the contract.
“I support it, but I don’t support giving anything close to the whole amount,” said commissioner Sharp.
Williams suggested the board present a list of services they would like covered by Planned Parenthood and the prices to Peace Island Medical Center staff. The hospital staff can then determine if those items compete with the services already provided by the hospital, which is prohibited by the subsidy agreement’s third amendment and the resolution to draft a contract with Planned Parenthood.
“You don’t need to draft a contract with Planned Parenthood to determine what services to offer to the community,” said commissioner Mark Schwinge, who voted against the resolution.
The board passed the third amendment to the original subsidy agreement with PIMC on Nov. 23 in a 3-2 vote. The amendment allows the district to use $50,000 out of the roughly $1 million subsidy to contract with other vendors to provide services the hospital refuses. As a Catholic Healthcare Ministry, PIMC doesn’t provide end-of-life services or reproductive services like elective abortions. This was the first discussion of how that $50,000 would be used at a district meeting.
The district requested nine services to be provided to the community by PIMC in 2016, according to Pam Hutchins, district superintendent, in an interview with The Journal. Services included dermatology, immunizations and comprehensive reproductive healthcare. Hospital staff explained they could not provide the latter because they cannot offer elective abortions as a Catholic nonprofit, and are reviewing the other eight items.
At the meeting, the board added curbing tobacco, marijuana and alcohol abuse amongst youth to the list, as requested by commissioner Michael Edwards.
Edwards noted the ambiguous reporting of reproductive services by PIMC. Sharp said that when asked by the board what maternity services the hospital provides, staff reported pregnant women receive services by primary care physicians, only.
Harrington explained that the two OBGYN doctors at the hospital lease office space at PIMC and schedule and bill their own patients. The doctors are associated with Island Hospital in Anacortes, where their patients’ deliveries are performed. Therefore, the district’s subsidy does not fund any of their services; the subsidy only funds the primary care physicians who treat pregnant women.
Those OBYGN doctors come to PIMC on the first Tuesday and fourth Thursday of the month. Friday Harbor’s Planned Parenthood is open from 8 a.m. to 5 p.m. on Thursdays, only, and has two employees.
During the public comment section, Necia Quast said her primary care physician referred her to request a birth control prescription from one of the Island Hospital OBGYN doctors.
Harrington also said Planned Parenthood provides an alternative place for people to obtain services those contracted doctors may provide — like contraceptive and STD testing — without consulting their regular doctor and, often, for less money.
The Reproductive Privacy Act is listed in the resolution as a reason for its approval. The act says the state — which Williams said the district represents — cannot discriminate against women’s reproductive rights by not offering options for birth control and abortions. According to the Washington Secretary of State’s website, over half of San Juan County voters passed the legislation in 1991.
“No one is alleging it’s a legal obligation to offer these services,” Williams told The Journal. “The public hospital district decides what it wants to offer to the public. So if we take the tax revenue that comes through and we provide health services in general across the population and do in such way that we do not provide any documentable support for reproductive health services, there’s the appearance of discrimination.”
Edwards agreed that the district is not obligated to offer any services and that PIMC already offers women’s reproductive services through their primary care physicians and Island Hospital doctors who lease space at the medical center.
“It’s not like there is a significant deficit in women’s health care in the district,” Edwards told The Journal.
In 2016, the Community Foundation of San Juan Island listed funding for Planned Parenthood as a health care need.
“Contraceptive is inadequate on the island,” said Dr. John Geyman, who spoke during the meeting’s public comment section and worked at Inter Island Medical Center for seven years, before PIMC opened. “Every year, half of the pregnant women on the island are on Medicaid and have financial restraints to leave the island for care.”
According to the Washington State Department of Health, 13 abortions were provided to San Juan County residents in 2015, 11 in 2014 and 7 in 2013. The district does not include the whole county, but most of San Juan Island, as well as Brown, Henry, Johns, Speiden and Stuart islands, so the number of abortions performed on district members could be less.
More than 70 people packed the county’s legislative room at the Feb. 22 meeting, with more overflowing to the lobby and conference room. Signs that promoted funding and not funding Planned Parenthood lined the meeting room. When Schwinge mentioned allegations of Planned Parenthood staff selling aborted fetus body parts, the majority of the crowd booed. When the vote for the resolution passed, some of the crowd scoffed.
“What a surprise,” said one audience member after the vote, in reference to the fact that the same commissioners who approved this resolution approved the subsidy reduction and one of them, Williams, wrote the resolution. Williams stopped the audience when outbursts occurred.
The subsidy is paid through a permanent levy on the district’s property owners to help offset the cost of services provided by PIMC — the only current contractional vendor with the district. These includes physician services and emergency care for people who cannot afford to pay. The subsidy does not cover nonmedical expenses, like utilities or staff wages.
A resolution to amend the district’s public comment procedures was tabled and the board agreed to deliberate on how to institute more public comment before the next board meeting on March 22, when discussion on the draft contract with Planned Parenthood would begin.
The resolution, written by Edwards, would move the public comment section of district meetings from the end of meetings to the beginning.
“We need to make votes in a public way and not in a vacuum,” said Edwards.
Edwards added that he wanted to hear from various institutions about funding Planned Parenthood, such as those who contributed to PIMC’s Critical Needs Assessment report like the San Juan County Health Department, Family Resource Centers, EMS and San Juan County Volunteer Hospice. The 2016 update to that report listed priority health needs as dementia services, hospice care, paramedicine (including fall prevention and visiting services), and curbing tobacco, marijuana and alcohol use for youth. It did not include reproductive services.
According to the U.S. Census Bureau, 30 percent of San Juan County is over age 65 (though the public hospital district does not include the entire county).
Commissioners agreed with a revision to meetings’ public comment timing, but Harrington said the public already commented about reproductive rights during the district’s 2015 election.
“We had a very contested election, with huge participation and I think it’s very clear, that for this audience, reproductive rights and access to reproductive health care was a very important issue and has been thoroughly discussed and debated often in the newspapers,” said Harrington. “So to suggest there has not been public comment is basically to say all of that input didn’t happen.”
According to the Washington Secretary of State’s website, more than 50 percent of San Juan County voters voted for each of the three newest commissioners in the November 2015 election.
Williams suggested draft resolutions be added to the district’s website so the public can read them before meetings. He hoped commissioners could follow county council’s lead to amend meeting procedures by conducting workshops, but he also questioned the timing of the change.
“It’s been done this way for so long, it’s interesting it’s being brought up now,” he said.
It took two and a half hours after the meeting started — after all resolutions were voted on — for the roughly dozen citizens to speak solely on the Planned Parenthood resolution during the public comment section.
During that time, in a shaky voice, under veiled tears, Carrie Brooks urged the district to respect each other and collaborate on pregnancy prevention.
“I really, really believe what I believe and I respect others with different opinions; I believe in almost everything Mr. Schwinge has said,” said Brooks, whose daughter had a child out of wedlock. “That baby brings so much joy in our lives. I talked to the first director of Planned Parenthood on the island and she was against abortion. I said that we ought to work together so girls don’t even have to think about having one.”
Read about the history of the San Juan County Public Hospital District No. 1 in this timeline.