St. Joseph Medical Center and Greater Baltimore Medical Center have settled on an operating structure that would allow GBMC to offer abortion and fertility services on its campus, should the two Towson hospitals agree to combine.
Officials of the nonsectarian GBMC had said last month that the hospital would stop performing abortions if it affiliated with St. Joseph, a Roman Catholic institution. However, GBMC said then that it would continue to provide other services, including sterilizations and in-vitro fertilization, which are not done at Catholic institutions.
After some opposition to the deal from women's groups, former board members and others, GBMC's board decided it wanted to maintain all services, including abortion.
Negotiators talked to counterparts from St. Joseph, and after consultation with the Archdiocese of Baltimore, the St. Joseph board approved the modified arrangement last week.
"Our feeling from the get-go -- and influenced by all the input we received -- is that we would not partner with any institution if it means any change in our services," Robert P. Kowal, GBMC's chief executive officer, said yesterday. "We believe the new organization structure we have developed in our discussions with St. Joseph would allow us to maintain our services."
GBMC's board is expected to decide soon whether to join with St. Joseph or with Johns Hopkins Medicine, which also is courting GBMC. Kowal said a choice is likely within a month.
If GBMC chooses St. Joseph, under the terms now on the table a new, separate, corporation would buy a condominium unit in an office building on GBMC's Towson campus, where it would have an operating room and lab.
The new corporation would be run by a board named by the current GBMC board and financed initially by $5 million from GBMC's endowment. Its name could not include any reference to GBMC. St. Joseph and its parent, Denver-based Catholic Health Initiatives, would receive no revenue from the services.
"The major thing that offered the opportunity here is that we are no longer talking about a legal merger but a joint operating agreement, which opened a lot of doors," Kowal said.
The joint operating agreement would mean the two hospitals, whose campuses are adjacent, would not merge their assets. A new operating company would manage both.
Linda Harder, director of public relations and marketing for St. Joseph, said what her hospital's board had approved was "a proposed concept. The actual organization structure requires input and approval of both boards and CHI, and we need to continue working closely with the diocese."
She added, "We will not enter into any relationship that would create a direct legal, financial or other connection with a provider of abortion or fertility services." Under any arrangement, she said, St. Joseph would continue to follow a document governing Catholic hospitals, called "Ethical and Religious Directives for Catholic Health Care Services."
Kowal said the separate corporation would be "invisible" to GBMC patients. Already, he said, "we have a dozen corporations right now," covering such areas as hospice care, laser surgery and wound care, and "when you come here for treatment, you don't know that." The services are performed in the same office building where they would be under the proposed deal, he said.
"This deals well with the concerns" that have been expressed, Kowal said. But some of those who have expressed the concerns were skeptical.
"The Women's Hospital has serious doubts that an arrangement with a separate facility or separate funding would ever really work," Cynthia L. H. Crawley, president of the board of the Hospital for the Women of Maryland, said.
She said the separate services, and potential controversies over what procedures are provided and how they are financed, would be "a constant irritant" that could cause serious problems in the joint operation over time. The board of the Women's Hospital, one of the entities that merged to form GBMC in 1965, still administers its endowment.
Susan C. Elgin, president of the board of the Women's Law Center of Maryland, who met with GBMC officials to convey its misgivings, said, "I don't see how there can be any affiliation that would not be impacted by the [Catholic health] directives."
But Frances Kissling, president of Washington-based Catholics for a Free Choice, applauded the arrangement. "From our perspective, it's an acceptable solution. It's better than losing the services," she said.
Her group issued a report this month saying that, of 64 mergers or other affiliations between Catholic and non-Catholic hospitals nationally since 1990, some or all reproductive health services were discontinued in 31, or 48 percent.
Joyce Ross, vice president of communications for Catholic Health Initiatives, said the 68-hospital chain has four joint operating agreements with non-Catholic hospitals.
She said, "CHI, in striving to achieve healthier communities, which is really the overarching goal of the organization, may form partnership agreements. In a partnership agreement, the non-Catholic partner may choose to provide services that fall outside the Ethical and Religious Directives, and CHI would not in any way provide those services or receive any of the revenue of those services."
Pub Date: 4/23/98