Design with kids in mind 3
Executive changes 7 PERIODICAL RATE PUBLICATION
MAY 1, 2019 VOLUME 35, NUMBER 8
Native American tribes, Avera Health zero in on health needs
Aaron Huey/Alamy stock photo 2012
By KEN LEISER
Youngsters and adults gather for horse races at the Veterans Powwow in Pine Ridge Indian Reservation in South Dakota, home of the Oglala Lakota Sioux Nation.
Native Americans are far more likely to suffer from obesity and clinical depression than the rest of the U.S. population. Nationally, their life expectancy is five years shorter than non-Native Americans. And their death rate from drug overdose is higher than the national average, according to the Centers for Disease Control and Prevention. In June 2015, Sioux Falls, S.D.-based Avera Health named Leroy “J.R.” LaPlante as its director of tribal relations — the health system’s primary liaison with regional tribal governments. Prior to that, LaPlante — who graduated from University of South Dakota School of Law — was South Dakota’s first Secretary of Tribal Relations and later an assistant U.S. attorney. LaPlante, 50, was born and raised on Continued on 4
Catholic Health collaborates with college to aid community, expand workforce
AMITA Health clinic embraces kids adjusting after perilous journeys By ELIZABETH GARONE
Their journeys to the United States have not been easy, taking anywhere from a couple of weeks to several months. They have come by bus, train, and on foot. When they arrive, they are often malnourished. They may have oral thrush, and rashes and insect bites on their arms and legs. Sometimes, their feet are covered in blisters from all of the walking. They are unaccompanied minors, age 12 to 17, who have made their way north to the United States from Mexico, Guatemala, Honduras, El Salvador and Nicaragua. Through the Unaccompanied Alien Children Program, which is funded through
By NANCY FRAZIER O’BRIEN
Catholic Health of Buffalo, N.Y., is getting in on the ground floor of a local college’s planned Health Professions Hub. The Hub — a 50,000-square-foot clinical training center on the campus of Buffalo’s D’Youville College — will educate students for eight health professions and include a primary care clinic with professional staff and resources provided by Catholic Health. It is expected to open in the fall of 2020. D’Youville College announced plans to build the Hub in September 2016 but acknowledged in talks with Catholic Health that “as a university they did not have the experience to run a primary care clinic,” said Joyce Markiewicz, presiMarkiewicz dent and chief executive of Catholic Health Home and CommunityBased Care. “But the idea of having a clinic on Continued on 6
Within 48 hours of arriving at Maryville Academy, unaccompanied minors must be brought up to date on immunizations.
nants that affect health, I know I’m not getting the full picture,” says O’Neill, who is a family medicine physician at Providence Medical Group Gateway in east Portland, Ore. However, “if I ask, but don’t have the resources to help, it’s impractical. I’m trained as a physician, not a social worker.” Now, with community organizations staffing resource desks at six Providence
the federal government’s Office of Refugee Resettlement, the Maryville Academy in Des Plaines, Ill., serves as a receiving site and a gateway to trauma-informed services and shelter in Northern Illinois. Many have entered the U.S. without visas, usually at the Southern border. Some have turned themselves in to a Border Patrol agent, because they are seeking asylum. Others enter without inspection and are apprehended by Border Patrol, said Mary McCann Sanchez, program direcMcCann Sanchez tor at the Maryville Academy, a child health and welfare organization rooted in Catholic social teaching.
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Providence St. Joseph Health's Oregon region has set up community resource desks in six of its clinics. This one is at its Providence Tanasbourne Health Center in Hillsboro, Ore. Specialist Yazmin Navarro, seen in the background, staffs this desk.
Providence St. Joseph Health regions use customized approach to take on socioeconomic need By JULIE MINDA
Before Providence St. Joseph Health’s Oregon region began inviting social service agencies to staff community resource desks in some of its clinics about three years ago, Dr. Elizabeth O’Neill says she often found herself at a loss as to how to address the pressing socioeconomic needs of patients. “If I don’t screen for the social determi-
Providence and its promotores bring telemedicine to Hispanic parishes By KATHLEEN NELSON
Low-income Hispanic immigrants face hurdles accessing health care. In Portland, Ore., Providence Health & Services combines parish-based telemedicine and a robust health promotores program to deliver basic care, information and screenings to that medically underserved group. Providence Oregon’s community health division started its parish-based Telehealth Clinics with Promotores program in 2014, and through 2018 provided screenings and basic health care to almost 3,000 Latinos in
the Portland area. A survey conducted by Providence found that, if not for these free clinics, more than 1,000 of those patients would have done nothing about their health concerns. Providence has made a six-year commitment to the program, and patient acceptance has continued to build. “The duration of this program has been key,” says Joe Ichter, senior program manager for Providence’s community health division. “It’s tough to build trust in a short burst. The fact that it’s entrenched in the community is what gets us the results.”
Sr. Lynda Thompson, SNJM, right, prays with a woman training to be a health promotore. Sr. Thompson directs mission integration for Providence St. Vincent Medical Center in Portland, Ore.
The parish setting alleviates fears of patients who may stay away from other provider sites out of a reluctance to give personal information regarding their immigration or insurance status. In fact, notes Antonio Gomez, program manager of community health promotion for Providence Oregon region, health promotores who do the patient intake at the clinics do not ask questions related to immigration status or insurance coverage. “Parishes have become a safe place for community members,” and the clinics are Continued on 6
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CATHOLIC HEALTH WORLD May 1, 2019
Las Vegas nonprofit responds to needs underlying nonemergency calls to 911
Every paramedic and emergency room nurse has a litany of stories like this: A chronically ill person falls at home and an ambulance is dispatched. The patient, complaining of pain, is taken to the emergency room, where medical personnel examine and discharge him or her. Three days later — maybe sooner — another 911 call comes from the same address for the same thing. The routine is dangerous for the patient, expensive for the ambulance authority and the hospital, and provides no real solution to the patient’s fall risk. A small agency in Las Vegas is trying to find a better way. The Second Responders 911 Referral Program began with student volunteers in 2013. It works with four area fire departments, including Las Vegas Fire and Rescue, to identify frequent users of 911 and find more cost-effective ways to meet their needs. Hospitals and psychiatric facilities also refer patients to the program. Dignity Health – St. Rose Dominican hospitals in Henderson, Nev., a suburb of Las Vegas, has donated more than $160,000 to Second Responders, including $60,000 in 2018 and $60,000 this year. The hospital says the program improves emergency medical services response times for the greatest emergency need and reduces ER wait times and ER visits. Dignity Health is part of Chicago-based CommonSpirit Health. Alexandria Anderson is executive director of the Southern Nevada Community Health Improvement Program, a nonprofit agency founded to operate Second Responders. She said the funding from Dignity Health – St. Rose Dominican, combined with municipal funding and other support, allowed her to hire a professional staff of five. “Some people are isolated and believe that calling 911 is their only option,” Anderson said. “When we get referrals, we go out and do holistic assessments to get a clear picture of what the needs really are and find appropriate help.” Services can be as simple as paying for transport on the Lyft ride-sharing platform
Catholic Health World (ISSN 8756-4068) is published semimonthly, except monthly in January and July, and copyrighted © by the Catholic Health Association of the United States. POSTMASTER: Address all subscription orders, inquiries, address changes, etc., to Kim Hewitt, 4455 Woodson Road, St. Louis, MO 63134-3797; phone: 314-253-3421; email: khewitt@ chausa.org. Periodicals postage rate is paid at St. Louis and additional mailing offices. Annual subscription rates: CHA members $45, others $55 and foreign $55. Opinions, quotes and views appearing in Catholic Health World do not necessarily reflect those of CHA and do not represent an endorsement by CHA. Acceptance of advertising for publication does not constitute approval or endorsement by the publication or CHA. All advertising is subject to review before acceptance. Vice President Communications and Marketing Brian P. Reardon
Editor Judith VandeWater jvandewater@chausa.org 314-253-3410 Associate Editor Julie Minda jminda@chausa.org 314-253-3412
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Dignity Health-supported program cuts inefficient use of ambulances
for transportation to clinics or hospitals. Anderson said the savings are considerable. An average ambulance call costs $870. She said her agency has been able to assist clients for an average cost of $305 per year. “If you have somebody calling 911 ten times, think of the savings,” she said. The Second Responders staff works with local hospitals, universities and social service agencies to create individual care plans, which have reduced the clients’ need to call 911 by two-thirds. The university connections also provide Anderson with student volunteers from their social work and nursing programs. Anderson said the students receive valu-
able experience and help the paid staff serve more people in need. Professional social workers also donate time. The Southern Nevada Community Health Improvement Program also sponsors other programs for the benefit of lowincome people, including neighborhood health fairs. Anderson said Sarah McCrea, an assistant Las Vegas fire chief and veteran paramedic, organized Second Responders. Anderson became one of the volunteers two years later, and the overseeing agency hired her as director in 2017. McCrea serves on the agency’s board of directors. The 911 follow-on service formally is called the Sec-
ond Responders Emergency Medical Services Response Program. McCrea became aware of the extent of the problem of people using 911 for nonemergency calls during her 14 years making runs as a firefighter/paramedic for the Las Vegas department. “A lot of people who use 911 truly have other unmet medical or social needs,” said McCrea. “Some think that a ride on an ambulance means they’ll see a doctor right away. Paramedics are trained for specific skills. It is frustrating to see the same people over and over again and not be able to solve their underlying problems.” In 2013, McCrea attended an emergency medical services conference and heard of a program in Spokane, Wash., that worked with a local university to help repeat 911 callers. With endorsement by her department, McCrea contacted the social work departments at local universities to recruit student volunteers. Second Responders was incorporated as a nonprofit in 2015. “I believe it’s working,” Anderson said. “We have reduced unnecessary EMS calls and visits to EDs. We are providing better health care to people, and the community benefits from more efficient use of its health spending.” Anderson said she and her staff outlined their efforts with a presentation in 2017 at the EMS World Expo, an annual convention and trade show for paramedics. Anderson said she learned of several other communities have similar programs. The grant from Dignity Health – St. Rose Dominican to Second Responders is part of the $350,000 that the hospital donated this year to eight area nonprofits to improve community health.
Upcoming Events from The Catholic Health Association International Outreach Networking Call
Human Trafficking Networking Call
Mission in Long-Term Care Networking Call
Ecclesiology and Spiritual Renewal Program for Health Care Leaders
Pre-Assembly Mission Leader Seminar
International Outreach Networking Call
Pre-Assembly Physician Leader Forum
Essentials for Leading Mission in Catholic Health Care
May 1 | 3:30 p.m. ET
May 5 – 10 (Invitation only)
Community Benefit Webinar: “What Counts as Community Benefit?” May 13 | 2 – 3 p.m. ET Sponsored by CHA and Vizient
Joint Global Summit: Compassion, Ethics & Excellence in Global Health May 14 – 15
Faith Community Nursing Networking Call May 15 | 3 p.m. ET
May 30 | Noon ET
June 8 | 1 – 5 p.m. CT
June 9 |8 a.m. to noon CT
June 25 | 3 p.m. ET
Aug. 7 | 3:30 p.m. ET
Pre-Assembly Community Benefit Program June 9 |8 a.m. to noon CT
In-Person Meeting: Sept. 9 – 11 Online Sessions: November 2019, January and March 2020
Pre-Assembly Program: The Heart of Aging Services
International Outreach Networking Call
2019 Catholic Health Assembly
Faith Community Nursing Networking Call
June 9 |9:30 – 11 a.m. CT
June 9 – 11
Nov. 6 | 3:30 p.m. ET
Dec. 10 | 3 p.m. ET
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A Passionate Voice for Compassionate Care® chausa.org/calendar
May 1, 2019 CATHOLIC HEALTH WORLD
Durable medical equipment meets the sharing economy at CARES Patients borrow ‘good as new’ medical equipment By KEN LEISER
Following the death of her father, Lillian Schonewolf’s family had a garage full of nearly brand-new medical equipment — and no place in or around Langhorne, Pa., to donate it for reuse. Schonewolf knew the University of Pittsburgh Medical Center had a successful medical equipment recycling program — she’d heard about it at a conference for volunteer Schonewolf management that she’d attended in her prior capacity as director of community outreach and volunteer services for St. Mary Medical Center in Langhorne. To find out more about it and whether the program could be replicated at St. Mary she embarked on a road trip to Pittsburgh. “It basically was exactly what I was hoping we could do,” recalled Schonewolf, who is now regional vice president for community health and well-being for Trinity Health Mid-Atlantic, the parent of St. Mary. “They took in equipment, cleaned it and then they were giving it out to those in need.” Schonewolf successfully pitched the idea of setting up a medical equipment reuse program in Bucks County, Pa., to leaders at St. Mary and the Community League of St. Mary. Now entering its fourth year, the Community Aid Refurbished Equipment Store, or CARES, cleans, inspects, repairs and hands out, on average, 300 wheelchairs, crutches, scooters, walkers and commodes each month. In doing so, St. Mary joined a number of nonprofits across the country that are extending the useful life of a wide variety of medical equipment and keeping durable goods out of landfills. The University of Pittsburgh Medical Center, for example, said it has distributed more than 15,000 pieces of refurbished equipment to people in need since the recycling program launched in 1999. That program provides wheelchairs, canes, walkers and other equipment to patients who lack insurance or don’t otherwise have the means to meet
St. Mary Medical Center in Langhorne, Pa., has loaned out gently used, durable medical equipment at its CARES store since May 2016.
their medical necessities.
Easy sell Schonewolf said, to move forward, St. Mary administrators had to answer some basic questions: Where would the program be housed? And how would it be funded? As for the location, Schonewolf had her sights on the two thrift stores down the street from the hospital run by one of the hospital’s foundations. “We thought, ‘Well, what if we take half of the one shop?’” She approached Eileen Moser, chairperson of the Community League of St. Mary — a volunteerMoser run fundraising arm of the hospital foundation. The Community League said yes to designating half the floor space in a thrift store to CARES and contributing $15,000 to buy an industrial-size sanitizing machine to clean the donated wheelchairs, walkers, canes and scooters at the facility and funding to transform a portion of the thrift shop into the CARES store. The operating budget was $59,328 in 2018. The store has one paid staff person and 10 volunteers. It is open three days a week
— Tuesday, Wednesday and Thursday — between 10 a.m. and 3 p.m. In addition to equipment that helps patients move safely, people have donated packages of Depends and gadgets to help patients who can’t bend over to put on their shoes. Store founders advertised for volunteers with engineering backgrounds or other skills to repair the donated equipment. Meantime, Schonewolf approached community organizations, senior centers, churches and others in search of medical equipment that could be restored and handed out. Since its opening in May 2016, the store has been featured in local media. The program benefited mightily from word of mouth, she said, and has taken over more floor space in the thrift store. Because those in need of medical equipment often are limited by their health plans to one such claim, customers do not have to be indigent or uninsured to make use of refurbished CARES equipment at no cost. In fact, people who apply to receive equipment do not have to reveal financial information to qualify. However, financial hardship can be a deciding factor if the demand for a certain piece of specialty equipment pits the needs of multiple applicants against one another,
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Schonewolf said. “Obviously, we want to help anyone in the community and we have been fortunate that we have been able to because we have enough equipment,” she said. “But our real concern is helping those who can’t afford it. Those who are underserved in our community are our main focus.” Moser said that the medical equipment that goes out of the CARES store is “better than new” and “probably cleaner than what you would get in a store or a medical supply place.” CARES has donated surplus walkers, canes and other medical equipment to hurricane-ravaged regions in Houston, Florida and Puerto Rico. Schonewolf helped deliver a truckload of refurbished medical equipment and donated cleaning supplies to federal emergency relief crews in Mechanicsburg, Pa., for shipment to Puerto Rico. Her grandparents lived in the U.S. territory at the time.
Lending library Those who receive the CARES equipment are able to donate it back to the store. Some mobility devices have been distributed more than one time, making the CARES facility more of a “revolving library,” Moser said. Moser took advantage of the lending service herself after a complete tear of her Achilles tendon in October. Her doctor told her she would need a transport wheelchair, a knee scooter, a raised toilet seat, a shower chair, a walker, crutches and a cane. Moser checked out a wheelchair and knee scooter from CARES and returned them once she recuperated. To date, the CARES staff has given out 4,500 pieces of equipment — not including the hurricane donations, Schonewolf said. Because of the success of the original store, Schonewolf said she is exploring the idea of opening a second CARES facility within Trinity’s Mid-Atlantic region. One of her favorite stories during the first four years of CARES was the man who left with a refurbished wheelchair. “Hey, I got my life back,” the man told store workers, “because I can actually take a walk with my wife.” kleiser@chausa.org
Ascension Sacred Heart opens replacement children’s hospital in northwest Florida Ascension Sacred Heart dedicated a state-of-the art, $85 million replacement children’s hospital at its Pensacola, Fla., campus on April 1. Patient care at the 126bed Studer Family Children’s Hospital is expected to begin this month. Speaking at the commissioning ceremony, 50 years to the day after the dedication of Sacred Heart’s first children’s hospital, Sr. Carol Keehan, DC, CHA’s president and chief executive officer, said “Caregivers are so motivated when they have the right
Bishop William Wack of the Diocese of PensacolaTallahassee attends the dedication of the Studer Family Children’s Hospital at Sacred Heart last month.
things and the right enviHeart Health System’s ronment to take care of board of trustees from children and to take care July 2004 to January of babies, and you have 2006, thanked Ascenmade that possible.” sion Health and the “I am honored to be donors who made the invited back,” Sr. Carol new children’s hospital told the crowd, which facility possible. included former colStuder Family Chilleagues. Sr. Carol moved dren’s Hospital draws to Pensacola in Janupediatric patients from ary 1969 to open Sacred northwest Florida, Heart Children’s Hospi- Sr. Carol Keehan, CHA president and chief southern Alabama and tal as its supervisor. She executive officer, talks with Dr. Robert K. southern Georgia. Critiheaded the nursing staff Wilson Jr., a retired pediatrician and long- cally ill newborns and and had responsibility for time advocate for the children’s hospital. children are transported development and advoto the facility aboard cacy. She helped launch its neonatal inten- specially equipped ground ambulances sive care unit — one of the first in the state. and aircraft. The hospital has a pediatric “I know well how much hard work has emergency department, a 72-bed neonagone into every day of this last 50 years,” she tal intensive care unit, a 10-bed pediatric told the audience. “Every child here is as important as any child in the entire world. Pensacola said that 50 years ago and you have said it again today.” The new four-story children’s hospital is expected to increase access to specialized pediatric care in the region and represents Sacred Heart’s single-largest investment in its 104-year history. The system committed $55 million to the project and raised another $29 million of its $30 million The pediatric CT at the Studer Family Children’s goal from local community members and Hospital is capable of scanning a child in less than organizations. two seconds, enhancing patient safety and reducSr. Carol, who was chair of the Sacred ing the need to sedate young patients.
intensive care unit, a pharmacy with specialists trained in preparing medications for infants and children, an imaging department with a CT scan in a colorfully distracting case modeled on an underwater reef, an inpatient rehabilitation gym, and a familyfriendly dining venue. The hospital’s Ronald McDonald Family Room is outfitted with a shower room, laundry room, kitchen, dining room and open living room. Three bedrooms will be available to families who need to be near children in critical condition. Sacred Heart’s Pensacola campus also has a Ronald McDonald House, where families are housed while their children are hospitalized. The new hospital “gives us the opportunity to provide an even more sophisticated, clinically advanced level of care to the children and families of this community in an environment of care and healing that’s exclusively designed with the unique needs of children and families in mind,” Tom VanOsdol, president and chief executive of Ascension Florida, said in a statement. The medical staff at Studer Family Children’s Hospital includes more than 120 board-certified physicians across 30 pediatric specialties. The new facility is 150,000 square feet and has 28,000 square feet of shell space for future growth. It is named for the family of Quint Studer, a Florida businessman and former chair of the Sacred Health System.
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CATHOLIC HEALTH WORLD May 1, 2019
Avera’s tribal relations From page 1
the Cheyenne River Sioux Indian Reservation in north-central South Dakota. The reservation encompasses Ziebach County, the poorest county in the nation, according to U.S. Census Bureau figures showing more than 56 percent of residents lived below the poverty level in 2017. LaPlante spoke with Catholic Health World about meeting the health care needs of Native Americans. How did your childhood on the LaPlante reservation and your education and career experiences prepare you to work as director of tribal relations at Avera? I’ve always walked with one foot in one world and one foot in the other world. I understand the Indian world and I understand the non-Indian world. I don’t feel at a disadvantage in either one. Roughly 30 percent of Native Americans are uninsured, or twice the national average. Between that fact and the underfunding of the Indian Health Service, what role can Avera play to address these kinds of systemic inequities? What I try to do with Avera Health, the tribes and Indian Health Service is to try to identify common interests that we have. One of those common interests would be to expand Medicaid in South Dakota. (North Dakota expanded Medicaid in 2013.) The expansion of Medicaid would vastly improve access to quality care for American Indians. It would create another funding source for Avera because IHS is traditionally a payer of last resort, especially for purchased care it cannot provide within its facilities. And to the extent the IHS could bill Medicaid and bring in that revenue to bolster their local services, that would be a tremendous advantage. The other thing we can do is help advocate for funding increases for the IHS at the federal level. One thing that a lot of people don’t realize is that IHS cannot lobby for funding increases at the federal level. You have said in the past that you believe Native Americans living on reservations suffer from Third World health care. Can you elaborate? Yes. I will tell you a story. A colleague and I were co-presenting at our physician academy a couple of years ago. She was giving her presentation about our Haiti mission trip, and she had a slide describing all the demographics of Haiti — population, median income, median age of death and so on and so forth. Then I was following her. As we were transitioning to my presentation, I said “Why don’t you just leave that slide up there?” Because those demographics are very similar to what you would find here in Indian country in South Dakota. The unemployment rate. The median age of death. The health disparities. So, it’s kind of an anecdotal example of how we don’t have to go outside the borders of the United States to find Third World health conditions because we really have those here in our own backyard. Our median age of death in South Dakota for American Indians in 2014 was 58. The median age of death for their nonIndian counterpart in South Dakota is 81. That median age of death was very similar to what you would find in Haiti. I think as you go across the country on other Indian reservations, you will find very similar statistics. What are some initiatives you’ve pursued with Avera Health to address pressing health care needs of Native Americans? The very first project I worked on was
a behavioral health collaboration we did with the Oglala Sioux Tribe. Between 2014 and 2015, the Pine Ridge Indian Reservation had suffered probably one of the worst suicide crises it had seen in its history. I think they had over 20 completed suicides in a 12-month period. All the people who died were under the age of 25. The tribal president called me and asked whether Avera would help assess what was going on. So, we took our behavioral health team, and went down and met with the IHS, the tribal leadership, and community program providers. Probably the biggest takeaway was that while there were a lot of different types of behavioral health services, they weren’t really collaborating very well, and a lot of the services were temporary. One of the things we were able to do
was help the tribe write a grant to the U.S. Health Resources and Services Administration’s office of telehealth and we helped them implement a program that evolved into a school-based, behavioral telehealth program serving students in six area schools. Telehealth and behavioral telehealth services were really among the first programs that we worked on in our American Indian health initiative. Avera is providing that care and building it out. After that, the Yankton Sioux Tribe came to us and said, “We’ve been trying to develop a dialysis program down here for years. It is not a historical program function service or activity of IHS, so we have to do it on our own.” The tribe had a building it wanted to convert into a dialysis unit and asked Avera for technical assistance. One thing led to another and eventually they
wanted us to come in and be their provider. The tribe owns the facility and the equipment, but they have contracted with Avera McKennan (Hospital and University Health Center) to provide the nephrology and dialysis services under a management agreement. How do you address the logistical challenges of providing essential services across the vast and remote reservations? I think the remoteness is the least of our challenges. If there is one thing that Avera has proven it can do, it can provide services in remote areas because of telehealth. Recruiting health care providers out to an Indian reservation can be a big challenge. kleiser@chausa.org
THE HEART OF...
Catholic Health Assembly JUNE 9 – 11 | DALLAS
2019 AWARD RECIPIENTS
Celebrating Extraordinary Contributions to the Catholic Health Ministry S I S T E R C O N C I L I A M O R A N AWA R D For demonstrated creativity and breakthrough thinking Holly Austin Gibbs, Director, Human Trafficking Response Program, Dignity Health, San Francisco, a member of CommonSpirit Health
L I F E T I M E A C H I E V E M E N T AWA R D For a lifetime of contributions Fr. Francis G. Morrisey, OMI, Ph.D., JCD, Professor Emeritus of Canon Law; Saint Paul University, Ottawa, Canada
TOMORROW’S LEADERS PROGRAM Honoring young people who will guide our ministry in the future Tiffany Capeles, Director, Health Equity, CHRISTUS Health, Irving, Texas W. Carson Felkel, II, MD, Lead Physician, Behavioral Health Program, Bon Secours St. Francis Health System, Greenville, S.C. Jenna K. Floberg, Executive Director, Villa Loretto Nursing Home and Villa Rosa Assisted Living, Mt. Calvary, Wis., a member of SSM Health Sunny Lay, Director, Nursing Operations, St. Anthony Hospital, Gig Harbor, Wash., a member of CHI Franciscan Health/CommonSpirit Health Bryan Lee, President and Chief Executive Officer, Our Lady of Lourdes Regional Medical Center, Lafayette, La., a member of Franciscan Missionaries of Our Lady Health System Abby Lowe McNeil, Vice President, Communications and Public Affairs, CHRISTUS Health, Irving, Texas
REGISTER NOW! Assembly 2019 | June 9-11 Join us in Dallas where CHA will celebrate these and the other award recipients on June 10, during the Awards Banquet.
chausa.org/assembly
Sponsor of the 2019 Tomorrow’s Leaders Program
Cody McSellers-McCray, Regional Director, Community Health, AMITA Health, Chicago, a member of Ascension Scott O’Brien, Chief Operating Officer, WashingtonMontana Region, Providence St. Joseph Health, Spokane, Wash. Peter Powers, Chief Executive Officer, St. Anthony Hospital, Lakewood, Colo., a member of Centura Health/ CommonSpirit Health Sara Vaezy, Chief Digital Strategy Officer, Providence St. Joseph Health, Renton, Wash. Heather Wall, Chief Nursing Officer, PeaceHealth Sacred Heart Medical Center at RiverBend, Springfield, Ore.
The children are transported to Maryville Academy by Office of Refugee Resettlement staff. In addition, a few of the immigrant children come to Maryville Academy after having lived alone in the community. Some lived with an older family member who passed away or was arrested. Eventually, these young immigrants and refugees will be placed with family members or sponsors, most locally or, in some cases, in other parts of the country. If reunification or sponsorship turns out not to be possible, children enter into long-term foster care. So far, Maryville Academy has welcomed about 400 children, according to McCann Sanchez. The academy houses and cares for the children when they arrive in the Chicago area and are waiting for their placements. Within 48 hours of coming to Maryville Academy, the Unaccompanied Alien Children Program requires each child undergo a full medical screening and be brought up-to-date with their vaccinations. The Maryville Academy has partnered with the New Beginnings Clinic at AMITA Health Holy Family Medical Center, also in Des Plaines, to make this happen. (AMITA Health is a member of Ascension.) The Maryville Academy and the AMITA clinic have a long-standing relationship,
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according to Yolande ing, agreed Del Toro, recalling the teen- their life,” said Del Toro. But, in order to be Wilson-Stubbs, president age brother and sister who saw their father resettled, the federal children’s program of AMITA Health Holy shot. The two came to the United States to requires that immunizations be caught up Family Medical Cen- be reunited with a mother neither remem- to their age group — and that can mean a ter. “This program is the bered because she had left when they were lot of needles. perfect continued mar- very young. Or, the two sisters who were It helps immensely that all of the staff riage in relationship with kidnapped and raped and then released. speak Spanish, the native language of most Maryville,” she said. They just kept traveling north so they of the refugee teens. The staff are able to Wilson-Stubbs The medical exams could find safety and a fresh start in the explain to the children everything that they aren’t just about check- United States. are going to do and why they are doing it. It ing the children’s physiIt is Del Toro’s job and that of the rest also gives the children the opportunity to cal health, according to of the clinic staff to help these vulnerable ask any questions, according to Del Toro. Teresa Del Toro, the New patients feel comforted and cared for as “They are able to relax, even after learnBeginnings Clinic nurse they undergo comprehensive medical ing that they are going to get eight or nine manager. “We cover exams. Common medical procedures, immunizations,” she said. And, by the everything: the physi- such as immunizations, may be foreign time they leave the clinic, they are usually cal, emotional and the and quite frightening to them. “Most of smiling — despite their sore arms. “For Del Toro spiritual. these kids have never had any vaccines in someone else to see them, to acknowledge “When (the immigrant teens) them, and to be there first walk into the waiting area, for them, that means a they are very nervous because lot,” she said. they don’t know what is going to Treating them like be expected of them,” said Del any other kid is one Toro. In many cases, the nurses of the best actions the know very little — if anything — staff can take, accordabout their individual stories. ing to Wilson-Stubbs. Sometimes, the minors are flee“They don’t treat them ing extreme poverty and depralike refugees, shuffling vation, or violence in their home them off into a cercountries. The patients may tain room. They treat have lost a parent to violence. them just like any cliTheir families might have been ent or family member displaced by a natural disaster. or child that comes Some of the teens have been into this clinic,” she raped, according to McCann said, “with dignity and Sanchez. An unaccompanied teen is shown near the border wall that separates Tijuana, Mexico, respect.” Their stories can be harrow- and the United States in this March 2018 photo. Ironwas / Shutterstock.com
Care for unaccompanied minors
May 1, 2019 CATHOLIC HEALTH WORLD
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CATHOLIC HEALTH WORLD May 1, 2019
D’Youville health job hub From page 1
campus made sense,” she said, noting that the school is “in one of the poorest ZIP codes in Buffalo” and home to a population that has been receiving health care primarily through emergency room visits. In late 2018, Catholic Health obtained a $5.07 million grant from Community Partners of WNY (Western New York) for the Health Professions Hub. That represents the largest campus investment in the college’s history and about a quarter of the project’s $20 million budget. Community Partners is a network of more than 100 health, human service and educational organizations; Catholic Health plus five community hospitals; and over 1,000 physicians. It is funded through the New York State Delivery System Reform Incentive Payment program with the dual goals of reducing avoidable hospital use and improving care to the Medicaid population. In addition to offering primary and preventive care as well as ob-gyn services, the Hub will include an on-site pharmacy and lab and imaging services, Markiewicz said. And the benefits of the Hub project are expected to go far beyond the confines of the neighborhood surrounding D’Youville College. “Most major cities have a real shortage of health care workers,” said Lorrie Clemo,
Telemedicine for Hispanic parishes From page 1
under that halo, Gomez says. The parishes “are a gathering place and have turned into a home” for Latino parishioners. That sense of a safe haven has contributed to the success of the Telehealth Clinics with Promotores program. From 2014 through 2018 promotores screened 2,970 patients. Nurse practitioners provided 626 patient consults, 222 referrals to other primary care providers and 202 prescriptions. Nurse practitioners also collaborated with the promotores to apply for and enroll 208 patients in free or reduced-price prescription programs.
Trusted influencers Providence has had a health promotores program in the Portland area since 2002. Over the years, it has trained volunteers from 16 parishes to provide practical information about care access, wellness and disease prevention to their fellow parishioners. Based on a care model developed in Latin America, the promotores have strong connections in the community, but they are not professional clinicians. Ranging in age from 20 to 70, the promotores receive 80 hours of training from the Providence Oregon region community health division to become trusted links to social services and health care resources for their neighbors. “They are part of the parish and community,” Gomez says. “They share the struggles and the goals of the community. They have built trust through other parish activities, so the patients know them outside health care. They use that trust to help people in need of medical services receive a level of basic care they would not otherwise have.” Each of those 16 parishes now has at least one annual Telehealth Clinic with Promotores; most host two to three annually. Most clinics are scheduled for Saturdays to accommodate working adults. In the clinics, promotores take patients’ height and weight and calculate body mass index. They check blood pressure and take a blood sample, which they insert into a testing machine to measure cholesterol (HDL and LDL), triglycerides and glucose. Results are available within 10 minutes. Promotores review the results with patients and
A conceptual rendering by CannonDesign of the planned Health Professions Hub at D'Youville College in Buffalo, N.Y. The Hub will include a primary care clinic run by Catholic Health.
president of D’Youville College. “In our area alone, by 2024, we will need an additional 10,000 health professionals. We will produce at least 700 a year at D’Youville.” The college offers certificates and associate, bachelor’s and advanced degrees in eight health professions: dietician, physical therapist, nurse practitioner, pharmacist, physician assistant, nurse, chiropractor and occupational therapist. In addition, students at five high schools within walking distance of the D’Youville College campus will have the opportunity to earn credits in the health sciences before graduation, thus decreasing the time and money they will need to obtain a bachelor’s degree.
discuss ways to reduce health risks. Patients with readings outside the normal range are given the option to make an appointment for a virtual visit with a nurse practitioner or get a referral to another primary care provider for a face-to-face consult.
Intimacy at a distance The e-medicine component of the clinic program operates through Providence Express Care Virtual. A promotore stays with the patient during the virtual visit to translate and advocate for the patient. Thanh Nguyen, a nurse practitioner and senior manager of Express Care Virtual’s clinical operation, said she and her colleagues were surprised that some patients preferred the virtual visits to a brick-andmortar clinic. “At first, I thought it was the newness of the technology, but the extra distance can also create comfort for patients,” says Nguyen. “And with the promotores there, people feel at home when they come to the visits.” Nguyen noted that some patients who might have been unwilling to discuss their mental health, or other medical conditions in a face-to-face visit, were more apt to broach those matters in a virtual visit when the clinician was not physically in the room. Nguyen says that as a clinician she is touched by the opportunity to make a difference in the lives of vulnerable people. “I get tearful when I see a family come to us, even if they are afraid because they have no resources,” Nguyen says. “Having the connection with us is just the beginning to open up all our other resources to them. I’m grateful for the opportunity to serve them and hear, ‘I’m so glad you’re here.’” Over the years Providence’s community health division has trained more than 400 promotores, some of whom have become certified as community health workers. About 150 remain active as volunteers in their parishes, 120 of them women. “Most are working community members, raising families, caring for their own children,” says Delfina Hernandez, program specialist from Providence’s community health division. “In the limited amount of time they have to volunteer, they are very passionate and really see the need” for community health outreach. The promotores understand how socioeconomic factors such as income, education and housing affect health status and keep people from accessing health care.
One aspect of the Hub that Clemo considers distinctive will be the interprofessional, team-oriented learning atmosphere. “I have not seen this model used anywhere in the country,” she said. “Students may be exposed to two or three of the (other) professions during their coursework (at other schools), but not all eight. “It provides a bridge from the college setting right into the workforce,” where cross-disciplinary teams are becoming the norm, Clemo added. Herself a nursing graduate of D’Youville College, Markiewicz said her training was almost entirely classroombased. “Even in recent years, at Catholic Health, we might have had students for a day or two, but now there is a real shift into community care,” she said. Markiewicz said Catholic Health also expects the Hub to provide opportunities for growth among the current workforce and to train potential employees for a variety of entry-level positions, including dietary aides and home health care aides. “All of that makes perfect sense to us, and will help us fill positions throughout
the system,” she said. The Hub will include a number of state-of-the-art simulation labs and gives Catholic Health a chance to help design its community clinic — which will be run on a long-term lease with the college — from the ground up. “Usually we are retrofitting a building” that was used for another purpose, Markiewicz said, adding that the Hub might also become a center for providing telemedicine to the broader community. She said work groups made up of representatives of the college and Catholic Health are exploring different configurations for the clinic, classrooms, simulation labs and common areas. Founded in 1908 by the Grey Nuns and named for their foundress, St. Marguerite d’Youville, the college currently has more than 3,000 students studying for undergraduate, graduate or doctoral degrees in health care, business and the liberal arts. Clemo said she expects the Hub project to “help us grow enrollment by 1,000 students in the next five years.” But she is most excited at how Clemo it will help the college achieve its three-pronged institutional goals “focused on the strengths of the college, the needs of the community and our desire for our students to succeed. “We see this as a model that other urban communities with health disparities and a low-income population could very easily adopt,” she said, adding that both d’Youville and Catholic Health are “mission-driven institutions, with mission-driven workforces that we want to strengthen. “We’ve been very intentional in finding partners that want to have the same sort of impact in improving our community,” Clemo said. “It is a wonderful partnership because of that shared mission.”
D
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May 1, 2019 CATHOLIC HEALTH WORLD
7
KEEPING UP Louisiana in Lake Charles. Lloyd succeeds Mark J. Neff, who is retiring.
ADMINISTRATIVE CHANGES
Tai Kim
Karadjoff
PRESIDENTS/CEOS Matt Caldwell to president of Bon Secours Mercy Health’s Greenville, S.C., market. He was president of the Mercy Health – Springfield, Ohio. Dr. Hyung Tai Kim to president of Mercy Health Saint Mary’s of Grand Rapids, Mich., effective May 6. He was senior associate dean for clinical affairs at Michigan State University College of Human Medicine. Kim succeeds Bill Manns, who now is president of sister hospitals, St. Joseph Mercy Ann
Opperman
Grate
Arbor of Ypsilanti, Mich., and St. Joseph Mercy Livingston, located in Howell, Mich. Interim President Dr. David Baumgartner will return to his role as chief medical officer. Don King to senior vice president, Ascension, and Kansas ministry market executive, from chief operating officer for Ascension Alabama. Donald H. Lloyd II to president and chief executive of St. Claire HealthCare of Morehead, Ky., from president and chief executive of CHRISTUS Ochner Health southwestern
Ascension, Catholic Health to take part in program to buoy frontline caregivers Ascension Michigan and Buffalo, N.Y.based Catholic Health are among the organizations in a new program to bolster the support offered to frontline health care staff. Cleveland Clinic created the $20 million initiative, “Transformational Healthcare Readiness through Innovative Vocational Education.” THRIVE will use screening tools to identify health care workers most in need of support, and then it will provide those staff members with one-onone coaching, life skills support, training and education. The goal is to improve the recruitment and retention of caregivers in frontline posi-
tions that historically have high levels of turnover. Cleveland Clinic will pilot THRIVE across three regions over the next three years: Cleveland Clinic in Northeast Ohio, Ascension in Southeast Michigan and Catholic Health in Western New York. The Ralph C. Wilson, Jr. Foundation is providing more than $15 million in grants for THRIVE. That foundation focuses on the same regions that Ascension and Catholic Health serve. Wilson was the founder and 54-year owner of the Buffalo Bills football team. The foundation began in 2015, the year after his death.
Organizations within St. Louis-based Ascension have made these changes: Earl J. Barnes II to executive vice president and chief legal officer and Ted Matson to executive vice president, chief business transformation officer of AMITA Health, a joint operating company of AdventHealth in Altamonte Springs, Fla., and Ascension. Dr. Thomas Graf to president of Ascension Medical Group. Brigitta Giulianelli to executive director of the Foundation of St. Mary’s Healthcare of Amsterdam, N.Y. Organizations within PeaceHealth of Vancouver, Wash., have made these changes: Tim France to chief development officer of PeaceHealth’s Oregon network. Dr. Andrea Halliday will add chief medical officer for PeaceHealth’s Oregon network to her ongoing duties as chief clinical officer of the PeaceHealth system. Livonia, Mich.-based Trinity Health and one of its subsidiaries have made these changes: Peter Karadjoff to Trinity Health senior vice president of performance excellence; and Scott Opperman to director of mission integration of Mercy Health Saint Mary’s of Grand Rapids, Mich. Kyle Grate to vice president of operations at SSM Health St. Joseph Hospital – Lake Saint Louis, Mo. Douglas J. Fiore to president of Mercy College of Health Sciences in Des Moines, Iowa. The college is part of MercyOne. MercyOne is jointly owned by CommonSpirit Health’s Catholic Health Initiatives and by Trinity Health. Judy Riopelle to director of mission integration for Penacook Place of Haverhill, Mass., part of Covenant Health.
ANNIVERSARIES St. Joseph’s Medical Center, Stockton, Calif., 120 years.
Providence Saint Joseph Medical Center of Burbank, Calif., 75 years. Hospital Sisters Health System, Springfield, Ill. 40 years.
AHA recognizes Rodgers as ‘powerful advocate’ for the vulnerable Michael F. Rodgers, who retired Jan. 31 as CHA’s senior vice president of public policy and advocacy, gives remarks at a ceremony where he accepted the American Hospital Association’s Honorary Life Membership Award. The April 8 event was part of the AHA Annual Membership Meeting in Washington, D.C. AHA President and Chief Executive Rick Pollack described Rodgers as “a powerful advocate for expanding access to health care for those who face barriers” who used his expertise to further CHA’s and AHA’s shared goal of improving patient care. Rodgers brought a deep knowledge of health care policy on aging to CHA. During his 18 years at the association, he advanced CHA’s vision for U.S. health care and promoted CHA’s advocacy agenda before Congress, the White House and federal agencies.
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CATHOLIC HEALTH WORLD May 1, 2019
Socioeconomic needs
program. And in several communities the health system operates outreach centers to bring together social service providers in one convenient location. The CARE Network team may include registered nurses, social workers and health coaches — St. Joseph Health has tailored its teams to meet the particular needs of the patient population in each of its communities in Northern California. For patients with pressing socioeconomic needs, the CARE Network provides intensive navigation for accessing medical respite, other housing assistance, food aid, transportation and mental health services. Stacey Stirling, a community benefit operations manager for St. Joseph Health in Sonoma County, located in San Francisco’s North Bay area, said patients in the CARE Network tend to have a high level of need, but a low level of trust in the institutions that could help them. Being present in their community, building relationships with them and helping them access services has increased the level of trust, she says. Nearly 300 miles north of San Francisco, in Humboldt County, St. Joseph Health has opened five resource centers
From page 1
Medical Group clinics and other Providence facilities in and around Portland where economic need is high, patients and other community members can get practical one-on-one assistance navigating and accessing social services. “It’s strengthened the relationships we have with patients,” O’Neill says. “It’s hard for me to imagine practicing medicine now without screening for the social determinants of health and referring people who need help to the desk.” O’Neill notes that with knowledgeable social service navigators helping patients get assistance with social service needs, her clinic’s advanced practice staff Brian Olson, right, senior community program and service coordinator at St. Joseph Health’s community have been freed to work to the top of their resource center in Eureka, Calif., assists a client trying to access social services. licenses and focus on medical care. As described in an October 2017 encouraged its six regions to pursue part- for public programs and other community National Academy of Medicine discus- nerships and market-specific approaches resources. They follow up to make sure the sion paper, “medical care is estimated to to address social determinants that cor- client is able to secure services, explains account for only 10 to 20 percent of the relate with poor chronic disease manage- Yazmin Navarro, an employee of Impact modifiable contribument and poor health NW who staffs one of the desks. tors to healthy outoutcomes. Navarro has helped people access “It’s hard for me to comes for a populahousing aid, health insurance, utility imagine practicing tion.” The other 80 to Live aid assistance, transportation help, supple90 percent — factors The help desks mental nutrition benefits, medicine now without called social deterat the Portland-area food pantries, dental care, minants of health — screening for the social primary care clinics and help with job searches. include health-related and other facilities She says most of the clients determinants of health are staffed weekdays she advises initially are behaviors, socioeconomic factors, and and referring people who by representatives of unaware that social serenvironmental factors. nonprofit community vices and health resources In its 2018 to 2022 need help to the desk.” organizations who are available to them. integrated strategic speak both English Nurse Pam Marieaand financial plan, and Spanish. (Trans- Nason leads the commu— Dr. Elizabeth O’Neill Providence St. Joseph lation services can be nity health division with recognizes the importance of social deter- arranged for people who speak another Shelley Yoder, a social minants of health to a population’s well- primary language.) worker and the program being and longevity. To advance physiHelp desk staff work with individu- manager of the community cal, spiritual and emotional health in its als and families to identify and prioritize resource desks in Oregon. communities, Providence St. Joseph has needs and help them fill out applications Mariea-Nason says the social service navigation responds to issues surfaced in community health needs assessments — including housing, food and transportation insecurity — by Michael Finamore, a CARE Network nurse, performs a medication connecting people directly review and fills his patient’s medication organizer. The patient had with service providers who been discharged to a medical respite room at Healing Ring in Eureka, can provide practical help. Calif. St. Joseph Health of Humboldt County rents five beds at this Yoder says this is essential clean and sober house for homeless patients. because “health care can’t solve these issues by ourselves. This needs where staff and volunteers from commuto be a community-wide solution.” nity partner organizations offer social services, classes, support groups and other Northern California outreach to community members. People Providence St. Joseph’s Northern Cali- who visit the centers can get help with fornia region, which continues to operate accessing food, housing, transportation, under the name St. Joseph Health, is tak- job training, family counseling, clothing ing a two-pronged approach to the socioand hygiene items. economic needs of its patients. A team Martha Shanahan, assists vulnerable patients who are tranmanager for commuDonna McQueen, center, a complex care nurse with the CARE Network in Humboldt County, Calif., helps sitioning from St. Joseph Health hospitals nity health investment her patient move to transitional housing. McQueen provides care coordination, navigation and support to to home with health and social services for St. Joseph Health in patients who are using the emergency department frequently. management through its CARE Network Humboldt County, says trust-building and relationships are key to the Shanahan success of the community resource centers. “And that’s what our staff do. And then we can funnel people to appropriate care.” s part of its efforts to get at unmet and other aid. to help reduce what it says is unnecesDan Schurman, community partnersocioeconomic need in its commuBefore going in front of a judge, people sary reliance on hospital resources by ship manager for St. Joseph Health in nity, Providence Health Care of Spokane, with qualifying charges — offenses like some community members. A hospital Sonoma County, the heart of California’s Wash., provides financial and other trespassing, panhandling and public staff member of Spokane’s Providence wine country, said there are many indisupport that allows a community court intoxication — meet with a prosecutor Sacred Heart Medical Center attends to offer alternatives to jail time to people and public defender at the community the court to help identify people seeking viduals and families who struggle with who commit nonviolent misdemeanors. court. During the sessions, the prosecutor help there who are high users of hospital homelessness there. Transportation also The court incentivizes offenders to seek and public defender move quickly from services. Her goal is to work with the can be a big barrier for people with limsocial services and other aid to address individual to individual, assessing their individuals, the court and community ited resources in Sonoma and Humboldt the problems that may be at the root of cases and in many instances negotiating organizations at the court to holistically counties. their offenses. agreements specifying defined steps the address the individuals’ concerns. St. Joseph Health taps community Overseen by the Spokane City Municioffender will take to confront his or her Providence Health Care has provided benefit funds to provide transportation pal Court, the court convenes every Monchallenges. If the person completes the $21,000 in funding for the court, to fill assistance to and from medical and social day in meeting rooms at a branch of the steps and graduates, the court will drop funding gaps, and is considering addiservice appointments. The aid comes in Spokane Public Library; another session the charges. tional contributions. And Sara Clementsthe form of bus passes, taxi rides and gas is held in a community center. RepreEstablished in 2013 — and modeled Sampson, manager of community cards, he said. sentatives of social service providers are after similar courts elsewhere in the U.S. health programs for Providence Health &
Spokane community court tackles socioeconomic needs A
present at both locations during the court sessions to help with access to disability assistance, job training, education, clothing, housing, food, transportation, trauma therapy, mental health care, medical care
— the court has graduated more than 700 people between its two locations. Part of Providence St. Joseph Health, Providence Health Care of Spokane supports the community court as one way
Services, sits on the community court’s board. — JULIE MINDA
jminda@chausa.org