Catholic Health World - February 1, 2023

Avera connects with African immigrants through community outreach consultants

By KATHLEEN NELSON

Sioux Falls, South Dakota, is one of the nation’s fastest growing immigrant gateway cities, ranking on the U.S. Census Bureau’s top 10 list in 2019 for immigrant population growth in cities with more than 100,000 residents.

The largest group of immigrants hails from Ethiopia. African immigrants make up the biggest foreign-born cohort in Sioux Falls, followed by immigrants from Mexico, Liberia, Guatemala and Nepal.

Many immigrants and refugees are employed in the meatpacking industry, where English fluency may not be required to perform manual labor jobs. But language skills are important when foreigners attempt to access and negotiate the U.S. health system.

In Sioux Falls, Avera Health’s Adane Redda and Moses Idris are community outreach consultants helping bridge the language and cultural chasm that can keep foreign-born patients from getting essential health care and social services.

Both Redda and Idris were resettled in the U.S. as African refugees. Redda, 73, arrived in Sioux Falls in 1999, having left his native Ethiopia because of political unrest and spending five years in a refugee camp in Kenya.

Idris, 28, arrived in 2010 at age 15 after

Little free pantries 2 Executive changes 7

Activists invite police, clinicians to get to know the locals in challenged Cleveland neighborhoods

By JULIE MINDA

When Barbara Anderson heard about a new “reverse ride-along” program in Cleveland a half dozen years or so ago, she was eager to participate.

In a typical ride-along, a community member spends part of a shift in an emergency vehicle, observing a first responder on the job. The reverse ride-alongs through the streets of Cleveland bring law enforcement officers, clinicians and others together with people who have deep knowledge of the economic injustice Clevelanders face after years of disinvestment and segregation.

Reverse ride-along participants talk about the aspirations, assets and challenges of residents of marginalized neighborhoods and the efforts of community members and nonprofits working to improve the quality of life and opportunities.

PeaceHealth team makes connections for residents at Eugene, Oregon, shelters

By JULIE MINDA

Accessing medical and mental health care can feel like an insurmountable task for people who are unhoused and mired in addiction, mental illness or declining physical health.

A team from a PeaceHealth safety net clinic in Eugene, Oregon, is working with residents of organized homeless communities run by a nonprofit to ease their access to the health system and social services.

“We ask: ‘What are the barriers to care?’ And then we address those barriers,” says Angela Bradley, a nurse practitioner with PeaceHealth Oregon’s Unified Care Clinic in Eugene. “Most of the people we’re working with at the shelter haven’t seen a health care provider in many years.” Most of them have serious untreated medical and mental health conditions, she says.

Transplant centers are adding organs from COVID-positive donors to supply

By LISA EISENHAUER

Dr. John A. Goss admits to having been a bit tense back in late 2021 when Baylor St. Luke’s Medical Center in Houston decided to start using some organs from COVID-positive cadaver donors for transplants.

Goss is medical director of transplantation at Baylor St. Luke’s, the site of the nation’s first successful heart transplant. Goss is also a professor and chief of the division of abdominal transplantation at Baylor College of Medicine. In 26 years, he’s performed more than 2,000 transplants, most of them at Baylor St. Luke’s. The hospital is part of St. Luke’s Health, a system whose

parent is CommonSpirit Health.

Once the medical community figured out how to check the spread of COVID through infection control measures and vaccination, Goss says he and his colleagues at Baylor St. Luke’s decided the need for organs outweighed any potential risks from transplanting organs from deceased donors who had tested positive for COVID but whose deaths were unrelated to the virus.

Since that decision was made in November 2021 and through mid-January, the medical center had transplanted more than two dozen organs — 20 livers, six kidneys and two hearts — from COVID-positive cadavers with no evidence of COVID

Members of the Cleveland Metropolitan Police force take part in one of the first reverse ride-alongs offered in the Ohio city. Participants tour distressed neighborhoods and meet with people who live with the consequences of economic injustice and work for community betterment.

Redda Idris

Residents of one of Community Supported Shelters’ sites gather on the porch of a sleeping hut. Clusters of huts create transitional housing communities in Eugene, Oregon.

Dr. Raquel García-Roca, program director of abdominal transplant and surgical director of renal transplant at Loyola University Medical Center in suburban Chicago, demonstrates robotic technology that she and other surgeons use for transplants. The medical center’s transplant center is among those transplanting organs from COVID-19 positive donors.

Subtract a canned good, add a canned good: little free pantry boxes are multiplying

By LISA EISENHAUER and KATHLEEN NELSON

It took a team to turn Laurie Camper’s idea for erecting and stocking a little free pantry box near Mercy Health — St. Rita’s Medical Center in Lima, Ohio, into reality. “I certainly could never have done this myself,” says Camper, a registered nurse in the surgery department of the hospital.

She says she was putting canned goods into a mini pantry, known as a blessing box, outside of her church on the outskirts of Lima when it dawned on her how needed a similar source of free nonperishable food, personal hygiene products and cleaning items was in the city proper.

“I thought to myself, ‘This is real nice, people can stop here and get things, but we’re maybe not very convenient to the Lima city people who need to have access to a blessing box and probably don’t have very reliable transportation to get outside the city,’” Camper recalls.

St. Rita’s is in the heart of Lima, a city of about 36,000 with a poverty rate of 24.2%, according to the U.S. Census Bureau. That is more than double the national rate of 11.6%.

Camper took her idea for installing a mini pantry box near St. Rita’s to her manager, who shared it with others at the hospital. That led to the formation of a committee with representatives from various departments, including ministry, volunteer and marketing, to oversee and promote the project.

“Everybody reached out and did what part of the project they were good at and had contacts in and with everybody doing what they knew how to do, it pulled together absolutely perfectly,” Camper says.

24-hour access

Ronda Lehman, president of Mercy Health — Lima, says because of community health needs assessments, “we know that food insecurity is a very real problem in many communities and, unfortunately, it’s a very real problem in ours.”

Lehman says Mercy Health — Lima, part of Bon Secours Mercy Health, works with food pantries and with organizations that try to improve access to high-quality food in food deserts, areas without a supermarket, green market or other convenient sources of fresh, affordable foods.

“This (blessing box) was just another outward sign and small way to be able to help people who are in need to have more secure food sources,” Lehman says. Unlike food pantries, which have a much wider variety of products but are open at set times, the outdoor food boxes are accessible at all times.

At least two other Mercy Health hospitals in Ohio, Mercy Health — Anderson Hospital in Cincinnati and Mercy Health — Clermont Hospital in Batavia, have blessing boxes. Both of those were built and installed in partnership with a food pantry, but the stocking of contents is being handled solely by the hospitals.

Little food pantries have been springing up across the country. Their hyperlocal origin and focus make the scope of the pantries and their impact difficult to track. The largest clearinghouse for information on the mini pantry movement is Little Free Pantry, which lists more than 2,300 boxes on an interactive map on its website: littlefreepantry.org.

The website also provides blueprints for building the outdoor cupboards, as well as suggestions for identifying the best location for the pantries and keeping them stocked.

SSM Health joined a partnership on a project called Little Free Food Pantries with the United Way of South Central Illinois and the University of Illinois Extension service by providing funding to stock dry food staples and canned goods in the four pantries in its focus area in Marion and Jefferson counties. To strengthen community buy-in,

Illinois Extension enlisted high schools and 4-H Clubs to build the boxes.

The partners support a pair of traditional food pantries and host a series of food giveaways organized as drive-thru markets staffed by volunteers. Plans call for a dozen little food pantries to be installed in the region.

Julie Robertson-Brooks, SSM Health’s community health specialist in Southern Illinois, says the partners hope the local communities make the little free pantry program their own. “When you need it, you use it, and when you have the opportunity

to give back, you put in supplies for the rest of the community.”

Making giving, taking easy

The team from St. Rita’s also cultivated community connection from the start, enlisting the help of a nearby trade school to design and build the first two boxes. In September the first blessing box was installed at a community garden about a block from the hospital. The second one will be located near another community garden.

To keep the mini pantries stocked, Camper created a cart with a list of needed items — canned and boxed foods, cleaning supplies and hygiene products. The cart rotates among departments at St. Rita’s that have volunteered to fill it and transfer the supplies to the blessing box.

“I have so many generous and caring co-workers at St. Rita’s who will do anything to help somebody else,” she says. “The whole idea of this blessing box was let’s help the community in any way that we can and let’s make it easy for the employees to be able to do it.”

Camper says that as soon as the box was in place and even before St. Rita’s process for keeping it stocked got rolling, the box was filling up with goods. She credits “random people” in the community who were eager to help.

The goods are claimed from the box as quickly as they are supplied. After her father died last year, Camper and her brothers took a load of goods from his pantry to the

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blessing box. “Two days later I went back with a small box of additional things and almost everything that we had put in there was already gone,” she says.

One of the features of the blessing box that Camper especially appreciates is its anonymity. People can claim as much as they want as often as they want without having to prove need. “Nobody says. ‘Take only two things.’ Nobody sets any rules,” Camper says. “If you need it, you need it.”

Upcoming Events

from The Catholic Health Association

Virtual Program: IRS 990, Schedule H — An Overview and Update on Current Tax-Exemption Issues Feb. 22 | 1 – 2 p.m. ET

Faith Community Nurse Networking Zoom Call Feb. 27 | 1 – 2 p.m. ET

Deans of Catholic Colleges of Nursing Networking Zoom Call March 7 | 1 – 2 p.m. ET

Laurie Camper, at right, a registered nurse at Mercy Health — St. Rita’s Medical Center in Lima, Ohio, listens to a speaker during the dedication of a blessing box at a community garden in September. The hospital installed the box at Camper’s suggestion. Hospital employees donate nonperishable food, personal hygiene products and cleaning supplies that are free for the taking from the outdoor cupboard.

Departments at Mercy Health — St. Rita’s Medical Center take turns donating supplies for the hospital’s blessing box.

PeaceHealth outreach

From page 1

The clinic outreach group — which normally includes a family nurse practitioner, nurse case manager, admissions counselor and peer support worker — spends several hours a week at the main hub of Community Supported Shelters, the organization that operates numerous clustered hut encampments around Eugene. The visiting team members provide some basic medical care like wound dressings and they guide individuals in need to primary medical and mental health care at the Unified Care Clinic.

Different brand of care

Unified Care Clinic treats patients who may no longer be welcome at other clinics because of behavior issues, noncompliance with medical instruction or because of drug seeking. “Drug-seeking behavior is common among all populations — it is just more stigmatized when it is a feature of someone who is unhoused or lower income,” says Alex Holmes, a nurse case manager for Unified Care Clinic.

Clinic nurse practitioner Kathy Kernan adds that patients at the Unified Care Clinic “feel they’re not judged by our team, they feel welcomed. We invite them to come in. They can grab a cup of coffee and chat with us. We have same-day appointments. We’re different from others.”

Bradley says that unlike many health care clinics, the Unified Care Clinic will treat patients even if they’re not sober or if they are in a symptomatic mental health crisis.

Clinic staff — usually the peer support specialist or case manager — assists patients in accessing long-term treatment for addiction and mental health problems and social service staff can provide referrals to housing and transportation assistance, job training programs and food aid.

Helping patients secure stable housing and addiction treatment is especially challenging because there is an affordable housing shortage in the Eugene area and wait lists for drug-dependency recovery programs. As clinic staff searches for open slots in treatment programs, Holmes says its clinicians practice harm reduction by providing “nonjudgmental care,” medications to counter opioid cravings, and counseling.

Outreach mission

Holmes says the clinic’s shelter outreach began several years ago. Clinic staff wanted to extend the clinic’s services to people who had no contact with any health provider in the Eugene area. Their first outreach was to a 29-unit transitional living community in Eugene called Opportunity Village. It gives people experiencing homelessness a place to regain a sense of community and some stability as they seek permanent housing.

When the PeaceHealth team had exhausted its list of prospective patients at Opportunity Village, staff there recommended that the clinic team connect with Community Supported Shelters. That organization has established 14 safe spot communities in the Eugene area, with a total of 144 huts. Safe spot communities are “legal, designated places for people who are without a conventional form of housing,”

Clinic welcomes people whose lot in life made care unattainable

Nearly a decade ago, PeaceHealth was seeking a way to provide integrated primary and behavioral health care to patients who have trouble accessing the health system, often because of mental illness, substance dependence and homelessness.

In its Eugene, Oregon, market PeaceHealth recruited nurse practitioner Kathy Kernan to establish a practice geared to these vulnerable people, using grant funding from the Trillium Community Health Plan, a Medicaid coordinated care organization.

Kernan designed the Unified Care Clinic, a primary care and mental health clinic especially for people who are “failing in primary care” by not making or showing up for appointments, and using emergency departments for urgent or routine care.

Alex Holmes is a nurse case manager for the Unified Care Clinic. He says other clinics and providers have refused to continue caring for people with mental and behavioral disorders. The practices may be unprepared to manage erratic behavior or meet the complex comorbidities of mentally ill patients, some of whom are dependent on illicit drugs.

“Primary care providers often feel ill-

equipped to help and prescribe to (these patients) without having access to a psychiatrist or psychologist to assist with the diagnosis and prescription process,” Holmes says.

Holmes says clinics for the indigent often have strict policies that remove patients from their rosters for missing appointments. Patients at the Unified Care Clinic are never dismissed for missing appointments. Holmes says that liberal policy can hurt his clinic’s financials “but is necessary for the population we see.”

Holmes says the Unified Care Clinic accepts patients who have been “violent or otherwise inappropriate” in other medical settings and frequent no-shows at appointments. Clinic staff is patient with them, while adhering to strict safety protocols. The clinic team strives to provide reliable, consistently nonjudgmental care, irrespective of a patient’s treatment compliance or progress. Holmes adds that generally as a patient’s health improves, that person’s life situation and behavior improve.

Kernan has grown her team over the past eight years to include nurse practitioners, case managers, master’s trained counselors, support specialists and

others. The Unified Care Clinic is located in a PeaceHealth Medical Group building across the street from PeaceHealth Sacred Heart Medical Center, University District. The clinic has several provider offices, five exam rooms and about 10 rooms for counselors and other staff.

Patients are usually referred to the Unified Care Clinic from the emergency department of PeaceHealth’s Eugene hospital, from outpatient clinics within the PeaceHealth network or from individual providers within the Oregon Medical Group clinician network.

The Trillium funding ended several years ago, and PeaceHealth since has been picking up expenses not covered by Medicaid reimbursement. Kernan notes Unified Care Clinic saves the Medicaid program money because clinic patients get better care and use the emergency department much less frequently for nonemergency conditions than they did before they had a primary care medical home.

Holmes notes the clinic is mission-driven and losses it incurs due to its liberal no-show policies and other differentiators are subsidized by PeaceHealth foundations, donors and state grants.

— JULIE MINDA

The nurse practitioner can write prescriptions that patients must pick up, usually at the pharmacy of their choice.

Once the residents are linked into the PeaceHealth and Unified Care Clinic system, the clinic team provides comprehensive support to get them mental and medical health services. So far about 20 patients have made the United Care Clinic their medical home, and the team is building trust with others who may one day seek preventive and acute care at the clinic.

Bumpy path to care

Kernan says it is usual for patients at the encampments to have substance abuse issues, mental health needs and unmanaged chronic illness such as uncontrolled diabetes.

according to Community Supported Shelters’ website.

The huts are transitional housing for adults only. Most residents stay about 10 months.

Each hut has a metal, arch-shaped frame, plywood base and vinyl covering. The interior is about 60 square feet, and there is a 20-square-foot porch. The organization says the huts’ “simple design uses a minimum of materials” to achieve a safe shelter option.

The huts do not have air conditioning or running water but provide a buffer from the elements and a secure place to store belongings. The residents can use their own propane heaters. The huts have insulation, and Community Supported Shelters offers residents sleeping bags, wool blankets, socks and hats.

Each camp has a communal kitchen

and port-a-potties. Community Supported Shelters’ main hub, which it calls its Reboot Station, has showers, a closet with extra clothing and hygiene supplies, and coffee and snacks. At the hub is the organization’s main office, where staff, including social service navigators, work. A shuttle runs between the organization’s transitional housing communities and the Reboot Station.

The basics

During their three-to-four-hour visits to the Reboot Station every other week, the PeaceHealth team meets with shelter residents who have signed up for appointments and offers unscheduled visits to those without appointments. If there is a need, the PeaceHealth team stops in at other Community Supported Shelters locations.

At the Reboot Station, the visiting team starts to establish a relationship with the residents and talks with them about their medical and mental health needs. The goal is to prepare them to become patients of the Unified Care Clinic.

PeaceHealth team members complete a baseline assessment of the needs of each patient, creating a record for the individual in the PeaceHealth electronic medical record. Only those not already accessing health care elsewhere are a match for the team’s services. Team members help patients who qualify for coverage to fill out Medicaid enrollment forms. At the Reboot Station, the visiting team’s clinicians can provide basic health screenings, blood pressure checks and simple wound care.

Some of the patients from the encampments cycle in and out of health care as periods of relative stability are punctuated with drug relapses or acute mental illness.

Others, like Jeffrey Thompson, 55, find firmer footing. Thompson is a Community Supported Shelters resident who met with the visiting Unified Care Clinic team in December. He and his wife and their two dogs have been living in huts at one of Community Supported Shelters’ sites since October. The property where they’d previously lived was sold, and the couple is wait-listed for an affordable rental unit from the St. Vincent de Paul Society. Thompson had worked as a landscaper for more than two decades, mainly in the Eugene area, but quit that work last year. His wife is permanently disabled.

Thompson had untreated hypertension for years and has unresolved dental issues. He has visited the Unified Care Clinic multiple times since his initial meeting with the outreach team. He’s getting his blood pressure under control with prescription medication and that could pave the way for him to get his teeth fixed by an organization that told him they could not treat him until his blood pressure was lower. (The Unified Care Clinic does not provide dental care but does help patients access that care elsewhere.)

He says of unhoused people like him: “We need help and can’t get it. It’s very difficult to get health care. But now I’ve found the right people to talk to and continue on the path to get care. I don’t know where I’d be without Community Supported Shelters and the Unified Care Clinic. They are angels.”

PeaceHealth nurse practitioner Kathy Kernan meets with patient Jeffrey Thompson, who lives in a hut at a Community Supported Shelters transitional housing encampment in Eugene, Oregon.

An aerial view of the huts at a transitional housing encampment operated by Community Supported Shelters in Eugene, Oregon.

Kernan

Holmes

Cleveland ride-alongs

From page 1

The participants meet up with more neighborhood residents for presentations and conversations at preplanned stops during the experience. Until his recent departure, Joseph Black led the Sisters of Charity Foundation of Cleveland’s program area for health equity. He notes most of Cleveland’s neighborhoods are poor and segregated. Many police and providers live outside the city boundaries. Black says, “The neighborhoods of Cleveland face economic injustice because of decades of racist and classist housing policy — including the idea of white flight.”

Among the neighborhoods the caravans have visited are Lee-Miles, Glenville, Cudell, Central-Kinsman, Central, DetroitShoreway, Asiatown and Slavic Village.

Immersion

Anderson had to be resourceful raising eight children in Slavic Village. Her family endured antagonism and violence as the first Blacks to move into the all-white neighborhood in 1982. A rock thrown through a window of the home struck one of their daughters in the head. Arsonists set fire to the Andersons’ home so many times that the insurance company canceled their policy.

The family stood fast, staying in their home for decades even after a nearby factory closed. That closure left many neighbors jobless and set off a cascade of home forfeitures. Lots became overgrown and crime increased as the area deteriorated. A similar downward trajectory befell other Cleveland communities impacted by the loss of industry.

The hardship and racial injustice motivated Anderson’s community activism. (See sidebar, page 5.) She has been instrumental in building community support in Slavic Village and other Cleveland neighborhoods, including by founding and running Another Chance of Ohio. The nonprofit operates a store in Slavic Village where all the clothing and merchandise is free for the taking.

Anderson now lives elsewhere in Cleveland. She says she volunteers as a facilitator on the ride-alongs because the immersive experience teaches first responders and health providers about the culture, community and day-to-day lives of people they may later encounter experiencing extreme distress as patients, or as crime victims or perpetrators. Ride-along participants get to know each other as people.

Jan Thrope is executive director of Inner Visions of Cleveland, a nonprofit she founded to encourage entrepreneurship and investments in economically depressed neighborhoods in the city. She came up with the idea for reverse ride-alongs and she partnered with the Sisters of Charity Health System’s Cleveland Central Promise Neighborhood to make them happen.

She says that during the ride-alongs, “there are moments of real talk, moments of sharing truth, moments that move the needle” in building relationships that positively impact the way program presenters and participants relate to one another.

Trading places

Thrope, a retired social worker and chemical dependency counselor, was working in a homeless shelter in 2006, when Cleveland was ranked as the poorest big city in the U.S. The next year, Thrope began tutoring a 7-year-old boy from Woodland Hills, a neighborhood in south Cleveland. He told her there were many things that frightened him in his neighborhood — an abandoned home, a street shrine to a murder victim, dead dogs rotting on curbs.

Thrope began exploring Woodland Hills and other poor neighborhoods. She listened to residents about the impact of poverty and heard about how things might be improved. And she took documentary-style photos, which she published along with commentary in her two books on poverty and hope in the urban core of Cleveland.

Thrope began taking teachers, college students and social workers on outings to meet residents in Cleveland neighborhoods who were actively involved in making positive changes in their communities.

When Thrope went on a citizen ridealong with police officers, she realized the police never saw the neighborhoods at their best nor did they have the opportunity to get to know residents under normal circumstances. That’s when she hatched the idea to drive police officers around and point out the strengths and potential of some poor neighborhoods.

What began as informal drives through select neighborhoods with police, police

cadets and public housing enforcement officers kicked into high gear when Thrope connected with and enlisted the help of Black. He brought the reverse ride-alongs under the auspices of the foundation’s Cleveland Central Promise Neighborhood and expanded their ridership to include nursing students, medical residents and other clinicians from around greater Cleveland.

The Sisters of Charity Health System’s St. Vincent Charity Medical Center has been an anchor in the Central neighborhood. The hospital closed its acute care services in November and the system now delivers ambulatory care services on the hospital campus.

Since 2017, Cleveland Central Promise and Inner Visions of Cleveland have hosted more than a dozen ride-alongs, reaching a total of about 500 riders. Cleveland Central Promise defines itself as a collaboration of organizations united to improve the health, education, safety and financial security of families in the Central community and beyond.

Black says the ride-alongs allow participants to learn the context of one another’s lives and build connections that likely would not happen outside of this program. The program organizers set out to place

ride-along participants and community members on equal footing and help them understand each other’s point of view. Black says the experience is often as beneficial to the residents as it is to those on the caravans.

Lunching, gardening, painting

Each ride-along begins with participants boarding a convoy of vans, each seating about a dozen adults. During the approximately eight-hour experience, as the vans travel through the streets of multiple neighborhoods, Black, Thrope, Anderson and other facilitators provide commentary on the private and public housing, the community nonprofits, food pantries, churches and informal gathering places.

The caravan makes a couple stops, where Black and Thrope have prearranged meetups. The stops are suggested by community leaders and differ each time.

Participants have visited day cares, churches, substance abuse counseling services, community gardens, barbershops, a gang prevention program and a homeless shelter. Each meetup stop centers around a group activity. Ride-along participants have lunched, gardened, created murals and danced with community members gathered at stops.

After each stop and throughout the drives, a facilitator in each van debriefs with the riders to process what they experienced. The conversations at the meetups and on the vans can be very vulnerable, authentic, revealing and raw, say the facilitators.

Breakthroughs

Thrope recalls one ride-along where a group of young Black men at a stop talked with the visiting police officers. One young man said an officer’s stance emphasized his holstered gun and was intimidating. The officer said he positioned himself that way to lift the weight of his heavy holster off his waist. He’d not been aware his stance came across as aggressive.

During another ride-along, conversation elicited a story from a medical resident who’d treated an impoverished patient. She’d been frustrated with the patient’s inability to manage his diabetes and was thrilled when his blood sugar levels finally improved. With emotion the clinician told the group she found out later that the patient’s food stamps had been cut off and his blood sugar dropped because he was starving.

Black says beyond talk of difficult life circumstances, residents also share what’s good about their community — the deep bonds, life-changing social service agencies, youth pursuing their dreams. The seeds for longer-term relationships

Reverse ride-along participants learn about neighborhood dynamics chatting with locals at The Keratin Barber College in Cleveland in July 2021.

gathering

operated by Catholic Charities of the Diocese of Cleveland.

Thrope

Cleveland community activist pursues racial justice as her life’s work

By JULIE MINDA

One of the regular facilitators of the reverse ride-along program is a Cleveland resident who had some national prominence because of her efforts to build up challenged urban neighborhoods and fight against exploitation of people who are poor and vulnerable.

Barbara Anderson’s influence as a grassroots activist has been fueled by her personal experience of violent racism, and by her perseverance, and by pluck. “I’ll just keep moving forward. I don’t have all the education; no letters before or after my name; no degree, except for a high degree of mother wit, street sense, common sense and wisdom,” she told the author of the bio she provided to this reporter. It encapsulates the 40-plus years she has worked to build up Cleveland’s hardscrabble neighborhoods one overgrown lot at a time.

She turned her own pain into righteous action: “I’m just thinking that all my life I have had to experience certain things so that I could properly advocate for others that are struggling,” she says in the bio.

Repeated arson

With her second marriage and dual

incomes, Anderson and her family bought a home in 1982 in Cleveland’s Slavic Village. The first Black family in what Anderson described as a “tight-knit ethnic community,” the Andersons were victims of numerous hate crimes.

One night, fires were set at all three exits to her house. “We weren’t meant to get out,” Anderson says in the bio.

The Andersons instructed their four children to take only one route on their walk home from school so Anderson and her husband would know where to find them. If they did not see their mother waiting on the porch when they got home, they knew to keep moving and get help.

Family tragedy

Anderson’s sister was in the final stage of terminal breast cancer around this time and she and her four children moved in with the Anderson family. The Andersons raised the children after the woman’s death.

Race-motivated violence escalated as more Black families moved into Slavic Village. In June 1985, an arsonist set a house fire that killed Mabel Gant, who was confined to a wheelchair. That night, Anderson answered the family phone to hear a racial epithet and a threat. The caller said they

had gotten Gant and now they’d get her.

“I was fed up,” Anderson says in the bio. “It was no longer about me, it was about Mabel.”

Anderson’s outrage propelled her as she connected with a community-led initiative called National Neighbors that encouraged her to document the assaults on her family. That organization facilitated her appearance on Sally Jessy Raphael’s television show and helped her engage in political activism.

In the 1980s she spoke on racial justice and fair housing in Ohio’s statehouse and testified in Washington before the Senate Judiciary Committee.

Financial travails

The mid-1990s brought crushing financial strain for the Andersons. The house was falling into disrepair and money was tight. The couple refinanced with an adjustable rate mortgage to free up home repair funds. But then Anderson’s husband’s health began to fail him and he had to quit his job. When the subprime mortgage crisis hit, the Andersons’ mortgage rate reset at an amount they couldn’t afford, and the home went into foreclosure.

Almost half the homes in Anderson’s neighborhood were in foreclosure. Yards became overgrown, people used the streets

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Eye-opening

Dr. Chuck Garven has lived in Cleveland for 60 years. The retired family physician went on a ride-along in March. He wanted to learn more about Cleveland’s neighborhoods because he’s on a committee that is advising the Sisters of Charity system’s leadership during the transition of its St. Vincent Charity Medical Center campus to a community health and social service center.

During the ride-along he met a young mother who said she felt many clinicians with patients from Central don’t really care about the people there and that they were not committed to the community.

He says facilitators of his ride-along told him the stereotype of the heartless and unfeeling clinician is common among people who don’t trust the health care system. Garven recognizes that he has on occasion relied on stereotypes in making assumptions about people unfamiliar to him. He says the ride-alongs enabled an honest exchange about implicit bias — a step toward moving beyond stereotypes.

“It’s an opportunity for folks in the community to get to know each other, whatever their title, and build connections and relationships,” he says.

as a dumping ground. Prostitutes and drug dealers set up shop.

Still, Anderson wasn’t giving up on her house or neighborhood without a fight. She challenged her mortgage servicer and had $20,000 in fees and charges refunded to her. She found a neighborhood bank that agreed to assume her mortgage and convert it to a fixed rate with a monthly payment the Andersons could afford.

She guided neighbors to take similar steps to keep their homes. She testified at community meetings about the dangers of predatory subprime loans. At a 2007 presidential campaign forum she told candidate Barack Obama about the racial injustice inherent in predatory lending. She later was featured in a documentary about the foreclosure crisis, “Cleveland Versus Wall Street.”

Anderson started a neighborhood betterment club that did cleanup work, created a neighborhood garden, cut lawns at abandoned properties and organized street parties. The club set up surveillance cameras for use in monitoring and reporting drug dealers. Unarmed neighborhood men patrolled the area. Anderson helped folks from other neighborhoods launch similar neighborhood protections. For her efforts she was named to People magazine’s “Heroes Among Us.”

During a June 2019 gathering at the Fatima Family Center, a reverse ride-along participant hoists up a boy who was taking part in the event. The Fatima Family Center is run by Catholic Charities of the Diocese of Cleveland.

Anderson

Baylor St. Luke’s transplant center ranks high in minority recipients

Eric Figueroa, a successful salsa and Latin jazz artist, producer, composer and family man, spent nine years on dialysis because of polycystic kidney disease, a genetic condition that shut down his kidneys.

In 2017, he moved from Puerto Rico to Texas in hopes of getting better care. It was at Baylor St. Luke’s Medical Center in Houston, part of St. Luke’s Health, that doctors told him he was a potential transplant candidate. St. Luke’s Health is part of CommonSpirit Health.

The transplant team at Baylor St. Luke’s guided Figueroa through the process of getting his name on the national waiting list for a donor kidney. They also worked with him on a nutrition plan that contributed to him losing about 100 pounds, improving his health along with his prospects for a successful transplant.

In April 2022, Figueroa got the call that he says changed his life. It was his transplant team alerting him that a suitable kidney was available. He underwent transplant surgery a day later.

These days, instead of spending the better part of three days each week connected to a dialysis machine and dealing with the resulting exhaustion even longer, the 63-year-old pursues his passions. He’s spending quality time with his wife, children and grandchildren. He’s also back at his piano, performing, composing and arranging music. Over the course of his musical career, he’s contributed to dozens of salsa and Latin jazz albums. He shared a 2002 Latin Grammy for arranging and producing a song on the album that won Best Merengue Album.

“I feel free, away from the machines,” Figueroa says. “And that has helped me so much, physically and also definitely mentally.”

Tackling disparities head on National figures show that Black and Hispanic Americans tend to make up a higher percentage of those on organ waiting lists than of those who receive transplants. Dr. John A. Goss, medical director of transplantation at Baylor St. Luke’s, says the medical center invests human resources to ensure that Latinos and patients from other minority groups have fair access to transplants.

COVID-positive organ donors

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infection or other adverse effects in the recipients. “At the beginning we were kind of nervous, but now we just follow the protocol,” Goss says.

“We really don’t even think about it much anymore because we’ve done so many of them and we know there hasn’t been any spread.”

Evidence-based practice

Transplant centers across the nation have seen similar success in the use of organs from COVID-positive patients, both living and deceased, according to evidence compiled by the Ad Hoc Disease Transmission Advisory Committee of the Organ Procurement & Transplantation Network. The network is the public-private partnership that links professionals involved in the U.S. donation and transplantation system.

The committee’s most recent report covers evidence from various scenarios involving COVID-positive donors. Among the findings it points to is that deceased donors who did not have active COVID symptoms when they tested positive 21-90 days after the onset of the virus “are unlikely to transmit infection.”

Those efforts have brought results, Goss says.

Based on figures compiled by the Scientific Registry of Transplant Recipients, he says, the medical center outpaces many of the nation’s other 250 or so transplant centers in various categories for racial and ethnic minority recipients. For example, more than half of the heart transplants at Baylor St. Luke’s transplant center are for patients who are Black, more than double the national rate of 21.6%. Liver transplants for Black and Latino patients at the medical center exceed the national rate by nearly 20%.

Goss says demographics are part of the reason for the higher percentage of transplant recipients from minorities at Baylor St. Luke’s. Houston is among the most diverse cities in the nation, with large populations of Latino, Black and Asian residents.

That said, Baylor St. Luke’s, Goss says,

has been intentional about getting minorities onto national waiting lists for organ donations. The staff assists prospective recipients throughout the evaluations and appointments that are prerequisites to qualifying a patient to get in line for an organ donation, even checking that they have transportation to appointments.

The transplant team — including doctors, nurses, care coordinators, financial counselors and social workers — has people with the language skills and cultural expertise to connect with people of various ethnicities and backgrounds.

To ensure that patients who aren’t fluent in English comprehend and correctly complete the necessary forms, staff provide additional direct support.

Goss points out that many prospective transplant patients are daunted just by the enormity of the Texas Medical Center campus, where Baylor St. Luke’s is located. On a

ORGAN DONATION IN

104,562

• More than 400,000 people are alive today with a functioning transplant.

• In 2022, there were 42,887 transplants, a record number and almost 4% more than the year before.

• In September 2022, the total number of transplants ever done in the U.S. hit 1 million.

• Half of all the transplants ever performed in the U.S. have taken place in just the past 15 years.

typical day, 250,000 people are on the campus, which is in the middle of a bustling city.

Non-English speakers and those unfamiliar with the campus may find it frightening and overwhelming to navigate, Goss says. “The schedulers and the coordinators and nurses and everybody have to spend a lot of time trying to get these people in the right spot,” he says.

“We try to individualize how we take care of (transplant candidates), so it’s not just a cookie cutter thing where people will fall off the list or kind of fall off the radar,” he says.

After his transplant surgery, Figueroa made a video about his experience for Baylor St. Luke’s YouTube page. In it, he encourages others who might need a transplant to seek out care. “There’s nothing scary about the process,” he says in the short video. “The outcome will always be better than what you’re going through.”

The report goes on to say that the decision on whether to use organs in such cases should factor in several variables, including the recipient’s risk of death or further complications without immediate transplant. Individual transplant centers make the final decision on which organs to accept for transplant.

Maximizing the supply

Dr. Raquel García-Roca, program director of abdominal transplant and surgical director of renal transplant at Loyola University Medical Center in suburban Chicago, says that hospital began using organs from deceased COVID-positive donors in spring 2022. The medical center is within the Loyola Medicine system, which is part of Trinity Health.

García-Roca and the other transplant doctors at the medical center, in consultation with its infectious disease experts, decided that since there were no documented cases of COVID infection transmission through organ transplants, opportunities to help gravely ill patients were being missed by rejecting these organs. “Because the number of asymptomatic (COVID) infections are so high, we ended up losing a large amount of good organs,” she notes.

Through mid-December, GarcíaRoca estimates about 20 liver, kidney and

People who were on transplant waiting lists as of Jan. 15

17 People who die each day waiting for an organ transplant

THE U.S.

Sources: United Network for Organ Sharing and federal Health Resources & Services Administration

Eric Figueroa takes a walk shortly after undergoing a kidney transplant at Baylor St. Luke’s Medical Center in Houston, part of St. Luke’s Health. He had been on dialysis three times a week for years before he got his replacement kidney.

Four days after the surgery, a jubilant Eric Figueroa prepares to ring the bell that patients sound to celebrate a successful transplant at Baylor St. Luke’s. Behind him at left is his wife of 43 years, Wanda Colón.

Goss

García-Roca

“At the beginning we were kind of nervous, but now we just follow the protocol. We really don’t even think about it much anymore because we’ve done so many of them and we know there hasn’t been any spread.” — Dr. John A. Goss

PRESIDENTS AND CEOS

Kevin J. Slavin is retiring at the end of this year as president and chief executive of St. Joseph’s Health of Paterson, New Jersey.

The St. Joseph’s Health Board of Trustees has convened a search committee to oversee a national search for his successor.

Ascension has made these changes: Tim Adams to regional operating officer and senior vice president for Ascension, overseeing facilities in 10 states. He was president and chief executive of the Ascension Saint Thomas subsystem in Nashville, Tennessee. Fahad Tahir will succeed Adams as Saint Thomas president and chief executive. Tahir was chief strategy officer of Ascension and president and chief executive of Ascension Saint Thomas Hospital Midtown and West campuses in greater Nashville.

Bon Secours Mercy Health has made these changes: Brian Gwyn to president of Mercy Health’s Cincinnati market, effective Feb. 6. He was Atrium Health senior vice president and west market president. Gwyn succeeds Dave Fikse, who retired last year.

Andrew Morgan to president of Mercy Health — Tiffin Hospital and Mercy Health — Willard Hospital in Ohio. He had been interim president since July. Sonya Selhorst to president of Mercy Health — Defiance Hospital in Defiance, Ohio. She had been interim president since July.

Stephanie Manson to Our Lady of Lourdes Health market president, from chief operating officer of Our Lady of the Lake Health. Our Lady of Lourdes is based in Lafayette, Louisiana, and Our Lady of the Lake Health is based in Baton Rouge, Louisiana. Both are part of Franciscan Missionaries

of Our Lady Health System.

Jeffrey Methven to president and chief executive of St. Mary’s Healthcare in Amsterdam, New York. He was executive vice president of Saratoga Hospital/Albany Med Health System in New York. Methven succeeds Scott Bruce, who is retiring.

Dr. Timothy Quinn to president and chief executive of Mercy Cedar Rapids, Iowa. He was executive vice president and chief of clinical operations. He replaces Timothy Charles, who retired Dec. 31.

Kelly Morgan plans to retire this summer as president and chief executive of CHI Mercy Health in Roseburg, Oregon. CHI Mercy parent company CommonSpirit Health is conducting a national search for his successor.

ADMINISTRATIVE CHANGES

Kathy Donovan to chief operating officer of Hospital Sisters Health System of Springfield, Illinois.

Ken James to market chief operating officer of Mercy Health — Cincinnati, part of Bon Secours Mercy Health.

Matthew Brandt to chief financial officer of Saint Francis Healthcare System in Cape Girardeau, Missouri.

Tamera Larsen-Engelkes to chief nursing officer at Avera McKennan Hospital & University Health Center in Sioux Falls, South Dakota.

St. Mary’s Healthcare in Amsterdam, New York, has made these changes: Raquel “Rocky” Parisi to vice president of nursing and chief nursing officer. Patricia “Trish” Sanders to vice president of operations and chief operating officer.

Melanie Campbell to vice president of

institutional advancement, philanthropy and community engagement for Mercy College of Health Sciences in Des Moines, Iowa. The college is part of Trinity Health.

GRANTS

Among the recipients of federal funds from the omnibus bill President Joe Biden signed Dec. 29 are three ministry members: Holy Name of Teaneck, New Jersey, has received a $3.3 million federal appropriation to launch a graduate medical education program. Holy Name plans to use the funding to train 90 doctors per year in clinical specialties including internal medicine, psychiatry, general surgery, obstetrics and gynecology, orthopedics, nephrology, and palliative care. The money will fund the purchase of equipment for the residency program and pay for some facility renovations. The residency program will launch in 2025.

Marian Regional Medical Center in Santa Maria, California, has received $1 million in federal funding in support of an obstetrics and gynecology residency program clinic Marian is opening this spring. The money will help cover the costs associated with medical equipment and construction fees for the clinic. The clinic will provide prenatal and postpartum care, birthing education, lactation support, counseling programs, women’s preventive care, and management for acute and chronic gynecologic conditions. The clinic will primarily serve low-income women. It will have full-time Spanish and Mixteco translators. Marian is part of CommonSpirit Health.

St. Joseph Healthcare of Bangor, Maine, was awarded $708,000. The facility will use the funds to upgrade mammogram equipment.

CONSTRUCTION

Trinity Health Michigan plans to build a replacement hospital at its campus in Brighton. Inpatient and outpatient services will be relocated from the aging Trinity Health Livingston hospital in Howell to Trinity Health Medical Center – Brighton. Construction begins later this year on the four-story, 174,000-square-foot hospital. It will have 56 acuity-adaptable beds, 18 short stay unit beds, and eight operating rooms. The existing Brighton facility also will be renovated. The three-year construction project will cost about $238.2 million.

T a k e y o u r p a ss i o n f o r a d v o c a c y t o a l l l e v e l s o f h e a l t h c a r e

pancreas transplants from COVID-positive donors have been done at Loyola University Medical Center without any cases of infection transmission. Recipients of the organs have fared as well as those whose donors did not test positive for COVID, she says.

“If you ask, ‘Is the organ worse because of the COVID?’” García-Roca says, “we haven’t seen any difference whatsoever.”

The Loyola transplant team’s protocols for the use of organs from COVID-positive patients include informing patients when an available organ is from a donor who has tested positive for the virus. Patients choose whether to accept the transplant. After their surgery, recipients are tested for COVID three days after the transplant and again four days later.

Even with the COVID-positive donors added to the pool, García-Roca points out that the need for organs outpaces demand. “We are all trying to optimize and maximize all types of donors,” she says of transplant centers. “Even with all the strategies that we do, still, there’s a lot of people that are sitting on the waiting list and who actually die waiting for an organ.”

The Health Resources & Services Administration, part of the U.S. Department of Health and Human Services, says 17 people die every day in the United States waiting for a transplant.

Neither Loyola nor Baylor St. Luke’s is using COVID-positive organs for lung transplants as they await more evidence on the safety of such transplants. In its report, the Ad Hoc Disease Transmission Advisory Committee of the Organ Procurement & Transplantation Network says of COVIDpositive lung transplants: “The only confirmed donor-derived transmissions have been through the airway; demonstration of non-airway transmission has not been confirmed at this time.”

Experience has benefits

More than a year after its start, Goss says Baylor St. Luke’s integration of COVIDpositive organs into the hospital’s transplant supply continues to go smoothly. Lonnie Dunlap, the recipient of the first COVID-positive transplant at the medical center, is an example of its success. Dunlap passed the first anniversary of his life with a

new liver in November.

Before his transplant, Dunlap’s health had been slipping since his liver began to fail in 2017. His condition left him bloated and in need of weekly procedures to remove fluid that filled his abdomen. He now sends Goss and others on the team that did his transplant pictures of himself deep sea fishing for yellowfin tuna. “He’s doing great,” Goss says.

Part of Baylor St. Luke’s COVID protocol is to ask all organ recipients to stay up to date on their vaccinations for the virus before transplant. After the surgery, the patients are screened for symptoms of the virus for three weeks.

The doctor points out that, over its long history of organ transplantation, Baylor St. Luke’s has adopted protocols to keep organ recipients safe from many viral contagions, including herpes simplex, Epstein-Barr and other coronaviruses.

“That’s been a benefit to the entire transplant system, having to work with viruses for years already,” Goss says. “It wasn’t too much of a stretch to adopt a protocol for COVID patients as well.”

Slavin

Morgan Parisi

Manson Adams Selhorst

Sanders

Quinn

Tahir Methven Campbell

Donovan

“We are all trying to optimize and maximize all types of donors. Even with all the strategies that we do, still, there’s a lot of people that are sitting on the waiting list and who actually die waiting for an organ.”

— Dr. Raquel García-Roca

Outreach for immigrants

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fleeing Eritrea. Members of the Kunama minority, his family lived in a refugee camp in Ethiopia for a decade before coming to America.

“I didn’t have an opportunity to learn English back home,” said Idris, who speaks fluent Kunama and English now but joked that as a refugee in Ethiopia, he “picked up some English words from movies — all kinds of bad words.”

Connecting to Avera

Before joining Avera, Redda worked in refugee resettlement at Lutheran Social Services’ Center for New Americans. He speaks Arabic, Amharic, Oromo, Russian and English, and helped resettle Idris’s family in Sioux Falls.

Idris said he developed an interest in a health care career in high school, where he attended his first formal English classes, and thought he could help his community if he became a medical interpreter. He became familiar with Avera in 2018 after suffering a work-related injury that required he undergo surgery on both knees. His college career, part-time job and coaching youth soccer were put on hold.

“When I wasn’t able to do any of that, it destroyed the confidence that I had,” Idris said. “I wasn’t communicating with my family or eating well, so my family took me to Avera.”

He spent three weeks at the Avera Behavioral Health Center, he said, where “the doctors don’t judge, and they want to help you. That’s where I found God’s grace. You put your trust in God because he created you to do great things.”

Idris and Redda were interpreters for Avera in the early days of the pandemic, when the system collaborated with social service organizations to provide information on testing, symptoms and treatment to employees at a large meat-processing plant where there was a COVID-19 outbreak. “In two weeks, we had reached everyone,” Redda said. “I believe we saved many lives.”

Julie Ward, Avera’s vice president of diversity, equity and inclusion, was especially grateful for the interpreters during a drive-thru COVID testing event. “Moses, Adane and several others stepped up and spent three days in the cold rain, helping everyone through testing,” Ward said. “We could not have done it without them. If I had an opportunity to hire them, I wasn’t going to let it slide by.”

The interest was mutual, as both Idris and Redda approached Ward about working at Avera. She hired Idris as an intern in the summer of 2020 before he returned to college to finish a bachelor’s degree and start a master’s in health care administration. He was working part-time in patient care at Avera when the position of community outreach consultant was created. He applied and started in November 2021. Redda was hired in January 2022.

A typical day

Both men provide interpretation on a daily basis for patients, employees and the community. Redda visits hospitalized patients at their bedsides to help them understand insurance benefits and the care they are receiving and to answer questions about follow-up care when they are ready to be discharged.

“This is not the way they got health care back home,” Redda said of the employment-based U.S. health insurance system. “It is very difficult to understand their benefits. They need support,” someone who understands not just the health care financing system, but their cultural frame of reference.

“Patients are surprised to see me because they didn’t ask for help, and they’re happy when I ask if they need anything,”

Redda said. “They are surprised to learn that we have such (personalized support) services, but it is the kind of thing we do to bridge the gap between patients and Avera.”

The two also represent Avera at job fairs, helping job seekers with limited English proficiency fill out applications, and they assist new Avera employees with limited English language proficiency fill out paperwork and complete orientation.

They represent Avera in meetings with leaders of the African immigrant communities. “We meet with them to see how we can connect more and how we can improve health care,” Idris said. And as they make those connections, they cultivate trust in an unfamiliar system. “When you don’t grow up in this health care system, there’s not a lot of trust.” Idris added that the trust is rein-

forced when he can connect immigrants with social and wraparound services as well as medical services.

Redda traveled in spring 2021 to an Avera clinic in Marshall, Minnesota, to assist clinic managers in a meeting with leaders of the Oromo ethnic community of Ethiopians. Oromo leaders discussed the supports they thought would be of immediate benefit: an interpreter at the clinic who speaks Oromo, transportation to appointments, sending reminders to patients about upcoming appointments.

“In my opinion, it was successful because the clinic manager understood the issues and offered many ways to help improve the health care,” Redda said.

As a youth soccer coach, Idris maintains supportive connections with young immi

grants, helping them adapt to their new country and culture and providing an adult presence while their parents juggle multiple jobs in the struggle to earn a living. “Parents will do whatever they can to provide for their kids, take any job and work long hours,” Idris said. “But the kids need more support from their parents, and there’s a lack of connection there. I’ve been trying to help out with the soccer program, and Avera has been supporting me in that work.”

Expanding to community health pilot

Idris and Redda both completed training as community health workers and are contributing to a pilot program Avera launched in November to help immigrants understand the importance of regular checkups and the coverage benefits available through their health insurance. The pair assists four Avera community health workers who are natives of Mexico, South Sudan and Eritrea. Among the goals is to build trust and encourage immigrants to use preventive care and annual wellness exams, to seek help before health concerns become urgent.

Ward said, “We can help our immigrant groups learn to navigate the Avera system and help educate them about the importance of primary care. But the only way that happens is through trust. And Moses and Adane are two of the most trusted members of their communities.

“I have learned more from these two than they have learned from me. They are so patient with my many questions. They are so generous with their time and knowledge, and are so willing to help us learn. They know their culture but are also immersed in