Catholic Health World - December 1, 2020

All-abilities playgrounds 8 PERIODICAL RATE PUBLICATION

DECEMBER 1, 2020 VOLUME 36, NUMBER 13

Armed with conviction: Addiction specialist cares for incarcerated, homeless

Gary Brister credits the support and stability he found at Bonaventure House with saving his life.

AMITA Health’s outreach benefits LGBTQ community

When Dr. Fred Rottnek rolls up his sleeves, students at the Saint Louis University School of Medicine can see their professor’s commitment to social justice permanently inked onto his arms.

On Rottnek’s left forearm, stretching from his wrist to his elbow, are the words of the Eighth Amendment to the U.S. Constitution: Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.

Rottnek, a professor of family and community medicine at SLU, got the tattoo four years ago when he left his post as medical director at the jail in St. Louis County, Missouri. The tattoo signifies the 1976 ruling by the U.S. Supreme Court that denying health care to incarcerated people is unconstitutional. It also symbolizes Rottnek’s commitment to correctional care.

The tattoo has become a teaching tool, Rottnek said.

“Students ask all the time, ‘What is it?’

And then I tell the story of a patient popu-

Dr. Fred Rottnek uses questions about his tattoos to start conversations on health care and social justice with students in the community medicine and physician assistance programs at Saint Louis University. He directs an addiction medicine fellowship for positions, to integrate expertise in substance dependence treatment into primary care.

lation that is guaranteed a right to health care,” he said.

On Rottnek’s right forearm is a popular

Sid Hastings/© CHA

By MARY DELACH LEONARD

quote, of unknown origin: The hottest places in hell are reserved Continued on 6

By NANCY FOWLER

In 2017, Gary Brister of Chicago was newly out of jail and trying to maintain a life without the cocaine and crystal meth he’d used for nearly a decade. A patchwork of recovery and housing programs helped, but he needed a solid path back to stability.

“I had lost my business of 12 years, my home, my clothes — everything,” Brister said.

Then Brister, 45, discovered Bona– venture House in Chicago’s Lakeview

Astro soothes abused children treated at Providence center

Dog’s presence helps children to begin to heal, staff to obtain vital evidence

By JULIE MINDA

Continued on 4

During the pandemic, Astro, a courthouse facility dog, has been doing some of his work with child abuse victims remotely, via videoconferencing.

An unlikely hero got a lot of the credit three years ago when a pair of siblings, aged 9 and 11, gained the inner strength to face in court an abuser who had inflicted horrific harm on them. Reassured by the trusted presence of Astro, a courthouse facility dog, the two provided the testimonies needed to achieve a favorable outcome in court.

That is according to Dr. Joyce Gilbert, medical director of the Sexual Assault Clinic and Child Maltreatment Center, a freestanding medical clinic in Lacey, Washington, that is associated with Providence St. Peter Hospital.

Continued on 5

Ascension, CHRISTUS host virtual memorial services to honor deceased CHA tool sets forth competencies for mission leaders

By JULIE MINDA

CHA has just released its revamped Mission Leader Competency Model. The new version differentiates its guidance on the role of mission leaders by the leaders’ level of experience. It includes resources for mission leaders to plot their career path and boost their skills.

First issued nearly 20 years ago, CHA’s Mission Leader Competency Model defines the role of the mission leader in Catholic health care and gives practical guidance Continued on 2

Systems help co-workers to process grief

By JULIE MINDA

A Friday morning in October found Stephen Kazanjian, CHRISTUS Spohn Health System vice president of mission integration, gathered with about a half dozen frontline clinicians in the intensive care unit of CHRISTUS Spohn Hospital Beeville in southern Texas, offering them spiritual support as they grieved a colleague who died of COVID-19.

Kazanjian asked a few of them about the attributes that made their colleague special to so many at the hospital. He was gathering anecdotes for a virtual memorial he and his mission department colleagues put together. Since the pandemic’s onset his team has hosted four virtual memorials honoring CHRISTUS Spohn employees, all

Stephen Kazanjian, second from left, CHRISTUS Spohn Health System vice president of mission integration, rounds with associates at a CHRISTUS Spohn hospital. He is part of a mission services team that helps associates cope with trauma experienced at work, including the death of a colleague.

of whom succumbed to COVID. Millions of health care workers have been providing frontline health care amid the pandemic at increased risk to them-

selves. The Guardian and Kaiser Health News are investigating 1,396 deaths of frontline health care workers in the U.S. Continued on 7

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CATHOLIC HEALTH WORLD December 1, 2020

Competencies for mission leaders From page 1

on performing the work. CHA updates the model periodically to best reflect the evolving role and responsibilities. The version revised by a committee over the past year and released early last month differs in several significant ways from the model it replaces: It assumes that all mission leaders possess the personal qualifications and leadership skills expected of all leaders. It delineates skill sets according to three tiers of experience level and it sets out competencies necessary for promotion to positions of greater responsibility. It also calls out formation, operations, strategy and advocacy as competency areas in their own right, unlike with past iterations of the model.

Becky Urbanski is senior vice president of mission integration and marketing for Benedictine of Duluth, Minnesota, and chair of the task force that shepherded the model’s Urbanski revision. She says that as mission leaders, “we have come such a long way,” and the new model reflects that. It recognizes that “as mission leaders we need to be courageous, we need to motivate and we need to inspire others, but we also need to measure what we do.”

She says the model can be used to advance mission leaders’ work throughout the Catholic health ministry.

Changing role CHA initiated the revision work in June 2019 in partnership with the Reid Group consultancy of Seattle. Over the past decade or so, the period since the model underwent its last major revision, mission leaders have taken on a broader portfolio of responsibilities. The job description has become more standardized across systems and facilities, and many systems have metrics to track a leader’s contributions and performance toward goals.

While recent iterations of the Mission Leader Competency Model had kept up with the maturation of the role, the new version of the tool is clearer and more concise about the breadth of responsibility mission leaders assume, elevating the formation, operations, strategy and advocacy functions.

Wanda Cole-Frieman is senior vice president of talent acquisition for CommonSpirit Health and a member of the CHA task force that revised the model. She says, Cole-Frieman “the executive mission leader’s role is no longer only the spiritual guide for a Catholic health facility but rather to be a full executive leader, who also needs to understand the balance sheet and strategy — and to comment on finances and strategy.”

“We’re asking (senior) mission leaders to show up in this way, and the Meyer McGrath Mission Leader Competency Model shows them how to do that,” she says.

Carrie Meyer McGrath, CHA director of mission services, says, “we want every mission leader to see themselves in this model, but we want them to also see where they can stretch.”

Three tiers, seven competencies To secure input for creating the model, the Reid Group interviewed more than 30 key stakeholders including ministry sponsors, chief executives and other C-suite executives; surveyed more than 600 mission leaders; and convened focus groups made up of system executive mission leaders.

Residents of Villa St. Benedict in Lisle, Illinois — a ministry partner of Benedictine — say a socially distanced thank you to volunteers of the community. This expression of gratitude is in keeping with the Benedictine mission and values that mission leaders help put into action at Benedictine facilities.

The 50-page, 2020 edition of the Mission Leader Competency Model is available at chausa.org/missionleadercompetencies in electronic form, and it can be downloaded there as a booklet.

The publication has a section on each of seven core competencies: Catholic identity, strategy, operations, formation, spirituality, ethics and advocacy. Each section breaks out operational competencies for entrylevel leaders, mid-level and executive mission leaders.

For example, the strategy competency of the model calls upon the mission leader to apply Catholic theological and ethical tradition to strategic discussions. Entry-level mission leaders should be able to understand and articulate the principles, midlevel mission mangers should be able to invite discussion of the principles in senior leadership meetings, while executive mission leaders should be innovative in bringing forth new strategic opportunities to advance the mission.

A self-assessment coaching tool breaks out how mission leaders can improve in each competency and provides a virtual coach to measure progress. When a mission leader completes the assessment, that person will receive coaching tips tailored to his or her responses. The tips are computer-generated — CHA developed them based on consultation with experts in the mission field.

Dennis Gonzales, CHA senior director of mission Gonzales innovation and integration, says this career coaching tool “pro-

vides a blueprint or guide, including for mission leaders coming into the role from different disciplines, for concrete ways to improve their skills.”

Practical applications Catholic organizations can use the model to clarify internally or externally what the mission role is, to enhance formation and development of mission leaders and for succession planning.

CommonSpirit’s Cole-Frieman says that system likely will use the model as a reference as it is standardizing its job descriptions, performance management systems, and human resources management work. Cole-Frieman says the revised Mission Leader Competency Model will help CommonSpirit and other ministry systems to create career ladders and pathways for mission staff.

Benedictine’s Urbanski says she expects the model will help with attracting new recruits to careers in mission because it will enable the system to more clearly define mission leadership and illustrate the role’s centrality within the ministry.

CHA’s Gonzales notes that the model is applicable to organizations across the continuum of Catholic health care as well as to other types of Catholic institutions, including universities and social service agencies.

He adds that the model also is of interest to academics who prepare students for mission leader roles and already are building the concepts presented in the new model into their curriculum.

CHA’s Meyer McGrath says, “People in the ministry should remember that this is their tool. It came from them and it’s theirs to use and run with.” jminda@chausa.org

Associates at Cerenity Senior Care in White Bear Lake, Minnesota, a Benedictine ministry partner, demonstrate Benedictine’s core value of stewardship by painting an accent wall in a courtyard patio.

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Mercy Health team cautiously resumes parish nursing program

By LISA EISENHAUER

Knowing how skittish some people have been about returning to hospitals and clinics with the threat BON SECOURS of COVID-19 linMERCY HEALTH gering, the parish nursing team at Mercy Health — Lorain Hospital in Ohio decided to be deliberate in how they went about restarting a parish nursing program that had been put on hold for months because of the pandemic.

First, the team reached out to the pastors of the participating churches to see if and when they would be ready to resume the screenings and exercise programs that are offered mostly free to the public through the program. Based on the issues raised, the team set up video meetings to provide open forums between the pastors and the Lorain County Public Health director, an infectious disease doctor from Mercy Health — Lorain Hospital and other experts.

“It allowed them to be totally vulnerable, to ask whatever questions they wanted,” Catherine Woskobnick, who leads the parish nursing team as part of her job as Mercy Health — Lorain director of community health, said of the forums.

The parish nurse team got a grant from the charitable Community Foundation of Lorain County to stock “COVID boxes” with masks, gloves, thermometers, cleaning supplies and precaution-related signage. After they had distributed the boxes — actually, large plastic bins — to the churches, the team, working with their volunteer counterparts at each of the churches, began the program’s relaunch in June.

By mid-September, the team — Woskobnick, two registered nurses and an office coordinator — had overseen nine of the screening events that are the core of the program, making sure that COVIDrelated precautions such as social distancing, hand sanitizing and masking were in place. Those first nine screening events drew more 200 people for blood pressure checks, blood sugar tests and other wellness assessments.

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“In this time of COVID, what’s been one of our biggest barriers is that people are afraid to come to the hospital,” Woskobnick said.

“But they trust their churches and they’ve always trusted their churches, where the word of God is spoken and where their pastor is guiding them and using God and Jesus as an example.

That’s where their hope and inspiration is.”

Nurse Donna Sims, second from left, hands off supplies for medical screenings to Linda

program as a companion piece to the sacred experience that churches provide.

“The clergy is there for the spiritual and we are there for the physical,” Sims said.

Visiting the churches of various faith communities, as Sims has done for two years as a parish nurse, has given her a window on different faiths and diverse people. “I’ve learned that you reverence their sacred space,” she said.

One thing that’s common at all of the churches, the team members say, is the gratitude that people express for the parish nursCapers, a volunteer with the parish nursing program, at an event at Second Baptist Church in Lorain, Ohio.

Sims is part of the parish nursing team at Mercy Health – Lorain Hospital.

Safe spaces ing program and the care that it brings into communiSharon Wyckoff, a registered nurse who has been part of the to a doctor within the Mercy Health system. ties. Some of the churches that held screenDonna Sims, the other registered nurse ings over the summer weren’t yet open for parish nursing program for nine years, sees that trust in faith-based institutions as key with the parish program, encourages the in-person religious services, but they were to the success of the program. “Even if it’s people who come to screenings to “know nevertheless eager to see the health pronot their church, they feel safe before they your numbers” — including blood pres- gram resume. walk in the door,” Wyckoff said of those who sure, blood sugar level and body mass It came as no surprise to the nursing come to the screenings. index — and how those number figure into team that the turnout at the screenings, The Sisters of the Humility of Mary, overall health. while solid, wasn’t as high as it was prefoundresses of Lorain Hospital, started “Some people don’t even realize that COVID. At one event in early September, 30 the parish nursing program there in 1994 they are diabetic or hypertensive,” said people showed up. A year earlier, the same with health care outreach to just a few Sims. “We get these stories like: ‘I’m a suc- event had drawn 45.

Catholic churches. It has since expanded cess. You helped me catch this, so I am “We are seeing lower numbers,” Wyckoff to 92 churches of various denominations, safe.’” said. “But the people who are coming out including Baptist, Methodist and United are extremely appreciative, so it is very, very Church of Christ. In 2019, 12,000 people Working in sacred spaces needed. We understand that.” took advantage of the screening events.

Sims and her colleagues see the nursing leisenhauer@chausa.org The 350 fitness classes that also are offered annually under the auspices of the program have drawn about 17,000 people.

Some of those classes have been moved to the virtual realm, others have resumed inperson with COVID precautions in place.

The specific offerings of the program vary from church to church, depending on the congregation’s preferences. “There’s a needs assessment that we can go through with them to find out what they think they need,” Wyckoff said.

The assessment might lead to the creation of a smoking cessation program, The parish nursing team at Mercy Health — Lorain Hospital founded the United in Glory program mental health screenings or suicide preto help people of color confront health challenges. The team includes, from left, Sharon Wyckoff, vention outreach.

Empowering others Although team members have been attending the screenings to ensure that pandemic precautions are in place, the events normally are handled by churchbased volunteers. Those volunteers – some with medical backgrounds and some not — are trained to do the health assessments and explain the results, such as whether someone’s blood pressure level indicates the need for immediate medical attention.

“It’s not about us doing all the work,” Woskobnick said. “It’s about us empowering them and then teaching them so that they feel that they have that ability but yet they have Mercy Health as their support system.”

At the screening events, blood draws are done by licensed phlebotomists and sent to a lab for testing. The results are shared with the patient and their primary care physician. Woskobnick said that while every person screened is asked about whether they have insurance, the screenings are done without charge for everyone and insurance is not billed.

Lisa Schneider, the program’s office coordinator, said that while most of the people who come to the screenings have either private insurance or Medicare or Medicaid, often they face co-pays and deductibles that are unaffordable. Lots of people turn to the program for the convenience of getting the free lab testing done and the results sent to their doctors, who can then issue or renew prescriptions.

For patients who don’t have a primary care physician but may need follow-up care, the nursing team will make a referral

a registered nurse; Marilyn Chavalia, a volunteer; Donna Sims, a registered nurse; Lisa Schneider, coordinator; and Jade Larkins, an intern with a leadership development program called Leadership Lorain County.

‘United in Glory’ inspires better health practices

T

he $10,000 grant the Sisters of the Humility of Mary gave Mercy Health – Lorain, came with instructions that the funds be used for a community project related to COVID-19.

Edwin Oley, chief executive and market president for Mercy Health – Lorain, turned to Catherine Woskobnick to ask what should be done with the grant. “I knew that Ed was going to expect that whatever we were going to do with these dollars, it was going to impact lives,” said Woskobnick, the Ohio health system’s director of community health.

She and her team came up with a plan to use the money for a program to help people of color who have health challenges improve their health status, since COVID has proven especially dangerous for that group. They named the program “United in Glory.”

In October the program enrolled its first cohort of 29 adults with the goal of educating them on how diet and fitness relate to health and inspiring them to make changes that might stand them in better stead should they contract coronavirus.

All of the participants will undergo an initial assessment so they will “know their numbers” — including weight, blood pressure and body mass index. They will all get a goody bag of tools such as tape measures, cooling towels and a journal to record their progress. They also will get gift cards for walking shoes or other needs. They’ll take part in monthly Zoom discussions with physicians on topics like how proper nutrition and exercise relate to overall health.

Woskobnick and her team worked through community groups including the Lorain County Urban League and El Centro De Servicios Sociales, a nonprofit agency that supports the Latino community, to distribute applications. In the end, everyone who applied was accepted.

The program got underway in mid-October with a virtual gathering that included the participants, some of the hospital’s leaders and a pep talk from Dr. Robert Thomas, a Black physician who will serve as the group’s physician coach.

Once the program concludes in May, Woskobnick plans to award prizes to those whose numbers reflect the most progress, such as a lower body mass index and a higher level of good cholesterol. And, if this first session of the program goes well, she hopes to expand it.

“It’s about increasing activity, knowing their numbers, giving them the tools and then celebrating,” she said.

—LISA EISENHAUER

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CATHOLIC HEALTH WORLD December 1, 2020

LGBTQ From page 1

neighborhood. The sober house is one of four programs of the AMITA Health Housing and Health Alliance, formerly known as Alexian Brothers Housing and Health Alliance. The programs serve individuals of all sexual orientations. Last year, the alliance had 367 clients, about one quarter identifying as LGBTQ. At Bonaventure House, Brister found a number of gay, HIV-positive men like himself and the support he needed to eventually land a job as a floral designer, an apartment and a partner.

“It truly saved my life,” Brister said.

The Alexian Brothers congregation opened Bonaventure House in 1989 in a convent they had repurposed as a hospice for AIDS patients. The patients they cared for were almost exclusively gay men with no place else to go. Among their ministries, the Alexian Brothers also sponsored Alexian Brothers Health System, which became a part of St. Louis-based Ascension in 2011.

Ascension formed a joint venture with Adventist Midwest in 2014 to form AMITA Health, which would later also include Presence Health.

AMITA Health, based in suburban Chicago, has continued the brothers’ legacy of caring for the most marginalized in society in part through support for the Housing and Health Alliance. Korrey Kooistra, the alliance’s executive director and AMITA associate vice president, says the organization’s work is a continuation of the Alexian Brothers’ mission.

“The brothers believed all people deserve dignity, and opened their doors for everyone,” Kooistra said. “That’s what still guides us today.”

‘Housing is health care’ Kooistra says disproportionate numbers of LGBTQ individuals struggle in their daily lives with housing insecurity, substance abuse, employment discrimination, the threat of violence, food insecurity, mental health issues and access to health care. She said such hardships fall most heavily on Black LGBTQ individuals and on all transgender people.

Many have experienced shame while seeking health care in the past. They may remain wary, which is one reason the Housing and Health Alliance’s embrace of this community is so important, Kooistra said.

“Our focus has always been that housing is health care,” Kooistra said. “You might not take medications if you don’t have a home. You might not go to the doctor if there’s nowhere for the doctor’s office to call to set your appointment. But when you have a roof over your head and three meals a day, you start to see your health improve.”

Focusing on LGBTQ youth A disproportionate number of homeless youth identify as LGBTQ, and many of them are rejected by their families, according to Kooistra. The Housing and Health Alliance is helping to address this problem through The Harbor sobriety-based residence in Waukegan, Illinois, for those 18 and up.

The housing alliance opened The Harbor in 1998 in Lake County where it has long partnered with the Lake County Health Department and has provided services to its clients. Two years ago, the alliance began a program with the health department, area schools and an indoor sports facility, with the goal of connecting with homeless and LGBTQ youth.

“It’s been interesting to see when you partner with others, how much further you can throw out a net to connect to people,” Kooistra said.

Efforts to help LGBTQ youth in Lake County also include launching Waukegan’s first pride parade in 2019. This year, to maintain social distancing during the COVID-19 pandemic, participants drove in cars rather than marching. The change did not detract from the importance of this event, which provides a life-changing vis-

Korrey Kooistra and Richard Gash pause from cheering participants in the AIDS Run & Walk 2020 Chicago fundraiser. Kooistra is executive director of the AMITA Health Housing and Health Alliance and Gash is lead receptionist at the alliance’s Bonaventure House, having regained his footing as a resident there.

ibility for the area’s entire LGBTQ population, Kooistra said.

“It takes away any perception that, ‘We don’t have to worry about LGBTQ issues because this is not something that’s in our community.’ It’s in every community, in every corner of our world,’” Kooistra said.

“The parade tells this population that they’re cared about, that they matter and should be celebrated.”

Stable housing, spiritual healing Richard Gash of Chicago was in his 30s when he found himself homeless. He’s a gay, HIV-positive man who once abused cocaine and crystal meth. He was able to

concentrate on his recovery from substance Seeking out the marginalized dependence at Bonaventure House.

Alexian Brothers’ focus on LGBTQ For Gash, 50, one of the clients inspires John Halstead, AMITA most valuable aspects of Health’s chief mission integration officer the Bonaventure experiand a senior vice president. The brothers trace their lineage back to the 1300s when ence is that residents can groups of religious men cared for victims of spend up to two years the black plague. there. When he arrived, The congregation’s first hospital in the shortly after a relapse, U.S., a wood frame house in Chicago, cared Gash was surprised to Gash for patients in the city’s 1866 cholera outhear his case manager insist he not worry about the future for a full break. They carried that desire to work with year. society’s disadvantaged forward, opening “He told me, ‘I do not even want you to Bonaventure House as a home for HIV/ think about housing; I want you to focus on AIDS positive people society had shunned. your recovery and on your health, see your “They constantly lean in to serve these doctor, see your psychiatrist,’” Gash said. people who are marginalized,” Halstead Gash, a former said. “So AMITA has restaurant manager, a historical, a spirienjoyed the gentle spirtual and a theologiitual guidance offered cal calling to engage at Bonaventure. in this work, to meet “They allowed me to the needs of these find myself, to find my individuals.” true faith,” Gash said, AMITA’s Hous“and to discover who I ing and Health was and who God is to Alliance puts into me.” action the system’s He also benefited foundational beliefs from the occupational about providing for therapy that helped vulnerable populahim manage his weekly Bonaventure House is adorned with a balloon tions, Kooistra said. appointments, and rainbow for its annual Sober and Proud event “We are very learn to make and stick last year. much supported by to a budget. He ended our Catholic health up working part-time, then full-time as system to do this work with everyone that Bonaventure’s lead receptionist, a position we serve, including the LGBTQ populahe holds today. “They kind of taught me tion,” Kooistra said. how to be an adult,” Gash said.

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December 1, 2020 CATHOLIC HEALTH WORLD

Therapy dog From page 5

She says that the younger sibling especially experienced severe anxiety as the court date had neared. But the care team had prepared thoroughly with the child and Astro. Once in the courtroom, with the dog at his feet, the child “got on the stand and held Astro’s leash and disclosed more information in court than he had at any other point in the process,” Gilbert says.

Astro has soothed victims and caregivers in big and small ways since 2014, when he arrived at the center and at its partner facility, the Monarch Children’s Justice and Advocacy Center. The 8-year-old Labrador-golden retriever mix was bred for his calm traits and obedience and specially trained to provide a comforting presence to children who have suffered trauma, and to the loved ones and staff who are helping them recover.

“He takes care of everybody,” Gilbert says. “He is a blessing.”

Tambra Donohue, a clinical psychologist who directs the Monarch center, says Astro “has transformed our work.” The Monarch building, where Astro does the bulk of his work, provides a central location for preventing, investigating, prosecuting and treating child abuse in Thurston County, Washington.

Daunting process Monarch staff coordinate the involvement of organizations that respond when

coordination, mental health and child forensic interviews and medical services. The sexual assault clinic run by Providence St. Peter is one of the providers, and it is located at the Monarch center.

When social services, law enforcement, medical providers or others learn of a potential case of child abuse, they can refer the child’s family to the Monarch and Providence centers. Providence center physicians, nurse practitioners and nurses specialized in sexual assault response conduct forensic medical evaluations of the child, and Providence center social workers provide crisis counseling for the victim and family.

Together, the Monarch and Providence centers then coordinate the process of conducting further forensic investigation and providing mental health therapy.

When criminal charges are being pursued, the centers together support the child victim during depoTambra Donohue, director of the Monarch Children’s Justice sitions and court testimony. The and Advocacy Center in Lacey, Washington, says Astro senses centers provide follow-up care, when someone needs a nuzzle. Astro splits his time between treatment and support to the child.

The idea to add a courthouse Monarch and the collocated Providence St. Peter Sexual facility dog to the care team was Assault Clinic and Child Maltreatment Center. first proposed by Dr. Deborah Hall, who retired as medical director of the sexa child, adolescent, or adult is sexually or physically abused, neglected, a witness to ual assault clinic. She engaged the Courtviolence or trafficked. Most of its clients are house Dogs Foundation of Bellevue, Washchildren. ington, to help her introduce the concept The centralized services include advo- to professionals engaged in child abuse cacy, case management, multi-disciplinary cases in Lacey. At the time, fewer than 50

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such dogs were at work in 20 states. Today there are 255 courthouse dogs working in 41 states, according to the Courthouse Dogs Foundation.

Well trained Astro is a graduate of Assistance Dogs of Hawaii, a nonprofit that trains service dogs for specific tasks. That organization raises funds to provide the dogs free of charge to the organizations where they are placed. Assistance Dogs of Hawaii placed Astro with Monarch. Donohue traveled to Hawaii to live for a week with Astro and to learn how to be his primary handler. Since his arrival in Lacey, four more staffers of the Monarch and Providence centers have received training — 12 hours apiece — to serve as secondary handlers. They can work with Astro in cases in which Donohue is not legally permitted to be in the room with a child, for confidentiality reasons. Astro and his primary handler were certified by Assistance Dogs International and are recertified every year by Assistance Dogs of Hawaii.

Donohue says Astro knows more than 90 commands relevant to helping traumatized children, including commands to snuggle or to lay next to them. He is near to children as they undertake the emotionally fraught process of being examined, interviewed and put on the witness stand. And, the handlers can engage the children in interacting with Astro, so that they gain confidence and control. For instance, the children can help “train” Astro to retrieve items.

“Every aspect of interacting with Astro is soothing and positive for the child,” Gilbert says.

Studies have shown that exposure to, and bonding with, animals helps traumatized children. Gilbert says, “The children come in scared. They’ve made some disclosure, and now they’re not sure what will happen next. When Astro comes, their heart rates go down, they’re breathing more normally, they’re thinking more clearly,” and they can move forward with the difficult tasks they’ll have to do at the centers.

Donohue adds that “families come in very stressed, and when they see their child relaxing and engaging with Astro,” they begin to relax themselves.

The staff members of the centers and partnering organizations — who also are affected by ongoing exposure to trauma — turn to Astro for comfort too, Gilbert says.

Celebrity status Gilbert estimates that before the pandemic, Astro interacted with upwards of 100 people each week, including greeting those throughout the centers; supporting victims in intensive medical examinations, interviews and therapy sessions; and being present for emotionally stretched staff. The clinic was closed for two months as part of coronavirus-related shutdowns but has since reopened and resumed its services, including visits from Astro. Staff have put in place infection control procedures, such as disinfecting his vest between visits.

Donohue notes that Astro has been performing his job at Monarch via telehealth in limited cases during the pandemic. She says he learned very quickly how to interact with children on the computer screen and to respond to them.

Donohue calls Astro “a communitylevel intervention,” because he serves as an ambassador to so many people. The centers hand out trading cards and bracelets with Astro’s picture on them — and these novelties can function as what Donohue terms “transitional comfort items” that children can carry with them when they leave the centers. She says Astro is a central figure at the centers — children draw pictures of him and there are photos of him all over the centers.

“It’s amazing when you see the interaction between the children and Astro,” says Gilbert. “Astro senses who needs what — who needs a hug or a nuzzle — and he meets them at their level.” jminda@chausa.org

6

CATHOLIC HEALTH WORLD December 1, 2020

Addiction medicine

Hospital in St. Louis, where the focus was on community medicine.

“It wasn’t fancy health care,’’ Rottnek said. “It was going to homeless shelters and talking to guys who were down on their luck. And I just connected with them. I could be myself with them.’’

Although current addiction treatment relies heavily on medications to suppress cravings, Rottnek believes more work must be done to ensure that patients get behavioral help tailored to their needs.

His work with incarcerated patients, who are forced to detox, taught him that people are incredibly resilient — and that clinicians should always look for the underlying cause of a patient’s addiction.

“People develop addictions or risky use as a response to something. And that could be toxic stress and trauma in their lives. It could be untreated mental illness. It could be institutional racism,’’ he said. “Medications are important, especially early on, but the behavioral interventions almost always have to be there, and we’re finding out there are a lot of different ways to do that.’’

Rottnek reminds his students that addiction is a chronic disease — and that some patients will relapse.

“You show me a chronic disease where people don’t have their bad days,’’ he said.

“For example, every person I know with diabetes has had their blood sugar really high some days. But do we give up on them and take away their insulin? No, we find out what’s going on.’’

From page 5

for those who, in time of great moral crisis, maintain their neutrality.

He calls that one his “solace” tattoo — his response to the nation’s divisive political climate.

Since graduating from SLU medical school in 1995, Rottnek has melded his love of teaching with his passion for providing health care to people who, as he puts it, “don’t have access to hospitals with water features in the lobby.’’ He cares for patients in jails, homeless shelters and clinics. Many are struggling with untreated mental health and substance abuse disorders.

When the American Board of Medical Dr. Fred Rottnek splits his week between working at home and on campus at the Saint Louis University Specialties announced in 2016 that addic- School of Medicine. Here, Michelle, one of his two black cats, Zoom-bombs a video meeting. tion medicine would be “If they ran out of soap — recognized as a subspetough,’’ he said. “Or, they had to cialty, Rottnek saw a new buy it at the commissary, assuming path for helping people they had money.” with addictions. At the Rottnek, 56, grew up in St. Louis, time, he was leaving his where his parents owned a hardcounty jail post after 15 years because the county ware business. He attributes his was considering privatizdrive and work ethic to his bluecollar upbringing, but it was his ing correctional care. experience with depression that “As I like to joke, I sat for eventually led him to medical my second board exams school. at the tender age of 53,’’ He describes what it was like Rottnek said. “This was to “hit a wall” that forced him to about the time when the leave graduate school at Harvard, opioid epidemic was startand, later, a Jesuit novitiate, before ing to take a huge toll.” realizing that he was battling major Humble sage Rottnek now directs depression and needed treatment. the SLU Addiction MediRottnek serves on the boards of St. Louis “When it was time for me to health care nonprofits, including the Saint cine Fellowship, which he think, OK, I’m feeling better, I Louis Regional Health Commission, Alive helped to create, to teach doctors how to care for Rottnek is in full academic regalia for the Saint Louis University bicentennial kick- started thinking about values that and Well Communities, and the ARCHway are important to me,’’ Rottnek said. Institute, an organization that assists peopatients with addictions. off ceremonies at the Gateway Arch grounds in September 2018.

He decided that becoming a ple recovering from substance dependence The fellowship is one of the first in the nation. Participants complete director of business development at ARCA, doctor would allow him to combine his love and mental illness. He is an editorial adviser rotations in family medicine, psychiatry, said that if he could create an award for of teaching with his goal of incorporating to Health Progress, CHA’s journal. telehealth and maternal fetal health at SSM community medicine physicians it would his personal values into his work.

The National Council on Alcoholism “I took the back door into medicine, and Drug Abuse honored Rottnek with its Health Saint Louis University Hospital and bear a likeness of Rottnek, complete with and that’s why one of my taglines is, ‘I don’t 2020 Pioneer Award, citing his innovation SSM Health St. Mary’s Hospital – St. Louis, ponytail, glasses and bow tie. and community clinics. The program is “The addiction fellowship program is love medicine. I love what I can do with it,’’’ and transformational impact in the field of open to board-certified and board-eligible cutting edge,’’ Laxton said. “I think he chal- Rottnek said. substance use disorders. physicians.

But Rottnek eschews the notion of being lenges each of us professionally to be at the The first fellows — a family medicine top of our field. He builds people up, and he Roots of addiction considered an “expert.” doctor from a rural town and an emergency brings people with him.’’

“If I have an expertise in this field,’’ he After graduation from Saint Louis Unimedicine doctor — applied because they said, “it’s only because I’ve had years of versity medical school, he joined the famwere seeing a growing number of patients Can do boots-on-the-ground experience.’’ ily medicine program at the old Deaconess addicted to opioids, Rottnek said.

At the onset of the pandemic, Laxton The one-year fellowship is funded by worked with Rottnek to develop new lowSLU, SSM Health, the nonprofit Missouri contact and telehealth programs to keep Foundation for Health and the Missouri patients in treatment.

State Opioid Response program.

“A lot of people are quick to acknowledge COMING “The opioid epidemic is an equal oppor- that there’s a problem,” Laxton said. “With SOON tunity killer,’’ Rottnek said. “It’s bringing Dr. Fred, it’s ‘OK, how do we fix it?’ And that more attention to addiction medicine and is contagious.’’

Fellows also work with Dr. Jaye Shyken, behavioral health disorders – and also to the need to reimagine how to deliver health a SLU professor and medical director of the Women and Infant Substance Help Cencare in America.”

CATHOLIC HEALTH ASSOCIATION’S ter at St. Mary’s Hospital. The center treats women with addictions during their pregLearning life’s lessons with a two-by-four nancies and post-partum periods.

“This opioid epidemic is not going Rottnek joined the SLU medical faculty in 2008. He is director of community medi- away,” said Shyken, who is associate direccine and the medical director of the physi- tor of the fellowship. “We need to integrate this expertise into primary care.’’ cian assistant program.

Rottnek’s ability to make connections This semester, he is teaching some courses virtually due to the COVID-19 pan- with people helped get the addiction medidemic, but he insists that clinical interview- cine fellowship up and running, she said.

This year, we’ll be offering a reflection and “He did a really tremendous job finding ing classes be held in person. short video for every single day of Advent, “We have to help students manage risk agencies and people who had goals that and benefit and get used to the awkward- were aligned, but who didn’t necessarily plus Christmas Day. We’ll also have a ness that comes with COVID,’’ Rottnek said. know it,’’ Shyken said. downloadable coloring sheet for children.

“The worst thing we can do is have them do everything at home, and then, all of a sud- Hand soap den they’re seeing patients live.’’

As Rottnek’s tattoo suggests, he remains Rottnek has always involved students committed to improving health care in jails, in his work in jails and shelters. The expe- prisons and juvenile facilities.

Stay tuned to CHAUSA.ORG/ADVENT for this annual complimentary set He recently became medical director rience is challenging — he calls it learning of resources. life’s lessons with a two-by-four — and it of family courts and juvenile detention for

2020 Advent Reflection series is coming soon!

requires students to leave their comfort zones.

Doctors in the addiction medicine fellowship work one day a week at Assisted Recovery Centers of America in St. Louis, where Rottnek is medical director. ARCA provides in-person and telehealth services throughout Missouri.

Aaron Laxton, a social worker who is

the 22nd Judicial Court of St. Louis. And he has joined with advocacy groups pushing for safety protocols to control the spread of COVID-19 in the nation’s jails.

While visiting jails in Michigan and Louisiana, for example, Rottnek was astounded to find limited access to hand soap, even as inmates were being told that hand washing is critical.

December August 1, 2020 CATHOLIC HEALTH WORLD

Memorial services From page 1

suspected of having died of the virus as of Nov. 18. In a joint “Lost on the Frontline” project, their reporters are writing short profiles of caregivers for whom COVID is the confirmed cause of death .

CHRISTUS Health and Ascension are two Catholic health systems that pay tribute to their deceased associates, irrespective of the cause of death, to give the colleagues who cared about them a space to grieve. Both systems are being intentional about preserving the sanctity and meaning of their traditional in-person memorial services, now delivered via video link because of the pandemic.

Kazanjian says he’s heard from staff that they found the virtual memorial services to be “beautiful, reverent, moving and poignant.” Those hosting the services strive to capture the personality and achievements of the deceased including how they advanced the misKazanjian sion of Catholic health care through their work. “The stories from people who knew them well” are very poignant, Kazanjian says.

Layers of support Kazanjian says it is customary for CHRISTUS Health facilities to hold services to memorialize associates, but pre-COVID, those services were usually held in the facilities’ chapels, with all colleagues invited to attend. He says while some employees have asked that services be held in-person now to preserve the intimacy of that format, he has held firm on the need for virtual remembrances. “It would be a sad irony to gather to honor someone who died of COVID, and then to have someone contract COVID from that gathering,” he says.

The virtual memorials have been gather-

ings of 70 to 100 people — a crowd size that would have exceeded infection prevention restrictions.

CHRISTUS Spohn’s mission integration department, including Kazanjian, his assistant and department chaplains, usually schedule the employee memorial services to take place after the family has held their own memorial or funeral service.

Colleagues and the deceased’s loved ones can attend the virtual CHRISTUS Spohn services.

Presented on the Zoom platform, the services normally include prayers, scripture, a video montage remembering the life of the deceased, music and eulogies by colleagues and family members. The service “paints a picture of who they were and how they lived,” says Kazanjian.

Kazanjian suspects there are people who attend the virtual services who in usual times would be tethered to a particular hospital unit during working hours, and so unable to attend a chapel service.

He says the mission department supplements the virtual services with in-person, socially distanced rounding and crisis intervention presence for the team hit with loss of a colleague.

Kazanjian has been leaving a blank condolence journal in the chapel of the facility where each deceased colleague worked — friends and co-workers write down their thoughts and prayers. The book goes to the family of the deceased.

Kazanjian says he believes the services and additional support have been healing for health care staff who have been traumatized and exhausted by the pandemic.

“It’s been a very difficult six months — a time none of us would have expected.

I always try to see the good in things, though; and I’ve seen heroism, courage and selflessness in the way our doctors and nurses have put themselves on the line. Sadly, some of them have died. What they’ve done and risked has inspired me and my team” in offering spiritual support.

Honoring the brave Dave Ebenhoh, vice president of mission integration for the 146-hospital Ascension, says that in addition to virtual memorials that the system’s facilities hold to honor individual associates, Ascension is remembering decedents at a systemwide level.

Since April, representatives of Ascension’s mission integration, human Ebenhoh re–sources, and marketing and communications departments have collaborated on ways to “honor and celebrate the sacrifices being made by our associates in the face of COVID-19, especially those who have died,” says Ebenhoh. One way they are doing this is through monthly systemwide remembrances that begin with an email message to all 160,000 Ascension associates from President and Chief Executive Joseph Impicciche that pays tribute to colleagues who have died of COVID or other causes in the prior month.

Before including the names on the list, Ascension secures the permission of next of kin and ensures that the Ascension facility where the person had worked is tending to the spiritual needs of the colleagues and others mourning the person.

At the end of the week that the remembrance email message goes out, the Ascension departments involved in memorializing associates host a virtual service that

is open to all Ascension employees. The service normally includes readings and prayers. Frequently, Impicciche helps to lead the services.

Holy and sacred Ebenhoh says the service is intentionally very simple, with individuals recognized by name, “remembering that God has called us by name and, in doing so at the time of death, we offer them back to God.” “It is a holy and sacred moment to be a small part of witnessing their return to God’s hands,” Ebenhoh says.

Since Ascension began the services in May — at the start, they took place every other week — the system has memorialized 29 associates in this way. Ebenhoh says he’s heard from staff who said they “were deeply grateful for the opportunity to gather, even virtually,” to honor their colleagues.

He says, “We often underestimate the connection that people have with coworkers. There is a real and tangible sense of community that is often seen and experienced more deeply at moments of great tragedy, and COVID-19 has forced us to face many such moments together.

“To honor our friends and colleagues in this way invites God into our own hearts at a time when all of us need deep, deep healing,” he adds. jminda@chausa.org

KEEPING UP PRESIDENTS/CEOS Dr. Jeffrey DiLisi to president and chief executive of Roper St. Francis Healthcare of Charleston, South Carolina, effective Dec. 7.

He was senior vice president and chief medical officer of Virginia Hospital Center in Arlington.

Elaine Couture is retiring in early 2021 as executive vice president and regional chief executive for Providence St. Joseph Health Washington and Montana. She has worked in Catholic health care for more than 40 years — 34 of those years at Providence.

ASHLEY-O’ROURKE CENTER

for Health Ministry Leadership

Theological Depth and Spiritual Maturity For Health Care Ministry The Ashley-O’Rourke Center for Health Ministry Leadership at Aquinas Institute of Theology is proud to introduce two new programs designed specifically for Catholic health care leaders who wish to draw upon the rich Dominican tradition of study and its contribution to the Church’s healing ministry.

Graduate Certificate in Health Care Mission This online, five-course Certificate prepares current and future professionals to foster strategic and collaborative thinking and spirit in their organizations in order to ensure faithfulness to their purpose, identity, and values. Designed for any health care leader seeking competency in the theological and ethical dimensions of health care mission.

Master of Arts in Practical Theology with Specialization in Health Care Mission This 36-credit Master of Arts in Practical Theology (MAPT) with Specialization in Health Care Mission builds on the Five-course Certificate program with seven additional courses providing a firm foundation for health care leaders seeking a more comprehensive theological grounding with others committed to a deeper understanding of the Catholic faith.

application deadlines: Fall: Priority: March 15 / Final: August 1

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7

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“Catholic health care leaders know health care, but they also need to know why they do what they do, why it matters, and what it means from a theological perspective. This is what the AOR Center at Aquinas Institute does best.”

– fr. charles bouchard, op senior director, theology & sponsorship, catholic health association

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8

CATHOLIC HEALTH WORLD December 1, 2020

Every kid can get in on the fun at all-abilities playgrounds

Catholic health facilities help bring innovative play spaces to their communities

By JULIE MINDA

motor skills and balance, build social skills, exercise their imagination, engage with family members and peers and practice selfcalming techniques. The Star Institute for Sensory Processing Disorders consulted with Ascension St. Vincent on the playground’s design to help ensure play pieces would be therapeutically sound for children with sensory issues.

“Helping children through play is very important,” Del Rio says. “They can adapt better if this therapy is done through play. The work (of therapy) is less scary if it is done through play.”

U

ntil recently, Keesha and Rich Sonnemaker had a dilemma whenever they wanted to take their four children to the park. The playgrounds that their 11-year-old and 8-year-old sons loved to visit mainly had equipment for older children.

And none of that equipment was accessible to the Sonnemakers’ 5-year-old son, who uses a wheelchair because of a degenerative muscular disease, nor safe for their 4-year-old daughter, who has poor muscle tone and struggles to maintain her balance because of the same medical condition.

“We’d have to split up — with one of us taking the older kids to the parks they like and the other taking the younger kids to a park for small children, where we can lift Emmett up onto the equipment,” and where there is safer terrain for Eleanor, says Keesha Sonnemaker, of Spokane, Washington.

Their dilemma was solved Oct. 23 when — as snow fell and the temperature hovered at 30 degrees — Providence Health Care and the city of Spokane opened the Providence Playscape all-abilities playground.

The Sonnemakers were honorary ribbon-cutters, and Keesha Sonnemaker says all four of her children had a blast trying out the play equipment. She says despite the cold temperatures that have lingered since opening day, all four children have been clamoring to return to the playground, designed to be accessible to all children.

The Sonnemakers’ enthusiasm is music to the ears of John Kleiderer, chief mission integration officer for Providence’s Washington and Montana Region.

“Having a place like this means the world for families” whose children with differing abilities once had to watch from the sidelines as their siblings and peers played on inaccessible playgrounds.

Kleiderer says the new playground — funded entirely by a $1 million Providence community benefit grant — “resonates so closely with our mission. We’re fostering connections among people.”

Providence is among a sampling of Catholic health facilities that are building their communities playgrounds that kids of all abilities can enjoy. Other playground innovators include Ascension St. Vincent Evansville in Indiana, CHRISTUS St. Frances Cabrini in Alexandria, Louisiana, and SSM Health’s Agnesian HealthCare in Fond du Lac, Wisconsin. All of their playgrounds are open, with COVID infection prevention guidelines in effect.

Not a luxury Andie Daisley is a certified child life specialist at Spokane’s Providence Sacred Heart Medical Center & Children’s Hospital and a member of a committee convened to consult on the design of Providence Playscape. She says through play children learn to identify and process feelings.

Committee members included pediatric health experts, parents of disabled children and

During a frigid Oct. 23 ribbon-cutting celebration for this all-abilities playground in Spokane, Washington, the Sonnemaker family had a great time trying out the We-Go-Round and other accessible equipment. Providence Health Care funded the playground through a community benefit grant. From left are siblings Oliver, Emmett and Dallin.

other community members. The end product of their collaboration with playground designer Inclusion Matters is a colorful, 11,600-square-foot section of Spokane’s Riverfront Park that has more than 20 play pieces to stimulate the senses.

There is a wheelchairaccessible We-Go-Round turning platform, swings for children of differing abilities, a sensory wall and sand table for tactile stimulation, musical chimes for auditory pleasure and an enclosure where children can retreat to seek calm.

Inclusion Matters donated the park’s design.

Kleiderer says play “is not a luxury, it is a necessity,” and the Playscape ensures kids of all abilities feel inspired to explore.

Early adopter Agnesian HealthCare, a member of SSM Health, and the Agnesian HealthCare Foundation were

A child plays during the October opening event at an all-abilities playground in Alexandria, Louisiana, funded by the foundation of CHRISTUS St. Frances Cabrini.

early supporters of accessible and inclusive play spaces. The Agnesian HealthCare Foundation funded a “barrier-free” playground in Fond du Lac’s Lakeside Park in 2007, giving the community its first wheelchair-accessible playground.

Last year, the Agnesian HealthCare Foundation contributed $44,000 for an all-abilities playground at the Rock River Intermediate School in rural Waupun, about 20 miles from Fond du Lac.

The foundation of Agnesian HealthCare, a member of SSM Health, provided funds for this all-abilities playground at the Rock River Intermediate School in Waupun, Wisconsin. Here, fifth graders take a ride on one of the 24 pieces of equipment.

Waupun Memorial Hospital, part of Agnesian HealthCare, serves the Waupun community. The playground has 24 play pieces that can be used by kids of all abilities.

Funded entirely by grants, the playground was the brainchild of two moms whose disabled sons in the past had to watch at a distance as their classmates played on old playground equipment at recess.

Shawn Fisher, Agnesian HealthCare Foundation’s executive director, says both playgrounds’ design and equipment address the needs of children with developmental delays, special sensory requirements and other physical challenges. She says, “It has been truly rewarding to see how our communities have completely wrapped their arms around these efforts.” This support includes fundraising.

Another Waupun-area school hopes to build its own accessible and all-abilities playground.

Skill building At Ascension St. Vincent Evansville, the on-campus, donor-funded Patricia Browning Stone Sensory Playground can be used comfortably year-round because it is an indoor-outdoor therapy play space. Opened in spring 2019, it has a variety of equipment that provides sensoryrich play experiences and that is accessible to children with a wide range of ages and abilities, says Dr. Maria Del Rio, medical director, pediatrics service line, Ascension St. Vincent Evansville.

Clinicians — including occupational, physical and speech therapists — join their young patients and their families to use the play equipment for therapy work that doesn’t feel like work, says Del Rio. The play space is open to the community’s kids during select hours.

Del Rio says the equipment helps pediatric patients improve

Family support Lauren Guillory, manager of the CHRISTUS St. Frances Cabrini Pediatric Therapy Center, was part of a team of pediatric therapy experts who helped to pick play equipment for the Coughlin Sanders Inclusive Playground. CHRISTUS Cabrini Foundation supported the playground through planning and fundraising efforts.

The playground opened in September on land donated by a local stadium.

The playground has equipment that is therapeutic for children with physical disabilities, autism, cognitive impairments, sensory processing disorders and other conditions. CHRISTUS St. Frances Cabrini Health System explains that different pieces of equipment promote physical, social-emotional, sensory and cognitive development. This equipment includes wheelchairaccessible slides, a roller slide, a sensory wave seat, music-making equipment and a horizontal climbing wall for kids with mobility challenges.

Guillory hopes that families who have children who are disabled — and who may have felt isolated in the past — will connect with one another at the playground and form an informal support network. She notes that “the Central Louisiana community has a staggering number of children with special needs.”

She says the playground can provide the fun, challenges and stimulation that children with special needs require. “For the first time in our community, these children will be able to be included in playground fun,” which she says will boost their self-esteem, confidence and social engagement.

Visit chausa.org/chworld for more playground photos and for a video of children at play at the Spokane playground. jminda@chausa.org

The Patricia Browning Stone Sensory Playground at Ascension St. Vincent Evansville’s Center for Children has indoor and outdoor therapeutic play areas. Clinicians from the center bring patients to the playground for therapy that feels like play.