Frequently Asked Questions – FAQs

28 September 2022

Will services be affected if the DKH-Covenant plan succeeds?

o Yes – services and access to services will be significantly changed. Most families will see the effect for young and old alike. Our healthcare system and its employees would now conform to the Ethical and Religious Directives (ERDs) of the United States Conference of Catholic Bishops. These rules dictate that some services cannot be offered by a Catholic hospital. You may have to seek some services outside the DKH system and even out of the area.

Will my doctor still be able to prescribe birth control pills for contraception?

○ No. Any birth control for contraception will be forbidden. This includes birth control pills, IUDs, tubal ligation, vasectomies, and other reproductive healthcare such as IVF, emergency contraception, aspects of miscarriage management and more.

○ Employees will be prohibited from prescribing or treating anyone for contraception. Yet this places the employee at risk of violating professional ethics and the patient from exercising informed choice.

Will my advance directives be honored?

○ If your advance directive is contrary to Catholic teaching, it will not be honored

○ On February 15, 2022 the Public Health Committee introduced SB 88, An Act Concerning Aid in Dying for Terminally Ill Patients, which would authorize medical aid in dying in Connecticut. "Death with Dignity Act" may pass this session. Its provisions may be disallowed at DKH.

Can my family members who are struggling with gender identity or expression be helped by DKH services?

○ Because of the principles of the Catholic Church they may experience behavioral health care that may not conform to the generally accepted medical standard of care.

But can I get a referral from my doctor for services that DKH no longer provides because of the ERDs?

○ No – The ERDs specifically prohibit those kinds of formal referrals. Without a formal referral, you may not know where you may seek care, your insurance may not cover the treatment, or the provider may be out of your network.

Will allowing Covenant to buy DKH provide us with better quality of care?

○ No – in fact the three acute care hospitals that Covenant owns have lower quality and patient satisfaction ratings than DKH. The Covenant hospitals are not accredited by The Joint Commission, and each has lower scores on national quality ratings by Leapfrog and the Centers for Medicare & Medicaid Services. Acquisitions are associated with lower quality of patient experiences.

I understand that even if Covenant buys DKH, there will be no change to employee benefits. Is this true?

○ That is not correct. DKH has indicated that individuals wishing to obtain access to birth control would do so through a secondary plan that is administered directly through Aetna and independent of Covenant’s group health plan. There would be no additional cost, but after the transition, employees could only enroll at hire or in the open enrollment periods. The secondary insurance covers birth control (as required by the Affordable Care Act) but likely will not cover other reproductive rights access such as fertility treatment or gender affirming care.

Will all our DKH employees keep their jobs? Eighty percent live in our area and DKH is the largest employer here.

○ We do not know the plan but it is likely that jobs will be lost. Covenant promises no aggregate job loss for only six months after the agreement is complete. DKH projects lower salary and benefit costs if the sale is complete than if it is not. Covenant plans to centralize many administrative services. It says that human resources, information technology, finance, risk management, legal services, physician practice administration, philanthropy, medical interpreter services, quality management, patient financial services, provider credentialing, employee training, marketing, corporate communications, and commercial insurance contracting may be conducted elsewhere.

Why is Day Kimball Healthcare arguing that it should be bought by an out-of-state health system now?

Is DKH’s financial position that unexpected and bad?

o DKH has showed an operating profit for four of the past ten years. This situation is common, especially for non-profit, independent, rural hospitals and many hospitals in Connecticut have lower operating margins than DKH.

Will Covenant help DKH get its financial and capital improvement needs met?

o Covenant's financial position is no better than DKH's. Essentially Covenant will help very little. DKH’s unfunded pension plan will be resolved through a federal program and Covenant only offers to make "efforts" to upgrade the electronic medical records system. DKH says that it needs aid for capital expenditures. Yet Covenant has not committed funds beyond what DKH has historically provided for itself. Covenant will control all DKH buildings, equipment, cash, land, and savings.

o There is no evidence that hospital systems lower costs or that they improve operating performance. Cost savings are a myth.

I am being told that the only alternative to the sale is bankruptcy and closure. Is that true?

o This is not true. No one wants DKH to close. There are alternatives to the Covenant sale. There are potential short-term measures to stabilize the hospital and more longer-term measures to ensure that DKH will be maintained as an independent, community, acute-care hospital.

Will we still have a say in our healthcare system?

o In effect, the answer is no. A local board of directors and a CEO will be appointed by Covenant. One person from the DKH board, who will be approved by Covenant, will sit on the Covenant board with one vote. Essentially any decision made locally can be overridden by the Covenant board. We will have local input, but no local control.

• Can we do better than this?

o Yes. All hospitals need good management and the support of their communities and states. When hospitals are locally controlled, they improve access, quality, cost, and health outcomes. Community members know their neighbors, their health needs, and the resources in their community. They are better able to collaborate with others to address fiscal challenges and creatively solve problems. DKH, with the support of its community has met and overcome many challenges in its 128-year history. We will have work to do to keep DKH solvent and local, but we have options. We can do better than Covenant.