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Posted at 10:27 PM ET, 01/25/2011

Choosing the wrong hospital

By Jill Brantley, Silver Spring

To read Rob Stein’s front-page story, “Reproductive-care restrictions at Catholic hospitals spark conflict, scrutiny” at 8 a.m. on Jan. 20 and, then, watch the Maryland Health Care Commission in action that afternoon was to experience parallel universes.

In the first, real people, both patients and providers, are suffering real harm because of real restrictions imposed by Catholic Church directives. In the other — the world of the MHCC as it awarded Holy Cross Hospital rather than Adventist HealthCare the right to build a new hospital in northern Montgomery County — the story’s account, or any account, of suffering was a non-issue, present only tangentially save for the moment that Maryland NOW president Linda Mahoney ran a bureaucratic gantlet and attempted to describe it.

Despite the problems documented in Mr. Stein’s article and a flood of letters to the commission expressing concern with the restrictions of Catholic-affiliated hospitals, the MHCC commissioners were hardly able to muster even a question in the less than 15 minutes it took them to decide for Holy Cross. One had to conclude that something is wrong with the system by which government constructs boards when an issue of this importance goes for all practical purposes undebated.

The Maryland legislature needs to craft legislation to ensure state boards that offer genuinely divergent points of view.

The writer is a vice president of the Montgomery County NOW chapter, which is a founding member of the Montgomery County Complete Care Coalition.

By Jill Brantley, Silver Spring  | January 25, 2011; 10:27 PM ET
Categories:  Maryland, Montgomery County, faith, health care  
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Comments

As a member of the MCCCC coalition I couldn't agree more. The Maryland Health Care Commission completely abnegated their responsibilities by refusing to consider the serious access issues suffered by women in Montgomery County. I am astounded by the lack of analysis or even discussion.

They also refused to consider emerging evidence that Catholic Hospitals are delivering substandard care to women with pregnancy complications. http://www.nwlc.org/resource/below-radar-religious-refusals-treat-pregnancy-complications-put-women-danger. The coalition will continue its fight because women deserve better health care than Holy Cross will provide.

Posted by: morrisonjill | January 26, 2011 10:38 AM | Report abuse

One issue with the decision should be why Maryland would grant a certificate of need for a hospital in an area which, by the Chairperson's own explanation, contains other medical facilities which would be expected to provide reproductive health services that Holy Cross refuses to provide. Especially when Adventist has already bought the land and acquired necessary permits to build in an area without similar medical facilities, and in conformity to the the county growth plan.

Another issue is why the state would choose the hospital which will be built on county land, invoking potential lawsuits by county residents who object to religious decisions restricting services in a publicly licensed facility on public land.

Apart from the specifics of what services would not be provided by Holy Cross, it is amazing that the state does not appear to have guidelines requiring that ALL LEGAL services MUST be provided by any hospital - let alone any new hospital - being certified by the state. And when the specifics are raised, like refusal of counseling of condom use for patients with HIV/AIDS, the prevention of a death sentence by an infectious disease appears to be an inconsequential consideration of the Commissioners.

Holy Cross is congratulated in the press as providing services to impoverished women. But Holy Cross is reimbursed by Medicaid and Medicare for medical services, and Catholic Charities is substantially funded by other charities like United Way and by federal funding to provide services for low income citizens. So it's not like they are the only agency able to provide these services.

One has to wonder why Chairperson Moon would publicly discount the county's own growth plan, flatly stating that "it's not going to happen that way". And why would she deem "inappropriate" - her word - the letter from 12 upcounty state legislators requesting that the Commission favor the Adventist proposal? Surely, these legislators are more in touch with the county and that particular area than Marilyn Moon.

The final issue is why was there such a rush by the Commission to grant a certificate, when they were aware that litigation might tie up the start of construction for a number of years. Was the intent to block Adventist from building, while buying time for the population growth to develop which would render an "unsustainable" - the state agency's characterization - Holy Cross hospital to turn a profit?

Probably by the time there is a formal hearing, deals have already been made. Nevertheless, Marylanders deserve to at least have issues raised in the hearings - before the Commissioners rubberstamp the Chairperson's recommendations.

Posted by: RedRocksinDC | January 26, 2011 11:38 AM | Report abuse

I agree with the author, as well. Patient treatment should be based on what is in the best interest of the patient, not on religious directives. Women, who make up more than 50% of the population, will be the most affected. And concerns about reproductive health care are not "a distraction" as stated by a representative of Holy Cross Hospital. That comment alone is telling of the dismissive attitude Holy Cross has for women in Montgomery County.

Opponents of comprehensive reproductive health care for women will try and paint this as an "abortion" issue. While I think abortion is a part of the care some women need, the restrictions also include infertility services, for couples trying to have a child. HIV/AIDS prevention and end of life matters as well. In other words, this affects women and men who live in Montgomery County.

The Maryland Health Care Commission had a clear choice if it wanted to approve a hospital that would provide a full range of services to residents in Montgomery County, but instead it chose to green light discrimination.

There are clear church-state separation issues in this decision that cannot be ignored. The Holy Cross facility would be built on public land yet allowed to discriminate in the provision of services based on religion. The First Amendment protects us from this.

The Maryland Health Care Commission got it wrong, will it take the court to get it right?

Beth Corbin

Posted by: BAC104 | January 26, 2011 11:53 AM | Report abuse

I agree with the author, as well. Patient treatment should be based on what is in the best interest of the patient, not on religious directives. Women, who make up more than 50% of the population, will be the most affected. And concerns about reproductive health care are not "a distraction" as stated by a representative of Holy Cross Hospital. That comment alone is telling of the dismissive attitude Holy Cross has for women in Montgomery County.

Opponents of comprehensive reproductive health care for women will try and paint this as an "abortion" issue. While I think abortion is a part of the care some women need, the restrictions also include infertility services, for couples trying to have a child. HIV/AIDS prevention and end of life matters as well. In other words, this affects women and men who live in Montgomery County.

The Maryland Health Care Commission had a clear choice if it wanted to approve a hospital that would provide a full range of services to residents in Montgomery County, but instead it chose to green light discrimination.

There are clear church-state separation issues in this decision that cannot be ignored. The Holy Cross facility would be built on public land yet allowed to discriminate in the provision of services based on religion. The First Amendment protects us from this.

The Maryland Health Care Commission got it wrong, will it take the court to get it right?

Beth Corbin

Posted by: BAC104 | January 26, 2011 11:54 AM | Report abuse

It's puzzling that the Commission would approve the Holy Cross plan to build a hospital that refuses to provide entire classes of needed care when Adventist's plan would provide complete care.

Holy Cross Silver Spring will not and does not provide a wide range of critically important, even life-saving care. The Ethical and Religious Directives for Catholic Health Care Services prevent Holy Cross facilities from providing needed care, and would supersede best medical practices and judgment in the provision of health care at the proposed hospital.

Holy Cross would not offer end-of-life care, control of STDs and HIV/AIDS through condom distribution and appropriate counseling, equal and fair treatment of LGBT families, as well as fertility and reproductive care.

Commission Chairwoman Marilyn Moon acknowledges these failings would pose “a serious impact,” if residents cannot find this care in an accessible, timely way. We agree. Lack of access to critical care would remain a serious problem if the Holy Cross hospital is built.

These facts and conditions confirm: Holy Cross will not address current and anticipated health care needs in the upcounty region and its proposal must be rejected despite the Health Commission's erroneous decision to support it. Adventist would meet current and future needs and should be approved.

This is a once-in-a-generation decision to build the first new area hospital in decades. Upcounty residents cannot afford to wait another 30 years for a complete care facility, nor can they afford a delay of even 30 minutes when seeking health care. The belief that rape victims, women in labor, and others can roam from one facility to another searching for legal, medically necessary care which Holy Cross does not provide in Silver Spring and will not provide in Germantown is misguided at best.

Area residents cannot afford to run around the county looking for the care they need. Not in emergency situations, and--considering insurance restrictions, transportation limitations and congestion, and other factors--not under any conditions.

Approval of Holy Cross and its admittedly limited care proposal over the complete care option offered by Adventist would fail to fulfill the Maryland Health Commission's duty to work with all stakeholders, and to evaluate all available data to identify under-served communities and help provide accessible, available health care.

The public should not accept excuses that the first new hospital in 30 years will not even try to meet current and expanding needs, nor rely on nebulous assurances that existing facilities which cannot meet current needs will somehow cover for Holy Cross's inability to fully serve community health care needs. With a better option on the table, there is no excuse for approving the flawed, limited Holy Cross proposal.

Bottom line: Upcounty residents deserve complete care, not religious directives, excuses, or a runaround. They need complete care.

Posted by: MikeHersh | January 26, 2011 12:00 PM | Report abuse

While I do not personally like the churches stand on reproductive rights of women,given the choice between Holy Cross and Adventist, Holy Cross is clearly superior. Adventist is a large national corporation that treats it's employees and patients poorly, tries to squeeze every last dime form their employees and patients and has serious deficiencies with basic quality of care and management practices. Too bad other medical systems like Johns Hopkins or the University of Maryland could not be invited to build a hospital in upper Mo Co.

Posted by: 10bestfan | January 26, 2011 12:01 PM | Report abuse

I would add to the comments of my colleagues that I find it remarkable that the Commission blithely ignored a study produced by the Montgomery County Council dealing with the health needs of a large segment of our population. Councilmember Trachtenberg's Reproductive Health workgroup, led by Professor Susan Wood, conclusively highlighted the growing needs of the population of women of reproductive age. As the recession grinds on and local and state budgets continue to shrink, that need grows even more pressing.

The Commission had a copy of this government study, and just brushed it off.

Dana Beyer, M.D.

Posted by: db299 | January 26, 2011 12:09 PM | Report abuse

I've sought care at Adventist and Holy Cross facilities. I've found Holy Cross understaffed, with disinterested personnel. I cannot speak to treatment of employees, but those at Holy Cross seemed depressed and not very motivated. By contrast, the personnel at Adventist have upbeat attitudes, every station is well-staffed, so wait time is very short. Adventist personnel are helpful and friendly. From my personal experiences, it would seem Adventist treats its people (and its patients) much, much better.

As for concerns about Adventist as a "large national corporation," Holy Cross owes its allegiance to the Catholic Church--not exactly known for treating its female and other employees with anything close to equality.

Posted by: MikeHersh | January 26, 2011 12:25 PM | Report abuse

There are a lot of arguments about hospital policies and care which can go back and forth. What cannot be argued is that because this is public land, there needs to be a more public process. The state is not interested in public process. That means the Montgomery County Council must step in from a land-use perspective. They might say they don't have a role, but they do. Councilmembers Floreen and Leventhal are the key ones to approach because they will look to push this through without the proper procedures. The County Council must tell the college to go through a proper land process, including opening land bidding to other health-care providers around the state. Imagine if Maryland health system was interested? That makes more sense than a private institution getting public land.

Posted by: kensingland | January 27, 2011 5:27 AM | Report abuse

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