Catholic Health World - March 15, 2021 by Catholic Health Association

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MARCH 15, 2021 VOLUME 37, NUMBER 5

Advocates work on acute and structural causes of food insecurity As employers have shut down or scaled back their businesses because of pandemic impacts, job insecurity has increased, with low-wage, hourly workers impacted most. Lacking money for food, high numbers of people have been seeking emergency food aid. While government and private aid has helped address food insecurity in the U.S., food demand remains high, according to a sampling of leaders from the health care, social service and academic fields. Those leaders said the needs of the hungry — needs that go well beyond sustenance — highlight the necessity for broad systemic change that involves partnerships between governmental and private agencies to address root causes of food insecurity.

Neil Blake/The Grand Rapids Press via AP

By JULIE MINDA

Cars line up in the parking lot at a drive-thru food pantry at Woodland Mall in Grand Rapids, Michigan, in April 2020. There has been a high demand for food aid since the outset of the pandemic.

“We need to make sure that our systems are fair,” Michele Sumilas told the participants in “The Face of the Person Who is Hungry,” a virtual conference convened by Pittsburgh’s Duquesne University School of Nursing in the fall. She was executive director of the Washington, D.C.-based Bread for the World advocacy organization when she spoke at the conference. She is now assistant to the administrator of the bureau for policy, planning, and learning at the United States Agency for International Development.

Spiked demand Jane Stenson is vice president of food and nutrition and poverty reduction strategies at Catholic Charities USA. Food aid is the agency’s biggest service. Stenson Continued on 4

Hospice patients Health ministry, partners help contain virus spread among homeless maintain the bond with Providers want homeless people their furry or feathered prioritized for vaccination By JULIE MINDA friends through Pet When the coronavirus began its rapid spread about Peace of Mind a year ago, public health agencies quickly recognized how dangerous it would be if the virus were to infect people in crowded encampments and homeless shelters, putting this highly vulnerable population — and the broader community — at great risk. The public health threat and humanitarian concerns spurred federal, state and local government agencies and homeless services organizations and their partners including members of the Catholic health ministry to undertake a massive effort to mitigate the risk. Together, coalition members supplied the funding and resources needed to depopulate homeless shelters by offering temporary housing such as hotel rooms, and otherwise tending to the health and socioeconomic needs of people without permanent housing. The coordination between public and private efforts kept things moving with urgency. For example, the Sisters of Charity Foundation of Cleveland contributed to the Greater Cleveland COVID-19 Rapid Response Fund, a collective pool of philanthropic Continued on 3

Lulu found a new home through Pet Peace of Mind. The service gives hospice and palliative care patients the gift of knowing their pets will be well cared for as their health declines.

Karen Otto, a member of the Mount Carmel Health System Street Medicine team, meets with a man experiencing homelessness in Columbus, Ohio.

Playbook perfect: SCL Health vaccinates 5,000 at one event By LISA EISENHAUER

By KATHLEEN NELSON

For a hospice patient living alone, the companionship and unconditional love of a pet can add a layer of comfort and emotional support at a trying time. Yet, caring for a dog, cat, bird or other animal can become increasingly difficult or impossible for a person in declining health. And when end of life approaches, worrying about who will take care of a furry or feathered friend can increase stress and anxiety — exactly what hospice is designed to relieve. “Pets are family members,” said Dianne McGill, president of Pet Peace of Mind, which helps hospice patients maintain the bond with their pets. “Since hospice is a Continued on 2

One relative arranged vaccine appointments for 11 of her family members age 70 and older, including these three individuals resting after getting vaccines at a mass vaccine event run by SCL Health at the National Western Complex in Denver on Feb. 6.

When Colorado Gov. Jared Polis asked SCL Health in January to lead a one-day mass vaccination event for some of the residents of the state who were most vulnerable to COVID-19, Lydia Jumonville, the system’s president and chief executive, says there was no hesitation. A team within the system chose a date, secured a site, set up an online registration process, crafted a communications strategy, coordinated with community groups to arrange transportation and recruited hundreds of volunteers, all within a few weeks. The Feb. 6 vaccination drive at the National Western Complex, a convention space in Denver, got shots into 5,000 arms within 10 hours. If SCL Health had had enough vaccine, Jumonville is confident 10,000 people could have gotten shots. “I think the efficiency of what we Continued on 8

CATHOLIC HEALTH WORLD March 15, 2021

Izzy

Amber

Pet Peace of Mind From page 1

family-centered program for patients, pets fit into that equation. Our services take a lot of the chaos out of patient care. We offer services that a patient may neglect or be incapable of providing and a preferable alternative to sending a pet to a shelter.” Founded in 2009, Pet Peace of Mind works with more than 250 hospices and palliative care programs across the nation, including several in the ministry. Several partners who initially offered the pet care service to hospice patients now make it available to home health and hospital patients too. “It transfers extremely well, but it does require a volunteer infrastructure to staff it,” McGill said. Pet Peace of Mind provides staff and volunteer training, all forms and McGill documents necessary to run the program and ongoing coaching for a one-time training fee.

Lightening the load Mercy Hospice in St. Louis has a Pet Peace of Mind program that provides financial assistance for pet food, litter and veterinary care including vaccinations, medications and grooming. The program is entirely self-funded through donations from the Nestle Purina PetCare Trust Fund and a grant from Mercy Women with a Mission, part of the Mercy Health Foundation. “Unfinished business Preheim weighs heavily on hospice patients,” said Nancy Preheim, manager of client services for Mercy Hospice. “If they don’t know what’s going to happen with their pet, they hold on and add to their worries. This program enables us to remove one worry from their end-of-life journey.”

Jake

Mercy delivers its services largely though its hospice volunteers, who have walked dogs, delivered food and driven pets to vet visits. (Some services have been limited since the COVID-19 pandemic.) In addition to funding, Mercy Women with a Mission provided a session for volunteers with a pet trainer, who offered insights into pet behavior and how to approach an unfamiliar dog or cat. When end of life nears and the pet of a hospice patient needs a new home, Preheim works with Petfinder, an online, searchable database for pets available for adoption, and relies on volunteers to help spread the word via social media. Preheim provides contact information of prospective owners to the hospice patient and family, who then decide on the best fit.

Wet Nose Project Among those who have adopted the pet of a hospice patient is Tracy Rumpf, founder of the Wet Nose Project in suburban St. Louis. Her group’s mission parallels Pet Peace of Mind, paying for veterinary services of sick, abused and injured animals and building a network to provide homes for terminally ill shelter dogs. When the first adoptive home didn’t work out for Max, a 13-year-old terrier mix owned by a hospice patient, Rumpf agreed to foster him. Max and her son, Brennan, grew so attached, though, that the Rumpfs soon adopted the dog. “I could see the way he looked at Brennan,” said Rumpf, who has fostered several dogs and owns a 90-pound American bulldog. “Max loves the boys in my family. I’m one dog away from a divorce, but my husband loves the fact that Max prefers him over me. He’s completely fit into our pack. It’s nice to give a hospice patient a sense of peace, knowing we’ll take care of Max.” Since starting the program in spring 2019, Mercy has provided services for 29 patients who have owned a total of 34 dogs and 16 cats. The group also found homes for 13 pets, including Max. “End of life is a time with dignity and

Jazz

Kiki and Gizmo

Above, a gallery of pets who have found new homes through Pet Peace of Mind programs. Below, Brennan Rumpf snuggles with Max, a 13-year-old terrier mix who his family adopted through the Pet Peace of Mind program at Mercy Hospice in St. Louis.

respect that should be as stress-free as possible,” Preheim said.

Golden solution Bon Secours Hospice and Palliative Care in Richmond, Virginia, has worked with Pet Peace of Mind since 2013, providing services to 108 families and placing 18 pets in new homes. The program has grown from its own funding, including grants from the Bon Secours Foundation, to help patients pay for medication and grooming. Like Mercy, Bon Secours provides volunteers to walk pets, though the COVID-19 pandemic has limited their participation, and has partnered with a veterinarian who charges reduced fees. “At a time when they have so many things they have no control over, we want to help in a small way so that they feel a sense of control,” Ellen Manning said of hospice Manning patients. She is volunteer

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services manager for Bon Secours Hospice in Richmond. She recalled a patient with a terminal illness, living alone with a 10-year-old golden retriever. Because the patient couldn’t afford medicine, the dog developed a bad case of fleas. One of her neighbors agreed to walk the dog but was reluctant to do more because she was unsure how sick the dog was. Bon Secours’ Pet Peace of Mind provided money for vet services and medication, returning the dog to health, then assisted the neighbor in adopting it. Perhaps more so than the initial funding, Manning is grateful for the guidance that McGill has provided for seven years. “Dianne reminds us that this is a patient program, not a pet program,” she said. “We can’t make big promises, but we can take one big worry away.” Manning has adopted one of the dogs of a hospice patient. Manning accompanied McGill on a visit to Congress in January 2019 to showcase the range of hospice services and discuss policy issues with members of Congress. Other ministry hospices that have joined Pet Peace of Mind include SSM Health at Home–Hospice Care Services in St. Louis; Catholic Hospice in Miami Lakes, Florida, an affiliate of St. Catherine’s West Rehabilitation Hospital; PeaceHealth hospices in Eugene and Florence, Oregon, and Vancouver, Washington; and Providence Hospice — Portland, Oregon. McGill estimated that Pet Peace of Mind serves about 3,000 people and their pets annually. “When you’re terminally ill, many people stop visiting, so the person-animal bond becomes even more essential,” she said. “The program is designed to honor that bond, even after the patient passes.”

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March 15, 2021 CATHOLIC HEALTH WORLD

Protecting the unhoused From page 1

dollars that supported de-concentration of emergency homeless shelters until federal dollars began flowing for this purpose. Similar coordinated efforts in communities across the U.S. brought marked success. The U.S. Interagency Council on Homelessness reports the incidence of COVID-19 cases and deaths among people experiencing homelessness has been significantly and dramatically lower than had been originally projected. Angela D’Orazio, senior program officer for the homelessness focus area for Sisters of Charity FounD’Orazio dation of Cleveland, says this has been the case in Cleveland, where “because of our shelter de-concentration efforts, we have been able to maintain shelter census at or below 53% and have seen a less than 8% positivity rate in our shelters.” The coalitions now are focused on ensuring that people who are homeless are prioritized for vaccination. Last month the Biden administration said it planned to ship vaccine directly to federally qualified health centers, whose patients include homeless individuals.

Building on success “It has been an unprecedented collaboration of homeless services providers,” says D’Orazio. “It’s been tremendous — there’s been enormous support and recognition of the needs of people who are experiencing homelessness,” says Jaime Dircksen, vice president, Community Health & Well-Being at Trinity Health. “The whole idea now is: Can we leave homeless services in a better place than we found them?” says Barbara DiPietro, senior director of policy for the National Health Care for the Homeless Council, a CHA advocacy partner that represents federally qualified health centers DiPietro focused on serving homeless populations. “In virtually every major community around the United States, there was a sea change in how homeless services were delivered,” DiPietro says. Public-private partnerships mobilized to depopulate homeless shelters to allow for social distancing. In most cases service providers identified underused space — often rooms in hotels and motels left vacant by the COVID-19 lockdown — to function either as medical respite housing for people with COVID-19 or as an alternative to homeless shelters or encampments for individuals in high-risk groups, usually frail elders and

Juanita Gonsalves wraps the foot of a resident at the Sam Jones Homeless Shelter. Jessica Quintal tends to another patient. Gonsalves and Quintal are medical assistants with the Providence St. Joseph Health – Sonoma County mobile health clinic in California. The clinic has been meeting medical needs of homeless people throughout the pandemic.

chronically ill people. Many of the coalitions organized corps of health care and social service providers to tend to the needs of the temporarily resettled people as well as to people in shelters and encampments.

Vaccine equity DiPietro says some states, but not all, specifically mention homeless populations in their vaccination plans. There is wide variance in how state protocols are written and interpreted and implemented. In general, though, vaccine distribution sites must operate within the parameters of the state’s priority tiering.

In many communities, vaccine appointments are extremely hard to secure. Homeless services providers are trying to figure out how to make sure that homeless people who qualify for a priority slot based on age or health status can get a vaccine. Especially given the variance in how governmental bodies at every level are carrying out vaccination efforts and prioritizing people, homeless populations may be overlooked, says DiPietro. Also, many states are focused on mass vaccinations at large venues, such as stadiums, or drive-thru clinics. Homeless people may be unable to travel to those venues or may feel uncomfortable going there. Trinity Health’s Dircksen says other hurdles include the logistical challenge of administering two doses, weeks apart, to homeless individuals who may be transient or else unwilling or unable to supply contact information.

Employees of the Centers for Disease Control and Prevention partnered with Atlanta’s Mercy Care to provide COVID testing to staff and residents of homeless shelters. This April 2020 testing is at Gateway Center, an Atlanta homeless shelter for men.

Finding a way Despite logistical challenges, some homeless services providers in the ministry have been able to begin vaccinating or supporting the vaccination of people who are homeless. For instance, Joseph’s

Ministry tends to health, social service needs of homeless people C

atholic health care systems and facilities — and in some cases their social service ministries — have dialed up their direct outreach to people who are homeless. Street outreach teams fielded by Trinity Health and emergency department staff use the health system’s social services hotline to identify and refer homeless individuals in need of food, housing or transportation to social service agencies, some of which receive financial support from Trinity Health. Trinity Health’s Mercy Care staff in Atlanta are among Trinity Health clinicians and social service staff rounding at homeless shelters and encampments to educate people on virus precautions, distribute hand sanitizer and complete basic health and COVID screenings and testing. Mercy Care provides ambulatory care at its clinics and via telehealth with a focus on patients who are homeless.

Mercy Care collects prepackaged items including granola bars, fruit cups and tuna pouches and packs them into individual meal kits. Staff hand out the kits at Mercy Care clinics and at homeless shelters and encampments, says Tom Andrews, chief executive of Atlanta’s Saint Joseph Health System, parent company of Mercy Care. He says with the pandemic, the need for meal kits escalated to thousands Andrews a month due to usual food sources no longer being available. The Sisters of Charity Foundation of Cleveland and Joseph’s Home, both affiliates of the Sisters of Charity Health System, are deploying and/or supporting volunteers — many of whom once had been homeless — to educate the unhoused about COVID, taking advantage of a foundation of trust and credibility.

Sonoma County, California, has one of the state’s largest homeless populations, when counted per capita, according to Jennifer Eid-Ammons. She is the manager of Providence Eid-Ammons St. Joseph Health — Sonoma County’s mobile health clinic, which cares for the community’s poor and vulnerable, including many homeless immigrants who lack legal immigration status. When clinics shut down in-person visits at the start of the pandemic, Providence’s mobile clinic was the only health care access many homeless people had. Eid-Ammons says the mobile clinic’s services were especially appreciated by the many undocumented immigrants who are homeless. — JULIE MINDA

Home, which is a Sisters of Charity Health System-sponsored medical respite for people who are homeless, was partnering with others to vaccinate its eligible clients earlier this month and track them to ensure they are able to receive a second dose. E. Gaye Woods, system director of community benefit at SCL Health, says that system is coordinating with its community partners, including those that work with people who are homeless, to include vulnerable populations in mass vaccination events. SCL Health helped to provide transportation to a February mass vaccination for vulnerable community members. And it is strategizing with homeless service providers to get the vaccine to homeless people where they congregate, most likely using mobile clinics. Woods says that often people who are housing insecure will frequent particular locations for food and shelter on a regular basis. SCL Health will provide vaccinations at some of those sites. “We are Woods excited to be able to meet people where they are,” she says. Vaccine hesitancy is a hurdle to mass vaccination of homeless populations, Woods says. People of color make up a disproportionate percentage of homeless populations, and they also are among the most distrustful of the COVID vaccines. “That’s why we have to put in the time to grow people’s trust,” says Woods. Trinity Health recently announced it will spend $1.6 million to build trust in COVID vaccines and get the shots to high risk and medically underserved populations. It planned to spend $500,000 of the sum on a radio and social media campaign to launch this month. The social media campaign will use influencers who represent the culture and ethnicity of the community. The campaign will raise awareness of how and where to be vaccinated. Trinity Health plans to offer vaccination in accessible locations, particularly places that are convenient to the elderly, the unsheltered and people living in rural areas. Some of the funding will be used to transport vulnerable people — including homeless people — to vaccination events. As Catholic Health World went to press in early March, Trinity Health sponsored street medicine and medical programs for the homeless — Pittsburgh Mercy’s Operation Safety Net and Mercy Care in Atlanta — planned to do vaccine outreach to individual patients as state priority stratification made them eligible for inoculation.

Uncertainty ahead DiPietro says homeless services providers may not have a great grasp of the true extent of homelessness in their communities, since homelessness point-in-time counts have been delayed due to the virus. Also, the number of homeless people could increase dramatically if current eviction moratoriums end. Beth Graham is executive director of Joseph’s Home. She anticipates there will be an ongoing need for trauma-informed mental health care since homeless people have Graham been enduring the dual trauma of the pandemic and homelessness. Graham says while many people may speak of a return to normal, in her view, “getting back to normal is not acceptable for people experiencing homelessness. We don’t want to go back to how things were.” Graham’s colleague D’Orazio asks rhetorically, “How do we capitalize on our newfound ability to think differently about homeless services? How do we sustain this in the future? How do we quickly help people in housing crisis and minimize their trauma? And how do we get them back to their own home, which is where it’s best for them?”

CATHOLIC HEALTH WORLD March 15, 2021

Responding to hunger From page 1

said when the pandemic hit, “the demand for food skyrocketed,” partly because of panic buying, and “the food distribution system was out of whack, with grocery store shelves empty, food pantries empty.” While food insecurity was relatively stable just before the pandemic, Stenson said that many Stenson people became newly food insecure last spring. Scurrying to fig- This model conceptualizes the relationship between food insecurity and health care expenditures. The ure out how to implement new infection figure appeared in a Feb. 17 article, “Examining the bidirectional relationship between food insecurity and control protocols, lacking personal pro- healthcare spending,” in Health Services Research. tective equipment and with supply chains disrupted by the pandemic, many food Interconnected issues concluded that disease management pantries initially had trouble responding Duquesne University President Ken plans targeting the upstream determito the crush of demand. Gormley told partici- nants of food insecurity and general poor Layoffs, furloughs and work hour pants at the Duquesne health may be more effective at breaking reductions had cut into affected worknursing school sympo- the food insecurity-poor health cycle than ers’ household food budgets. According sium on hunger that the interventions that solely target disease to “Unemployed Without a Net,” a Seppandemic worsened pre- management costs. tember brief from researchers at Harvard existing basic inequaliKennedy School’s Malcolm Wiener Center ties. He said the vulner- Advocacy with partners for Social Policy, unemployment jumped able populations hit Kathy Curran is CHA senior director Gormley from 4% in February to 15% in April. “The hardest by the pandemic of public policy. She said as a symposium economic toll of the coronavirus outbreak are reeling from a complex set of inter- panelist that the pandemic has laid bare has been particularly severe for service connected problems, including financial how interconnected America’s food consector workers,” including those in retail, hardship, medical costs, housing insecufood service and hospitality, the research- rity, social isolation and hunger. Speakers wrote. ing specifically about hunger, he said, According to “The Impact of the Coro- “food insecurity is a growing concern navirus on Food Insecurity in 2020,” an worldwide, and families and individuOctober report from the nonprofit hunger als are being forced to make very difficult relief agency Feeding America, before the decisions.” pandemic, there were more than 35 milA Feb. 17 article in Health Services lion people who were food insecure, and Research, “Examining the bidirectional this was the lowest U.S. food insecurity relationship between food insecurity and level in more than two decades. healthcare spending,” delves into one Feeding America estimated that about aspect of the interlocking issues — food 50 million people and health. The Given that health is so experienced food authors analyzed insecurity in 2020. data on health strongly linked to nutrition care expenditures, The organization said in a December and other social factors, CHA food insecurity press release that its and medical conworks closely with Catholic ditions for 10,886 national network of food banks had conadults included partners and other allies on in surveying in tinued to consistently report a nearly 60% 2016 and 2017. a range of policy issues to increase in demand The authors conadvocate for social justice. cluded that being compared to the previous year and confood insecure in tinues to require more food and resources one year was associated with higher odds to provide to people in need. in the next year of having greater total Stenson said significant influxes of gov- health care expenditures. The authors ernmental aid and philanthropic relief also found that having greater health care (see sidebar) have provided temporary expenditures in one year was associated help for individuals and families facing with slightly higher odds of being food food insecurity. Despite that aid, demand insecure in the next year. for food is still high, she said. Based on their analysis, the authors

cerns are with federal, state and local policy in numerous areas. These include lawmaking around unemployment benefits, aid packages, health care, banking, education, job creation and technology. Given that health is so strongly linked to nutrition and other social factors, CHA works closely with Catholic partners and other allies on a range of policy issues to advocate for social justice. Sumilas agreed on the vital importance of advocacy to affect these systems for change. She said that inequities worsened by policies at many different levels and in many Sumilas different areas of government can have dire consequences for vulnerable people. Working with partner organizations on advocacy efforts, building relationships and trust with lawmakers and presenting data and personal stories that illustrate the gravity of the inequities can help to bring about real change, she told the audience. “As Christians we are obliged to use our power to urge change when it comes to the things Jesus told us to care about,” including hunger, Sumilas said. jminda@chausa.org

Federal government moves improve food security

uring the pandemic, several federal actions have had a significant impact on food insecurity and related concerns: Signed into law in March 2020, the Families First Coronavirus Response Act included additional funding for the Special Supplemental Nutrition Program for Women, Infants, and Children and for a Commodity Assistance Program that was part of the Emergency Food Assistance Program. That act also funded nutrition services for Aging and Disability Services Programs. And it waived some requirements so that it would be easier to get food to schoolchildren and to people dependent on SNAP. A second law adopted in March was the Coronavirus Aid, Relief and Economic Security Act, which provided a stimulus payment of up to $1,200 for individuals, $2,400 for joint taxpayers and an additional $500 for each qualifying child. That law also increased unemployment payments by $600 weekly through July 31. In December, a new COVID relief deal was passed into law under omnibus appropriations legislation that increased the maximum benefit allowed under SNAP and increased the amount of aid provided under the Emergency Food Assistance Program. It increased funding for food for very young children, school children and older adults. It also provided a payment of $600 for people earning up to $75,000 annually and a payment of $1,200 for couples earning up to $150,000 annually, along with $600 per child in a household. It provided an additional $300 weekly in federal aid to unemployed people through March 14. In January, President Joe Biden signed executive orders to increase SNAP aid for women, infants and children. The order also increases monetary aid to families with children who have lost access to food aid due to school and childcare closures, through the Pandemic Electronic Benefits Transfer program. The order also aims to improve the SNAP program to better address recipients’ needs.

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March 15, 2021 CATHOLIC HEALTH WORLD

Catholic health systems, partners tackle food insecurity close to home By JULIE MINDA

With the onset of the pandemic, many people joined the ranks of the food insecure and social service agencies scrambled to meet the increased demand for food aid. Catholic health systems and facilities have made it a priority to assess food insecurity in their communities and to partner with social service agencies to mount a response. Uliana Stephanie Uliana is an Ascension community benefit manager focused on Ascension St. Vincent’s Indiana market. Pre-pandemic, a key aim of her department was increasing Indiana schoolkids’ access to free meals in schools, including by expanding the availability of school breakfasts. When the pandemic hit and schools discontinued or sharply curtailed in-person learning, Uliana and her community benefit colleagues in the region talked with each of the 16 hospitals Ascension operates in Indiana as well as with food aid organizations and schools Ascension had partnered with in its prior work to address food insecurity. They also talked with a statewide coalition focused on school breakfast.

Some of the produce grown at the Farm at St. Joe’s goes to people who are poor and vulnerable. That farm is operated by Saint Joseph Mercy Health System.

New approaches The conversations revealed that there was a need to expand the scope of food aid work. Community members who already were food insecure before the pandemic’s onset were hit hard financially by coronavirus-related business shutdowns and scale-backs. Low-income community members with kids were having trouble feeding their children — with schools closed, there initially were no free breakfasts or lunches. In Indiana the percentage

Amanda Sweetman, regional director of farming and healthy lifestyles for Trinity Health in Michigan, works to ensure vulnerable populations can access healthy produce.

to close amid lockdowns. Dircksen says Michigan-area farms, including a farm Trinity Health hospitals helped their food associated with Saint Joseph Mercy aid partners to pivot to Health System. Prior to new models and work- Community members the pandemic, the work arounds to safely deliver involved getting fresh who already were food. For instance, they fruits and vegetables from assisted walk-in pantries food insecure before the farms to hospital staff in finding ways to reduce and patients, as well as to the pandemic’s personal contact in the low-income community handoff of food, such as members. With the onset onset were hit through drive-thru lanes of the pandemic, Sweetstaffed by employees or hard financially by man and her farm comvolunteers in personal munity partners sought coronavirus-related ways to get the produce protective gear. Dircksen notes that newly food-insecure business shutdowns to local philanthropy has people. This included increased during the arranging for delivery of and scale-backs. pandemic and that has produce to homebound enabled organizations that address food people who are patients of Saint Joseph insecurity to buy more food and feed more physicians. people. Trinity Health’s Sweetman coordi- jminda@chausa.org nates food aid efforts by small Ann Arbor,

of children living in food-insecure households has increased from 17.5% in 2018, to a projected 25.3% for 2020, according to information from Feeding America. The community benefit representatives’ conversations also revealed that the schools’ food service directors were grappling with how to get free meals to kids outside of the school venue. Uliana says Ascension listened to the schools to understand the challenges they were facing in getting food to kids, and then tried to assist them in addressing those challenges. For instance, one Ascension hospital purchased equipment that enabled a school to get hot, nutritious meals to kids who were learning remotely.

Workarounds Jaime Dircksen is vice president of Community Health and Well-Being at Livonia, Michigan-based Trinity Health, and Amanda Sweetman is regional director of farming and healthy lifestyles for Trinity Health in Michigan. Dircksen says during the pandemic Trinity Health markets have registered a significant increase in need for food aid. The Dircksen markets reported that the traditional emergency food system — particularly walk-in food pantries — were struggling to meet the demand. Meals on Wheels could not rely on its large corps of older adult volunteers to make deliveries for fear of exposing them to contagion risk. Soup kitchens and churches that provided food aid had

Ascension St. Vincent's Indiana market community benefit teams assisted local schools in pivoting to new ways of getting food to students during the pandemic. The system’s Salem, Indiana, location bought 24 of these coolers so a school could store breakfasts and transport them to classrooms.

Workers unpack coolers purchased by Ascension St. Vincent Salem in Indiana for use in a school breakfast program.

Ascension employs digital tool to assess, address the complexities of food insecurity A

year ago, Ascension put a tool into use systemwide that it had found useful in one of its markets for assessing and responding to community need. That tool is helping Ascension to learn in an in-depth and ongoing way about food insecurity in each of the communities it serves, including among associates. Ascension markets are using that information to adapt and focus their work with partnering organizations to address hunger in their communities. Mary Paul is Ascension vice president of mission integration. She said the Social Response Framework tool is a digital network that Ascension developed to gather intelligence from its local markets. It provides “a systematic process to listen, track barriers, organize learnings and develop responses that are tailored to the needs of the community.” “This process enables us to go beyond the initial concern, to develop a response that reflects the complexity of the social condition,” Paul said. To use the tool, leadership records top community needs in a real-time manner. During the pandemic, food insecurity was identified as the top shared need. Then Ascension asked its community benefit representatives systemwide to gather insights through conversation with internal and external contacts and then log that information into this centralized tool. That intelligence is informing Ascension’s efforts to develop market-specific anti-hunger initiatives in collaboration with its local social service partners. Ascension developed the tool in its Wisconsin market to understand the reasons vulnerable expectant mothers were missing prenatal care appointments and design responses. One of these responses was the creation of a child waiting area where children are supervised during prenatal appointments. Another was the introduction of food boxes tailored to the nutrition requirements and medical conditions of expectant moms. When the pandemic shut down local economies, Paul said, Ascension leadership recognized the value of the tool for gathering information efficiently from around the system. Leadership in Ascension markets had said that food insecurity was the top socioeconomic issue arising locally at the start of the pandemic. Paul said through the tool, Ascension learned that the number of people requiring food aid has expanded greatly, that food insecurity is very complex and that one strategy will not work across the system. “Our solutions and responses are built in and with our community, one conversation at a time,” Paul said. Paul said Ascension now is finalizing plans for a healthy food initiative to respond to both associate and community food insecurity. This initiative will be a broad approach that each market will be able to tailor to address its specific circumstances. — JULIE MINDA

CATHOLIC HEALTH WORLD March 15, 2021

Avera Health puts rural women in close touch with diabetes educators, nutritionists It can be difficult to monitor and manage patients with gestational diabetes who live in remote rural areas, but Avera Queen of Peace Hospital in Mitchell, South Dakota, has developed a telemonitoring program so successful that it has expanded it throughout the state. Digital telehealth visits with diabetes educators and registered dietitians are part of the program, as are educational videos that teach patients how to test blood sugar levels and even inject insulin. Blood sugar readings from a glucometer are automatically uploaded to an app, which eliminates the need for patients to track and report their own blood sugar levels. Even in rural areas where there is poor cell service, patients can get to a cafe or library in town for a Wi-Fi connection to transmit their data to clinical staff for review. “Micromanaging of blood sugars early on is important,” said Angie McCain, director of the Women’s Center at Avera McCain Queen of Peace and also director of the hospital’s education services and telemedicine. “If a woman shows a spike two days in a row, whoever is on intake will call to review her diet.” McCain continued, “If a woman made a bad choice for an evening snack, one of our dietitians can talk with her about a better choice. If we continue to see a spike after her diet is adjusted, then we can refer the woman to a tertiary care center. We do feel our program is the gold standard, and our goal is that every Avera provider will refer into it.” The program was initiated in 2016 after a request from a physician having difficulty managing the care of rural obstetrics patients with gestational diabetes, said Dr. Kimberlee McKay, clinical vice president of Avera’s obstetrics service line and McKay medical director of the gestational diabetes program. “From the beginning, our hope has been to achieve the same result as with usual care in a traditional program,” McKay said. She noted that South Dakota has a higher gestational diabetes rate than the rest of the nation, 10 – 15%, compared to 6 – 8%. Three counties in the program’s service area have a large population of Native Americans, who have a higher rate of gestational diabetes than other groups.

Time sensitive McKay emphasized that when caring for patients with gestational diabetes, physicians have just a small amount of time to affect a big change in the physiology of the mom and baby. “There is a lot of programming of the metabolism of the fetus in uteri,” she said, “and for a mom to have well-controlled gestational diabetes also reduces her risk for diabetes over her lifetime. That requires tight controls.” McKay said to date, some 350 patients have participated in the diabetes monitoring program. Avera received a four-year grant from the Health Resources and Services Administration’s Federal Office of Rural Health Policy and a three-year innovation grant from the South Dakota Department of Social Services to offset the costs. McCain, project director for the grants, noted that the program has expanded to all parts of South Dakota served by Avera and also is moving into Avera’s Minnesota markets. “What’s special about the program,” McKay noted, “is the concept of bringing immediate medical expertise to patients who otherwise would have to travel or not have access to care.” From the beginning, the program’s goals have included reductions in the instances of large-for-gestational-age infants, shoul-

Nathan Johnson/Avera Health

By PATRICIA CORRIGAN

Tina Rank Dikoff, an early participant in Avera Health’s eGestational Diabetes Program, and baby Irelynn visit with obstetrician Dr. Michael Krause in this 2018 photo. The telehealth program provides nutrition education and close glucose monitoring to pregnant women who live far from health care services.

der dystocia, postpartum hemorrhage and primary Caesarian sections and also fewer admissions to the neonatal intensive care unit. Those goals are being met, McKay and McCain reported. “Most of our babies are normal size at birth now,” McCain said. “We also recently had a patient who’d had to go on insulin for gestational diabetes with a prior pregnancy, but this time we intervened more quickly and monitored her more closely than in a traditional clinical model. She had her baby

at 39 weeks with no complications, the baby was normal size and there were no issues after the birth. She was very happy.”

Convenience factor Patients report that one big benefit of the program is the telehealth appointments, which allow those who have smartphones or laptop computers to check in while at home or at work. That saves time and money for patients, McCain said, because they no longer have to drive to a clinic or

pay for the gas those trips require. “In a twoyear period, patients saved 58,000 miles of travel, $5,600 in gas money and over 200 days of work that otherwise would have been missed,” she said. Part of the state grant may be used to provide more patients with laptops or tablets. “We’ve also seen increased physician satisfaction due to the program,” McCain said. “Our core team touches base about our patients with the providers every week, so they are in the loop. Also, the program has allowed physicians a lot of clinic time back, which means the clinics are operating more efficiently.” And soon, the program will add a patient health navigator. McKay said Avera “believes that where you live should not influence the care you receive.” She added that the remote gestational diabetes program has achieved financial viability and quality patient care. Noting the success of the remote monitoring program, McKay issued a challenge to policy makers, insurance chief executives and health systems. “We’ve had people willing to innovate and try new things to put a process in place to meet the patients where they are,” she said. “We’ve made this program easy for our patients to use, and that allows them to enjoy their pregnancy while doing what’s best for the baby. I would ask health care leaders this: If you know a program like this would make a difference, what barriers will you remove to use the technology?”

“In the diversity of peoples who experience the gift of God, each in accordance with its own culture, the Church expresses her genuine catholicity and shows forth the ‘beauty of her varied face.’” POPE FRANCIS | Evangelii Gaudium (Joy of the Gospel), #116 | 2013

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March 15, 2021 CATHOLIC HEALTH WORLD

KEEPING UP PRESIDENTS/CEOS Providence St. Joseph Health of Renton, Washington, is putting in place a new leadership structure, with two new regional leadership roles responsible for the northern and southern portions of its service area. These and other leadership changes include: Lisa Vance to president of operations and strategy for Providence St. Joseph Health’s northern regions, which are in Alaska, Oregon, Washington and Montana. Vance also continues as chief executive for the Oregon region. Erik Wexler to president of operations and strategy for Providence St. Joseph

Health’s southern regions, which are in Northern California, Southern California, Texas and New Mexico. Wexler was chief executive of the Southern California Bergmann region. Kevin Manemann to chief executive of the Southern California region from chief executive of physician enterprise. Greg Hoffman to chief financial officer of Providence St. Joseph Health. Jo Ann Escasa-Haigh to chief inte-

Houston

Salnas

gration officer. Michael Bergmann to president of Ascension’s Fox Valley, Wisconsin, region, overseeing Ascension NE Wisconsin – St. Elizabeth Campus, Ascension NE Wisconsin – Mercy Campus and Ascension Calumet

Hospital. Bergmann was primary service area president for Waukesha/Jefferson in Wisconsin at Advocate Aurora Health. Anthony A. Houston to chief executive for CHI Saint Joseph Health of Lexington, Kentucky, effective April 5. He concurrently will be president of that organization’s Saint Joseph Hospital and Saint Joseph East. He was president and chief operating officer for CHI Memorial in Chattanooga, Tennessee. The facilities all are part of CommonSpirit Health. Todd Salnas to chief executive of the PeaceHealth Oregon network, from interim chief executive.

Brennan was Providence’s first lay chief and Ascension’s first chief Don Brennan died Feb. 12 at age 83. His career in health care and insurance administration spanned 40 years, with half that time in Catholic health care leadership and governance. Brennan was the first lay president and chief executive of a predecessor of Providence St. Joseph Brennan Health and the first president and chief executive of Ascension. Brennan was a “true inspiration and guiding hand” for the ministry and a “passionate advocate for health reform and the mission of Catholic health care,” says Sr. Mary Haddad, CHA president and chief executive officer. She says Brennan’s commitment and dedication are “shining examples for us all.” After serving in the U.S. Navy and working several years as a laborer in Denver, Brennan was the first in his family to attend

college. He earned an accounting degree and a master’s of public administration from the University of Colorado. Beginning when he was a graduate student, he worked at the University of Colorado Medical Center in Boulder. Brennan started at Group Health Cooperative in Seattle in 1974, rising to the role of chief executive in two years. In that capacity, he led the creation of one of the first Medicare health maintenance organizations. He departed Group Health in 1980 to join the Sisters of Providence Health System, a predecessor of Providence St. Joseph Health. As that system’s chief executive, he oversaw its transition into an integrated health care delivery system, its establishment of a health plan and its pioneering participation in the Program of AllInclusive Care for the Elderly, commonly known as PACE. Upon his 1993 retirement from Providence, Brennan began a two-year tenure as a chair of Washington’s Health Services

Commission, which implemented that state’s new health reform law. In 1999, at the behest of the Daughters of Charity National Health System of St. Louis, he helped that organization to merge with the Sisters of St. Joseph Health System of Ann Arbor, Michigan, to form Ascension Health. He was St. Louis-based Ascension’s chief executive from 1999 to 2001. Brennan served on the board of CHA, as well as multiple Catholic health care systems. In 2001, the year after his retirement from Ascension, he received the Sister Concilia Moran Award. CHA annually gives

the award to a trailblazing thinker with an understanding of Catholic health care as a ministry of the church. In nominating Brennan for the honor, three women religious who were sponsors of the former Daughters of Charity National Health System wrote of his vision in seeking to create “a strong, vibrant Catholic health ministry.” They described him as a man of integrity. They wrote, “through his ideas, influence and actions Don mentors and encourages others.” Brennan’s private funeral will be at St. James Cathedral in Seattle March 22.

Holy Redeemer rebrands as Redeemer Health Holy Redeemer Health System is changing its name to Redeemer Health and adopting a new logo. The health system based in Huntingdon Valley, Pennsylvania, serves southeastern Pennsylvania and 12 counties in New Jersey. It includes an acute care hospital, home health and hospice services, three skilled nursing facilities, a retirement community, low-income housing, an independent living community, and a transitional housing program for homeless women and children. “This rebrand is part of broader strategic initiatives to grow and expand the system to meet the changing needs of the communities we serve in Pennsylvania and New Jersey,” Mike Laign, president and chief executive of Redeemer Health, said in a press

release announcing the rebranding. The system’s name comes from its founders, the Sisters of the Redeemer. The rebranded name and logo were revealed to the public Feb. 24. They will be rolled out across the system throughout the year. While Redeemer Health is the primary name the system will use for most of its services, it plans to retain the legacy names of some facilities. Those include Holy Redeemer Hospital and Holy Redeemer St. Joseph Manor, a continuum of care center that, like the hospital, is in Meadowbrook, Pennsylvania.

Editor, Health Progress CHA seeks an editor for Health Progress. As the principal architect of the content and quality of CHA’s journal, the editor is a thought leader in the Catholic health ministry. CHA advances the Catholic health ministry of the United States in caring for people and communities. Composed of more than 600 hospitals, 1,600 long-term care, and other health facilities in all 50 states, the Catholic health ministry is the largest group of nonprofit health care providers in the nation. The editor sets editorial philosophy and strategy in collaboration with the association’s leaders, identifying current trends and related topics and soliciting the best experts from relevant fields to author material for publication. The editor is the public voice of the magazine and may make presentations to member and external audiences regarding issues and developments in the ministry and health care sector. The editor manages the journal staff; sets standards; writes and edits as needed; selects and directs the work of artists/illustrators and creates and monitors editorial calendars, production schedules, procedures, etc. Additional accountabilities include ensuring integration of CHA’s mission, goals, strategies, and policies in HP editorial efforts, and contributing as needed on other communications projects of the association. Some travel may be required. Minimum qualifications: Seven+ years in journal editing or publishing. Three to five years in Catholic publishing or Catholic health ministry, yielding knowledge of Catholic teaching, tradition. Three+ years supervisory experience. Bachelor’s degree or equivalent work experience in English, communications, journalism, or related field. Graduate-level work in Catholic theology and history an asset. To view a more detailed listing of this position visit the careers page on chausa.org. Cara Brouder, Senior Director, Human Resources Catholic Health Association 4455 Woodson Rd. St. Louis, MO 63134 Phone: 314-427-2500 For consideration, please email your resume to HR@chausa.org We are an Equal Employment Opportunity employer.

CATHOLIC HEALTH WORLD March 15, 2021

SCL mass vaccine event

ment to help them get comfortable with the vaccine itself and also with the process to get them vaccinated.”

From page 1

planned blew us away a little bit,” she says. The event was the first of two parts, with the process set to repeat on March 6 to give the booster shot. Part one went so smoothly that SCL Health has been circulating the master plan for organizing its event to others, including health systems, government agencies and community groups. “We’re happy to share our playbook with anybody,” Jumonville says. “We want to get everybody in this country vaccinated as quickly as possible, especially those who are most vulnerable and have been most impacted by COVID.” While other systems have staged similarly large drive-thru vaccination events in Denver, SCL Health’s was unlike those in that it was an inside event. People didn’t have to have a car or a companion with a car to attend. Groups that the health system worked with arranged transportation — including buses, shuttle vans and Lyft service — for patients who needed it. Accommodations were in place to assist those using walkers and wheelchairs.

A patient closes her eyes as an SCL Health volunteer administers a COVID-19 vaccine at the system’s first mass event Feb. 6 in Denver. Members of underserved communities and communities of color were specifically invited to the event.

and president of SCL Health Foundations, helped craft that education effort. She says Speed and agility it hasn’t taken a hard sell to get most associThe indoor venue also meant that ates who have been caring for patients with patients didn’t have to sit in cars and work- COVID to get the vaccine. ers didn’t have to be stationed under tents “I think our frontline workers have seen on a parking lot for hours. what COVID has done, so everyone was The mass event fit really responsive and nicely into the vacjust grateful for the cination strategy that opportunity to be vacan SCL Health team cinated,” Mahncke that includes pharmasays. cists, doctors, nurses The first vials and communications arrived at SCL Health’s specialists began craftSt. Joseph Hospital in ing months before the Denver around 3 p.m. first vaccines got fedDec. 15 and by the eral approval. The goal end of the day nurses has been to move as had given hundreds quickly as possible to of shots to frontline get the system’s frontworkers. SCL Health line workers inocusaid in late February lated and then pitch that the overwhelmin on the public effort, ing majority of its with a special focus on associates across its those who are eligible eight hospitals and but with limited access more than 150 clinics to vaccination sites. had been vaccinated. As of Feb. 24, SCL A volunteer sanitizes chairs during SCL As the public Health had adminis- Health’s mass vaccination event. Hundreds of rollout began, SCL tered 100,000 shots the Denver-based health system’s associates Health expanded and to its associates and volunteered to assist at the Saturday event. diversified its educathe public. Jumonville tion strategy for the credits that number to an agile team that communities it serves across Colorado and moves swiftly to ensure that whatever sup- Montana. The system added a section on ply is available gets put to use. vaccine resources to its website with expla“One of the things that improved in our system the minute COVID hit in March, is that we found out we need to be very flexible, and most of us move a lot faster and make decisions a lot more quickly than I think we had done in the past,” she says. An example of a decision that came about quickly was one made in response to an uptick in last-minute cancellations or no-shows, which Jumonville attributed to people putting their names on various lists or making multiple appointments for shots. In response, SCL Health set up a “rapid-call list” that patients who hadn’t been able to secure an appointment can put their names on. If at the end of vaccination events there are leftover doses, the system contacts patients on the rapid-call list who live within 15 minutes of the sites. The remaining doses are prioritized for those who meet state eligibility requirements.

Educating associates At the end of 2020, before the vaccine rollout began for SCL Health associates, system leaders posted and emailed to them educational material about the safety and efficacy of the vaccines. Workers could attend online meetings that featured Jumonville and other system leaders discussing the process and answering questions. Megan Mahncke, senior vice president of marketing and communications

nations of the eligibility rules in both states and links to where patients can sign up to be notified of vaccination opportunities. That information gets constant updates as the states revise their eligibility guidelines and as an increasing vaccination supply allows SCL Health to offer more opportunities for shots.

Removing barriers The health system has posted information from its own experts and other trusted sources on its social media channels. It’s sent letters and made phone calls to its patients who are eligible for the vaccine to tell them how to sign up and to answer their questions. To reach minority communities that have proven to be especially vulnerable to the infection, SCL Health has worked with churches and organizations that serve those populations. The partners have helped provide education and access to vaccines through webinars, meetings and pop-up clinics. In addition, the system has sought out “community influencers,” such as pastors, teachers and neighborhood organizers, to get vaccines and speak out about their safety. “We’ve tried to remove barriers for vulnerable populations,” Jumonville says. “We’ve had teams go out to their churches and physicians talk to them and answer their questions about the vaccine. We have Spanish-speaking providers who’ve gone out to meet with people in their environ-

The big event SCL Health used the same strategy of partnering with community groups to reach out to residents when it began planning its mass vaccination drive in Denver that targeted vulnerable residents who were 70 or older. Mahncke says about 40 nonprofit groups were tapped to help spread the word, register eligible residents and transport them to the event. It took the combined effort of about 600 volunteers — including coordinators, clinicians and escorts — to pull off the event. Most of those volunteers came from SCL Health. Mahncke says she and other SCL Health leaders were uncertain how associates would respond when asked if they would donate their services for the Saturday event, especially given that they’d been under intense stress for a year because of the pandemic. “Within two hours, we had over 500 of our own associates volunteering for this event, which just floored us,” she recalls. Organizers planned the event precisely to avoid lines and to ensure social distancing. They arranged specific arrival times for patients, kept entrances and exits separate, set up pairs of chairs for the patient and a companion a safe distance from others, and moved each patient through the process, including a required post-shot observation of 15 minutes, in about 30 minutes. Tears and gratitude Mahncke and Jumonville were among the “goodbye greeters” who saw patients off. “It was one of the most moving things I think we’ve ever been a part of because for the patients coming out — these are people who have been isolated and many living just in fear for the last year — this was the first hope they’d had,” Mahncke says. “The tears and the gratitude was just something I’ve never experienced before.” Jumonville says SCL Health will continue to pursue and refine its vaccination strategy until everyone who wants to be inoculated is. Meanwhile, it is pursuing a second goal with its community outreach: assuring patients that they don’t have to fear returning to hospitals and clinics for care. “We actually see maybe the bigger risk right now and into the future months is people delaying care or continuing to delay care,” she says. “I think that’s one of our biggest concerns going forward.”

SCL Health associates prepare for a stream of patients at the check-in points at the entrance to the mass vaccination clinic on Feb. 6. The event took place at the National Western Complex, a convention space in Denver. In 10 hours, 5,000 people were inoculated.