Standing against assisted suicide 2 Child’s play in hospital design 3 CHA builds its mission services team 7 PERIODICAL RATE PUBLICATION
NOVEMBER 15, 2019 VOLUME 35, NUMBER 20
Providers increase disaster readiness among vulnerable Relationship building is essential, say experts
Dirk Collins, left, and his brother Darin evacuate their home in Healdsburg, Calif., Oct 26, ahead of strong winds that could heighten wildfire risks. The Sonoma County Sheriff’s Office said it would be the biggest evacuation in the county in more than 25 years. Evacuations can be especially difficult for people with health conditions and disabilities.
In recent years, St. Elizabeth Community Hospital of Red Bluff, Calif., has been inviting people with developmental or physical disabilities to take part in disaster response drills. Ruth Ann Rowen, the hospital’s emergency management coordinator, said the inclusion of people who may not be able to walk or otherwise rapidly respond to emergency instruction helps staff and leadership anticipate and prepare for the special needs that can arise among vulnerable people in an emergency. It also helps the community members gain trust in, and familiarity with, the hospital. This way, if a real disaster occurs, chances are better that both hospital staff and community members will be prepared.
By COLLEEN SCHRAPPEN
Providence Portland Medical Center has been out front in the greening of health care. The hospital has been recognized by Practice Greenhealth for superior performance in environmental
Continued on 4 Courtesy of Providence Health & Services
John Burgess/The Press Democrat via AP
By JULIE MINDA
Anesthesiologist cuts carbon emissions in Providence Oregon’s operating rooms
Menagerie recalls joys of farm life for Villa Loretto residents Ranch’s livestock are goodwill ambassadors to the larger community
MOUNT CALVARY, Wis. — Walk into the entryway of Villa Loretto here, and it is immediately clear that SSM HEALTH there is something wildly different about this skilled nursing home. A resident maneuvers his wheelchair up to a birdcage and strums his fingers along its wires, chattering happily to the parakeets. Nearby, a staff member leads an exuberant dog to a delighted elderly woman in an easy chair. Several paces away, a resident strolls by a second birdcage — this one rises from floor-to-ceiling — peering at the dozen or so birds flitting about inside. Head out back of Villa Loretto a few steps Continued on 8
Photo by Harle Photography, courtesy of Agnesian HealthCare
By JULIE MINDA
Dr. Brian Chesebro is working to reduce the carbon footprint of surgical anesthesia gas emissions.
sustainability. Even against that high bar, Dr. Brian Chesebro’s efforts have stood out. Chesebro, a physician with Oregon Anesthesiology Group who recently added the role of medPROVIDENCE ical director of enviST. JOSEPH ronmental stewardHEALTH ship for Providence Oregon to his portfolio, has made it a mission to educate fellow anesthesiologists and health professionals about the carbon footprint of anesthesiology gases. “It’s been known for about the last
Sr. Stephen Bloesl, a member of the Sister Servants of Christ the King, manages the Cristo Rey Ranch that surrounds a Catholic long-term care campus in Mount Calvary, Wis. Opie, the lemur, is one of the hundreds of animals that live at the ranch.
Continued on 6
By LISA EISENHAUER
CHICAGO — Going back to its origins among women religious, Catholic health care has extended beyond ministering to the sick. The foundresses were concerned with basic human needs including safe shelter, CHA President and Chief Executive Officer Sr. Mary Haddad, RSM, said at a recent conference on the nation’s affordable housing crisis. “We weren’t founded to provide health care,” she said of congregations of women religious. “We weren’t founded to provide education. It’s very clear that sisters went in and said, ‘What’s the need and how do we best respond to that need in the community?’” Sr. Mary shared her views on the Catholic health ministry’s efforts to build respect for human dignity and serve the common
good, at the closing plenary of Foundations for the Future of Housing. The conference, held Oct. 28-30 at the Renaissance Chicago Downtown Hotel, was sponsored by the Urban Institute, a Washington, D.C.-based think tank, and the John D. and Catherine T. MacArthur Foundation, a private organization that funds a variety of causes. Sr. Mary pointed to efforts like those of her congregation, the Sisters of Mercy, who, in addition to caring for the health needs of people across the country, opened homes and started education programs for women and children in California during the cholera epidemic that broke out during the Gold Rush. “They were unstoppable in their work and in what they would do in providing care,” she said of the Mercy sisters. The socially minded vision of women religious and others who founded and grew Catholic hospitals and community-based
Residents participate in an onsite food pantry at a Mercy Housing community in Chicago. Catholic hospitals and health systems have partnered with Mercy Housing to increase access to affordable homes.
Courtesy Mercy Housing
CHA’s leader spotlights ministry’s involvement in housing programs for the poor across the nation has been embraced by executives who run today’s large Catholic health systems, Sr. Mary said. Among the ways the sisters’ work continues is through community benefit programs run by Catholic hospitals as a way to reach into their communities and get upstream of chronic health conditions. Catholic health care providers partner with Catholic Charities, Mercy Housing and other national and community organizations to help fund the construction of senior housing projects, neighborhood revitalization programs, and affordable housing units including housing for people with disabilities. “The religious women in this country have done a significant job of influencing and creating a vision of how we need to work together in health care and housing Continued on 3
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CATHOLIC HEALTH WORLD November 15, 2019
Physician-ethicist says doctors should oppose assisted suicide By JULIE MINDA
Organizations that advocate for the legalization of physician-assisted suicide have been increasing their efforts in almost every state where the practice it is not yet permitted. As part of their strategy, such organizations have been gaining influence on state medical associations and urging them to change their stance on assisted suicide, from opposition to neutrality, according to Dr. Daniel Sulmasy. In a CHA webinar late last month, Sulmasy, an Sulmasy internist, professor of biomedical ethics at Georgetown University and acting director of Georgetown’s Kennedy Institute of Ethics, said physician organizations should be actively opposing the practice. They should not be declar-
Correction
A story in the Nov. 1 issue of Catholic Health World mistakenly omitted the name and biographical information for one of the 19 experts in Catholic health ministry who underwent CHA training as external assessment observers. These observers can be commissioned to offer guidance to systems or hospitals using CHA’s Ministry Identity Assessment to measure how well they live out their mission as a ministry of the church. Assessor Robert Fale, president and chief executive of Robert Fale HealthCare Consulting, has 43 years’ experience in Catholic health care. He is a past president and chief Fale executive of Agnesian HealthCare of Fond du Lac, Wis. He is an experienced judge for the Wisconsin Center for Performance Excellence, the state version of the Malcolm Baldrige National Quality Program. He has a master of health care administration.
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ing themselves “neutral” as the American Academy of Family Physicians did by resolution in October 2018 — or, worse yet, outright supporting it as the New York State Academy of Family Physicians has done.
Since some physicians support physicianassisted suicide, associations may see striking a neutral stance on the issue as a reasonable compromise. Sulmasy takes umbrage at this docility. Physician neutrality on medically assisted suicide “is an abdication of our professional responsibility,” he said.
Nationwide push According to the website of the Death with Dignity organization, eight states and Washington, D.C., now permit medi- Countering opposing arguments cally assisted suicide: California, ColoDuring the webinar, Sulmasy rebutted common arguments rado, Hawaii, Maine, New Jersey, Ore- “We need to recognize what’s made in defense of physician-assisted gon, Vermont and at stake. The timidity of suicide. Washington. In response to In most of these the opposition to assisted the contention that states, medical associations had taken suicide has gotten in the way medically assisted suicide should be a neutral stance on assisted suicide be– of maintaining resistance in available to patients who want it, Sulmasy fore the state had medical associations.” said that patient legalized the prac— Dr. Daniel Sulmasy autonomy is not tice, according to the only principle an article Sulmasy co-authored that was published in the May in play. Suicide is never a private act that 2018 edition of the Journal of General Inter- harms only one person. A loved one who witnesses a patient die after the self-adminnal Medicine. In states where physician-assisted sui- istration of a lethal prescription could sufcide is prohibited, Sulmasy said, organiza- fer from that experience. And there can be tions including Compassion & Choices are a contagion effect if medically assisted suiworking to sway physicians to take a neu- cide weakens mores against suicide in the tral position on medically assisted suicide. broader culture. To those who contend it is humane Sulmasy said physicians who favor neutraland compassionate to allow terminally ill ity can work their way onto medical associpatients to avoid prolonged suffering, Sulation ethics committees or into other leadership roles and then use their influence to masy would say that palliative care and hospush for the organization to withdraw its pice care specialists can effectively manage opposition to medically assisted suicide. physical pain and anxiety in a terminally ill Sulmasy said opponents should fight patient. He called on physicians to work to these efforts, including through personal improve knowledge of and access to palliainvolvement in state medical societies, by tive and hospice care that address physical, joining and participating actively and even mental and spiritual needs. seeking leadership positions. Sulmasy said that people who seek aid “We need to recognize what’s at stake,” in dying may do so because they fear they he said. “The timidity of the opposition will not be able to have personal agency to assisted suicide has gotten in the way and dignity as their medical condition of maintaining resistance in medical deteriorates at the end of life, and they do associations.” not want to become a burden on others. Sulmasy said for now many state medi- The ethical and compassionate response cal associations seem to be “holding the for physicians who vow to do no harm is not line politically,” but once they stop formally to provide a lethal prescription but rather opposing assisted suicide, momentum to direct patients to palliative and hospice seems to build in favor of assisted suicide. services that focus on alleviating this menHe added that advocates for assisted sui- tal and physical suffering, Sulmasy said. Sulmasy said some physicians who are cide “know this well.” Sulmasy said medical associations do personally opposed to assisted suicide do not want to sow discord among members. not feel they should impose their beliefs
on others. But all law and ethics requires judgment and restrictions on behavior, Sulmasy said, and physicians should be willing to argue for what they believe is right for society and for patients, if it will protect patients’ lives. While some may argue that prohibiting medically assisted suicide is tantamount to abandoning the sufferer, Sulmasy said the opposite is true. When physicians say that they will write a lethal prescription to end the suffering of a terminally ill patient, they are abandoning their patient, said Sulmasy. When physicians treat or palliate a patient’s symptoms, they are saying, “I want to walk that last mile with you, and accompany you.” Sulmasy said those who contend there is no real difference between assisting with suicide and allowing someone to die are wrong. Intent matters, and physicians should never intend to kill their patients, he said. To those who would argue that opposition to physician-assisted suicide is based on religious doctrine and that church and state should not mingle, Sulmasy counters that the primary arguments against legalizing assisted suicide are not religious in nature. He pointed out that many atheistic and nonreligious individuals oppose the practice too.
Bad medicine Sulmasy said physicians should support a ban on medically assisted suicide because it is an affront to the physicianpatient relationship, ripe for abuse and a slippery slope to other morally questionable practices, including assisted suicide for people who may not be mentally competent to authorize it at the time it is done and assisted suicide for people with severe disability who are not at the end of life. Sulmasy told the webinar audience that physicians are responsible for healing, not harming, their patients. When healing is no longer possible, he said it is nevertheless ethically incumbent on a physician not to ignore, endorse or practice harmful practices like physician-assisted suicide. The CHA-hosted “A Discussion of Why Organized Medicine Must Maintain Its Opposition to Assisted Suicide Webinar” took place Oct. 24. It is available to CHA members at chausa.org/learning. jminda@chausa.org
Upcoming Events from The Catholic Health Association Navigating the New Wired World: An Exploration of the Ethical Considerations of Online Searching for Patient Information Nov. 19 | Noon ET
Faith Community Nurse Networking Call
Human Trafficking Networking Call Dec. 12 | Noon ET
2020 International Outreach Networking Call Feb. 5 | 3:30 p.m. ET
Critical Conversations 2020 Feb. 12 – 13 Atlanta (Invitation only)
Diversity and Disparities Networking Call Feb. 19 | 1 – 2 p.m. ET
Dec. 10 | 3 p.m. ET
A Passionate Voice for Compassionate Care® chausa.org/calendar
November 15, 2019 CATHOLIC HEALTH WORLD
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Our Lady of the Lake Children’s Hospital has room for romping Young patients step into a playful setting when they walk through the front doors of the new Our Lady of the Lake Children’s Hospital. The tools and spaces for the Baton Rouge, La., hospital’s serious mission of healing are housed on five floors that each have friendly animal mascots and bright color schemes that relate to the region and landscape. On the first floor, the main entrance has blue swirls within the tile floors that call to mind the Mississippi River, which skirts the city. Some of the walls have bubble-like indents, just big enough for a small body to climb inside. Benches with wavelike humps line the walls, perfect for youngsters to do some make-believe surfing while they wait to see doctors. Outside are meditation gardens that include playhouses and mounds where kids on recess from their care can climb and roll off some energy. Dr. Trey Dunbar, president of Our Lady of the Lake Children’s Health, said the hospital’s planners “very intentionally” put its patients’ needs and Dunbar likes at the forefront of their designs. “I think it really helps disarm some of that anxiety that a child might feel coming into a health care setting,” he said of its many kid-friendly features. “It provides a nice kind of healing environment. They’re distracted from why they’re here.”
A tiny patient is greeted by staff upon arrival at the new Our Lady of the Lake Children’s Hospital in Baton Rouge, La. Patients were transferred from the hospital’s former quarters in nearby Our Lady of the Lake Regional Medical Center.
The hospital opened Oct. 5 just a few blocks from Our Lady of the Lake Regional Medical Center, where it had been housed for years on the third floor. The hospitals are part of the Franciscan Missionaries of Our Lady Health System, which is based in Baton Rouge. Our Lady of the Lake Children’s Health is a network within FMOL composed of the flagship campus in Baton Rouge, Our Lady of Lourdes Women’s and Children’s Hospital in Lafayette, as well as in Monroe with St. Francis Pediatrics. The Baton Rouge children’s hospital has six floors, but only the first five are fully built out and operational. The top floor is shell space, open until the need to expand arises. Dunbar said that time might come soon. In the week after the hospital’s opening, surgery volume climbed about 20 percent and its emergency room count shot up 20 to 30 percent. The $230 million project was funded in part by a $55 million private capital campaign and $20 million in state support. The private support has come from about 60,000 contributors. Dunbar sees that base of With remnants of the pediatric hospital’s opening celebration on generosity and the fact Oct. 4 scattered around her, a child found a spot to take a break and that thousands of people work on a coloring book. The hospital officially opened a day later.
Housing and health care From page 1
for the future,” she said. The three-day conference brought to– gether mission-driven housing providers, affordable housing policy advocates and their partners. Its stated goal was for participants to collaborate and come up with ways to increase housing access and affordability. The closing plenary was titled “Galvanizing New Actors for Housing Collaboration.” The focus was on bringing together prominent voices in philanthropy, advocacy and health care to share their hopes for the future and explain why better access to stable and affordable housing is central to achieving meaningful progress. Sr. Mary shared the stage with Marian Wright Edelman, founder and president emerita of the nonprofit Children’s Defense Fund; and Dylan Hayre, senior policy adviser with JustLeadershipUSA, a nonprofit that advocates for reducing the prison population. The moderator was Emily Badger, a reporter who covers urban issues for The New York Times. Edelman emphasized the importance of keeping the nation’s policymakers focused on the overall needs of children. She said the electorate must keep the pressure on decision makers to act as parents would by enacting laws and programs that strive to keep children safe, educated, housed and nourished.
Hayre focused on the intersection between the criminal justice system and the nation’s social ills, including chronic homelessness. “If you have been incarcerated at least once in your life, compared to the general population, the chance of your experiencing homelessness is seven times higher,” he said. “If you’ve been incarcerated two or more times, that likelihood goes up to 13 times higher than the general population.” He said the U.S. criminal justice system is based on “mass incarceration” and creates a cycle that victimizes the nation’s already most marginalized populations — the poor and minorities — and gives them few options to find stable housing and become part of thriving communities. All three plenary speakers agreed that collaboration between health care and social service providers is one of the keys to building strong communities and fostering wellness for all populations. Sr. Mary said that despite the Catholic tradition of ministering to the whole person — body, mind and spirit — there had at times been a tendency among health care and social service providers to “silo the work we do” and not look at the bigger picture. She said that started to shift when reimbursements from insurers became more tied to chronic disease management and prevention. Nowadays, providers of health care and social services recognize that “we have to start working together in order to be able to increase the health and wellness of the pop-
Mackenzie Scalan, 13, cradles a toy pelican, a mascot at the new children’s hospital. Once settled in her room, Mackenzie drew a sketch of the sunrise outside of her window.
showed up for preopening tours on one of the hottest days of the summer as indications of widespread support for the hospital. “It just really shows you how ingrained this hospital is in the community already and it really speaks to what we should be able to do with this building as a lever to improve care moving forward,” Dunbar said. Construction of the 360,000-squarefoot hospital began in February 2016. The building houses more than 25 pediatric specialties and one of only two pediatric trauma centers in the state with an aroundthe-clock emergency room, which planners expect will treat more than 35,000 patients annually.
Photos courtesy Our Lady of the Lake Children’s Hospital
By LISA EISENHAUER
The exterior of the six-story, 93-bed Our Lady of the Lake Children’s Hospital.
The hospital houses five operating rooms where over 5,000 pediatric surgeries will be performed annually, a 30-bed intensive care unit and 40 medical/surgical inpatient beds. The facility has a hematology/oncology floor — with 30 inpatient specialized beds and an outpatient clinic — that is an affiliate of St. Jude’s Children’s Research Hospital, based in Memphis, Tenn. The hospital has an extra-large room designated for children receiving end-of-life care. It was funded by philanthropy from a family who lost a child to complications of a brain tumor. The hospital will be home to the Our Lady of the Lake pediatric residency program. And it anchors a statewide FMOL pediatric health network that includes hospital-based services at St. Francis Pediatrics and Our Lady of Lourdes Women’s and Children’s Hospital. Early next year, the 93-bed Baton Rouge hospital will add an 11-bed neonatal intensive care unit. In addition to the growth space on the sixth floor, Dunbar said the hospital was built so that two more floors could be added to expand its care and its staff of 500, if needed. “Our goal is to improve the health and well-being of Louisiana’s children and this is a huge anchor for us to be able to do that,” he said. leisenhauer@chausa.org
Sr. Mary Haddad, RSM, CHA president and chief executive officer, discusses how the tradition among Catholic ministries of addressing social needs like housing traces back to the founders of Catholic health care in the United States. She was speaking on Oct. 30 at the Foundations for the Future of Housing conference in Chicago.
ulations we serve,” she said. “We’re calling it population health.” And while the term “social determinants of health” has become a trendy one to explain root causes of chronic illness and poor health outcomes, Sr. Mary said members of the Catholic health ministry have long called on policymakers to do more to address issues like housing and income
disparity to improve Americans’ overall wellness. She added that expanding awareness of those social issues and “raising the consciousness” of the nation and its leaders around the relationship between poverty and health status is imperative to being able to care for the communities that Catholic ministries serve.
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CATHOLIC HEALTH WORLD November 15, 2019
Disaster preparedness “This is important to us because these are our neighbors and friends,” and they will fare better in an emergency if they and the hospital have practiced their response, Rowen said. Rowen is among several emergency management experts from around the Catholic Rowen health ministry who told Catholic Health World that their facilities are going well beyond what regulators require them to do to prepare for disasters, in order to be ready to aid vulnerable people in their hospitals and in their communities. These experts said that people who are very young or elderly, disabled, chronically ill, homeless, mentally ill or non-English speaking are at heightened risk when disaster strikes. Advance preparations can reduce their vulnerability, they said. In addition to Rowen, whose hospital is a member of CommonSpirit Health, Dr. Osbert Blow, Blow president and chief medical officer of CHRISTUS Spohn Health System of Corpus Christi, Texas; Brian Boudreau, manager of safety and emergency preparedness, and Manuel Fernandez Villaderey, emergency manLuke agement specialist, both of St. Peter’s Health Partners of Albany,
John Burgess/The Press Democrat via AP
From page 1
Bernadette Yabadi and her son Victor settle into a Red Cross shelter at the Sonoma County Fairgrounds in Santa Rosa, Calif., Oct. 27, after evacuating their home as a fire safety precaution. St. Joseph Health’s Sonoma County outreach staff provided basic primary care at some shelters during the emergency.
N.Y., in the Trinity Health system; and Kenneth Luke, disaster, base station, and infectious diseases coordinator for Dignity Health Mercy Medical Center of Redding, Calif., part of CommonSpirit, discussed emergency management response for special needs populations with Catholic Health World.
Groupthink Blow said CHRISTUS has leaders who participate in a southeast Texas coalition called Coastal Bend Regional Advisory Council. It is made up of health care, emergency response and governmental bodies along the Texas coast that coordinate their disaster planning and response activities. A central focus is evacuating areas deemed at highest life safety risk in
the projected path of a strong hurricane. Blow, some CHRISTUS colleagues and others are on the Special Populations
Community leaders who are responsible for disaster preparedness for their organizations “need to know us and trust us” so the hospital and those representatives will connect and share information in an emergency. — Ruth Ann Rowen
Committee of the coalition. It studies how vulnerable populations can be protected, and their current focus is on people who are homeless. Blow says the committee has set out plans for assisting homeless people in evacuating or finding safe shelter before a hurricane. The committee also has taken flu vaccinations out to homeless people and passed out water bottles during hot weather. Rowen represents St. Elizabeth on a health care coalition focused on emergency preparedness for two Northern California counties. Its membership includes acute care facilities, long-term care facilities, outpatient clinics, dialysis facilities, public health agencies, local emergency management agencies, organizations for the disabled, schools, emergency medical services, tribal health care entities and “nearly anyone else that would deal with our residents in a medical or health role,” Rowen said. She and her emergency management colleagues at St. Elizabeth work with schools, first responders, and eldercare and disability groups. They aid those organizations in building and refining emergency plans and in assuring their plans are coordinated with others in the community. Rowen said networking is a big part of her job. Community leaders who are responsible for disaster preparedness for their organizations “need to know us and trust us” so the hospital and those representatives will connect and share information in an emergency. Rowen said St. Elizabeth disseminates information about personal and organizational disaster preparedness at community fairs, health and safety events and the Special Olympics. St. Elizabeth staff
Ministry staff help frail patients stay safe amid Northern California fires Mobile teams tend to homebound, evacuees, homeless people
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ildfires and power outages that impacted millions of Californians in October and early November put the frail elderly and homebound in particular danger. “Especially for people who are homebound, it is very scary to be in a bed that they know they can’t get out of, and know there’s a fire,” said Sandy Jay, a family nurse practitioner and supervisor of the House Calls primary care program and mobile clinic for St. Joseph Health Sonoma County. “We are all nervous, but those people are really traumatized by something like this.” The outages and wildfires affected communities throughout California this month and last, and Catholic providers throughout the state assisted in the response. Catholic Health World spoke to ministry home health and community outreach teams aiding vulnerable community members in Northern California. St. Joseph Health, which is part of Providence St. Joseph Health, and CommonSpirit Health’s Dignity Health reported their respective home health staffs in areas threatened by fire or blackouts provided direct care, medication and guidance to ensure the well-being of vulnerable patients. Outreach teams from both systems also provided basic primary care to evacuees and homeless people in affected areas, administering steroids, inhalers and antibiotics to those experiencing respiratory issues from the heavy smoke.
Rolling power outages Charlotte Haisch, Dignity Health North State director of home health and hospice, said her staff kept in regular contact with more than 150 home health patients in the northernmost counties of Siskiyou, Shasta
Registered nurses Laura Heronand, right, and Tracy Norman load medical supplies for delivery to home care patients impacted by a planned power shutoff in October intended to reduce wildfire risk. The nurses practice in Dignity Health’s North State region, which includes the northernmost counties of California.
and Tehama where homes were left without power when California’s largest electric utility began a wave of blackouts beginning Oct. 9. Kristin Duarte, Dignity Health North State’s emergency services coordinator for home health and hospice, said special attention was paid to patients dependent on electric-powered medical devices such as oxygen concentrators or temperaturesensitive medications to ensure the patients would be able to implement individualized contingency plans for access to electricity and refrigeration.
Dignity Health’s Mercy Medical Center Redding and St. Elizabeth Community Hospital in Red Bluff, as well as St. Joseph Health’s St. Joseph Hospital assisted outpatients who came to their emergency rooms to get oxygen tanks or battery-powered essential medical devices, or to recharge medical equipment.
Fire threat St. Joseph Health’s House Calls primary care service for the homebound has about 100 clients in Sonoma County, many of them bedbound, said Jay. Some of its
patients live alone. About 10 patients were under mandatory evacuation orders due to fire when Jay spoke to Catholic Health World on Oct. 30, and her team was tracking their whereabouts and well-being. Jay said her six-person team had been in regular contact with all 100 or so patients throughout the disaster, tracking their location and status, ensuring they were evacuated to a safe location, and ensuring their essential medical equipment was functioning properly. She noted that in a power outage, people in electric hospital beds who must be repositioned on a schedule to prevent pressure sores, and those whose oxygen equipment requires electricity are particularly vulnerable. She said her team had been making more than its usual number of in-person, at-home visits to check on clients experiencing heightened difficulty, and making pharmacy runs to deliver patients’ prescription medications when usual pharmacy delivery services were interrupted. What is needed in crises like wildfires and widespread power outages are staff “who are ready, willing and able to do what needs to be done at the moment,” Jay said. As part of his role, Dan Schurman oversees a St. Joseph Health’s mobile clinic in Sonoma County. The clinic is staffed by two nurse practitioners and three medical assistants. It makes regularly scheduled visits to homeless shelters and other locations to reach people with little or no usual access to care. Schurman said that during the fires, the mobile unit also provided basic primary care at churches near evacuation centers. When high winds made it too dangerous for the mobile clinic to be on the road, nurses and medical assistants grabbed their medical “go bags” — and traveled by car to care sites. — JULIE MINDA
November 15, 2019 CATHOLIC HEALTH WORLD
presents a human face for the hospital, so community members will have a positive impression of the hospital before they must trust it in an emergency. Her department works with schools and disability groups to drill on emergency response, such as staging a decontamination demonstration with schoolkids. The department enlisted community organizations to recruit non-English speakers who tested the effectiveness of using pictorial aids to explain mass vaccination activities that may be needed in a disaster.
Caring for kids Luke said Mercy Medical also prioritizes relationship-building with community members and organizations, to lay a foundation of trust before disaster strikes. “A hospital is one of the most critical pieces of a community’s infrastructure, and when people don’t know what to do, they will often go to a hospital,” and that’s why the connections are so important. Mercy Medical has coordinated emergency preparedness training that specifically covers pediatric disaster response. Funded through the Department of Homeland Security and a branch of the Federal Emergency Management Agency, the course taught first responders, Mercy
“We want to provide that friendly voice, we want to emphasize we’ll help them. We want (vulnerable people) to feel comfortable and safe here.” — Manuel Fernandez Villaderey need extra comfort in a crisis, and so as part of their disaster preparation their department, the health system’s Office of Safety and Emergency Preparedness, has facilitated training in Mental Health First Aid for 140-plus hospital colleagues. In a mass casualty incident or disaster, these individuals can be dispatched quickly to provide mental health triage and referrals to mental health providers, as appropriate. The four-hour training sessions cover how to speak to a traumatized person in a manner that calms rather than retraumaSt. Joseph Health, Santa Rosa Memorial in Santa Rosa, Calif., set up this command center last month to respond to the threat posed by power outages planned by a local utility. The hospital remained open. tizes them. This includes how staff can tailor their communications with members Medical staff and representatives from dren during or after a disaster. They also of vulnerable groups including children, local organizations how to interact learned how to safely shelter children in elders and people who are mentally ill. Fernandez Villaderey said this trainwith distressed and overwhelmed chil- a weather event and reunify children with loved ones if they’ve been separated dur- ing is for when “we’re the very first touch” ing a crisis, and they learned procedures after a disaster. “We want to provide that used in decontamination of children friendly voice, we want to emphasize we’ll help them. We want (vulnerable people) exposed to toxic chemicals. to feelacomfortable and safe here.” Luke explained, “They are not just little Get Kit Supplies Health World at chausa. Visit Catholic adults, and their care should be totally dif- Of Emergency The first step is to consider an emergency org/chworld forhowmore information. ferent than adults’ care.” might affect your individual needs. Plan to make it on Preparing Makes your own, for atThe least three days. It’s possible that you November-December issue of will not have access to disaster assistance, a medical Sense. Get Ready Now. Preparing Makes Health Progress includes a special secMental health corps facility or even a drugstore. It is crucial that you and your family think about what kinds of resources you The likelihood that you and your family will Boudreau and Fernandez Villaderey tionbasisonanddisaster response and vulnerable Sense For People use on a daily what you might do if those resources are limited or not available. recover fromPeter’s an emergency tomorrow said St. in Albany hasoften anticipated populations. With Disabilities, Basic Supplies: Think first about the basics on the planning and preparation that distressed, vulnerable people will jminda@chausa.org for survival - food, water, clean air and any lifeOthers with Access depends
FEMA offers tips to help vulnerable e Informedfor disaster peopleBprepare
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About What Might Happen
Some of the things you can do to owprepare wellfor antheolder person, orassembling a person unexpected, such as an emergency supply kit and making an with a disability, fares a disaster emergency plan are the same in regardless of the can type of emergency. However, it’s important to stay be greatly impacted by how effectively informed about what might happen and know what types ofor emergencies are likely to affect your that individual his or her caregivers region. For more information about specific types of emergencies, and visit www.ready.gov. have anticipated planned for the
Be prepared to adapt this information aftermath. to your catastrophe and its immediate personal circumstances and make every effort to follow instructions received fromapp, authorities At ready.gov, and on its the on the scene. Above all, stay calm, be patient think before youManagement act. With these simple FederalandEmergency Agency preparations, you can be ready for the unexpected. provides guides to help people and In addition to your personal preparedness, consider organizations plan for disasters and getting involved in neighborhood and community emergency preparedness activities. Assist emergencies all kinds including fires, emergency of planners and others in considering preparedness needs of the whole community, floodsthe and terrorist attacks. FEMA disasincluding people with disabilities and others with access and functional needs. Communities are to ter preparation brochures are tailored stronger and more resilient when everyone joins the various populations and can team. People with disabilities often be haveordered experience in in adapting and problem solving that can be very multiple languages. useful skills in emergencies. There are checklists other inforPreparing Makes Senseand for People with Others with Access and mationDisabilities, that address the particular needs Functional Needs and theAmericans, Whole Community. of older people with disabiliGet Ready Now. ties and families with young children. ThisMastandrea information was developed by the US.FEMA’s Department Linda directs of Homeland Security in consultation with AARP, the Office of Disability Integration and on CoordiAmerican Red Cross and the National Organization Disability and updated by the FEMA Office of Disability nation,Integration whichandhelps individuals, comCoordination. munities, organizations and emergency management agencies across the country to prepare for disaster. Mastandrea said FEMA’s state and local counterparts are charged with educating people — including frail elderly and people with disabilities — about how they can best prepare to stay safe in an emergency and its aftermath. Those local agencies also build linkages “when the sky is blue,” with organizations that serve the vulnerable, to determine together how best to encourage clients in making disaster plans specific to their individual situation. READY-RP-0406-01.
Ways to prepare The agency encourages everyone to lay in basic emergency supplies to survive on their own for three days including water and food, flashlights, a batteryoperated radio, extra batteries and other essentials. The online checklists for people with disabilities recommends preparing two emergency supply kits — one for sheltering in place and a smaller kit to take along if it becomes necessary to leave the home — and the website offers detailed suggestions for the content of the kits. FEMA advises that seniors and people with disabilities have on hand at least a week’s supply of prescription medications and extra medical supplies. They should talk to their pharmacist or doctor about accessing care during a time of disruption, including by identifying backup service providers. A patient who uses medical equip-
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and Functional Needs and the Whole Community. Get Ready Now.
1
done today. While each person’s abilities and
needs are unique, every individual can take steps to prepare for all kinds of emergencies
Share the By evaluating your own personal needs and making emergency plan that joy ofan the fits those needs, you and your loved ones season with can be better prepared. This guide outlines commonsense measures individuals with a Christmas disabilities, and others with access and message towho assist functional needs, and the people and support themcan take to start preparing the ministry from fires and floods to potential terrorist attacks.
for
emergencies
before
they
happen.
Preparing makes sense for people with
w Water, one gallon of water per person per day for at least three days, for drinking and sanitation w Food, at least a three-day supply of non-perishable food and a can opener if kit contains canned food w Battery-powered or hand crank radio and a NOAA Weather Radio with tone alert and extra batteries for both w Battery-powered or hand crank cell phone charger w Flashlight and extra batteries w First aid kit w Whistle to signal for help w Dust mask to help filter contaminated air and
disabilities,others with access and functional
plastic sheeting and duct tape to shelter-in-place
needs and the whole community.
w Moist towelettes, garbage bags and plastic ties
Get Ready Now. www.ready.gov
sustaining items you require to maintain your health, safety and independence. Consider two kits. In one kit put everything you will need to stay where you are and make it on your own for a period of time. The other kit should be a lightweight, smaller version you can take with you if you have to leave your home. Recommended basic emergency supplies include:
for personal sanitation w Wrench or pliers to turn off utilities w Local maps w Pet food, extra water and supplies for your pet or service animal
The Federal Emergency Management Agency provides brochures in several languages to help people plan to be self-sufficient in the days following a major disaster.
ment that requires electricity will want to know what to do if the power goes out. FEMA recommends that an individual who relies on a motorized wheelchair have a lightweight portable wheelchair available for emergencies. Advance preparation for individuals with a disability should include solidifying a plan with a personal support network of family and friends they can turn to in a disaster. One or more people in the network should be prepared and available to administer medicine and use lifesaving medical equipment in an emergency. Seniors and individuals with disabilities should think in advance about how they’ll make an informed decision to stay or go in an emergency, how they’ll tend to the needs of pets and service animals and where they’ll go if they must evacuate. Local emergency management agencies can provide help in this planning. All people with serious illness or disabilities also should have ready to go information on their health history, copies of their prescriptions, the serial numbers of medical devices, contact information for medical providers and insurance cards. — JULIE MINDA
Include your organization’s Christmas message in the Dec. 15 issue of
Catholic Health World invites you to extend a
holiday greeting to your employees and to colleagues in the Catholic health ministry. Visit chausa.org/Christmas for more details. Send an email to ads@chausa.org to reserve your ad space. Ads due by Nov. 18.
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CATHOLIC HEALTH WORLD November 15, 2019
Greener anesthesia From page 1
10 or so years that these agents were potent greenhouse gases,” Chesebro said of anesthesia gases. “But the information was not widely broadcast through the anesthesiology community.” He himself learned more about it a couple of years ago while he was Chesebro assessing his personal carbon footprint. He found his biggest imprint was made in the operating rooms at Providence Portland Medical Center. Most anesthesiologists use one of two gases during surgeries: desflurane or sevoflurane. Patients who are put under metabolize 5 percent of the gas when they inhale. The rest is exhaled into a ventilation system and makes its way outdoors. Most doctors start their careers using one or the other and stick with their choice out of habit. Chesebro said the two gases are mostly interchangeable, but there is a major difference between desflurane and sevoflurane when it comes to the environ-
Isoflurane and sevoflurane are commonly used in surgeries at Providence Portland Medical Center.
ment. The former is 25 times more damaging to the atmosphere, trapping much more of the sun’s energy and punching well above its weight as a greenhouse gas. According to a 2015 study published in Geophysical Research Letters and reported by ScienceDaily, a pound of desflurane is equivalent to more than 2,800 pounds of carbon dioxide in terms of greenhouse warming potential. Though it represents a miniscule percentage of all globalwarming gases, desflurane is more potent, pound for pound, in its harmful effects, scientists said. Yale School of Medicine anesthesiology and epidemiology professor Dr. Jodi Sherman told ScienceDaily that health care is one of the worst polluting industries, generating up to 10 percent of U.S. greenhouse gases. “It behooves us to do a better job with emissions,” she said.
Simply put After learning of the residual potency of desflurane, Chesebro decided the best approach to reducing emissions was through education. He has a pretty big megaphone, with more than 270 physicians in his private practice group. Providence Portland Medical Center, where he works, is one of eight Providence hospitals in Oregon. Providence St. Joseph Health, the system parent, has 51 hospitals and 1,085 clinics and surgery centers in seven states. Chesebro’s efforts have been featured on National Public Radio and CNN. Jean Marks, public relations manager for the medical center, said that in his new role as medical director of environmental stewardship, Chesebro will continue his anesthesia practice part-time. He will assess and manage programs throughout Providence Oregon intended to reduce the environmental impact of hospital operations overall. “In addition, he will work to improve the resiliency of our communities as we adapt to the evolving health challenges associated with environmental change,” she said. Chesebro has shared his data on the
carbon footprint of anesthesia gases with colleagues one on one and in presentations to groups of 2,000 hospital managers. “Most people were surprised,” he said. “They said, ‘I had no idea,’ or ‘I knew there were differences, but I never appreciated how different they were.’ In some cases, anesthesiologists made the switch from desflurane overnight. “This has been written about in academic medical journals. I translated the academic into a resonant argument for real-world, day-to-day anesthesiologists.” One of his most effective tools has been a slide showing the environmental consequences of an anesthesiologist who treats patients with desflurane. Most doctors assume their greatest area of impact happens outside of work. In fact, it’s the opposite. In this example, emissions from the anesthesiologist’s house, car and air travel comprise 10 percent of his environmental footprint. The other 90 percent stems from the use of desflurane. Chesebro uses hospital data from electronic medical records and pharmacy receipts to determine how much the desflurane costs in dollars and in emissions. He can separate the usage numbers for each individual anesthesiologist. “This isn’t this nebulous problem. It strips away the anonymity. Everyone is held accountable for their own performance. It’s very effective for motivating change,” he said.
sustainable choices.” Voluntary changes Over the past 18 months, there has “Brian’s work has had a huge impact on our ministries in Oregon and is begin- been an 80 percent drop in desflurane ning to spread across all of Providence usage in Providence Oregon hospitals. St. Joseph Health,” Lisa Desflurane costs 2.5 times as much as the Vance, executive vice usual alternative, sevoflurane, saving the president and chief system $500,000 annually. The savings are significant, Vance said, executive of Providence Health & Services – but not the primary focus. “Providence St. Oregon Region, said in Joseph Health believes this is part of our mission, and something we are called to an email. do — to be wise stewards of our resources.” “He did a lot of work Vance Chesebro pointed to the “double to pull data, and then spent time talking with each doctor to involvement” of the health care industry show them their usage and explain how in global warming: “We’re contributors to using different anesthesia gas would make the problem, and we’re called on to care a difference. For anesthesiologists who for people suffering the health effects of climate change … practice in our hospitals, nearly all of “We’re contributors to the It hits the poor and vulnerable the hardthem have changed problem, and we’re called on est, and that’s who their practice.” Some hospitals, to care for people suffering we’re called to care such as Yale New for in a missionHaven Hospital, have driven health system the health effects of imposed a ban on like Providence.” climate change.” desflurane. Chesebro He cited Pope said, based on the Francis’ 2015 encyc— Dr. Brian Chesebro voluntary changes lical on the environhe has seen, a mandate is not necessary ment, Laudato Sí: On Care for Our Comwithin Providence Oregon. mon Home, as connecting care for the “We try to avoid that kind of decision environment with faith and social justice. because it disempowers physicians,” he Said Chesebro, “He doesn’t shy away said. “Based on what we’ve seen in Ore- from it, and I don’t think we should, gon, it’s not necessary. People are feeling either.” really engaged and excited about making
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November 15, 2019 CATHOLIC HEALTH WORLD
Dennis Gonzales joins CHA’s mission services team Dennis Gonzales, an expert in mission and organizational development, will join CHA in January as senior director of mission innovation and integration services. “Dennis’ educational and work experience in organizational development and mission integration, as well as his
personal qualities, professionalism and thought leadership are recognized by his peers throughout the ministry,” said Brian Smith, CHA vice president of sponsorship and mission services. Gonzales is on CHA’s Mission Leader Advisory Committee.
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Gonzales is currently regional vice president for mission integration at CHRISTUS Santa Rosa Health System and The Children’s Hospital of San Antonio, a position he’s held since 2013. He joined CHRISTUS Health in 2008 as a quality and performance improvement facilitator at CHRISTUS St. Vincent Regional Medical Center in Santa Fe, N.M. He directed the hospital’s organizational development department, earning both a doctorate in organizational Gonzales development and a promotion to the hospital’s vice president for mission and spirituality in 2011. As a mission executive for CHRISTUS, Gonzales has played an essential role in the oversight of theology, mission and core values integration; leadership formation; spiritual care services including in palliative care; organizational spirituality; clinical and organizational ethics; and community benefit programs. Gonzales received his doctorate from the University of New Mexico Albuquerque and a master’s degree from the Department of Educational Technology at San Diego State University, with an emphasis in organizational development. A former De La Salle Christian brother novitiate, he taught high school for six years. He is a native of Santa Fe and is fluent in Spanish.
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7
KEEPING UP PRESIDENT/CEO Charles Prosper to chief executive of the PeaceHealth Northwest network, from interim chief executive. He replaces Dale Zender, who retired Sept. 30.
ADMINISTRATIVE CHANGES Sheri Shapiro to senior vice president and chief strategy officer of Trinity Health, Livonia, Mich. Jennifer Jackson to chief nursing officer of West Hospital, part of Mercy Health Cincinnati. Shannan D. Ritchie to chief operating officer of St. Vincent Charity Medical Center of Cleveland, part of Sisters of Charity Health System of Cleveland. Qualenta Forrest to vice president of human resources and CJ Richards to director of performance excellence, both for CHI St. Vincent of Little Rock, Ark.
GRANT Avera eCARE, the telemedicine program of Sioux Falls, S.D.-based Avera Health, has received a $4.3 million grant from The Leona M. and Harry B. Helmsley Charitable Trust to develop and launch a national telehealth certificate program. This program will standardize and elevate the quality of care provided through telehealth platforms, according to an Avera press release.
CHA Chief Operations and Finance Officer CHA is seeking a strategic executive aligned with the association’s mission to serve as its chief operations and finance officer. A member of the CHA president’s advisory council, this individual will be accountable for leading key financial and operational functions during a pivotal time for the association, with a recently appointed president and chief executive officer and a new strategic plan under development that will be in effect beginning July 1, 2020. Based in St. Louis and reporting directly to the president/CEO, the chief operations and finance officer will be responsible for the financial and operational vision and alignment of operations to advance CHA’s strategic priorities and ensure the financial, technology, production and business intelligence functions remain efficient, effective and service-oriented. Strong financial acumen and demonstrated fiscal stewardship are top priorities as this person will be the key staff liaison in support of the association’s finance committee, co-staff for the organization’s audit and compliance committee, and its corporate treasurer. In addition, this person must have a proven ability to build relationships and collaborate effectively with other leaders. Excellent verbal and written communication skills are imperative as well as the ability to maintain integrity, establish credibility, and earn trust and respect. Requests for additional information or nominations should be directed to the consultants supporting this search: Donna Padilla, Jim King, and Wendy Brower c/o WittKieffer 7733 Forsyth, Suite 725 St. Louis, MO 63105 Phone: 314-754-6072 Email: wbrower@wittkieffer.com CHA is an equal opportunity employer.
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CATHOLIC HEALTH WORLD November 15, 2019
Call of the wild at Villa Loretto and find even more surprises: dozens of large pens inhabited by lively pigs, chickens, ducks, rabbits, lemurs and goats; a barn and fields with cows, horses, sheep, alpacas and even a camel ambling about; and beautifully maintained floral gardens and walking paths. All of this is easily accessible to Villa Loretto’s dozens of residents, as well as to the residents of its sister assisted living facility nearby, Villa Rosa, and to staff, visitors and the general public. “It’s all about living life here,” says Sr. Stephen Bloesl, a member of the Congregation of Sister Servants of Christ the King, “and there is life all around us” with the hundreds of animals living on the property. For decades, Sr. Bloesl, her fellow sisters and dozens of paid staff and volunteers have helped to build up the Cristo Rey Ranch, which is home to about 300 animals. The ranch is located on a 120-acre property in rural central Wisconsin that also houses the motherhouse and convent of the Sister Servants of Christ the King as well as Villa Loretto and Villa Rosa. The sisters founded the ranch, skilled nursing home and assisted living facility. While Fond du Lac, Wis.-based Agnesian HealthCare acquired Villa Loretto and Villa Rosa in October 2015, and SSM Health acquired Agnesian in January 2018, the four remaining sisters are an active presence at the facilities. Two live in the nursing home and two in the convent.
One lamb The ranch had its humble
Photos by Harle Photography, courtesy of Agnesian HealthCare
From page 1
Cristo Rey Ranch volunteer Lori Quackenboss, says she is particularly fond of the ranch’s alpacas, including this one named Parker.
beginnings more than 50 years ago when the sisters were operating a nursing home on the large acreage. A sister with a heart for animals took in an orphaned lamb. After that, several sisters agreed they’d like to get a goat as well. Once that goat began escaping its pen to seek out companion animals, the sisters decided they needed to take in more animals. As the sisters realized how much the nursing home’s residents enjoyed the animals — and as the sisters gained a reputation locally as compassionate souls who would adopt animals in need of a home — the animal family grew. Farm caretaker Christine Koch says many animals are rescues, some had been hoarded, some had outlived their owners, some had been donated by fans of the ranch. “Every animal has a
Rita Witkowski, a resident of the Villa Rosa assisted living facility, makes birdwatching part of her day.
Jerry the camel has his fans among Villa residents.
story,” Koch says. The ranch has evolved to include the animal pens, walking paths, gardens, barn and fields. It surrounds Villa Loretto, so residents can saunter out any time. The ranch has eight paid caretakers and about 100 volunteers. It welcomes the public, including for tours and retreats. It offers formal farm therapy programs, including for adolescents with behavioral health needs. Ranch hands take the animals out into the community for petting zoos, parades and other events. “When you say ‘Cristo Rey,’ everyone seems to know about it from the petting zoos” and other community activities, says Lori Quackenboss. She has been a volunteer at the ranch for about four years. 4-H club members help
The Cristo Rey Ranch is part of a senior services campus. The Villa Loretto nursing home is immediately behind the chapel. The Villa Rosa assisted living facility is located elsewhere on the property.
Villa Rosa resident Gerald Diederichs feeds a banana to Opie, a very sociable lemur.
her train and socialize the alpacas and other animals to interact with the public. She says of the ranch, “It just makes you happy to come here.”
Baby boom Sr. Bloesl has held several leadership roles at the nursing home, including director, and now focuses primarily on running the ranch. Her email address winks at her unusual vocation/ occupation: nunbetter farm@hotmail.com. She and her ranch crew and many among the campus’ continuum-of-care staff of about 100 ensure that ranch life is interwoven with the seniors’ lives. Mary Jean Schroeder, an activity supervisor who is retiring in December after a 54-year career at Villa Rosa and Villa Loretto, said, “In the spring, Schroeder there were lots of animal babies, and we would
bring them in for visits.” The residents helped bottle-feed the baby kittens, bunnies and goats and gave them plenty of attention. Schroeder says she and other staff commonly accompany the residents for walks outside and sometimes ranch hands will take them on hayrides around the acreage — even those who normally are confined to a wheelchair can ride. Rita Witkowski, a resident of Villa Rosa assisted living, was born on a farm and says she relishes going out onto her balcony to see the sheep and horses in the adjacent field. She enjoys walking around the ranch, visiting with the animals. “The animals love us,” she says. “They are ‘people animals.’” The ranch’s camel, Jerry, is one of her favorites. Retired dairy farmer Gerald Diederichs, a resident of Villa Rosa, says being around so many animals makes him feel right at home. He is especially fond of the ranch’s cows — he had donated some of them to the ranch. Marilyn Johnson, another resident, says her grandchildren love to come and visit, and they are always drawn to the animals. Jenna Floberg, executive director of Villa Loretto and Villa Rosa, says people are happier around animals and that includes residents, their family and friends, staff, and community members.
Therapeutic value Ranch caretaker Bernard Mueller is a retired dairy farmer who had worked at the Villa as a certified nursing assistant. He says the animals have a therapeutic effect on residents that “does as much good as medicine.” Schroeder says it is very common for staff to calm an agitated resident in cognitive decline or a resident nearing death with a visit from that person’s favorite animal. Nurse Mary Pickart agrees the animals are an “amazing tool” for reaching residents with dementia. Being close to animals may spark Pickart pleasant memories, and that is especially so for residents who have grown up on farms. “The animals may open up a bridge we hadn’t been able to open,” she says. The ranch also has a respite program for children with behavioral health concerns, and many of these children have become close to animals. The ranch welcomes up to four children at a time for weekend stays in a guest house on the property. Participating children are clients of a Fond du Lac social services agency. They can take advantage of equine therapy. The ranch also hosts a summer camp for children with autism and their neurotypical peers. Sr. Bloesl admits to fleeting doubts about the emphasis on animal husbandry at a senior care facility: “Sometimes I’ve wondered, ‘Is this really what the Lord wants?’ But then I see how all of this is impacting people, and I know it is all worth it.” Visit chausa.org/chworld for more information on the benefits of animal therapy and video of the ranch animals. jminda@chausa.org
Spreading their word The Sisters of Bon Secours USA used a big platform to share some short messages this summer. One of them was “Be kind.” Another was “Spread peace.” The Marriottsville, Md.-based congregation was among nonprofits that were given the use of an electronic billboard that towers over a section of New York City’s Times Square to celebrate National Nonprofit Day on Aug. 17. Nearly 380,000 pedestrians pass through Times Square each day, according to its official website. “It is amazing how one small act of kindness really can change the world, one act at a time,” said Sr. Rose Marie Jasinski, the congregation’s leader, in a press release. “Until the world is truly a better place, we can’t afford to give up on this!” The Sisters of Bon Secours was founded nearly 200 years ago in Paris. The congregation came to the U.S. in 1881 to establish a health care ministry at the invitation of Baltimore’s bishop. Beginning in 1919, the congregation established or managed multiple Catholic hospitals, long-term care facilities and other health care services in the U.S. Many of those facilities now are part of Bon Secours Mercy Health and are sponsored by the public juridic person Bon Secours Mercy Ministries.