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Colorado hospitals that refuse services, like tying tubes, will have to say so publicly

Legislation will require providers to notify patients about certain types of care they do not provide
Mercy Hospital in Durango stopped providing optional tubal ligations, a form of female sterilization, on April 15. (Brandon Mathis/Special to the Herald file)
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An unknown number of women in Colorado – including an aide to state Rep. Brianna Titone – have learned while in the hospital to give birth that the hospital they chose will not tie their tubes to prevent future pregnancies.

Older Coloradans and those with terminal illnesses have discovered near the end of their lives that the hospital system they’ve gone to for years does not prescribe aid-in-dying medication.

And transgender people, about 27% of them according to a national survey, say they were denied medical care in the past year because of their sexual orientation or identity, sometimes after they showed up at an appointment and still had to pay for it.

Colorado hospitals and clinics that for ethical reasons do not provide certain types of care are not currently required to disclose this to their patients or the public.

That’s about to change. Under a bill passed by the state Senate on Tuesday and soon headed to Gov. Jared Polis’ desk, hospitals would have to post online publicly and inform their patients directly what services they do not provide. The state health department will work out the specifics, but the legislation is aimed at creating transparency about reproductive health care, gender-affirming care and end-of-life options.

The issue has attracted more scrutiny in Colorado in recent years after mergers joining secular or Protestant hospitals with Catholic ones, which follow the Catholic Ethical and Religious Directives. The directives prohibit aid-in-dying care, abortions and sterilization, including tubal ligations for women and vasectomies for men. The only exceptions are when a patient’s life is in danger.

The mergers, along with unclear information from Catholic hospitals about what services they won’t provide, has created a confusing health care landscape.

SCL Health, for example, includes two Catholic hospitals – Saint Joseph Hospital in Denver and St. Mary’s Medical Center in Grand Junction – that observe the ethical and religious directives. Two of the system’s secular hospitals – Lutheran Medical Center in Wheat Ridge and good Samaritan Medical Center in Lafayette – also comply with the Catholic health care rules. But Platte Valley Medical Center in Brighton does not.

Several other hospitals in Colorado are operated by CommonSpirit Health, the largest Catholic health system in the country. Among them is Mercy Hospital in Durango, which made no public announcement when it decided it would no longer let women get tubal ligations following cesarean sections. The hospital had already prohibited sterilizations after vaginal births but had allowed them after C-sections because it had been considered an undue burden to make patients schedule a separate surgery at another hospital – until last month.

Mercy informed the physicians who deliver babies at its hospital, the only one in town with a maternity ward, but left it up to them to tell their pregnant patients, doctors told The Colorado Sun. The hospital posted a vague statement on its website noting it was “conducting itself in a manner consistent with the ethical principles of the Catholic church ministry” but made no direct mention of reproductive health care or any other procedures.

The legislation, which received final approval in the state Senate on Tuesday, does not force hospitals to offer certain services, but requires that they make it known. The bill passed 43-19 in the House and 21-to-12 in the Senate. Republicans who voted against the Democratic-backed legislation made little comment in committee hearings or elsewhere.

“If the hospital chooses not to offer that, that’s their choice,” said Sen. Sonya Jaquez Lewis, a Boulder County Democrat and a lead sponsor of the bill. “We are just trying to shine a light on which hospitals do offer that care.”

The legislation requires the Colorado Department of Public Health and Environment to create a form by August 2024 that hospitals and clinics would have to complete and post online. It also requires that hospitals inform patients of their policies at the time of scheduling.

The Colorado Hospital Association asked for an amendment that specified that hospitals would have to inform only the patients who were requesting a type of care that was not provided. The way the legislation was initially written, even “me as a 40-year-old male getting an arthroscopic surgery on my knee would get disclosure about reproductive health services,” argued association lobbyist Joshua Ewing.

The measure has support from AARP Colorado and the national groups American Atheists and Catholics for Choice, which said the law was “urgently needed.”

“The devastating impact of obstructing another’s conscience by refusing or denying care cannot be overstated,” said Shannon Russell, policy director for Catholics for Choice. “As Catholics, we cannot and do not presume to tell others how best to listen to their own consciences as they make important choices. We strive to make sure all people have the resources, including details regarding which providers deny services for nonmedical reasons.”

Rep. Titone said her aide didn’t find out “until the very last minute” that she couldn’t get her tubes tied at the hospital where she had chosen to have a baby. Instead, she had to schedule a separate procedure at a different hospital.

“Nobody should spend time and money seeking health care only to be unexpectedly turned away,” Titone said.

The Colorado Sun is a reader-supported, nonpartisan news organization dedicated to covering Colorado issues. To learn more, go to coloradosun.com.

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