Catholic Health World - September 15, 2019

Investing in housing 2 Make It OK 4 Executive changes 8 PERIODICAL RATE PUBLICATION

SEPTEMBER 15, 2019 VOLUME 35, NUMBER 16

By LISA EISENHAUER

The avocado BLT has been a big hit with residents and staff at D’Youville Life & Wellness Community.

Vladimir Mesidor, director of dining services, says the wrap is among the menu options he has developed or refined with the health of residents of the senior living and care community in Lowell, Mass., in mind. The fact that the sandwich — made with traditional BLT ingredients but with the avocado added to provide some extra nutrients — has been popular among workers in the D’Youville cafeteria has been a bonus.

Mesidor says the nutritional aspects of what goes onto residents’ trays is of primary concern to him as the person in charge of D’Youville’s food and nutrition operations.

“Healthy eating is what we are looking for, healthy eating, healthy living,” Mesidor says. “And we really try our best to make sure the food not only tastes good, but that it actually has all the nutrients they need in it.”

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Christy Nary/Courtesy of D’Youville Life & Wellness Community

Suicide rates rising dramatically; ministry strives to be part of solution

Care providers look to the pantry to improve patient outcomes

Vladimir Mesidor, director of dining services at D’Youville Life & Wellness Community in Lowell, Mass., says nutrition is always on his mind as he plans the menus. His crew prepares meals for residents, day care patients and staff.

Dignity Health, partners launch online education company for workforce development

SSM Health’s Monroe Clinic in Monroe, Wis., used this poster to promote a mental health workshop in spring 2018 aimed at increasing awareness of potential mental health issues among farmers. The workshop was for agribusiness professionals who interact with farmers.

By JULIE MINDA

“If someone told you that 117,000 Americans were going to die this year of preventable causes, wouldn’t you consider that a national crisis?”

That was a question posed in a blog post late last year by Dr. Rod Hochman and Tyler Norris. Hochman is president and chief executive of Providence St. Joseph Health and Norris is chief executive of the nonprofit Well Being Trust. The two Hochman men were referring to the number of people in the U.S. who had died in 2017 of what mental health experts call diseases of despair. Nearly 50,000 of those deaths were suicides.

Norris Report after report from researchers in recent years show that suicide rates — as well as the rates for other diseases of despair such as drug addiction — have been rising dramatically nationwide and among all age groups studied.

The rates of suicidal ideation or behavior are highest among people who are young, people who are minorities and people who identify as lesbian, gay, bisexual, transgender or questioning. The Catholic health ministry is among the many sectors in the U.S. seeking to understand what is behind this national crisis — and what can be done to reverse it.

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In partnership with PeaceHealth, the FOOD for Lane County Youth Farm, a Community Supported Agriculture Program, runs an organic produce stand at PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Ore. It is open on Thursday afternoons in the growing season. The Youth Farm provides its teenage crewmembers with training in gardening, nutrition, leadership and financial management.

PeaceHealth nourishes community health by improving access to nutritious food Food insecurity can be gateway to lifelong health problems

By DALE SINGER

When you’re trying to change someone’s behavior, it’s easier to use incentives than punishments — carrots, not sticks.

In furthering PeaceHealth’s efforts to combat malnutrition among families in the Pacific Northwest, Meghan McCarthy suggests literal carrots — or broccoli, or asparagus, or any healthy vegetable favored by kids — be offered at meal and snack times instead of fat or McCarthy sugar-dense treats. If that sounds simple, it’s not. Fresh vegetables and fruits can be hard to come by in lowincome neighborhoods.

As system director of community health at PeaceHealth, McCarthy is spearheading a drive to educate the public on the connections between a poor diet and a range of bad side effects that can include poor school performance, a weakened immune response, higher stress levels, and the onset of chronic diseases like obesity and diabetes.

“This is a problem that is facing all America,” she said of poor nutrition. “I don’t think you would find a physician anywhere in the United States that isn’t worried about patients not eating well.”

A caregiver transports a patient at a Dignity Health facility.

By JULIE MINDA

Food insecurity Eating healthfully is a particular challenge for families who endure food insecurity, McCarthy said. According to the U.S. Department of Agriculture, in 2017, an estimated 11.8 percent of U.S. households were food insecure at some point during the year and 4.5 percent of households experienced

During a fluke encounter in Europe several years ago, education consultant Andrew Malley COMMONSPIRIT got to talking with HEALTH a group of Dignity Health executives about the pervasive challenges health care organizations face when trying to find well-educated, well-trained recruits for all types of positions. The group lamented that because there is such

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CATHOLIC HEALTH WORLD September 15, 2019

Bon Secours Mercy, Dignity Health advance affordable housing initiatives

By KEN LEISER

Cincinnati-based Bon Secours Mercy Health system and San Francisco-based Dignity Health are two of six U.S. health system participants in an affordable housing initiative announced early this year.

Dubbed Accelerating Investments for Healthy Communities, the initiative will assist participating hospitals and health systems in partnering with others in their communities to preserve and increase the supply of affordable housing, according to the Center for Community Investment at the Lincoln Institute of Land Policy.

“Hospitals and health systems can play an important role in creating robust community investment systems that reduce health inequities and help people thrive,” said Robin Hacke, executive director and co-founder of the Center for Community Investment, which is the organization running Accelerating Investments for Healthy Communities.

Affordable housing is key to ensuring good health, as well as social and economic stability in communities, the group said.

In Baltimore, Bon Secours Health Sys-

Dignity Health, part of CommonSpirit Health, provided a $1.2 million bridge loan to help fill a funding gap in the development of the Arrowhead Grove Neighborhood Revitalization project, shown above. A publicprivate partnership has committed to build about 400 units of affordable housing, a community center and other amenities to transform a former crime-ridden public housing project in San Bernardino, Calif., into a place where people can thrive.

tem, a forerunner of Bon Secours Mercy, has been developing affordable housing in distressed neighborhoods since the late 1980s, said George Kleb, executive director, housing and community development, at Bon Secours Baltimore Health System.

The projects have included renovating row houses and schools, as well as new construction.

“We’ve got a subsidiary that does affordable housing — that develops and manages affordable housing,” Kleb said in an interview. “We do want to accelerate our investment as part of the (Center for Community Investment) program. The fact that we had some track record helped us to be chosen to participate.”

Kleb said Bon Secours has developed

CHRISTUS completes $335 million restructuring of Corpus Christi campuses

CHRISTUS Spohn Hospital – Shoreline in Corpus Christi, Texas, hosts a grand opening event for its tower in the spring.

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CHRISTUS Health has completed a fiveyear, $335 million project to restructure services and renovate facilities at two of its campuses in the Corpus Christi, Texas, region: CHRISTUS Spohn Hospital — Shoreline and CHRISTUS Spohn Hospital — Memorial.

Dr. Osbert Blow, president and chief medical officer of CHRISTUS Spohn Health System, said CHRISTUS made this — its largest-ever investment in a single project — because it anticipates future growth in South Texas and is committed “to remaining the health care leader here for years to come.”

The project updated the Shoreline campus with a new tower, consolidated the inpatient services of the Shoreline and Memorial campuses to Shoreline and converted Memorial into an outpatient facility.

CHRISTUS opened the new North Tower at Shoreline in the spring. It includes an emergency department with 55 exam rooms. The tower also houses the region’s only Level II trauma center. Prior to the project it was a Level IV center. The North Tower project added 200 patient beds to Shoreline. Previously, Shoreline and Memorial had a combined 419 beds. Shoreline now has “about 400,” according to information from CHRISTUS. In January 2017, CHRISTUS finished converting Memorial into the Dr. Hector P. Garcia Memorial Family Health Center.

That ambulatory care site offers primary and preventive care, laboratory services, a pharmacy and other services.

As part of the broader project, CHRISTUS also expanded primary care offerings elsewhere in South Texas.

more than 800 affordable rental housing units in West Baltimore, an economically challenged area. The system partners with a third-party property management company. The units run at about 98 percent occupancy.

Baltimore housing prices have increased steadily, albeit not as rapidly as markets such as Washington, D.C., or San Francisco, Kleb said. Bon Secours and its partners have developed the affordable housing through the use of low-income housing tax credits and private loans.

Bon Secours Mercy’s investment in West Baltimore is an extension of the health system’s historic mission to assist the communities it serves, he added.

More than 2,500 miles away, in San Bernardino, Calif., a team from Dignity Health has worked with its community partners and the state to leverage more than $20 million for the multiphase Arrowhead Grove Neighborhood Revitalization project.

Dignity Health, which is part of Chicagobased CommonSpirit Health, has a tradition of lending to developers of affordable housing through its community investment program. Recognizing the promise of the Arrowhead Grove project, Dignity Health provided a $1.2 million bridge loan to help fill a critical funding gap.

“Health systems are just starting to understand that somehow participation in the social determinants of health — housing being one of them — is essential to the health of the community,” said Dr. Margo Young, director of community health for Dignity Health in the Inland Empire service area.

Dignity Health, she said, is committed to serving as a “vital partner” in rebuilding the San Bernardino community “neighborhood by neighborhood.”

Other health systems participating in the Accelerating Investments for Healthy Communities initiative are Boston Medical Center; Kaiser Permanente in Prince George’s and Montgomery counties, Md.; Nationwide Children’s Hospital, Columbus, Ohio; and UPMC in Pittsburgh.

The initiative receives support from the Robert Wood Johnson Foundation.

Upcoming Events from The Catholic Health Association Webinar: Transforming Spiritual Care Research into Policy and Practice Sept. 18 | 1 p.m. ET

Diversity and Disparities Networking Call Sept. 26 | 1 – 2 p.m. ET

The Urgent Need to Heal Our Home: A Feast of St. Francis Webinar Sept. 26 | 3 – 4 p.m. ET Sponsored by CHA and the Catholic Climate Covenant

Sponsor Formation Program for Catholic Health Care Session One: Oct. 10 – 12 Chicago (Invitation only)

Community Benefit 101: The Nuts and Bolts of Planning and Reporting Community Benefit

Chase Park Plaza Royal Sonesta Hotel St. Louis Oct. 15 – 16

Deans of Catholic Colleges of Nursing Networking Call Oct. 22 | 3 – 4 p.m. ET

International Outreach Networking Call Nov. 6 | 3:30 p.m. ET

Faith Community Nursing Networking Call Dec. 10 | 3 p.m. ET

Human Trafficking Networking Call Dec. 12 | Noon ET

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

September 15, 2019 CATHOLIC HEALTH WORLD

From page 1

Mesidor’s belief that healthy food is a key component to healthy living, while perhaps not new, is one that is being increasingly embraced by care providers as a means to reduce health care costs and improve patients’ quality of life.

Just this year, the federal government revised its rules to allow some Medicare Advantage plans to offer nutrition benefits such as home meal delivery for beneficiaries. The change had been sought by experts who say nutritious food can be as important as medicine in keeping some people healthy.

“I think people are just realizing that it really makes a difference, if patients are well-nourished when they come to the hospital and if they stay nourished afterward it keeps them out of the hospital,” says Julie Trocchio, CHA’s senior director of community benefit and continuing care.

Cutting costs, saving lives A study published this spring by researchers at the Friedman School of Nutrition Science and Policy at Tufts University in Boston supports the idea that providing financial assistance to improve the diets of some Medicare and Medicaid recipients could be life changing for them and cost saving for the nation.

The researchers, with funding from the National Institutes of Health, used statistics from the National Health and Nutrition Examination Surveys and set up a computer simulation to estimate the health and economic impacts of giving people subsidies to pay for healthy food.

The study evaluated two policy scenarios for adults insured by Medicare or Medicaid, and for people eligible for both insurance programs. One was a 30 percent subsidy on the purchase of fruits and vegetables and the other was a 30 percent subsidy on several healthful foods including fruits, vegetables, whole grains, nuts/seeds, seafood, and plant oils.

Among its findings: Over a lifetime, the fruits and vegetable incentive would prevent 1.93 million cardiovascular disease events, including 350,000 cardiovascular deaths, and save $40 billion in health care costs.

Also over a lifetime, the incentive that covers more foods would prevent 3.28 million cardiovascular cases, including 620,000 cardiovascular deaths, and 120,000 diabetes cases and save $100 billion in health care costs.

Yujin Lee, who holds a doctorate in nutritional sciences and is a postdoctoral fellow at Tufts, was one of the lead researchers in the study, which Lee took almost two years to conduct. She says the findings back the idea that food can be a form of medicine.

“We found that our intervention is as cost effective as the medical intervention, such as the hypertension medication, and other medication and procedures,” she says.

While the study didn’t use any human subjects, Lee says its results will be tested in a pilot program planned by a Floridabased nonprofit called Living Hungry on a low-income prediabetic and diabetic population.

Though traditional Medicare and Medicaid have yet to provide assistance for healthful food purchases for recipients, Lee sees reason to hope that they might in the future. She points to other ways government is adopting the food as medicine concept, such as the $25 million Produce Prescription Program that was part of the 2018 Farm Bill. That funding will be parceled out as grants to programs that encourage produce consumption through financial, educational or other incentives.

“This kind of funding can provide support for future pilot programs,” Lee says.

“We are hoping that they can test this

Ascension’s Milwaukee pantry equates nutrition and health A

t Ascension Ebenezer Health Resource Center in Milwaukee, a food pantry and health education outreach center offering disease prevention and wellness programs, the food-as-medicine concept is in full practice. In fact, clients come in with prescriptions for food.

The center is located in a predominantly working class, African-American neighborhood — a medically underserved area and food desert without many sources for healthy, fresh food. The center’s food pantry is open two afternoons a week to help fill that gap.

The pantry calls itself “diabetic friendly” because, in addition to lean meats and fresh produce, it stocks other foods that are high-nutrient, have low added sugar or no sugar, have low or reduced salt and have high fiber content.

Ascension Wisconsin’s Community Services team provides “prescription food cards” to case managers and health care providers at Ascension clinics throughout Milwaukee and those clinicians refer patients to the center for supplemental food and for nutrition education.

The clinicians provide details on the cards about the person’s health status.

When a client comes in to the center with one of the cards, one of the two community health nurses from Ascension Wisconsin assigned to the center can help steer the individual to food pantry items that could contribute to their best health outcomes.

“We can work out what would be the best food options for them and educate them Buchanan on that,” says Brenda Buchanan, one of the registered nurses.

Buchanan provides practical infor-

model through the pilot programs and see how much the health outcomes can be improved by providing this healthy food.”

Nutrition as treatment Another analysis with similar findings to the one done by the Tufts researchers is cited in a report called “Next Steps in Chronic Care” released in July by the Bipartisan Policy Center, a Washingtonbased think tank. The analysis was done

by Ananya Health Innovations, a firm that provides advisory services in the design and implementation of value-based care models. It looked at the impact providing medically tailored meals could have on hospital readmissions for Medicare recipients who have two or more of 11 chronic conditions, such as congestive heart failure, depression and diabetes.

“Full participation could lead to 575,408 eligible beneficiaries, with 1,012,590 eligible inpatient stays and 9,719 fewer readmissions attributable to the supplemental benefit,” the report says.

Overall, the study found that every dollar spent providing the meals could lead to $1.57 in health care savings, including from fewer hospital admissions, emergency room visits and skilled nursing facility stays.

While Medicare and Medicaid don’t cover food costs beyond any meals provided during hospital and care center stays, CHA’s Trocchio points out that there are other programs that get government funding, such as the Special Supplemental Nutrition Program for Women, Infants and Children, the Supplemental Nutrition Assistance Program and Meals on Wheels, that do provide food assistance and that cover some of the same populations.

She says studies have looked at those programs and found their benefits go beyond just keeping people from being hungry to improving their quality of life and health.

Meals on Wheels has proven itself very cost effective, Trocchio says. “One study called ‘More Than A Meal’ shows that when

Courtesy of Ascension Wisconsin

Patient nutrition

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Jackie Johnson, organizer of the food pantry at the Ascension Health Resource Center in Milwaukee, helps a man pack food to take home. Anyone who needs food can stop by to select from offerings that include lean meats and fresh produce. A registered nurse is on site to offer advice on selections based on the health issues of the person seeking food.

mation related to a patient’s diagnosis. For example, she steers people who are battling renal disease away from whole grains because the phosphorous content might be problematic for failing kidneys.

“Food choices are directly related to the disease or have a direct impact on the disease,” she says. “So, helping people to understand how to eat better for themselves is huge because they don’t know what they don’t know.”

Buchanan said that while she offers advice, it’s up to the people who come to the food pantry to make their food choices.

She gives cooking demonstrations to teach people how to prepare nutritious foods they might not be familiar with, such as squash, and to give them the opportunity to taste dishes to see if they want to add a recipe to their diets.

The center is a collaboration between Ascension Wisconsin, Ebenezer Church of God in Christ and the Hunger Task Force,

a Milwaukee nonprofit organization. In addition to the food pantry, it offers education, on chronic disease management assistance with insurance enrollment, instruction on advance care planning and lunch-and-learn sessions on a wide range of health topics. Nurse Julia Means provides diabetic foot care and screening for diabetes and high blood pressure at the resource center.

Buchanan said the food pantry is open to all Milwaukee residents, but its target is the people who live in nearby neighborhoods who either can’t afford to buy fresh items, or don’t have transportation to get to stores that sell healthy, high quality food.

“It isn’t just to take the hunger away,” she says of the pantry’s offerings. “It’s to provide food that’s actually nutritious for their body.”

you’re bringing food to, especially older people, the impact is more than nutrition,” she says.

That study — funded by AARP Foundation and done by the Brown University Center for Gerontology and Healthcare Research — found impacts that included fewer falls and less social isolation among the recipients of the program’s homedelivered hot meals.

of patients and residents at D’Youville Life & Wellness Community.

He takes steps like opting for fresh produce (locally sourced, if possible), modifying favorite recipes to lower the fat and salt content, and trying out new offerings, such as vegetarian chili, to make his menus as healthful as possible for D’Youville’s elderly residents.

Mesidor says: “If we’re just focusing on the food and we’re not focusing on the nutritional value of the food and the healthy eating, we’re not really caring for the residents like we’re supposed to.”

Healthful and locally sourced While he’s not a direct caregiver, Mesidor sees his role as meal overseer as directly connected to the health outcomes

— LISA EISENHAUSER

leisenhauer@chausa.org

Kids get pampered at day of glamour Patients at The Children’s Hospital of San Antonio get their hair, makeup and nails done by professional stylists during the Kidd’s Kids Glam Event in mid-July. The pop-up salon was open for a day in the pediatric hospital’s Child Life Center. Stylists from Toni & Guy, an international chain of hair salons, also brought their services directly to hospitalized kids who were unable to visit the salon. The Kidd’s Kids foundation, which sponsored the event, was founded in 1991 by the late Kidd Kraddick, a television and radio personality.

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CATHOLIC HEALTH WORLD September 15, 2019

Essentia Health–St. Joseph’s enlists community to reduce mental health stigma

By JULIE MINDA

A significant portion of the population experiences mental illness, but it is common for people to forego or delay seeking treatment because of societal stigma.

Reducing the stigma of mental illness within a community could result in more people being willing to seek mental health care and doing so before they are in crisis.

That is the concept behind a mental health campaign that Duluth, Minn.-based Essentia Health and its St. Joseph’s Medical Center in Brainerd, Minn., launched last year.

Through “Make It OK,” the health care organizations and a coalition of community partners are delivering presentations that let people know that mental illness is common — one in five U.S. adults experiences mental illness every year — and treatable. The coalition members and campaign “ambassadors” present this message and provide related resources in their own workplaces; to school staff and parents of students in the local school district; and to community members at churches, businesses and organizations throughout Brainerd and surrounding communities.

The resources include a tip sheet on what to do to help people at various levels of mental health crisis, and information on local organizations that can assist.

Kathy Sell, Essentia Health marketing and communications manager, helped to establish and launch the program in Brainerd and is an ambassador. She says, “Every time I give the Make It OK presentation, someone shares a deeply personal story from years ago about a family member who died by suicide, and they’ll share that they’ve never talked about it.

“Stigma runs deep,” she says. “The more we can reduce stigma, the more we can help people seek help earlier, and truly impact lives.”

Pervasive problem According to information from St. Joseph’s, more than 25 percent of adults in Crow Wing County, Minn., have been diagnosed with a mental illness at some point in their lives. Crow Wing has a population of about 62,500; and its county seat Brainerd, a population of nearly 13,600.

Sell says the pervasiveness of mental health conditions has led to continually increasing numbers of people coming to St. Joseph’s emergency department in mental health crisis. The facility recently invested $1 million to renovate its emergency department to make it safer and more accessible to people in acute mental distress. The hospital has a 12-bed inpatient mental health unit called the Grace Unit.

To actively engage the community to reduce suicides and avert mental health crises through prevention and early treatment, the hospital turned to its mental health task force to vet ideas. Among the task force’s members are former Grace Unit patients and mental health clinicians, including a psychiatrist and nursing director.

That task force recommended the Make It OK campaign, which was being used elsewhere in Minnesota, to combat the stigma around mental illness. The National Alliance on Mental Illness Minnesota; HealthPartners, a Bloomington, Minn.-based nonprofit insurance and health care provider; the Mayo Clinic Health System; as well as other hospitals, foundations, nonprofit service organizations and a media partner developed the educational presentation and a tool kit of resources. That tool kit includes flyers, brochures, a guide on what to say to someone who is mentally ill and other items.

All the Make It OK materials are free for use.

Brainerd rollout For the Brainerd implementation, St. Joseph’s worked with Crow Wing Energized, a grassroots organization created,

School district employees in Brainerd, Minn., attend a Make It OK training session about a year ago. The training is part of a broad campaign by Essentia Health and its St. Joseph’s Medical Center of Brainerd aimed at reducing mental health stigma. Presenting is Lisa Henry-Stawarski, a child care coordinator for the district.

supported and funded by Essentia and Crow Wing County to improve health and wellness in the county. Sixty churches, community groups, business groups, cities, nonprofit organizations, health care providers, schools and businesses are partners of Crow Wing Energized. Sell is on the organization’s steering committee.

St. Joseph’s and Crow Wing Energized launched Make It OK in spring 2018.

More than 2,600 people, including all St. Joseph’s and Essentia providers and staff in the region, have attended a Make It OK presentation.

St. Joseph’s and Crow Wing have main-

tained the momentum with hospital and clinic employees by publishing articles in an internal newsletter and staff emails. In these communications, staff share their own experiences with mental illness.

Since the summer of 2018, St. Joseph’s and Crow Wing Energized have trained more than 200 people as Make It OK ambassadors. Ambassadors commit to give at least two presentations annually. Last summer, 900 employees of Brainerd Public Schools heard the Make It OK presentation during their back-to-school meetings. The school district has its own ambassadors giving presentations to parents and child care staff.

How to help The two-hour interactive Make It OK presentation includes videos, opinion quizzes, audience discussion and opportunities to practice what is learned. Participants learn about the pervasiveness of mental illness and the added suffering and harm engendered by social stigma that keeps people from seeking help. They get coached on how to interact with people with mental illness and receive suggestions about what to say and what not to say to a person experiencing symptoms of a mental illness.

A theme of the presentation is that mental illnesses are medical illnesses and people should not be shamed or ostracized for mental health issues.

Sue Hilgart was a Make It OK ambassador before she moved out of the Brainerd area this year. She says she felt compelled to take the training after a rash of suicides in the Brainerd area. In a blow for the small community, three youths and several adults had taken their own lives within about a 12-month period.

“I wanted to be part of any action that would help make a difference,” Hilgart says.

In her view, Make It OK can make a difference by encouraging community members to recognize and support those struggling with mental illness. “This program has the ability to open eyes, open up dialogue and raise awareness of mental illness. The program can change lives, change minds, change outcomes,” she says. jminda@chausa.org

E N D-OF-LI FE GU I DE

Palliative and Hospice Care

This ethics publication from CHA helps patients, families, physicians and caregivers with decisions about palliative care and hospice care. The guide is part of a collection that addresses advance directives, serious illness and end-of-life care.

CHA developed the guides in collaboration with physicians, nurses, theologians and ethicists within Catholic health care. Although the guides reflect the perspective of the Catholic tradition, the information is helpful to people from any religious tradition. Available in both English and Spanish.

Copies of all three guides are available to order or download at chausa.org/store

September 15, 2019 CATHOLIC HEALTH WORLD

Suicide prevention From page 1

“We’re seeing people continue to die prematurely due to preventable causes,” says Benjamin F. Miller, chief strategy officer of Well Being Trust, which Providence St. Joseph Health established as an indepenBenjamin F. Miller dent foundation in 2016 to tackle mental health issues. Miller says, “people are crying out for help and looking for solutions.”

“We cannot accept the status quo,” he says of the health care sector. “We have to push for better.”

Complex, multifaceted September is Suicide Prevention Awareness Month. CHA is building awareness of the crisis of rising rates of suicide, identifying resources for evidence-based approaches to stemming the public health crisis and highlighting ministry members and others making inroads at chausa.org/suicidepreven tion and in a social media push.

According to statistics from the Centers for Disease Control and Prevention, suicide rates increased in nearly every state between 1999 and 2016, with rates rising more than 30 percent in half the states. Issue briefs from the Trust for America’s Health indicate that between 2011 and 2016 suicide was the second leading cause of death for people aged 15 to 34.

Research published in JAMA and research from the Suicide Prevention Resource Center and the CDC show that black children, American Indian and Alaskan Native people, LGBTQ populations and veterans are at a much higher risk of suicide

than other populations. These and other statistics are on CHA’s webpage.

Michael Miller Jr., system vice president of mission and ethics for St. Louis-based SSM Health, says the roots of these “diseases of despair are so complex,” with cultural, Michael Miller Jr. emotional, psychological, social, genetic and many other factors at play. While it’s impossible to pinpoint exact causes of the spike in suicides, he says, generally speaking it is clear that a lot of people today “have lost hope and a sense of belonging.”

Indu Spugnardi, CHA director of advocacy and resource development, concurs.

She says that especially the young people most at risk of suicide, but also individuals in the other groups with rising rates, are feeling isolated. They’re less engaged with the community, with many replacing in-person connections with social media connections. Plus, many are financially stressed.

Unable to secure good jobs, they can’t pay their large college debts or afford housing.

“These are really thorny problems,” Spugnardi says.

“You can’t just flip a switch” to fix them.

Triggering events Dr. Brent Bell, a psychiatrist with SSM Health Bell St. Anthony Hospital – Oklahoma City, adds that circumstances can push a mentally fragile person to contemplate or act upon suicidal thoughts.

For instance, young people frequently are triggered by relationship problems and the elderly by health crises. Drug and alcohol dependency is highly correlated with sui-

cide among adults, he says.

Anne De Biasi, director of policy development for Trust for America’s Health, a public policy foundation, says the antecedents of suicide tend to cascade upon one another for peoDi Biasi ple in mental health crisis, until problems may feel insurmountable.

Bell adds that social media can breed suicidal thoughts, in part because online bullying can exacerbate sufferers’ mental health concerns and also because there is much information online about how and why people commit suicide. In some ways, it can create a “contagion” effect as mentally fragile people see suicide almost glamorized online, he says.

Working together There are public health, hospital-specific and clinical approaches that have been shown to achieve traction in reducing suicide risk, say the experts who spoke with Catholic Health World.

“We all need to work together across sectors — we need to invest in prevention to reverse the trends,” says De Biasi. She says what works is promoting connectedness, or ways to link people with one another; equipping people with social and emotional coping skills; and helping build protective resources for people, including by addressing the socioeconomic needs that can cause people to despair.

Miller of Well Being Trust says health and social service organizations must push for systemic change by advocating at all levels of government for public policies and investments that help the mentally ill. This can include policies that put mental health care at parity with medical care, when it

comes to access and reimbursement. Miller says advocacy efforts also should support changes that reduce fragmentation in care delivery.

Bell of SSM in Oklahoma City adds that broad awareness building and training throughout communities is important. By helping community members to understand the pervasiveness of mental health concerns, the urgency of addressing those concerns before a crisis point, and how a person in crisis can be helped, more people will be equipped to intervene. And, stigma can be reduced, he says.

Catholic social teaching Spugnardi notes that the Catholic health ministry is well positioned to escalate its work addressing mental health concerns and suicide: Ministry providers have established community partnerships in rural, suburban and urban markets nationwide; and they have staff expertise.

SSM’s Miller says the Catholic health ministry has done much important work in taking on the issue of suicide. He says this work is rooted in Catholic social teaching, particularly “the idea of the dignity of the human person … in the context of promoting and protecting life.”

Miller notes that the ministry’s efforts to get at the heart of the issues connected with suicide are right in line with providers’ call to serve the poor and vulnerable — to provide them with the care they need.

“Sometimes the vulnerable are hidden to us, but we have a special calling to seek them out,” he says. And people in mental health crisis are certainly among the most vulnerable people in the U.S. today, he says. “Catholic health care, with our holistic approach and sense of hope, can provide what people in despair critically need.”

Ministry providers take many-layered approach to suicide prevention M

inistry providers making suicide prevention a priority are developing comprehensive strategies that hinge on community engagement and collaboration, the integration of mental health into primary care and public policy advocacy.

Across the country, ministry providers are working to reduce the stigma of mental illness in order to encourage people to seek help before they are in crisis.

Some are sponsoring Mental Health First Aid trainings to equip health care workers and people throughout their communities to talk about mental illness within their professional and social networks, to recognize people who are developing a mental health issue and to steer people to professional services or other means of emotional support.

Mental Health First Aid was created in Australia. The National Council for Behavioral Health and the Missouri Department of Mental Health operate the program in the U.S. and are working to make the training as common as classes in cardiopulmonary resuscitation.

SSM Health St. Anthony Hospital – Oklahoma City offers mental health and suicide awareness training to staff and to the greater community. That facility ran a two-day suicide academy this year for the leaders of Oklahoma City behavioral health care facilities. The course was aimed at reducing suicide attempts in their patient populations. SSM Health St. Anthony also offers crisis intervention training for police to help them better understand mental illness and deescalate potentially volatile situations.

SSM Health and Avera Health have created programs that target another vulnerable group — farmers. Weather extremes and record low commodity prices are taking a heavy toll in farming communities. The Monroe Clinic, an SSM Health affiliate in Monroe, Wis., has partnered with a University of Wisconsin Extension Campus to offer workshops — one for agribusiness professionals who interact frequently with farmers and the other for farmers’ wives — to help them better recognize signs of severe mental distress and speak up to encourage the

Panelists present on potential mental health concerns of farmers, at the “Resilient Farm Women” event last fall at a church in Monroe, Wis. SSM Health’s Monroe Clinic helped host the event.

individual at risk to seek professional help.

The Monroe Clinic also provides Mental Health First Aid training.

In January, Avera Behavioral Health, based in Sioux Falls, S.D., opened a Farmers Stress Hotline. The triage service for farmers, ranchers and their families and friends links callers to mental health providers for follow-on care.

Facility-level interventions

Avera Health, SSM Health of St. Louis and Mercy of Chesterfield, Mo., are among CHA members that have gotten behind the Zero Suicide Initiative. The nonprofit Safe Communities coordinates the initiative, which engages health care systems, mental health centers and community organizations with a role to play in suicide prevention in identifying people at risk of suicide and ensuring there is a pathway for them to get help.

Zero Suicide initiatives include training staff throughout health care facilities — not just in behavioral health — on suicide awareness and prevention; implementing mental health screening for all patients; and ensuring referral pathways, navigation and follow-up are provided to people in mental health crisis.

In line with its Zero Suicide work, SSM Health St. Anthony recently renovated its emergency department to better protect

people who may be suicidal. Dr. Brent Bell, department chair of psychiatry at the hospital, says the redesigned rooms allow staff to restrict access to electrical cords and oxygen equipment so they are not accessible to patients but are to staff.

Mental health technicians can assist in the care of emergency department patients.

Gaye Woods, system director of community Woods benefit and population health for SCL Health in Broomfield, Colo., says that system also has increased its protection of emergency department patients who may be suicidal. Two of its hospitals have implemented protocols to provide more intensive intervention and followup for patients who are admitted to the emergency department after a failed suicide attempt.

These hospitals now have mental health experts in their emergency departments to assist with stabilization and to refer these patients — after they are cleared medically — to a crisis center outside the hospital.

Both the hospitals and crisis center maintain follow-up with the patient in the ensuing weeks to ensure mental health needs are being addressed, says Woods. SCL Health

5

will expand the concept beyond the initial hospitals, Woods says.

Like many other hospitals, SCL Health is working to integrate mental health care into its primary care clinic system.

Increasing numbers of SCL Health clinics now have a mental health care professional stationed on-site so that when a primary care provider screens a patient and identifies a mental health need, the patient can see the mental health care expert without delay.

In rural SCL Health care sites, such needs are addressed through telehealth, Woods says, both because of the shortage of mental health care providers and to protect patients’ anonymity. People in small towns often fear the stigma related to seeking mental health care.

Public policy

Benjamin F. Miller, chief strategy officer of Well Being Trust, says his organization is helping Providence St. Joseph Health and other health care organizations across the nation to undergird their important suicide prevention work in their communities with advocacy and public policy efforts. He says local, state and federal advocacy is needed to address the fragmentation in mental health care delivery that can make it difficult for patients to access and navigate their care.

Indu Spugnardi, CHA director of advocacy and resource development, says the association and its members actively advocate for improved access to and better reimbursement for mental health services.

CHA supports legislation that would ease financial, housing and other socioeconomic burdens for vulnerable people.

Addressing the social determinants of health can reduce economic stress that in turn can lower the risk of suicide, she notes.

She says of the many efforts of Catholic health care providers around suicide prevention: “When we have a shared understanding of the problem and solutions, and a shared commitment to act,” much can be achieved.

— JULIE MINDA

6

CATHOLIC HEALTH WORLD September 15, 2019

Dignity Health’s online ed From page 1

inconsistency in the quality and type of training available for many health care roles, it can be a challenge to find applicants who are prepared to take on these jobs.

The group agreed there are people who want to do really important work in health care, and they deserve a quality education, Malley recalls of the conversation. The executives and Malley wondered whether Dignity Health could use the expertise of its tens of thousands of staff to create a better health care education product.

That conversation was the genesis of the Dignity Health Global Education online education company, a joint venture of Dignity Health and Global University Systems of Amsterdam and minority partners. Global University Systems is a familyowned business with both for-profit and not-for-profit subsidiaries.

Launched in February, Dignity Health Global Education is offering online academic degrees and certifications as well as professional, executive and leadership training for health care workers worldwide.

The new business has both for-profit and not-for-profit aspects. In July the company began its first class, which is part of a nurse leadership certificate program offered in conjunction with Duke University Corporate Education Division.

Malley, who is Dignity Health Global Education’s chief executive, says, “It’s about health care taking ownership of the education issue, and making an impact.

“Our main focus is to up-skill and improve education outcomes for workMalley ers,” he says. “And when they have the most up-to-date education and resources, it’s better for patients.”

Buildup Dignity Health and Global University Systems spent two years setting up the structure for the company, establishing partnerships with well-known universities and other educational institutions and developing coursework.

Gregg Davis is senior vice president for international business and strategy for Chicago-based CommonSpirit Health, which is Dignity Health’s parent. He says Global University Systems iniDavis tially supplied expertise in developing online educational platforms — it works with higher education institutions worldwide to provide both in-person and online education. And, Dignity Health has been enabling access to clinical and nonclinical leaders from throughout its system to consult on what education and training is needed and assist with creating course content.

The 41-hospital Dignity Health has 60,000 staff and 10,000 employed or affiliated physicians. Its parent CommonSpirit has about 159,000 employees and 25,000 physicians and advanced practice clinicians at its 142 hospitals and 700-plus other care sites in 21 states. Davis says CommonSpirit will become increasingly involved in the online education company, including by enabling its clinical and nonclinical staff to contribute to course content.

Both Dignity Health and Global University Systems are providing funding for Dignity Health Global Education’s development.

Content development Kurt Hayes is chief learning experience officer for Dignity Health Global Education. He says the company’s goal is to Hayes offer content that is practical for today’s health care workforce, and

Partnerships span nation, cross ocean D

ignity Health Global Education plans to form partnerships with a dozen educational institutions by the end of the year.

So far, in addition to a nurse leadership program with Duke University’s Duke Corporate Education unit, it has partnered on an “RN-to-BSN” program with Webster University for nurses pursuing a Bachelor of Science in nursing; a certificate in health care marketing and a certificate in healthcare analytics from Pepperdine University’s Graziadio Business School; a certificate in health care innovation and a master’s in global management, both from Arizona State University’s Thunderbird School of Global Management; and a certificate in health care project management from American University.

The Pepperdine, Webster and one ASU program are enrolling for fall. The American University and other ASU course will begin in January.

to equip those staffers with the skills and knowledge that their employers need them to have in order to best serve patients.

Hayes says to achieve this, Dignity Health Global Education develops its offerings and coursework collaboratively.

First its executives, plus the faculty and administrators of the partnering school as well as CommonSpirit leadership brainstorm the outcomes they want to achieve and the type of educational programming they’d need to generate those outcomes.

Next, Dignity Health Global Education interviews a broad swath of in-hospital leaders, managers and frontline staff on program content. Dignity Health Global Education develops an outline of course activity, gets sign-off from the original group that proposed the programming and then sets out to create the coursework.

Hayes says Dignity Health Global Edu-

Dignity Health Global Education also has formed a partnership with the United Kingdom’s University of Exeter around nutrition, recovery and rehab coursework.

The online education company is finalizing a partnership with Chicago’s DePaul University to provide degrees and standalone courses in information technology, cybersecurity, analytics, health law and nursing. And, Dignity Health Global Education has a relationship with the Goodwall career development network to offer those services to students.

In time, Dignity Health Global Education plans to offer coursework in health care finance, data science, ethics, informatics, administration, leadership, innovation, management, law, logistics and supply chain, quality improvement and other areas.

— JULIE MINDA

cation curriculum developers work closely with the education partner’s faculty and with CommonSpirit’s frontline clinicians and other staff to create the course content.

This way, the most up-to-date information as well as practical application information is included.

For credit-bearing courses, faculty normally will deliver the tailored content through online live courses. For non-creditbearing courses, content will be produced in Dignity Health Global Education’s multimedia studios, where course developers will create interactive, easily digestible segments of instruction that students will be able to consume at their own pace.

Most coursework will involve cohorts of students who pace their studies as a group and interact with faculty and classmates through online private chat rooms and other electronic communications. In some

cases, online courses and seminars will be supplemented by hands-on clinical trainings at CommonSpirit facilities. Projects and tests all will be geared toward what will be usable in students’ day-to-day work.

Anyone at CommonSpirit can apply for the courses. Dignity Health Global Education also hopes to attract students from around the U.S. and the world.

The coursework will be co-branded by, and tailored for, Dignity Health Global Education and the partner school. Dignity Health Global Education will receive a portion of its students’ tuition payments, and the partner school will receive a portion.

Dignity Health Global Education will either reinvest those funds in content development or distribute the funds to the joint venture founders.

Relevancy Malley says the vision is to stay ahead of what health care organizations need in terms of workforce development — by combining the applied working knowledge of CommonSpirit and Dignity Health with the educational underpinnings of the schools involved in the partnership. The hope is to respond quickly in developing new coursework to stay abreast of evolving challenges facing health care.

Davis says CommonSpirit hopes to use the Dignity Health Global Education platform to train people so they can be “better leaders and better managers and so they are better able to manage patient care — to provide better care.”

“This way, health care professionals will be better prepared to address issues, in a way that is in line with our mission,” he says.

Visit chausa.org/chworld for information on Dignity Health International, the organization that runs the new global education company. jminda@chausa.org

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Malnourished

7

tives to improve the economic and health status of low-income families.

From page 1

very low food security. Food insecurity is characterized by a lack of consistent, sufficient and varied nutrition — family members may eat lower quality foods to make their food budget stretch, but people generally don’t go hungry. In households with very low food security, there may be intermittent hunger.

PeaceHealth’s service area includes Washington, Oregon and Alaska. According to the U.S. Economic Research Service report on food security for 2015-2017, food insecurity in Oregon and Alaska were in line with U.S. averages while Washington state fared better than the U.S. average. But PeaceHealth found that areas served by its three networks or divisions have food insecurity rates that are higher than the national average of about 12 percent. Most impacted families have single women as head of the household.

The 2016-2019 community health needs assessment by PeaceHealth Southwest Medical Center in Vancouver, Wash., identified food insecurity among children as a major concern. In 2016, more than one in five children in the hospital’s service area were food insecure, according to the report. The hospital funds community programs that provide healthy meals for children, nutritional education for parents, cooking classes for kids and adults and school-based gardening programs to increase the consumption of fruits and vegetables.

Undernourished and overweight McCarthy said Americans expect malnourished children and adults to be underweight, but the food insecure can be overweight or even obese. According to the nonprofit Food Research & Action Center, “food insecurity and obesity can be independent consequences of low income and the resulting lack of access to enough nutritious food or stresses of pov-

All hands on deck To make more progress against malnutrition, McCarthy said PeaceHealth wants an all-hands-on deck approach to frame the issue as a community priority and find solutions at the community level.

“We really need more activists,” she said. “We all make hundreds of decisions every day about food. We are immersed in it. Our communities are based on who we break bread with. When we learn for ourselves and provide that knowledge to our families and our neighbors and our churches, then we really have made an impact on our communities.”

PeaceHealth’s effort to nourish communities follows a seven-step plan (see graphic below) and includes highlighting existing successful partnerships, identifying gaps, encouraging caregivers to give nutrition advice, working with community organizations, advocating for government programs and providing community education.

The final step, McCarthy said, is making sure to care for PeaceHealth staff members themselves, giving them access to emergency assistance and educational programs to improve their own nutrition.

That effort, she added, has a booster in the system’s president and chief executive, Liz Dunne, who is a registered dietitian.

“This comes from a fundamental belief in the power of food,” McCarthy said. “At a core level, senior leadership allowed us to be really innovative. I don’t know of any other CEO who brings that emphasis, so we have the opportunity to bring attention to making this one of our core values.”

Making healthy eating a positive value at PeaceHealth can have a multiplier effect, she said. “In health care, we are not always great about walking our talk, but we realized that the most direct way to improve the health of our communities, where many times we are the largest employer, is to start with ourselves. “

Cecelia Jacobson, a PeaceHealth registered dietitian, stirs salad greens on the opening day of an organic farm stand on the campus of PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Ore.

erty.” Low-income families and individuals may live in neighborhoods where there is easy access to fast food franchises but no full-service grocery. Produce, if available, may be higher cost and lower quality.

“Nourishment is not just about calories,” McCarthy said, “So we have to totally shift our thinking in health care” to recognize and combat food insecurity. To that end, PeaceHealth has made improving nutrition and tackling food insecurity a systemwide priority.

Health care providers have a role to play in identifying individuals and families facing food insecurity and in linking them to community resources and assistance. McCarthy said that clinicians can open the way to “better conversations” about the relationship between diet and health and identify food insecurity by asking patients to answer yes or no to the following statements:

“Within the past 12 months, we worried whether our food would run out before we had money to buy more.”

“Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more.”

Two federally funded programs — the nonprofit Meals on Wheels and the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants and Children — have been around for decades and have helped reduce hunger and malnutrition, McCarthy said. But those programs don’t cast a wide enough net.

PeaceHealth’s current efforts to combat malnutrition include veggie voucher programs and food pharmacy programs in its service areas. The system is addressing the root causes of food insecurity by supporting community programs that increase access to healthy foods for children and families and through its initia-

Family & Childhood Nutrition:

Nourishing Our Communities Access to healthy, affordable food is a critical issue affecting children and families across our communities. Our Mission and Core Values call on us to nourish the health of our communities, not just because we believe everyone should have access to nutritious food, but also because food insecurity can lead to a lifetime of consequences.

There is a clear connection between food insecurity and high levels of stress, poor nutrition and chronic diet-related diseases, like obesity and diabetes.

The Need

Deeper Dive — Research*

• More than 215,000 of those we serve are food insecure, and one-quarter earn too much to qualify for assistance.

• Food insecurity among our children is equal to or higher than the national average.

• While many think food insecurity equates to starving, underweight children, in America, overweight and obese children are often more symptomatic of this problem. Both are caused by the same root problem: poor nutrition.

Food Insecurity Rate

PeaceHealth commissioned research to provide a deeper understanding of the issues facing those in our communities most at risk. This population:

• There is a clear connection between food insecurity and diet-related disease.

• Skews younger (18–44) and female (59%)

• Children can suffer a lifetime of consequences including a higher risk of chronic diseases, learning difficulties and social and behavioral problems.

• Often lives in a household of 5 or more people (40%) • Is very poor, earning less than $20K annually (62.5%) • Spends less than $100 per week on groceries (48%) • Reports eating an unhealthy diet at home (39%) and fast food 5 or more times in the previous month (51%)

13.4%

➤ 66%

15.4%

➤ 79%

We are taking the

13%

➤ 75%

making nutrition and

Oregon Network

Nationally

H Y P E RT E N S I O N

H E A RT D I S E A S E

OBESITY

Aid Eligibility

➤ 77%

Northwest Network

DIABETES

• Is 30% more likely to be “very obese”

14%

Columbia Network

Impact on Community Health

Food Insecurity Being uncertain at times of the ability to acquire or of having enough food for all members of the household due to lack of money or other resources.

TAKING ACTION — What PeaceHealth Is Doing important step of

1

food insecurity a systemwide community health priority.

HIGHLIGHTING existing successful partnerships in the area of food insecurity and nutrition, and looking at ways to broaden our participation;

2

IDENTIFYING

program gaps where PeaceHealth sponsorship and/ or participation can make a meaningful difference;

3

Specifically, we will devote human and financial resources to:

5

ADVOCATING for local, state and federal programs that provide food assistance and nutrition education;

6

PROVIDING

community education; and

7

ENHANCING

the ability of our caregivers to identify food and nutrition-related issues among those we serve, and to provide counsel and access to assistance;

TAKING CARE

of our own PeaceHealth family through access to emergency assistance and educational programs.

4

PARTNERING

with community organizations, educational institutions, health partners, businesses, the media and government to improve food security and nutrition awareness in our communities;

* Conducted by CentraForce Health, the research looked at a statistically significant sample (13,117) of adult households (18–54) in the Columbia & Northwest Networks (excluding Alaska) with one or more children under 18 and a household income at the federal poverty level or less, and spending less than $150 weekly on groceries.

Source: PeaceHealth

8

CATHOLIC HEALTH WORLD September 15, 2019

KEEPING UP PRESIDENTS/CEOS Chris Cullom to president of Mercy Catholic Medical Center, part of Trinity Health Mid-Atlantic. In this role, he will oversee operations at Mercy Catholic Medical Center – Mercy Fitzgerald Campus in Darby, Pa., and Mercy Catholic Medical Center – Mercy Philadelphia Campus. He was assistant executive director at the University of Pennsylvania Health System/Hospital of the University of Pennsylvania. He succeeds Sue Cusack, who is retiring.

Michael Ricks to chief executive of Providence Saint John’s Health Center in Santa Monica, Calif., and of the hospital’s John Wayne Cancer Institute, effective Sept. 30.

He was executive vice president and chief

Yanes

Baalrud

operating officer at Hoag Memorial Hospital Presbyterian in Newport Beach, Calif. He succeeds Marcel Loh, who is retiring.

John C. Yanes to president of Saint Joseph London of London, Ky., and Saint Joseph Berea of Berea, Ky., effective Sept. 9.

He was chief executive of Andalusia Health in Andalusia, Ala. The Kentucky facilities are

Laatsch

Thompson

part of CommonSpirit Health’s CHI Saint Joseph Health.

ADMINISTRATIVE CHANGES Suja Chandrasekaran to senior executive vice president, chief information and digital officer of CommonSpirit Health of Chicago.

HSHS Sacred Heart Hospital of Eau Claire, Wis., and HSHS St. Joseph’s Hospital of Chippewa Falls, Wis., have made these changes: Laura Baalrud to director of community health and Lisa Laatsch to director of marketing.

Dr. Mark Thompson to president of medical groups — SSM Health Wisconsin Region.

OBITUARY Michael Mahoney, who was Essentia Health’s vice president of public policy, died Aug. 22. Six of Duluth, Minn.-based Essentia’s 15 hospitals are part of the Catholic health ministry.

University of Louisville to acquire KentuckyOne facilities in Louisville, Ky. Pending regulatory and Catholic Church approvals, the University of Louisville is poised to acquire on Nov. 1 three acute care hospitals, a neuroscience and rehabilitation center, a behavioral health hospital, as well as physician groups and outpatient facilities in Louisville, Ky., from subsidiaries of Catholic Health Initiatives.

Under the terms of the acquisition, the University of Louisville will pay an amount based on the financial liquidity of the facilities at the time of the acquisition. The university has agreed to pay $10 million, but that amount will be increased or reduced based on whether the estimated combined net working capital of the facilities on Oct. 31 is greater or less than $76.4 million, which represents their target net working capital as of Dec. 31, 2018.

The sellers are Jewish Hospital and St. Mary’s Healthcare, KentuckyOne Health, and CHI Kentucky — all related entities and all part of CommonSpirit Health. CHI merged with Dignity Health early this year to create CommonSpirit Health.

The sellers also have agreed to cancel two promissory notes amounting to $19.7 million from University Medical Center, a university subsidiary. Those prom-

issory notes are related to a 2013 joint operating agreement between two CHI subsidiaries, KentuckyOne Health, University of Louisville and University Medical Center.

As part of the acquisition agreement, in order to support the facilities’ use and operations, the foundation of Jewish Hospital and St. Mary’s Healthcare will provide $40 million to the University of Louisville over four years; the Jewish Heritage Fund for Excellence has committed $10 million; and the Economic Development Cabinet of the Kentucky state government will provide a loan of $50 million to the university. That loan will begin at an interest rate of zero and then will transition to a low-interest rate.

Half of the principal will be forgivable if the university meets certain criteria.

Plans call for the acquired facilities to rebrand with the moniker “U of L” when the deal closes.

Currently, Sts. Mary and Elizabeth Hospital, one of the three acute care hospitals changing ownership in the deal, and Our Lady of Peace Hospital, the behavioral health hospital, are Catholic facilities. Once the acquisition is complete, the facilities no longer will be Catholic, according to infor-

From Insight to Wisdom: Experiences in Reflective Leadership A new book from Terrance McGuire, D.Min Available now on Amazon!

In From Insight to Wisdom , Terry McGuire discusses the impact of being reflective in our personal and professional lives.

This book is intended for those presently in positions of ministry leadership; others who are emerging leaders; and individuals who work to develop, foster, and advance leadership education.

To that end, the content is applicable to all leadership learning environments where there is a continuous desire to seek out and find life-changing knowledge.

“Terry McGuire’s insights into how reflecting on our Judaic Christian heritage can contribute to ministry formation is a gift to today’s Catholic health care leaders.”

—Julie Trocchio, Senior Director, Community Benefit and Continuing Care, Catholic Health Association of America “Terry accomplished some wonderful insights into long-term leadership, especially how important reflective leadership is during these stressful times in long-term care!”

—Sr. Peter Lillian Di Maria, O.Carm., Director, Avila Institute of Gerontology

Organizations set for acquisition by University of Louisville Jewish Hospital of Louisville, Ky., including a heart and lung center and outpatient center

Frazier Rehabilitation and Neuroscience Center of Louisville Sts. Mary and Elizabeth Hospital of Louisville, a Catholic facility Jewish Hospital of Shelbyville, Ky. Our Lady of Peace Hospital of Louisville, a Catholic behavioral health facility Physician groups affiliated with KentuckyOne Health Outpatient facilities mation from KentuckyOne. KentuckyOne was the result of a 2013 merger between two CHI subsidiaries, Jewish Hospital and St. Mary’s HealthCare of Louisville and Saint Joseph Health System of Lexington, Ky. Englewood, Colo.based CHI continued to operate the combined entity after the merger. For a time, the University of Louisville Hospital and the James Graham Brown Cancer Center were part of KentuckyOne through a joint operating agreement but that agreement was dissolved June 30, 2017.

In May 2017, CHI had announced plans to divest of nine of its KentuckyOne facilities — most of them in Louisville — and to retain the remaining eight hospitals in central and eastern Kentucky. The eight that it retained were rebranded in January as “CHI Saint Joseph Health.”

CHI transferred ownership of Saint Joseph Martin of Martin, Ky., one of the facilities slated for sale, to Appalachian Regional Healthcare on June 30, 2018.

CHI had been negotiating to sell the

remaining Louisville-area facilities to the New York-based management firm BlueMountain Capital Management. Those talks ended with no sale. CHI began negotiating with the university last fall.

In June, the university ended talks, saying that it could not secure a partner to help it finance the deal, and it could not put the university’s finances at risk by acquiring the KentuckyOne facilities. The discussions between CHI and the university resumed in August after the state agreed to provide the loan and the foundations agreed to infuse capital into the facilities slated for acquisition.

According to information from KentuckyOne and the university, the terms of the acquisition will enable the university to preserve about 5,000 jobs associated with the acquired facilities and to maintain and strengthen health care in and around Louisville. The university has no plans to close facilities or reduce services, according to information from the university.

CHA Senior Director, Mission Integration and Innovation This position provides thought leadership in the areas of mission innovation and integration. As an interdisciplinary position, the focus is to identify, develop, and coordinate programs, products, and services for ministry leaders responsible for mission integration. Additionally, this position is responsible for connecting mission executives through committee meetings to facilitate the development and sharing of successful practices in these areas. Travel is required.

The Catholic health ministry is the largest group of nonprofit health care providers in the nation. It is comprised of more than 600 hospitals and 1,600 long-term care and other health facilities. To ensure vital sponsorship and a vibrant future for the Catholic health ministry, CHA advocates with Congress, the administration, federal agencies, and influential policy organizations to ensure that the nation’s health systems provide quality and affordable care across the continuum of health care delivery.

Minimum qualifications: CHA is seeking candidates with a minimum of five years working in a leadership position in mission integration at a local, regional, or national health care level. This position requires a minimum of a master’s degree in theology or related field (or equivalent work experience).

To view a more detailed posting for this position, visit the careers page on chausa.org.

Interested parties should direct resumes to: Cara Brouder, Senior Director, Human Resources Catholic Health Association 4455 Woodson Rd. St. Louis, MO 63134 Phone: 314-427-2500 For consideration, please email your resume to HR@chausa.org