Catholic Health World - June 15, 2019

Bundled pricing made easy 2

Oh the places he’ll go 8 PERIODICAL RATE PUBLICATION

JUNE 15, 2019 VOLUME 35, NUMBER 11

Sr. Carol led CHA through historic changes in US health policy, health ministry WASHINGTON, D.C. — The months and weeks leading up to the March 2010 enactment of the Affordable Care Act were fraught with hyperpartisan politics. The stakes were enormous — the legislation would usher in the biggest reset in health care finance in almost 50 years. The bill touched upon nearly every aspect of the U.S. health care system and held the potential to expand health insurance coverage to tens of millions of the nation’s uninsured.

Sr. Carol Keehan, DC, who retires as president and chief executive officer of CHA June 30, saw the ACA as a promising, if imperfect, vehicle to advance the Catholic health ministry’s vision for health reform that leaves no one behind. Having brought the priorities of the Catholic health ministry into meetings and calls with White House and congressional officials where the central concepts of health reform were framed

Foto © Vatican Media

By JUDITH VANDEWATER

CHA President and Chief Executive Officer Sr. Carol Keehan, DC, right, used a May 8 visit to St. Peter’s Square for Pope Francis’ General Audience to introduce Sr. Mary Haddad, RSM, center. Sr. Carol retires June 30 after almost 14 years at CHA. Sr. Mary will succeed her in CHA’s top post.

Health systems step up training to make childbirth safer in US

By KEN LEISER

The United States is one of the most dangerous places in the developed world to deliver a baby. More than 700 women die each year in the U.S. because of pregnancy-related complications, according to the Centers for Disease Control and Prevention. Across the country, about 50,000 women annually suffer serious complications related to childbirth.

“That’s just a travesty,” said Cris Daskevich, chief executive at The Children’s Hospital of San Antonio and senior vice Daskevich president of maternal services for the CHRISTUS Health system.

“Two women die in childbirth almost every day in our country.”

Based out of Irving, Texas, with U.S. hospitals in Texas, Louisiana and New Mex-

ico, CHRISTUS Health is among a growing number of U.S. health systems taking steps to make childbirth safer for mothers and babies.

Its initiatives include standardizing maternal health care across all of the system’s rural and urban facilities, intensifying efforts to train doctors, nurses and other child-delivery personnel, and sharing best practices with other providers.

Efforts have been underway for several years in the system’s home In the CHRISTUS Santa Rosa Simulation Center, Theresa state of Texas, where lawmakers Mangold, clinical director of CHRISTUS Santa Rosa Hospital – established a Maternal Mortal- Westover Hills, uses a medical manikin to demonstrate ity and Morbidity Task Force. The techniques used to train doctors and nurses to handle both panel is comprised of maternal- normal and complex deliveries. The simulation center is fetal medicine specialists, obstetri- located inside The Children’s Hospital of San Antonio. cians, administrators and nurses.

The group began reviewing cases of mater- 89 maternal deaths from 2012 and found nal deaths in May 2015. that 38 percent were pregnancy-related — In its most recent report, issued in meaning death of a woman “from any cause September, the Texas task force reviewed Continued on 3

AMITA crowns chapel restoration with art glass windows

By KATHLEEN NELSON

Stephen Serio

AMITA Health Resurrection Medical Center Chicago recently completed restoration of its chapel with the installation of seven art glass windows depicting images of healing from scripture. Their messages have struck an emotional chord with visitors, said Darren Henson, who was AMITA’s vice president of mission and discernment, during the restoration.

“They’re astounded,” he said. “You can see the amazement in their eyes and hear them say ‘wow’ under their breath.”

The windows are the crown jewels and finishing touch on a renovation necessitated by a fire in December 2014 that destroyed most of the chapel. The restoration project was funded through insurance and private donations.

At the time of the fire, Resurrection Medical Center was part of Chicago-based Presence Health. St. Louis-based Ascension acquired Presence in March 2018 and

made Presence a part of AMITA Health, a joint operating company of Ascension and AdventHealth system of Altamonte Springs, Fla. Shortly after the fire, Presence Health formed a chapel renovation advisory committee. It engaged Fr. Mark Joseph Costello, OFM Cap, a liturgical consultant with background in the design of sacred spaces, to advise them on the architectural guidelines of the Second Vatican Council and the United States Conference of Catholic Bishops.

One of seven stained glass windows commissioned for the chapel at AMITA Health Resurrection Medical Center Chicago.

Bridging past and future “We wanted to envision very intentionally what a chapel in a Catholic hospital should look like in the 21st century,” said Henson, who left AMITA May 31.

The committee started almost from scratch. The monumental crucifix was removed for refurbishing along with the marble from the altar and the Stations of the Continued on 6

out, she put all her personal and political capital on the line to secure the final votes needed for the bill’s passage.

Ensuring that everyone gets the quality health care all people deserve, not just the care they can afford, has been the through line connecting Sr. Carol’s vocation as a Daughter of Charity and her career as a nurse, hospital executive and leader of CHA. “The Affordable Care Act could not have been enacted had it not been for the tenacity and generosity and grace and determination of Sr. Carol Keehan,” said NancyAnn DeParle, who was President Barack Obama’s chief architect of the ACA. Sr. Carol’s public support for health reform infuriated ACA opponents, including some influential conservative bishops who maintained the law would expand access to abortion and birth control. Critics amped up their attempts to demonize Continued on 4

Barrow researchers bring artificial intelligence to bear on ALS

By KEN LEISER

Researchers at Barrow Neurological Institute in Phoenix are using artificial intelligence to better understand the origins and potential treatment of amyotrophic lateral sclerosis, or ALS. Dr. Robert Bowser is chairman of neurobiology and director of the ALS Research Center at Barrow, which is part of Dignity Health St. Joseph’s Hospital Bowser and Medical Center. In a conversation with Catholic Health World, Bowser expressed measured optimism about the potential for artificial intelligence to advance ALS research.

His research team used artificial intelligence tools to disCOMMONSPIRIT cover five new genes HEALTH associated with the fatal neurological disorder. The team employed an IBM Watson Health technology platform that applies advanced natural language process, machine learning and predictive analytics to advance research in cell biology. Scientists hope the addition of AI will speed the development of new ALS therapies.

Separately, Barrow researchers are using AI to detect subtle changes in speech patterns of ALS patients (an effort that may offer insights into the biology of disease progression) and they are using AI in an effort to predict treatment outcomes using electronic medical records.

What is the state of medical research into treatments or potential cures for ALS? It’s an exciting time because we’ve made a lot of progress and inroads in the last five Continued on 3

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CATHOLIC HEALTH WORLD June 15, 2019

Ministry hospitals use MDsave platform to offer price transparency On platform, patients can compare costs, purchase vouchers for services

By JULIE MINDA

Despite a push by patients, patient advocates and government agencies for greater transparency and affordability when it comes to the prices of health care services, consumers continue to find pricing very difficult to understand; and they say costs are too high, according to polling.

More than 200 U.S. hospitals are trying to make inroads in addressing the longstanding complaints through the MDsave online health care marketplace. MDsave, a private, for-profit company based in Brentwood, Tenn., works with its health care provider clients to arrive at a single, bundled price for each of a range of medical tests and procedures. The company then posts those prices online and enables patients to purchase vouchers to receive the services at a given facility at those prices.

Facilities within St. Louis-based Ascension; Chicago-based CommonSpirit Health; Springfield, Ill.-based Hospital Sisters Health System; and Chesterfield, Mo.-based Mercy are among those that have signed on with MDsave. MDsave is one of multiple companies using online platforms as a conduit for health providers willing to bundle and discount episode-ofcare prices so patients know ahead of time how much they will pay for a specific procedure or treatment.

Omaha, Neb.-based CHI Health, part of CommonSpirit, went live on the MDsave website in November. Dr. Cliff Robertson, CHI Health chief executive, says the service is designed for — and is proving popular with — people who are uninsured as well as people who have high-deductible health plans.

Robertson says offering the MDsave bundled pricing option to patients is in line with CHI Health’s commitment to be more transparent, accountable and affordable when it comes to pricing.

Convoluted, expensive The Centers for Medicare and Medicaid Services says hospitals providing services to Medicare-insured patients must post their standard charge master publicly. Additionally, dozens of states have passed laws requiring or encouraging hospitals, other health care facilities and/or insurance companies to be more transparent and clear with consumers about pricing and insurance plan coverage.

Clay O’Dell, CHA director of advocacy, notes price transparency is getting attention in Congress and could be addressed through legislation soon.

According to recent reporting from Kaiser Health News, several federal lawmakers are advancing legislation aimed at curbing “surprise billing,” in which a patient gets unexpected bills, often for emergency care provided by out-of-network clinicians, but also for aspects of surgical care and other planned procedures. President Donald Trump has indicated he’d support action to curtail the problem.

There is widespread agreement in the industry that pricing and transparency are significant issues — though there is no such agreement on causes or solutions.

“In today’s marketplace, health care can be confusing and expensive, especially for consumers who are uninsured,” John Jeffries says in a January release on a group of Hospital Sisters Health System hospitals launching an MDsave site. Jeffries is director of finance for one of those hospitals, HSHS St. Joseph’s Hospital of Breese, Ill. The American Hospital Association says it is challenging to offer straightforward, meaningful pricing information because health care services can vary so much by patient, and the out-of-pocket costs for

services vary significantly based on individuals’ insurance status and coverage. Health care systems, physician groups and facilities negotiate different rates with different insurers, and insurers for their part offer numerous plans to consumers, with varying levels of coverage and out-of-pocket cost.

Another complicating factor is that so many stakeholders are involved in the pricing and payment equation, including hospitals, physicians and other clinicians, pharmaceutical and medical device providers, commercial and government payers, employers, patients and regulatory agencies. All of this makes it difficult, if not impossible, for patients to figure out their out-of-pocket costs in advance of receiving health care services.

In 2017, Public Agenda, the Robert Wood Johnson Foundation and the New York State Health Foundation released a survey in which 63 percent of respondents said there is not enough information available about how much medical services cost. And a 2018 survey from the Commonwealth Fund found that people’s confidence in their ability to afford health care had declined every year since the start of Commonwealth Fund’s tracking of the measure in 2014.

New approach MDsave’s online marketplace publishes bundled prices for over 1,300 procedures at participating hospitals in nearly 30 states.

MDsave says it provides its health care clients a recommended rate for each service that is “based on a fair market analysis.”

The hospital has the final say on the services it will offer and the voucher price it will accept for a given service or treatment. Hospitals pay MDsave a monthly subscription fee and what MDsave describes as a “small fee” for each transaction when patients purchase the health care services.

The MDsave website provides examples of potential patient savings using the vouchers, with a complete blood count, for example, costing $20 as compared to an estimated national average of $40; a mammogram screening costing $202 as compared with an estimated national average of $400; and a colonoscopy costing $2,127 as compared with an estimated national average of $4,412.

Most patients need a valid physician order to use MDsave. According to MDsave’s website, patients then can geo-

graphically search for what they need by procedure, provider, specialty or ailment; make an apples-to-apples comparison of bundled prices guaranteed by competing providers; purchase vouchers for the services they choose to use; and then bring those vouchers to the participating provider to cover the full cost of the services.

The participating hospitals put together the team of providers that will deliver the full scope of services needed to fulfill the voucher, according to information from CHI Health and HSHS. MDsave says patients can use pretax dollars in health savings or flex spending plans to purchase their health care services through the online marketplace. MDsave also markets a credit card that enables patients to finance their purchases.

Scaling up CHI Health and HSHS say they are starting with a menu of basic health care services and will expand the list over time. For instance, the HSHS Southern Illinois Divi-

sion hospitals currently using the platform offer it for diagnostic imaging such as ultrasounds, CT scans and MRIs. They plan to expand the list later this year to include laboratory testing, physical therapy and some medical procedures.

CHI Health says it offers some services through the MDsave platform that are not covered by insurance, such as plastic surgery or new treatments still under review by insurers for coverage approval.

The hospitals will build out the list further in the future.

Formerly a family doctor, Robertson says clinicians at CHI Health value “being able to help on the spot when that dreaded exam room question comes up: ‘How much will this cost?’

“Now we have a tool that is very easy to use and consumer friendly,” to answer the question, and to provide more manageable costs. jminda@chausa.org

Best friends at an ice cream social Dr. Frank LaBarbera, an obstetrician and gynecologist affiliated with St. Claire HealthCare in Morehead, Ky., shares a frozen treat with his dog during a PAWS for Behavioral Health gathering on May 11. The event was hosted by St. Claire HealthCare at the Morehead Dog Park as part of Mental Health Awareness Month. Pet owners learned how communing with a pet can reduce loneliness and stress, lower blood pressure and improve cardiovascular health. Dogs and people enjoyed free ice cream while hearing from Morehead Mayor Laura White Brown and other guest speakers. St. Claire HealthCare is a not-for-profit health system sponsored by the Sisters of Notre Dame – Covington Province.

Upcoming Events from The Catholic Health Association Mission in Long-Term Care Networking Call June 25 | 3 p.m. ET

International Outreach Networking Call

Essentials for Leading Mission in Catholic Health Care

In-Person Meeting: Sept. 9 – 11 Plus Five Online Sessions

Community Benefit 101: The Nuts and Bolts of Planning and Reporting Community Benefit Oct. 15 – 16

Aug. 7 | 3:30 p.m. ET

A Passionate Voice for Compassionate Care® chausa.org/calendar

June 15, 2019 CATHOLIC HEALTH WORLD

Childbirth complications From page 1

related to or aggravated by her pregnancy or its management.”

In the deaths that were related to pregnancy, the leading underlying causes were cardiovascular conditions, obstetric hemorrhage, and infection, according to the report. The findings largely mirror national studies looking at the causes of maternal death and injury.

More recently, following a series of articles on maternal mortality and morbidities in USA Today, congressional leaders from both parties sent letters to health agencies within the Donald Trump administration to request briefings on efforts to curb childbirth complications.

In May, the CDC released a report showing that three of five pregnancy-related deaths are preventable.

Focus on training CHRISTUS Health has 27 acute care facilities in the U.S. with 17 that provide obstetric services. Each year, the system delivers about 19,000 babies. CHRISTUS Health’s goal is to ensure that every baby is born as healthy as possible and that moms can go home with their babies, said Rhonda Thompson, chief nursing officer at The Children’s Hospital of San Antonio and co-chair of CHRISTUS Health’s perinatal task force. “The saddest thing for any OB provider is sending a dad home with the baby without mom,” Thompson said.

In addition to its participation in the Texas Maternal Mortality and Morbidity Task Force and the TexasAIM quality collaborative, the health system is undertaking several additional measures to improve maternal health, including: Creation of a CHRISTUS Health perinatal task force to address maternal-fetal complications and improve processes across the health system as part of a joint effort to elevate women’s services in all of its ministries.

Collaboration among CHRISTUS Health, The Children’s Hospital of San Antonio and Baylor College of Medicine to reduce the rising maternal morbidity rate resulting from maternal cardiac arrest.

The effort, funded through a $2 million National Institutes of Health grant, will develop curriculum for a national pregnancy resuscitation program to train hospital health care providers and emergency responders who treat pregnant women experiencing cardiac arrest.

Education and simulation training

ALS research From page 1

to 10 years, but we still don’t have effective therapies to treat these patients with a horrible, hideous disease. But as science is evolving and our ability to ask certain questions has evolved, we’ve made incredible insights and discoveries into both the basic science and actually into the disease itself.

In 2016, you teamed with IBM Watson Health and used an artificial intelligence algorithm to identify five new genes that are linked to ALS. How did that work?

IBM Watson used its text-based algorithms and a semantic approach to review published literature, including abstracts of previously known RNA-binding proteins.

It made interpretations and then tried to almost make guesses as to what’s the next leap and what can be predicted based on that.

More than 30 genes have been linked to ALS, and mutations in the 11 genes that encode RNA-binding proteins cause familial forms of ALS. A person’s DNA encodes for more than 1,500 RNAbinding proteins. It is unknown if other RNA-binding proteins may contribute to ALS. With so many, the cost and time required to examine them all would have

Sandra Martinez, right, a labor and delivery nurse at Providence Holy Cross Medical Center in Mission Hills, Calif., assists Julie Masson, left, during an obstetrics training using a computerized medical manikin. Masson is a nurse leader of the simulation program.

in obstetric emergencies for nurses and providers to help them identify high-risk patients and intervene early when complications occur.

Simulating complex births Dr. Shad Deering, a maternal fetal medicine doctor and CHRISTUS Health’s new medical director of simulation, said the childbirth complication of shoulder dystocia — in which the infant’s shoulder gets stuck behind the Deering maternal symphysis during delivery — is just one example of how training through simulated childbirths can improve health outcomes.

In the case of shoulder dystocia, a doctor has only four to five minutes to deliver the baby because the umbilical cord is usually compressed, and the baby is not getting oxygen. Historically, the injury rate to the infant has been as high as 40 percent. But a recent study in the United Kingdom found that training providers for the emergency on manikins can significantly reduce the risk of injury, Deering said.

“The better paradigm is how do we practice this and get good at it so when a life’s on the line, it isn’t like this is the first time the doctor has actually done it,” Deering said. Other major maternal events that CHRISTUS will offer simulation training on in the future include maternal cardiac arrest, umbilical cord prolapse and obstetric hemorrhage.

CHRISTUS has simulators at hospitals throughout its system.

been prohibitive.

The Barrow team provided a list of 11 RNA-binding proteins with known mutations that cause ALS. Watson crossreferenced the list with medical literature from 28 million MEDLINE abstracts to rank order all other 1,500 RNA-binding proteins encoded by our genome to try to identify those linked to ALS. What the Watson platform couldn’t do was take experimental results from my scientific lab and upload that information, and then use that information in combination with the textmining approaches to gain new insight.

How would you improve upon artificial intelligence research tools?

I think the most obvious way we need to go is to be able to incorporate findings from the actual benchwork, from the actual lab itself into the artificial intelligence database query. Uploading that information into an algorithm is a challenge due to the various types of platforms that generate experimental data.

In the Barrow research project ALS AT HOME, patients who are early in the disease provide weekly speech samples by phone or tablet. What do scientists hope to learn from this research?

There are a few other groups around the country using these types of speech

Safety protocols Mercy Medical Center in Baltimore has held down childbirth complications largely because of safety practices that have been in place for years, including a massive transfusion protocol instituted in the obstetrics department 14 years ago to respond to instances of obstetric hemorrhage, said Dr. Robert Atlas, the medical center’s chair of obstetrics and gynecology.

In addition, Mercy requires the two OB-GYN physician groups that deliver babies at the hospital to have a physician on call virtually aroundAtlas the-clock, Atlas said. This has helped the hospital “greatly” in its response to emergency situations.

“We have had that in place for probably six years or so,” Atlas said. “What we found is that our doctors help each other.

You know, if there’s a difficult situation, we have someone else who can quickly jump in and help. Our two groups are incredibly collegial with each other, which is awesome.”

‘Fourth trimester’ Recently, there has been increasing emphasis on the months following childbirth. In April 2018, the American College of Obstetricians and Gynecologists proposed a new paradigm for postpartum care to emphasize the need for ongoing care above and beyond a routine followup medical appointment for the mother six weeks after delivery.

“New mothers need ongoing care during the ‘fourth trimester,’” said Dr. Alison

or voice analytics with AI approaches to look at speech and speech recognition in ALS patients. The idea is to determine if we can identify changes that either predict the course of the disease, predict the future events that might occur clinically in a disease, or use speech as an outcome measure in clinical trials. So, if you have a drug that would be impacting the neurons that help control speech, if you’re protecting those neurons, then the deficits in speech should slow or level off if the drug is effective. Could that be an outcome measure that the FDA would find enticing to actually approve a drug? That’s down the road, but that’s where some of that research is moving. That is very exciting.

Does the algorithm recognize changes in speech that are so subtle as to be undetectable by the patient or their loved ones?

Yes. The analytic tools could separate (patients with ALS) rather quickly from the control subjects. But it also separated ALS patients that self-reported no abnormalities in speech from the control subjects, indicating that the algorithm could detect speech alterations before the patient or the patient’s family could recognize any changes in speech. That again is very exciting. As we are looking for tools or biomarkers for the disease, right now what we use are obviously the hard-core clinical assess-

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Stuebe, lead author of the opinion. “We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families.”

About 40 percent of women who have given birth do not attend a postpartum visit, the organization said. (Attendance rates are even lower among women with limited resources, contributing to health disparities.) Postpartum visits should include a full assessment of physical, social and psychological well-being.

A study published in the 2016 edition of Obstetrics & Gynecology reviewed 211 maternal deaths in Colorado between 2004 and 2012 and found that “self-harm” — suicide and accidental overdose — was the most common cause of pregnancyassociated mortality, with most of the deaths occurring in the postpartum period. The study, which looked at death certificates, coroner reports and medical records, found 63 — or 30 percent — of the deaths were due to self-harm. The Colorado panel that reviewed maternal deaths did not limit itself to the CDC definition of pregnancy-related mortality, the study stated, which excludes deaths from accidental or incidental causes.

Authors of the study also found that while there have been advances in screening and treating mental health disorders during pregnancy, “there has been relatively little focus on maternal deaths resulting from self-harm, specifically those related to accidental overdose and suicide.”

Dr. David Legrew is executive medical director of women’s services for Providence St. Joseph Health, Southern California, and a high-risk obstetrics specialist.

Legrew “The risk for suicide and overdose is actually less while you’re pregnant because most women say, ‘Wait a second, I don’t want to hurt the baby too,’” Legrew said. “But because of postpartum depression, the pressure of a new child, etcetera, then what you see is — paradoxically — an increase in that first year after delivery.”

He said that medical professionals need to do a better job in identifying the mothers at higher risk of suicide or overdose “so that we can help them for a longer time period.” kleiser@chausa.org

ments. Those clinical assessments are global assessments of the patient. In order to impact and change those global assessments, a lot of underlying biology has probably changed internally within the patient.

Finding biomarkers that are able to quantify those underlying biological changes and therefore distinguish changes in ALS patients prior to our current clinical parameters are greatly needed to help us identify more effective therapies. This AI project is one approach to doing just that.

Do you see artificial intelligence playing a significant role in the future research into ALS? Yes. I remain hopeful that AI approaches will provide an impact toward the development of new treatments, new ways to monitor patients, new outcomes measures for trials. I am hopeful that AI approaches will lead us in that direction and be a part of that solution. We are still in early stages of incorporating AI into ALS or any other diseases for that matter, but I see a great need and potential to use AI in this disease and I think we need to leave no stone unturned.

AI provides a new opportunity to make new discoveries and make new insights into the disease. kleiser@chausa.org

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CATHOLIC HEALTH WORLD June 15, 2019

Sr. Carol’s legacy and marginalize her after the law’s narrow passage — there were no Republican votes in favor in either chamber. She got death threats in her email in-box. ACA protestors mounted the altar at St. Aloysius Church in Washington and screamed insults as she delivered a commencement address to the Gonzaga College High School Class of 2010.

(She would later joke that in the spirit of the commencement ceremony, it was one of the rare speeches where she did not focus on access to health care insurance.)

Rather than strike back at her critics, Sr. Carol continued to speak publicly about the dignity and economic security that health insurance expansion under the ACA would bring to vulnerable families.

Pete Souza/Courtesy of Barack Obama Presidential Library

From page 1

set up at Sacred Heart — to offset the unreimbursed costs of providing care to sick babies.

The group of legislators wanted to shift some of the money in the bill to train neonatologists. Sr. Carol looked them in the eye and told them to go elsewhere for funding.

“I will help you with a medical education bill, but I will not let you do this,” Sr. Carol told the men. “This is an end run and it’s wrong.” The NICU grant funding was preserved in its entirety.

People, process, Faith seeks understanding culture “I think it is her deep faith, her deep From Sacred Heart, prayer life and sense of humor that got her Sr. Carol stairstepped through those rough days following the to posts of increasing passage of the ACA,” said Ron Hamel, who responsibility within the was CHA’s senior director of ethics at the President Barack Obama meets with CHA President and Chief Executive Officer Sr. Carol Keehan, DC, and other hospital Daughters of Charity time and now is president of SSM Health’s executives in the Roosevelt Room of the White House March 16, 2010, five days before the House voted to approve the AffordNational Health System, public juridic person. “She is very coura- able Care Act and a week before it became law. Lloyd Dean, who was then president of the predecessor company to Dignity which became a foundgeous. She will stand her ground, but she Health, and Nancy-Ann DeParle, Obama’s chief architect of health reform, also are shown. ing member of Ascenwill always do it respectfully.” sion in 1999. She was Sr. Patricia Talone, RSM, a former CHA in the U.S.; and, I would say, without exag- in Emmitsburg, Md., gained experience as vice president for nursing at Providence vice president of mission services, added, geration, that the role of Carol Keehan in an emergency room nurse and worked with Hospital in D.C., and chief executive at “Her work is about the health ministry of this (preparation) was huge. Huge!” he said. pregnant women and young children.

Sacred Heart Hospital in Cumberland, Md., Christ and the church. Her cause is about When a steady drumbeat of mergers, She moved to Pensacola, Fla., to open before returning to Providence Hospital people who are sick or poor, so she is partnerships and affiliations among and the first Sacred Heart Children’s Hospital as president and chief executive. Later she unafraid to act.” between Catholic and other-than-Catholic as its head of nursing, development and built Carroll Manor Nursing & RehabilitaAt every CHA gathering, and on stages parties led the United States Conference of advocacy. It was there she began to hone tion Center on the grounds of the hospital. from the City Club of Cleveland to the World Catholic Bishops to reexamine the theolog- her knowledge of health care finance and She returned to Pensacola as chair of the Economic Forum in Davos, Switzerland, ical implications of such pairings, Sr. Carol develop her political chops.

Sacred Heart board of trustees before takSr. Carol has framed access to health care as underscored that partnerships were essenFinancing a children’s hospital that pro- ing the top job at CHA. a human right and a moral imperative. tial to the viability of the Catholic health vides care for every child, irrespective of a In Washington, where Sr. Carol spent “What Carol said is what Carol believed,” ministry in the marketplace. family’s ability to pay, requires a reliance on the bulk of her career, she reversed the failsaid Colleen Scanlon, executive vice presiSaid Slubowski: “Sr. Carol’s belief is that, philanthropy and state funding. Sr. Carol ing fortunes of Providence Hospital and dent and chief advocacy officer of Com- first and foremost, anything that strength- said she learned to advocate from physi- restored the enthusiasm of a demoralized monSpirit Health. Scanlon chaired CHA ens Catholic health care is a good thing.” cian leaders, lawyers and ethical politicians staff. She got to know the hospital’s cafwhen the ACA passed. “Good public pol— people whom she said demonstrated eteria workers as well as the city’s power icy was always first and foremost to her. Born on Capitol Hill integrity, competence, determination and brokers, once attending the State of the Because of who she is, a woman of great After the passage of the ACA, then- humility in working to advance the pediat- Union as a guest of First Lady Laura Bush. integrity and faith, people listened,” Scan- Senate Majority Leader Harry Reid, D-Nev., ric hospital. “That’s been helpful to me my She served for a number of years on the lon said. invited Sr. Carol and Sen. Bob Casey, D-Pa., whole life,” she said.

USCCB’s health care subcommittee and Sr. Carol urged Catholic domestic council. health executives, some of She established meaningful relationwhom were dubious about ships and lasting connections. “She is very health reform, not to blame the engaging and understands that change poor for financial challenges in comes through people, process and cultheir institutions. “I had symture,” said Slubowski, who is president and pathy for the CEOs struggling chief operating officer of Trinity Health. to make budget, to give the staff DeParle said that with Sr. Carol, relationwhat they deserved in benefits ships are personal, not transactional. “She and wages, and have the right enters the room, she radiates goodness, equipment, but it was not on par and you want to lift your game.” with the sympathy I had for the millions and millions of people Listen and learn — including children — who Colleagues say Sr. Carol leads by lisdid not have health care. I knew tening, respecting people’s expertise and firsthand the suffering of pargiving employees a path to work to their ents who could not afford health highest capacity. Throughout her career, care for a sick child,” Sr. Carol she’s made it a practice to get to know her said. employees at all levels of the organization.

Mike Slubowski, the outgo“There is something so human and ing chair of the CHA board, said authentic about her as a leader,” Slubowski he’s been inspired by Sr. Carol’s said. “People like to be around her, like to “unrelenting and unflappable talk with her. She can take the job seriously, commitment to ministry and to but not take herself seriously. People follow advancing the human condi- With a wink towards Moses, editorial cartoonist Roger Schillerstrom’s August 27, 2007, illustration for Modern her because they see this is a vocation, not tion for all people, regardless of Healthcare shows Sr. Carol carrying stone tablets down a mountain. a job to her.” means, race, religion or creed.”

“I love the people in health care,” Sr. to lunch in his private dining room. They She knew instinctively how to wield the Carol said. “It’s not an effort for me to want Leading through change were joined by members of Casey’s and moral weight of her cause to maximum to talk to people about the work they are While working to bend public policy Sr. Carol’s staff. impact and, when necessary, to marginal- doing and how they are doing it. People to serve the poor, Sr. Carol also was guid“Tell me about yourself,” Reid said to Sr. ize those who put their personal agendas really do care about the work they do unless ing the CHA membership through a time Carol, “for instance, where were you born?” ahead of the common good. She acted you drive the caring out of their hearts by of significant change in the ministry. This “Right outside your window, sena- without a whiff of sanctimony, although the way you treat them, or the impossible included the founding religious congrega- tor,” she replied, nodding in the direction there was sometimes a glint of mirth in her obstacles you put in their way. tions’ accelerating transfer of sponsored of Providence Hospital in the Capitol Hill tactics.

“I’ve been a nurse’s aide, a staff nurse. works to lay sponsorship, governance and northeast neighborhood — a hospital she When she got wind that a group of Flor- You see what it means if the people in cenadministration. Archbishop Joseph Augus- headed for 15 years before joining CHA. ida legislators had waited until she was on tral supply get their job done, if the comtine DiNoia, OP, adjunct secretary for the Together with her older brother and religious retreat out of state to divert money puter works, if the emergency generator Vatican’s Congregation for the Doctrine younger sister, Sr. Carol grew up in south- from a bill she had helped shape and cham- works, you get an appreciation.” of the Faith, said he has been impressed ern Maryland in a family that read two to pion, Sr. Carol left the Daughters of CharSr. Carol’s penchant for personal conwith the effort that CHA and its members three daily newspapers — one of which she ity retreat center in Emmitsburg, at 4 a.m., nection translates into relentless travel. brought to the formation of lay sponsors delivered as a teen. At age 21, with a nursing drove to D.C. and hopped a flight to Talla- By rough calculation, she will have logged and leaders to prepare them to fulfill this diploma from DePaul School of Nursing in hassee, Fla. more than 70,000 miles in the first six sacred trust.

Norfolk, Va., she entered the Daughters of The legislation would enable the state’s months of this year — the equivalent of “It was a massive transition in the way Charity. By 25, she’d earned a Bachelor of first five neonatal intensive care units — nearly three times around the globe.

Catholic health care would be carried out Science in nursing from St. Joseph’s College including the Level 3 NICU she had helped When she joined CHA almost 14 years

June 15, 2019 CATHOLIC HEALTH WORLD

Pro-life stance Casey, a pro-life Democrat, got to know Sr. Carol in 2009. He said Sr. Carol and CHA’s advocacy staff were a resource to him and other senators during complicated negotiations over components of the evolving health reform legislation. “Whether it was making sure the Hyde Amendment (barring the use of federal funds to pay for abortion) would continue and be in place for (insurance) exchanges or making sure we had additional provisions in place to support pregnant women,” Sr. Carol and CHA staff lent expertise, he said.

Casey said one faction of Democrats was trying to move health reform legislation in a pro-choice direction while a group of ACA opponents was trying to derail the legislation by claiming it expanded abortion access. Sr. Carol and CHA’s efforts ensured the final bill was abortion neutral, meaning it would not expand federal funding for abortion. “She had a real commitment to her faith and making sure we didn’t move the needle, so to speak, on the issue of abor-

alarmed by the USCCB’s charge that the ACA would expand access to abortion. (Smith became CHA’s vice president of advocacy and public policy when Rodgers retired in January as CHA’s senior vice president of public policy and advocacy.) Sr. Carol explained to the representatives how CHA’s legal experts came to the opposite conclusion as the USCCB staff: there was language in the bill, an executive order and a congressional colloquy that all established congressional intent to not expand federal funding for abortion through the ACA. “I never saw it as an act of defiance against the bishops,” Sr. Carol said recently of her ACA advocacy. But some people interpreted it that way. “They had their opinion and we had ours.

We have a conscience as Sr. Carol leaves the altar at the Basilica of the National Shrine well. We see the suffering of the Immaculate Conception in Washington, D.C., where CHA of people without health members commemorated the association’s 100th anniversary with insurance.” a Mass on June 7, 2015.

With patience and intentionality, Sr. Carol set out tion,” Casey said. to repair the public rift with the USCCB Sr. Carol and CHA’s Lisa Smith and and relations between the two groups have Michael Rodgers called on pro-life Catho- gradually gotten back on an even keel. lic Democrats in the House who were In recent years, the USCCB has opposed efforts to repeal the ACA in the absence of replacement legislation that would establish viable protections for “real families who need and deserve health care.” Hamel said a new pope, along with new leadership and staff turnover at the bishops’ conference built a foundation for improved relations. © CHA

ago, she went on a listening tour to get to know members and their priorities. “After that, I was going back to visit friends,” she said. “I get energized from those visits.”

The visits kept her connected to members’ needs and priorities.

Scanlon said Sr. Carol is a consensus builder. “Carol knows advocacy is a collaborative venture. Usually you don’t have great success alone. Our voices when multiplied are the true influencer. Being able to bring others along with us and truly partner is really essential,” Scanlon said.

Sr. Carol, right, often traveled to visit CHA members. In this June 2016 photo she poses on a dock in Southeast Alaska with Sr. Andrea C. Nenzel, CSJP, now vice chair of the board of PeaceHealth. The women were in Alaska to attend the opening of an expansion of PeaceHealth Ketchikan Medical Center on Revillagigedo Island.

Critical boost At a crucial moment in the run-up to the 2010 House vote on the ACA, Sr. Carol wrote a column for this newspaper recognizing “a historic opportunity to make great improvements in the lives of so many Americans.”

The column, posted on the CHA website, heartened a White House that was then about 20 votes shy of a win in the House.

(The Senate already had passed the bill.)

Sr. Carol’s support turned the tide,

DeParle said. “This was someone people trusted as a leader saying it was time to stand up. It just gave me and the president so much of a lift and so much heart to know we weren’t the only ones standing there. As a result of her having the courage … there was this organic thing that happened. We saw other hospital associations step up.”

NETWORK, a Catholic social justice lobby, sent an open letter to Congress signed by 50 leaders of congregations and communities of women religious. “This is the REAL pro-life stance, and we as Catholics are all for it,” the authors said of ACA provisions that would protect people with preexisting conditions from being denied insurance and would substantially expand health care access for pregnant women and children.

“It almost brought me to tears,” DeParle said of the letter.

Guarding a treasure Earlier this year, as Sr. Carol began winding down her tenure at CHA, she spoke at a meeting of health care sponsors and a meeting of system mission executives. At both events, she acknowledged challenges facing the Catholic health ministry including the possibility that a federal appeals court will vacate the ACA, ongoing threats to Medicaid and Medicare funding, the perils of “skinny” health insurance plans that are thin on coverage, and the pressure from new competitors seeking to channel money from profitable services away from health systems that rely on that money to fund essential, but unprofitable service lines.

She asked this question at the end of her comments at each of the meetings: “Do you believe the best days of Catholic health care are ahead of us or behind us?”

And how would she answer that question?

“We need to have stronger, more empowered mission leaders. And the people in sponsorship, governance and executive management need to model mission,” she said. “We need to make sure that people value the Catholic part of Catholic health care. I think we need to make that resurgence happen. We must make this happen. We need people to say we are guarding a treasure.”

Visit Catholic Health World at chausa. org/chworld to read about CHA’s vision for health reform. jvandewater@chausa.org

Sr. Carol brought nursing values into health care administration policy R

ight out of the gate, an 18-year-old Carol Keehan knew she’d made the right decision by enrolling in nursing

school. “I was totally and completely hooked on nursing and health care,” she said. “Sometimes you just know this is it.

This circa 1970 photo shows Sr. Carol and Dr. Reed Bell at Sacred Heart Children’s Hospital in Pensacola, Fla., where she was the supervisor over nursing, advocacy and philanthropy and he was medical director.

This fits. This works. I have loved nursing ever since.”

With her nursing diploma in hand, she joined the Daughters of Charity, a congregation that is committed to bettering the lot of the poor. One of her earliest nursing jobs was in the emergency room and it was a great fit for the energetic, extroverted young nurse. “I liked the fact that you spend all your time nursing,” she said of the ER. “You are there at critical moments in people’s lives.”

She earned a bachelor’s degree in nursing and became the first supervisor of the Sacred Heart Children’s Hospital in Pensacola, Fla. She connected with patients and their families just as she had when nursing at the bedside.

She tells the story of a patient who pegged her as a soft touch.

The child had been hospitalized multiple times for complications of diabetes and she knew Sr. Carol.

Once the girl was admitted in the middle of the night; she was asleep when Sr. Carol made morning rounds. When the unit manager came to check on the girl, the child told her, “If Sr. Carol knew I was here, she would want me to have a doll.” The unit man-

5

ager came back with a doll.

Sr. Carol’s heart for the poor and her vantage point as a nurse administrator fueled ideas about how the hospital could do more to provide services to families on the health care margins. But, Sr. Carol said, her ideas frequently got shut down by those who controlled the hospital’s spending.

Sr. Carol with a patient.

“They would start to use all the jargon of health care finance: nice but not reasonable, nice but not affordable.” To defend her proposals and get to yes, Sr. Carol took accounting and statistics

courses and she went on to earn a master’s degree in health care finance.

“I never wanted to do finance,” she said. “It doesn’t appeal to me, but what does appeal is making it possible to give people the care they need in a setting that enhances their human dignity, and to be in control of that.”

Michael Rodgers, CHA’s former senior vice president of public policy and advocacy, said nursing has given Sr. Carol a window into the issues underlying health care disparities. “Along the way, she saw very practically the kinds of things that needed to improve in our health system,” he said. “It wasn’t like she was some outsider, she saw it firsthand.”

Today, Sr. Carol is a member of the prestigious National Academy of Medicine (formerly the Institute of Medicine). She holds 11 honorary doctorates and the Pro Ecclesia et Pontiface Cross, a decoration of honor for distinguished service to the Vatican.

But it’s her nursing credential that defines her.

“I want to be a nurse,” she said. “I’m proud to be a nurse. It’s important to me to be able to say I still have a license.”

— JUDITH VANDEWATER

CATHOLIC HEALTH WORLD June 15, 2019

Healing art Through discussions with the sisters, Fr. Costello and system leadership, the idea emerged to replace the clear glass windows with stained glass images of healing. The committee created a list of Gospel and Old Testament stories with healing and restorative imagery and distributed the list to staff, the sisters, nurses, spiritual leaders, even the regulars at Mass. With their input, the committee narrowed the list to 10.

The committee took those stories to the artists they had chosen to interview. From three finalists, they selected Kathy Barnard, who specializes in etched glass and has a studio in Kansas City, Mo. Barnard developed sketches for the 10 stories, from which she and the committee settled on seven: Moses and the Bronze Serpent: Numbers 21:4 – 9 Elijah and the Widow’s Only Son: 1 Kings 17:1 – 24 The Man Born Blind: John 9:1– 41 The Hemorrhaging Woman: Luke 8:43 – 48; Matthew 9:18 – 26; Mark 5:21– 43.

Jairus’ Daughter: Mark 5:21– 43; Matthew 9:18 – 26; Luke 8:40 – 56 The Good Samaritan: Luke 10:25 – 37 Washing of the Feet: John 13:1 – 15 Design coherence To create design cohesion, Barnard incorporated into the windows elements from other parts of the chapel, such as the gold stars and blue background on the ceiling and the band of amber used as an outline around the altar. The blue glass in each of the side wall windows forms a free-form arc through each set of three windows, gradually flowing upward to heaven in the windows closest to the altar.

“I don’t need people to be hit over the head with what everything means at once,” Barnard said. “I want them to discover something different every time they go in there.”

She worked with a glass company in Germany, flying there to approve the exact coloring of the glass, which was shipped to her studio in sheets. Working with two assistants, Barnard created patterns, then laid them on the glass. They cut the glass, then dry fit the pieces together before inserting lead between the fragments.

Barnard etched the title of each work into the window. The scripture citation and passage are in a plaque next to the window.

She also experimented with a technique of painting faces on glass, then firing them in a kiln, rather than using stained glass to piece together a face.

“I felt so confident with this group,” she said of the restoration committee. “I was upfront and questioned them if they were willing to take the risk to take the painted glass and fire it in the kiln. It was a learning experience for all of us, and I think it turned out well.”

Moses and the Bronze Serpent

Stephen Serio

Cross before the chapel was gutted.

Only one of the original seven stained glass windows remained intact after the fire, an image of St. Margaret Mary Alacoque. (St. Margaret Mary was a 17th century nun and mystic who promoted devotion to the Sacred Heart of Jesus.)

The other windows were broken in the effort to put out the fire.

Henson said the windows “spoke to the spiriHenson tuality” of the Sisters of the Resurrection, the hospital’s founding sponsors.

The original windows on one side of the chapel depicted Mary; the other side featured images of Christ at his resurrection and as king. They were replaced temporarily with clear glass. The image of St. Margaret was reinstalled on the back wall of the chapel.

The Hemorrhaging Woman

to her ill mother, was grateful for the visits, as she and Henson shared their stories of caregiving as much as updates on the windows. “We talked about how the project helped us find healing, life and hopefulness through the difficulties we were facing at the time,” Henson said.

After working on the windows in her relatively cramped studio, where they were stacked and leaned against a wall, Barnard

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Jairus’ Daughter

and her crew traveled to Chicago to install the windows themselves.

“I thought I would be sad when the windows left my studio,” she said. “But once they got in the chapel, you knew they belonged there. Being in the space and feeling the lines and color flow from when you walk in to the front, I was so happy to see

them all together.”

Henson said he knows from personal experience and from observing visitors to the chapel that the windows and the stories they tell “can be a source of healing, hope and comfort for our patients and their families. You can see it and feel it anytime you’re there.”

THANK YOU

DALLAS / JUNE 9 – 11

From page 1

Working through life’s travails Throughout the 18-month design process, Henson traveled to Kansas City to visit his ailing parents and to check on Barnard’s progress. Barnard, who was tending

Stephen Serio

Chapel restoration

Mitchell Solomon

6

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June 15, 2019 CATHOLIC HEALTH WORLD

7

KEEPING UP

Harbarger

Diamond

PRESIDENT/CEO Claude W. Harbarger will retire as president of St. Dominic Health Services of Jackson, Miss., effective June 30. He’s worked at St. Dominic’s for 32 years. Lester

Goetz

Andersen

K. Diamond, president of the system’s St. Dominic Hospital, will succeed Harbarger as president of St. Dominic Health Services.

St. Dominic’s will become part of Baton Rouge, La.-based Franciscan Missionaries

of Our Lady Health System on July 1 and will transition to the sponsorship of Franciscan Calais Ministries. Diamond will be a member of the executive and operating leadership team of FMOLHS.

Initiatives and Trinity Health.

Elva Sipin to vice president of operations at PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Ore., effective June 24.

ADMINISTRATIVE CHANGES

GRANT

Organizations within Livonia, Mich.based Trinity Health made these changes: Katy Hoffman to chief nursing officer of St. Joseph Mercy Ann Arbor of Ypsilanti, Mich., and Nick Nickolopoulos to chief nursing officer of St. Mary Mercy Livonia of Livonia.

Kathy Goetz to market vice president of women’s services and MercyOne Children’s Hospital. Dr. Tara Andersen to physician dyad leader for the same entities. They are part of MercyOne Des Moines Medical Center of Des Moines, Iowa. MercyOne is a joint operating company between Catholic Health

Providence Heart Institute of Portland, Ore., has received a $75 million gift from Phil and Penny Knight. The facility will use the funds to enhance cardiac services, including the development of a heart transplant program at Providence within a year.

This donation builds on $25 million given by the Knights in 2014, which was equally matched by other donors. The heart institute is focused on clinical care, prevention and wellness, and research and innovation.

Phil Knight is a founder of Nike.

Providence Tarzana to enter joint venture with Cedars-Sinai

Sparking memories with song The “Together in Song” chorus performs a “Broadway Review” May 13 at Mercy Medical Center in Cedar Rapids, Iowa. The performers are people who have dementia and other chronic conditions, as well as their care partners, spouses and volunteers.

Chorus conductor Steve Nurre says a growing body of research shows singing has a positive impact on people with dementia and memory loss. While they may not remember names or dates, they often can recall song lyrics from the past, according to information from Mercy Medical. Singing can spark happy memories and taking part in the group can create meaningful social connections for participants. A number of similar choirs are starting around the country.

Mercy Medical President and Chief Executive Tim Charles narrated the performance of show tunes from Broadway musicals.

Providence St. Joseph Health of Renton, Wash., and Cedars-Sinai of Los Angeles plan to enter into a joint venture this summer with the goal of improving access to medical care and specialized services in the Tarzana, Calif., area. Tarzana is about 20 miles northwest of downtown Los Angeles.

The deal has the 51-hospital, nonprofit Catholic system and the 40-plus-hospital, nonprofit Jewish academic health organization partnering to bolster Providence’s Tarzana hospital. That hospital, Providence Tarzana Medical Center, will be renamed Providence Cedars-Sinai Tarzana Medical Center. Providence will maintain the controlling interest in the medical center. Specifics on its financial stake are confidential, according to Providence.

Providence and Cedars-Sinai will operate as independent organizations. The

Tarzana medical center will retain its Catholic identity, according to a press release.

Under the agreement, Cedars-Sinai will help Providence to complete a $550 million renovation of the Tarzana campus begun in 2016 and slated for 2022 completion. The project is adding an inpatient wing with all private rooms to the Providence Tarzana campus, expanding the facility’s emergency department and diagnostic treatment areas, and renovating its neonatal and women’s care areas.

The partners also will expand primary and specialty care services on the campus and add to heart, cancer and women’s services.

Providence said the partnership will enable Cedars-Sinai to expand its network of care in California’s San Fernando Valley and help to ensure there is a full continuum of health care in the region.

New Look, New Features, MORE ET HIC S INFOR MAT ION!

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CATHOLIC HEALTH WORLD June 15, 2019

South Florida’s Holy Cross gets kids reading, sets stage for success

By JULIE MINDA

offers tutoring for students struggling with reading.

Holy Cross’ annual Dr. Seussthemed event draws hundreds of preschoolers for fun activities.

Each child gets a Dr. Seuss book as a gift.

The hospital’s mobile health literacy library for children from preschool-aged up to sixth grade is stocked with books, puzzles, matching games, number and letter blocks, flash cards, stories and activity packs, all with a health theme. The mobile library travels to day cares, preschools, after-school programs and other locations, particularly in at-risk communities.

R

esearch shows that childhood literacy correlates with academic and career success and with improved health and well-being, even into adulthood. So, the low litTRINITY eracy rates common HEALTH among children in many low-income communities have far-reaching implications.

This is according to information from Holy Cross Hospital in Fort Lauderdale, Fla. As part of its community benefit work, the hospital helps to promote literacy among children.

Kim Saiswick, vice president of community health and wellbeing for Holy Cross, points out education is a social determinant of health that also is tied to other social determinants connected to healthfulness, such as income, housing and transportation.

Golden (book) correlations Holy Cross is located in Broward County, where 20 percent of children live in poverty, 25 percent receive free lunch by virtue of their family’s income and more than 30 percent are uninsured. About 45 percent of the county’s thirdgraders read below proficiency level, based on the Florida Standards Assessment.

According to information summarized by the Annie E. Casey Foundation in a 2010 report, reading proficiency by third grade — often defined as the ability to read independently and fluidly — is the

Dr. Mario Hernandez of the Holy Cross Hospital Medical Group reads to a patient at a pediatric clinic in Fort Lauderdale, Fla.

because they cannot refer to written instructions.

Talking is teaching Research presented in the Family and Community Engagement 2013 Research Compendium shows that 61 percent of low-income children have no children’s books at home. And, by age 3, children from lowincome homes have heard about 30 million fewer words than children from middle- and upper-income homes, according to other studies, including one covered in the book Meaningful Differences in the Everyday Ex– perience of Young American Children by researchers Betty Hart and Todd R. Risley.

The efforts of Holy Cross physicians and Holy Cross Hospital put copies of Maybe Something staff to reduce the literBeautiful: How Art Transformed a Neighborhood in its acy gap start with parpediatric waiting rooms as part of its participation ents of babies born at in the “Read for the Record” initiative in Broward the hospital. Through County, Fla. the “Blessed Beginnings: Talking is Teachmost important predictor of high ing” program, Holy Cross’ materschool graduation and career suc- nal and child health department cess. Studies show that children staff encourages parents and who can read by third grade have other family members to talk, read a decreased chance of being delin- and sing to their new babies, as quent and of serving jail time later these activities have been found in life. to match with successful developResearch shows that chil- ment and later school success. dren from birth through age 5 Holy Cross’ medical group who are oriented toward literacy takes part in a national, evidence— through talking, reading and based program called “Reach Out singing, for instance — are more and Read” through which primary likely to meet developmental care physicians and pediatricians milestones. And as compared talk to parents during their chilto their literate peers, people dren’s well visits about the imporwho are illiterate in adolescence tance of reading to their kids. The are more likely to engage in clinicians also give free books to unhealthy behaviors and have an all their 4- and 5-year-old patients. increased risk of incarceration.

This year’s book giveaway is Adults who can’t read are more Thank You, Omu! There are plans likely to experience chronic ill- to expand the program to distribness. Illiteracy correlates with ute more titles, so kids can build a shortened life expectancies. book collection at home.

Saiswick notes that adults who Many Holy Cross clinicians can’t read may have limited health and staff also volunteer for onecare knowledge and find it chal- on-one, web-based weekly tutorlenging to follow a doctor’s orders ing sessions with a first-grader.

The hospital says the personal attention of a caring adult reading stories and encouraging a child through learning exercises “has a huge impact.” The pairings are coordinated through United Way.

Return on investment Holy Cross has prioritized childhood literacy in its community benefit and outreach programming for more than a decade.

Saiswick estimates the hospital has spent about $100,000 so far, and adds, “the amount of time, energy, and love that goes into the program is huge by comparison to the actual cost.”

Holy Cross’ “Project Book” initiatives include a monthly inperson book club for students in elementary through high school grades run by Vanessa Graham, a community outreach representative. Most of the participants are between age 8 and 11. Graham selects a title that appeals to a wide age range of children, such as something from the Diary of a Wimpy Kid series. The library

Holy Cross provides books to schools, community gardens and a community initiative called Read-A-Lot @ Your Laundr-OMat, which stocks lending libraries in five laundromats in lowincome communities. (The kids can keep the books.)

Holy Cross promoted a community effort for Broward to compete in — and in 2016, to win — JetBlue airline’s Soar literacy challenge. As the community that drove the most people to the Soar website in 2016, Broward won 100,000 books. It dispensed that windfall to citizens through book vending machines set up in parks and other public venues.

“Broward Reads,” a program Wash and read launched in 2013 by Broward In recent years, Holy Cross has County Public Schools and the extended its reach and impact Children’s Services Council, aims through involvement in broad to increase the number of kids community partnerships promot- who read at their grade level by the ing childhood literacy. end of third grade.

The hospital provides monthly Holy Cross staff are among the thousands of “Read for the Record” volunteers who, on a single day each fall, fan out across Broward County with the goal of reading the same book to every 4- and 5-year-old. Every child gets a copy of the chosen book.

Most Holy Cross staff do their public readings at Holy Cross pediatric offices. Other community volunteers go to schools, libraries, grocery stores and other hubs. The 2018 book was Maybe Something Beautiful: How Art Transformed a Neighborhood. The prior year’s selection was Quackers.

The community’s focus on literacy is Sisters pass the time with a picture book at the improving children’s Fort Lauderdale clinic. reading comprehension, vocabulary, report in-services and children’s books card grades, self-confidence to adults in a Foster Grandparent and social skills, say Saiswick, Program that is run by the South Graham and Sandra BernardFlorida Institute on Aging. The Bastien, chief communications volunteers mentor children who officer of the Children’s Services are impacted by poverty, food Council. insecurity and housing instability.

“By improving literacy rates, Participating children may have we’re investing in the future,” says physical, mental, behavioral and Saiswick. social-emotional challenges. jminda@chausa.org

Amy Corderman, right, community outreach manager for Holy Cross, welcomes Talia German, left, and her preschool class to the hospital in March for the facility’s annual Dr. Seuss literacy event.