OLYMPIA – Public hospitals that provide maternity services must also provide access to contraception and abortion, even if they contract with a private company that bars such services, state Attorney General Bob Ferguson said Wednesday.

In a formal attorney general’s opinion, Ferguson said state law, approved by voters in 1991, requires a public hospital offer “substantially equivalent” abortion and contraceptive services if they provide maternity care.

Private hospitals, including those run by the Catholic Church which has religious objections to contraception and abortion, have no such obligation, he said. . .

. . . While private hospitals dominate Washington’s major cities, many rural areas have established public hospital districts, which elect board members and levy taxes to help cover some of the costs of medical care. Most Eastern Washington counties, including Pend Oreille, Ferry, Lincoln, Adams and Whitman counties, have one or more districts.

Ferguson said he didn’t know of any districts that currently violate the law. His office was asked for the opinion by a Puget Sound legislator because the San Juan Hospital District has an agreement with PeaceHealth, a Catholic health care corporation, to build and operate a new hospital, providing only the services within its religious doctrine.

State attorneys didn’t analyze the agreement between the hospital district and PeaceHealth, and at this point they aren’t defining “substantially equivalent,” Ferguson said. The state can’t tell the corporation it has to provide abortions or contraceptives, but the district could find another way to provide contraception and abortion services that comply with the law.

 The issue is also being raised around the state with mergers and acquisitions of health care facilities. Along with abortion and contraception, some groups have raised questions about access for gay and lesbian couples and for assisted suicide, which is legal in Washington state but is forbidden by some Christian faiths. In a letter earlier this summer to the American Civil Liberties Union, Gov. Jay Inslee said his staff was “closely examining a number of scenarios that may put at risk certain access to care rights and give rise to difficult legal issues.”

Asked if the state would sue a district if it didn’t provide those services, Ferguson said he hadn’t made such plans. He said he was sending a copy of the opinion to the more than 50 hospital districts in the state, adding, “I trust that they’ll meet their obligations under state law.”

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