September 17, 2012 San Juan County Public Hospital District One Commissioners: Lenore Bayuk, MS, ARNP; J. Michael Edwards, DDS, MD, FACS; George Foster, MD, FACS, Keri Talbott BA, Rosanna O’Donnell Dear Commissioners, We, the undersigned, appreciate all of the hard work the commission has done in bringing a hospital to San Juan Island. The hospital will play an important role in the fabric of our community for generations to come. As the new facility is getting ready to open, we have specific questions for the hospital commissioners about the subsidy agreement that was made with PeaceHealth and how that will affect health care for islanders in the near-term and over the 50year lifespan of the agreement. We feel compelled to ask these questions because we believe it’s critical to ensure that health care needs of current and future islanders are addressed in a fair and equitable way. We know there are many islanders who have expressed an interest in these issues, and the hospital board has said that it wants to operate with transparency, so we respectfully request the hospital board to respond in writing and publicly to the following questions/concerns: In the agreement, PeaceHealth has the right to merge, acquire, or be acquired by another facility that shares its same mission. It has declared its intent to merge with a division of another, much larger
1
Catholic health system, Catholic Health Initiatives (CHI), resulting, in the CHI CEO’s words “in a fully integrated new health system.” Catholic Health Initiatives says on its web site and in its employee handbook that it follows the Bishops' Ethical and Religious Directives. The bishops' directives prohibit many types of medical procedures and require others and according to one of the directives, all employees are required to follow all of the directives as a condition of employment. Among the forbidden services/activities/procedures: • Abortion under any circumstance, including in the case of extrauterine (ectopic) pregancies, rape, or incest • All contraception, including IUDs, The Pill, and emergency contraception (Plan B) • Sterilization, including tubal ligation and vasectomies • Participation by physicians and other health care providers in the Washington Death with Dignity Act (DWDA), which was approved by 72% of the voters in San Juan County, including providing information about the DWDA to patients, as well as referrals to organizations that provide counseling and support to patients who want the option to use the law The directives also require employees to disregard patient health advance directives if they conflict with the bishops' directives. This means, among other things, that patients similar to Terri Schiavo who are in persistent, vegetative states must be given artificial nutrition even if the patient has expressly directed otherwise through an Advance Directive. Given all of the above, here are our questions: • What written and legally binding guarantees did the hospital board get from PeaceHealth that services and practices currently available through InterIsland Medical Center but which are in conflict with the bishops'
2
directives, especially those related to reproductive health (e.g., IUD placement, birth control services), will be available in theory and in practice at the new taxpayersubsized medical facility over the life of the agreement? • What written and legally binding guarantees did the hospital board get from PeaceHealth that patient advance directives, especially with respect to artificial nutrition (feeding tubes) will be followed? • Given that between 95% and 97% of taxpayer health care dollars funded through the hospital taxing district and not subject to voter approval are committed to PeaceHealth through the next 50 years, what legally binding provision is there for funding health care treatments that are not or will not be available through PeaceHealth? (An example today might be reproductive health services; an example into the future might be treatments for Parkinson's or other diseases made possible through the use of embryonic stem cells, which the bishops' directives expressly forbid.) • After seven years, PeaceHealth has the ability to withdraw from the agreement with three years' notice if reimbursement rates change substantially or if they determine that the hospital is not financially viable. What provisions exist for the District to withdraw from the agreement over the next 50 years if future hospital board commissioners believe that PeaceHealth is not meeting the health care needs of islanders? We look forward to reading your responses and we thank you for your attention to these issues.
3
Respectfully, Coalition for Health Care Transparency and Equity (list attached) Alex Alice Alice Alice Alicia Alison Alison D. Allison Alvin Amy Andrea Andrea Coffelt Ann W. Anne Anne Annette Antoinette A Arlin Artha Audra B. Carla Barbara Barbara Barbara Barbara Barbara Barbara Barbara Barbara Barry Becky Beth Bob Bob Brad Brent
Shapiro Acheson Swan Hibberd Wollman-‐Simson Longley Harris Hart Lengyel Dreyer Lear Simmons Kuetzing Nelson Pope Sheridan Garver Poulsen Rothauge Kass Adelberger Wright Conrad Cox Marrett Sharp Starr Van Eeckhout Wollman Wheeler Jacobson Kilpatrick Hetrick Free Jones Pillow Snow
4
Brian K. Bruce Bruce Camille Carol Carol Carole Carolee Carolyn Carrie Catherine Chad Charlene Charles Charles E. Charlie Cheryl Chris Clare Claudia Colette Colleen Craig Cynthia Dan Dana Dana Dave David David David David David David Dawn Deb Deirdre Denis Denise Diana Diane Dianne Dick
Lynch Howe-‐Gregory Clark Uhlir Maas Jackson Davis Maya deRoos Lacher Barnhart Lyons Caren Richardson O'Clair Bodenstab Suit Downing Kelm Salquist Landerville Howe-‐Gregory Melvin Hubbard Shelley Bune Roberts Zeretzke Bayley Meiland Moulton Hanson Geist Dehlendorf Cleary Bruels Morris Goudie Steinbrueck Asher Martindale Hall Coffey 5
Doris Dove Earlene Edie Edward Eileen Eko El Elaine M. Eleanor Elena Elizabeth Elizabeth (Bette) Ellen Erin Fiona Florence Fred Gail Gay Gay Gene Gerald Gigi Gordon Gordon Greg Gretchen Gretchen Hawk Heidi Helen Holly Ingrid J.J. James James Mead Jan Jan Jan Jane Jane
Van Alen Toll Rothauge de Chadenedes Dillery Drath Noble Baylis Kendall Hartmann Thoms Plunkett Story Roberts Braybrook Norris Harrison Henley Leschine-‐Seitz Wilmerding Graham Krattli Rasmussen Zakula Haverstock Koenig Gerhardstein Allison Gubelman Pingree Lopez Venada Durham-‐Guckian Fabianson Davis, MD Hamilton Maya Osborn Jones Cyre Baier-‐Nelson Gerhardstein 6
Janet C. Jared Jason Jean Jean M. Jeanne Jeff Jeff Jennifer C. Jerold P. (Pat) Jim Jim Jim Jim Joann Jody Joe John John John J. Jolie Joyce Joyce Joyce Juan Jude Judith Judith Judy Julie Julie Julie June L. Karin Karina Karl Karrie Kate Kathleen Kathleen Kathryn Katie Kay
Wright Starr Miniken Turner Shreve Lee Sarantopolus Durham-‐Guckian Black Miller Slocomb Skoog Specht Uhlir Ashlock Burns Miller Dustrude Soderberg Brash Wheeling Harrell Lewin Sobel Lopez Hennen Chovan Lingerfelt Henley Lewis (Hanks) Young Anderson Hart Agosta Serna Kuetzing Cooper Wood Moss Krattli Ross Hover Jakutis 7
Kelly Ken Kerwin Kira Kirsten Kurt Larry Lawrence Leah Lee Lesley Linda Linda Linda Lisa Lisa Lisa Liz Liz Liz Liz Liza Lori Lori T. Lorie Louise Louise Luanne Lynn Lynn Maggie Maggie Malinda Margaret Margaret E. Marie Marilyn M. Marita Mark Mark Marta Martha Martha J.
Snow Wood Johnson Liu Daniel Schwalbe Soll Brud Joslin Moulton Sturdivant Liddle Cooper Larsen Ellsworth Duke Henderson Lawrence Covert Illg Pillow Taylor Michaelson Stokes Miller Narum Dustrude Lelevich Pasik Danaher Thomerson Lesoing Savage Dreyer Johnson Stack Rothlisberger Schultz Dillery Hetrick Madsen Specht Scott Huleatte, Ed.D 8
Marty J. Mary Mary Mary E. Mary Ellen Mary Jane Mary Karen Melanie Melonie Michael Michael Michael Michelle Midge Mike Mike Mike Mitch Molly Molly Monica Monty Myra Nancy Nancy Nancy Nancy Nancy Nancy Nancy Nikki Pat Patricia Patricia Patricia Patricia Patrick Patty Patty Paula Pauline Peggy Peggy Sue
Robinson WillAllen Nash Rice Courtney Anderson Ryan Thea Walter Hurwicz Tranfo Bonacci Lyons Levy Buettell Harrington Lazzari Lesoing Hogan O'Neil Harrington Berke Finch DeVaux Larsen Maron Wight Best Schafer Jones Ruggiero McDole Brightman Otley Frances Hansen Kirby Brownlee Pimack-‐Hamilton West Mulligan Weir McRae 9
Pegi Peter Peter Philip Randolph Renate Richard Richard Richard Richard Richard W. Rita M. Robbie Robert Robert Robert H. Robin Robin Rod Roger Roger Roger Ron Ronda Ruth Ruth Sam Sandra F. Sandy Sandy Sara Sarah Sasha Seanene Shannon Shannon Sharon Sharon Sharon Sheila Sheila A. Sheldon Shelle
Melvin McCorison Risser Daniel Moss Arnett Grout Norris Otley Barnhart Wright O'Clair Lawson Arnett Tripp Stavers Jacobson Blair Kulbach deRoos Longley Salquist Lehman Jones Fleming Offen Stitt Wilson Richard Strehlou Jensen Crosby von Dassow Kennedy Dean Miniken Pigman Abreu Wootton Gaquin Harley Gregory Cropper 10
Sondra Stacy
Stephanie Stephen G. Steve Steve Steve Steve Steve Steve Sue Susan Susan Susan J. Suzanne Suzanne Tal TeriLyn Terrea Terry Thor Tifni Tim Tim Tom Trish Trudy Valerie Vanda J. Virgil Wayne Wendy E. William William R.
Bayley Markman Prima-‐ Sarantopulos Belluomini Schramm Bowman Ashlock Hopkins McKenna McKenna Buettell Risser Dehlendorf Lee Pingree Olson Sturdivant Brown Bennett Ogle Jensen Twitchell Lynch Dustrude Nelson Young Lehman Dallas MD Tibbett Randall Hennen Fitzgerald Shepard Agosta Greene, MD
11
