Islanders voiced concerns last week about the county’s first-ever hospital and its affiliation with Franciscan Health Systems.

With a standing room only crowd on hand, questions and answers about Peace Island Medical Center zinged across the room at the Sept. 18 Hospital District Commission meeting.

But whether pledges by district commissioners or by PeaceHealth officials will soothe a budding apprehension about the prospective partnership between PeaceHealth, which will operate the medical center now under construction in Friday Harbor, and Franciscan Health Systems, remains to be seen.

The medical center is part of the PeaceHealth system of Catholic hospitals and medical clinics in Washington, Oregon and Alaska.  It is financing roughly two-thirds of the $30 million construction cost the medical center, which will open at the end of year. It will be a 10-bed critical access hospital providing expanded primary care and specialty clinic, enhanced diagnostic center, a cancer care suite providing on-island chemotherapy and cancer services and a 24-hour emergency room.

On Aug. 22, PeaceHealth announced it was engaged in partnership talks with Franciscan Health Systems, an operator of hospitals and clinics in Washington, and which is owned by health care giant Catholic Health Initiatives of Denver, Colo.

It has sparked some community concern that certain health services will not be offered at the new facility.

During the meeting, Commission Chairwoman Lenore Bayuk once again reiterated her confidence in the Peace Health representations of future care, and that the panel of elected hospital districts officials would “carefully review and respond to” a list of concerns outlined in a letter endorsed by about 300 islanders and presented to the commission at its latest meeting.

In addition, Bayuk read a letter from Sister Kathleen Pruitt, a board member of PeaceHealth and a member of the newly named board of PIMC, which said flatly, “The commitments we made to you will be honored.” Twice the letter repeated, “A promise made is a promise kept.”

Pruitt, who participated at the meeting via telephone conference link, added that, “This is an opportunity for Peace Health and the local community to show what can be done in working together to carry out the values and goals that we share.”

PIMC will replace San Juan Island’s 38-year-old medical clinic, Inter Island Medical Center, once it opens. The hospital district will pass onto PeaceHealth its annual property tax revenue –  about $1.2 million a year – to subsidize health care at the new medical center.

In recent weeks, around 300  islanders have formed the Coalition for Health Care Transparency and Equity. At the meeting, Monica Harrington distributed a letter signed by all coalition members.

Among other things, it asked, “What written and legally binding guarantees did the hospital get from PeaceHealth that services and practices currently available through InterIsland Medical Center … will be available in theory and in practice at the new taxpayer-subsidized medical facility over the life of the agreement?”

The letter also raised other issues relating to end-of-life measures, funding health care not available through PeaceHealth and contractual provisions relating to withdrawal from the agreement between PeaceHealth and the Hospital District.

The Catholic identification of PeaceHealth, and the public funds dedicated to PIMC for 50 years under the contract between the district and Peace Health, has led islanders to seek assurances that reproductive health care services now offered at IIMC, such as contraception, will continue to be delivered at PIMC.

Previously, PeaceHealth announced that abortions will not be provided, and that IIMC doctors have themselves decided they will not provide that service. Exceptions are provided, according to PeaceHealth documents, “when a woman’s life is in danger or in the case of an imminently lethal fetal anomaly.” Emergency contraception (“Plan B”) will be offered in cases of sexual assault. Vasectomies and tubal ligations are performed “when it is determined that such a procedure is medically indicated,” PeaceHealth documents state.

PIMC Chief Operations Officer Jim Barnhart has assured local residents and the hospital commission that all services presently provided by IIMC will be continued.

Despite assurances, some remain skeptical. Harrington and Mt. Baker Planned Parenthood CEO Linda McCarthy want to know where in the contract these promises were made.

“To be enforceable, these promises must be in the contract,” Harrington said.

Nancy Steiger, CEO of St. Joseph Medical Center in Bellingham, a PeaceHealth unit that will be collaborating extensively with PIMC, referred to a “Statement of Common Values” prepared by PeaceHealth, urging everyone to read that statement in conjunction with the contract.

Robb Miller, executive director of Compassion and Choices, who has worked with PeaceHealth on implementation of the Death With Dignity initiative, relaxed a little of the tension in the room by saying that he’s worked very well with PeaceHealth.

“Much better than with other Catholic hospitals in Seattle,” Miller said. “I want to say that Peace Health has always kept its end of any bargain. Our negotiations about information and referrals have always been honorable and honest.”

Harrington later issued a statement confirming her insistence that contract language needs to be included in the discussion.

“Contracts exist to delineate responsibilities and resolve ambiguities,” she wrote. “This 50-year contract gives too much discretion to a religious institution over how our taxpayer dollars will be spent.”