Board of Health Recommends Oversight for Merged Hospitals
The Louisville Metro Board of Health wants to add a new layer of oversight in the pending hospital merger.The board's decision comes after studying the pending merger between University of Louisville Hospital, Jewish Hospital and Catholic Health Initiatives. The panel was inundated with questions about how reproductive health, end of life care and a number of other issues would be handled with a Catholic partner controlling a majority of the hospitals.The board's final report concludes that the merger could potentially create barriers to healthcare equity and access. At least one procedure—tubal ligations for women—will be moved to another facility outside of the merger. But rather than say whether the merger should or should not happen, the board says the partners should agree to be monitored to ensure they keep their promises to preserve care. (Read the board's full report here.)“There needs to be a mechanism that is thought out in a collaborative way, in a proactive way, that can monitor and provide assurance that any of the commitments made are carried out in the way that they've been spoken and also that there isn't a change to health access in the community," says Board of Health Vice-chair Gabriela Alcalde.Alcalde says the exact means of oversight have yet to be determined. The board has sent its recommendations to the attorney general and governor, who could push to implement any changes. Alcalde says the attorney general's office will have to determine how the oversight will work and if there would be any penalties if the merged entity changes its practices.“Traditionally public health does have some level of enforcement. Certainly we would want there to be some consequence, some power and some impact to this sort of assurance," she says.At a forum last month, the partners announced how reproductive issues other than tubal ligations will be handled:
- Miscarriage management will not change
- Elective abortions are not performed at University Hospital and will not be performed after the merger
- Medically indicated abortions (when the life of mother is threatened or the fetus has a lethal anomaly) will be performed at University Hospital
- Emergency contraception (the morning after pill) will still be offered. “At this point in time it will remain the same,” said Dr. Makhija.
- Family Planning is usually done in outpatient centers and will not change.
- Vasectomies are out of office procedures and will not change
- In vitro fertilization will remain an out of office procedure
- Contraception counseling and prescriptions will be available, but the hospital will no longer fill prescriptions for contraceptives.
This turkey of a merger is half baked and needs to be re-evaluated as this will affect Kentucky taxpayers as well as our health care for generations. There are just too many logistical and financial questions along with religious concerns for either the Governor or the Archbishop to sign off on. Let's put this bird back in the over to cook fully.