In Snohomish County, the opinion affects tax-supported hospitals in Edmonds and Arlington, which have maternity units.
The opinion by Attorney General Bob Ferguson did not spell out how the services must be provided, such as whether they must be provided on-site or whether hospitals can contract with other organizations.
The decision could also affect negotiations among public hospitals in Arlington, Anacortes and Mount Vernon.
The three hospitals are considering business proposals from four larger health care organizations, two of which are Catholic -- Seattle-based Virginia Mason, Catholic-affiliated Peace Health, Seattle's UW Medicine and Providence/Swedish, a collaboration between nonprofit Catholic and secular health care organizations in Western Washington.
The possibility of joining up with a Catholic health care organization has been opposed by a community group, People for HealthCare Freedom, as well as the American Civil Liberties Union, over Catholic health care restrictions on birth control and prohibitions on abortion.
Clark Jones, chief executive of Cascade Valley Hospital in Arlington, said he didn't think the attorney general's ruling would slow a decision on which organization the three hospitals will join.
Jones said he thought a decision will likely be made during a meeting of the boards of the three hospitals Aug. 29 in Mount Vernon.
"If we were to select a Catholic health care organization with which to affiliate, any issues raised by the attorney general will have to be addressed," he said. "I think that's pretty clear."
Jones said he didn't think the hospital boards will allow the fact that there are complications with joining up with a Catholic organization to eliminate those organizations from consideration.
The three hospitals must make a decision on picking a business partner based on which organization can provide the most benefit to their communities, Jones said.
Clark Todd, president of the board of commissioners for Skagit Regional Health in Mount Vernon, said the hospitals seem to be on course to make a decision over the next week and a half.
Board members have no intention of agreeing to a business partnership with any organization that would diminish the services that are offered, including women's health services, he said. "We've listened to our community."
Ferguson was asked by an Orcas Island lawmaker whether public hospitals that do not provide reproductive care violate Initiative 120, which said residents have a fundamental right to choose or refuse birth control or abortion.
The law requires that public hospitals providing maternity care must also provide substantially equivalent benefits, services or information on contraception and abortion.
During a news conference to announce his decision, which he called a "formal opinion," Ferguson said he was not asked to define what steps public hospitals would have to take to meet that standard.
Officials at Swedish/Edmonds hospital said late Wednesday afternoon that it was too soon to know how the ruling might affect its operations. The public hospital in Edmonds is the former Stevens Hospital; Swedish started running the hospital in 2010. Taxes are collected from property owners who live within the hospital district.
Sharon Salyer: 425-339-3486; firstname.lastname@example.org.
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