In December, the Washington State Department of Health (DOH) filed a state code rule that will increase transparency around religious-secular health system affiliations. The new rule requires hospitals to reveal their policies on reproductive health care, end-of-life care, and nondiscrimination.
The rulemaking resulting in the change was spurred by a letter the ACLU-WA and its allies sent to Governor Inslee last May. It called on the Governor to protect Washingtonians’ access to health care as religious health systems have been taking over secular ones at an unprecedented pace throughout the state, resulting in the reduction of important health services.
Religious health systems in Washington state are predominantly Catholic and are therefore required to follow the Ethical and Religious Directives for Catholic Health Care Services (ERDs) promulgated by the U.S. Conference of Catholic Bishops. These Directives compromise Washingtonian’s access to best-care medical services by restricting reproductive and end-of-life health services. The Directives may also result in restricting access to LGBT health services free of discrimination.
The ACLU-WA had advocated for greater transparency about the services provided at individual hospitals, urging that the DOH require all hospitals to fill out a simple checklist of reproductive, end-of-life and LGBT health services. While the adopted rules were a significant step forward in achieving these goals, the new policy disclosure requirements do not go far enough to protect patient access. The ACLU continues to advocate for the adoption of a checklist of services.
“Hospital policies often are unclear and confusing,” stated Leah Rutman, ACLU-WA policy counsel. “Patients should not have to ‘read between the lines’ to understand what care they will be able to receive at a hospital. Rather, there should be a straightforward means of informing patients of the services available at a facility.”
The ACLU-WA also submitted comments and testified for DOH oversight of religious-secular health system takeovers. Many of these takeovers have evaded DOH review as they have been framed as affiliations or a change in corporate membership, rather than a “sale, purchase or lease” – the criteria required for the Certificate of Need (CON) review process. As a result, the DOH amended the CON rules to more accurately define such transactions. DOH approval, through the CON review process, would be required before a religious health system may take over a secular hospital.
Unfortunately, the amended rule was overturned by Thurston County Superior Court in June. The action came in response to a petition filed by the Washington State Hospital Association which asserted the DOH had overstepped its authority in adopting the rule. The ACLU-WA hopes the state will appeal the ruling.
Other significant changes still are necessary to make sure that religious restrictions do not limit patients’ access to health care. A comprehensive review and revision of state health regulatory programs is needed. The State of Washington has a responsibility to ensure access to best care medical services for all its residents.