Voters in and around Skagit County, Wash., will decide whether the two hospitals that make up Affiliated Health Services will go their separate ways.
At a series of open- and closed-door board meetings Sept. 15 and 16, the leaders of the system's two hospitals agreed to seek placement of an advisory referendum on the Nov. 8 ballot that would ask voters whether the hospitals should dissolve their four-year affiliation.
A second referendum on the ballot would ask voters who support a breakup whether they'd pay additional hospital district taxes to support the conversion of one of the facilities back to a full-service hospital.
Affiliated has yet to calculate the cost of converting the facility or the subsequent increase in hospital district taxes needed to pay for it.
The boards are starting a petition drive to get the necessary signatures for putting the questions to voters. By delegating the fate of Affiliated's two hospitals to the public, the system's board backed off previous stances that could have led to an immediate separation of the facilities and the termination of Patrick Mahoney as system president and chief executive officer.
"It's vital that the support of the public be there to continue with a successful affiliation," Mr. Mahoney said. "At least the preliminary thinking is that the referendum will sort this thing out once and for all."
The five-member board of United General Hospital, a district hospital in Sedro Woolley, Wash., put Mr. Mahoney on the bubble last month when it passed a motion calling for his dismissal.
The five-member board of Skagit Valley Hospital in Mount Vernon, Wash., about eight miles southwest of Sedro Woolley, responded by passing a resolution calling for the dissolution of Affiliated if United dumped Mr. Mahoney.
United General and Skagit Valley formed Affiliated in January 1991, and leaders of the two hospitals have been at odds since last fall, when the hospitals' acute-care services were consolidated at the Mount Vernon facility and the Sedro Woolley facility became an outpatient diagnostic center with a 12-hour urgent-care center.
A Sedro Woolley community group, Concerned Citizens of Hospital District 304, says the consolidation was never part of the affiliation deal, and it wants the old United General facility to be converted back to a full-service hospital with a 24-hour emergency department.
The group has taken the matter to court and has succeeded in getting three of its members elected to the United General board.
In fact, the boards of both facilities had instructed Mr. Mahoney to prepare an agreement that would outline how to divide the two hospitals if they voted to disaffiliate (Sept. 19, p. 12).
Local observers expected the disaffiliation issue to come to a head at the Sept. 15 meeting of the United General board and the Sept. 16 meetings of both the Skagit Valley board and Affiliated's 11-member joint board. However, cooler heads prevailed.
According to Mr. Mahoney and local press reports, the United General board tabled the motion terminating him. Instead, it passed a resolution making the disaffiliation issue part of the Nov. 8 general election. The Skagit Valley board then tabled its resolution calling for a possible disaffiliation. And Affiliated's joint board had a normal business meeting, Mr. Mahoney said.
Mr. Mahoney said Affiliated posted an 8.1% operating profit margin through the first eight months of the year compared with a 2.8% operating profit margin during the same period last year.
Last year, Affiliated earned $2.8 million on total revenues of $60.4 million, according to HCIA, a Baltimore-based healthcare data company.