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Task force weighs the pros and cons

A special CHA task force is studying the question of whether for-profit health care organizations that also maintain Catholic identity should be allowed to continue membership in the association. The issue ultimately will be decided by CHA members in a vote at the Catholic Health Assembly in June.

Membership in CHA historically has been limited to not-for-profit, Catholic-sponsored health care organizations. But the association saw the need to reconsider its membership criteria in light of the increasing number of for-profit entities among Catholic health care organizations. A temporary bylaw revision, approved by the membership at the 2011 assembly, allows member organizations that recently converted to for-profit status to remain in the membership during fiscal year 2012 as the association studies its membership categories and criteria.

"This is a complex, multidimensional question about the identity and voice of CHA," said task force chair Colleen Scanlon, "and the task force is approaching it in a very honest, thoughtful, and prayerful manner. We are committed to conducting this discernment as an open, transparent process with as much opportunity for member input as possible." Scanlon, a past chair of CHA, is senior vice president of advocacy for Catholic Health Initiatives.

Arrangements that are contributing to a changing Catholic health care landscape include:

• The 2010 acquisition of Caritas Christi Health Care, Brighton, Mass., by the private investment firm Cerberus Capital Management. Caritas Christi's six hospitals, now part of Steward Health Care System, were converted to for-profit entities. The hospitals are recognized as Catholic facilities by Boston Cardinal Sean O'Malley.
• Saint Mary's Hospital in Waterbury, Conn., sponsored by the Archdiocese of Hartford, Conn., initiated a joint venture this year with LHP Hospital Group, an equity and management group. Hartford Archbishop Henry J. Mansell said in a statement released when the joint venture was announced that Saint Mary's will continue to abide by the Ethical and Religious Directives for Catholic Health Care Services and to operate in accordance with the moral, ethical and social teachings of the church. The Connecticut attorney general is reviewing the deal.
• Ascension Health of St. Louis teamed with private equity firm Oak Hill Capital Partners in the spring to form a for-profit health care system, Ascension Health Care Network. Ascension Health said that it created the new system to acquire and secure a stable future for investment-capital-starved Catholic hospitals and health systems. To date, Ascension Health Care Network has not announced any planned acquisitions.

The task at hand
The charge to the CHA task force is twofold: study the potential structural and organizational models that CHA members might adopt in response to the changing health care environment and make recommendations to the CHA Board of Trustees regarding what changes, if any, should be made to the association's membership categories and criteria. The task force is to deliver recommendations to the board in April to allow for the membership to vote on any bylaw changes at the June assembly in Philadelphia.

The task force has met twice. In their discussions, the group has focused on issues of Catholic identity, its compatibility with for-profit status, and the impact on CHA of including for-profit entities in its membership, Scanlon said. "We are looking at the different kinds of for-profit structures that ministry organizations are adopting or considering. And, throughout our conversations, we're using the ministry's 'shared statement of identity' as a touchstone, always reminding ourselves of the values and commitments of Catholic health ministry."

In its initial meeting Sept. 10, the task force reviewed the history of membership eligibility at CHA. In 1993, the association broadened eligibility by eliminating the requirement that members be tax-exempt. That change was reversed in 1995.

Last month, CHA convened its administrative committees at a joint event in Dallas. At that meeting, the attendees — about 100 people from member organizations representing various roles in the ministry — discussed the importance of criteria for membership in CHA and what kinds of organizations should be considered for inclusion. Participants expressed an interest in CHA being as inclusive as possible but voiced a concern about possible negative impact on CHA's credible advocacy voice if the membership includes for-profit organizations.

The task force weighed the comments at its second meeting held in Chicago Nov. 17, the day after the joint committee meeting adjourned. "The discussion at the joint committee meeting provided us with rich input," Scanlon said. "Similar to conversations the task force members have engaged in, the groups in Dallas raised the potential risks of diluting our identity by being too inclusive or diluting our strength by being too restrictive."

Member input sought
Future CHA gatherings of member representatives will provide additional opportunities for engagement. Also, the association has provided a dedicated email address, [email protected], for persons in member organizations to direct questions and comments about the membership issue. The CHA board will take up the issue at its February planning retreat.

Scanlon emphasized that the task force is eager to hear all perspectives on the membership question before it formulates its recommendations to the board. "There is no foregone conclusion here," she said. "We are committed to giving this process the time for input and reflection that will lead to the best possible direction for the future of the association."

CHA Membership Task Force