Catholic Health World - July 1, 2020

CHA 2020 VIRTUAL ASSEMBLY COVERAGE PERIODICAL RATE PUBLICATION

JULY 1, 2020 VOLUME 36, NUMBER 7

A threshold moment requires trust in God, letting go of what has been

Racial disparities in health brought to fore by COVID-19

By LISA EISENHAUER

By SR. MARY HADDAD, RSM CHA president and chief executive officer

The coronavirus pandemic, which is the greatest public health crisis that most of us have faced in our lifetime, has presented Catholic health care with immense and unprecedented challenges in the span of just a few months. It has also demonstrated once again how our healing ministry steps up and rises to the call to care during a crisis.

While the challenges of responding to COVID-19 will remain with us for the foreseeable future, we have already seen the same unwavering commitment by our caregivers that Continued on 2

Martha Simmons, the first COVID-19 patient admitted to CHRISTUS Ochsner St. Patrick Hospital in Lake Charles, Louisiana, is discharged with a celebration on June 12 having spent almost three months in the hospital. The pandemic has taken an especially harsh toll on African Americans.

By JULIE MINDA

In the view of futurist Jamie Metzl, the world will never be the same after the pandemic — it will be transformed either for the better or for the worse. Speaking as the keynote for CHA’s virtual Catholic Health Assembly June 8, he said that it is incumbent upon the Catholic health ministry to advocate rebuilding that is done for the better — that is, in the name of the common good.

The world that existed before the pandemic “is not coming back, at least not in the same way it was,” Jamie Metzl said Metzl. “And the question for all of us now is: Can we — while we fight this pandemic — can we begin to lay the foundation for the kind of world we would like to live in?”

He said the pre-pandemic world was replete with inequity and injustice, and society’s most vulnerable were not protected. The nation and the world can come back from the pandemic with a much better system that provides protections for everyone, not just the advantaged.

Continued on 10

Continued on 12

CHA lauds frontline health care workers at virtual assembly

By LISA EISENHAUER

Assembly keynote speaker says ministry must help lay just foundation for nation’s rebuilding

Pamela Mitchell-Boyd remembers exactly when the breadth of the racial disparities of the coronavirus pandemic hit her full bore.

It was April 6 and she was listening to a press conference on the coronavirus by Chicago Mayor Lori Lightfoot. Among the statistics the mayor cited, Mitchell-Boyd recalls, was that more than half of the Chicagoans who had tested positive for COVID-19 and 72% of those who had died from the virus were black, and that’s in a city where African Americans make up 30% of the population.

“When these numbers presented themselves it just became astounding and I knew that our health system needed to address our patient population and understand how the disease was affecting the people that we care for,” said Mitchell-Boyd, system director of diversity, inclusion and language services for Ascension’s AMITA Health.

She reached out to colleagues within the Chicago-based system. They quickly set up a team with executives, advocacy leaders, and analytics and research specialists to compile demographic data from AMITA’s 19 hospitals and 200 other care facilities about patients who had tested positive for the coronavirus. The team hopes to use data on

Although the pandemic kept health ministry leaders from gathering in person at CHA’s annual Catholic Health Assembly for the first time in 105 years, hundreds convened online June 8 for an inspiring and forward-looking virtual version of the event.

At 90 minutes, the online gathering was a much-shortened stand-in for the planned 2½-day meeting in Atlanta. Nevertheless, it served to rally senior leaders of Catholic health systems and hospitals across the U.S. who along with health care workers everywhere have spent most of the year fighting the spread of the deadly novel coronavirus and grappling with the pandemic’s toll on lives, communities and economies.

“The founders of our health ministries had the courage to move beyond their known reality. They responded to God’s call and trusted in God’s abiding presence,” Sr. Mary Haddad, RSM, CHA’s president and chief executive officer, said in her opening remarks. “Today, we, too, are called to trust God; to embrace what is emerging in Catholic health care; and to have the courage to step through the threshold into a new reality.”

Workers at risk sionate care for patients and families; its “I’d like to begin by recognizing all the demand for an ethical allocation of coroheath care workers who have given so navirus tests, medical supplies and other much in service to those resources; and its advoimpacted by COVID-19,” cacy for funding to supSr. Mary said in her comport Medicaid, long-term ments, which followed a care, safety net hospitals video homage to the staff and affordable health of Catholic hospitals and insurance. nursing homes caring for The assembly’s openpatients with COVID-19. ing reflection was given “On behalf of the entire

by Archbishop José H. ministry, I offer our heartGomez of Los Angeles, felt appreciation and president of the United gratitude.”

States Conference of CathShe compared their olic Bishops. Before offerselfless service to that of Archbishop José H. Gomez of Los ing a prayer for all those the religious women who Angeles, president of the United suffering from the panfounded and sustained States Conference of Catholic demic, he addressed those Catholic health care dur- Bishops, gave the opening reflection health care workers on the ing times of national cri- at CHA’s virtual assembly. He thanked front lines saying, “I hope sis, including the Civil War health care workers on the front lines you know how grateful we and the Spanish flu pan- of the pandemic. are and how much we are demic of 1918. indebted to you.”

“Our response to this pandemic demonstrates that the mission of Catholic health Disparities and protests care has never been stronger,” Sr. Mary said.

Sr. Mary said that COVID-19 has underShe added that the Catholic ministry scored the disparities in health outcomes continues the healing ministry of Jesus in based on race and economic status. She many ways, including through compasContinued on 7

Rural hospitals work to stave off financial hit of pandemic

By LISA EISENHAUER and JULIE MINDA

While some organizations are warning that the COVID-19 pandemic could spell doom for many rural hospitals that were already on shaky financial ground before the crisis, several executives with rural Catholic hospitals say they expect their organizations to withstand the health emergency with government help.

In April, the National Rural Health Association warned of more trouble ahead. The

organization said nearly half of rural hospitals were losing money before they added to their financial precariousness by canceling nonemergency services because of the pandemic. “The rate of rural hospital closures, already at crisis levels preCOVID-19, will soon escalate to cataclysmic rates,” the association said.

Twelve rural hospitals closed in the first five months of the year, eight of them in March and April, and 18 closed last year, according to the North Carolina Rural

Health Research Program at the University of North Carolina at Chapel Hill.

Many hospitals and health systems have gone public about their financial woes related to the national emergency. Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana, said in a press release in mid-April that it expected its net revenue losses for April and May to be about $120 million.

Rene Ragas, president of FMOL’s Our Continued on 11

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CATHOLIC HEALTH WORLD July 1, 2020

ASSEMBLY 2020

CHA members elect three new board members during Membership Assembly During CHA’s annual Membership Assembly — this year held virtually June 8 — CHA members elected three new board members and installed new board leadership.

The new members are: John A. Capasso, executive vice president of Trinity Health of Livonia, Michigan, and president of Trinity Health’s continuing care division.

Sr. Sharon Euart, RSM, canon lawyer and executive director of the Resource Center for Religious Institutes in Silver Spring, Maryland.

Bob Sutton, president and chief executive of Avera Health of Sioux Falls, South Dakota.

Each was elected to a three-year term.

Capasso

Sr. Euart

Sutton

During the Membership Assembly, members also named Dr. Rhonda Medows the association’s chairperson elect. She is president of population health management for Providence St. Joseph Health of Renton, Washington.

Two board members’ terms ended: Michael Slubowski and Karen Reich.

Slubowski is president and chief executive

Medows

Slubowski

Reich

of Trinity Health, a past CHA board chair and outgoing speaker of the Membership Assembly for the association. Reich is chief executive and system senior services executive for Bon Secours St. Petersburg Health System of St. Petersburg, Florida.

The Membership Assembly also included the election of Julie S. Manas as CHA board chair. Her term officially begins

Sr. Mary From page 1

is the hallmark of our founding congregations. Our doctors, nurses, chaplains, and all of our colleagues who are caring at the bedside or supporting this sacred work reflect the enduring values of justice, compassion, preferential option for those who are poor and marginalized, respect for life, and the common good.

The early history of Catholic health care in the United States is replete with stories of religious women who demonstrated a selfless commitment to care for patients during wars, epidemics and times of extreme scarcity.

The chapter of Catholic health care being written today contains stories of tireless and selfless service, stories of caring communities, stories of being a voice for those unable to be heard, and stories of removing barriers to care for all regardless of ability to pay or immigration status. Through these collective actions we continue the mission of Catholic health care.

And while we can be proud of our work so far, we also need to recognize how this pandemic has exposed issues of health disparity and focused a bright light on the importance of a strong public health system. It also has demonstrated the dire need for health care financing reform. These are challenges that we must confront head-on and with the same determination and courage that we’ve exhibited in responding to the needs of COVID-19 patients.

Editor’s note Dear reader, This issue marks Catholic Health World’s return to print after a 3-month, pandemicrelated hiatus when we didn’t have access to essential graphic design equipment and software. We’ve continued to publish stories about the Catholic health ministry’s response to the pandemic in our online edition at chausa.org/chworld. We hope you’ve made it a habit to read the paper online and will continue to visit the website even now that the newspaper is back in your mailbox or inbox. We’ll add fresh content online between print issues.

The Catholic Health World team is delighted to have the paper back on the press in time to publish the profiles of CHA’s inspiring 2020 award winners. The outstanding work and achievements of these individuals brings to mind what Margaret Mead said about a small group of thoughtful, committed people being the only thing that has ever changed the world. The global pandemic, and protests around the world demanding racial justice, remind us that much work remains in shaping the world for the better. Stories in this issue leave no doubt that CHA members are determined to be a catalyst of that change.

— JUDITH VANDEWATER

The Incarnate Word Foundation is displaying four billboards with this message in and around St. Louis on behalf of St. Louis Catholic Sisters. Thirteen congregations are partnering in the project. The billboards will be up for eight weeks.

Although chronic conditions such as diabetes, obesity, asthma and hypertension are some of the reported risk indicators for COVID, it is well documented that underlying social conditions including inadequate health care, poverty, unemployment, unaffordable housing, and food scarcity have put individuals at greater risk.

The fact that black Americans account for 13% of the U.S. population, yet represent 25% of all coronavirus deaths underscores the harsh reality of health disparities in this country. Lending our voices to the calls for racial justice that have cried out across this country in recent weeks is not enough — we must take action to ensure that equal access to public health and safety, and to highquality care, is a fundamental human right.

We also know that the pandemic has exacerbated the fear, isolation and financial turmoil being felt by so many and has highlighted the mental health issues confronting our society. Unfortunately, COVID has also

disproportionately impacted the frailest among us, with 32,000 coronavirus deaths linked to nursing homes where, once again, racial disparities were revealed. Again, lending our voices on behalf of expanded mental health coverage and services, and adequately funded eldercare programs and long-term care is needed — but so is action to make sure that better public policy is enacted and put into practice.

With all these challenges before us, it is clear that we are at a threshold that we must boldly step through.

During the virtual Catholic Health Assembly last month, I referenced the book The Soul’s Slow Ripening, in which the author, Christine Valters Paintner, tells us that in the Celtic tradition thresholds are the thin times or places where heaven and earth are closer together, and the veil between the two worlds is very thin. The author goes on to say that thresholds are challenging because they demand that we

Upcoming Events from The Catholic Health Association Human Trafficking Networking Call

Catholic Ethics and the Challenge of COVID-19 Webinar Series Part 11: Ethical Trials and Tribulations of Evaluating New Therapeutics

July 17 | Noon ET

Formation in a Virtual World July 23 | 1:30 p.m. ET

July 2 | 1 p.m. ET

Deans of Catholic Schools of Nursing Networking Call July 16 | Noon ET

Formation Community in Practice Webinar Session 1: Our History July 28 | 1:30 p.m. ET (invitation only)

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

Manas

Sexton

with the start of the fiscal year on July 1.

She is president of Ascension St. Vincent’s North Region. With her installation, outgoing Board Chair Kevin Sexton becomes speaker of the Membership Assembly. He is the retired president and chief executive of Holy Cross Health of Silver Spring.

step into the in-between place of letting go of what has been, while awaiting what is still to come. Thresholds are rich and graced places of transformation.

The founders of our health ministries had the courage to move beyond their known reality. They responded to God’s call and trusted in God’s abiding presence.

Today, we too are called to trust God, to embrace what is emerging in Catholic health care, and to have the courage to step through the threshold that is now before us.

The healing ministry of Jesus continues through our compassionate care for patients and families, including end-of-life care; it is expressed through our demand for an ethical allocation of resources including testing, medical supplies and a soon-to-be vaccine; and it is heard through our public voice, advocating for funding in support of Medicaid, affordable health coverage and residential care and hospitals, especially safety net hospitals.

COVID didn’t teach us anything we didn’t already know, but it has fueled our will to act. And as an essential ministry of the Catholic Church, we are impelled to act by stepping forward to bring our patients, our communities and nation to a greater wholeness.

Catholic Health World (ISSN 87564068) is published semi­monthly, except monthly in January, April, July and October and copyrighted © by the Catholic Health Association of the United States. POSTMASTER: Address all subscription orders, inquiries, address changes, etc., to Kim Hewitt, 4455 Woodson Road, St. Louis, MO 631343797; phone: 314-253-3421; email: khewitt@chausa.org. Periodicals postage rate is paid at St. Louis and additional mailing offices. Annual subscription rates: CHA members free, others $55 and foreign $55.

Opinions, quotes and views appearing in Catholic Health World do not necessarily reflect those of CHA and do not represent an endorsement by CHA. Acceptance of advertising for publication does not constitute approval or endorse­ ment by the publication or CHA. All advertising is subject to review before acceptance.

Vice President Communications and Marketing Brian P. Reardon

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July 1, 2020 CATHOLIC HEALTH WORLD

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ASSEMBLY 2020 ACHIEVEMENT CITATION

Alaska CARES’ holistic treatment helps young abuse victims recover and thrive When someone reports maltreatment of a child in the greater Anchorage area, Alaska CARES is at the ready to help coordinate a response that is both compassionate and culturally sensitive.

CARES is an acronym for Child Abuse Response & Evaluation Services. The program sponsored by Providence Health & Services Alaska and coordinated through The Children’s Hospital at Providence in Anchorage provides treatment in a facility where several organizations use their separate expertise to assess, plan and manage the care for victims and the law enforcement response and where a variety of resources are readily available.

“All the different agencies that are in the building are purposefully here because we are all working together to support children and families,” says Jessica Nichols, Alaska CARES’ assistant manager.

For its innovative, collaborative approach to helping ease the suffering for young victims of maltreatment and their families by streamlining the care and investigation process, Alaska CARES is the 2020 recipient of CHA’s highest annual honor — the Achievement Citation. The award presentation will take place at the Catholic Health Assembly in Indianapolis in 2021.

The 2020 annual assembly was held virtually June 8 because of the coronavirus pandemic.

Culturally appropriate response At the Alaska CARES facility, children who suffer any type of maltreatment, including sexual and physical abuse and intimidation, undergo medical, mental and forensic assessments and examinations by professionals trained to work with young victims. After the initial evaluations, the victims and their families can be referred for care or assistance to counselors and social service programs, some of which have offices in the same facility as Alaska CARES. Among the advantages of having the various organizations under one roof is that forensic interviews of the victims can be done by one person with input from representatives of the other organizations who are in separate monitoring rooms. That process avoids the need for victims to repeatedly relive their trauma through duplicative interviews for criminal complaints and child welfare agencies.

In addition to coordinating its efforts with state and local law enforcement and with Alaska’s Office of Children’s Services, Alaska CARES works with and gets support from the Southcentral Foundation, a nonprofit health care and social welfare organization that is run and funded by native Alaskans. The foundation has an advocacy team based at the Alaska CARES facility.

Photos by Stephanie Cook/© CHA

By LISA EISENHAUER

Jessica Nichols, Alaska CARES’ assistant manager, stands next to the butterfly wall at the facility in Anchorage, Alaska. The wall was inspired by a 4-year-old who was a patient in the program, which helps children recover from physical and sexual abuse. While in therapy, the child said: “I hope my caterpillars turn into butterflies.”

“Since it was founded in 1996, Alaska CARES has helped approximately 21,000 children escape from abuse and begin more positive and productive lives,” Providence says in its narrative nominating the program for the Achievement Citation.

Dr. Cathy Baldwin-Johnson, former medical director of Alaska CARES, says the high rate of child maltreatment is fueled by significant rates of substance and domestic abuse, historical trauma, and social isolation in Vibrant art brightens the halls, offices and waiting rooms at the nation’s largest and largely Alaska CARES. Some of it depicts the state’s wildlife and landrural state. scapes. Many of the artworks were made by local artists.

“We also have a number of people, for example, who come “They’re there to get those families up and do seasonal work or who come up into appropriate services,” Bryant Skinner, through the military, and often when peoAlaska CARES’ director, says of the South- ple move here to Alaska for whatever reacentral Foundation advocacy team. “They son, they don’t have extended family with have access to services that we would not them,” Baldwin-Johnson says. have access to, so having them here working with those families is extremely important.” Child-friendly facility In the spring of last year, Alaska CARES High rate of dysfunction moved into a new facility specifically Alaska is among states with the highest designed for the services it and its colrate of child maltreatment in the nation.

A report released in January by the U.S. Department of Health & Human Services put the rate of child victims of maltreatment in Alaska at 14.2 per 1,000 in 2018. Nationwide, the rate was 9.2. Alaska CARES assists about 1,000 patients from newborn to age 18 every year.

Bryant Skinner, director of Alaska CARES, displays a toddler’s shoe from a kids’ closet at Alaska CARES. Sponsored by Providence Health & Services Alaska, the program helps abused children and their families recover from their trauma.

Most of the program’s annual operating budget of $2.3 million also comes from Providence, as part of the health system’s community benefit effort. “It’s a missiondriven program in terms of serving the poor and vulnerable in our community and statewide,” Skinner says.

Skinner and Nichols are among the program’s 23 full- and part-time staff members, who include administrators, doctors, nurse practitioners, forensic interviewers, forensic nurses and family advocates.

Alaska CARES is accredited by the National Children’s Alliance as one of 881 child advocacy centers nationwide and one of 13 in Alaska. To be accredited, the nonprofit alliance requires a program to follow its model and set up a “child-friendly facility in which law enforcement, child protection, prosecution, mental health, medical and victim advocacy professionals work together to investigate abuse, help children heal from abuse, and hold offenders accountable.”

Easing the way Baldwin-Johnson says the child advocacy center model pairs well with Providence’s efforts to smooth the way from treatment through recovery for patients.

For young abuse victims and their families, that can mean helping them through the child protection process and the legal process and connecting them with follow-up medical and mental health resources.

“I think all of this really follows that easing-the-way model,” Baldwin-Johnson says. “And really this facility is designed for that and the staff is highly trained to do that.”

The strategies used in extended care for clients include art therapy and pet therapy from a dog named Kiska, who helps put some children at ease.

From anger to peace A story Providence uses to highlight Alaska CARES services to the greater Anchorage community is about Kimi (not her real name). She started therapy in the program when she was 8 after being sexually abused by a neighbor along with a younger sister. The girl was able to escape from the room where the neighbor was abusing them, but her younger sister couldn’t get away. The older girl told someone what had happened, and the abuser faced criminal prosecution.

One of the girl’s first drawings was a tight red ball of scribbles that she described with the words “anger, hurt, sad, guilt, nervous, scared.”

After a year of therapy, she drew a painting with three animals, one much smaller than the others, on a background with a sky, grass and a sliver of sun. She called it “Peace.”

In nominating Alaska CARES for the Achievement Citation, Providence says that by giving A polar bear pediatric exam table is one of the many child-friendly feaKimi and other traumatures intended to make patients feel safe at Alaska CARES. Professionals tized children the tools, trained to work with young abuse victims provide medical, mental and guidance and support forensic assessments as well as therapy at the facility. they needed to navigate their way through many laborators provide. Among the child- and complicated emotions, “Alaska CARES family-friendly features in its offices are changed the trajectory of their lives.” private waiting rooms so families in crisis Nichols adds, “When kids are seen here can have their privacy. Colorful murals and and they’ve been able to go through the other wall art provide a playful touch to put process — the forensic interview, medical young patients at ease. exam — sometimes they will look a little difProvidence provided a $12.8 million ini- ferent, they’ll stand a little taller, talk a little tial capital investment for the facility, much different, just because they’ve been able to of that raised through a capital campaign share their story of what happened to them led by the Providence Alaska Foundation. and they’re not carrying that burden on Community partners and donors helped them anymore.” raise more. leisenhauer@chausa.org

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CATHOLIC HEALTH WORLD July 1, 2020

ASSEMBLY 2020 SISTER CAROL KEEHAN AWARD

Graf believes that everyone deserves a safe, affordable place to call home

By MARY DELACH LEONARD

The lucky one Graf joined Mercy Housing in 1992 to lead the organization’s California regional office when the housing development offices of Catholic Charities and Mercy Housing merged. She was named president and chief executive of Mercy Housing in 2014.

Although she is retiring this summer, Graf plans to stay involved in the affordable housing sector and hopes to mentor young leaders. She serves on a number of boards of housing nonprofits, including the National Housing Trust.

Graf has helped thousands of people through her work, but she insists that she is the lucky one.

“People are unbelievably brave and resilient, and the strength I get from meeting folks who have survived some pretty tough stuff is profound,’’ Graf said.

It never gets old watching people, who have struggled for years, move into their new homes, she said.

“Those are amazing moments,’’ Graf said.

“It’s really hard to get anywhere in life if you don’t know where you’re going to sleep, or if you’re living in conditions that are so horrible you just can’t get a break.’’

Graf, who grew up in Minneapolis, knew from a young age that she wanted a career helping people. She credits her parents

Photos courtesy of Mercy Housing

For more than 40 years, Jane Graf has championed efforts to provide safe, affordable housing for vulnerable Americans — the elderly, people with special needs, lowincome families and those experiencing homelessness — because good health and a good home go hand in hand.

“You can’t be healthy and not have a decent place to live,” said Graf, president and chief executive of Mercy Housing, the nation’s largest affordable housing nonprofit.

“Everybody — I don’t care who they are — deserves a decent place to live,’’ she said during a recent interview. “It’s just so basic to the human condition that if we can’t do that, what is the matter with us?’’

In recognition of her lifelong service, Graf is the recipient of the inaugural Sister Carol Keehan Award. The award was created in honor of Sr. Carol, who retired as CHA’s president and chief executive officer last year. Throughout her life, Sr. Carol has been a champion of social justice and health care access for all — regardless of means, race, religion or creed. The award, which will be given annually, is earmarked for an individual who has boldly defended the poor and vulnerable, and courageously championed a cause that advanced the public good.

Due to the coronavirus pandemic, and the resulting need for CHA to host a virtual Catholic Health Assembly this year, Graf and other 2020 CHA award winners will accept their awards in person at the 2021 Catholic Health Assembly in Indianapolis.

Graf’s commitment to social justice is unwavering, said Charlie Francis, chief strategy and transformation officer for CommonSpirit Health. He serves on the board of trustees of Mercy Housing and has known Graf for years.

“The work that Jane is focused on to make sure that there’s affordable housing for the vulnerable populations is foundational to who she is, and it is foundational to the common good and Catholic social teachings,’’ Francis said.

He describes Graf as one of the best leaders he knows.

“She’s an incredible human being with a capital ‘H.’ She’s very approachable, very real,’’ Francis said. “Her passion and her commitment to making the world a better place — and to the Mercy Housing mission and employees — is very, very deep.’’

programs with health care providers.

Among her many firsts: While working for Catholic Charities in 1987, Graf became one of the first in the nation to use the groundbreaking Low-Income Housing Tax Credit. She tapped it to develop the Peter Claver Community in San Francisco for lowincome residents who have HIV/AIDS. In 2001, Mercy Housing’s 93-unit Presentation Senior Community complex in San Francisco became one of the first in the Bay Area to incorporate an on-site day health and activity center and in-room support aimed at replicating assisted living not available for low-income seniors. As a result, elderly residents are able to live independently and avoid premature placement in nursing homes.

Jane Graf visits a Mercy Housing construction site in California in August 2006.

with teaching her about fairness and social justice.

“I always had whatever I needed,’’ she said. “It wasn’t that we were wealthy, it was just that we had support. And seeing people without support, I had a lot of empathy for that.’’

‘No’ is the wrong answer After graduating from the University of Minnesota in the mid-1970s with a degree in sociology, Graf helped people with intellectual disabilities find jobs. She quickly recognized that housing was a major obstacle preventing them from living independently and reaching their potential. If they made too much income, they no longer qualified for subsidized housing and resources, something they would always need.

Graf decided that if she wanted to make a difference, she would need more knowledge. She attended graduate school at the University of Oregon, earning a master’s degree in public affairs with a focus on housing issues that affected people with disabilities.

Looking back, Graf recalls a pivotal moment that fans her persistence to this day.

While serving as a housing specialist for the Association for Retarded Citizens of Oregon, Graf was determined to expand housing for people with developmental disabilities. During a meeting with a state housing agency official, he told her there were no resources — and he saw no role for nonprofit organizations in such an effort.

“It just infuriated me,’’ Graf said. “Nobody was going to do it. But there was no role for a nonprofit. And I thought, ‘Are you kidding?

Because you can’t imagine this, it won’t be done?’’’

Graf convinced three statewide nonprofits to back her concept. In 1981, she founded Specialized Housing Inc., a nonprofit housing development corporation in Oregon that serves people with developmental disabilities.

Learning on the fly Graf describes herself as one of a generation of “self-taught’’ housing advocates who learned to utilize resources and think creatively.

“When I got into the business, I took a commercial real estate course — the only thing that was available,’’ she said. “I knew literally nothing other than the need was acute.”

To learn the ropes, Graf assembled a board with diverse expertise.

“I got one of everything I thought I needed — a Realtor, a guy who owned a construction company, a developer, a land use attorney, a banker,’’ she said. “They taught me the real estate business.’’

Graf also began forming partnerships with other nonprofits and government agencies — and she developed innovative

Calculated risks Graf credits the mentorship of the late Sr. Lillian Murphy, RSM, whom she succeeded as chief executive of Mercy Housing, for encouraging her to be a courageous advocate for social justice.

“She was so good when it came to recognizing that you needed to take risks if you were going to get anything of any significance done,” Graf said.

Mercy Housing, established in 1981 and based in Denver, is sponsored by eight communities of Catholic sisters dedicated to social justice and serving the needs of people living on the margins of society. Mercy Housing, which operates in 41 states, is one of the nation’s largest providers of housing for the formerly homeless and many of its buildings incorporate social services.

“The sisters are fearless,’’ Graf said.

“There is this feeling that if we see a problem and just because nobody knows how to fix it, that doesn’t mean we shouldn’t put resources to it and try to figure out how to respond.’’

Honor in work Val Agostino, who recently retired as Mercy’s senior vice president of community impact and health care partnerships, said of Graf, “The riskier and scarier and harder something seemed, the more she would grasp onto it and figure out how to make it happen.’’

Agostino said Graf rolls up her sleeves and pitches in. That includes helping staff at a Mercy property distribute food to residents who were hit hard by the economic fallout of the coronavirus pandemic. “It’s a really motivating thing for the people we’re sending out to the front lines to know that the CEO of the organization gets that what they’re doing is important.’’

In this circa 1999 photograph, Jane Graf, far left, then president of Mercy Housing California; Suzanne Swift, chair of the Mercy Housing board; and the late Sr. Lillian Murphy, RSM, chief executive of Mercy Housing, accept a donation from the Sisters of Mercy of the Americas.

Safe at home In a sense, the pandemic has intensified the importance of affordable housing.

“The only healthy, safe place is your home,’’ Graf said. “I mean, that’s what this whole thing has been saying to us. ‘You are not safe, and you can’t be healthy anywhere else right now.’’’

Throughout her career, Graf has steered organizations through turbulent times, but nothing approaches a worldwide pandemic, she said.

“I used to tell folks that this is guerrilla warfare. You’ve got to come at it from every angle because there isn’t a single answer,’’ she said. “It’s also going to take the ability to be flexible and to listen hard and make decisions when you really don’t know what the answer is because we’ve never been here before.’’

July 1, 2020 CATHOLIC HEALTH WORLD

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ASSEMBLY 2020 SISTER CONCILIA MORAN AWARD

Casey ensures that medically fragile children get individualized emergency care

By MARY DELACH LEONARD

Patricia Casey adds the hashtag #OneKidCounts to social media posts about her groundbreaking program that connects St. Louis area children who have special health care needs with the first responders who answer their emergencies.

The hashtag encapsulates Casey’s belief that all children are entitled to everything it takes to care for them during an emergency, no matter how complex their medical issues. It has become the motto for the Special Needs Tracking and Awareness Response System, known as STARS, that Casey coordinates at SSM Health Cardinal Glennon Children’s Hospital in St. Louis.

When children leave the hospital, STARS writes individualized emergency care plans that are shared with EMS personnel in their communities.

Casey, a longtime St. Louis paramedic, helped develop STARS. Like many in the world of emergency medicine, she recognized that most EMS training is geared toward adults and is rarely about children with medical conditions that fall outside traditional emergency protocols. Casey set out to supply first responders with critical information before they arrive at a child’s house.

For her trailblazing efforts on behalf of children with specialized medical needs, Casey is the recipient of the 2020 Sister Concilia Moran Award. Named for a visionary leader in Catholic health care, this CHA annual award recognizes an individual who has demonstrated creativity, leadership and breakthrough thinking that advances the Catholic health care ministry. Casey will accept her award in person at the Catholic Health Assembly in Indianapolis next year.

“There is no typical special needs child,’’ Casey said. “One of the most important aspects of caring for patients with complex medical needs is knowing what is normal for them. It’s tough when you have a kid that doesn’t breathe like other kids and doesn’t move like other kids and doesn’t have the same color because they don’t have as much oxygen in their blood.’’

STARS now serves more than 700 highrisk children, from infants to 18-year-olds, throughout Missouri and Southern Illinois at no cost to the family and regardless of their child’s hospital affiliation. Many of these children depend on home ventilators and tracheostomy tubes. They have medical conditions ranging from severe neurological or genetic disorders to cardiac issues and autism. The STARS database — the first of its kind in the nation — is integrated into 911 dispatching systems so that first responders arrive prepared to provide emergency support.

Connecting EMS and the ER “If there’s ever been a circumstance of one person making a difference for many, this is it,’’ said Shawn Dryden, vice president for pediatric ambulatory services for SSM Health at Cardinal Glennon. “It really is a very simple concept. But it is one that’s not being met across the country. It has taken somebody like Tricia, who cares enough about this patient population to be willing to take on the 5,000 barriers that have prevented it from

tors and tracheostomies because that’s their airways — that’s what keeps them alive,’’ she said. “I always made sure to immediately go to their caregivers and include them in the care. I would ask, ‘Hey, what do you see going on? Do you see that he’s deviating from his normal state?’’’

Casey also experienced emergency medicine from a parent’s perspective after one of her daughters was born with a rare form of epilepsy and a mild bleeding disorder.

“Her seizures are not typical, and a lot of physicians or nurses in emergency rooms would not recognize that she was having a seizure,’’ Casey said. “So that really, really worried me that I would be at work and she would potentially be having a seizure and no one would recognize it.’’

After a fellow paramedic who lived in her district had a baby with cardiac and lung issues, Casey began searching for a solution.

“This was a baby coming home to the district that I worked in, and I really wasn’t comfortable,’’ she said. “I didn’t know what type of emergencies he was likely to have and I didn’t know how to fix them.’’

Patricia Casey poses with Carlie, a tracheostomy patient in the Special Needs Tracking and Awareness Response System. Casey organized the STARS program to equip and train EMS personnel in the St. Louis area to respond to emergencies involving medically fragile children.

being resolved or addressed, up until this point.’’

Casey’s experience as a paramedic helped her bridge the gap between hospitals and the EMS community, Dryden said.

“Tricia genuinely cares about these children as if they’re her own,’’ he said. “She makes the time to not only connect to the kids, but to connect with their families.

And to connect with the first responder community.’’

Casey credits pediatric emergency medicine doctors at Cardinal Glennon for recognizing the value of STARS. She joined the hospital staff five years ago to develop STARS and still works part time as a paramedic with a St. Louis city ambulance unit.

She works on the ambulance to keep her skills fresh, and to stay in touch with EMS colleagues, she said. Plus, she loves helping people as a paramedic.

STARS has attracted interest from health care systems around the nation — Dryden says SSM Health is contemplating how to deploy its STARS database not just across

this region, but across the country. Casey frequently speaks about the program at conferences.

Special needs, extra consideration “There is no ‘Easy’ button,’’ Casey said about the preparation required to respond with maximum competence to the acute needs of chronically ill children in an emergency. “Everybody’s been looking for an ‘Easy’ button to fix this for years. It’s actually going to take education and time and each child must have a team of people to develop their emergency plan. That’s just how it is.”

Casey points to a 2016 survey in which 62 percent of St. Louis area paramedics reported no formal training on tracheostomy emergencies. So, training is a key component of STARS. Casey can’t point to one lightbulb moment that inspired her to develop STARS. There were many.

“It’s something that I was aware of very early in my EMS career — the gap of knowledge. And, not just for pediatrics but for any patient who had special needs,’’ she said.

Casey remembered seeing her father, who had a rare neurological disorder, struggle to get appropriate emergency health care.

“The emergency room became a frightening, uncomfortable place, and you could not wait to get out of there, and back to your specialist who could actually manage your loved one’s care,’’ she said.

Ask the experts During EMS training, Casey worked in a hospital’s ICU department with patients who needed ventilators and tracheosCasey, right, coordinator of the STARS program at SSM Health Cardinal Glennon Children’s Hospital, tomy tubes. visits a station in the Florissant Valley Fire Protection District in suburban St. Louis along with “So, I had a speSTARS patient Jason Minor, then 11, and his mother, Anita Minor. Jason has a STARS profile to tell cial consideration for EMS personnel about his medical history and special care requirements. people with ventila-

Scared to death At first, Casey used an emergency information form for special needs pediatric patients developed by the American Academy of Pediatrics. She created a colorcoded folder system so dispatchers could relay information to paramedics responding to calls.

Today, even as the STARS program has adopted more sophisticated technology, Casey remains focused on the basics: ensuring that emergency care for frail children is appropriate to their needs because they can be harmed by overtreatment, as well as undertreatment.

For parents like Jamie Masinelli, whose son has special medical needs, STARS has been life changing. Her comments were among the tributes included in the form nominating Casey for the Sister Concilia Moran Award.

“It means that I can call 911 and just be his mom,’’ Masinelli stated. “If I’m calling 911, it’s because I know I can’t get him to the hospital in enough time and I am scared to death for my son.’’

Until STARS trained her local EMS personnel, Masinelli felt it was her responsibility to get her son to the hospital.

“STARS removed the burden from us, and we are so grateful. It is comforting to know that I can call 911 and give his STARS number and they can pull up his medications and have his emergency care plan in front of them before they even arrive at our house.”

Know your patient Chris Torno, a firefighter and paramedic, works with Casey in his role as STARS coordinator with the Eureka, Missouri, Fire Protection District. About 15 children in the district are enrolled in the program.

“Any question we have, Tricia is just a text message, phone call or email away,’’ Torno said. “Coming from EMS herself, she knows the different things that we need to know before we even see the patient.’’

Several times a year, Casey conducts training sessions for the district and encourages the first responders to meet with STARS children before they have an emergency.

Most of the district’s emergency calls are to assist adults, including many older adults, Torno said. Their needs are very different from STARS patients.

“With the STARS program, we have set guidelines,’’ he said. “It really takes the stress of the call off your back and allows you to think clearly and provide the highest quality of care.’’

6

CATHOLIC HEALTH WORLD July 1, 2020

ASSEMBLY 2020 LIFETIME ACHIEVEMENT AWARD

Nurse-ethicist-professor identifies most of all as a healer

By NANCY FRAZIER O’BRIEN

Johnny Cox has had many jobs during his lifetime: nurse, ethicist, professor, hospice director, mission leader, health system sponsor. But the role he most identifies with is healer.

“I always sensed a calling to be a healer, primarily from the example of my mother, who was a nurse,” said Cox. The retired vice president, theology and ethics, for St. Joseph Health system in Orange, California, continues to serve as chief ethics adviser for the Alliance of Catholic Health Care in Sacramento.

Cox, 76, is the 2020 winner of CHA’s Lifetime Achievement Award. Due to the coronavirus pandemic, and the resulting need for CHA to host a virtual Catholic Health Assembly this year, Cox and other 2020 CHA award winners will accept their awards in person at the 2021 Catholic Health Assembly in Indianapolis.

Growing up in California, Cox saw his mother and the entire family caring for his younger brother, Brian, who suffered a grand mal seizure at age 3 and experienced a lifetime of epilepsy seizure disorder, leaving him severely developmentally disabled.

Johnny and Barb Cox both had vocations in the Catholic health ministry. The couple worked together for a time in mission leadership at St. Joseph Health in Orange, California.

“He lived at home with us until it was impossible,” with three other children born into the family after him, Cox said. “My family’s life revolved around caring for him. My mother’s compassionate nursing and the family’s commitment to Brian were imprint events on my life.”

Brian, who died at the age of 55, lived in institutions and group homes after he could no longer be cared for at home.

Groundbreaker, mentor Cox’s professional life has been a series

age said. “I didn’t see myself in a leadership role, but he prodded me and others to develop into those leadership roles, tapping on whatever our skills were.”

Johnny Cox

of firsts. He was hired by Gonzaga University in Spokane, Washington, in 1972 as the first person to teach ethics as a theological discipline. After hearing about the concept of hospice, he helped establish and then directed Hospice of Spokane, one of the first dozen hospices in the United States. Sacred Heart Medical Center in Spokane (now Providence Sacred Heart Medical Center & Children’s Hospital) hired him as the first ethicist employed full time in a community hospital in North America, and he later was appointed as the first vice president of mission for Providence Services. (Providence Services joined with Providence Health System to form Providence Health & Services. St. Joseph Health merged with Providence Health & Services in 2016 to form Providence St. Joseph Health.)

Barbara Savage is president of Providence Ministries, one of the two public juridic persons of Providence St. Joseph Health. She served with Cox on the original sponsor board of that public juridic person.

She first met Cox when she was his student at Gonzaga in the early 1970s and helped him found the Hospice of Spokane. She said one of his greatest gifts is the encouragement and support he gives to colleagues that helps them recognize and grow their own leadership skills.

“I was a bedside nurse in ICU and I would have never imagined myself being an integral part of forming a hospice,” Sav-

Love and devotion But above all else, Cox is “very, very much a family man,” Savage said. “His family has always been his heart and his focus.”

Cox and his wife, Barb, have four grown children — Brian, Sarah, Mike and Dan — and 10 grandchildren. The couple had worked together in mission leadership at St. Joseph Health in Orange, and also worked for competing health systems.

“For Barb and me, our state of life was marriage and family, but our vocation was in the healing ministry,” he said. “We were much better together than we were apart.”

Both now retired, they divide their time between Phoenix and Spokane after Johnny Cox vowed to “never shovel snow again.”

Cox chafes at the notion of health care as simply a career, noting that the word “career” has the same root as “careen” or a car “heading in your own direction.” “But a vocation is never an individual calling; it’s always a calling into a community,” he said.

Professor Cox and son Brian in the young professor’s office at Gonzaga University in Spokane, Washington.

Along with sponsor colleagues from Providence Ministries, Johnny Cox, center, joins with sponsors of St. Joseph Health Ministry as both groups sign the covenant establishing Providence St. Joseph Health.

Faith-based community of care He sees one of the greatest threats to Catholic health care in an erosion of its understanding as a service and the view that it is just another “commodity in a marketplace.” The main challenge for Catholic health care ethicists today and in the future is “to strengthen and fulfill the commitments” of the first three directives of the Ethical and Religious Directives for Catholic Health Care Services, he added.

Those directives state that Catholic health care must be a community “animated by the Gospel of Jesus Christ and guided by the moral tradition of the church,” must be delivered “with the compassion of Christ” and must distinguish itself by service and advocacy to the most vulnerable in society.

With the commodification of health care and the secularization of society, Catholic ethicists and health care leaders “will be challenged with deepening the foundations of their work in our faith tradition and making it explicit in their work,” Cox said.

“Many good, committed people are attracted to us because they see a valuesdriven organization committed to the common good,” he said. “But in addition to being values-driven, Catholic health care must be a faith-based community of persons serving with the compassion of Christ the most vulnerable in our society.

The unseen erosion of Catholic health care would be satisfaction with a values-driven organization and not a faith-based community infused with God’s love and Jesus’ healing ministry.”

Lifelong teacher and learner William J. “Bill” Cox, president and chief executive of the Alliance of Catholic Health Care, which represents 16% of all California hospitals, said Johnny Cox (no relation) “has helped me enormously in understanding Catholic moral tradition and how it is to be applied to Catholic health care.” He also helped the California bishops navigate complex ethical issues in health care for many years by consulting and editing a bioethics brief distributed to the bishops.

Johnny Cox also taught for many years in the Ministry Leadership Center formation program based in Sacramento, a consortium of several Catholic health systems that educated some 1,000 chief executives and senior executives, Bill Cox said.

The formation program no longer exists because each health system has incorporated it into in-house training programs, he added.

Sr. Katherine “Kit” Gray, CSJ, met Johnny Cox in the early 2000s when she was general superior of the Sisters of St. Joseph of Orange and he was vice president, theology and ethics, at St. Joseph Health.

“I learned from him different ways of thinking, styles of presentation, ways of engaging people in the ethical conversations that health care entails,” she said.

“As a nurse, he brought wonderful clinical experience to these very important conversations: what are the ethical principles and how do we apply them in real life?”

Sr. Gray also described Cox as a “lifelong learner” and said he is “always looking for the next thing to think about.”

Asked about that description, Cox said his current focus is “learning about Sabbath — God’s rest — by experiencing it.”

Because his work with the Alliance of Catholic Health Care “is not very timeconsuming,” he said, “I have the time and the opportunity to gaze without interruption on the faces of the people I love, my family and friends. And I feel gratitude and delight for the beauty and goodness I find in them.”

July 1, 2020 CATHOLIC HEALTH WORLD

7

ASSEMBLY 2020

CHA lauds pandemic workers From page 1

noted that the mortality rate of black Americans from the virus has been 2.4 times that of white Americans. She also noted that nursing home patients have died at a disproportionately high rate from the virus than the population at large.

“COVID didn’t teach us anything we didn’t already know, but it has fueled our will to act,” Sr. Mary said. “And as an essential ministry of the church, we are impelled to act and bring our communities to wholeness.”

Sr. Mary also referenced the courage of peaceful protesters who have taken to the streets across the nation since late May demanding an end to police brutality against blacks and changes in policing practices and budgets. “It takes courage to change our perceptions and to walk in solidarity with those crying out for change,” she said.

Strategic plan revised Kevin Sexton, outgoing board chair, listed some of the highlights of the last year for CHA. One was the work under way to draft the next strategic plan for the association. Sexton, the retired president and chief executive officer of Holy Cross Health, said the “four overriding strategic directions” of the plan are: Increase access to health care, especially for the poor.

Enhance the health of the communities served by Catholic health care.

Help CHA member institutions and systems to thrive.

Speak to and strengthen the Catholic identity of health ministries.

“Our original goal was to provide you with a completed plan at this meeting, but the board has wisely determined that the tactics behind these strategic directions should be finalized after taking stock of the post-COVID world,” Sexton told the audience. He added that the crisis has revealed not only the disparities for the poor and for people of color in the nation’s health care system but shortcomings in how the system is financed that shift costs and prioritize market strength over improved health.

He said flawed financing policies have led to skyrocketing Medicare and Medicaid spending that dwarfs spending in areas that also are critically important to health, including education and housing.

“We must confront this challenge of matching resources to our most important mission aims, but we do so at a time of great risk to the institutions we love,” Sexton said. “As a result of COVID, many need immediate help and CHA will advocate for that help.

“At the same time, we need courage to push for broader long-term change as a society, a government, and an industry or we will not, with the best of intentions or individual actions, make our society sufficiently healthy or fair.”

Rapid response Julie S. Manas, president of Ascension St. Vincent North Region, was commissioned for a one-year term as CHA’s board chair.

Manas expressed confidence that Catholic health ministries will withstand the current challenges. For inspiration, she cited what she said was one of her favorite Bible passages, Jeremiah 29:11: “For I know the plans I have for you, declares the Lord, plans to prosper you, and not to harm you, plans to give you hope and a future.”

Manas said the pandemic has cost lives, including that of her brother-in-law, shuttered businesses, put people out of work and taken away the health insurance of many. But she noted that it has prompted remarkable displays of hero-

experiences,” she said.

Many hospitals are operating under financial duress related to the pandemic. Manas said it is important that Catholic hospitals survive and thrive. She noted that one in seven hospital patients, many of them “poor, vulnerable, marginalized and voiceless,” receive care in a Catholic facility.

“Yes, it will be difficult.

Yes, we are up for the challenge,” she said. “And yes, here we are, taking one day at a time.”

Other highlights of the assembly included videoSr. Mary Haddad, RSM, CHA president and chief executive officer; Julie S. Manas, CHA’s new board chair and president taped messages from three of Ascension St. Vincent North Region; and Kevin Sexton, the association’s outgoing chair, share the screen during CHA’s CHA board members: virtual Catholic Health Assembly on June 8.

Karen Reich, Dr. Rhonda Medows and Darryl Robinthe hands of their patients weakened by son. (See sidebar.)

“Yes, it will be difficult. Yes, COVID-19 so they can see and hear family Futurist Jamie Metzl said in his keynote we are up for the challenge. members via FaceTime. Manas said that presentation that U.S. health care could COVID-19 spurred rapid changes in health be on the verge of transformative change And yes, here we are, taking care delivery infrastructure that enabled and that Catholic providers should play physicians to shift patients to virtual office an active role in making sure that change one day at a time.” visits, a shift that was implemented with advances the common good and benefits — Julie S. Manas remarkable speed. the poor and vulnerable.

“I have never been more proud to be a ism and compassion, such as the stories of part of our Catholic health system, for all leisenhauer@chausa.org nurses in Catholic hospitals gently bracing of those heartwarming, and heartbreaking

CHA board members point toward a sharper focus on social justice T

he coronavirus pandemic that has been CHA and its members must continue to Expanding technology use fundamentally altering life in the U.S. advocate at every level of government for Dr. Rhonda Medows is the association’s for months and the civil unrest that has policies that root out institutional racism, board chair-elect and president of populabeen shaking the nation for weeks are add- he said. “We’ll be most effective when we tion health management for Providence ing urgency to long-standing failings in the advocate for the common good.”

St. Joseph Health of Renton, Washington. health system and introducing unexpected She said in a prerechallenges.

Elevating long-term care corded video that the In comments delivered during the virDuring the virtual assembly three pandemic has made it tual Catholic Health Assembly June 8, CHA CHA board members offered insights clear that population leadership provided indications about how and framed concerns in prerecorded health — the health and the association likely will sharpen its focus remarks that Sexton and Manas well-being of the people on social justice, particularly as it relates responded to live. in communities — to addressing health disparities, improvOutgoing CHA board member must remain a priority. ing health care access and creating more Karen Reich called for the nation to Health inequity must diverse workplaces. prioritize the well-being of vulnerable be addressed, includKevin Sexton, outgoing CHA board elders, rather than downplaying their Dr. Rhonda Medows ing by engaging social chair, incoming speaker of the needs. services, community organization’s Membership AssemReich, chief execuresources and social supports, she said. bly and retired president and chief tive and system senior Technologies and technology applicaexecutive of Holy Cross Health of services executive for tions such as telehealth, telepsychology, Silver Spring, Maryland, said what Bon Secours St. Petershome monitoring and artificial intelthe nation needs is “major healing burg Health System of ligence can be applied to greatly expand change. We in Catholic health St. Petersburg, Florida, how populations of people are cared for, care have a great opportunity to discussed the especially Medows said. contribute to that change, and we harsh toll that the panIn his video commentary, CHA board must respond. I believe we will.” demic has taken on member Darryl RobinKaren Reich frail patients in longson, senior executive Addressing disparities term-care facilities vice president and Sr. Mary Haddad, RSM, CHA president and what is needed now to safeguard chief human resources and chief executive officer, said Catholic patients and staff. Her recommendaofficer of Chicagohealth care will “need to be strategic and tions include prioritizing the availbased CommonSpirit more intentional about providing access to ability and distribution of personal Health, said that it will care for everyone in our communities.” protective equipment to long-term be important to assess Julie S. Manas, incoming CHA board care providers and widespread and what has been done chair and president of Ascension St. Vinfrequent coronavirus testing of all right and what can cent’s North Region, said that in line with residents and staff.

Darryl Robinson be done better when CHA’s goal to reduce health care dispariReich also said long-term care it comes to the ways ties in the U.S., the board will meet in late sites need better guidance on reopenthe ministry has been using technology July to discuss how the association and its ing and that, over the longer term, these to alter how it delivers care amid the panmembers can best address disparities — facilities will need to have their liability demic. He cautioned though, that moving not just with words, but also with action. concerns addressed. forward, health care providers should not Sexton said Catholic health care sysManas said that the ministry needs to let technology dominate the care experitems and facilities must begin, or deepen, support long-term care institutions and ence. efforts to hire, promote and train a diverse ensure elders have a voice, especially in “Technology should be a complement staff. The ministry must always ensure Catholic health care. to providing great hands-on care, and diverse voices are heard in decision-makSexton agreed that long-term care frankly I think that’s what makes Catholic ing including on frontlines as the care is must be respected as a vital part of the health care unique,” Robinson said. delivered. health care system. He said a big issue Sexton said he is optimistic this can be Sexton said it’s important that Catholic to pay attention to as a policy priority done. He added that of the challenges and health providers locate their services in is making sure long-term care facilities opportunities involved with progressing in communities most in need and that are paid in a fair manner by government this time of great change, “I believe Cathothey thoroughly evaluate how and why insurers. And, he noted, the reimburselic health care is made for this time. Let us health outcomes differ among populament should be linked more closely with move forward together.” tions in order to address root causes of quality indicators.

— JULIE MINDA those disparities.

8

CATHOLIC HEALTH WORLD July 1, 2020

ASSEMBLY 2020 TOMORROW’S LEADERS

CHA recognizes and celebrates contributions of Tomorrow’s Leaders

By KATHLEEN NELSON

Grounded in tradition and faith, each member of the CHA 2020 class of Tomorrow’s Leaders is advancing the work of the founders of the Catholic health ministry.

Their intelligence, resourcefulness and enthusiasm will help Catholic health care navigate through the challenges that lie ahead, and do so with an unblinkered commitment to care for the poor and vulnerable. Here is a look at the contributions of this year’s honorees.

Natalie Blum

System director, quality and infection prevention, PeaceHealth, Vancouver, Washington

Natalie Blum arrived at PeaceHealth with a blueprint to develop systemwide standards for quality and patient safety. She says she stayed because of the mission.

“I don’t know if I knew what the mission was where I worked before,” Blum says Blum, 35. At PeaceHealth, “the mission is in everything we do. It’s in my quality plan; it’s in every tool kit for best practices. With my public health background, the focus we have on the health of the communities and the compassion we have for community members seems like a natural fit. I could never go back.”

To put her blueprint in action, Blum assembled teams of leaders and caregivers, each focused on a specific quality or safety metric. Each team collected best practices within the system, researched and compared them to best practices nationally, then developed a standardized approach to quality improvement that included detailed weekly reporting on each metric. In 18 months, PeaceHealth achieved a 47% reduction in hospital-acquired pressure injuries, a 42% reduction in catheterassociated urinary tract infections and a 33% reduction in central line-associated bloodstream infections.

“It was exciting to see that and to see how engaged the teams were,” Blum says.

She also assembled a team to develop rapid management Code Sepsis protocols for emergency departments throughout PeaceHealth and has started a pilot program using electronic health records and predictive modeling to identify admitted patients at risk of sepsis. All Code Sepsis patients get antibiotics within 60 minutes of risk identification.

“Natalie has a real knack for getting out in our networks and building relationships,” says Dr. Mark Hallett, senior vice president and chief medical officer for PeaceHealth.

“She demonstrates compassion and understanding for what it’s like to be an operational colleague by knowing not only what we need to accomplish at an organizational level, but also what that will take in terms of support and how challenging it will be for our caregivers.”

Lindsay Flannery

Vice president, patient care services, Avera Sacred Heart Hospital, Yankton, South Dakota

Initially trained as an intensive care unit nurse, Lindsay Flannery built her health care management skills as administrator of two critical access hospitals in South Dakota, Avera Flandreau Hospital, near the Flandreau Santee Indian Reservation, and Avera Dells Area Hospital in Dell Rapids.

“Critical access administrators wear so

many hats,” says Flannery, 38. “The variety brought me energy and enthusiasm, as well as much learning.”

She helped organize a prayer team at Avera’s Dell RapFlannery ids hospital. Members visit and pray with patients, and the group also gathers daily to pray for patients, colleagues and community needs.

In Flandreau, Flannery learned to address subtle racism and raise cultural sensitivities with “delicacy and conviction,” says Kara L. Payer, vice president of mission at Avera Sacred Heart Hospital. Flannery’s personal outreach in a capital campaign that helped fund expansion and renovation of the hospital as well as a new clinic and offices in Flandreau made contributors feel a sense of ownership and pride, no matter the size of their gift.

“Underlying all of her hard work and leadership is her heart to serve those less fortunate. I am a better person, Flandreau is a better place, and people are still impacted because of Lindsay’s leadership,” says Dr. Scott N. Peterson, who practices family medicine at Avera Medical Group and Avera Flandreau Hospital.

Since moving to her current role overseeing clinical care at Avera Sacred Heart, Flannery has improved efficiency by combining medical and surgical nursing units. She helped launch the Mentoring in Motion program, which pairs experienced nurses and new graduates, and has increased employee retention in all nursing units. Flannery is adept at consensus building, a skill she puts into practice as liaison between Avera and independent providers.

“I have the fortune of working with an incredible team at Avera Sacred Heart and across the Avera Health footprint,” she says, “intelligent, genuine, skilled individuals, striving to make a positive impact in the lives of our patients and residents.”

Wendy Gaudet

Director of pharmacy, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, a member of Franciscan Missionaries of Our Lady Health System

Shortly after joining Our Lady of the Lake in 2013, Wendy Gaudet was charged with opening three pharmacies as well as overseeing pharmaceutical services to 30 clinics and an outpatient surgery center that were joining the system as LSU Health Baton Rouge. At the same time, though, Gaudet she could not look away from the daily needs of the region’s at-risk populations: mothers who couldn’t afford basic antibiotics for their children; diabetic patients who couldn’t afford their insulin; cancer patients avoiding their infusions because they already owed too much.

“My eyes were opened to the needs of my own community,” says Gaudet, 39. “I knew this was why I was called to work in a faith-based ministry. This is what being the hands and feet of Christ would be about for me.”

She’s led efforts to expand the system’s 340B program and sustain a vital patient assistance program to provide free drugs to patients without the ability to pay, including more than $5 million annually for cancer patients. She’s deepened a partnership with the St. Vincent DePaul Community

Pharmacy, brokering discussions about repackaging prescription medications for the homeless and the poor. She worked to create the first acute care and infusion suite pharmacy catering to medically underserved patients at the Our Lady of the Lake North clinic and emergency department, a partnership with the state of Louisiana.

Gaudet, who has been instrumental in developing the system’s expertise in oncology pharmacy, created a best practice in pharmaceutical sterile and hazardous compounding as well as clean room compliance that has been recognized by The Joint Commission.

“I am a better leader because of Wendy’s determination, encouragement and daily example of servant leadership,” says Lesley Tilley, vice president of operations for Franciscan Missionaries of Our Lady.

Morgan Griffith

Vice president, digital strategy and transformation, Bon Secours Mercy Health, Cincinnati

Morgan Griffith assembled of team of 32 from the ground up that guides the digital and transformation strategies of Bon Secours Mercy Health.

In the past three years, her team has unified digital marketing and media platforms, Griffith launched organizational blogs and redesigned websites that reported a 70% increase in organic search traffic. These changes made access to the ministry’s providers easier for patients because of new provider directories.

Griffith also guided the system in establishing a partnership with FC Cincinnati, the city’s Major League Soccer franchise.

She helped establish Mercy Health as a sponsor of the team’s community impact projects focused on opioid abuse, youth sports and community gardens that bring fresh foods to underserved communities.

“Morgan is a dynamic leader with a passion and dedication for improving the wellness and connectedness of our communities,” says Sandra Mackey, chief marketing officer for Bon Secours Mercy Health. “She continuously focuses on improving engagement with health care consumers in a way that enables us to meet their needs at a time and place they need it with greater ease and predictability.”

She also leads the team creating a digital platform that aims to be a one-stop shop for consumers to access health care and wellbeing information, including the development of a mobile app.

“One of my favorite sayings is ‘The meaning of life is to find your gift. The purpose of life is to give it away,’” says Griffith, 36. “I cannot describe how fortunate I am to have found my gift, and now to work to give it away in support of a ministry that truly prioritizes the complete and whole health of people. It’s really not work when you enjoy it though. Right?”

Dr. Karthik Iyer

Chief medical officer and medical director of critical care, Mercy Hospital Jefferson, Festus, Missouri

Dr. Karthik Iyer decided to pursue medicine as a youngster, after his mother revealed that she had lost her first child because of inadequate medical resources.

One of the first nocturnists at Mercy Hospital Jefferson, he committed to caring for patients in the hours when resources are

limited and fears are at their highest.

“Particularly gratifying has been the COVID-19 ex– perience, where our sickest patients on ventilators were able to make an Iyer improbable recovery and reunite with their families,” says Iyer, 39.

He didn’t imagine himself as a leader, though, until one of his mentors challenged him.

“Taking on these challenges and trying to find a solution, knowing your decisions for the hospital can have a huge impact on the local community gives you a huge sense of responsibility,” he says.

Under Iyer’s guidance, the intensive care unit has seen a drop in the mortality rate and a reduction in overall length of stay for all patients, including those requiring ventilators. He also helped develop RESCUE, a program aimed at decreasing readmissions for patients with chronic obstructive pulmonary disease at Mercy Jefferson. Upon discharge, patients receive an early followup with a pulmonologist in a new COPD clinic that also includes COPD education from a respiratory therapist/nurse; consultation with Mercy Virtual providers; and home care equipment, including an iPad and medications.

He is especially proud, though, of helping to launch Code Hour One, which reduces the mortality rate by speeding the response to patients with indicators for severe sepsis. The program assigns a dedicated nurse to the patient, providing a nurse-patient ratio of 1:1 to complete the sepsis bundle within 60 minutes.

“It takes a great clinician to improve a patient’s life, but it takes a physician leader to promote a healing culture,” says Dr. Raymond Weick, vice president of Mercy Clinic and a member of the Tomorrow’s Leaders class of 2015. “Dr. Karthik Iyer is such a leader.”

Prub “PK” Khurana

Chief strategy officer, Providence St. Joseph Health — Southern California; chief executive, Providence St. Joseph Health Network, Irvine, California

Prub Khurana has an instinct for finding synergy and partnerships. Raised in the Sikh religion, he has found a perfect fit in Catholic health care because both religions share a belief that learning and formation Khurana are constants and that special considerations should be made to care for the vulnerable.

“In the Sikh faith tradition … we are staunch defenders of those who cannot defend themselves and are a voice for the voiceless,” Khurana says. “When I came to realize that keeping our ministry’s identity and heritage alive and thriving was as simple as being myself, I was liberated.”

His ability to find common ground has led to a series of business partnerships for Providence. Chief among them is a relationship he helped forge with the insurance provider Oscar Health that aligned incentives between them and expanded Providence’s “high-performing network” throughout Southern California. “It is one of the opportunities that really leverages the scale of Providence in the market and demonstrates our leadership role as a health provider,” he says.

July 1, 2020 CATHOLIC HEALTH WORLD

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ASSEMBLY 2020 TOMORROW’S LEADERS Khurana, 38, also helped form a partnership with Collective Health, a Silicon Valley-based self-funded employer benefits platform for insurance plan administration, patient navigation and engagement and analytics. In addition, he represented Providence in its partnership with Exer Urgent Care. Together, they operate 16 high-acuity urgent care centers across Southern California and plan to add 25 locations throughout the region.

“He does this work so well because he is trusted,” says Mike Butler, president of strategy and operations for Providence St. Joseph Health. “No one doubts that PK has our mission and values at heart in everything he does.”

Tiffany Parker

Director, inpatient behavioral health, addiction and domestic violence services, St. Agnes Hospital, Agnesian HealthCare, a member of SSM Health, Fond du Lac, Wisconsin

Starting her career as a domestic violence advocate, Tiffany Parker joined St. Agnes Hospital in 2013. She has grown domestic violence and be– havioral health services at the hospital and created a mulParker tifaceted hub for the vulnerable that includes legal advocacy, offender services, counseling and crisis intervention and serves 150 to 200 patients per month.

“Tiffany has changed the landscape of her community,” says Katherine Vergos, president of St. Agnes Hospital. “Through her passion to bring awareness and education to a community, she has helped many victims of violence and addiction come forward that otherwise might have stayed silent.”

Parker also formed partnerships with law enforcement to screen people at risk of homicide as a result of domestic abuse and with educators to create a school-based violence prevention program. The prevention education program works with an average of 5,000 students, community members and nurses per year.

Since assuming her current role last year, Parker has integrated services for patients and for victims of domestic violence across the care continuum. Her goal is to build a stand-alone mental health facility for adults and adolescents struggling with all types of emotional trauma. Parker, 30, says St. Agnes Hospital was well-positioned to bring these behavioral health services to Fond du Lac. “I find myself often emotionally and spiritually drawn to individuals who are experiencing some type of unfair or uncontrollable hardship,” she says. “I have often felt inspired and aligned with the Congregation of Sisters of St. Agnes (founders of St. Agnes Hospital), who made it a priority to serve these vulnerable individuals throughout their life’s work, and I feel the call often to continue the work they started.”

Aaron Puchbauer

President and chief executive, HSHS Good Shepherd Hospital, Shelbyville, Illinois, a member of Hospital Sisters Health System

Aaron Puchbauer assumed his role in May 2017, less than five months after the rural Shelby Memorial Hospital was acquired by the Hospital Sisters Health System and was renamed HSHS Good Shepherd. His goals: to connect, engage and establish a healing culture with colleagues and the community.

“He hit the ground running with his well-honed skills in operations, health

care, finance and a dedication to our mission,” says Mary StarmannHarrison, president and chief executive of Hospital Sisters Health System.

“Aaron’s passion for Puchbauer collaboration at all levels has led to the development of many initiatives that have drastically improved the patient care, culture and operations.”

Programs and initiatives under his guidance have led employees, patients and the community to not only engage but embrace the culture of the founding sisters.

He helped secure federal grants to expand behavioral health and substance abuse services. Under his leadership, the HSHS Good Shepherd Family Rural Health Clinic added three primary care providers in the last 18 months. The hospital improved its culture of safety score from the 83rd percentile to the 99th percentile. To accomplish this, he brainstormed with each department about ways to maximize safety for patients and staff.

Visible and engaged in the hospital, he also reaches out by rounding with physicians and staff, meeting with providers to discuss care improvement. He encourages staff members to pray with patients and physicians before surgery.

He volunteers in the Shelbyville Community Garden on the hospital campus, one of two plots created in partnership with a Presbyterian church. The hospital plot produces up to 200 pounds of produce that is distributed through the church pantry, used in free community meals and donated to the school district.

“I appreciate having a chance to address the mind, body and spiritual needs of the patients and colleagues,” says Puchbauer, 37. “If your staff is engaged, they’ll take great care of our patients and help us grow our services.”

program became the basis for the Better Prescribing, Better Treatment program that he now leads statewide across more than 40 health systems and 20,000 providers.

He also helped guide “ER is for Emergencies,” geared to patients suffering from substance abuse disorder and mental illness who made frequent use of emergency rooms. In its first year, the program reduced opioid prescribing for the target population by 24% and saved the state more than $31 million.

Schlicher says there is no one right way to best care for patients and make the best health system possible, and that keeps him focused and fired-up. “Doing our best to figure it out day by day and solve the problems is exciting. It’s a new challenge every day,” says Schlicher, a former state legislator and president-elect of the Washington State Medical Association.

Bernardita Ureta

Vice president, mission integration and social responsibility, Red de Salud UC CHRISTUS, Santiago, Chile

Bernardita “Berni” Ureta is charged with overseeing the integration of Catholic identity and mission of the Red de Salud UC CHRISTUS, a partnership between CHRISTUS Health and the Pontificia Universidad Católica de Chile.

Ureta She has found ways big and small to bring the spiritual healing touch to

patients, colleagues and community.

Ureta guided a palliative care program with a multidisciplinary team that supports expectant parents with a prenatal diagnosis indicating their baby will die before or shortly after birth. She designed a holistic training program for clinicians. She helped institute Code Lavender, a moment of prayer announced when a patient dies in the hospital. She developed a program for the Red de Salud to hire people with special needs. During the social unrest in 2019, she helped organize safe physical and virtual spaces for associates and community members to focus on well-being activities that helped them remain resilient through the crisis.

She guided the rigorous Catholic Identity Matrix process after Red de Salud UC joined CHRISTUS to assess the Chilean system’s fidelity to its Catholic identity and mission. She helped assemble a team of 60 leaders from each system to integrate and align values “that make sure we can be a good Catholic institution,” says Ureta, 36.

“It was a challenge, but the reward was bigger and will last longer than one individual program.”

Jeffrey M. Puckett, executive vice president and chief operating officer at CHRISTUS, says of Ureta, “We know she’s not just a textbook or average health care leader. She’s unafraid of tackling difficult problems, and she’s as good as her word in finding solutions.”

Before joining CHRISTUS in 2015, Ureta was a social worker in Brazil, Seville and Rome. “Jesus came to heal us, not only the physical but spiritual and emotional,” she says. “I get up every day asking, ‘How I can get others to keep our mission alive in their lives and their work?’”

BLESSED ARE THE HEALTH CARE WORKERS Blessed are the ones who cannot be isolated.

Dr. Nathaniel Schlicher

Regional medical director, quality assurance for emergency medicine, CHI Franciscan, Tacoma, Washington, a member of CommonSpirit Health

After 11 years with Catholic Health Initiatives, Dr. Nathaniel Schlicher refers to himself as “one of the old guys.”

He is 37. He graduated from high school at 14, collected his first college degree when he was 17 and earned law and medical degrees by age 23.

He also holds a master’s in business administration.

Schlicher “He has been a passionate leader, dedicated to his community, and will continue to be a driving force for years to come,” says Jennifer Hanscom, chief executive of the Washington State Medical Association.

Schlicher helped design and write the program for the bed placement algorithm for the Mission Control Center, CHI Franciscan’s artificial intelligence center that determines system capacity and the daily transfer pathways.

He set up protocols and programs to combat the opioid crisis. By sharing prescribing trends with colleagues, Schlicher reduced opioid prescriptions by more than 58% at St. Joseph Medical Center in Tacoma, Washington, from January 2016 to March 2018. In that span, fewer than 4% of emergency department patients at the hospital received an opioid prescription, a rate that ranked it among the best in the nation for safe prescription practices. This

Blessed are all the health care workers.

Blessed are the hands that are raw from scrubbing and sanitizing, and the hands for healing, comforting, and supporting.

Blessed are the shoulders that carry the weight of life and death.

Blessed are the feet that are aching from standing at the bedside, running between rooms, and answering phones.

Blessed are the hearts that are frightened and breaking.

Blessed are the mothers and fathers, grandmothers and grandfathers, sisters and brothers, partners and friends, who cannot go home.

Blessed are the families who become isolated from each other, the ones who sacrifice their own comfort so that others need not be alone in their suffering.

Blessed are the sick and the dying, those who bear the image of God before us.

Blessed are those who look upon their work as sacred and as a gift at this time of overwhelming demand.

Blessed are those who lack the space to process all that lies ahead and may others bear their burden with them.

Blessed are the ones who are found weeping in corners of our emergency rooms, our hospitals, our primary care offices, our outpatient centers so that we might see a strong face to greet our need.

Blessed are those who weep openly with us, so that even our tears have companions.

Blessed are you, O God: quietly holding each of us along the way. Come quickly, abide unceasingly. Love us while we see the worst, and give us the hope to do our best and continue our mission with compassionate care.

Amen.

— KATE WILLIAMS

For more prayers visit chausa.org/prayers

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CATHOLIC HEALTH WORLD July 1, 2020

Here comes the sun: Hospitals send recovered COVID patients home with a song

By LISA EISENHAUER

When the 100th patient to recover from COVID-19 left SSM Health Saint Louis University Hospital earlier this month, she was sent off, like others who have overcome a severe bout with the virus, with cheers and applause from caregivers and Justin Timberlake’s “Can’t Stop the Feeling!”

At Trinity Health’s Nazareth Hospital, the music for farewell fetes for COVID patients is “Gonna Fly Now” the theme from Rocky. It’s an appropriate choice based on geography and the arc of the script since the hospital is in Philadelphia and the movie about the underdog fighter who goes the distance against a mighty opponent was set there, too.

At Mercy hospitals in the St. Louis region, a “Code Sunshine” is called when a COVID patient is being discharged and the song selection, appropriately, is the Beatles’ “Here Comes the Sun.” Staffers at Catholic hospitals across the nation are savoring the brief timeouts from their frontline role in the national emergency caused by the pandemic as they rejoice in the victories of patients who have survived serious or near-fatal complications of the virus and are going home. By mid-June, more than 2.2 million

with COVID-19 patients reaching the goal of being discharged, it represents a great show of triumph and overcoming barriers,” Aidt said.

Paula Harlan gives a thumbs-up to her caregivers as she leaves SSM Health Saint Louis University Hospital on May 11. Harlan was the 100th patient with COVID-19 to be discharged. The hospital plays “Can’t Stop the Feeling!” when COVID patients go home.

Americans had tested positive for the virus and more than 118,000 had died, according to tracking done by Johns Hopkins University.

“We’ve had patients here who haven’t seen their family in over 30 days and so the first time that they get to do that, you can imagine the emotion that comes with that moment,” said Jennifer Garnica, the administrative director of nursing operations at SSM Health’s SLU Hospital. “It’s

Hospital staffers wax lyrical in their pandemic response

A

long with inspiring the selection of tribute songs for farewell celebrations for recovering COVID-19 patients, the pandemic has spurred staffers as some Catholic facilities to get in touch with their musicality.

SSM Health staffers recorded a socially distanced video for an inspirational tune dedicated to those on the pandemic’s front lines called “We Rise.” The refrain includes: “We are called to service. We stand together here.”

The song was written by John Nguyen, the St. Louis-based system’s chief marketing officer, and the video features him singing and playing guitar as well as the voices and instrumental skills of 15 system colleagues. It combines a mashup of separate recordings from their homes with dozens of poignant photos of staffers on the job during the pandemic. Brad Hood, an SSM Health executive assistant, collaborated with Nguyen on the arrangement. The video had gotten more than 14,000 views on YouTube by mid-June.

Benedictine is using social media to share a bouncy COVID-related video that features an original song. The song, “Stay Back,” is a “social distancing groove” that was created for residents. Until those distancing precautions are eased, residents and others will only be seeing the recorded version.

It is performed on the video by songwriter Russ Britton, director of facilities at the senior living community Villa St. Benedict in the Chicago suburb of Lisle, Illinois. Britton sings to an acoustic rock rhythm. The lyrics promote maintaining a six-foot distance from others and frequent hand washing. The backup dancers in surgical masks — Mario Monarrez, a general maintenance technician at the care center, and Raymundo “Ray” Guela, a janitor — incorporate some moves to demonstrate.

The lyrics include: “Keeping away is what we say and we’re trying to keep you safe.”

— LISA EISENHAUER

emotional for the providers as well. It’s a really exciting thing for us to see people getting better and getting out of here.”

Up for a vote Garnica, who is known among her colleagues as “the cheerleader,” led the charge in arranging the sendoffs for COVID patients and selecting a theme song. She decided to get the whole staff involved in that selection by narrowing the choices to five and then putting the finalists up to a vote. Timberlake’s catchy “Can’t Stop the Feeling!” won in a landslide over rivals that included the Bee Gees’ disco anthem “Stayin’ Alive” and the Beatles’ “Good Day Sunshine.”

“It’s just an upbeat song,” Garnica said.

“When you hear it, you can’t help but get excited and you want to get up and dance and clap your hands.”

Other hospitals have also put the song decision for their farewell events up to a vote. At PeaceHealth St. Joseph Medical Center in Bellingham, Washington, the popular choice was Journey’s enduring smash “Don’t Stop Believin.’”

As at Nazareth Hospital, “Gonna Fly Now” pours from the PA system at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, when a COVID patient heads home. A “Code Rocky” is called for the occasion.

Tammi Aidt, manager supportive care services at the hospital, said the choice was meant to mark a milestone as it did in the movie when Rocky Balboa was finally fit enough to charge up all 72 steps at the Philadelphia Museum of Art. “As

Going the distance AMITA Health Resurrection Medical Center Chicago plays a Rocky theme, too, but the facility opted for “Eye of the Tiger”

by Survivor from the third installment of the movie franchise. The song’s lyrics include “Went the distance, now I’m back on my feet. Just a man and his will to survive.”

Holly Seletos, the hospital’s director of patient experience, said the song “instills the feeling of building up of stamina. It makes our discharged COVID patients feel as though they have made it through the fight of their lifetime and come out strong and it gives the COVID inpatient hope and encouragement that they too will hear this song played for them one day soon.”

Seletos said the hospital has dubbed its discharge celebrations Code Joy. “It makes our staff so happy each and every time we hear it played, it brightens our day with a sigh of gratefulness that we could send another one home,” she added.

Lifting spirits The Beatles classic “Here Comes the Sun” is a popular discharge choice for COVID patients at hospitals across the nation, including at PeaceHealth Southwest Medical Center in Vancouver, Washington.

At the suggestion of Dr. Dayna Groskreutz, a pulmonary/critical care physician on the front lines of the COVID fight, it’s also the parting serenade at several Avera Health hospitals.

“As we treat patients and prepare for an increase in cases, we need something to lift the spirits of staff and emphasize that people are getting better,” Groskreutz said in a press release in late April when the selection was announced. “Hope is important right now. And hope does not disappoint us, because God has poured out his love into our hearts by the Holy Spirit, whom he has given us. (Romans 5:5)” The song is also being played at Avera hospitals when babies are born.

At Mercy Medical Center in Canton, Ohio, the hospital lets COVID patients pick which song they want to hear as they are heading out. Among the choices so far are “Don’t Stop Believin’” and “Stayin’ Alive.”

So far, no one has requested James Brown’s “I Feel Good.” leisenhauer@chausa.org

ASSEMBLY 2020

Metzl From page 1

demiologist and dean of the faculty at the Harvard T.H. Chan School of Public Health.

Sanchez is a lecturer at the school.

Brokenness exposed Metzl is a health care and technology futurist who has urged in numerous venues since the coronavirus outbreak that people and nations around the world seize upon this moment in history to work toward more just, equitable and sustainable systems.

In his address to more than 900 CHA members, Metzl said the pandemic has laid bare some of the many structural problems that exist in the U.S., including in the health care system. He said the coronavirus exposed that the country was not prepared to head off an avoidable pandemic. The virus also revealed “terrible weaknesses” in the public health infrastructure. And it exposed “underlying societal failures that have really weaponized inequality,” he said.

He pointed out that more poor people than wealthy people died from COVID-19.

Citing a recent column in the Washington Post co-written by Michelle Williams and Jeffrey Sanchez, he said, “Racism is a public health challenge. Inequality is a public health challenge.” Williams is an epi-

For better or worse?

Referring to a concept introduced earlier in the virtual assembly by CHA President and Chief Executive Officer Sr. Mary Haddad, RSM, Metzl said that the nation stands at a “threshold moment,” and “we don’t know — will the new world be better or worse?”

“It’s so essential that at these threshold moments we do everything we can to go forward to a better place,” he said, “and I know that is what your ministry is all about.”

Metzl said the Catholic Church elevates the protection of human dignity, the quest for justice and the provision of holistic care. He said the ministry must advocate to ensure that such values undergird the foundations as the nation emerges from the pandemic and rebuilds.

Metzl said, “While we do all that we possibly can do to heal and respond to this crisis, we all now have a much bigger role and obligation — we need to think systemically” about a rebuilt nation and advocate for the right kind of change.

For instance, he said, the ministry has

to “think systemically about structural deficiencies driving differential health outcomes, to think systemically about how to fix a broken health care system to provide not just more equity but also to provide better care for everyone.”

Humane use of technology Metzl noted that this opportunity for meaningful, positive change comes in the midst of technological and related genetic revolutions that are transforming the way people understand “health” and “health care.” For the first time, providers have the ability to harness the power of genetic engineering, artificial intelligence and other breakthrough science to make dramatic changes to people’s health outcomes.

This technology can be used either for the betterment of all people, or not, Metzl said. He said the Catholic health ministry should use its collective voice to ensure that those making decisions about the deployment of new technology respect human dignity and the common good.

He said, “What are the values we use to guide our technology — that is the issue — and whose voice is heard in determining how these technologies will be used?”

Collective well-being Metzl said that the pandemic has shown the world that there is a deep level of interconnection and interdependence among all people.

He said the impact of coronavirus has illustrated that it’s not simply an act of charity to help other people — helping others can be “the best investment we can each make in our collective well-being.” By protecting the most vulnerable from danger, groups of people simultaneously guard the collective whole from danger.

He said this is the type of thinking that should prevail as society reimagines a different health system. “In a threshold moment, we are all called upon to do something bigger. I believe to my core this is one of those moments and the Catholic health care community — which has done so much to help provide essential care to the most vulnerable people — you among others have a unique responsibility to think systematically.

“History will judge each of us and all of us — are we living up to our principles?

This is our moment, and we all need to step through that door,” he said. jminda@chausa.org

July 1, 2020 CATHOLIC HEALTH WORLD

Rural hospitals

equipment because of massive reductions in revenue and the availability of supplies.

We are asking for the state legislature to prioritize hospitals and ensure adequate funding for hospitals and health care works.”

From page 1

Lady of the Angels Hospital in Bogalusa, Louisiana, said that while his rural hospital fell behind budget in March, it wasn’t operating in the red. April proved harsher. For the first half of the month, the hospital had billed $2.5 million less compared to the year before.

Despite the challenges, Ragas said the hospital, one of the largest employers in a parish of about 46,000, will weather the crisis. He credited money from the Coronavirus Aid, Relief, and Economic Security — or CARES Act — and the hospital’s affiliation with FMOL. “I don’t think we’re in a position where we have any fear of closing,” Ragas said.

Many other executives with rural Catholic hospitals said they are worried about the financial repercussions of the drastic changes they have had to make to their operating models because of the pandemic.

Those changes included temporarily suspending elective procedures and outpatient care.

While many hospitals have restarted some or most of the suspended services, some executives said their balance sheets will need shoring up because of the months of lost revenue.

Help falls short On its website, the American Hospital Association called the CARES Act that President Donald Trump signed on March 27 an important first step forward to aid rural hospitals in dire financial need due to the pandemic. According to the National Law Review, of the $175 billion allocated for the Provider Relief Fund through the CARES Act and the subsequent Paycheck Protection Program, $10 billion was earmarked for rural hospitals and clinics.

On June 9, the Department of Health and Human Services announced additional distributions of about $15 billion to eligible providers that participate in Medicaid and the Children’s Health Insurance Program.

Each provider will get at least 2% of reported gross revenue from patient care, the agency said. HHS said $10 billion more would go to “hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care.”

It is not known how many rural hospitals will qualify. The agency set up a portal for hospitals to report their patient revenue, which will be used to determine their share of the aid.

More will need to be done for rural providers to deal with the unprecedented challenge of this virus, the AHA stressed.

Kathy Curran is CHA senior director of public policy. She said CHA is working to ensure that hospitals get additional federal financial assistance for personal protective equipment, for testing and for COVID-19 treatment. “We want to make sure rural and safety net hospitals are treated equitably when Washington, D.C., is allocating funding,” she said.

Curran said the Centers for Medicare & Medicaid Services was quick to give providers flexibility to offer telehealth and virtual care in order to restore access to some nonessential care that had been discontinued during the pandemic to safeguard patients.

But many rural communities do not have access to high-speed internet to support such services. “We need to address the problem of rural broadband access,” she noted.

Lifeblood Executives with Catholic systems who spoke with Catholic Health World said that prior to the pandemic, their rural hospitals were in fairly good financial shape, as compared with many other rural hospitals.

Smith Angie Smith is vice president of nursing for St. Bernards Medical Center in Jonesboro,

11

Staff members work at an outdoor COVID-19 screening and testing site on the campus of Providence Seward Medical Center in Alaska.

Arkansas. The hospital’s parent system, St. Bernards Healthcare, includes rural facilities. She said that because of good financial stewardship her system was well prepared for emergencies like natural disasters. However, the pandemic’s scope and duration have taken a deep bite. To stem financial losses, St. Bernards has implemented furloughs and asked other staff members to voluntarily reduce their hours.

St. Bernards’ chief executive had recommended across-the-board salary reductions to offset the system’s COVID-related losses and to reduce the necessity for more widespread furloughs. Smith was among vice presidents who agreed to take salary reductions.

DeAnn Thurmer, president of SSM Health’s Waupun Memorial Hospital and Ripon Medical Thurmer Center, both in Wisconsin,

CHA VIRTUAL ASSEMBLY

said that the temporary suspension of elective surgical services and outpatient procedures to reduce contagion risk dealt a hard financial blow. (Those services have been resumed.)

Additionally, Thurmer said, the two hospitals incurred costs to retrain clinicians to care for patients with COVID-19. For example, because critical care nurses are in short supply in rural hospitals, floor nurses and respiratory department clinicians were trained in assisting with caring for COVID19 patients in the emergency department and intensive care unit. Thurmer said that CARES Act funding, while welcome, won’t make up for the anticipated financial shortfall.

In an April 13 email to four Wisconsin legislators, Thurmer wrote: “The federal government’s relief is not going to be enough. Hospitals in Wisconsin are already being forced to furlough staff, reduce payroll and conserve precious personal protective

Relying on efficiencies Richard Morin, interim president for the CHRISTUS Spohn Alice and Kleberg hospitals in south Texas, said both hospitals were financially healthy through February.

“March was a difficult month, same thing will be for April,” Morin said in mid-April.

Nevertheless, Morin isn’t predicting doom, in part because of steps the hospital is taking on its own to address expenses, such as partnering with local sources to keep costs down, and in part because his hospitals have the backing of the CHRISTUS system. “Every month we are working to make sure we’re as efficient as possible, that we’re being good stewards of our resources,” he said of his hospitals.

Double advantage Providence Seward Medical Center has only six inpatient and two emergency room beds for the community of about 3,000 it serves on the southern coast of Alaska.

The little hospital has a seemingly safe financial niche even amid the extra challenges created by the coronavirus crisis, thanks to being publicly owned and tax-supported by the town and its affiliation with Providence Alaska, which the community contracts with for management.

“There’s kind of a double advantage,” Administrator Robert Rang said. “We do have the resources of Providence to get us through the pain point, but the city has also recognized that this could affect our revenue for a while and understands that they may need to help us out.”

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leisenhauer@chausa.org and jminda@chausa.org

AWARDS

CHA Congratulates Its Honorees for Extraordinary Contributions to the Catholic Health Ministry

SISTER CAROL KEEHAN AWARD

Jane Graf, President and Chief Executive Officer, Mercy Housing Inc., Denver

SISTER CONCILIA MORAN AWARD

Patricia Casey, Program Coordinator, Special Needs Tracking and Awareness Response System (STARS), SSM Health Cardinal Glennon Children’s Hospital, St. Louis

LIFETIME ACHIEVEMENT AWARD

Johnny Cox, RN, Ph.D., Former Sponsor, Providence St. Joseph Health, Renton, Washington and Chief Ethics Advisor, Alliance of Catholic Health Care, Sacramento, California

TOMORROW’S LEADERS HONOREES

Karthik Iyer, MD, Chief Medical Officer and Medical Director Critical Care, Mercy Hospital Jefferson, Festus/ Crystal City, Missouri

For boldly championing society’s most vulnerable

For demonstrated creativity and breakthrough thinking that advances the ministry

For a lifetime of contributions

Honoring young people who will guide our ministry in the future

Natalie Blum, System Director, Quality and Infection Prevention, PeaceHealth, Vancouver, Washington Lindsay Flannery, Vice President, Patient Care Services, Avera Sacred Heart Hospital, Yankton, South Dakota Wendy Gaudet, Director, Pharmacy, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana Morgan Griffith, Vice President, Digital Strategy and Transformation, Bon Secours Mercy Health, Cincinnati

Prub Khurana, Chief Strategy Officer, Providence St. Joseph Health, Irvine, California Tiffany Parker, Director, Inpatient Behavioral Health, Addiction Services and Domestic Violence Services, St. Agnes Hospital, Fond du Lac, Wisconsin Aaron Puchbauer, President and Chief Executive Officer, HSHS Good Shepherd Hospital, Shelbyville, Illinois Nathaniel Schlicher, MD, JD, MBA, FACEP, Regional Medical Director, Quality Assurance for Emergency Medicine, CHI Franciscan Health, Tacoma, Washington Bernardita Ureta, Vice President, Mission, Red de Salud UC CHRISTUS, Santiago, Chile

12

CATHOLIC HEALTH WORLD July 1, 2020

Racial disparities

president of population health management. “We want them to actually do more outreach, do more frequent calls, more check-ins with the complex populations after we’ve expanded who it is that they’re looking at,” she said.

Providence’s medical record system already was integrated with a social services platform called Community Pathways to Health — the system has functionality that merges COVID-19 incidence rates with details about patient needs. That information informs local health ministries about what social services are needed by the vulnerable groups and helps them decide how best to partner with agencies and nonprofits in their communities to set up things like food banks to address those needs.

In addition, Medows said, Providence is ramping up efforts to assess patients for Medicaid eligibility and to help those who qualify to enroll. It’s also working with companies that make its virtual tools, such as smartphone apps, to ensure that those tools are in languages and formats that make them easy to use.

“These are all things that are in progress,” Medows said. “Showing people the data goes a long way in explaining why it’s important.”

From page 1

case and death characteristics to help the system identify populations in the communities it serves who are most vulnerable to severe outcomes from the infection and improve their access to testing, care and services.

“We’re in the process of trying to figure out what Mitchell-Boyd communities we can be the most helpful to in improving some of these results,” Mitchell-Boyd said.

Breaking down the numbers A report posted in early April by the Centers for Disease Control and Prevention found that of people hospitalized for COVID-19 whose race was known, 33% were black. U.S. census data says black Americans make up about 13.4% of the population. At the time race and ethnicity was missing or not specified for nearly two out of three COVID-19 cases reported to the CDC. An analysis published by the Kaiser Family Foundation on April 21 pooled CDC racial and ethnic data on COVID-19 with state reported data to reach the same conclusion: the virus was disproportionately affecting communities of color. The Kaiser report said that in six states Hispanics were overrepresented among those confirmed to have gotten the virus. The foundation said underlying health, economic and social issues made communities of color more vulnerable to the pandemic.

A few days before the CDC report posted, seven physicians organizations led by the American Medical Association urged the U.S. Department of Health and Human Services to collect, analyze, and make available standardized data. The association said that data should include race, ethnicity, and preferred spoken and written language related to the testing status, hospitalization, and mortality associated with COVID-19.

“These data are essential to understanding the unique challenges and inequities facing communities of color and individuals with Limited English Proficiency,” the organizations wrote to HHS Secretary Alex Azar.

“While COVID-19 has not created the circumstances that have brought about health inequities, it has and will continue to severely exacerbate existing and alarming social inequities along racial and ethnic lines, e.g., in housing stability, in employment status, in health care access, and in food security,” the physicians groups wrote.

Demographic data mandate On June 4, HHS issued guidance to laboratories doing COVID-19 testing that requires them to collect demographic data for patients that includes race and ethnicity and submit that information along with test results.

CHA supports legislation to improve the collection of racial and ethnic data related to those who have contracted COVID-19.

The association also is pressing Congress and the administration to provide additional funding and policy support for outreach, testing and treatment in communities of color and additional resources for vulnerable communities suffering the economic consequences of the pandemic to address social needs such as homelessness, housing and rental assistance, and food assistance.

Speaking May 7 during a podcast hosted by CHA, Dr. Sam Ross, chief community health officer Ross for Bon Secours Mercy Health, said the statistics showing the disproportionate racial impact of the virus are not surprising. Ross said the numbers spotlight racial disparities in health care that existed before the pandemic.

“The real issue now is not that it’s occur-

Ikedrick Williams is discharged in April from AMITA Health Adventist Medical Center Bolingbrook in suburban Chicago to the delight of his family. He recovered from a severe bout with COVID-19.

ring and being highlighted, but what are we going to do about it,” he said. “We’ve been talking about these issues of inequities for now decades.”

What needs to be done, in Ross’ view, is for health systems to develop trust among communities of color by bringing them to the table when programs, policies and services are taking shape. “If we start to behave in a way that is really about engaging and including, then I think that will go toward building trust and us understanding whether or not what we’re doing is really the right intervention,” he said.

Action, advocacy Rosalyn Carpenter, senior vice president and chief diversity officer for CommonSpirit Health, said caring for underserved communities and addressing racial disparities is at the core of the Carpenter health system’s mission.

CommonSpirit is addressing COVID-19 disparities in part by providing free virtual urgent care visits for anyone experiencing mild to moderate symptoms of the illness, Carpenter said. For all COVID-19 patients, it has suspended billing until cost-sharing between government and insurers is sorted out.

The health system also is advocating for government assistance packages to include the heavily minority service workforce that has had to remain on the job amid the pandemic, Carpenter said. In addition to financial help, she said, the workers need onthe-job protections to keep them safe from contagion and they need to have access to testing, and health care services if they contract the virus.

“We need smart policies and massive financial assistance packages that enable people to continue to be safe,” she said.

Carpenter noted that many of the people who have had the worst outcomes from COVID-19 have preexisting conditions, such as high blood pressure, stroke, diabetes, cancer or asthma. Those are conditions that disproportionately afflict people of color. And she said research has shown that those higher rates of chronic disease are driven by socioeconomic factors, such as lack of access to health care, unemployment and underemployment, poor access to nutritious food and inadequate housing.

“We know that if we work to address those social determinants of health, ulti-

mately we will improve the health of those individuals — be they vulnerable, be they people of color — wherever they live,” she said.

Localizing disparities Providence St. Joseph Health is breaking down data related to COVID-19 from its 5 million patients geographically and sharing it with local ministries so they can use it to identify the most vulnerable Medows people in their communities, said Dr. Rhonda Medows, the system’s

Seizing an opportunity Like other health systems, Providence has been advocating for COVID-19 testing and treatment for high-risk populations, but Medows said the system doesn’t plan to stop there. It will be urging that those patients be given access to potential treatments such as the drug remdesivir, which studies suggest can lessen the virus’ impact in some patients. And, should a vaccine for the virus be developed, she said she and others with the system will be champions for its use first among those populations that have been hit hardest.

“We always say that out of adversity comes opportunity,” Medows said. “This is an opportunity to help a lot of people who historically have not received the aid they need.” leisenhauer@chausa.org

A Beloved Resource Available as an Audiobook & eBook!

First published in 1991, Food for the Journey,

by Sr. Juliana Casey, IHM, continues to offer spiritual nourishment and inspiration to caregivers, clinicians, executives, administrators, operational staff, volunteers and many others who serve in Catholic health care.

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Theological Foundations of the Catholic Healthcare Ministry

Learn more about the available eBook options at chausa.org/foodforthejourney