Lenore Bayuk, MS, ARNP; J. Michael Edwards, DDS, MD, FACS

George Foster, MD, FACS, Keri Talbott BA, ... Claudia% Salquist% ... Roger% Longley% Roger% Salquist% Ron% Lehman% Ronda% Jones%...

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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  

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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'  

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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.

 

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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  

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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  

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