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U of L Appeals Merger-Related Open Records Ruling

The University of Louisville has filed an appeal to an attorney general’s ruling regarding an Open Records dispute with the American Civil Liberties Union.

Last summer, the ACLU filed an Open Records request for materials related to the pending merger of U of L Hospital, Jewish/St. Mary’s Hospital System and Catholic Health Initiatives.

U of L refused to turn over 13 e-mails, claiming they were preliminary in nature and exempt from the Open Records law, and that some of them were also protected by attorney/client privilege.

The ACLU appealed to the attorney general, which ruled that four of the e-mails were not exempt from the request.

U of L is now appealing that decision in Jefferson Circuit Court.

The attorney general also ruled last month that the company that operates U of L Hospital is a public entity, which would make the merger subject to state approval.

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Skeptics Continue Questioning Hospital Merger

A group that’s critical of the pending hospital merger has released another round of questions for the merging partners.

Honi Goldman leads the unnamed group. Her questions for University of Louisville Hospital, Jewish Hospital and Catholic Health Initiatives largely concern funding for the merger and the final management structure of the merged entity. The deal is still a work in progress, and it’s pending state approval. Goldman released the questions in a release to the media and wrote about them on Insider Louisville. She says she hopes the governor, attorney general and legislators see the questions and seek answers.

“We’re hopeful that they share our skepticism around this, because these are tax dollars at work. Tax dollars are going to be funding this merger,” she says, adding that she is not opposed to the merger.

Last week, the merging partners spoke at a Board of Health forum. They revealed that University Hospital will not be under Catholic care directives after the merger, but will rather follow a contract that is still being written.

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Baptist Hospital East to Handle Tubal Ligations After Merger

The hospital merger that is meant to enhance care across Kentucky will result in some procedures being moved to facilities outside of the merger.

The University of Louisville has expanded its decade-old partnership with Baptist Hospital East to relocate procedures that will eventually be banned at U of L Hospital. The hospital is merging with Jewish Hospital and a division of Catholic Health Initiatives. Afterward, all doctors will have to follow Catholic care directives in merged facilities. That means women will not be able to have their tubes tied at University Hospital.

U of L has been in talks to move tubal ligations to Baptist Hospital East for weeks. The partnership means that women who want to have a ligation after a caesarean section will have to plan to deliver at Baptist Hospital.

“It would be exactly the same as a patient with a brain tumor who is seen at the James Graham Brown Cancer Center and is told that their neurosurgery would be done at Baptist Hospital whereas they might come back to University Hospital for the chemotherapy and radiotherapy,” says School of Medicine Dead Edward Halperin.

U of L officials announced the partnership today, ending weeks of speculation and rumors. Officials say differences in insurance coverage for U of L and Baptist Hospital are minimal but will be worked out and transportation will be provided for indigent patients.

“Obviously these guys have never been in labor. To transport a woman past hospital after hospital just to get to Baptist East is a little bit ludicrous,” says merger critic Honi Goldman.

“You’re still going to have a built-in time lag for these people and that’s just not fair and it’s not right,” says attorney and former nurse Beverly Glascock, who is also a critic of the merger. “This is a community hospital and they should try to make this hospital work for the community and not just the members of the merger.”

Goldman says the partnership doesn’t resolve ongoing concerns about University Hospital–a top choice for uninsured and low-income residents–merging partners have not adequately explained how end-of-life care issues will be addressed.

The school of medicine is not part of the merger and other procedures banned by the Catholic Church will likely be provided in U of L clinics or facilities, if they aren’t offered in them already. The procedures include abortions, contraception counseling and vasectomies.

The merger still requires approval from the governor and attorney general. Both have raised questions about the future of reproductive and end-of-life care at University Hospital, which has a number of low-income patients.

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Local News Politics

Lawmaker Has More Questions About Hospital Merger

The principals of three merging healthcare systems in Kentucky can expect more questions from state lawmakers.

Last week, representatives from University of Louisville Hospital, Jewish Hospital and Catholic Health Initiatives addressed the Interim Joint Committee on Health and Welfare. They fielded questions about how reproductive and end-of-life services would be protected after the entities merge and Catholic care directives are enforced at University Hospital.

They said the U of L medical school will not merge and all services, such as vasectomies and tubal ligations will still be provided, though possibly at another facility. But committee co-chair Rep. Tom Burch, D-Louisville, says the alternate facilities may work for procedures that can be scheduled beforehand, but not for emergencies.

“I don’t need my beliefs—and I’m Catholic—I don’t need my beliefs pushed on somebody else,” said Burch the day after the meeting in an interview with WFPL News. “I would refuse to do that. I’ll be darned if I want to go into a hospital and they say, ‘We can’t do this here we can’t do that here,’ because the Catholic Church is opposed to it,”  says committee co-chair Tom Burch of Louisville.

He says the best option would be to exempt University Hospital from Catholic rules. Burch plans to send a list of questions about the merger to the principals. Specifically, he wants to know the religious affiliation of the merged entity’s management boards.

“I think everybody has a right to know who these people are and what would move them in one director or another. Some peoples’ religion causes them to do a thing they might not want to do,” he says.

Burch’s request has drawn criticism, but he insists it isn’t over the line, since lawmakers routinely volunteer their religion.

He expects to call the principals back to Frankfort for another hearing early next year.

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Lawmakers Ask Hospital Officials About Undoing Merger

Representatives from the University of Louisville, Jewish Hospital and a division of Catholic Health Initiatives discussed their facilities’ pending merger during a General Assembly committee meeting today.

Committee members asked a series of questions about how reproductive and end-of-life care would be preserved after CHI takes majority ownership of University Hospital. Hospital staff will have to follow Catholic medical directives, and some lawmakers posed specific scenarios about contraception for rape victims and prenatal care for cancer patients.

Hospital officials explained that the medical school will not merge and staff will provide all currently-offered services, perhaps in a different facility.

“Where is the outside facility?” asked Representative Mary Lou Marzian, D-Louisville. “How is that gonna happen?”

Officials didn’t know what that facility could be. Other hospitals have established secular facilities or enclaves to provide banned procedures.

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Conway Says State Must Approve Hospital Merger, Ramsey to Address Lawmakers

Kentucky Attorney General Jack Conway and Governor Steve Beshear are attempting to assert their role in a pending hospital merger.

Questions have been growing around the proposed merger of University of Louisville Hospital, Jewish Hospital and Catholic Health Initiatives. The merged hospitals will have to follow Catholic health directives. That means University Hospital would have to change how it handles reproductive health issues and end-of-life care.

Conway previously announced his intentions to look into the merger to make sure services will be protected after CHI takes 70 percent ownership of the hospital. He told WFPL last week he couldn’t stop the merger, but could recommend that the Federal Trade Commission not allow it to go forward. After reviewing the merger documents, Conway now says the state Finance and Administration Cabinet and Beshear’s office must approve the merger. Governor Beshear issued a statement saying his approval relies on all services currently offered still being offered after the merger. Louisville Mayor Greg Fischer has taken a similar stance. Last year, University Hospital received $61 million from the state and $7 million from the city.

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Beshear Says Commonwealth Won’t Approve Merger Until Concerns Are Addressed

Kentucky Governor Steve Beshear has weighed in on the pending merger between University of Louisville Hospital, Jewish Hospital and a division of Catholic Health Initiatives. Under the merger, U of L Hospital will not be able to provide abortion, stem cell research, vasectomies, treatments for infertility, emergency contraception for rape victims and birth control counseling.

In a statement released Wednesday afternoon, Governor Beshear said the Commonwealth has two roles in the review of the proposed merger: “[T]o review the legal issues associated with the merger and, just as importantly, to review the public policy of how the University of Louisville Hospital will continue to honor its mission as a public teaching hospital that provides access and care to citizens, especially those who are indigent.”

The statement continues:

The Commonwealth must approve changes to the existing leases of public land and facilities as well as any changes to the agreements that provide for the operation of the hospital. Before those approvals will be given, additional discussion and transparency will be needed to provide full disclosure on how the public mission of University Hospital will be honored.

Each time I have spoken with University of Louisville representatives associated with this hospital merger, I have been repeatedly assured that University Hospital’s public mission would continue in every aspect of care. However, it is clear there are growing concerns within the community about issues related to the hospital’s future level of access to medical services, and those concerns need to be fully vetted before the Commonwealth takes the legal steps required to approve this merger.

In order to address the continuing questions related to health care access and availability, my administration will hold a series of conversations with the principals in the proposed merger and other interested parties. The first step in this process will be a meeting with Mayor Greg Fischer, Auditor Crit Luallen, Attorney General Jack Conway, representatives of my administration including Cabinet Secretary Mary Lassiter, Cabinet for Health and Family Services Secretary Janie Miller, Economic Development Secretary Larry Hayes and Finance Secretary Lori Flanery, and the principals involved in the hospital merger to discuss how University Hospital’s public mission will continue to be met. I will also seek additional input from the community and other interested parties to ensure that we have fully reviewed the many questions that must be answered before the proposed merger can move forward.

This process will be deliberate and thoughtful, and we will take whatever time is necessary to resolve these issues.

Mayor Greg Fischer has also expressed concern about the deal, and Attorney General Jack Conway says he’ll be looking into the merger.

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Two Sides of Hospital Merger Debate Represented in Newspaper Ads

Several pages of the Louisville Courier-Journal will be dedicated to the pending University of Louisville hospital merger this weekend, but not editorial pages.

Two groups have paid for ad space to defend their positions on the merger between U of L Hospital, Jewish Hospital and a division of Catholic Health Initiatives.

The first group is representatives from the hospitals. They say while doctors will follow Catholic health directives, banned procedures such as vasectomies and contraception counseling will continue at other U of L facilities not under the merged hospital.

But a group of local women is concerned that the services may not truly be protected, or will be too difficult to access. They’ve collected more than 400 names on a petition and will run the list as an ad this weekend. Four state lawmakers and three Metro Council members have signed the petition, which calls for the merger to be changed.

U of L officials say details of the deal are still being worked out. If federal approval is granted, the merger could begin in the next year.

Representatives with the hospitals did not return a request for comment.

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Local News Noise & Notes Politics

City Lawmakers Denounce Hospital Merger

Joining state lawmakers and hundreds of residents, three members of the Louisville Metro Council are criticizing the pending merger between U of L Hospital, Jewish Hospital and a division of Catholic Health Initiatives.

Council members Tina Ward-Pugh, D-9, Vicki Aubrey Welch, D-13, and Marianne Butler, D-15, signed a petition that will appear as a half-page advertisement in the Courier-Journal this weekend, which protests the hospital merger and says it will “stop vital medical procedures” for residents in the area.

The lucrative deal makes the Denver-based Catholic institute a majority owner over University Hospital, Jewish Hospital & St. Mary’s HealthCare and Lexington-based St. Joseph Health System. But critics of the merger are concerned about the future of certain healthcare services such as vasectomies, stem cell research and other medical procedures of which the Catholic Church does not approve.

Welch says the merger endangers women’s reproductive rights because University Hospital serves poorer patients who rely on their healthcare services more than most.

“My main concern is that it won’t be status quo with women’s and men’s reproductive health. I certainly believe people have the  right to decide if they want a tubal ligation or a vasectomy for family planning, ” she says. “And since University Hospital is our most indigent populated hospital, this is really going to cause problems.”

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Local News Next Louisville Politics

Hospital Partnership Formally Announced

Three major hospitals are joining forces to provide a statewide healthcare delivery system for Kentuckians.

The partnership involves University of Louisville Hospital, Jewish Hospital in Louisville and Saint Joseph Health System in Lexington. They’re still working on a name for the joint effort, but James Taylor of U-of-L Hospital says the partnership means better healthcare for Kentuckians.

“By training more physicians, sharing our academic expertise and collaborating on best practices, this partnership is poised to make a difference in many lives,” Taylor said at a press conference today in Frankfort.

Taylor says the new system will have a medical staff of more than three thousand physicians. It will involve hospitals, medical clinics and home health agencies in 91 locations statewide. Regulatory approval of the partnership could take about a year.