A planned affiliation between Harrison Medical Center and Franciscan Health System is expected to become final this week, while some who don’t support it are looking for ways to turn the tide.

Harrison and Franciscan filed a proposed agreement with the state Department of Health last Thursday. While the Department of Health has up to 30 days to determine whether the affiliation needs to go through a process called “certificate of need,” which would require public comment, Harrison officials and those at Franciscan have asked for a streamlined approval that would not require that.

The proposed affiliation, which was officially announced this past November, is sought by Harrison to keep health care affordable and keep services current, according to Harrison Chief Executive Officer Scott Bosch.

But some residents of the area, employees of Harrison, and patients of the medical center worry that the affiliation will limit the services that will be available.

Harrison has operated as a secular medical institution for years and would be joining forces with Franciscan, which is part of the Catholic Health Care Systems in the United States.

As part of that system, some fear that Harrison would fall under the Catholic Ethical and Religious Directives that ban abortions of any kind, assisted suicides, stem cell research and some forms of birth control.

Bosch did his best last week to try to answer questions and calm nerves about the pending Harrison affiliation with Franciscan, during a meeting of the Central Kitsap Community Council.

Bosch said patients won’t be losing anything with the joint venture and will actually be giving themselves a better chance to keep a local hospital nearby.

“The (Harrison) board has done a great job of crafting this affiliation,” Bosch said. “The board has done a phenomenal job of protecting your rights as a secular organization.”

Bosch said Harrison will retain its own board of directors who will set policy. And Harrison will remain a separate secular institution, not held to Franciscan’s Catholic Ethical and Religious Directives.

He explained that there are three standards, however, that Harrison will abide by. One is no elective abortions. Harrison also will not follow the so-called Death With Dignity provisions of state law. And the third is that Harrison will not paticipate in stem cell research.

“None of these things are things that we do now,” he said. “So it amounts to no change.”

He said that doctors who are employees of Harrison now refer patients elsewhere if they want an elective abortion or want to follow Death With Dignity. He said the hospital has never done stem cell research and most of that in this area is done at the University of Washington.

“Our physicians will still be able to provide counseling on these subjects, and can still provide contraceptives, tubal ligations, vasectomies, and discuss end-of-life decisions,” he said.

Bosch said the reason Harrison’s board decided to look at an affiliation is because of the rising costs of providing health care and the uncertainty of what changes will take place when the Affordable Heath Care Act is fully operational.

“It’s a black hole,” he said. “We’re not certain but it could cost us upward of $2 million in the first year. We’re not big enough to cover that. But Franciscan is.”

What the affiliation brings, he said, is more buying power.

“Because of their reserves, as part of Franciscan we can get better interest rates when we go to borrow,” he said.

Bosch told the audience that Harrison may need to go to an electronic record-keeping system (Epic) and would not be able to afford that without the affiliation. He also said the affiliation will mean a better chance to upgrade buildings, equipment and services for patients.

He said employees and physicians who are hospital employees will not see any immediate changes and will retain their jobs.

“In time, there may be some movement to Franciscan’s benefits and some employees may actually go to work for other companies because their work will be outsourced, but all of those things are decisions that this hospital administration and board would have a say in.”

Bosch wouldn’t give the actual dollar figure that Harrison will save through the affiliation, but said that it is “significant.”

He added that Franciscan has been very efficient and has great reserves and that is why they are in a position to work with Harrison. He said their main goal has always been to create and maintain healthy communities.

When it came time for questions, Bosch admitted that the power lies with the board of the Franciscan Health Systems to hire and fire the Harrison CEO and approve Harrison board members, and that the Franciscan board could implement other care directives. But he called that an “unrealistic scenario.”

But Judith Hughes, of Bremerton, who was at the meeting, is worried that it could happen.

“However well-intended its health care mission, the Roman Catholic Church in America has found a way to syphon taxpayer dollars from Medicare and Medicaid through its hierarchy and into the Vatican,” Hughes said. “U.S. taxpayers are endowing a religious institution which imposes its Ethical and Religious Directives on all who need hospital care — sick people who may not be able to refuse treatment.”

Hughes said she is concerned that eventually the Catholic Church will be running Harrison.

That’s also on the radar of the American Civil Liberties Union of Washington. The ACLU has asked for more time to consider mergers and affiliations of health care facilities, citing concerns over the impact of tax-funded hospitals joining with Catholic health care organizations.

Gov. Jay Inslee is looking at whether to impose a six-month moratorium on hospital partnerships. A spokeswoman for the governor said no decision has been made about the issue as of this week.

As for limiting public comment, Bosch said last week that the hospital has been “very open” since the affiliation news became public.

“We’ve met with everyone involved,” he said. “We’ve had several public sessions on it. The reason why we don’t feel we need the certificate of need process is that it applied to the sale of health care facilities. Affiliations are not included in that.”

Bosch was not available at mid week to comment on either the ACLU’s actions or the possible moratorium by the governor.