At least two major details appear to have been overlooked when Walla Walla City Council members discussed endorsement of Providence St. Mary Medical Center’s plans for expanded ambulatory surgery: St. Mary isn’t the only provider seeking state approval for same-day surgery services, and it didn’t ask for an endorsement.

Both St. Mary and Walla Walla Clinic had announced their intention to add same-day surgery services in the wake of Walla Walla General Hospital’s closure.

Discussion at a Jan. 10 Council meeting, during which Council members agreed to affirm their support for Providence but declined a letter written by former Mayor Allen Pomraning before his term ended, elicited feedback from Walla Walla Clinic CEO Kevin Michelson.

In it, Michelson reiterated his operation’s proposal. Walla Walla Clinic wants to allow community surgeons, including those employed by Providence Medical Group, to work in the operation’s existing same-day surgery facility.

Open since 2000, the facility performs about 2,400 surgeries per year. Michelson said another 1,000 could be accommodated per year if community surgeons were allowed to use the facility.

His letter asks the Council to take a neutral position and let the Washington State Department of Health process both applications on their own merit.

The proposal, which Michelson announced in an August 2017 column in the Union-Bulletin, is vastly different from St. Mary’s plan, which was announced in December.

St. Mary’s plan would include the purchase and repurpose of the Walla Walla General Hospital facility. St. Mary administrators said they wanted to convert the space into a multiuse outpatient facility with primary care, an ambulatory surgery center, urgent care, and other services.

That surgery center would include two operating rooms and two endoscopy procedure rooms to address patient needs in the greater community.

Based on Washington Administrative Code, Walla Walla Clinic and St. Mary appear to be in competition more than they are individually likely to be granted the certifications.

True to its name, a Certificate of Need is granted when necessity is demonstrated.

A detailed method is used to measure and determine need that includes, among many factors, the inventory of rooms in the area, number of surgeries performed, time on the surgeries and projections for future need.

An attempt to reach Michelson for comment was not successful.

In his letter to Council one week ago, he said Walla Walla Clinic’s surgery center is “significantly more affordable than other existing surgical options in our community.”

The facility is also the only place locally for procedures not performed elsewhere due to religious directives. Those include vasectomies and tubal ligations.

Walla Walla Clinic’s plan would be to convert its existing three-operating room ambulatory surgical center to one that operates with a Certificate of Need. Based on the letter of intent to the Department of Health last July, the estimated capital expenditure is $175,000.

St. Mary’s capital expenditure estimate on its proposal is $3.7 million.

“The decision belongs to the Department of Health,” said Kathleen Obenland, director of marketing and communications for St. Mary. “The Washington State Department of Health Certificate of Need program is a regulatory process that requires health care providers to demonstrate that there is current need for the requested services in the community. The state’s decision is based on many factors, including population and the ability of low income people to get care.”

She said conversations about a written endorsement for St. Mary and its proposal were not initiated by the hospital, although they would have been accepted. Instead, the Jan. 10 Council meeting where Pomraning’s letter as presented brought feedback over the hospital’s religious stance and its range of services that exclude vasectomies and tubal ligation.

“Providence believes it is important to inform community leaders about how we are working to meet the community’s health care needs, so late last year met with the then-mayor Allen Pomraning to talk about our plans for the former WWGH campus,” Obenland said. “He volunteered to write a letter in support of Providence’s Certificate of Need application.”

Given that Providence didn’t request such a letter, however, “we have requested that no action be taken by the current mayor or City Council Wednesday,” she said.

Council meets tonight at 7 p.m. in City Hall, 15 N. Third Ave.

Vicki Hillhouse can be reached at 509-526-8321, or on Twitter at

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