Confronting patient prejudice 7 Executive changes 8 PERIODICAL RATE PUBLICATION
JUNE 15, 2022
Environmental work is social justice work
As gun deaths rise, many health care groups call for more funding for research
Vatican initiative challenges providers to take on big system change
A megadrought in the Western U.S. has dropped water levels in Nevada’s Lake Mead to historic low levels. The integral ecology philosophy driving much environmental work in the Catholic Church today posits that the climate disaster is part of a global ecological catastrophe that is connected not only to a loss of biodiversity but also to human crises such as extreme poverty and mass migration.
Joshua Bessex/Associated Press
Continued on 2
John Locher/Associated Press
By JULIE MINDA
A new Vatican initiative is calling on the global Catholic Church, including Catholic health care, to ground its environmental work in integral ecology. This concept recognizes the interrelatedness of various ecologies or relationships — natural, social, economic and cultural — and captures how the global ecological crisis is a result of these relationships falling out of balance. CHA is taking part in and endorsing the initiative, which is called the Laudato Sí Action Platform. Catholic health systems that have signed on include Ascension, Providence St. Joseph Health and CommonSpirit Health. Concern about the devastating health impacts of pollution and
Bon Secours Mercy increases housing stability for homeowners, renters
Andrew Harnik/Associated Press
By JULIE MINDA
"No Job No Rent" signs drape from apartment windows in Northwest Washington, D.C., May 20, 2020. While government agencies put a moratorium on evictions and foreclosures for more than a year during the pandemic, housing stability was — and remains — a pressing challenge nationwide.
“
“The most affordable housing unit is the one that you’re in.” That credo shared by Emily Dowdall, a staffer at a community development financial institution, helps to explain why Bon Secours Mercy Health last year allocated hundreds of thousands of dollars in direct payments to community members falling Dowdall behind on bills or in danger of eviction or foreclosure.' The one-time aid, given out with very few restrictions, had the intended effect of increasing housing security for people in two neighborhoods surrounding the health system’s Cincinnati headquarters. Bon Secours Mercy Health undertook Continued on 8
People hug outside the scene after a shooting at the Tops supermarket in Buffalo, New York, on May 14. The massacre left 10 people dead and three wounded. By LISA EISENHAUER
Two massacres in 10 days in May — one at a supermarket in Buffalo, New York, in which 10 people were killed and another at an elementary school in Uvalde, Texas, that left at least 19 children and two teachers dead — have stunned a nation where mass shootings and other gun violence are becoming increasingly common. The rampages happened just days after statistics from the Centers for Disease Control and Prevention showed a spike of 14% in gun deaths and 34% in gun homicides in 2020 from 2019. Advocates for violence prevention programs within the Catholic Continued on 4
SSM Health Foundation funds final wishes for hospice patients
I’ve been
fortunate to see
By LISA EISENHAUER
something that I cared so much
about. It was a gift.” — John Holzhauer
VOLUME 38, NUMBER 10
John Holzhauer looks down on the playing field during a tour of Lambeau Field, home of the Green Bay Packers. The trip to the stadium fulfilled a wish of Holzhauer’s. It was financed in part through the SSM Health Foundation’s Memories That Last program.
John Holzhauer said the best word he could come up with to describe how he felt as he toured Lambeau Field, home of his beloved Green Bay Packers, is awestruck. Four months after his siblings surreptitiously arranged the 450-mile trip last December from his home in tiny Kinmundy in Southern Illinois to what to many fans of the National Football League team is a shrine in northern Wisconsin, Holzhauer’s memories of the outing remained vivid. He described the 50-foot atrium-filling
replica of the Vince Lombardi Trophy, named in honor of the legendary Packers coach and awarded each year to the winner of the Super Bowl; shared statistics cited by his tour guide about the cost of maintaining the storied football field; and laughed about being told his tour group was 20 stories up from the 50-yard line at one point. “I’ve been fortunate to see something that I cared so much about,” said the 63-year-old Holzhauer, a cancer patient who was under hospice care at home from St. Louis-based SSM Health until his death Continued on 6
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CATHOLIC HEALTH WORLD June 15, 2022
Environment climate change, particularly on the poor and vulnerable, has been a major driver in Catholic health care’s environmental efforts. The Vatican sees the initiative as a way to raise awareness and understanding of integral ecology and to provide the framework to help participants to operationalize the concept. This way their environmental work could be more deeply integrated with other priority social justice and mission work as well as business practices and advocacy efforts. Laura Richter, system vice president of formation and spirituality at the 23-hospital SSM Health system, says the integral ecology approach recogRichter nizes “that we as humans are intimately united with all that exists. We are intimately connected with our community, and we are to be responsible stewards and responsible citizens. We are to have the global perspective that what we do affects all. “It is about interconnectedness,” she says.
One world The concept of integral ecology appears in Pope Francis’ 2015 encyclical on the environment, Laudato Sí … On Care for Our Common Home. Indu Spugnardi, CHA director of advocacy and resource development, explains that drought, floods, war, famine, pollution, diseases related to health inequity and even human trafficking are not separate crises. Spugnardi points to Pope Francis’ discussion in Laudato Sí of how the roots of environmental and social degradation are knotted and cannot be addressed in isolation. He writes, “Given the scale of change, it is no longer possible to find a specific, discrete answer for each part of the problem. It is essential to seek comprehensive solutions which consider the interactions within natural systems themselves and with social systems. We are faced not with two separate crises, one environmental and the other social, but rather with one complex crisis which is both social and environmental.” And, according to the conceptual framework, many of these plagues are rooted in disconnectedness from natural and social relationships. This can have the effect of allowing individuals and societies to ignore the exploitation of people and of the Earth. Spugnardi adds that the Vatican’s Dicastery for Promoting Integral Human Development launched the Laudato Sí Action Platform last year to unite the Catholic Church and others around the world in responding to ecological threats and social injustice — “the cry of the Earth” and “the cry of the poor” — in a unified way. The aim is to engage people and organizations in seeking societal change and gain the critical mass to make an impact on a global scale. Organizations, families and individuals signing on to the action platform develop plans to combat environmental degradation, discrimination and race-based or status-based injustices and annually share progress on how they are enacting their plans and what impact they are having. They also are to encourage others to participate in the Laudato Sí Action Platform. CHA is a signatory and is sharing its environmentalism resources with the Vatican for use by participants. The association also is assisting the Vatican in developing new resources for the initiative. CHA provided input on the self-assessment and reflection process for health care providers taking part in the action platform. The association is advising ministry systems and facilities on how to participate in the Laudato Sí Action Platform. Resources including suggested actions are available at laudatosiactionplatform.org and laudatosiweek.org.
eco-catholic.com
From page 1
This image from an animated video explaining integral ecology illustrates people futilely attempting to engineer the way out of ecological crises through technological fixes. To treat the root causes of the unfolding ecological catastrophe will require “a new way of seeing, thinking and acting,” according to the video from Eco-Catholic, which makes resources to explain Catholic teachings on ecology.
Upstream Sr. Mary Ellen Leciejewski, OP, is system vice president of environmental sustainability for the 140-hospital CommonSpirit Health. She says Catholic health care and its founding congregations long have prioritized environmentalism and social justice, and in recent years many in the ministry have formally approached those areas in a manner that recognizes the causal links between environmental degradation, disease and Leciejewski health inequity. People of color with low incomes are most likely to live in areas where the air, ground and water contain toxins. Increasingly, through work to address social determinants of health, Catholic health care systems in the U.S. are trying to improve the health status of populations. For instance, they are promoting safe housing and they are advocating for environmental justice. All around the world, people living in poverty suffer the most from environmental disasters including climate change. Sr. Leciejewski says integral ecology is tied into an eco-spirituality that posits that as the Earth cares for humanity, so should humanity care for the Earth. Doing so will get at the forces that are further harming vulnerable people, she says. She says engaging in the Vatican’s action platform is challenging CommonSpirit to critically assess its extensive work around environmentalism and social justice to determine what more it can do in these Project1_Layout 1 5/23/22 9:06 AM Page 1 areas.
Environmental justice Elizabeth Schenk is executive director of environmental stewardship at Providence St. Joseph Health. Well before the 52-hospital system signed on to the action platform, it had made environmental and social justice top advocacy priorities at the local, state and federal levels, Schenk notes. Providence has made strides in reducing its envi- Schenk ronmental impact and in its pursuit of social justice aims, she says. She adds that pollution reduction efforts on a national scale will require collective will, public policy changes and large-scale investments. For example, a wholesale move to reduce the proportion of carbon-based energy in the nation’s energy grid is an accomplishment that would make it possible for hospitals and other industries to achieve sweeping reductions in their carbon footprints. However, this would require more government programs supporting clean energy sources. Schenk says that having a new worldwide movement propelled by the Vatican will normalize integral ecology, and inspire more people — including those in positions of power — to take meaningful, impactful action. Every department, every individual Lou Fierens, executive vice president of administrative services at Trinity Health, says that 88-hospital system is pursuing many of the goals set forth by the Vatican. Fierens says that Trinity Health prioritizes environmental preservation in decision-making in every department includ-
ing supply chain, operations, community health and well-being, mission, communications and finance. Schenk adds that since 2020, all leaders at Providence have had ecological goals that they must meet and document as part of their formal responsibili- Fierens ties. “We needed that level of accountability,” explains Schenk. Sr. Leciejewski describes how environmental accountability plays out at CommonSpirit by giving an example of a supply chain manager who, in addition to evaluating quality, price, availability and suitability of products also has to weigh the environmental impact of production methods and product disposal. The manager also would consider whether the goods were manufactured using forced labor. Richter says at SSM Health, environmentalism and the pursuit of social justice are so ingrained in the culture that the system asks employees to determine what they personally can do to advance the common good. Her family raises hens for their eggs; they compost and garden; and Richter drives a hybrid vehicle. She notes that she’s seen SSM Health President and Chief Executive Laura Kaiser joining employee trash pickup crews along roadsides; and Kaiser encourages staff to host multiple recycle drives — and she is a big contributor to the drives. “We all have to work together, we all have to be proactive,” Richter says. “It’s about promoting a sense of community, writ large.” Visit chausa.org/chworld for more information. jminda@chausa.org
Upcoming Events
from The Catholic Health Association Diversity & Disparities Networking Zoom Call June 23 | 1 – 2 p.m. ET
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Faith Community Nurse Networking Zoom Call July 20 | 1 – 2 p.m. ET
Deans of Catholic Colleges of Nursing Networking Zoom Call July 26 | Noon–1 p.m. ET
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June 15, 2022 CATHOLIC HEALTH WORLD
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Catholic health care explores how to accelerate greening Given the dire stage of the climate crisis, pressure is mounting on the health care sector to do more to reduce its oversized environmental footprint. And given their own mission imperative to safeguard human health and the planet, many Catholic health systems and facilities are intensifying their efforts and aiming to get quicker results. Those leading efforts at environmentally forward ministry systems say some paths that hold the most promise in the near term include benchmarking to identify and further invest in what is working, physical plant improvements and closer involvement of clinicians in identifying ways to reduce the environmental burden. “We know we in health care have a huge effect on the climate, and the focus on this is integral to our mission,” says Sr. Mary Ellen Leciejewski, OP, system vice president of environmental sustainability for CommonSpirit Health. “Because we are responsible for our negative impact on the environment, our voice is critical (in achieving change). We’re making great strides, but it’s not happening fast enough.” More momentum is needed, she says.
Race to zero According to information from Practice Greenhealth, the nonprofit membership organization for sustainable health care: Health care facilities consume close to 10% of the total energy used in U.S. commercial buildings and spend more than $8 billion on energy every year. The health care sector is responsible for 8.5% of U.S. greenhouse gas emissions. Hospitals produce more than 5 million tons of waste each year. Hospitals use approximately 7% of all water consumed in commercial and institutional U.S. facilities. Operating rooms produce more than 30% of a facility’s waste. Kaiser Permanente holds the honor of being the first U.S. health system to achieve
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By JULIE MINDA
A 1,000-pound palette of baled blue wrap is ready to be recycled at a distribution facility in Wilsonville, Oregon. Many PeaceHealth facilities recycle the blue wrap that is used as packing for surgical instruments.
carbon neutrality, doing so in 2020. It is pushing to be net carbon positive by 2025, meaning the system will be buying enough clean energy and carbon offsets to remove more greenhouse gases from the atmosphere than it emits. Providence St. Joseph Health aims to be net carbon negative by 2030. CommonSpirit has pledged to cut in half its operational emissions by 2030 and has set a goal of removing more carbon from the atmosphere than it generates by 2040. Ascension is aiming for net zero carbon by 2040. Last year was the first year the United Nations Climate Change Conference focused on health care, illustrating the attention health care pollution is gaining worldwide. Representatives from CommonSpirit and Providence St. Joseph Health spoke at the November meeting held in Glasgow. During a panel discussion on energy, Shelly Schlenker, CommonSpirit executive vice president and chief advocacy officer, called climate change a health equity issue. She said CommonSpirit’s environmental commitment has “grown out of decadeslong work to examine our own practices and move the rest of the health care industry with us to examine their impact on the environment.” Elizabeth Schenk, executive director of environmental stewardship at Providence, told attendees about the vital roles nurses can play in addressing the climate crisis. The U.S. was among 50 countries at the U.N. gathering to commit “to develop climate-resilient and low-carbon health systems.” The Office of Climate Change and Health Equity, established by the U.S. Department of Health and Human Services, will assist in this work.
En route Most ministry systems and facilities have long-standing commitments to environmental stewardship and sustainability. Julie Trocchio, CHA senior director of community benefit and continuing care, says this commitment is due in large part to the influence of Catholic health care providers’ sponsors. Executives from CommonSpirit, PeaceHealth, Providence, SSM Health and Trinity Health said their systems and facilities pursue a wide variety of tactics to reduce environmental impact including in the supplies they purchase, reuse and recycle; the food they serve; and the waste they generate. Their facilities have joined with health care sustainability organizations including Practice Greenhealth and Health Care Without Harm to share best practices and get better at the work. Some of the areas where these ministry systems report great progress, or where they are gaining much traction, include: eliminating the use of mercury in health care delivery, reducing the use of environmentally harmful anesthesia gases, cutting
back on energy use and tapping into more renewable sources of energy, increasing the use of locally grown and other sustainable food sources, cutting back on waste that goes to a landfill and following environmental sustainability standards in construction projects.
Accelerating change Often employing third party contractors, CommonSpirit, Providence and Trinity Health are collecting data from all their facilities on energy use and emissions; water consumption; heating, ventilating, and air-conditioning system performance; and waste management. Through data analysis, they refine tactics and rank where individual facilities fall on the performance spectrum. CommonSpirit’s Sr. Leciejewski and Providence’s Schenk say their systems see much potential in decarbonization initiatives — the work to achieve net-zero greenhouse gas emissions. Both systems will be doing this by identifying and installing new energy-efficient technologies and encouraging their vendors to do the same. Providence categorizes its decarbonization work into five areas: waste, energy
THREE INITIATIVES BY SSM HEALTH
Stamping out Styrofoam SSM Health's use of styrofoam has plummeted 92.2% since 2017.
Plastic purge SSM Health has moved to plant-based packaging that is similar to paper to keep plastic water bottles out of landfills.
Taking out (much less) trash By reprocessing medical devices, using smaller pre-assembled custom kits for medical use, and switching to battery-free soap dispensers, SSM kept more than 100 tons of waste out of landfills in a single year.
and water, agriculture and food, chemicals, and transportation. Approaches are multilayered. For example, it is reducing energy consumption through the widespread use of advanced building automation to control temperature, humidity and lighting; heat pump technologies that heat and cool air without the use of fossil fuels; using ground to help cool buildings where feasible; avoiding unnecessary ventilation when spaces are not in use; and it is moving away from natural gas use toward more electricity from renewable sources. Lou Fierens is executive vice president of administrative services for Trinity Health. He sees a high potential return on investment for capital spent on constructing or renovating facilities to be more energy efficient, and the system is funding such projects at the rate of about $35 million annually. He said Trinity Health pilots have shown automation systems can greatly reduce the use of resources, including for heating, air, ventilation, lighting and water in hospitals. He cites Trinity Health St. Joseph Mercy Ann Arbor in Michigan as a region that has realized significant savings through its sustained efforts to improve energy efficiency: Between January 2004 and January 2021, that region decreased its natural gas consumption by 28%, its electricity use by 29% and its water use by 57%. SSM Health is benchmarking the energy consumption of each of its hospitals this year against similarly sized facilities nationwide, using Energy Star Ratings for Hospitals, the measure provided by the U.S. Environmental Protection Agency. Each SSM Health hospital is being held accountable for improving its rating by 2024.
Ask a clinician In February 2021, Brian Nelson became the sustainability programs manager at PeaceHealth Southwest Medical Center in Vancouver, Washington, the first person assigned full time to focus on sustainability in the PeaceHealth system. He said the system is using its flagship hospital, Southwest Medical, to pilot green ideas to move out to other PeaceHealth sites. Nelson said clinicians are becoming increasingly involved in assessing the Nelson environmental impact of their work, and many green programs at Southwest Medical were initiated by physicians and other frontline providers. Given that an estimated 30% of waste is generated in operating rooms, Nelson said he’s particularly interested in having O.R. staff identify opportunities to green-up the surgery suites. Already, through clinician involvement, numerous ministry sites have gotten rid of or greatly reduced the use of environmentally harmful gases including anesthesia gases and cut waste in medical equipment and packaging. Clinicians are helping facilities reduce the use of single-use, disposable equipment as well as the use of prepackaged surgical kits that come with many instruments that may not be needed for specific procedures. Beyond reducing system energy use and medical and other waste streams, SSM Health is among the many ministry facilities that are engaging as many people in the organization as possible in asking what they personally can do to reduce the environmental footprint of their own work — as well as their footprint at home. Laura Richter, SSM Health system vice president of formation and spirituality, said “It’s about thinking of ourselves as part of a natural ecosystem and being in solidarity with each other.” Involving as many associates as possible will propel the environmental work, Richter said. jminda@chausa.org
CATHOLIC HEALTH WORLD June 15, 2022
David Carson/St. Louis Post-Dispatch via Associated Press
Family members of a 12-year-old boy grieve at the scene where police say the child was shot and killed while playing with a gun that he and a 10-year-old found inside a home in St. Louis.
Support for gun research From page 1
health care ministry say the numbers bright line a devastating trend. “There is no room for negotiation around this, we have got to have stricter gun laws in this country,” said Sr. Mary Haddad, RSM, CHA’s president and chief executive officer. Gun violence, she said, is a public health crisis. Mike Slubowski, president and chief executive of Trinity Health, cites the CDC’s gun death figures and especially the drastic rise in gun homicides in explaining why his system sees firearm violence as a major public health issue and why it advocates for more funding for research on what’s behind the violence. “I think havSlubowski ing better data collection and more research will help us understand the root causes and risk factors of gun violence,” he says. “It would be our hope that we would find some evidence-based solutions to the issue.”
Plea for more funding Trinity Health and CHA are among almost 300 health care organizations that signed a letter dated April 28 urging the leaders of the House and Senate appropriations committees to increase to $60 million from the current $25 million the amount earmarked for the CDC and the National Institutes of Health to study prevention of firearm morbidity and mortality. CDC’s latest figures on gun deaths, released in mid-May, break down the total of 45,222 gun fatalities in 2020 to 24,245 sui-
cides, 19,350 assaults and 1,627 accidents or other causes. The agency says the total is the highest on record. While official gun fatality figures for 2021 won’t be released for months, the not-forprofit Gun Violence Archive says the data it has gathered from law enforcement agencies and other sources across the country show at least 45,000 gun deaths last year. The group has counted more than 17,000 gun deaths through May 25 of this year and 213 mass shooting incidents. Those shootings include the one May 14 in Buffalo that is being investigated by the FBI as a hate crime. Authorities say the 18-year-old white suspect drove 200 miles to the grocery in a Black neighborhood with the intent to kill Black people. Eight of the 10 people who died were Black. The school shooting May 24 in Texas, with 21 dead according to early reports, was second in lethality among elementary and high school shootings only to the one in Newtown, Connecticut, in 2012 that claimed 26 lives, including 20 children. Authorities say the 18-year-old gunman in Texas opened fire in a fourth grade classroom. A day before the Texas shooting the FBI released a report showing that active shooter incidents — those in which at least one gunman kills or attempts to kill people in a populated area — increased more than 50% in 2021 from the year before. Those incidents left 103 victims dead and 140 wounded.
No safe havens Slubowski points out that Trinity Health’s advocacy efforts around gun violence include supporting the Break the Cycle of Violence Act sponsored by Sen. Cory Booker, D-New Jersey, and other law-
workforce that health care executives say is strained and traumatized by the COVID pandemic.
Urging action to address gun violence CHA has a long record of advocacy efforts in partnership with other health care and faith-based organizations aimed at reducing gun violence. The efforts include calling on Congress to: Ban the purchase and sale of assault weapons. Ban the purchase and sale of high-capacity ammunition magazines. Establish universal background checks and close the private gun sale loophole. Close the Charleston loophole, which permits federally licensed dealers to sell guns to a buyer if three business days pass without the FBI having completed a background check. Repeal the Dickey Amendment and restore funding to the Centers for Disease Control and Prevention for research on gun violence. Oppose expanded concealed carry reciprocity legislation, which seeks to turn houses of worship into congregations armed with guns and weaponry. Enact a gun violence restraining order law, which would temporarily prohibit an individual from purchasing or possessing firearms when deemed by a judge to pose a danger to self or others. Oppose legislative efforts to deregulate the purchase and sale of gun silencers. Close the boyfriend loophole, which allows convicted abusers and stalkers to buy and own firearms.
makers. That measure calls for investing at least $5 billion in federal funding over eight years for community-based gun violence prevention programs. Violence isn’t just an issue outside the doors of medical facilities. Federal statistics show an upward trend in workplace violence toward care providers. Slubowski says Trinity Health, like other health systems, has had violent incidents on its campuses targeted at both providers and patients, some of them involving guns. “We’re spending significant resources to enhance security measures,” he says. The cost of gun violence includes the physical and emotional toll violence and the threat of violence take on a health care
U.S. gunmakers ramp up production threefold in 20 years The number of guns made by licensed manufacturers in the United States increased in 2020 to 11.3 million, almost three times as many as were made in 2000, according to a report released May 17 by the Department of Justice. Over the same period the number of guns imported into the country jumped 350% and the number exported spiked 240%, the report shows. The report was produced by the Justice Department’s Bureau of Alcohol, Tobacco, Firearms and Explosives. It was requested in April 2021 by President Joe Biden and Attorney General Merrick Garland as part of the department’s strategy to combat the rise in violent crime, according to a media statement that accompanied the release of the 306-page report on May 17. “We can only address the current rise in violence if we have the best available information and use the most effective tools and research to fuel our efforts” said Deputy Attorney General Lisa O. Monaco. “This report is an important step in that direction. The department will continue to gather the data necessary to tailor our approach at the most significant drivers of gun violence and take shooters off the streets.” Among the report’s other findings: The number of firearms manufactured per 100,000 people in the U.S. in 2000 was 1,397; in 2020 it was 3,410. The number of suspected privately made firearms, also
Privately made firearms, also known as “ghost guns,” seized by police in Pennsylvania.
known as “ghost guns,” recovered by police increased tenfold between 2016 and 2021, when 19,344 of the untraceable guns were confiscated. Pistols dominate the market, with 5.5 million made in the U.S. in 2020 compared to 2.8 million rifles. The number of short-barreled rifles manufactured annually increased 24,080% between 2000 and 2020. Between 2000 and 2020, annual silencer manufacturing volume increased 3,699%. — LISA EISENHAUER
Call to action In a statement released hours after the school shooting in Texas, Sr. Mary said: “On behalf of Catholic health providers across the United States, we are horrified, but sadly not shocked, about the news of another massacre and loss of so many lives. CHA has long advocated for sensible firearms policies, including banning weapons that enable the slaughter of many people in a matter of seconds. We also believe it is important to support research into the root causes of gun violence.” The CDC says gun injuries surpassed motor vehicle crashes as the leading cause of death for children and adolescents in 2020. Researchers say 4,357 children and teens were killed by guns in that year. The new CDC figures also show that firearms continue to take a particularly harsh toll on communities of color, with 77% of gun homicide victims identified as Black or Hispanic. Paulo Pontemayor, a CHA director of federal government relations, points out that zeroing in on health issues that disproportionately affect minority populations is part of the We Are Called campaign that CHA launched last year to conPontemayor front racism by achieving health equity. Most CHA members have joined the initiative. Pontemayor agrees research is the key to identifying causes for the violence and its disparate impact and to crafting successful interventions. “We truly are called to find ways that we can mitigate this and to find ways that we can all be safe and healthy and thriving in our communities,” he says.
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June 15, 2022 CATHOLIC HEALTH WORLD
Playing catch-up A congressional decree in 1996 that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control” effectively halted federal research into gun safety. The decree came amid heavy pressure from the National Rifle Association to eliminate the CDC’s National Center for Injury Prevention and Control after a study it funded in 1993 showed gun owners were at higher risk for violent crime in their home. The center survived but federal appropriations for gun violence research dried up until 2018 when lawmakers appropriated $12.5 million each to the CDC and the National Institutes of Health. They did so again in the next two federal budgets. The studies the appropriations are funding remain in progress. The letter CHA and the other healthrelated organizations sent to congressional appropriations leaders urging more funding notes: “A recent, rigorous report estimated that the federal government will need to spend approximately $100 million per year to fully fund a comprehensive research agenda on reducing gun violence.” Analyzing, advocating Laura Krausa, who oversees CommonSpirit Health’s violence prevention programs as the system director for advocacy programs, says health care providers know the importance of having reliable data to
inform their work. “Gun violence data at that macro level will be the data that informs public policy strategies and prevention and intervention strategies,” she says. She adds that CommonSpirit providers across its 21-state footKrausa print cared for 3,149 patients who had gun injuries in the fiscal year that ended June 30, 2021. The cost of their medical treatment was $32 million. A third of those patients were assault victims; the rest were injured in gun accidents. However, the assault victims tended to incur the most egregious injuries and require the highest acuity care, Krausa says. “Two-thirds of the costs were for assault and a third for accidental shootings, which I think speaks to the particularly devastating nature of assault and potentially the kinds of weapons that are used,” she notes. Krausa says CommonSpirit uses its patient data on gun violence to inform its education and prevention strategies, including systemwide approaches to reducing gun violence as well as specific interventions with partners at the community level. She points out that within the CommonSpirit system, assault-related injuries are more common in urban areas and hunting accident injuries more likely in rural areas. “We need to make sure we’re always measuring, because we want to make sure that whatever we’re doing is actually work-
ing,” she points out. In addition to advocacy efforts around gun safety policies and partnerships in community-based violence intervention programs, CommonSpirit’s violence prevention efforts include shareholder advocacy. The system urges companies to adopt policies that enhance gun safety. For example, Krausa says, CommonSpirit has engaged in efforts to pressure credit card companies to stop allowing sellers of “ghost guns” to use their services in transacting sales of untraceable firearms and components.
Gun safety focus Both Krausa and Slubowski say that in advocating for violence prevention efforts their systems are respectful of the sensitive nature of discussions around gun ownership in the U.S. Krausa says CommonSpirit has issued statements making clear its position that “the Second Amendment can absolutely peacefully exist with sensible and reasonable solutions to gun violence.” Slubowski says Trinity Health’s support for research and prevention efforts around gun violence is not a political stance but rather an extension of its mission to be a compassionate and transforming healing presence in the communities it serves. “Safety is one of our core values,” he says, “and ultimately our goal is to improve the health of communities and to keep people safe.” leisenhauer@chausa.org
2 22 AWARDS
CHA Congratulates the 2022 Award Recipients
Winner announced at the 2022 Assembly.
ACHIEVEMENT CITATION For innovative programming that changes lives
LIFETIME ACHIEVEMENT AWARD For a lifetime of contributions
SISTER CAROL KEEHAN AWARD For boldly championing society’s most vulnerable
SISTER CONCILIA MORAN AWARD For demonstrated creativity and breakthrough thinking
TOMORROW’S LEADERS HONOREES Honoring young people who will guide our ministry in the future
Sr. Maureen McGuire, DC, Former Executive Vice President and Chief Mission Integration Officer, Ascension, St. Louis, Missouri Dr. Alexander Garza, Chief Community Health Officer, SSM Health, St. Louis, Missouri
Mary Anne Sladich-Lantz, Senior Vice President, Mission and Formation, Providence St. Joseph Health, Renton, Washington
Andrew G. Ochs, Regional Director, Mission Integration, SSM Health, Oklahoma City, Oklahoma Sarah Reddin, Vice President, Ministry Formation– Mission Integration, Ascension, St. Louis, Missouri
Dave Benner, Chief Ancillary Officer, CHRISTUS Health, Irving, Texas Jacquelyn Bombard, Executive Director, Federal Relations, Providence St. Joseph Health, Renton, Washington Amanda Bottolfson, Director, Medical/Surgical, Swingbed, ICU, and PCS Staffing, Avera Sacred Heart Hospital, Yankton, South Dakota Ashley Brand, System Director, Community Health, Integration & Housing, CommonSpirit Health, San Francisco, California
Andrew Ritz, Vice President, Operations, Mercy Hospital, Durango, Colorado Heather Runnels, Vice President, Patient Care Services, Our Lady of the Lake Ascension, Gonzales, Louisiana Ryan E. Stuhlreyer, Vice President, Service Line Strategy, Bon Secours Mercy Health, Richmond, Virginia Adrienne Webb, Director, National Communication, Issues and Reputation Management, Providence St. Joseph Health, Renton, Washington
A Passionate Voice for Compassionate Care®
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Ministries’ partnerships put violence prevention efforts into practice
C
ommonSpirit Health is among the Catholic health systems making community partnerships key to its efforts to reduce violence, including assault, bullying, child abuse, youth violence, intimate partner abuse, human trafficking and gun violence. Laura Krausa has overseen violence prevention programs for more than a decade for Catholic Health Initiatives, which joined with Dignity Health in 2019 to form CommonSpirit Health. As system director of advocacy programs at CommonSpirit, she continues to provide guidance for the communitybased violence prevention initiatives which the organization has funded over the years with $35 million in grants. One of CommonSpirit’s longstanding partnerships is with the Chester Community Coalition in Delaware County, Pennsylvania. Chester has a population of about 34,000 and a homicide rate 25 times higher than elsewhere in the county. CommonSpirit provides funding for a program that uses the evidencebased Sanctuary Model to create a trauma-informed community and safe and healing environments for children, families and adults who have experienced chronic stress and adversity. The program taps the services from a coalition of groups to provide a range of bereavement and trauma-informed interventions for those aged 8-18 who have been impacted by homicide. “The coalition and its work is facilitated by the money that we’ve put into it and we’re essential in helping to connect all the dots,” Krausa explains. One of Trinity Health’s community-based violence prevention efforts is Hartford Communities That Care, a partnership through its Saint Francis Hospital and Medical Center in Hartford, Connecticut. The collaborative uses distinct and overlapped programs and service models to address violence and trauma in underserved parts of the city. Part of the effort is a hospitalbased violence intervention at Saint Francis that connects shooting victims and their families to various services, including medical, mental health and social support. Mike Slubowski, president and chief executive of Trinity Health, says over the program’s several years in existence more than 1,800 gunshot victims have availed themselves of it. In May, the city announced that the program would be expanded across Hartford through a partnership involving several organizations, including Trinity Health, two other health systems and Hartford Communities That Care. SSM Health Cardinal Glennon Children’s Hospital and SSM Health Saint Louis University Hospital are among four hospitals in St. Louis taking part in an initiative called Life Outside of Violence. The program uses grant funding to cover the salaries of social workers who provide case management, therapy, counseling and mentoring services for any victim of gunshot, stabbing or assault age 8-24 who comes into emergency rooms for care. — LISA EISENHAUER
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CATHOLIC HEALTH WORLD June 15, 2022
Memories That Last
Bax helped set up a visit to the weather station at Scott Air Force Base, near St. Louis. “They went over all the equipment and they treated her so well there,” Bax recalled. “They gave her one of their military coins that shows that you’re a part of their unit. It was a really special day.”
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May 3. “It was a gift.” The SSM Health Foundation partly financed the gift through its Memories That Last program. The program provides financial gifts of $25-$500 to cover the cost of fulfilling wishes of patients in their final days and creating special memories for their loved ones.
‘Awesome and amazing’ That certainly happened for Holzhauer and his relatives. His older sister Janice Winks recalled how stunned her brother was to tour the home turf of a team he has cheered on for decades. “He was standing there, and he was trying to take it all in and he didn’t even know what to say,” said Winks, who accompanied Holzhauer on the trip along with another sister, Marsha Meister, and Meister’s husband. The sisters and another of the eight siblings in the family gathered at Holzhauer’s apartment in April to talk about his big trip, which stretched over three days. They also reminisced about a shorter one he took a couple of weeks later to Busch Stadium, where another of Holzhauer’s favorite teams, the St. Louis Cardinals baseball team, plays.
John Holzhauer, left, takes a break for a drink with his brother-in-law Leroy Meister at Lambeau Field, home turf of Holzhauer’s beloved Green Bay packers.
Touring the stadiums was on Holzhauer’s bucket list. While Memories That Last funding didn’t specifically go toward the trip to St. Louis, by covering some of the expenses for the Lambeau Field visit, the family said it made the second tour possible. Andrea Shupe, a SSM Health hospice social worker, was the family’s connection to the program. When she overheard Holzhauer’s siblings discussing his wish to go to Lambeau Field, she told them that the SSM Health Foundation might be able to chip in on the cost. “I didn’t do much,” Shupe said. “I put them in contact with the person who actually had access to the money.” Marsha Meister was effusive in her praise for Shupe, the SSM Health Foundation and the people in the Packers and Cardinals organizations who set up the tours and followed up with gifts. “John never asks for anything and when we got this together with everybody’s help, it was awesome and amazing,” she said.
Dream takes flight Tobi Bateman, an SSM Health hospice nurse case manager, helped with a Memories That Last experience for a patient named Barbara Woodruff who had a dream of piloting a small airplane. Bateman said that she contacted SSM Bateman Health hospice social worker Gina Bax the same day she heard about Woodruff’s wish. “I finished up my visit and I wasn’t even
Barbara Woodruff stands on the tarmac of an airfield in Chesterfield, Missouri, between the plane she briefly piloted and Tobi Bateman, an SSM Health hospice nurse who accompanied her on the flight. Woodruff’s adventure was planned by SSM Health hospice workers and financed through the SSM Health Foundation’s Memories That Last program.
out of the parking lot and I’m on the phone to Gina,” Bateman recalled. “Gina got really excited and she’s like, ‘I’m not gonna do anything else this afternoon but look into this.’” Woodruff, 72, had advanced cancer and had grown too weak to tolerate chemotherapy. She was getting hospice care in a residential nursing facility. Bax contacted several companies that give flying lessons and eventually arranged a flight with Elite Aviation of Chesterfield, Missouri, at a discounted rate. The delicate process of getting the medically fragile Woodruff on the plane was complicated further Bax by a couple of factors, Bateman and Bax said. First was the weather, since it was the middle of winter. Next was Elite Aviation’s request that someone on Woodruff’s care team accompany her. That required SSM Health’s legal team to get involved to ensure that any potential liabilities were covered. Bateman wound up in a seat right behind Woodruff on the Feb. 10 flight. She witnessed Woodruff’s elation when the pilot briefly handed over the controls as the plane soared over St. Louis and the surrounding region. “She was just giddy,” Bateman said. After the plane landed, Elite Aviation presented Woodruff with a flight log as a keepsake. Woodruff’s support team — three close friends, a chaplain, Bateman and Bax — toasted her on the tarmac with sparkling juice. “I was a little scared to death, to be honest, but I’m so glad that I got to experience it with her and to be able to document it,” said Bateman, whose Facebook post with pictures of Woodruff piloting the plane drew dozens of likes and several shares. Woodruff died March 28.
All hands on deck Bax said it’s not usual for Memories That Last projects to require more than financial support, such as the sign-off from the legal team for Bateman to be on Woodruff’s flight. She described an “all-handson-deck” effort by SSM Health and SSM Health Foundation to arrange the outings or events and make sure any exigencies are addressed. The wishes the program fulfills aren’t always as grand as taking a road trip to a stadium or piloting an aircraft. Bax said Memories That Last has funded meals from favorite restaurants, birthday parties and even a small wedding. The program helped one patient throw a surprise retirement party for a hospice nurse who had helped with his care. Another time, Bax tracked down a supplier of a patent’s favorite canned clam chowder, which wasn’t on store shelves because of the season, and tapped funding from the program to arrange a special delivery. Another wish fulfillment that Bax remembers especially fondly was for a
“Hospice isn’t all just death and dying. It’s about helping people live their life the best way with what they have left. If we can make somebody’s dream come true, that’s just amazing.” — Tobi Bateman woman who had been a civilian meteorologist for the military during World War II and mentioned that she was curious about how much the equipment might have changed.
Happy tears Another hospice patient, 60-year-old Cullen Clark of Warrenton, Missouri, had wished to attend a car show. Fulfilling that wish was complicated because Clark was medically fragile due to colon cancer and because the COVID-19 pandemic had put a halt to most car shows and other live events. Bax and some of her colleagues came up with the novel idea of bringing a car show to Clark. They partnered with a group called the Misfit Toys Car Club and arranged a parade through Clark’s neighborhood in March 2021. As Clark sat in his wheelchair in his yard surrounded by relatives and friends, about 150 cars cruised past with the drivers honking and waving. “He couldn’t believe that many people cared enough to show up for him,” Bax said. “The parade brought him to tears — happy tears. It really touched him, and all of us.” Clark died about a month after the car parade. Shupe, Bateman and Bax said being able to grant wishes to patients with the help of Memories That Last inspires their work. “Hospice isn’t all just death and dying. It’s about helping people live their life the best way with what they have left,” Bateman said. “If we can make somebody’s dream come true, that’s just amazing.” leisenhauer@chausa.org
Relatives and friends surround Cullen Clark outside his home in Warrenton, Missouri, as cars parade past. The procession was planned by SSM Health hospice workers as part of the SSM Health Foundation’s Memories That Last program. Cullen was a fan of car shows. He died shortly after this event.
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Confront, don’t tolerate, patient prejudices, system representatives urge By LISA EISENHAUER
When a nursing leader at a hospital within the Bon Secours Mercy Health system observed a nursing resident withstanding insults and slurs hurled by a patient, she asked him how long he had been enduring that treatment. “And his response was, ‘Oh, I’m used to this, this happens all the time, not just with this patient, but other patients I’ve seen, too,’” said Pavarisa Amornkit, the system’s program manager for diversity and inclusion. The nursing leader Amornkit informed the new nurse, a person of color, that the abusive treatment was not OK and he could request to be removed from the care team of patients whose behavior toward him is offensive. Kathleen Murray, manager of learning and development at Benedictine, said residents at some of the continuumof-care system’s facilities at times have rejected the assistance of care providers and tried to shame those staffers in front of Murray others based on their skin Project2_Layout 1 5/23/22 9:05 AM Page 1 color, accent, tattoos or fears about their
sexual orientation. In at least one case, a resident reported abuse by a staff person. After investigating, it was determined that there was no abuse but rather the resident having racist views toward that staff person that was the genesis of the complaint. “For the most part our staff enjoy great relationships with our residents but biased and racist behavior is a problem that we definitely have to deal with,” Murray said. Amornkit and Murray joined Patrick McCruden, chief mission integration officer at SSM Health, as the featured speakers at a webinar May 18 titled “Handling Racist Behavior by Those We Serve.” The discussion of how the speakers’ sysMcCruden tems confront prejudice was sponsored by CHA as part of a series under the umbrella of the association’s We Are Called initiative focused on confronting racism by achieving health equity.
Training and resources Amornkit shared that Cincinnati-based Bon Secours Mercy Health provides training on biases and racism for all of its 60,000 associates. The system’s internal website includes a racial justice and equity resource center with articles, materials and tools
about prejudice and how to confront it. “We also in the training provide the language for our leaders to check in with their associates and colleagues to listen to their experiences, to validate them, to try to understand because we know that we all don’t share the same experiences,” Amornkit said. In addition, she noted that Bon Secours Mercy Health coaches its chaplains and clinical leaders on how to explain to patients that granting requests involving racial, ethnic or other forms of discrimination would conflict with the system’s mission and values. If confronted with a belligerent patient, those doing the explanations can advise that the patient has the option to seek care elsewhere.
McCruden said St. Louis-based SSM Health has policies at the system level on how staffers should respond when patients reject care from or lash out at providers based on prejudice. He acknowledged, however, that in practice situations are often complex. He noted that when there is an incident involving prejudice by a patient, an administrator or a supervisor is called in to explain that bowing to discriminatory requests would go against the system’s Catholic identity, which is based in part on the belief that each person is created in the image and likeness of God and has an inherent human dignity. At the same time, McCruden said, SSM Health is committed to protecting its staffers “so that they’re not put into a place where they’re going to have to absorb ill behavior from the patient.”
“For the most part our staff enjoy great relationships with our residents but biased and racist behavior is a problem that we definitely have to deal with.” — Kathleen Murray Opening a dialogue The speakers all agreed that there are instances when a patient’s request for a different care provider might fall into a gray area because the request is based on the patient’s culture or lived experiences. For example, they discussed how people of some religious faiths might insist on being seen only by doctors who are the same gender as they are and African-American patients might be aware of studies showing better care outcomes when they are treated by African-American physicians. In situations where the motives behind a patient’s request for a change of care provider is unclear, McCruden said: “I think you have to have that dialogue with the patient” to ask why the individual is making this request. He pointed out that systems have to be mindful that incidents involving bias can transcend the ethical realm and move into the legal one. Federal civil rights laws, for example, prohibit employers from reassigning staff based on factors such as race or gender. “The legal backing is there, if you want to use that explanation with patients, that’s very appropriate,” McCruden said. Celebrating diversity Murray said Duluth, Minnesota-based Benedictine is early in its efforts to craft policies addressing patient bias at its eldercare communities. She is leading a task force on the subject. The group has broken its work into three parts. One is to review the system’s admissions documents and policies about resident behavior in terms of respecting staff. The task force is identifying what education and training is needed for staff to respond to prejudiced patients and, if patients act out on their biases, how to educate residents and their families on diversity and inclusion. Lastly, Murray said Benedictine is looking for opportunities to highlight cultural traditions that celebrate the diversity of its staff. As an example, one community had an altar display created by a Hispanic associate to commemorate the Day of the Dead last fall. “It’s an opportunity to rid people of assumptions and prejudices and get in front of it with exposure,” Murray said. leisenhauer@chausa.org
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CATHOLIC HEALTH WORLD June 15, 2022
KEEPING UP PRESIDENTS AND CEOS
HONOR
GRANT
Michael Korpiel, president of Dignity Health Mercy San Juan Medical Center of Carmichael, California, has accepted the expanded role of Greater Sacramento market president. The facility is part of CommonSpirit Health. Dr. Timothy Quinn to president and chief executive of Mercy Medical Center in Cedar Rapids, Iowa, effective Jan. 1, 2023. His current role is executive vice president and chief of clinical operations. He will replace Timothy Charles, who will retire Dec. 31.
The National Minority Quality Forum has named Paulo G. Pontemayor a 40 under 40 national leader. Pontemayor is a CHA director of government relations. Here, Pontemayor, second from left, is at the ceremony with, from left, Xavier Becerra, secretary of the U.S. Department of Health and Human Services; Gary A. Puckrein, president and chief executive of the National Minority Quality Forum; and U.S. Rep. Robin Kelly, D-Illinois, chair of the Congressional Black Caucus Health Braintrust.
The Flaget Memorial Hospital Foundation has received a grant of more than $2 million from the Legacy Foundation of Kentuckiana. Flaget Memorial Hospital of Bardstown, Kentucky, will use the funds at its CHI Saint Joseph Health – Cancer Care Center to purchase a new linear accelerator, a radiation treatment device for cancer patients. The hospital is part of CommonSpirit Health.
ANNIVERSARY Marian Regional Medical Center, Santa Maria, California, part of CommonSpirit Health, 10 years.
Evictions
recipients’ behalf in disputes. Hemenway says by connecting fund recipients “to financial counseling in addition to providing resources, our aim was to expand financial knowledge, education of additional community resources, and set residents on a path to financial and housing stability that community partners could continue to nurture.”
the program, dubbed the Cincinnati Housing Response Program, after 2016 community assessments of Cincinnati’s Bond Hill and Roselawn neighborhoods revealed housing concerns and after 2019 surveys of residents determined that many of them were worried that they would not be able to maintain their housing. What they wanted was immediate, direct financial assistance. And that is exactly what Bon Secours Mercy Health delivered to 174 households from December 2020 through October 2021 — a window of time when the pandemic had worsened the financial picture of many people living in the targeted neighborhoods. Bon Secours Mercy Health worked with nonprofit organizations already active in the community to identify people experiencing housing instability, make them aware of the availability of the funds and guide them in applying for the financial assistance. A follow-up report says that the aid achieved the goal of increasing housing stability among fund recipients. “We listened to the community” and responded, says Kendra Smith, vice president of community health for Bon Secours Mercy Health. “We wanted to address social determinants of health, but the question for health care providers like us is, where is our space” in this work? “This was a great opportunity to explore Smith community partnerships, with us as convener. We tapped into well-established community partnerships, helped them build capacity and leveraged their expertise.”
Through the cracks The Cincinnati area experienced shutdowns and cutbacks at the start of the pandemic that played out as more job and income instability in the working-class neighborhoods of Bond Hill and Roselawn, says Dowdall, a policy director for
Bond Hill is one of the communities where Bon Secours Mercy Health made direct one-time payments to qualified applicants. The program helped residents bridge immediate financial shortfalls.
Photo courtesy of Cohear
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Residents of the Bond Hill and Roselawn communities in the greater Cincinnati area gather at Roselawn Condon School in spring 2019 to discuss their housing priorities with Bon Secours Mercy Health representatives. The health system convened four such meetings to better understand conditions in the communities surrounding the system’s headquarters campus.
Reinvestment Fund's research group. That organization evaluated the Cincinnati Housing Response Program’s impact for Bon Secours Mercy Health. Many in Bond Hill and Roselawn were struggling to make ends meet before the pandemic. People burned through any funds they had at hand and fell behind on rent, mortgage, utility, tax and other payments. Even people who had never needed assistance before began having trouble with the bills, says Hope Wilson, director of operations and housing program Wilson manager for Working in Neighborhoods, or WIN, a Cincinnati nonprofit that Bon Secours Mercy Health partnered with. Pandemic-related rent and mortgage moratoriums and government direct payments paid for through the Coronavirus Aid, Relief, and Economic Security Act provided temporary relief for some, but the underlying challenges remained. Gina Hemenway, community health director for Bon Secours Mercy Health’s Cincinnati region, explains, “Threats of eviction and foreclosure were not new with the onset of COVID-19, but were merely exacerbated. Those already in housing and financial trouble Hemenway found themselves falling further behind. Those with new issues of housing and financial instability simply were given more time to find a solution due the moratoriums. It was understood that the moratoriums would end at some point.” The goal of Bon Secours Mercy Health’s Cincinnati Housing Response Program was to ensure renters and homeowners were in good standing when that happened, she says.
Listen and learn Before the pandemic, Bon Secours Mercy Health had secured nearly $300,000
through Accelerating Investments for Healthy Communities, a grant program from the Robert Wood Johnson Foundation and the Center for Community Investments. And Bon Secours Mercy Health contributed nearly $200,000 of its own funds to the Cincinnati Housing Response Program. Bon Secours Mercy Health originally planned to use the capital for affordable housing construction. But the 2019 surveys of community members revealed they did not want that; they wanted to receive direct aid to stabilize their household finances. Bon Secours Mercy Health pivoted, and in late 2020 and throughout most of 2021, it engaged with Cincinnati nonprofit Housing Opportunities Made Equal, or HOME, in identifying renters and with WIN in identifying homeowners experiencing housing instability. Staffers with those two agencies spread the word about the availability of funds and invited Bond Hill and Roselawn residents experiencing housing unstability to apply.
“This was a great opportunity to explore community partnerships, with us as convener.” — Kendra Smith Eligible renters could receive up to $1,000 per household and homeowners up to $5,000. The one-time financial assistance bridged them through some immediate shortfalls. HOME and WIN staffers also identified additional sources of financial aid for some people in the program. When community members received the Bon Secours Mercy Health assistance, they also became connected to HOME and WIN’s bread and butter services, including financial education, and links to job programs and social services. HOME and WIN staff helped with communication with landlords and mortgage companies and advocated on the fund
Stopgap According to HOME and WIN staffers, recipients used the financial assistance to pay missed rent or mortgage payments, late fees, delinquent utility bills or other home or apartment living expenses. The money was a stopgap until other forms of income kicked in. Janet Brown, manager of tenant advocacy for HOME, notes that Social Security and unemployment payment systems had been disrupted due to the pandemic, and the assistance gave people some breathing room until those checks came in more reliably. Other recipients Brown had found jobs after being let go, or their furloughs were ending, but they had not yet caught back up with bills. Reinvestment Fund and Greater Ohio Policy Center analyzed the impact of the Cincinnati Housing Response Program. In their joint report, those organizations said that 90% of renters and all homeowners reached through the Bon Secours Mercy Health program evaluation remained in the same housing unit up to seven months after receiving assistance. That stability is especially important as about two-thirds of those interviewed reported that someone in their household had a chronic disease or ongoing mental health challenge. Reinvestment Fund and Greater Ohio Policy Center said it was difficult to isolate the neighborhood-level impact of the direct payments from the Cincinnati Housing Response Program in part since there were funds from multiple government pandemic response programs flowing into the neighborhood simultaneously. But they estimated that without all the financial assistance there could have been double the number of foreclosure filings in the affected communities and evictions may have been up by as much as 40%, once the moratoriums were lifted. Smith says when it comes to addressing housing concerns, the Bon Secours Mercy Health team learned that “stabilization is as important as new housing,” and that stabilization should be done in the way that the community says it should be done. “At the end of the day, this aid was short term, but a goal is to be thinking of how we can be more present in partnering long term in these housing conversations,” says Smith. “This was a great baseline for us, and it changes the conversation about what it is to invest in housing.” jminda@chausa.org