THIS MONTH’S Parable magazine of the Diocese of Manchester has an article by Bishop Libasci entitled “Preserving Catholic Healthcare in New Hampshire”, a misleading assurance. The “definitive agreement” outlining this ‘partnership’ is lengthy and intricate, but I would like to offer “Cliff Notes” on the proposal.

The most dishonest statement in the Parable article reads: “The proposed partnership in no way would be an acquisition or a takeover of CMC by Dartmouth-Hitchcock Health”. Go to the NH Department of Justice website, however, and search the Division of Charitable Trusts. There you find the proposal listed under “Pending Hospital Transactions”, where it is under review as are all “acquisition transactions involving health care organizations in New Hampshire.”

As such, the director of Charitable Trusts is accepting public comments and holding public hearings before making his determination in late April. The fact that this is an acquisition is evident throughout the “Combination Agreement”. On page 1 we are told that Dartmouth-Hitchcock Health (D-HH) is the coordinating organization, adding on page 2 that Granite One Health (GOH) which includes Catholic Medical Center (CMC) is the supporting organization.

In Article 3, we are told D-HH is to change its name to Dartmouth-Hitchcock Health Granite One. It will be the sole corporate member of D-HH and also of Monadnock Community Hospital and Huggins Hospital (both previously under the umbrella of CMC within Granite One). It will also be a co-member of CMC and all its related corporations. It will be responsible for “strategic direction and management of the System”. There is no reciprocity where CMC would be involved in “the reconstitution of D-HH or in any other acts necessary to prepare D-HH to serve as the coordinating and managing organization of the System”.

Furthermore, the System Board of Trustees will have 15 voting members. Nine of those members are chosen by Dartmouth-Hitchcock, the remaining six divided between CMC, Monadnock, and Huggins. As well as the overarching System Board, CMC and CMCHS will maintain their own boards. Up to one third of those appointees will be nominated by the System Board.

CMC and CMCHS however have no influence on the composition of the other component boards. The System Board may veto any CMC Board nominee. The System Board reserves the right to remove any member of the CMC Board of Trustees, the Chair of the Member Board, the CEO, and/or the Regional President.

Reserve powers and authority of the System Board over CMC and CMCHS include:

Size of the Member Board; approval of nominees

Amendments to Articles of Agreement and Bylaws

Operating and Capital Budgets

Indebtedness; Borrowing

Disposition of Assets

Auditing

Clinical Service or Programs

Academic and Research Matters

Exercise of CMC/CMCHS Reserved Powers over own Subsidiaries

Strategic Plans; Key Strategic Relationships

Merger/Change of Control; Divestiture

Bankruptcy; Closure; Dissolution

Participation in System Strategies; Programs; Initiatives

Changes in Clinical Services

Against the backdrop of all this takeover and control of CMC, we are assured that the Bishop will have reserve powers to protect the Catholic identity and the Ethical and Religious Directives (ERD’s) will be enforced within the four walls of the current CMC. At best, this represents turning Catholic Health Care in New Hampshire into a ghetto operation.

The situation presently is actually worse than that, however. Not all the ERD’s are in keeping with the Catechism of the Catholic Church, or current scientific discovery. Also, practices in secular medicine continue to outpace the development of corresponding ERD’s. Finally, at CMC some ERD protocols are not being followed currently.

For example, ERD #36 proposes that under very specific diagnostic criteria, Plan B may be administered to sexual assault victims to prevent pregnancy. At CMC’s Emergency Department, however, Plan B is administered without following that protocol. A faster and cheaper protocol has been substituted which violates the ERD. If there is not compliance now, what are we to expect under Dartmouth influence?

On the other end of the spectrum, CMC distributes from the front desk, two separate Durable Power of Attorney instructions and forms. One is the Catholic Three Beliefs, and the other is the NH secular document. Why, if you are adhering to Catholic moral teaching, would you hand out a form that violates those ideals and practices?

In closing, Catholic Medical Center would be wise to concentrate its energies on understanding and incorporating its own Catholic mission for which it was founded. Please contact the Office of the Attorney General Division of Charitable Trusts with your comments and plan to attend one of the public comment sessions listed on their website.

EDITOR’S NOTE: The public forum on this issue scheduled for March 30 at Memorial High School in Manchester has been postponed

Colleen McCormick, APRN, MA, a Catholic medical ethicist and associate of the Catholic Medical Association, resides in Manchester.

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