Hospital merger: Groups want legal proof of services

Reproductive, end of life issues continue to concern coalition

Sue Vorenberg | The New Mexican

2/19/2008 - 2/20/08

It's not that we don't like you; it's just that we don't trust you.

That's the message a coalition of community groups say they would like to convey to St. Vincent Medical Center and Christus Health before the two private nonprofits enter into a partnership agreement that could threaten reproductive services and end of life care at the hospital.

The groups, which include the American Civil Liberties Union of New Mexico, NARAL Pro-Choice New Mexico, the Southwest Women's Law Center and several others, want to see what's in the binding agreement between the two parties — at least the parts relevant to key community issues — before they'll feel comfortable supporting the merger, said Peter Simonson, executive director of ACLU of New Mexico.

They're concerned that Catholic ethical and religious directives will override the hospital's ability to provide contraception, sterilization procedures and the application of living wills since St. Vincent will fall under those directives in the merger.

So far, representatives of the hospital have said that's not going to happen, and any problem areas will be moved to a new nonprofit organization called SVH Support Co., which won't be under direct control of Christus.

But none of those assurances have been in legally binding documents.

"The hospital and Christus have been asking the community to simply trust that they'll continue end of life care and reproductive health services to perpetuity, but they're not willing to write those into an agreement," Simonson said. "We've made that request repeatedly. We've asked to see the contract to see how Catholic ethical and religious directives will be applied."

The coalition will hold a public meeting tonight at 6 p.m. at the Unitarian Universalist Congregation of Santa Fe, 107 Barcelona Road, designed to educate the public about the issues of concern, said Heather Brewer, executive director of NARAL Pro Choice New Mexico.

"We have no problem with how St. Vincent has conducted this process," Brewer said. "But we're starting to find that the devil is in the details. We want to make sure that although people have heard the meaningful assurances from St. Vincent, unless those are in writing, they aren't really meaningful."

The partnership agreement is still in due diligence and hasn't yet been formalized, said Arturo Delgado, a spokesman for St. Vincent.

There is no deadline by which the partners have to sign the agreement, he added.

The investment by Christus will remove $37 million in debt the hospital carries from projects such as its cancer center and emergency department remodeling and will also pay for further hospital expansion projects.

St. Vincent and Christus don't plan on showing the agreement to anyone and aren't legally bound to do so, he said.

St. Vincent posted a document on its Web site at www.stvin.org titled "Here it is in Writing" that tries to reassure the public about some of the concerns.

The document says family counseling, contraception and end-of-life care will be provided according to state law.

But some of the wording is a little suspicious, Brewer said.

"The (ethical and religious directives) provide that 'there should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens to the patient.' The ethical and religious directives conform to current practices on this point," the document says.

The Web site statement also isn't legally binding despite it being a step in the right direction, Brewer said.

"It's great that they put that on the Web site, but unfortunately what they put on the site doesn't guarantee that an elderly patient gets the end of life care that they need," Brewer said.

Because St. Vincent gets federal, state and community funding, it should have some sort of ethical obligation to prove its protecting the community as it says, Simonson said.

"Right now, though, we're just trying to prevail upon their desire to be faithful to the community's best interests," he said.

The other problem is that while St. Vincent representatives have said they can dissolve the agreement at any time, the reality is that would be a very difficult thing to do, Simonson said.

"Is it realistic to think that Support Co. could unwind itself from its arrangement with Christus? It's not going to have a staff, a manager or support for that capability," he said. "I think it's unrealistic to think Support Co. is capable of buying out Christus, taking over the hospital or continuing on its own."

That's why its important to make sure the agreement resolves community issues before it's signed, he said.

"There are examples where Christus and other Catholic health groups have changed the rules of the game once a merger is complete," Simonson said.

He pointed out a case where Christus acquired McCuistion Regional Medical Center in Paris, Texas, made similar guarantees and then "two years later announced it would remove maternity services that would let a woman have a tubal ligation after giving birth," Simonson said.

Even if the guarantees are in writing in the contract, it's still not an "iron-clad guarantee" that the Catholic Church won't try to overturn some hospital practices, he added.

"Contracts can change," Simonson said. "But we would hope they would at least disclose the relevant parts of the contract that would assuage the community's concerns for now."

IF YOU GO

• What: Community meeting sponsored by groups concerned about St. Vincent-Christus merger
• When: 6 p.m. tonight
• Where: Unitarian Universalist Congregation of Santa Fe, 107 Barcelona Road