The Connecticut Health Strategy raises questions about the proposed deal between the Massachusetts-based Catholic health system Covenant Health and Day Kimball Hospital in rural Putnam. If the deal is approved, the new owners will remove some of the hospital’s reproductive health services.
Under the terms of the deal, Covenant Health will acquire Day Kimball by bringing the troubled rural health system into its larger network and absorbing tens of millions of dollars of its debt. Day Kimball is one of the few remaining independent hospitals in the state and is performing poorly financially compared to other hospitals in Connecticut in recent years.
But acquiring from a Catholic health system would mean that Day Kimball must adhere to the Ethical and Religious Directives on Catholic Health Services or ERD, which restrict reproductive health services, emergency contraception, fertility, gender mainstreaming, end-of-life and other care. A similar proposal from Waterbury Hospital fell apart a decade ago after opposition from women’s reproductive rights advocates.
Covenant and Day Kimball announced their deal late last year. This April, Day Kimball applied for a 726-page application in the state – known as a “certificate of need” – seeking approval from the Office of Health Strategy for the transfer of ownership.
On 27 May, the OHS responded by requesting additional information from both hospitals on several aspects of the application, including the ERD.
OHS asked how Day Kimball will provide access to services that have been discontinued as a result of the adoption of the ERD; whether Day Kimball will provide referrals and transportation for patients seeking these services; and which other entities in Day Kimball – the system includes home and hospice care operations, a medical team and four health centers – will be subject to changes in policies and procedures under the Agreement.
The letter also asked about costs and quality, the limitations of women’s health services at another Covenant medical center, and further details about Day Kimball’s financial challenges. The hospital has 60 days to respond.
Kyle Kramer, CEO of Day Kimball, said in an e-mail statement that the planned accession to Covenant Health would actually allow Day Kimball to expand patient care by “serving people of all faiths, backgrounds and incomes.” While previous discussions with other hospital systems have failed, Kramer said the agreement with Covenant will ensure that Day Kimball retains many of its services, including childbirth and childbirth, intensive care and other hospital care.
Noting that Day Kimball is the largest employer in the region, Kramer said: “Our relationship with Covenant Healthcare will provide a strong and stable financial position and accelerate the financing of future clinical and infrastructure capital needs.”
In an e-mail statement, a Covenant Health spokesman said the two hospitals were reviewing OHS’s request and planned to “provide a careful written response” within the required timeframe.
“Based on our due diligence to date, it is clear that the proposed accession will preserve a wide range of high-quality health services and jobs for community members in Northeast Connecticut,” said spokeswoman Karen Sullivan.
The proposal comes amid a heated debate across the country on access to abortion, contraception and other reproductive health services. As many states – including Connecticut – seek to expand access and provide safe haven for abortion patients, ethical and religious directives could restrict Catholic health systems in those states from providing some of the services they need to protect. legislators work.
The best Catholic health systems, like many large health systems, are becoming the dominant providers in their regions, growing through the acquisition of smaller, more difficult hospitals. Four of the country’s 10 largest health systems are Catholic and control hundreds of emergency hospitals, emergency clinics, medical practice groups and other facilities.
In Connecticut, Trinity Health, the nation’s sixth-largest system, according to a recent report, operates Saint Francis Hospital in Hartford, Johnson Memorial Hospital in Stafford and Saint Mary’s Hospital in Waterbury, among other facilities.
As Catholic health care providers grow, advocates and researchers are concerned about the growing influence of the ERD in patient care.
Lori Friedman, a professor at the Bixby Center for Global Reproductive Health at the University of California, San Francisco, said patients often do not know the difference between Catholic and secular hospitals and which services are offered in one and not the other.
If a woman loses her pregnancy, Friedman said, a secular hospital can offer her a choice between waiting to see if she can give birth naturally, taking birth control drugs or having an abortion.
“Catholic hospitals are different,” Friedman said, “because they can only offer her” look and wait. ” [option] until he gets sick. Once she falls ill, they are allowed to intervene.
Friedman said most people do not understand these nuances. And in rural areas like Putnam, emergency patients may not be able to travel longer, even if they have a preference for care.
Megan Holden, a spokeswoman for the American Civil Liberties Union in Connecticut, who grew up near Putnam, said: “In general, what these ethical and religious directives mean for caregivers is less. And when you talk about a rural hospital like Day Kimball, it can have pretty dire consequences for people in the community.
One of these options is no longer available. In 2020, the Planned Parenthood of Southern New England closed its health center in Danielson, the closest place to Day Kimball, citing economic hardship caused by the pandemic.
“We are not an exclusively Catholic community. There are Jews, Muslims and people of other faiths here, and there is no faith, “said Rev. Jane Newell, pastor of the Federal Church of Christ in Brooklyn, Connecticut, who occasionally serves as a priest in Day Kimball. “Being subject to some other directive and being your only choice in a rural area is very worrying,” Newell said.
According to the application for a certificate of necessity, Day Kimball “has not performed any voluntary abortions for many years.” In fact, most abortion procedures – 95%, according to Friedman – are performed in clinics, not hospitals.
But the app outlines several procedures that Day Kimball would no longer offer if she became part of Covenant Health, including vasectomy, IUD insertion and tubal ligation, known in the conversation as “tied tubes.”
In examining Day Kimball’s application, as with any certificate of need application, government officials focus on price, quality and access issues, said Stephen Lazarus, an OHS analyst.
“Looking at the candidate, we look at the financial data to make sure there is financial stability. “We also want to make sure we have access to services and continue to ensure that quality is maintained,” he said.
Once Day Kimball responds, OHS will review the application again and may request additional information. That could go back several times, Lazar said.
Members of the public are welcome to comment and there will likely be a public hearing in the next few months once the review is over. Residents can follow the CON portal of the Office of Health Strategy (document № 32538).