Nine commission members voted unanimously in favor of Holy Cross, and three members recused themselves. The panel's vice chairman, Garrett Falcone, did not vote.
In recent weeks, the limitations on care available at Catholic hospitals such as Holy Cross have raised concern among women's and religious groups. After the vote, Catholics for Choice called the vote "troubling." In a statement, the group said the vote means women in Montgomery County who go to Catholic hospitals will have no access to abortion, even in cases of rape or incest, in-vitro fertilization, and treatment for ectopic pregnancies.
A coalition of advocacy groups had urged the state to reject Holy Cross, citing concerns about access to reproductive health care, especially for poor women and teenagers.
The meeting at commission headquarters in Baltimore drew a standing-room-only crowd of about 120.
Commission chairman Marilyn Moon, who last month recommended Holy Cross over Adventist, said she understood the concerns about family planning and reproductive health services. But she said there are no state standards that require hospitals to offer such services.
She said she believed that she followed state health requirements and addressed the reproductive rights issues appropriately during her review.
"This has been a lengthy but thorough process," she said. Adventist officials had sought to delay the vote, but Moon said: "I do not believe I need additional time or additional information. I do not believe additional work needs to be done."
During a brief question-and-answer period between commission members and hospital representatives, an audience member, Linda Mahoney, president of Maryland NOW, tried to ask a question but was ruled out of order because public comment was not allowed. After the vote, an unidentified woman told the commissioners, "Thank you all for deciding women are not people."
Moon's recommendation that the full commission adopt the Holy Cross proposal for a $202 million, 93-bed hospital on the Germantown campus of Montgomery College clearly carried significant weight in the final vote. She said the Silver Spring-based Holy Cross proposal was superior to that of Rockville-based Adventist HealthCare, which wanted to build a $177 million, 86-bed hospital a few miles to the north in Clarksburg. The new hospital will be the sixth in the county.
In a memo summarizing her decision, Moon said the Holy Cross approach would do a better job improving access to hospital services for residents of upper Montgomery County and providing adequate bed capacity for the future "that is both reasonable in its cost and located [in] the area of the county that will experience the highest levels of population growth." She also said Holy Cross's parent organization, Trinity Health, a Catholic hospital system based in Michigan, is financially well positioned to undertake the project.
In her decision, Moon also noted that women could find reproductive health services elsewhere in the county. Religious directives restrict a variety of services, including hormonal contraception and tubal ligations.
Holy Cross's president and chief executive, Kevin J. Sexton, said in a statement that he was pleased that the commission "agreed that Holy Cross Hospital is the best choice to bring this much-needed expansion of health care to the residents of northern Montgomery County." He added: "Our financing is in place for the new hospital. We look forward to finishing our work to secure the required approvals so we can start construction as soon as possible."
Adventist's president and chief executive officer, William Robertson, said in a statement: "We are deeply disappointed in today's ruling, especially for the thousands of upcounty residents and community leaders, many of whom spent almost a decade working with us to expand access to health care in the region and create jobs with the Clarksburg Hospital." Adventist said it will evaluate options for appeal to the commission and also consider a court challenge.
Advocacy groups were concerned that Maryland would set a bad precedent if it chose a hospital with religiously mandated service restrictions to be built on publicly owned land.
Beth Corbin, national field director for Americans United for Separation of Church and State, said that her organization was considering possible legal action. The group was among several advocacy groups that filed a lawsuit under similar circumstances in Florida a decade ago over the operation of a public hospital under Catholic religious doctrines. The case was settled out of court; the hospital no longer operates under Catholic directives.
Adventist had sought to delay the vote, citing Moon's lack of evidence to support her conclusions about the availability of reproductive health services in Montgomery County.
Holy Cross said it provides emergency contraception for victims of sexual assault. A spokeswoman said the largest access problem in Montgomery County is prenatal and primary care services for uninsured women. Holy Cross is the largest provider of such care, she said.
Adventist had long planned to build a hospital in Clarksburg to complement Shady Grove Adventist Hospital in Rockville and its emergency center in Germantown. Adventist purchased the land in Clarksburg in 2001 and received the necessary county land, traffic and environmental approvals before Holy Cross offered its rival proposal in August 2008.
Adventist's proposal for a Clarksburg hospital is along Interstate 270 between Shady Grove Adventist and Frederick Memorial hospitals. Clarksburg would have been part of a medical complex with office buildings for doctors and a nursing home.
Holy Cross's proposal for Montgomery College's Germantown campus would provide on-the-job training for nursing students.
In a recent letter to the commission, 12 upcounty state legislators said they continued to support Adventist and were concerned about possible duplication of health-care services at the Adventist-operated Germantown Emergency Center, which is about a mile from the proposed Holy Cross site.