Catholic health systems, healthcare — February 24, 2015 at 7:02 am

What happens if Michigan’s independent Crittenton Hospital joins a Catholic health system?


If past experience is any indication, some healthcare services will no longer be available.

This is the second in a multi-part series on the rise of Catholic health systems and the impact on patient care. You can read the first post in the series HERE.

Refusal to treat patients on religious grounds in Michigan has made national news recently, with the case of a pediatrician who turned away a baby because her parents are lesbians.

But what isn’t so much in the news — although it should be — is the proposed acquisition of Crittenton Hospital in Rochester, Mich., by St. Louis-based Ascension Health.

According to Brooke Tucker, staff attorney for the ACLU of Michigan, Ascension Health is the largest Catholic health system in the country.

Officials at Ascension Health and Crittenton Hospital don’t seem to be talking much about the impact the Ethical and Religious Directives for Catholic Health Care Services (“the Directives”) that govern Catholic-sponsored or -affiliated hospitals could have on patient care.

Here’s the only reference to Ascension Health’s Catholic orientation in a piece about the acquisition of Crittenton Hospital — being billed as a merger — in an article published in Crain’s Detroit Business:

[Roy Powell, Crittenton’s CEO] said there will be ‘limited impact’ to certain Crittenton services that may conflict with Catholic canons. He did not specify which services.

What exactly does that mean? It’s unclear — as is often the case when it comes to enshrining religious doctrine where it doesn’t belong. Let’s remember how vague the Michigan law requiring women to purchase a separate insurance rider to cover elective abortion services is, leaving even some OB/GYNs a bit uncertain.

What’s crystal clear are the Directives, which forbid hospitals and physicians from providing services including abortion — even if the mother’s life is at risk — birth control counseling and sterilization of both men and women.

The ACLU of Michigan fully intends to find out how much Catholic doctrine will drive medical decision-making if Crittenton Hospital becomes part of Ascension Health. Right now, the two entities are in a six-month due diligence process that began December 31, 2014, Tucker says.

One of the advantages is that we found out about this six months ahead of time rather than after the fact. Whether it’s stopping the merger or just ensuring that reproductive healthcare — and healthcare in general — is not compromised, we want to make sure hospitals stay open and functional in a way that serves all of the community’s residents.

Tucker and her colleagues at the ACLU of Michigan know what’s at stake if Crittenton stops offering services it does today, such as tubal sterilization, commonly known as “getting your tubes tied.”

In addition to the troubling case of Tamesha Means, who was sent home twice by a Catholic-affiliated Michigan hospital in the throes of a miscarriage — putting her health in jeopardy — there’s now a sterilization procedure ban in place at Genesys Health System in Grand Blanc, which is part of Ascension Health.

The ACLU of Michigan has contacted the Michigan Department of Licensing and Regulatory Affairs (LARA) urging them to “require Genesys to stop further implementation of the tubal sterilization ban.”

According to the ACLU of Michigan letter to LARA, tubal sterilization is the most common form of permanent birth control in the world per the American College of Obstetricians and Gynecologists. It’s an overwhelmingly safe, effective form of contraception that’s often performed immediately following a Cesarean section to spare the woman a second surgery and additional anesthesia.

Women who have Cesarean sections at a Genesys hospital — which, for some, is the only hospital where their OB/GYN has privileges — must wait six weeks to heal before having the tubal sterilization performed elsewhere, which then requires additional healing time. Otherwise, they must choose another birth control option. For women who are told by their doctors not to get pregnant again, having to choose a less effective form of birth control could put their health and even their lives at risk.

In a case cited in the ACLU of Michigan’s letter to LARA, one woman and her OB/GYN were not aware of the Genesys ban on tubal sterilization until two weeks before her delivery date. It was too late to choose another OB/GYN with admitting privileges at another hospital — nor should the woman have been forced to make that decision. She had her C-section without the tubal sterilization.

Could this happen at Crittenton Hospital if it becomes part of Ascension Health? No one’s quite sure, which is why the ACLU of Michigan will be watching the proposed merger closely, Tucker says.

An out-of-state provider wants to come in and take over the last independent non-profit hospital in Southeast Michigan, and there’s a whole host of problems with that. Not only do we have the loss of local control but the Catholic nature on top of it.

What’s more, an Ascension Health subsidiary just announced that it’s buying Michigan-based insurer U.S. Health and Life Insurance Co. for $50 million (more on the money in a future post). It’s not yet clear how this could impact the offerings of the insurer, but it’s yet one more step in the march of Catholic health systems establishing a bigger footprint in the healthcare industry.

“It’s not just hospitals,” Tucker says. “It’s urgent care centers, outpatient facilities, nursing facilities and other service organizations that would be governed by the Directives.”

In the months ahead, the ACLU of Michigan will be educating people in Rochester and surrounding communities that rely on Crittenton Hospital for care on the implications of the merger. They also intend to gather community input to make sure the voices of patients are heard before the merger is completed.

“The ultimate goal,” Tucker says, “is to make sure the same healthcare services that are currently provided at Crittenton continue to be provided after a merger.”

If you want to provide input on the proposed Crittenton Hospital merger, email Brooke Tucker at the ACLU of Michigan. We’ll keep Eclectablog readers updated on the progress of the merger as this series on Catholic health systems continues over the coming weeks and months.