Some of Ashland Community Hospital's policies will change if a partnership is formed with Dignity Health, representatives from the hospital system said Thursday night.

Some of Ashland Community Hospital's policies will change if a partnership is formed with Dignity Health, representatives from the hospital system said Thursday night.

Physicians at an ACH run by Dignity Health would not be able to prescribe patients who qualify under the Oregon Death with Dignity Act medication that induces death upon ingesting, system officials told about 45 people at the first of two forums on the possible merger.

"If the physician is on our dime "… the thing that the physician cannot do is write the prescription and hand it to the patient," said Carol Bayley, Dignity Health's Vice President for Ethics and Justice Education.

Currently, ACH has "no policies that dictate the issue one way or another," said Mark Marchetti, ACH chief executive officer.

Marchetti had said Wednesday that the end-of-life care its patients receive will not change if a partnership is formed with Dignity Health; but, according to Bayley, it will.

Community members asked a wide range of questions concerning the merger, as the meeting extended well past its 8:30 p.m. deadline, and Dignity Health representatives agreed to stay "as long as we need to," to answer questions.

Questions concerning aid in dying and abortion were the attendees primary concerns — but the composition of the new board of directors would look, and how much independence ACH would retain were frequent questions.

If a merger is formed, the hospital's physicians still will be able discuss the option of aid in dying with patients, Bayley said.

"Abortion, unless it's to save the life of a mother, is not done in any of Dignity Health's hospitals," she said.

Currently, ACH doesn't perform direct abortions, said Marchetti, in the past, ACH has performed abortions.

If Planned Parenthood facilities disappear, one community member asked, would Dignity Health reconsider its policy and provide abortion services to the communities it serves.

"If access to abortion were threaten in this community "… we would think long and hard about how to make sure the community gets the services it needs," Bayley said.

That decision would have to made by Dignity Health's board of directors.

"Hospital restrictions — such as those proposed by Dignity Health — have a chilling effect on the medical community," said Jason Renaud, a representative from Compassion & Choices of Oregon. "Thousands of persons retired to Jackson County in part because of the liberties allowed by the Oregon Death with Dignity law.

"If ACH merges with Dignity Health we foresee less access to the law, and that's a loss for Ashland."

Concerning board member selection, if a merger is formed, the current board would likely remain, pending approval from Dignity Health's primary board of directors. The local board would pick and approve its new members.

Currently, the Ashland City Council appoints ACH's board members.

Dignity Health and ACH have signed a memorandum of understanding, a general agreement to a merger but a definitive agreement will have to be signed before the merger is official.

Because the hospital operates under a long-term lease with the city of Ashland, the City Council will have a say in approving whatever lease arrangement emerges out of an alliance.

And the lease arrangements will remain the same if a merger is formed, said Peggy Sanborn, Dignity Health's Vice President of partnership integration.

Dignity Health, the nation's fifth-largest hospital system, is based in San Francisco and operates 40 hospitals and 150 care centers in California, Arizona and Nevada, employing about 65,000 people. A partnership with ACH would be its first affiliate in Oregon.

The relatively small size of ACH and the likelihood that possible cuts in Medicare and Medicaid reimbursements would further strain its resources drove the ACH board to pursue a partnership over a year ago, said Marchetti.

Unreimbursed costs associated with treating Medicare and Medicaid patients, other unpaid medical bills and charity care made up the bulk of a $2.5 million loss ACH posted last fiscal year.

The partnership would strengthen the hospital's ability to compete with larger hospitals in Medford and increase patient services, Marchetti said.

Sanborn said Dignity Health has identified ways to bring ACH into the black, and increase its services.

Reach Ashland Daily Tidings reporter Sam Wheeler at 541-499-1470 or email