Grants fuel transformational programs 2 New CHRISTUS headquarters 2 Executive changes 7 PERIODICAL RATE PUBLICATION
NOVEMBER 15, 2023 VOLUME 39, NUMBER 18
Healthcare Here media campaign calls attention to harmful commercial insurance practices
A FRESH START
By VALERIE SCHREMP HAHN
CHA is rolling out a social media campaign to call out commercial insurance companies that are posting record profits while making it hard for people to get care. CHA launched Healthcare Here at healthcarehere.org on Oct. 23 along with its partners in the Alliance for Access to Care. The alliance includes the American Hospital Association and other health care providers and patient advocacy groups. The idea for Healthcare Here came about earlier this year after a CHA affinity group meeting of Catholic health system CEOs. They had long heard from patients and clinicians about the impact commercial insurance denials have on the ability to access care. The leaders also pointed to distortion and disinformation campaigns from activists and for-profit commercial insurance providers over the last year, at a
Nurse Lindsay Barleycorn leads a grocery tour at a Dollar General store with several participants of the Geaux Get Healthy Clinical Program, based at Our Lady of the Lake Health in Baton Rouge, Louisiana. The tour is part of the eight-week program that the system offers to people who are food insecure.
Our Lady of the Lake program teaches how to buy, cook healthy foods >>> Trinity Health launches Health Comes
SSM Health’s Baskets of Hope help nourish patients as they heal at home
First initiative. 8
By LORI ROSE
Continued on 8
By VALERIE SCHREMP HAHN
Live from Ukraine: CHA webinar explores needs, Catholic relief in war-torn country By VALERIE SCHREMP HAHN
As with every container of medical supplies and equipment collected for donation by Hospital Sisters Mission Outreach, when the 40-foot container of supplies bound for Ukraine was ready to leave the shipping dock in Springfield, Illinois, in April, people gathered around it. “Everyone who’s in the building, our volunteers, our staff, even the truck driver gathers in a circle and says our container prayer,” Erica Smith, president and executive director of the nonprofit, said during a webinar hosted by CHA on Oct. 26. The prayer, she said, is “for everyone who’s worked on this container, Smith who’s going to help transport it, and most importantly for the people who are going to use the materials.” The webinar connected Smith, who joined from Springfield, with people in Ukraine who have seen how the container’s contents have been welcomed and put to use as part of the Catholic humanitarian relief effort. The effort began just after Continued on 7
Stephanie Joseph enthusiastically lists the new things she’s It’s hard to focus on healing when you’re hungry or worried learned during her classes with the Geaux Get Healthy Clinical about feeding your family. But several SSM Health hospitals in Program. Wisconsin are working to alleviate food concerns by sendInstead of sipping her usual morning Coca-Cola or ing new moms home from the hospital with an emerDePaul program downing her medications with juice, she drinks cold gency supply of groceries. lets patients water with a slice of lemon. Instead of buying tuna in Partnering with local food banks, SSM Health dealing with cans packed in oil, which she loved, she buys tuna launched a program called Baskets of Hope. The initiahunger choose packed in water. Instead of premade lasagna high in tive is designed to help food-insecure patients continue food for box. Inside | 5 sodium, she makes a healthier version with ground turto heal once they get back home and to connect them key. She eats more vegetables and fruits than meats. with more permanent community resources. “Before, I just ate what I want,” says Joseph, 60, who has diaSSM Health started the program specifically for new moms betes and kidney disease. “I don’t eat what I want now, but I pay who identify as having food access challenges and is expanding it Continued on 4
Continued on 5
Mission leaders use ‘distinct voice’ to advocate for ministry priorities By JULIE MINDA
Josh Kramer, a staff member of Sen. Bob Casey, D-Pa., visits with Cathy Cardillo, Trinity Health MidAtlantic regional advocacy director. Cardillo was part of a contingent of Trinity Health advocates who met with staff of congressional offices of both political parties during CHA’s mid-October Advocacy Days. The Trinity Health advocates spoke extensively with their mission leader colleagues to prepare for the visits.
WASHINGTON — For the first time, CHA this year encouraged system mission leaders to join their advocacy colleagues at the association’s Advocacy Days, which took place here Oct. 18 and 19. Hospital Sisters Health System was among the ministry systems that took CHA up on the invitation. HSHS Chief Mission Officer Rachelle Barina joined HSHS President and CEO Damond Boatwright on multiple visits with the staffs of Congress members representing the Illinois and Wisconsin communities HSHS serves. It was Barina’s first time making such visits on Capitol Hill. She said that “having the opportunity as a mission leader to join conversations with our representatives” enabled her and Boatwright, chair of CHA’s Continued on 6
2 CATHOLIC HEALTH WORLD November 15, 2023
Providence’s Well Being Trust grants fuel programs to transform communities By LISA EISENHAUER
An outpatient relational health unit for children in Lubbock, Texas, and a crisis receiving center in Missoula, Montana, are among the programs that got funding in the first round of what Providence’s Well Being Trust plans to make an annual grant process. The trust awarded nearly $5 million for 29 new behavioral health initiatives in communities across the footprint of Providence St. Joseph Health in Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Dr. Arpan Waghray, the foundation’s CEO, says the grants went to programs that are innovative and transformational for communities. Providence sites submitted more than 50 applications for grants. The requests totaled three times what the trust had budgeted. “This is happening just on the other side of the COVID pandemic, so one would imagine that our caregivers are hard-pressed to take on new initiatives, but I’m so proud to be a person of Waghray Providence where our people care so deeply about these challenges that patients and community members are experiencing,” Waghray says. Providence established the trust in 2016 with an endowment. Its goal is to advance mental, social and spiritual health across the nation. Last year, it shifted its focus inward to support programs in the communities the health system serves, with the hope that those programs can be refined and proved scalable elsewhere. Waghray says the idea behind the grant allocation was simple: “How do we empower the people on the front lines to partner with their patients, families and community members to address some of the most challenging issues and deepest problems that communities are facing?” He adds that all the programs funded by the grants are aligned with Well Being Trust’s strategic priorities of expanding access to care, raising the quality of care, and improving mental health and resilience in communities.
Pediatric mental health care Covenant Children’s in Lubbock got a grant for its Relational Health Center that
The Relational Health Center at Covenant Children's in Lubbock, Texas, opened in August. The unit is meant to bridge a gap in mental health care in Northwest Texas for children and teenagers.
opened in August. Dr. Amy Thompson, Covenant Children’s CEO, says the unit will address the lack of services in Northwest Texas for those 18 and younger who need mental health care and the disconnect among the services that do exist. Post-COVID data from Covenant’s emergency Thompson department shows that the number of patients who are in a mental health crisis has tripled. “While the number of kids entering our ED in crisis is staggering, unfortunately an even larger number are not making their way to seek care,” Thompson adds. Covenant’s new unit houses spaces for psychiatry appointments, an intensive outpatient program and a partial-day hospitalization program. In addition to psychiatrists, the unit is staffed by a pediatrician, counselors, therapists and social workers. In time, Thompson says, Covenant hopes to add inpatient care. “Our goal is to try to put all of those services together and run them out of the same place so that they’re coordinated,”
she says. The unit is being operated in partnership with the Texas Tech University Health Sciences Center. Covenant has a longstanding collaboration with the university, with the school providing physicians and the hospital offering opportunities for medical students and residents. Waghray says the grant approval process included whether the programs have partners that are grounded in the community and willing to provide support. Other criteria were how many people the programs had the potential to reach, whether they had a built-in health equity lens to ensure that those who are often marginalized are served, and whether they had a long-term sustainability plan.
Crisis receiving center A partnership called the Strategic Alliance for Improved Behavioral Health is behind the crisis receiving center set to open this month in Missoula. The alliance includes Providence St. Patrick Hospital and several other mental health care providers in the community as well as city and county agencies and people who have lived
experience with mental health conditions and substance use disorders. Jeremy Williams, a nurse who is director of behavioral health at St. Patrick Hospital, says Missoula County has a lack of outpatient mental and behavioral health resources for people in its population of about 120,000. “You really have this no Williams man’s land or gray area for folks that are in need of resources as they are going through crisis,” Williams says. “They might not need an acute admission, but still need those supportive resources, such as seeing a therapist or doing some resource planning.” Adults will be able to check themselves into the receiving center for stays of up to 24 hours. They can rest, be examined by a nurse, talk with a counselor, and seek out longer-term resources. The center will be open 24/7 and staffed by a nurse, a mental health technician, a security officer, a social worker or therapist, and a peer support counselor. The grant from Providence’s Well Being Trust will assist in underwriting some of the center’s initial operation expenses.
Creating a warm welcome To ensure that the care is respectful of indigenous communities, the center’s planners consulted with the nonprofit All Nations Health Center. One of the accommodations that resulted was space for patients to conduct smudging ceremonies, a cleansing ritual involving sacred herbs. “We wanted to create a warm welcome within so that people feel like they can reach out whenever they need assistance,” Williams says. “We will have staff there waiting to help regardless of race, creed, faith, gender — whoever they are and wherever they’re coming from.” As with all the programs it supports, the trust will be analyzing data from the grant-funded initiatives, Waghray says. The foundation will be checking whether the initiatives are helping it advance its goal to provide access to behavioral health care to 1 million more Americans and lifesaving interventions to 100,000 patients over the next three years. “We’re doing this important work to save lives,” Waghray says. leisenhauer@chausa.org
Correction In a Nov. 1 Catholic Health World story about the leadership summit of the National Association of Latino Healthcare Executives, the first name of CHRISTUS Health Senior Vice President and Chief Nurse Executive Gerardo Flores was misspelled.
The new headquarters of CHRISTUS Health in Irving, Texas, will house about 2,000 associates.
CHRISTUS headquarters moves to 15-story tower CHRISTUS Health in mid-October unveiled its new, 15-story corporate headquarters on a 4.2-acre parcel in Irving, Texas, a suburb of Dallas. The 460,000-square-foot tower will house about 2,000 CHRISTUS Health associates who support the nonprofit health system from Irving. The building sits adjacent to a 10-story parking garage. The new building will replace leased office space in Irving. Since CHRISTUS consolidated corporate offices over a decade ago, the health system has grown from 30,000 to nearly 50,000 associates in four
countries. “This move is so much more than a new, physical location,” Ernie Sadau, president and CEO of CHRISTUS Health, said in a release. “This symbolizes our 150-year legacy in the communities we serve across Texas, Louisiana, New Mexico, as well as Mexico, Colombia and Chile in Latin America.” He added: “While we don’t have hospitals in the Dallas-Fort Worth region, it’s important to us to invest in our associates who office here to support our ministries and their growth around the globe.”
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November 15, 2023 CATHOLIC HEALTH WORLD 3
CHA launches book club for Catholic health care leaders CHA is starting a book club for Catholic health care leaders called “Reading the Signs of Our Times.” The book club includes six sessions, starting Dec. 19. Participants will receive six books, or eBooks if they prefer, that touch on essential elements of the Catholic health care ministry: ethics, mission, formation, advocacy, sponsorship and well-being. The hourlong virtual sessions, which will be held bimonthly at 1 p.m. ET Tuesdays, will each be led by a CHA expert on the book’s topic. The book club follows the success of an ethics book club CHA hosted from October 2022 through August. About 120 people participated, and some said they would love to do it again, but with a wider subject range of books. “I think that people just appreciate it, coming together as a group and discussing something of importance to their work,” said Brian Kane, CHA’s senior director of ethics. “This is one of the reasons why we decided to do something a little bit more variable this year — we had people from lots of different aspects of Catholic health care. We had some ethicists, we had some mission leaders, we had pastoral care people, we had some clinicians — it was a real mix of people.” Authors of the books participated in some of the ethic book club’s sessions. Some authors will participate in the new group’s gatherings, too, including O. Carter Snead, who wrote What it Means to Be Human: The Case for the Body in Public Bioethics. That book will be discussed at the first session.
Little artists unleash colorful imaginations Some young artists have turned what had been a stark white hallway at PeaceHealth Ketchikan Medical Center in Alaska into a corridor bursting with color. The children from the hospital’s Child Development Center decked the hall this summer with rainbows, flowers, smiley suns and an array of vivid smudges. Some of the artists even signed their work. At bottom left, Lindsay Lamon, a labor and delivery nurse and mother to one of the youngsters, and Rheman Seludo, a child care attendant, watch as the creative process takes form. Photos by Kate Govaars @ PeaceHealth Ketchikan Medical Center
The other dates and books are: Feb. 20 — The Four Agreements by Don Miguel Ruiz April 16 — Making All Things New: Catholicity, Cosmology, Consciousness by Ilia Delio June 18 — Unlikely Entrepreneurs: Catholic Sisters and the Hospital Marketplace by Barbra Mann Wall Aug. 20 — Together: The Healing Power of Human Connection in a Sometimes Lonely World by Dr. Vivek Murthy Oct. 22 — Subversive Habits: Black Catholic Nuns in the Long African American Freedom Struggle by Shannen Dee Williams The registration fee is $175 for CHA members and nonmembers. To register, visit chausa.org/events.
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4 CATHOLIC HEALTH WORLD November 15, 2023
Geaux Get Healthy
to learn on the Dollar General tour that a package of ramen noodles or a Totino’s party pizza each has two high-sodium servings. Ardoin calls the tours valuable. “That is really meeting people where they are and encouraging them to shop healthier and choose healthier options,” she says.
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attention.” The clinical program is based at Our Lady of the Lake Health in Baton Rouge, Louisiana, part of Franciscan Missionaries of Our Lady Health System. Clinicians and community health workers screen patients and community members for food insecurity and enroll those who are interested in the eight-week program. It includes handson cooking classes, a grocery store tour, nutrition education and access to other resources and support. Antrice Johnson, a community health worker, taught Joseph’s class. She says there are many reasons people don’t eat as healthily as they should. For instance, they may not have easy access to nutritious foods, or they may have never tried some healthy foods that are Johnson available. “We just try to get them to break tradition, because a lot of people cook the way they cook because that’s what they grew up on,” she says. Some, for example, have never thought of adding jalapenos instead of salt to chili to make it healthier and still give it flavor — something she has done since she started teaching classes about a year ago.
Farm friends The clinical program is part of a broader initiative across the city — collectively called Geaux Get Healthy — that includes more than a dozen organizations collaborating to make fresh food affordable and accessible and to provide education and resources to move community members to better health. Geaux Get Healthy partners include Baton Roots Community Farm, a four-acre urban farm with about 30 associated urban gardens; Top Box Foods, which provides fresh food delivery; Three O’Clock Project, which provides out-of-schooltime meals; and YMCA of the Capital Area. This coalition started in 2018 as a project of HealthyBR, a nonprofit housed within the Baton Rouge mayor-president’s office. HealthyBR’s priorities include behavioral health, healthy living, maternal and infant health, violence prevention, health equity and racial disparities, sexually transmitted diseases, HIV and hepatitis C. More than 150 organizations are now part of the effort. Last year, the Geaux Get Healthy Clinical Program received a $100,000 grant from Healthy Blue Louisiana, a Medicaid managed health care provider. Path to healthy outcomes Kelli Rogers, project manager for Geaux Get Healthy, calls the partnership with Our Lady of the Lake Health “huge.” “Anytime that you can connect somebody’s access to care with an organization or hospital, being able to touch all of those social determinants, you’re really looking at much better health outcomes rather than, oh, here, let me give you a food box,” she says. Evidence supports that it takes behavior changes such as learning how to cook and eat differently and having support to manage a chronic disease to make real improvements in food insecurity, Rogers says. The Geaux Get Healthy Clinical Program started in 2020. It is offered regularly at Our Lady of the Lake North and Our Lady of the Lake Silverside clinics in Baton Rouge. As of this summer, just over 1,000 people had been screened for food insecurity, answering questions about whether they have enough money for food, if they feel like they have cut back on healthy food because they can’t afford it, and if they have access to healthy foods. Of those screened, 754 were eligible for the clinical program and 433 enrolled. Meeting people where they are Program Director Dr. Tiffany Wes-
Chef Traci Vincent Druilhet with the American Heart Association demonstrates knife skills and safety to a participant in a cooking class that's part of the Geaux Get Healthy Clinical Program. The program is within a broader initiative across Baton Rouge, Louisiana, that includes more than a dozen organizations collaborating to make fresh food affordable and accessible and to offer education and resources to improve health.
ley Ardoin says when she was in residency, she counseled her patients on healthy eating, but many didn’t follow her advice. That’s how she got more interested in food insecurity — which the Department of Agriculture defines as a lack of access to enough food for an active, healthy life for all houseArdoin hold members. “I found that this was a big problem with my patients,” she says. About 9% of Americans and 16% of Louisiana residents deal with food insecurity. That number is 14% in East Baton Rouge Parish, where the clinics are located, according to a 2021 community health needs assessment. Of those in the parish who are food insecure, about 33% do not qualify for most federal nutrition programs. Ardoin points out that clinical care only determines about 20% of a patient’s overall health, with the remaining 80% determined by factors such as healthy foods and the patient’s overall environment. “It’s fantastic to see a clinic-based approach to really bridge that gap between the hospital system and community-based organizations to promote health within our community,” she says.
of fresh food, such as vegetables, fruit and meat, from Top Box Foods. They also get a tour of a grocery store with a dietician. The Our Lady of the Lake North campus is next door to a Dollar General store that sells fresh produce. In 2020, after the mayor invited Dollar General to collaborate in HealthyBR, the company remodeled two stores in Baton Rouge to stock fresh produce. There are now nine Dollar General stores in the city that carry fresh produce and nearly 3,900 stores that now carry it nationwide. Johnson, the instructor, says reading food labels can be eye-opening for people in the program. Even she was surprised
Making changes The program is getting some encouraging results. According to findings from one study published in October, 57 enrollees were surveyed and the mean food insecurity scores improved upon completion of the program and six months afterwards. Ardoin says she has heard other feedback about the program: that it has gotten some participants out of deep depression, that many have lost weight and been able to stop taking blood pressure and diabetes medications, and that it helped improve one woman’s relationship with her teenage son because they started cooking and working out together. “Many of our participants talk about how they spread this education into the community,” she says. “That education is very powerful coming from our community members, not necessarily from us.” Johnson teaches participants how to make a healthier version of a banana split with Greek yogurt and homemade chocolate sauce. She said one participant now makes the treat with her grandchildren. Children who tag along to class try new foods. “You want to start them young,” she says. “The younger they are that they start, the better they have a chance of growing up to be healthy adults, right?” Joseph, who took the classes this summer, has been able to decrease some medications and is at a healthier weight. She enjoyed getting out of her house, where she lives alone, to attend class. The program provides transportation. Joseph doesn’t live near a grocery store and doesn’t own a car. She relies on neighbors or her daughter to get her groceries. She points out that healthier foods are often more expensive. Nevertheless, she’s determined to keep her healthier eating habits, and she encourages others to sign up for the program. “It’s a good program to be in, and they can join, and they are going to love it like me,” she says. vhahn@chausa.org
“We just try to get them to break tradition, because a lot of people cook the way they cook because that’s what they grew up on.” — Antrice Johnson Most participants in the clinical program are middle-aged women who have attained no more than a high school education or GED, and have a household income of less than $25,000, says Ardoin. Most of those who sign up are obese and have high blood pressure and diabetes or prediabetes.
Classes and a grocery store tour The Geaux Get Healthy classes use the American Heart Association’s Healthy for Life curriculum. Participants get a free box
Advent resources now available Order this year’s Advent resources, which include different reflections, stories, artwork, and a coloring page for each week of Advent!
chausa.org/advent
November 15, 2023 CATHOLIC HEALTH WORLD 5
DePaul program lets patients dealing with hunger select box of food items DePaul Community Health Centers in New Orleans offers patients who screen positive for food insecurity an opportunity to select 20 food items a month that will be boxed and ready for pickup. The order-ahead program began in March 2021. The program is run in partnership with Second Harvest Food Bank. Patients make their choices from several categories and place their orders through a smartphone app, getting assistance if they need it from DePaul community health workers. The items they select are packaged at Second Harvest and brought to DePaul for pickup on the fourth Friday of the month. The food program is among many that Stephenie Marshall oversees as execu-
tive director at the health centers’ parent, Ascension DePaul Services. She says the program is part of a constellation that DePaul, a federally qualified health center, operates to address social needs that affect the health of the largely low-income, minority population it Marshall serves. “I think DePaul is considered as a beacon of light of the community,” she says. Working with Second Harvest, DePaul also offers a food giveaway the second Friday of every month that is open to anyone. That distribution of food boxes includes fresh meats and produce, but the hundreds of people who stop by for the boxes don’t
get a choice on what they take home. The order-ahead program is much smaller. It had been averaging about 35 participants a month. This spring, after some new food options were added, enrollment was up to 66. Margaret Brocks was among those who were taking part in the program over the summer. She says she shares her box of food with her sister. “It supplements us greatly,” Brocks says. “When we fall short, we always know that we have that we can depend on.” Brocks says her choices always include fresh produce, something she can’t always afford. She adds that she would recommend the program “to anybody and everybody that qualifies.” Lindsay Hendrix, Second Harvest’s chief
impact officer, says the food bank has hundreds of partners who help it distribute 48 million pounds of food a year in 23 parishes, or counties, across the Gulf Coast of Louisiana. It only offers the order-ahead program through DePaul. Hendrix says the program is challenging for Second Harvest because it requires an operation that usually provides food in bulk to put together custom orders. “It’s been a learning curve for us as a food bank,” she says. Nevertheless, given the program’s success at DePaul, she says Second Harvest hopes to figure out how to expand it to other partners. — LISA EISENHAUER
CHA joins call to revise rule for skilled nursing care coverage
Volunteers Sue Morrison and Justin Manke fill bags as part of the Baskets of Hope program at SSM Health St. Mary’s Hospital — Madison in Wisconsin. The program provides a bag of food for new mothers who screen positive for food insecurity. Baskets of Hope is run in partnership with local food banks at several SSM Health hospitals in Wisconsin.
Baskets of Hope From page 1
to other patients. Following a patient’s discharge, an SSM Health community health worker checks in to see how they are doing and to help them establish contact with other services. “We already were connecting our patients with resources but wanted to let them feel that in a tangible way,” said Megan Timm, SSM Health regional director of community health. “We know providing emergency food Timm is not fixing insecurity, but it does really fall within our mission of providing exceptional care and revealing the healing presence of God. And that’s really a beautiful thing.”
Pantry partners The idea came about in 2020 when members of the SSM Health regional community health team attended a summit looking at ways to address hunger. Patients arriving at SSM Health hospitals already were being screened through a series of questions that focus on food challenges, safety, and other issues. Now, if a new mom screens high for food insecurity, she is given a voucher for an on-site food closet, supported by a local food pantry partner. The voucher is good for a basket, actually a bag, of shelf-stable food she can take home when leaving the hospital. Larger families get two bags. The program gives nurses and other staff a way to address food insecurity immediately — rather than simply sending patients out the door with a list of resources and hoping they follow up later with a food pantry, Timm said. The response from area food pantries
to the Baskets of Hope program, which first rolled out at SSM Health Monroe Hospital, has been positive, Timm added. “They jumped right in,” she said. “We are so blessed and grateful. We can’t do our work without them.” Marcia Voss of Green Cares Food Pantry, which delivers grocery supplies to SSM Health Monroe, said that as food insecurity returns to pre-pandemic levels, food banks are seeing more people desperate for help. Working directly with health care providers is a great way to reach those in need, she said. Voss worked with Tammie Jamiska, an SSM Health community health specialist who also volunteers at the food pantry, to develop Jamiska the contents of the food bags, which include nonperishable items such as cereal, tuna, canned vegetables and beans.
Expansion plans Timm said the partnerships with local food pantries call to mind SSM Health’s founding in 1872, when five Catholic nuns arrived in St. Louis from Germany ready to care for those suffering from smallpox and other diseases. Starting with only $5 between them, the sisters visited patients in their homes, bringing food, medicine and supplies to ease their suffering. Five years after their arrival, the sisters opened their first hospital, St. Mary’s Infirmary in St. Louis. Today, SSM Health delivers comprehensive care to communities in Missouri, Illinois, Oklahoma and Wisconsin. With more than 12,800 providers and 23 hospitals, SSM Health continues to explore new ways to invest in communities and provide a safety net to those in need. The Baskets of Hope program has expanded to the family birth areas at SSM
A bag of shelf-stable food sits at the ready for give away to a patient through the Baskets of Hope program.
Health St. Mary’s Hospital — Janesville, SSM Health St. Mary’s Hospital — Madison, and SSM Health St. Clare Hospital — Baraboo, with plans to expand to other hospitals and service areas in the coming months. At SSM Health — Monroe, the program already has been extended to departments beyond family birth, necessitating the need for an additional food pantry partner. In the last year, the hospital distributed almost 300 bags of food to patients, Jamiska said. Recently, health care workers there saw a need for bags specifically designed for patients who are unhoused. These bags contain ready-to-eat foods and cans with pop-top lids as well as essential items like hand wipes. “We’re happy that we’re helping so many people in need, but also very sad, because of all of the need that’s out there,” Jamiska said. “But one of the things I love about SSM is we are truly trying to help our patients with their needs even outside our walls. That makes a healthier community.”
CHA joined 33 other health- or agingfocused organizations in a letter urging passage of the Improving Access to Medicare Coverage Act. The legislation would make days spent by a patient in observation count toward Medicare’s three-day inpatient stay requirement to qualify for skilled nursing care coverage. The letter was sent Sept. 18 to the chairman and the ranking member of the House Ways and Means Committee. Currently, time patients spend under observation is considered outpatient care. The letter notes that patients discharged from observation to skilled nursing facilities can face the decision to pay high, oftenunexpected bills for skilled care or to forego needed follow-up care. The letter points out that Medicare had waived the three-day stay rule during the pandemic. Among the letter’s other signatories are the American Medical Association, AARP and Leading Age.
Upcoming Events from The Catholic Health Association
Reading the Signs of Our Times — A CHA Book Club for Leaders in Catholic Health Care
Bimonthly series begins Dec. 19 | 1 – 2 p.m. ET
Foundations Live
Jan. 30 – March 21 | 1 – 3:30 p.m. ET
Assembly 2024 June 9 –11
chausa.org/calendar
6 CATHOLIC HEALTH WORLD November 15, 2023
Areas of focus at CHA’s Advocacy Days
CHA governmental affairs experts prepare CHA members for Capitol Hill visits that were part of Advocacy Days in October. From left are Vice President of Advocacy and Public Policy Lisa Smith, Senior Director of Government Relations Lucas Swanepoel, Senior Director of Community Benefit and Continuing Care Julie Trocchio, Senior Director of Government Relations Paulo Pontemayor, and Senior Director of Public Policy Kathy Curran. Also presenting at Advocacy Days were congressional staff of both political parties, a Biden administration representative and staff of CHA partner organizations.
Advocacy Days From page 1
board, to bring the government representatives’ attention to topics like social need, community health and community benefit. “These are central matters for our ministry and our representatives were appreciative for the dialogue,” Barina said. In an interview after the visits, she said, “What I found especially interesting was the questions that our representatives had for us. Barina They are extremely interested and even invested in the strength of local health care organizations, and they had fantastic questions for us. “It really was a dialogue, with information and insight exchanged both ways,” she recalled.
challenges to and scrutiny of Catholic health care providers given their not-forprofit status. She said the ministry has “a distinct voice because we are grounded in mission and lead with mission,” and mission leaders are very well positioned to be that voice.
are poised to provide that because of how we interact with and serve the community.”
‘Boots on the ground’ CHRISTUS Health Regional Vice President of Mission and Spirituality Kathy Armijo-Etre was part of a contingent of CHRISTUS mission and advocacy leaders who visited the offices of two senators and one representative from states CHRISTUS serves. ArmijoEtre’s advocacy colleagues helped her prepare by suggesting that she share “the Armijo-Etre stories of caring for patients and responding to the community that are unique to Catholic health care.” She said because she is “boots on the ground,” working directly with CHRISTUS programs serving vulnerable people, she was able to share the many ways that the ministry cares for people and the devastating impacts that threats to Catholic health care could have on communities. For instance, she was able to tell the government officials about a CHRISTUS program for those who use emergency departments frequently for nonemergent care and who have debilitating behavioral health conditions. She told them about program participants who got help accessing social services and whose basic needs were met. This reduced their use of the emergency department. The program could be at risk if Catholic health care’s funding is cut, she told officials during the Hill visits.
On the Hill During Advocacy Days, ministry representatives gather in Washington to learn about government activity impacting Catholic health care and meet in-person with their senators and representatives. CHA had hosted the gathering every year for decades until the COVID-19 pandemic paused in-person events. This year, about three dozen ministry advocacy leaders, more than a dozen mission leaders and other top executives attended. During the first part of each of the two days, attendees heard from congressional and Biden administration staffers as well as representatives of CHA and partner organizations. These presenters spoke about congressional and administration agendas, the political environment more broadly and potential impacts on Catholic health care. During the afternoons of both days, attendees went to the Hill for meetings with Congress members of both political parties and their staffs. The ministry leaders took part in about 200 Hill visits.
‘Perfect marriage’ Rob Tasman, one of two Franciscan Missionaries of Our Lady Health System mission leaders who attended Advocacy Days, said their involvement in the event was “incredibly affirming” of the direction that system has been heading. Tasman was executive director of the Louisiana Tasman Conference of Catholic Bishops for seven years before becoming vice president of mission integration for FMOLHS’s Our Lady of Lourdes Regional Medical Center in Lafayette, Louisiana, in 2021. Given the strong advocacy component of his former role, he’s been advising FMOLHS Senior Vice President of Mission Integration Pete Guarisco Jr. on ways to increase mission leaders’ interconnection with advocacy representatives across the system. The mission leaders have been forging relationships with state and local policymakers, in close collaboration with their advoGuarisco cacy colleagues. Those efforts proved beneficial when Guarisco and Tasman met during Advocacy Days with the staff of Rep. Clay Higgins, R-La., Guarisco said. One of the congressman’s staff members, he said, “was very impressed with hearing our story from a mission perspective.” Tasman added that mission and advocacy are “the perfect marriage” for Catholic health care. “The advocates understand the process and know the players, they can present the data. But they need stories and points of connection, and mission leaders
Right time CHA Senior Director of Mission Innovation and Integration Dennis Gonzales explained that the idea for involving mission leaders in Advocacy Days flowed from recent CHA efforts to elevate the mission leader role in Catholic health care, including by ensuring mission leader competency in seven broad areas. When ministry mission leader Sara Lee of Mercy told CHA staff about her desire to delve deeper into the advocacy competency, that spurred Gonzales and his colleagues to look for ways to increase the interaction between mission and advocacy leaders at the national level. They saw Advocacy Days as one opportunity to do this. CHA President and CEO Sr. Mary Haddad, RSM, told mission leader attendees that “having you here now is timely and necessary” in part because of increased
Chesterfield, Missouri-based Mercy paired advocacy and mission team members for Capitol Hill visits during CHA’s Advocacy Days. From left are Vice President of Mission and Ministry Nelu Nedelea, Vice President of Mission Sara Lee, Director of Government Relations for Mercy Arkansas Jenna Goldman and Government Relations Manager Kayla Allison.
Rootedness While constraints prevented Trinity Health from having mission leaders join governmental affairs staff at Advocacy Days, there was a mission focus to the advocates’ preparations for the event, said Tina Weatherwax-Grant, Trinity Health senior vice president of public policy and advocacy. The dozen or so members of the advocacy team who made Hill visits had had a “robust conversation” with Rev. Dr. Kirtley Yearwood before their meet-
In preparing Advocacy Days delegates for their Capitol Hill visits, CHA staff keyed in on four priority areas of focus. They were: Financial pressures and workforce shortage concerns facing Catholic health care systems and facilities. Amid the challenging financial times, there are acute and intractable staffing gaps. The community benefit commitment of the ministry. The ministry is coming under increasing scrutiny for the level of community benefit it provides, given its tax-exempt status. CHA emphasized that those criticizing ministry systems and facilities for their efforts in this area often fail to take into account that community benefit is more than just “charity care” dollars. There is a wide range and depth of community programming that goes beyond those expenditures. The necessity to protect the 340B drug discount program. This program enables patients to access the outpatient drugs that they need at discounted prices through safety net hospitals. The program has been called into question. CHA stressed that the program is vital to vulnerable patients. The importance of maternal health and health equity. There is a high rate of maternal mortality in the U.S. and a racial disparity in maternal health outcomes. CHA explained the ministry’s commitment to addressing such disparities and advocated for legislation that supports this work.
ings. Rev. Yearwood is chief mission officer of Trinity Health’s Holy Cross Health in Silver Spring, Maryland. He reminded them of the importance of proximity and authenticity with each other and with the congressional delegates they were meeting. He also advised them to lead with the mission instead of treating it as an afterthought. Weatherwax-Grant noted that prior to Advocacy Days, Trinity Health already had been strengthening the link between mission and advocacy roles, and that will continue. Mission leaders help staff Trinity Health’s Weatherwaxsystem-level council that Grant shapes its advocacy agenda, take part in regional advocacy planning, help develop advocacy messaging and provide governmental affairs staff with real-life stories showing the value of Catholic health care. “This rootedness in mission and faith is essential for advocacy,” she said.
Evolution Lee, Mercy vice president of mission, said CHA’s move to involve mission leaders in Advocacy Days is an evolution for the association. She said it shows that CHA is open to change and to bolstering the connections between these important aspects of ministry. She was also new to Hill visits but believes that she and other mission leaders who were part of the delegation were able to “carry the identity and legacy” of Mercy to the visits. Lee said she and other mission leaders helped include in the conversations on the Hill the potential downstream effects that political and legislative decisions can have on vulnerable populations. Even more important, she said, was that she believes that their focus on mission “brings hope ... Our role is to inspire.” Visit chausa.org/chw to learn more about Trinity Health’s Capitol Hill visits. jminda@chausa.org
November March15, 1,2023 2022 CATHOLIC HEALTH WORLD 7
KEEPING UP
Wicklund
Kalin
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PRESIDENTS/CEOS Grant Wicklund to CEO of CHRISTUS Santa Rosa Health System of San Antonio. He was president and CEO of Lutheran Medical Center, part of Intermountain Health. Will Condon to president for Ascension Sacred Heart of Pensacola, Florida. He was president of Studer Family Children’s Hospital at Ascension Sacred Heart. Brenda Woodcock to president of Bon Secours Southside Medical Center in Petersburg, Virginia, and Bon Secours Southern Virginia Medical Center in Emporia, Virginia. She was Richmond, Virginia, market chief
Duggan
Nguyen
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nursing officer. Odette C. Bolano will retire in June as CEO of the Trinity Health West Region and president of Saint Alphonsus Health System in Boise, Idaho. A search will begin in January for her successor.
ADMINISTRATIVE CHANGES Dr. Aaron Kalin to senior vice president of the system and president and chief medical officer of physician enterprise, Catholic Health of Buffalo, New York. SSM Health of St. Louis has made these changes: Joan Bachleitner to chief strategy
Duffy
Grant
Hawkins
officer, Dr. Stephanie Duggan to chief clinical officer, John Nguyen to chief administrative officer and Kevin Smith to chief financial officer. Meg Duffy to chief strategy officer of Tulsa, Oklahoma-based Saint Francis Health System. Michelle Johnson Tidjani to senior executive vice president and chief administrative officer of CommonSpirit Health. Danna Grant to executive director of donor and community engagement for the philanthropy department of Providence St. Joseph Health’s south division.
DeWolf
Foret
Jason Hawkins to chief administrative officer of PeaceHealth Cottage Grove Community Medical Center in Cottage Grove, Oregon. Greg DeWolf to senior vice president of operations at Mercy Medical Center in Cedar Rapids, Iowa. Susan Foret to vice president of operations for Our Lady of the Lake Cancer Institute of Baton Rouge, Louisiana.
ANNIVERSARY Sisters of Charity Hospital of Buffalo, New York, 175 years.
Ukraine From page 1
Russia invaded Ukraine in early 2022. During the webinar, “Live From Ukraine: Catholic Partnerships in Ukraine: Reflections and Future Challenges in Healthcare and Mental Health Support,” Msgr. Robert Vitillo, secretary general of the International Catholic Migration Commission; Christian Kostko, a consultant for the Catholic Response for Ukraine Working Group; Dr. Ivan Budzan, a surgeon; and Maria Trakalo, a psychologist and psychotherapist, shared their perspectives from Ukraine. Bruce CompCompton ton, senior director of global health for CHA, moderated the discussion.
Mapping the journey Kostko said he was visiting the projects already funded by the International Catholic Migration Commission, which is the convener of the working group that is coordinating the relief effort among Catholic groups. He also was reviewing projects submitted for funding in the next cycle. Kostko, Msgr. Vitillo and others started their journey in mid-October in Poland and drove to Lviv, Ukraine, where the relief effort includes supporting mental health centers proKostko viding care to those traumatized by the war. From there they traveled south to Odesa, the scene of several recent bombings. “We continued our meetings with very brave and dedicated priests and laypeople who were working with children and adults in these areas, helping them to overcome the psychological and emotional difficulties of war,” Kostko said. One of their visits was with Budzan, a cardiac surgeon who is working in a hospital serving the military. The hospital got some equipment through the shipment coordinated by Hospital Sisters Mission Outreach. “I want to say thank you from all of my colleagues, from all doctors, for your support,” Budzan said. “It’s appreciated and it’s making us much more strong.” Impact and needs Msgr. Vitillo said the impact of relief efforts has been especially felt among rural hospitals because those facilities are caring for severely injured members of the military who are returning home. “Every single place we went to also alerted us that they need much more, and
Msgr. Robert Vitillo, secretary general of the International Catholic Migration Commission, looks at monitors along with the director of the inpatient unit at St. Luke's Catholic Hospital in Ivano-Frankivsk, Ukraine. The monitors were among the medical supplies shipped to Ukraine earlier this year by Hospital Sisters Mission Outreach.
they are grateful that they could identify the kinds of things that they need,” Msgr. Vitillo said. “And so we’re hoping that there will be a future container.” Msgr. Vitillo met with clergy, psychologists and students who expressed the need for continued fundMsgr. Vitillo ing for mental health treatment. He visited a center where children, many with autism, made pottery, and he visited residences for displaced elderly people, where many shared recipes with one another and even staged cooking contests. “This is all very, very important work that’s going on in every place,” he said. “When we were there, the request was ‘Please continue to support us.’” Trakalo said more than 70% of Ukrainians lack access to a psychologist or psychotherapist. Teenagers are particularly vulnerable, she said, because they understand a lot about the situation but can’t make their own decisions or protect their families. “Kids have more resilience than adults, but they use energy from adults in their family,” she said. “So if we are talking about military families, where parents are separated, that there is a soldier now, so many kids have no possibility of self-resilience because they haven’t two parents at home.”
Responsible relief Smith explained that the relief effort isn’t as simple as gathering supplies from anyone eager to donate. When the war in Ukraine broke out, she said aid groups were overwhelmed with offers to provide medical supplies and equipment. “Particularity in times of crisis, as hard as it is and as much of a need as it is, we really (need to) make sure our donation and the process is done responsibly,” she said. She said Hospital Sisters Mission Outreach first looks at logistics: Can the recipient handle getting a 40-foot container of medical supplies and equipment? Can they transport it? Can they store it and distribute things from it safely? And have people requested what is inside it? The shipment of supplies that left the United States in April included necessary paperwork and packing lists. Knights of Columbus in Poland acted as a consignee to get the container from the port when it arrived in June. The container was filled with about $300,000 worth of goods, including a EKG/ECG unit and trauma, surgical and general medical supplies. “When you do these things correctly, you prevent costs and delays in shipping,” Smith said. “It’s especially important when you’re working with partners who are in an acute crisis, whether that’s the aftermath of a hurricane or a natural disaster or war or conflict.”
If things are incorrectly shipped or if there are items that nobody said they needed, the supplies can get stuck on ports and tarmacs and clog the transport lines, she said. “There has been a really strong sense of connection with Ukraine,” Smith said. “And that can’t allow us to deviate from our standard practices, and it’s important everywhere that we strive to have this level of respect and quality.”
A papal perspective Over the last 20 months, Msgr. Vitillo said, the International Catholic Migration Commission has gathered more than $400,000 in support. He pointed out that donations can be made at icmc.net/ supportukraine. Msgr. Vitillo said Pope Francis is aware of the coordinated relief effort of Catholic Response for Ukraine, which is a new model for humanitarian response. He said the pontiff has endorsed the model. Msgr. Vitillo ended the webinar with a recent reflection from Pope Francis that evokes the story of the Good Samaritan. It says in part: “Let us ask the Lord for the grace to draw close to all migrants and refugees who knock at our door, because today anyone who is neither a robber nor a passerby is either injured himself or bearing an injured person on his shoulders.” vhahn@chausa.org
8 CATHOLIC HEALTH WORLD November 15, 2023
IN BRIEF
Trinity Health launched Health Comes First in October. The campaign calls attention to the need for commercial health insurance companies to provide fair payment to health systems, covering the true cost of care provided to patients. The campaign’s website is healthcomesfirst.org.
Trinity Health initiative calls for fair insurance reimbursements By VALERIE SCHREMP HAHN
Trinity Health has launched an initiative called Health Comes First to call attention to the need for fair reimbursements from insurance companies. The system said the campaign is in response to years of reimbursements that do not cover the true cost of care from health insurance companies that have been profiting at historic levels. The campaign’s site is healthcomesfirst.org. “We’re getting the word out to our patients, legislators and community and business leaders that there’s an imbalance here,” said Slubowski Trinity Health President and CEO Mike Slubowski. “We need to be paid fairly to continue to offer the kind of access to care that they’re expecting, the quality of care that they’re expecting, and to be able to adequately staff our facilities.”
“We’ve been silent too long about the imbalance that has now led to crisis proportions,” he added. The Health Comes First campaign says insurers often deny claims and managing those denials is costly for health systems. “We’re at the receiving end of death by 1,000 cuts,” said Slubowski. “On top of insurers refusing to pay us fairly, we’re facing denial of care at an escalating level. We pursue almost 90% of those denied claims and last year that cost us $120 million.” Of the clinical and documentation denials it appeals, Trinity Health says the majority are eventually approved. Slubowski added that commercial payers are demanding lower costs at the same time health care expenses are going up. “The math doesn’t work,” he said. “We are simply asking for the fair reimbursement we deserve.” Trinity Health points out commercial health insurers’ earnings grew 29% last year, while half of all U.S. hospitals lost money.
Healthcare Here launched on Oct. 23. It is an initiative backed by CHA and its partners in the Alliance for Access to Care. The website, healthcarehere.org, is part of a media campaign that calls out commercial insurance companies that are making it harder for people to get care.
Healthcare Here From page 1
time when nonprofit hospitals nationwide have faced two years of near-record financial losses. “This initiative was created after hearing from our members about the increasing impact commercial insurance denials are having on their patients and their ability to care for them,” said Sr. Mary Haddad, RSM, CHA’s president and CEO. “These barriers to coverage are limiting access to care. So the main goal of this public awareness campaign is to amplify the patient perspective and elevate the essentiality of our member hospitals.” The campaign will roll out initially in three target markets with a heavy concentration of Catholic health care facilities.
Care denied The campaign points out that insurance companies profit from denying care. Healthcare Here says that commercial insurers have raised premiums 14.5% over the past five years, and that average denial rates increased by 23% between 2016 and 2020. The campaign website cites a study from Becker’s Payer Issues that says profits from several major carriers went up 7% to 70% in 2022. Healthcare Here says: “While physicians
take an oath to prescribe beneficial treatments for their patients, it’s the commercial insurance companies who get the final say on what treatments are covered — sometimes to the detriment of patient health.” It points to a survey of 1,000 doctors from the American Medical Association in which 94% percent said prior authorization delayed access to medical care and 80% said prior authorization had led patients to abandon recommended care.
Hospitals under strain Healthcare Here says in 2019 nonprofit hospitals got $12.4 billion in federal tax exemptions. In the same year, nonprofit
“Through this campaign, we want the public and the policymakers they elect to understand how profit-driven actors are manipulating the health care system, which in turn is harming patients and the local hospitals that care for them.” — Sr. Mary Haddad
The system says it has taken significant actions and made sacrifices to weather the operational and financial pressures it continues to face post-pandemic and to build for long-term growth and success. Despite these ongoing challenges, Slubowski noted that Trinity remains focused on providing the high-quality care people need most. In addition, Trinity Health last year provided $1.5 billion in community benefit, the Health Comes First website points out. “Across the U.S., we serve communities, large and small, providing not just traditional care but also programs and services that would otherwise not exist, especially for those patients and their families who are experiencing poverty,” Slubowski said. “This campaign gives our local health systems a unified voice to call for fair payment and defends our patients’ in-network access to the care they trust and deserve. “In other words, we do all we can to make sure Health Comes First. We need health insurers to join us.”
hospitals dispersed more than $110 billion to community health programs. “Catholic health care in the U.S. has always attended to the needs of their communities and has led the way in addressing the social and environmental issues that impact health,” Sr. Mary said. “The community benefit investments our members make include not just charity care, but also programs that address chronic illness, poverty, health disparities, housing support, food insecurity and other factors that influence a person’s health.” While insurance companies are largely profiting from the current system, many hospitals are feeling the pinch. Healthcare Here says the median operating margin of hospitals, which is the proportion of revenue left after costs, is 1.3%. More than 30% of the nation’s rural hospitals are at risk of closure, according to the Center for Healthcare Quality and Payment Reform. The American Hospital Association says hospital expenses per patient for things like labor, drugs and supplies increased 20.1% from 2019 to 2021. Over the past 10 years, yearly commercial health insurance premiums have increased at twice the rate as the yearly rise in hospital prices.
Automated denials Healthcare Here says sometimes an insurance company’s algorithm, not a person, denies treatment coverage. The campaign website cites a ProPublica investigation that said Cigna used an automated system and spent an average of 1.2 seconds per case to deny more than 300,000 claims. Healthcare Here urges people to contact state and federal representatives and provides a template for a message to them. Said Sr. Mary: “Ideally, all sectors of the health care system should be working together to deliver affordable, accessible, and high-quality care for patients. Through this campaign, we want the public and the policymakers they elect to understand how profit-driven actors are manipulating the health care system, which in turn is harming patients and the local hospitals that care for them.” vhahn@chausa.org
Archbishop Thomas leads newly designated Las Vegas archdiocese At the same time that Pope Francis changed the Diocese of Las Vegas into the Archdiocese of Las Vegas, he elevated Bishop George Leo Thomas to archbishop. The elevation of both Archbishop Thomas and the diocese were celebrated Archbishop Thomas at a Mass Oct. 16. Archbishop Thomas was a member of CHA’s board of trustees from 2013 to 2022. St. Claire HealthCare gets grant to start recovery community A $300,000 federal grant to Morehead, Kentucky-based St. Claire HealthCare will support the establishment of the Rowan County Recovery Community Organization to help people struggling with substance use disorders. St. Claire said in a release that the one-year grant is Rural Communities Opioid Response Program-Overdose Response funding. The money is provided by the Department of Health and Human Services’ Health Resources and Services Administration. The recovery community organization will be a nonprofit center offering support services such as mutual aid, peer support, employment and housing resources, and fellowship with others from the recovery community. Services are intended for people seeking recovery, people in early recovery, people in long-term recovery, and the friends and family of people in recovery. Recovery community organizations do not attempt to provide treatment; rather, they help break down barriers to receiving treatment and other support services. St. Claire applied for the grant on behalf of the Northeast Kentucky Substance Use Response Coalition. The coalition is a HRSA-funded rural health network focused on building a community-based approach to addressing the opioid crisis that has impacted thousands of residents in rural northeastern Kentucky. Catholic Medical Center explores partnership with HCA Healthcare Catholic Medical Center has signed a nonbinding letter of intent to explore a partnership with HCA Healthcare. The two planned exclusive discussions to evaluate a potential agreement for the Manchester, New Hampshire, hospital to join HCA Healthcare, Catholic Medical Center said in a September release. “We have been on a journey to identify a partner that will, first and foremost, support our mission of health, healing and hope, as well as a partner who will embrace who we are as a Catholic hospital,” Alex Walker, Catholic Medical Center’s president and CEO, said in the release. “With HCA Healthcare, we believe we have found that partner. In addition to embracing our Catholic mission, HCA Healthcare also aligns with our core values and is committed to healthcare excellence, community service, and investing in our people and facilities.” The letter of intent is the first step in a lengthy process that includes negotiation of final terms and approvals, Catholic Medical Center said. The release noted that Nashville, Tennessee-based HCA, a for-profit system, intends to maintain the medical center’s Catholic identity and provide care in accordance with the Ethical and Religious Directives for Catholic Health Care Services. The release included a supportive statement from Manchester Bishop Peter A. Libasci.