California Says Catholic Hospitals Can't Stipulate How They're Sold

SACRAMENTO, Calif. — Catholic health care officials are opposed to a new California law that prevents the sale of Church-owned health facilities if the seller prohibits the new owner from offering unethical procedures such as abortion and direct sterilization.

The new law prohibits the state attorney general, who approves the sale of Church-owned and nonprofit health care facilities, from consenting to an agreement if the seller restricts the type or level of medical services the buyer can provide. It thus prevents Catholic hospitals from requiring their buyers to follow directives that forbid procedures counter to Catholic moral teaching.

Gov. Gray Davis, who has a strong pro-abortion record and is facing a recall election this fall, signed the law July 15.

Before the law was passed, Attorney General Bill Lockyer refused to approve the sale of a Catholic hospital until directives to limit reproductive procedures were dropped. In other transactions, the directives were retained.

Father Michael Place, president and chief executive officer of the Catholic Health Association of the United States, called the law “an unprecedented interference in the sale of property.”

“Historically,” he said, “sellers could put covenants on contracts for their buyers.”

The law “is an invasion of the government into the freedom of the private sector in carrying out business in accordance with its beliefs,” he said. “It is part of a larger coordinated effort to restrict Catholic health care [facilities] from carrying on their mission — to protect innocent human life and the dignity of human sexuality.”

The St. Louis-based Catholic Health Association represents more than 2,000 Catholic hospitals, health care systems and sponsors.

The Ethical and Religious Directives for Catholic Health Care Services, issued by the U.S. Conference of Catholic Bishops, consists of principles mandating Catholic health care facilities to provide adequate health care for poor people and pastoral care — especially administration of the sacraments — for patients. The directives also prohibit Catholic facilities from offering procedures such as elective abortions, direct sterilizations, contraceptives and assisted suicide.

These directives influenced the Sacramento-based Alliance of Catholic Health Care, which represents California's 63 Catholic and community-based hospitals, to oppose the measure because it could“affect the capacity of Catholic hospitals to sell their facilities consistent with our value tradition,” said Alliance president Bill Cox.

Holy Cross Sister Carolita Hart, director of health affairs for the Archdiocese of Los Angeles, said the law will limit Catholic hospitals' ability to sell to secular hospitals that might not agree to follow the Ethical and Religious Directives.

Kent Peters, director of the San Diego diocesan Office for Social Ministry, which advocates for pro-life issues, agrees with these health care officials.

“The law violates the freedom of Catholic hospitals to dispose of their property,” he said.

California Sen. Debra Bowen, who sponsored the legislation, defended the measure.

“The state is involved in nonprofit hospital sales to make sure people who need medical care can get it, not to enforce the values of the previous owner,” she said. “If a hospital or a clinic wants to abide by ethical and religious directives … I completely respect that decision. However, [sellers] shouldn't be allowed to require every subsequent owner of that hospital or clinic to abide by that same point of view.”

State Sen. Ray Haynes of Temecula, who opposed the bill, stated that the law will result in some hospital closures and some deals not being made.

Ned Dolejsi, California Catholic Conference executive director, agrees. However, the conference did not take a position on the new law, he said, because “it is not a direct affront to our religious liberty. The law allows Catholic hospitals to sell to buyers that are morally appropriate.”

Dr. Craig Barkacs, professor of legal, ethical and international studies at the Catholic University of San Diego, told the Register that an argument could be made on both sides of the issue.

“A seller should be able to stipulate any terms in the sale or lease of property,” he said, “and buyers can use the property for whatever purpose they choose.”

In the past, some Catholic hospitals in the United States required their purchasers to follow the Ethical and Religious Directives, while others did not.

The Jesuit St. Louis University sold its teaching hospital to Tenet Healthcare Corp. in 1998, which agreed to operate and manage the facility “in a manner consistent with the Catholic, Jesuit values of the university,” required in the transaction. The contract stipulated that Tenet offer pastoral care services for patients seven days a week, 24 hours a day; serve the city's poor and indigent population; and administer its graduate medical education programs in pediatrics, obstetrics and gynecology in partnerships with two other Catholic health care institutions in the area.

Tenet also agreed to follow the Ethical and Religious Directives when it purchased in 2001 Daniel Freeman Marina and Daniel Freeman Memorial hospitals in the Los Angeles area from the Sisters of St. Joseph of Carondelet.

However, the directives were eventually excluded in the sale of other Catholic hospitals in California before the new law was passed.

When the Sisters of St. Joseph sold Santa Marta Hospital in East Los Angeles to Star Healthcare Group in 2002, its agreement required the buyer to abide by the directives. But Attorney General Lockyer refused to approve the sale until the imposition of the directives was lifted. As a result, the directives were deleted and the name of the hospital was changed to ElaStar Community Hospital, a secular institution.

“I will not approve the imposition of religious principles on a secular for-profit hospital,” Lockyer wrote in a letter to the California Women's Law Center.

The directives did not apply in the sale of St. Francis Medical Center in Santa Barbara to Cottage Health System, which plans to use the property for housing employees for the three hospitals it operates.

Catholic Healthcare West, which operated the facility in cooperation with the Franciscan Sisters of the Sacred Heart, sold the medical center in June. The facility had lost $12 million during the past five years and could not meet state-mandated seismic retrofit work — in case of an earthquake — estimated at more than $20 million.

Catholic Healthcare West is sponsored by seven religious communities of sisters and operates 42 acute-care hospitals in California, Arizona and Nevada.

Peters of the San Diego diocesan Office for Social Ministry said laws similar to California's are “likely to be passed in other states due to the pro-abortion lobby's efforts to diminish the influence of Catholic health care.”

Joyce Carr writes from La Mesa, California.

Cardinal-elect Víctor Manuel Fernández was appointed by Pope Francis on July 1, 2023, to become the next prefect for the Dicastery for the Doctrine of the Faith.

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