CHA’s sponsorship and mission services department revitalizes its programming
By JULIE MINDA
In recent years, changing roles and responsibilities within CHA’s sponsorship and mission services department and the addition of new team members has brought fresh perspectives to that department’s work. When CHA released its vision statement and new strategic plan, the sponsor-
CHRISTUS Children’s expansion is improving pediatric care access in South Texas
By JULIE MINDA
SAN ANTONIO — Even though San Antonio is the nation’s seventh largest city, CHRISTUS Children’s assessments about six years ago indicated that families were often having to leave the metropolitan area to obtain vital pediatric specialty care for their kids.
Since identifying the dearth of these services as a pressing concern, CHRISTUS Children’s has been implementing a strategic plan to grow six focus areas that it calls its pillars of excellence and to build up related multidisciplinary teams and wraparound services. In recent years, the hospital also
ship and mission services group had the foundation for bringing more new ideas to the fore.
Members of the team say that they have been reimagining the type of programming they develop to meet the needs of members. This has resulted in new or updated offerings in the department’s focus areas, which are mission, sponsorship, ministry
formation, ethics, spiritual care and wellbeing. The department takes a cohesive, cross-disciplinary approach to its work, and it creates resources and programs that address CHA members’ needs, as identified through surveys and other forms of engagement. All the department’s activity is in service to CHA’s members and guided by its
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‘The power of presence’ Son’s rare disease rocked family’s world but not their faith
By NANCY FOWLER
In 2017, Chris Ostertag looked forward to the birth of his second child, imagining him sitting up, crawling and saying his first words. Ostertag and his wife, Rachel, pictured their son and his big sister chasing after each other and making mischief.
“We had a full-term pregnancy,” Ostertag says. “There were no concerns.”
But immediately after the birth of the son the couple named Hans at SSM Health St. Mary’s Hospital in St. Louis, doctors whisked him away for testing. Among other concerns, he had a large fontanelle or “soft spot” on his head and low-placed ears. The next day, Hans didn’t pass a hearing screening.
Even so, his father hoped for the best. “He seemed healthy and happy to me,” says
With new strategic plan, CEO leads effort to ‘illuminate’ Avera’s care delivery
By LISA EISENHAUER
system
When he moved from another system to take over the top post at Avera Health, Jim Dover says his first priority was “seeking to understand” the system.
He sees the biggest mistake a leader who’s new to an organization can make to be assuming to know the place well right away. “In reality, they don’t know anything,” says Dover, who became president and CEO of Avera Health in fall 2023.
Dover says he took his time to acquaint himself with operations at the Sioux Falls, South Dakota-based system. Avera serves four states and has 20,000 employees, a 1,200-member medical group, 37 hospitals, 200 clinics and 40 long-term care facilities.
“This year is its 25th anniversary,” Dover notes. “So, first and foremost, I wanted to understand the organization and its culture.”
Once he was familiar with Avera, Dover
Trinity Health
focuses on expanding footprint, services of PACE
By VALERIE SCHREMP HAHN
Trinity Health knows it has a mission to care for frail elderly people around the country. That’s one reason its Program of All-inclusive Care for the Elderly, or PACE, is one of the nation’s largest and has the broadest geographic footprint.
PACE is an option for elderly people who would be eligible for nursing home care to have access to a full continuum of health care services that allow them to live at home. People who are eligible for Medicare and Medicaid can take part in PACE. In the program, they have access to meals and light housekeeping, health care providers, transportation and day centers.
The PACE program got its start in San Francisco in 1971. Trinity Health started its first PACE program in Philadelphia in the 1990s. The system now owns or manages 25 centers in 12 states that house PACE programs, with four sites opening within the last year. As of Feb. 1, there were
From left, Sandra Mackey, Sally Deitch and Liz Foshage chat at the Sponsor Formation Program for Catholic Health Care in Itasca, Illinois, in March. The program is one of the many offerings of CHA’s sponsorship and mission services department. Mackey is chief marketing officer of Bon Secours Mercy Health; Deitch is executive vice president, nursing and operations infrastructure at Ascension; and Foshage has recently retired from Ascension’s executive leadership team.
Photo by Stephen J. Serio
Chris Ostertag holds Hans, his then 3-year-old son. Hans was born with Zellweger spectrum disorder, a rare disease that caused his death at age 5.
Immigration enforcement
As new immigration policies emerge, CHA is monitoring enforcement actions and providing resources for Catholic health providers.
Magnificat House
A nonprofit in Houston that gets some of its support from CommonSpirit Health works to guide people from “helplessness into hopefulness.”
SSM Health investment
The health system and two other local anchor institutions invest nearly $15 million into a St. Louis program that provides loans to businesses that strengthen the community.
Public health expert urges care providers to reduce use of plastics
By LISA EISENHAUER
One way the health care sector can help curb the threat posed by plastics in the future is to return to some practices of the past, says Dr. Philip J. Landrigan.
Landrigan led a CHA webinar in March focused on the climate and health risks of plastics. The webinar was part of CHA’s observance of Earth Day, which is April 22. He discussed how health care providers have moved away from a “circular economy” in which medical supplies such as gowns and masks were made of reusable materials.
and climate change. Among his research findings was a link between low-level lead exposure and lower IQs in children, which helped prompt federal regulators to remove lead from gasoline.
In the webinar, Landrigan covered the “very profound and pervasive impacts on human health” caused by the production, use and disposal of plastics.
“We don’t really need plastic sheets. We really don’t need plastic gowns,” he said. “We really don’t need plastic instrument trays, where we throw the whole tray away at the end of the procedure. We can go back to recyclable, reusable materials, return to our circular economy.”
Landrigan is a biology professor at Boston College, where he directs the Program for Global Public Health and the Common Good and the Global Observatory on Planetary Health. He has a long resume related to addressing the health risks of pollution
“Like so many environmental threats to health, those impacts fall most heavily upon the most vulnerable people in our population, especially unborn children in the womb, small kids, poor people, minorities, marginalized people, indigenous, people in low- and middle-income countries, people in small island states,” he said. “All of those who contribute very little to the plastics crisis are the people that suffer its worst health effects.”
Those health effects include the hazards faced by the people who do the dangerous work of extracting the fossil fuels needed to produce plastics and the risks posed by exposure to the toxic chemicals in plastic products that can leach out when those products are used and trashed.
“These chemicals could cause can-
cer, cause heart disease, obesity, diabetes, endometriosis, polycystic ovary syndrome,” Landrigan said. “The chemicals in plastics are really a soup of toxicity with multiple adverse effects.”
Landrigan referenced an editorial that appeared in the medical journal The Lancet last fall that urged the health care sector to “untangle necessity from convenience” when it comes to the use of plastic supplies.
He noted that some plastic use in health care is essential, such as for IV tubes and for scopes needed to examine the body. But he said care providers could employ glass syringes, rubber tubing and other reusable items that were in wide use before being replaced by nonrecyclable plastic supplies.
“It’s quite possible to go back, if we have the will to do it,” he said. “Right now, we’re using plastic because it’s convenient. We throw it away. We don’t understand that that plastic is causing great harm and great cost, because the harm and the costs are falling on other people. But make no mistake about it, those harms are very real. They’re very great.”
A recording of the full webinar is available at chausa.org/earthday. leisenhauer@chausa.org
Mission director discusses balance of workplace safety, human dignity
By VALERIE SCHREMP HAHN
In the gospel story of the Gerasene demoniac, Jesus encounters a man who could not be bound by shackles and chains or otherwise subdued. The man wandered among the tombs and the hillsides, crying out and cutting himself with stones.
“This is really a terrible situation of suffering,” said Andrea Thornton, a Catholic theologian and bioethicist and a mission director with Bon Secours Mercy Health. “Notice that the text gives us no explicit indication that he was ever violent against anyone but himself. He was restrained because people were afraid of his behavior, but the restraints did not work. Only Jesus could heal him with a compassionate encounter.”
bears the image of God, “and we must see them this way,” she urged.
A balancing act
Thornton said that one in five people admitted to the hospital for mental health treatment commits an act of violence during their hospitalization. She also pointed out there is tension between honoring individual good and the common good, and that sometimes short-term restrictions on a person’s liberty may be necessary for the safety of the group.
Thornton told the story of the Gerasene demoniac to set the stage for a March 5 CHA webinar called “Promoting Human Dignity and Workplace Safety During Mental Health Crises in the Emergency Department.”
Thornton, a doctoral candidate at Saint Louis University, pointed out that the Catholic tradition could guide participants’ thinking about patients with mental health issues.
“We often identify more with the people in the community that exile this poor man, rather than with Jesus and the disciples,” she said. “But our mission challenges us to approach mental illness with courage and not fear.”
Every person who arrives in the emergency room, even if they are aggressive,
But, she added: “Any profound violation of human dignity as a sacrifice for the greater good is not justified.”
She acknowledged there are “serious costs” to not maintaining safety in hospitals. According to a 2023 survey, 70% of the adults surveyed said that U.S. hospitals needed to do a better job of providing security, and 39% said they would avoid a hospital for fear of violence.
“I think that’s very sobering,” Thornton said.
Exploring solutions
When it comes to treatment, she said that segregating patients with mental health issues might increase feelings of isolation and may worsen their condition. Of all the organizational interventions she researched, she thought the “most exciting” one was the development of alternative access points, sometimes adjacent to the emergency department, where patients with mental health issues could enter.
As far as a personnel-related response,
escalation code teams trained for mental health crises are helpful, but Thornton said those teams may need to be small and focused. “Part of the concern is a large show of staff might again overwhelm the patient and escalate them,” she said.
De-escalation techniques used by staff can significantly decrease the use of restraints on patients, she said. But a review of international literature showed that there isn’t a consensus on the definitions of deescalation or aggression, and that some of the definitions are culturally relative, Thornton said. Training should focus on cultural sensitivity, she said.
Sometimes, she acknowledged, restraints must be used, such as consciousness-altering medications, sedation, restraint chairs that allow the patient to sit upright, and seclusion in a safe room. Sedating someone until they are unconscious or restraining them while they are lying down should be used as a last resort, she said.
Thornton pointed to one study suggesting that the first approach, if necessary, should be to use chemical restraints that keep someone conscious but help restore rationality.
“It allows someone the most liberty and (researchers) don’t consider it terribly intrusive to alter someone’s mood,” she said.
She called for more published research on de-escalation techniques. She recommended that hospitals develop de-escalation teams and investigate alternative access points for patients with mental health issues. vhahn@chausa.org
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Landrigan Thornton
Covenant Children’s stays focused on mission amid measles outbreak
By LISA EISENHAUER
In her 20 years in pediatrics, Dr. Lara Johnson had never treated a child with measles. That is, not until late January, when Covenant Children’s in Lubbock, Texas, where she is a hospitalist, started to admit patients with severe cases.
One of those patients, a school-aged child, died of complications of measles on Feb. 26. As of March 28, the hospital had admitted 53 children who needed acute care because of the virus.
Johnson, who is chief medical officer for the Covenant Health Lubbock service area, said the children’s hospital is preparing for many more. “I don’t know how long it will last, but based on some other outbreaks that have been studied and reported on, we’re probably maybe not yet halfway finished,” Johnson said in early March.
The Texas Department of State Health Services had tallied 400 cases in the outbreak by March 28. The death at Covenant Children’s was the only fatal case at that time.
Johnson said the death of the patient with a vaccine-preventable illness was emotional for the staff. “The whole hospital really came together to support everyone through that time as we would, as we do, anytime we have a sad outcome,” she said.
Care for a vast region
Covenant Children’s is the only strictly pediatric hospital for a vast region that spans northwest Texas and neighboring states. The hospital is part of Covenant Health, a subsystem of Providence St. Joseph Health.
Johnson said Covenant Children’s began preparing for a potential outbreak when confirmed cases of measles began popping up in Texas. The state health department issued its first release about two confirmed cases on Jan. 23. Those cases were in Houston, 500 miles from Lubbock. On Jan. 30, the department announced two more confirmed cases, this time in Gaines County, part of Covenant Children’s service area. That county has since had the most cases —270 as of March 28.
When its first measles patients were admitted in those final days of January, Johnson said, Covenant Children’s was at the ready:
The infectious disease experts had established protocols to keep the virus from spreading within the hospital.
The physicians, nurses and respiratory therapists had been briefed on how
to care for patients with severe measles cases, which can cause dehydration, difficulty breathing, and seizures, among other symptoms.
The facilities team had set up negative pressure rooms to isolate the patients with measles.
The supply chain team had a cache of protective equipment such as N95 face masks on hand for care providers.
The environmental services team was trained on proper cleaning procedures for areas where patients with the highly contagious virus were treated.
The pharmacy department had stocked a supply of measles-related medications, such as prophylaxis that can reduce the risk of contracting the virus after exposure.
The communications staff had processes in place to keep staff and the public informed on the hospital’s response.
“It was a whole hospital, whole system effort to kind of get up and running,” Johnson said.
To oversee all the pieces of the response, Covenant Children’s quickly set up an incident command center that will remain in place until the outbreak ends.
The hospital isn’t alone in its battle.
Johnson praised the collaborative efforts of local and state public health officials, including in assisting in contact tracing to pinpoint the sources of the spread, inform-
ing the public of the risk and setting up vaccination clinics.
“I think all of that has been working the way that you want it to,” Johnson said.
Vaccine hesitancy
Unvaccinated people have about a 90% chance of contracting measles if they are in a room with someone who has the virus, Johnson noted. Because measles has a typical incubation period of about seven days, people who get immunized within 72 hours of exposure reduce their risk of contagion.
Health officials have stressed that vaccine hesitancy is at the heart of the Texas outbreak. The outbreak began in a population with low vaccination rates.
In 1962, the year before the measles vaccine was licensed, the Centers for Disease Control and Prevention reports that there were almost 500,000 cases. In 2020, there were 13 cases. The number jumped to 285 last year, well below the 483 cases already confirmed by the CDC as of March 28.
Johnson thinks the reason for the uptick in cases of measles and other diseases that can be prevented with vaccines might be that the medical sector is a victim of its own success. “As these vaccine-preventable illnesses kind of fade from our common memory, I think it maybe changes how people think about them,” she said. “People may think about them as something from the past.”
She noted that an outbreak “may just help bring into focus that these illnesses are only preventable if we have a high rate of vaccination.”
Staying focused
Johnson has given several media interviews since the start of the measles outbreak. She talks up the need for and importance of vaccination and for people who don’t want to be vaccinated to take precautions to avoid infection. She said she’s not trying to use the crisis in Texas as a cautionary tale or wade into the contentious debate over vaccines.
“I think the intention is not to talk about anything controversial ever as a physician,” Johnson said. “My intention is just to talk about the things that are true, and to provide information and to answer questions. From my perspective, that’s what I’ve been trying to do.”
She added that she is avoiding social media, where conspiracy theories about vaccinations and the source of the Texas outbreak flourish, and she advises her colleagues to do the same.
“It’s important to keep our focus on the patients that we serve and on our mission,” she said. “We’re here to care for the poor and vulnerable, and we’re here to provide care to our community and be a resource to our community.”
leisenhauer@chausa.org
St. Mary’s in Richmond, Virginia, to complete $370 million expansion
Later this year, Bon Secours St. Mary’s Hospital in Richmond, Virginia, is set to begin construction on a $370 million project that will add a tower and renovate existing facilities.
The project will modernize the campus, elevate the facility’s tertiary and quaternary care capabilities, privatize patient rooms, add capacity to the cardiac and neurological intensive care units, improve the women’s and children’s services unit and add shelled space for growth, according to Bryan Lee, president of Bon Secours St. Mary’s Hospital and Richmond Community Hospital. The hospitals are part of Bon Secours’ Richmond market, which is part of Bon Secours Mercy Health.
Lee says the project is necessary in part because St. Mary’s is experiencing a shortage of intensive care unit beds. The new tower will nearly double the facility’s critical care capacity.
The new project also is needed because there is projected growth of about 8% in ter-
years.
ties, from acute to primary care and from inpatient to outpatient care, Lee says. The expansion project will account for these shifts.
Tower construction is to begin later this year, and the new facility is to open in 2028. After the tower opens, St. Mary’s will renovate legacy buildings, including expanding a women’s specialty care unit. Lee notes that multiple floors of the new tower will link to the legacy building with pedestrian walkways. The interconnected spaces will provide physical connections for new institutes at the hospital, including a women’s and children’s institute.
The project enables the relocation of the hospital’s helipad to a more appropriate place. The new tower will have two floors of shelled space for future use.
The hospital’s bed count of 391 will not change with the construction.
Lee says there will be about 375 new jobs created at St. Mary’s as a result of the expansion of services and capacity.
A prayer service followed a press conference at Covenant Children's in Lubbock, Texas, about the death of a child from measles. The hospital is in the thick of an outbreak of the disease.
Mary Conlon/Associated Press
Bon Secours St. Mary’s Hospital in Richmond, Virginia, is breaking ground later this year on a construction project that will add this tower to the campus. The tower is to open in 2028.
Johnson
Massachusetts memory care staff learn how to better help patients
By VALERIE SCHREMP HAHN
Mary Immaculate Health/Care Services in Lawrence, Massachusetts, strives to excel in the care it provides its residents, especially those with Alzheimer’s disease and dementia. Last fall and winter, more than 50 workers, including nurses, nursing assistants, and activity staff, completed the Alzheimer’s Disease and Dementia Care Seminar offered by the National Council of Certified Dementia Practitioners. The training qualifies staff as certified dementia practitioners. There are 262 total staffers at the facility.
The training was made possible in part by a $7,500 grant from The Josephine G. Russell Trust. The seven hours of training goes beyond the four hours required by the state, explained Rebecca Alfonso, memory care program director at Mary Immaculate, which is a member of Covenant Health. The person-centered approach shows caregivers how to focus on the needs of the patient to prevent agitation and confusion, enhancing the environment for all.
Alfonso spoke with Catholic Health World about the training and the special needs of Mary Immaculate’s residents. Responses have been edited for length and clarity.
Tell me about your facility and your residents.
I work on a 41-bed dementia specialty care unit. We also have a new advanced memory care unit, and 13 (residents) are there right now, out of 22 beds. I would say the change since the pandemic is they’re younger. I’m going to be 55, and they’re my age. It gives you a new perspective on things. I formed a bond with them because there are two younger ones on my floor, and we call ourselves the 50s chicks, and we hang out together. They’re very different than my residents who are 80-plus years old. They have totally different interests, needs and likes.
Our residents tend to come in more sick now than they used to, because a lot of families try to keep them home as long as possible. By the time they come to us, they’re pretty incapacitated and they don’t live as long, unfortunately. The average length of stay is six months to a year and a half. Before, we’d have people living here for eight to 11 years. Unfortunately, it’s a more rapid turnover of residents.
Why was it important to provide the extra training?
We wanted to give the staff more tools to use. Since we have younger residents, we wanted to learn how to provide care for
Seminar topics
These are the topics covered in the National Council of Certified Dementia Practitioners’ Alzheimer’s Disease and Dementia Care Seminar:
Introduction to dementia: diagnosis, prognosis, treatment
Communication and feelings
Depression and repetitive behaviors
Paranoia, hallucinations, wandering and hoarding
Aggressive behaviors, catastrophic reactions, intimacy and sexuality
Personal care: pain, bathing, dressing, toileting and nutrition
Activities
Environment
Staff and family support
Diversity and cultural competence
Spiritual care and end-of-life issues
them in a different way. We might have a resident who is 80 years old listen to Frank Sinatra to get him to take a shower, that’s not going to work with someone my age — maybe you’ll pull out Billy Idol or ABBA. It’s the same thing for providing activities for them. You want to make sure that you’re meeting them where they’re at in their illness.
We tell staff to take the word “no” out of your vocabulary. You have to learn to kind of go where (residents are) at and change your approach in order to be successful. It’s important for staff to remember that residents are adults and deserve respect. You have to find a new way to get them to do something without saying no to them. That requires a little bit more thought and a little bit more preparation in order to be successful. By preparing, you take five (minutes) to save nine. It seems inconvenient to take your time to do that, but if you don’t, you spend more than double that time dealing with the resident behavior that comes up.
What kinds of things have you heard from staff since the training? Have you
seen results?
Since I’m on the memory care floor, I’m always watching what staff are doing and how they’re interacting with people. I’ve definitely seen fewer catastrophic reactions since the class. The staff are better prepared to deal with a situation if the resident doesn’t want to do something. And then the staff will say, “OK, I’m going to give this person a few minutes for a break and then try to come back later.”
The staff are also more confident know-
“We tell staff to take the word ‘no’ out of your vocabulary. You have to learn to kind of go where (residents are) at and change your approach in order to be successful.”
— Rebecca Alfonso
ing how to do some of the activities, especially at night. After the activity staff leaves, if someone’s having a bad time, the staff are more confident going to the supplies and grabbing different things and interacting with them than they were before, which is great. It does take a team to engage everybody, so now the staff have a better understanding of the importance of activities.
How does this National Council of Certified Dementia Practitioners certification set you apart from other care facilities?
CDP certification is the gold standard in memory care. I’ve had my certification for about eight years now and I’ve always wanted to work in memory care. I always want the latest technology. I love how I can go onto their website, and I can pull up an online class, or I can look if there’s a new medication that’s come out. A family might say, “Have you heard anything about this?” And I can pull up the latest information. The thing that Mary Immaculate is great about is they want to make sure the residents have the highest quality of life possible and they’re willing to invest in education to help staff in providing that quality of care.
How does providing this training tie in with your mission as a Catholic health facility?
Our mission is compassion, integrity, collaboration and excellence. I think having taken that class, it helps achieve all four areas. It helps the staff understand that they need to be a little bit more empathetic with the residents. Once they learn a little bit more about dementia progression, they might think: This approach might work better than the other approach. They might not realize that they were causing the problem by how they were reacting, what their body language was saying. They now take the time to smile and perform their work with that level of compassion.
As far as collaboration, it helps if all of us work together. Sometimes you might need to tap out, because a resident is having a really tough time for whatever reason. You might say, “Gee, she’s really not having me tonight, can you take over for me?”
Of course, I think it helps with excellence, because it’s the gold standard for care. It shows that the staff have taken the time to show they want to improve their knowledge so they can provide better care for our residents. It helps make their lives better, it makes them safer, it helps prevent falls, it helps with customer and family satisfaction. The families feel more comfortable knowing (staff) got trained in this class and method, so we know that (residents are) being taken care of in a way that is cutting edge.
vhahn@chausa.org
Ethicist acknowledges challenges, urges mercy in providing health care to prisoners
By VALERIE SCHREMP HAHN
Prisoners are the only people in the United States who are constitutionally guaranteed a right to health care, but serious problems persist. How should Catholics and Catholic health providers respond?
Shaun Slusarski explored this question in a February CHA webinar titled, “The Ethics of Health Care in Prisons.” Slusarski, a doctoral candidate in theological ethics at Boston College, is working on a dissertation on the ethics of prison health care with a focus on using restorative justice principles to distribute care.
While the United States Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services doesn’t specifically mention incarcerated
patients, it points to serving and advocating for those at the margins of society, he said.
“Catholic health care should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society,” Slusarski said. “Obviously, sick people are marginalized, and incarcerated people are quite literally marginalized.”
Though incarcerated people have a right to health care, for there to be an Eighth Amendment violation they need to prove the medical need neglected is serious and that prison officials knew about it and willfully denied care, Slusarski said. Meanwhile, preventative care isn’t the norm, delays are common, follow-up care is inconsistent, and staffing issues are pervasive in prison health care, he said.
The crowded conditions of prison and poor nutrition also negatively influence health, Slusarski said. “One study suggests
that a person’s life expectancy decreases by two years for every one year in prison, and indeed, incarceration is considered to be a social determinant of health,” he added.
It’s important to provide humanizing care to prisoners, Slusarski said. “Incarceration is a dehumanizing phenomenon,” he said. “It’s always important to remember that these are human beings, even if they’ve in some cases committed serious crimes.”
It can be tempting for a health care worker to look up a patient’s criminal record, though that should be avoided unless it’s medically necessary, he said.
requests for ice chips.
“It’s important to remember that in the Catholic tradition, civil punishment belongs to the state alone,” he said.
Slusarski said shackling should be scrutinized. In general, Catholic hospitals should eschew punitive treatment whenever possible, he said.
Scan to read an extended version of this story.
Prison hospice programs have grown as the prison population has aged, and those programs have their own challenges, he said. One such challenge is that opioids are not permitted in prisons, making it difficult to provide comfort care.
He cautioned that knowing a person’s crime could result in biased treatment.
For example, based on the knowledge, a nurse might make less of an effort to visit or may delay or deny comfort measures like
In many cases, prisoners can become trained to provide end-of-life care, he said. “This can be such a humanizing process for both the dying prisoner and for the prisoner caring for them,” he said.
Alfonso
Slusarski
SSM hospital learns about, joins community aid efforts at Functional Friday events
By LISA EISENHAUER
ST. CHARLES, Mo. — After they packed boxes with goods, loaded the boxes onto carts, pushed the carts across the street and carried their cargo down to the basement food panty at St. Peter Catholic Church, the three dozen or so SSM Health St. Joseph Hospital — St. Charles and Wentzville, Missouri, staffers looked around as if to say: “What next?”
Within a few minutes they unloaded and stocked the shelves with the hundreds of items they had collected: boxes of cereal, granola bars, macaroni and cheese, peanut butter packets, cans of soup and tuna, cheese-and-cracker snack packs, and more.
Afterward, they stacked the empty boxes and wheeled the carts back across the street. Another Community Benefit Functional Friday had concluded.
The gatherings are the brainchild of Dr. L. Kristy Haggett, vice president of medical affairs and chief medical officer at SSM Health St. Joseph Hospital. The hospital’s campuses are in suburbs of St. Louis.
Haggett said she came up with the idea for the quarterly events after seeing how engaged the staff were during the food distributions that the hospital and others within the St. Louis-based health system host a couple of times a year.
“They wanted to participate,” she said. “We even had one that was in the freezing cold, and we had so many staff members out in the parking lot doing the food distribution. I saw how it increased morale.”
Learning and doing
The hospital already had Functional Friday learning events every other week. Those events, which are typically about 10 minutes long, focus on staff readiness. For example, one event was on the need for units to be prepared in the event of a power outage, including by having functioning flashlights. Afterward, the workers were sent back to their departments and encouraged to check their flashlights.
Haggett said Community Benefit Functional Fridays are a takeoff of those events,
but with the focus on outside efforts that the hospital supports. Beginning last year, once a quarter on a Friday morning, the hospital welcomes a representative of a local charity or public service group to give a brief talk about the organization’s work. SSM Health St. Joseph Hospital — St. Charles and Wentzville staff are invited to attend. Afterward, the staffers take part in a related hands-on project.
Representatives of Crisis Nursery St. Charles and of Sts. Joachim and Ann Care Service, which helps families in need of emergency aid, have been among past speakers.
The speaker on March 7 was Jan Haug, a longtime volunteer with the conference of the St. Vincent de Paul Society based at St. Peter Catholic Church in St. Charles. Haug discussed the origins of the society, noting that its first American conference was formed in St. Louis in 1845.
St. Peter Catholic Church is part of the Archdiocese of St. Louis, which now has 140 conferences. The St. Peter one dates to 1887.
“Our mission is to serve people that don’t have money,” Haug said. “People who are hungry. They are worried about their electricity and water being shut off. People who are threatened with eviction. People who are really losing hope.”
‘We go to their homes’
St. Vincent de Paul Society volunteers at St. Peter monitor a hotline and then decide
how best to help the callers. “We don’t make them come to an office,” Haug said. “We don’t make them fill out forms to qualify for anything. What we do is we go to their homes.”
Last year, the volunteers made 487 home visits. The aid they provided was funded in large part by the church, which in 2024 donated $132,000 to the charity. Haug said 98% of donations “goes right back out the door.”
“We are told to be traditionally poor ourselves, which means: Don’t hoard your money. If somebody gives you a donation, use it on somebody who needs it, not you,” Haug said.
Haug detailed the many ways the charity assists those in need, including with rental assistance, car repairs, and medical bills as well as by providing furniture, bedding, gas cards, tents and other goods.
The food pantry that SSM Health St. Joseph Hospital — St. Charles and Wentzville workers helped stock is run by the charity. It is mainly for people in crisis. Last year, it served more than 400 clients on an emergency basis, Haug said. One Saturday a month the pantry opens its doors to anyone. People can peruse the shelves and fill a box with whatever they need or want.
“People come in and they say, ‘Thank you for treating us this way. It’s fun to shop and not be judged,’” Haug said.
Mission demonstrated
Kacie Urbeck, pharmacy operations manager, was among the SSM Health St. Joseph Hospital — St. Charles and Wentzville staffers who listened to Haug. She
Dr. L. Kristy Haggett,
food pantry run by St. Vincent de Paul Society volunteers in St. Charles, Missouri.
said she tries to attend every Community Benefit Functional Friday. She enjoys learning about the work of local charities.
“I loved this,” she said of Haug’s discussion. “I didn’t know all the things that St. Vincent de Paul brings to the community.”
Jake Brooks, SSM Health St. Joseph Hospital — St. Charles and Wentzville president, was also in Haug’s audience. He joined afterward in packing and delivering goods to the food pantry. The items that went into the boxes had been collected from staffers over a few weeks.
Brooks said the quarterly events are just one of many ways, besides providing exceptional health care, that the hospital demonstrates its Catholic mission to reveal the healing presence of God.
“Sometimes it’s the simple acts of being able to serve others that helps us to get back to our roots and who we are,” Brooks said.
Haggett said she hopes the events help employees better understand the scope of the work done by charities that they and the hospital support and the need for those services in the community.
“Bringing those people in, they can educate us and we can learn about their resources,” she said. “It gives, I think, all of us more of an awareness of what’s going on in our community. It’s really nice to know what you’re contributing to, to see where it goes, to hear about the people that they serve.”
leisenhauer@chausa.org
Ministry leaders describe their personal spirituality in new CHA podcast series
By JULIE MINDA
A new podcast series from CHA gives viewers deep insights into the spiritual journeys of eight Catholic health care leaders. In the series, called “Inside Out,” the executives describe how their spirituality has evolved, key milestones in the formation of their faith, how they nurture their personal growth, and what it means to them to draw on their spirituality in their work in Catholic health care.
CHA has developed resources to accompany the eight podcasts — each one lasts between a half hour and an hour. Anyone can access the audio version of the podcasts on streaming services, while CHA members can access the video version. CHA has produced discussion guides to accompany each podcast. Those guides include a summary of the podcast, discussion questions, prayers and recommended resources. CHA members can access transcripts of the podcasts.
The podcasts and discussion guides are
available at chausa.org/insideout.
Darren Henson, CHA senior director of ministry formation, developed the podcast and leads the conversation in each episode. He says CHA designed the podcasts to give insights into how spirituality can support people’s roles and leadership in Catholic health care.
Henson notes that spiritual formation was woven into the everyday lives of the men and women religious who founded and initially led Catholic health ministries. Today, most Catholic health systems and facilities are sponsored and led in large part by laity. Normally, those lay men and women lack the high level of exposure to formal spiritual formation on an ongoing basis that the vowed religious who proceeded them had.
“The spiritual lives of lay leaders are necessarily different from those of men and women religious,” Henson says. “There can
be gaps in the organizational and communal structures that support laity’s ongoing spiritual development.”
Henson hopes the series will educate listeners that there are many ways to nurture spirituality. He hopes the examples will inspire people to think about what spiritual formation practices resonate with them.
“I hope this resource will encourage leaders across the ministry to share more readily about their own spiritual lives and practices,” he says. “There is a need to share with one another where we are finding spiritual nourishment, and — as one podcast guest said — how we are experiencing spiritual maturing.”
Henson adds he hopes the podcasts also will start conversations about what feeds people spirituality and how people can support one another in their spiritual lives.
The executives featured in the podcasts are: Damond Boatwright, president and CEO, Hospital Sisters Health System, Springfield, Illinois
Tom Bushlack, senior director of CHA’s Center for Theology and Ethics in Catholic Health. He formerly was vice president of mission and formation for St. Louis’ Mercy system
Laureen Driscoll, chief executive of Providence St. Joseph Health’s South Division, California
Dr. Mohamad Fakih, chief quality officer, Ascension, St. Louis
Ron Hamel, past member, SSM Health Ministries and board of directors, SSM Health of St. Louis and a retired senior ethicist at CHA
Mary Hill, retired chief mission officer, Avera Health, Sioux Falls, South Dakota
Ronda Lehman, president of Mercy Health’s Lima Market in Ohio, part of Bon Secours Mercy Health
Kimberly Webb, senior vice president/chief human resources officer, CHRISTUS Health, Irving, Texas
Suggestions for future guests can be sent to dhenson@chausa.org. jminda@chausa.org
left, vice president of medical affairs and chief medical officer at SSM Health St. Joseph Hospital, and Kelly Koppeis, director of clinical operations at SSM Health St. Joseph Hospital — Wentzville, guide a cart laden with donated food. The food was bound for the
Haggett
Haug
Brooks
Henson
CHI hospital gets to the heart of reducing readmission rates for cardiac patients
By VALERIE SCHREMP HAHN
Martha Green didn’t know what to think one Sunday morning last December when she felt extremely short of breath as she walked into church. She decided to get checked out at the emergency room at CHI Memorial Hospital in Chattanooga, Tennessee.
After a few days of tests, doctors diagnosed the retired nurse with heart failure. Her heart was not pumping adequately to serve her body. She was shocked, and scared. She went from taking almost no daily medications to taking eight.
“It was very overwhelming,” she said. “To me as a nurse, or to anybody, really, when you get anything to do with the heart, that is a frightening thing. Very frightening. And I’m a very strong person and take everything in stride ordinarily. At one point, I even became tearful, because I thought this is a lot more than I bargained for.”
Green is more confident now, and healthier, because she is a part of The Chattanooga Heart Institute’s heart failure readmission reduction program. The heart institute is part of CHI Memorial Hospital, a member of CommonSpirit Health.
The hospital educates its patients with heart failure on their diagnosis and treatment, following up with regular phone calls and helping them schedule appointments. Staff members help arrange transportation to those appointments and assist patients in finding the lowest prices on medications. Specialists and departments in the hospital communicate with one another about cardiac patients, and a pharmacist is dedicated to looking over the charts of patients with heart failure, ready to offer feedback.
“It seems intuitive, doesn’t it?” said Dr. Allen Atchley, a cardiologist and founder of the program. “It gives you a hint as to how complex patients are, how complex hospitals and hospital systems are, and how much effort it really does take to provide the care that patients need, and to coordinate that care and focus on education and communication.”
“and we still continue to work on and iterate on and try to bring our heart failure readmissions down.”
The program follows about 20 to 25 patients on their daily schedule, with about 80 to 100 in the program in any given month. When the program started in 2012, the national average for heart failure readmission within 30 days was 22-23%. CHI Memorial’s rate was 16.44%. Though clinicians knew the hospital was below the national average, they set a program goal of 15%. By the end of 2013, the readmission rate was 12.59%. In 2015, it dipped to 8.92%.
By 2024, the hospital’s readmission rate had ticked up to 17.36%, still lower than the national average of 19.8%. The hospital attributes the rate increase partly to a rise in the number of higher-risk patients.
medications, how to care for themselves, and whether they could make and get to follow-up appointments.
A multidisciplinary team of two nurses and a case manager worked with Atchley to develop the program. They looked at all the departments and people involved in caring for a heart patient: cardiologists, internal medicine, specialists, outpatient primary care, inpatient care, coding and documentation. They improved communication to get on the same page about the patients with heart failure.
when and how to take medications. They make sure the patients set up follow-up appointments with doctors and at the cardiac rehabilitation center. They arrange rides if needed.
As the heart failure program coordinator, nurse Emily Drake has two roles: She sees patients, educates them, and makes follow-up calls and she scours hospital data to see if she can find ways to improve care.
“The data tells us where we need to improve,” Drake said. “But the actual working with the patient is where I get my joy.”
The program also includes Alicia Johnson as the cardiac case manager and nurses Megan Anderson and Chelsey Tyler as patient educators.
“The beauty of it is it allows (patients) a comfort level with us, and then they get to ask all the questions they want,” said Drake. “They don’t feel put off, like I’ve got to hurry and get to the next patient. I think that’s one of the beautiful things about what we do here is that we can spend that time with them and/or their family members if they need it.”
A personal touch
Mandawat also loves working with patients and knows that each conversation about their priorities and quality of life will be different. “Some people want to go fishing, and other people go to Italy,” he said. “That’s what makes heart failure sort of interesting and special. Every case is different, and everyone has different expectations of what they want their life to look like.”
Dr. Aditya Mandawat, the current director, said the program takes a village. “I’d love to tell you that there’s one thing we did, or one thing that was rated critical, but the honest answer is there were a lot of people really important in getting our heart failure admissions where they are, and a lot of different pieces that fell into place,” he said,
“What we’ve seen over the last five years is that patients have gotten sicker, but they’re also living longer,” said Mandawat. “That’s not a unique phenomenon. A lot of it is just we’ve gotten better at taking care of sicker patients.”
Tackling the problem
Atchley said that before the program, departments involved in the care of patients with heart failure operated in silos and there were presumptions about whether patients understood how and when to take
They also had to identify the heart patients and their needs and learn more about their geographic limitations and expectations. Many patients are older, with multiple medical problems, rely on Medicare, and live within 30-40 miles of the hospital. Many live in skilled nursing and rehabilitation facilities.
Patient education
As part of the program, nurse educators meet initially with patients in the hospital, give them a packet of information and follow up with phone calls. They get in touch with the extended-care facilities where some patients live. They teach patients about heart failure and the things they could do on their own to improve their health, such as making diet changes, and
Atchley said the program adheres to the hospital’s goal of providing excellent patient care “but within our mission of the hospital, which is to do so with reverence, integrity and compassion. And I think if you do that, the patients always will do better.” Green, the patient, was at first reluctant to talk to her friends about her heart failure diagnosis, because she didn’t want them to worry or think of her as frail. “But now, if I hear of anybody who has heart problems, I tell them all the things that are available, that even as a nurse I didn’t know was available because I didn’t need it,” she said.
She’s doing well and attends cardiac rehabilitation twice a week. She’s grateful that the program helped her get the best deal on her medication.
She talks to Drake nearly every day. “We don’t have to, but if I have a question of any sort, she’s there, Johnny on the spot,” said Green. “That is a wonderful thing.” vhahn@chausa.org
Fluid management at Mercy clinics keeps heart patients out of hospitals
By VALERIE SCHREMP HAHN
George Largent can’t praise the staff of the Mercy cardiovascular clinic in Joplin, Missouri, enough.
“They’ll pray with you, cry with you, laugh with you, and hold your hand. And then tell you to stop eating salt,” he said, laughing.
Largent, 76, of Joplin, has been a Mercy heart patient since February 2024, when he had triple bypass surgery. He’s a regular patient at the fluid management program, which helps him manage his symptoms and monitor his heart health.
Chesterfield, Missouri-based Mercy has opened nine of these specialized programs for cardiac patients across Arkansas, Missouri and Oklahoma since September, and plans to open three more.
“Instead of spending several days in the hospital, patients can be treated at one
of the new fluid management sites within an hour on average, and then they get to go home,” Dr. Brian Seeck, a Mercy cardiologist in Washington, Missouri, said in a statement.
There, where the program was piloted, it logged more than 300 patient visits in the first few months.
The lack of circulation associated with heart failure, in which the heart struggles to efficiently pump blood, causes excess fluid to build up in the feet, ankles and lungs. When oral medication stops working, patients may need intravenous medication to reduce fluids in the body.
The fluid management programs are provided at Mercy cardiovascular clinics, which are typically attached to a hospital.
Dr. John Mohart, a cardiologist and Mercy’s executive vice president and chief operating officer, said he and other hospital leaders saw a need to treat these
patients in a physical setting that was patient-friendly and cost-effective. He pointed out that congestive heart failure is the leading cause of admission to hospitals in the United States.
what we didn’t anticipate is how excited the providers and the nurses are,” he added.
“Each hospital admission costs thousands of dollars, whether it’s a government payer or the patient,” he said. “If we can do these treatments in an outpatient setting for less than a couple hundred, because the cost of the medicine alone is very cheap, we get better outcomes and a better experience. It really fits our model of care.”
Mercy Hospital Washington has seen a drop of about 20% in congestive heart failure admissions and readmissions since starting the program in September, Mohart said.
Feedback from patients has been “exceptionally positive,” he said. “We thought it would be for the patients, but
Largent, the patient in Joplin, said a typical visit involves a blood draw to see if he needs an IV. He also gets an electrocardiogram. Since he’s diabetic, clinicians keep an eye on his blood sugar as well.
“I feel like I have a place to go to and places to respond to should we have questions or need help,” he said. “My experience with them has been absolutely perfect.”
He used to visit the clinic every 10 days, but now that he’s improving, he visits monthly.
“I do have a complaint,” he said, tongue in cheek. “When they scheduled me a month out, I said, ‘Now ladies, what am I going to do for a social life?’”
He feels grateful for the level of care he’s received from a group of people who have become like family. “Obviously, I trust them with my life,” he said.
vhahn@chausa.org
Seeck
Largent
Mohart
Exercise physiologist Danielle James works with heart patient Martha Green during cardiac rehabilitation at CHI Memorial Hospital in Chattanooga, Tennessee. Green is a part of the Chattanooga Heart Institute’s heart failure readmission reduction program.
Atchley
Mandawat
Drake
Mercy College of Health Sciences professor crusades against human trafficking
By LISA EISENHAUER
Joseph Moravec has a vivid memory from when he added a discussion of human trafficking to the curriculum of one of his courses at Mercy College of Health Sciences in 2016.
“When I first covered it, that first year, I had one of my students come up to me at break and say, ‘I’m being trafficked,’” recalled Moravec, a professor of philosophy and religious studies at the Catholic college in Des Moines, Iowa.
That class session included a visit from a trafficking survivor who shared her story. Moravec said the nursing student who approached him afterward had not given him any reason to suspect that she was being exploited in the sex trade.
He didn’t ask the student for details of what she was enduring, but he did take action. “I was able to get her some help, and she was able to get out of the life,” he said. The student also completed her degree.
Since becoming aware of the scope of trafficking, Moravec has launched a personal crusade against it. He not only covers it in his courses at Mercy College, he has joined organizations and served on boards focused on trafficking awareness and eradication.
He considers his efforts to be closely aligned with his faith. “This goes right to the core of what it means to be Catholic,” he said. “It goes right to the core of who we are and are called to be and do as followers of Christ.”
Hidden problem
The National Human Trafficking Hotline reports that in 2023 there were 9,619 trafficking cases involving 16,999 victims identified nationwide. Most of those cases involved sex trafficking and the others labor exploitation.
The hotline says fewer than 1% of trafficking cases are from Iowa. That his state might be a minor player in human trafficking compared to others doesn’t diminish Moravec’s fervor. He believes trafficking is a wider problem than the public knows and statistics indicate. He calls it a problem “hidden in plain sight” because it operates under the radar but in public spaces.
In Iowa, he said two factors in particular underlie trafficking. One is that the state is where Interstate 35, which links the Canadian and Mexican borders, meets Interstate 80, which connects the East and West coasts. The interstates and the motels and truck stops along them are known to draw
Sacramento’s Mercy General marks centennial
Mercy General Hospital in Sacramento, California, is marking the centennial of its opening at its current location.
The hospital, which is part of CommonSpirit Health’s Dignity Health, held a commemoration ceremony in February and plans to host additional events to mark the milestone in the coming year.
According to a timeline on Mercy General Hospital’s website, the Sisters of Mercy arrived by steamboat in Sacramento in 1857 to begin their ministry in California’s capital. In 1895, they agreed to purchase a small sanitarium that a doctor had started locally. Two years later, the sisters opened Sacramento’s first hospital, Mater Misericordiae Hospital — the name is Latin for “Mother of Mercy.” Over time, leadership determined that facility did not meet the community’s needs, despite several expansions, and that
“ Mercy College’s Proclamation Against Human Trafficking and Slavery “raises awareness of this ongoing atrocity and ensures that future health care
workers are equipped to recognize and respond to human trafficking in our communities.”
— Dr. Adreain
Henry
traffickers, says the Iowa Department of Public Safety. The other factor is that Iowa, being largely agricultural, has a high need for cheap labor, such as from migrant workers. Workers rights’ groups such as the International Labour Organization say migrants are much more likely to be exploited than other workers.
Spreading
awareness
Moravec said his awareness of human trafficking developed as he created lectures and discussion topics for his classes, which include Critical Thinking, Comparative Christian Traditions and Servant Leadership. He said his courses were the first at Mercy College to cover trafficking and the need for trauma-informed care for survivors. The college, which has about 850 students, is an affiliate of Trinity Health.
At Moravec’s urging, the president of Mercy College for the past seven years has signed a proclamation every January to mark National Human Trafficking Prevention Month.
“That’s something every Catholic college should do,” Moravec said. “Every Catholic college should have an annual proclamation. That’s the least we can do.”
Mercy College’s proclamation signing is paired with trafficking awareness activities, such as fireside chats and panel discussions, which Moravec organizes.
Dr. Adreain Henry, president of Mercy College, said the institution “places human dignity at the heart of our education.” Its Proclamation Against Human Trafficking and Slavery “raises awareness of this ongoing atrocity and ensures that future health care workers are equipped to recognize and respond to human trafficking in our communities,” Henry said in a written statement.
He added: “We are grateful for Dr. Moravec’s work at the state and national level to bring meaningful change and awareness to these crimes against human dignity and freedom.”
Teaching and training
Moravec went from teaching about human trafficking to joining initiatives to halt it. From 2018-2022, he served on the board of the Iowa Network Against Human Trafficking and Slavery. The volunteer organization is devoted to ending trafficking by building awareness and advocating for prevention, intervention, rescue and recovery services.
Moravec next got involved with Iowa Businesses Against Trafficking. That initiative was launched three years ago by the secretary of state and encourages businesses to join the fight to end human trafficking. Moravec led a committee that built up a cache of educational and training resources that are available on the initiative’s website.
His efforts included being an executive producer of a training video for workers in the lodging industry called “No Room For Trafficking: How to stop trafficking in Iowa hotels.” The video is part of the trafficking prevention training required for hotel and motel workers by law in Iowa since 2022. Thousands of workers have undergone that training.
“We’ve got to have a bold response if we’re going to defeat this enemy who’s doing bold evil in our world.”
— Joseph Moravec
Last year, Moravec worked with a nonprofit called Chains Interrupted to produce three videos that Iowa Businesses Against Trafficking will make available for training.
Patrick Waymire, assistant director of the Division of Intelligence and Fusion Center at the Iowa Department of Public Safety, has seen Moravec’s commitment in action. Part of Waymire’s job is to oversee the Iowa Office to Combat Human Trafficking. He said that office provides local and national training to the public, law enforcement, prosecutors and victim service organizations. “A lot of time during those trainings all those different groups are together,” he said. “The reason for that is to build those relationships needed and to share expertise and some of that knowledge about what’s
a “firetrap.”
Sisters of
out a new location. They purchased a swampy dairy farm for $18,837 and transformed the property into a medi-
going on and how to dismantle some of these organizations.”
Waymire credits Moravec with being “a great partner” in anti-trafficking efforts across the state. “Joe has brought different organizations together to help amplify the efforts,” he said. “I think that’s his greatest asset: how he relates to other people.”
Give something
The 900-plus businesses that are part of Iowa Businesses Against Trafficking have committed “to learn something and do something” in the quest to end trafficking. Moravec would like to see another piece added to that commitment, “give something,” because anti-trafficking groups need monetary support. “When you give, it’s called sacrifice,” he noted. “It’s really saying that you’re willing to give up something.”
To that end, Moravec has persuaded dealerships and an insurance company to donate four cars to aid investigators and rescuers from anti-trafficking organizations in their work.
He also has helped direct funds to nonprofits that combat trafficking and aid survivors through the Community Foundation for Inspired Giving. He is president of the foundation’s board and co-founder of one of its missions, Stop Trafficking Now. Both entities issue grants to support the work of charitable organizations.
One of the organizations the foundation has supported is Street Grace, which works to end the sexual exploitation of children. One of Street Grace’s tactics is cyber patrols that use artificial intelligence to identify sex trade customers online. Volunteers then confront and try to deter them.
Moravec said stopping buyers saves not only victims, but the expenses related to providing trauma care. “It’s a grace. It’s not shaming. It’s not penalizing,” he said. “It’s ‘Hello. Are you really thinking soundly? Are you thinking correctly?’ You’re interrupting and helping them.”
‘Bold response’
Moravec hopes to see more initiatives such as Iowa Businesses Against Trafficking across the country — so far, only a few states have such programs. He also wants to see businesses and other entities with financial resources put more of them behind antitrafficking efforts.
He thinks joining organizations and watching videos is not enough. “It’s a wimpy response,” he said. “We’ve got to have a bold response if we’re going to defeat this enemy who’s doing bold evil in our world.”
leisenhauer@chausa.org
cal center, nursing school and convent that opened in 1925. Mercy General remains at that location today.
In 1934, during the Great Depression, the hospital opened a clinic for impoverished children. That clinic was funded by donations, and doctors volunteered their time to treat clinic patients. In the 1940s, city leaders persuaded the sisters of the urgency to expand to meet the growing needs of the community. A citywide fundraising campaign met its goal in six weeks.
The ensuing decades have brought additional expansions as well as investments into clinical centers of excellence, including Mercy General’s cardiology and cardiovascular center.
Sr. Clare Dalton, RSM, vice president, mission integration for Mercy General Hospital, says the Sisters of Mercy congregation is proud to celebrate with the physicians, staff, and volunteers. She says the sisters “are grateful to the donors and supporters — past and present — who have contributed to the flourishing of the health care healing ministry over the many years.”
Today, Mercy General is a 313-bed hospital with 2,200 employees and a medical staff of 1,000.
A history brochure Mercy General created for its anniversary says that in 1919, Mother Mary Michael Irwin, superior of the
A crowd gathers for the opening ceremony for Mercy General Hospital on Feb. 11, 1925.
Mercy, and several other Mercy sisters scouted
Moravec
CHA, USCCB, Catholic Charities USA issue letter to Congress on Medicaid’s importance
Like the American Hospital Association, CHA is engaged in extensive advocacy efforts, calling upon Congress to protect and strengthen the Medicaid program amid the House and Senate’s budget negotiations.
On Feb. 27, CHA joined the United States Conference of Catholic Bishops and Catholic Charities USA in issuing a letter to both chambers of Congress, saying that “as you begin considerations for a Budget Reconciliation package, it is vital that social safety net programs like Medicaid are protected and strengthened for the most vulnerable in our society.”
The letter explained that Medicaid is a “vital lifeline for nearly 80 million low-income families, mothers, children, elderly, disabled individuals, the unhoused and working people across our nation.” Medicaid pays for about 41% of births in the nation, added the letter. As Catholic bishops and ministries of the church, the letter writers said, “we firmly believe that all people have the right to those necessities needed to live, found a family and flourish,” including the right to health care.
AHA conference speakers
‘Fight like heck’ to preserve Medicaid, protect U.S. health care, say
By JULIE MINDA
SAN ANTONIO — Throughout a rural health care conference here that took place as the U.S. House was finalizing a fiscal year 2026 budget proposal, speakers emphasized that potential moves by the government pose a significant threat to health care funding and access and that hospital leaders and other stakeholders must advocate to protect the health of vulnerable people.
At the 2025 American Hospital Association Rural Health Care Leadership Conference Feb. 23-26, numerous speakers from AHA and other health care organizations said that there are threats of significant cuts to Medicaid — perhaps as much as $880 billion — as well as other legislation under consideration that could put the health care safety net at risk. The speakers called on health care stakeholders to reach out to legislators to emphasize the importance of Medicaid and other programs for the vulnerable and to educate them on how cuts could negatively impact people and communities.
In an opening plenary session, AHA President and CEO Rick Pollack and AHA Board Chair Tina Freese Decker explained
that the health and well-being of millions of Americans are at risk.
“What unites us (as health care providers) is that we care for the people in our communities,” said Pollack.
“Our neighbors are counting on us,” Decker said to the audience of about 1,000 who had gathered for the 38th annual rural health conference.
Budget reconciliation
The conference occurred in the lead-up to the House’s Feb. 26 vote to adopt a budget proposal calling for about $2 trillion in spending cuts, including some that could impact Medicaid and other key health care programs.
As Catholic Health World went to press, the House and Senate were negotiating a budget reconciliation package.
On March 4, more than 150 hospital and health system leaders took part in an AHA Advocacy Day in Washington to get an update on such congressional activity and then to meet with lawmakers and their staffs.
Pollack said in a release about the Advocacy Day that “with so much at stake in the coming weeks and months, it is vital that we
continue to face health care’s challenges together speaking as one voice.”
Pressing challenges
The negotiations in Washington take place against the backdrop of increasing challenges for U.S. health systems and facilities and their patients. Throughout the rural health care conference speakers from AHA, its member hospitals and health systems, and partner organizations detailed many different pressures impacting hospitals, particularly those in rural areas.
During plenary sessions, Pollack and others identified as top concerns the changing health care delivery system, political fractures in the nation, insurance companies putting up barriers to care, government underpayment for health care, supply chain disruptions and workforce challenges.
Conference speakers also described other threats to health care access. They discussed how attacks on the 340B drug discount pricing program by pharmaceutical companies and others could put that program at risk. Some speakers explained how the rapid expansion of Medicare Advantage program use by senior adults is posing challenges to rural health care sites when the commercial insurers running those plans curtail enrollees’ access to care. Also of concern are so-called “site-neutral” cuts to Medicare payments for hospital outpatient departments. Another top worry is that enhanced premium tax credits for participants of health insurance marketplace plans connected to the Affordable Care Act are set to expire late this year, putting at risk the insurance status of people covered under those plans.
Advocacy priorities
AHA leaders discussed throughout the conference that the association is pressing forward with a comprehensive agenda to get ahead of potential government action that puts vulnerable people at risk.
That agenda for this year prioritizes these goals:
Ensuring access to care
Strengthening the health care workforce
Advancing quality and health care system resiliency
CHA, USCCB and Catholic Charities said in the letter that they “stand ready to work with you … in creating policies directed at improving health care for all to flourish.”
To access the letter and information about advocating for Medicaid’s preservation, visit chausa.org/ Medicaid.
Leading innovation in care delivery
Reducing health care system costs for patient care
AHA is part of the Coalition to Strengthen America’s Healthcare that is undertaking a multimedia campaign in line with this agenda. CHA is part of that coalition as well. The coalition’s campaign includes a television ad explaining how cuts to Medicaid could negatively impact the tens of millions of Americans who rely on the program.
Implications of cuts
Pollack and Decker acknowledged during the conference that fighting to protect the health care of vulnerable populations will be difficult.
“But, we’ve proven we can do hard things,” said Pollack.
He cited the work hospitals had done to take on the challenges of Ebola, the COVID-19 pandemic, cyberattacks, supply chain disruptions and numerous natural disasters.
He said the current risks to the health care system are “a serious matter.” Many rural hospitals, and especially critical access hospitals, are at heightened risk.
In the case of possible Medicaid funding cuts, Pollack said, some of the nation’s most vulnerable community members are endangered, including low-income people, frail elders and babies. The Medicaid program is a virtual lifeline for these populations and for the hospitals that care for them, he said.
Decker said, “AHA will continue to advocate, but we need your support and engagement, we need your voice to be heard. We will work together, and we must fight like heck” to preserve health care funding and access.
For information on AHA’s advocacy priorities and for related action alerts, visit aha.org/advocacy/action-center. jminda@chausa.org
American Hospital Association President and CEO Rick Pollack addresses attendees of the 2025 AHA Rural Health Care Leadership Conference in February in San Antonio. He spoke in part about AHA’s advocacy priorities.
Tina Freese Decker, American Hospital Association board chair, speaks at the rural health care conference. She urged attendees to continue to protect Medicaid.
Photos Courtesy of the AHA
Prepare now for ‘black swan’ events, leadership consultant tells AHA audience
Jamie Orlikoff tells rural health care leaders that amid threats to their sustainability, they must plan for a wide variety of challenges
By JULIE MINDA
SAN ANTONIO — Hospitals and other health care facilities that prepare effectively could mitigate the impact of “black swan” events, a leadership consultant told attendees of a rural health care leadership conference here. Black swan events are rare, seemingly unexpected, yet high-impact happenings that people — in hindsight — believe could have been predicted after all.
Jamie Orlikoff, president of the Orlikoff & Associates health care governance and leadership consultancy, told the audience of a plenary session of the 2025 American Hospital Association Rural Health Care Leadership Conference in February that it is necessary for health care leaders to adopt “black swan thinking.” Orlikoff defined such thinking as being willing to accept that crises can and will come and to engage in comprehensive planning for when they do.
As a top-of-mind example, he said that while hospitals and health systems will
press their elected officials to protect Medicaid rather than cut it, they also must recognize that significant cuts could come and plan for that contingency.
“It’s about rethinking the concept of risk, embracing the black swan, and thinking about a radically different world assuming that the cuts go through,” he said. “Should we stop the cuts? Yes, but let’s not be in denial that they could happen. Let’s be prepared and ready so we’re not so stunned by
the event that we can’t act.”
New normal Orlikoff, who is the national adviser on governance and leadership to the American Hospital Association, set the stage for his talk on hospital risk management by acknowledging the extremely challenging environment that hospitals are in.
Health care providers, he said, are dealing with pressing workforce shortages,
ongoing supply chain disruptions that perhaps will be magnified by tariffs on imports, public anger with and distrust of health care, overwhelmed clinicians, aging health care infrastructure, weakened balance sheets, and the repercussions of disruptors such as Walgreens and Amazon that took a share of the health care market before deciding to pull back from the sector.
The current environment is even more difficult for rural health care providers to weather, he said. By and large, rural populations are aging and can be disproportionately poorer than those in suburbs. Population trends are changing rural hospitals’ payer mix, and those hospitals have more patients who are uninsured or insured by Medicaid or Medicare, so they have more exposure and vulnerability to changes made by government insurers. Also, the acuity and lengths of hospital stays among rural patients have worsened.
These and other trends are endangering rural hospitals’ sustainability. From 2023 to 2024, the percentage of rural hospitals in the red increased to 50% from 43%, Orlikoff said. He added that between 2011 and 2023, nearly 300 rural hospitals dropped their obstetrics services, and between 2014 and 2023, more than 400 rural hospitals stopped providing chemotherapy services. Citing the Center for Healthcare Quality and Payment Reform, he said that more than 30% of rural hospitals are at risk of closure within the next three years.
He said it is likely that the pressures that hospitals are facing are not an aberration but the “new normal.”
New mental models
Orlikoff, who has consulted with hospital and health system governing boards since 1985, told the conference attendees that even while navigating the challenges of the new normal, they also must prepare for other black swan events.
As examples, he cited natural disasters like earthquakes, firestorms, volcanic eruptions and hurricanes; pandemics; cyberattacks; financial crises; mass technological failures; political instability; environmental catastrophes like oil spills; and terrorist activity.
“It’s impossible to predict what will happen, but we need to theoretically prepare by thinking about what could happen. The great challenge will be to still be standing after whatever is coming, comes.”
— Jamie Orlikoff
And, in the present day, he said, significant reduction of reimbursement from government payers is a potential black swan.
To try to prepare for such crises, Orlikoff said, requires a change in mental models. Hospital and health system leaders can and should be developing scenarios to explore possible impacts and responses, creating business continuity plans to maintain operations during and after such events, rehearsing responses, building resilience throughout the organization, obtaining appropriate insurance coverage and educating and training staff to respond.
“It’s impossible to predict what will happen,” he said, “but we need to theoretically prepare by thinking about what could happen.
“The great challenge will be to still be standing after whatever is coming, comes.”
jminda@chausa.org
Jamie Orlikoff urges health care leaders to prepare for rare, unexpected crises.
CHRISTUS Children’s
From page 1
has been finding ways to share its expertise with other hospitals — particularly those in rural areas — to further improve care access.
The result is that more San Antonio, and South and Central Texas kids and their families have been able to obtain the services they need close to home, according to Cris Daskevich, CEO of CHRISTUS Children’s and senior vice president of pediatric and maternal services for CHRISTUS Health.
She says that for the women’s and children’s hospital, “it is about being a leader and having the courage as an institution to invest in the people and programs that are necessary in providing accessible, comprehensive care.”
She says that in San Antonio and South Texas “no one else has invested and created access to pediatric subspecialty and highrisk maternal care like CHRISTUS Children’s. No one has built near the network that we have.”
Daskevich shared her insights on CHRISTUS Children’s growth during a breakout panel at the 2025 American Hospital Association Rural Health Care Leadership Conference last month in San Antonio and during a follow-up interview with Catholic Health World
Keeping up with growth CHRISTUS Children’s is part of CHRISTUS Health, which traces its roots to the 1869 founding of the Santa Rosa Infirmary in downtown San Antonio by the Sisters of Charity of the Incarnate Word. CHRISTUS Health operates more than 60 acute care hospitals, with 10 located across Central and South Texas.
CHRISTUS Santa Rosa ministry established the Children’s Hospital of San Antonio as a freestanding pediatric hospital in 2012, and Daskevich joined as CEO in 2018. The facility was rebranded as CHRISTUS Children’s in 2023 “to better reflect its network of comprehensive maternal and pediatric services,” says Daskevich.
Currently CHRISTUS Children’s encompasses the flagship pediatric medical center in downtown San Antonio and a network of freestanding emergency centers; multispecialty, maternal and pediatric clinics; outpatient rehabilitation centers; and mobile clinics.
Daskevich says CHRISTUS Children’s developed and implemented its strategic expansion plan around 2020 after recognizing that there had been significant population growth in San Antonio and surrounding communities, but that pediatric specialty care services had not kept up with the increase. A 2022 community health needs assessment showed the population of Bexar County, where San Antonio is located, grew nearly 6% between 2015 and 2019, to more than 2 million. Adjacent Comal and Hays counties are two of the
fastest growing counties in the nation.
Daskevich adds that beyond responding to the population increase, a key reason CHRISTUS Children’s has prioritized increasing access to high-risk maternal and pediatric services in San Antonio and South Texas is that there is a sizable segment of the population that is socioeconomically disadvantaged. Those vulnerable patients and families encounter numerous barriers in accessing care, especially when they must travel outside their region to do so.
Daskevich says in their planning and implementation, CHRISTUS Children’s leaders have been asking themselves, “How do we keep our patients and their families in their communities when they can’t afford to leave San Antonio? This is vital to our mission. We have built our ministry here — we don’t want people to have to leave.”
Pillars of excellence
CHRISTUS Children’s expansion has been organized mainly around six pillars of excellence:
Center for Surgical Innovation
Maternal and Fetal Care Center
Heart Center
Center for Neurosciences
Cancer Center
Mission and Ministry
For each of the clinical centers, the pediatric hospital has been greatly expanding the scope of maternal and pediatric services by building out the infrastructure and by hiring clinical experts and support staff. The hospital has increased these services not just at the downtown campus but also at a widening network of outpatient multispecialty clinics. CHRISTUS Children’s is addressing emerging gaps in care by increasing the number of maternal and pediatric subspecialists practicing in each of the pillar focus areas. And it has been
increasing the wraparound services for each pillar, including from child life specialists, dieticians, occupational and physical therapists, geneticists, pharmacists and social workers.
In partnership with Baylor College of Medicine, CHRISTUS Children’s also is a teaching hospital that has been expanding its areas of training and education as it has built out this network. The facility supports training programs for pediatric residents, fellows, nurses, rehab therapists, child life specialists and pharmacists.
Daskevich says in their planning and implementation, CHRISTUS Children’s leaders have been asking themselves, “How do we keep our patients and their families in their communities when they can’t afford to leave San Antonio?”
Daskevich emphasizes that CHRISTUS Children’s has relied heavily on local philanthropy to support the growth of many of its services. CHRISTUS Children’s Foundation is now in the silent phase of its largest capital campaign to date to generate more funds to invest in physician experts, staff positions, specialized programming and equipment — and not just in “bricks and mortar,” says Daskevich.
Help for socioeconomic needs
Daskevich notes that part of CHRISTUS Children’s work has been to address the many socioeconomic needs that San Antonio and South Texas families are facing.
The 2022 community health needs assessment says the proportion of households in Bexar County that are “asset limited, income constrained, and employed” — or working poor — rose steadily between 2010 and 2018, to about 35% of the population. They and other vulnerable populations have housing, transportation, food and other needs that the pediatric hospital recognizes must be addressed in tandem with medical needs through partnerships with other community-based not-for-profits.
For example, as part of its expansion work, CHRISTUS Children’s partners with the state of Texas to manage and operate eight women, infants and children clinics across San Antonio and surrounding communities. At these clinics, women and families can access consultants, case managers
and nutrition counselors. They also receive help in applying for Medicaid, the Supplemental Nutrition Assistance Program and other aid.
Bolstering rural care
An additional area of focus in recent years has been bolstering health care services for kids in rural areas of South Texas. Daskevich notes that there are about 30 million pediatric emergency department visits each year in the United States. More than 80% of those children receive that care in a facility that is not a children’s hospital. And, of that subset, more than 90% are seen in lower-volume emergency departments such as those in rural areas. In many cases, these rural emergency departments do not have kid-friendly or pediatric-specific equipment, nor do their clinicians usually have training specific to treating pediatric patients.
To help address this concern, CHRISTUS Children’s is undertaking a pediatric emergency department readiness program. A CHRISTUS Children’s team partners with rural facilities in the region and visits the sites in-person to assess how well prepared their emergency departments are for pediatric patients and what gaps exist.
Working with the emergency departments, the CHRISTUS Children’s team then puts together a program for addressing the gaps. This might include providing virtual training for the rural clinicians or inviting them to a CHRISTUS Children’s facility to learn how to adjust clinical practices to the physiologies of kids to allow for real-life simulation, teaching and training. In the near future, CHRISTUS Children’s will pilot a telemedicine connection with rural facilities so that the hospital’s pediatric specialists can provide on-demand consultation on patient treatment.
Additionally, CHRISTUS Children’s is using a grant from a South Texas donor to roll out a pediatric emergency fellowship training program that also will support the pediatric readiness initiative for rural hospitals.
Describing the work during the February AHA rural health conference, Daskevich said, “We want to focus on how to leverage our pediatric expertise at CHRISTUS Children’s for our hospital partners across San Antonio and South and Central Texas. This way, we can keep patients and their families in the most appropriate care setting — hopefully closer to home.”
When it comes to all this effort around care access and expansion, Daskevich tells Catholic Health World, “this is our obligation and our legacy to our community.” jminda@chausa.org
Dr. Katherine Barsness, chair of the department of surgery in pediatric general surgery, second from left, performs the first surgery in CHRISTUS Children’s minimally invasive surgical operating room suite in May 2024. CHRISTUS Children’s is in San Antonio.
A sonographer takes an ultrasound of a patient’s heart at CHRISTUS Children’s Heart Center.
Daskevich
IN BRIEF
HSHS plans $270 million investment for two Wisconsin hospitals
Hospital Sisters Health System leaders plan to invest $270 million to expand and remodel its two hospitals in Green Bay, Wisconsin, over the next few years.
Bob Erickson, HSHS Wisconsin market president and CEO, announced the plans for HSHS St. Mary’s Hospital Medical Center and HSHS St. Vincent Hospital at a press conference March 6. Erickson said the investment is meant to meet an increased need for care in northeast Wisconsin, according to a press release from HSHS. “With projected population growth, an aging population and a growing number of patients traveling to Green Bay from afar to seek health care, we see a significant need to open more access to patients who want to receive care from us,” he said.
HSHS St. Mary’s will be the site of the largest expansion and transformation. The plans for that hospital include a new tower that would allow for more intermediate and intensive care beds. Early design plans also call for additional operating and procedural rooms, wider corridors, spaces that offer more natural light and more parking.
Construction at HSHS St. Mary’s is
Trinity Health PACE
From page 1
3,167 participants enrolled in a Trinity Health PACE program.
Catholic Health World spoke with Dan Drake, president and CEO of Trinity Health PACE, and Donna Wilhelm, vice president of advocacy for Trinity Health PACE, about how and why the system is so invested in the program. Answers have been edited for length and clarity.
Why is the program so popular at Trinity Health?
Drake: We are in PACE to expand the footprint and expand services for the frail elderly throughout the country. That’s what our mission is. Our main focus is providing care for those who don’t have care and don’t have the ability to get care right now. Our goal is to expand this throughout as many locations as we can and break even. We are not for profit. We’re not in it for the glory or the money. We just think it’s such an innovative way of providing care for seniors.
Wilhelm: The important part is that we are not for profit. All the money, all the proceeds, all the revenue that we get goes back into patient care and goes back into growing the business for greater access. Our overarching goal for Trinity Health PACE is access and growth. We believe that all seniors should have access to the PACE program. It is for people who are nursing home eligible. We strongly believe that people should have options in that space. You shouldn’t have to just be admitted to institutional care if that is not what you want nor what you particularly need. PACE is really the granddaddy of value-based care.
How do you build a program? Do you start it where you already have a hospital and care established, or can you build from the ground up?
Drake: The majority of our centers are in close proximity to our hospitals, because that was our original model. Now, like with Pensacola, Florida, and Alexandria, Louisiana, we didn’t follow that so closely. We just thought there was great need in these areas.
expected to begin this summer and be complete in 2028.
Remodeling plans for St. Vincent will be announced later, HSHS said.
CHRISTUS opens second hospital in Beaumont, Texas
CHRISTUS Southeast Texas Health System has opened a second hospital in the Southeast Texas city of Beaumont.
The nearly six-acre CHRISTUS Health West Beaumont campus features medical offices, a 24/7 emergency department, surgical services, specialized procedures, advanced imaging and the latest in orthopedic care, CHRISTUS Health said in a release. The facility opened in mid-March.
CHRISTUS Health is the parent of CHRISTUS Southeast Texas Health System.
“As the need for health care grows in southeast Texas, we continue to expand our services to ensure community residents have access to the innovative, faith-based care they expect and deserve,” said Paul Trevino, president and CEO of CHRISTUS Southeast Texas Health System.
The new hospital is housed in the former Medical Center of Southeast Texas — Victory Campus. It is connected to the CHRISTUS Orthopedics & Sports Medicine Institute that opened in January. CHRISTUS Southeast Texas — St. Elizabeth is also in Beaumont.
Putting athletes to the test
Virginia Mason Franciscan Health teamed up with the Seattle Seahawks pro football team and the nonprofit Nick of Time Foundation in March for a day of heart health at the Virginia Mason Athletic Center in Renton, Washington. Nearly 500 young athletes received free EKG screenings that can detect heart abnormalities before they become life-threatening. Beyond screenings, athletes learned life-saving CPR skills from experts and got to test their athletic abilities with 40-yard dashes and vertical jump tests. Virginia Mason Franciscan Health is part of CommonSpirit Health.
But all of our new sites are from scratch. We find a building that meets our criteria, and then we build it to the specifications of PACE.
Wilhelm: In addition to that, we’re also building out our network. We not only become the provider of the care, but we’re also the payer. We are also paying others to provide that care, but again, overseeing the whole thing through the interdisciplinary team.
How do you sell this to communities and states?
Wilhelm: I think I like the word sell. We really are selling the program to them, but I think what comes out as most important to most states is what is it going to cost them? And although we’re taking care of the population that is nursing home eligible, our rates are lower than what (states) would typically pay a nursing home. So there’s an automatic savings, and because we’re 100% full risk (where providers are responsible for all costs), they know that there’s nothing beyond that. That’s their rate. That’s what (states are) going to pay for the rest of (a recipient’s) life. For this individual, even if they do end up in a nursing home, whether a short term or long term, the rate the state is paying is still what they’ve been paying for PACE. It’s a good deal for the state. But, on the other side, on more the touchy-feely side, I like to tell legislators in particular, that PACE is the kind of care that you would give your own mama.
In our program in Alabama, we had an 85-year-old woman whose air conditioner went out. She couldn’t afford to fix it. Her family couldn’t afford to fix it. It was thou-
sands and thousands of dollars. And she had lots of chronic health issues. Before PACE, she would have ended up in a nursing home. There would have been no other place for her to go, but as a PACE participant, it was just a heck of a lot better for her, and a heck of a lot cheaper, to just fix her air conditioner. It’s that kind of commonsense thinking of what you would do with your own mother.
One of our goals is really to expand PACE to every state. Right now, it is optional under CMS (Centers for Medicare and Medicaid Services), so a state can choose to do it or not choose to do it. We have been advocating for years that the CMS move PACE out of the optional bucket into the mandatory bucket. Currently, we have to work individually with every state to try to get them to either legislate it or put it into their state plan amendment, or both. But some of the states that we’re in primarily is because we advocated for it to happen. We work with a lot of trade organizations to help make that happen, and other PACE providers to help make that happen. To say it takes a village to build that into the state’s network is an understatement.
Drake: As far as selling it to the participant and their family, it’s the wraparound services. We will provide transportation to and from our center for your mother or father. We will make sure they’re in our network. They will be able to see a dentist, they’ll be able to see an eye doctor, they’ll be able to come into the center and socialize. This is something that other long-term care programs don’t do. They are strictly your insurance company. We are the provider and the insurer. Our goal is to keep you as healthy and as active as you can be, because
in the long run, it helps the participant that they’re at their highest baseline, and it helps us, because it costs less if you do it properly. So it’s kind of a win-win.
What are some of your biggest challenges?
Wilhelm: I would definitely say workforce is one of our bigger ones.
Like any industry, we have competition. We compete with other private health plans. You can’t be in a health plan and a PACE program. And although we offer a much more comprehensive program maybe it doesn’t look as frilly as other health plans. That’s been a huge barrier, I think, to the growth of PACE. It is not an apples-toapples comparison by any means.
There are lots of regulatory barriers that we have to growth. The first is that it isn’t in every state. So you really have to work hard to make that happen.
Drake: We get a lot of questions from people in other systems. There are a lot of people who think this is easy. It’s really not. It’s very time consuming. If we get a request for proposal (from a state to establish a PACE program), it takes us about a month and a half, two months to get back to them, then it takes them three to six months to get back to us, and by the time we pick out a center that we want to be located, do the construction, hire, it’s another 16 months before we can even open. And it’s very costly. You’re hiring 12 people: nurses, doctors, social workers, therapists, caregivers, van drivers. You have to have 12 people in place before you’re open for about three months before CMS comes in and gives you the blessing to open.
The startup cost is very high, but the benefit at the end is fantastic. After two or three years, you’re at a break-even point and we’re in it for the long haul.
How does PACE help fulfill your mission as a Catholic health care institution?
Drake: Expanding access to care for the frail elderly is our number one mission. There are a lot of people that would get no care if they didn’t have this program, because their alternative would be live at home in pretty bad conditions with no services because they’re afraid if they ask for services, they’re going to be placed in a nursing home. We run nursing homes. We want great nursing homes. We’re not anti-nursing homes, but if you could stay at home with the proper care, that’s where you should be.
vhahn@chausa.org
Drake Wilhelm
Participants at Trinity Health PACE Alexandria in Louisiana enjoy each other’s company during a Valentine’s Day painting activity. The program started in 2024 and is one of Trinity Health PACE’s newest.
Providence research shows genomic profiling can improve cancer outcomes
By JULIE MINDA
Studies by scientists from a Providence St. Joseph Health research center are confirming that testing called comprehensive genomic profiling of tumors can lead to improved treatment, better outcomes and longer life for patients with advanced cancer.
Dr. Carlo Bifulco, chief medical officer of Providence Genomics, and Brian Piening, program director of Providence Genomics, say while the testing is proving its worth, there are barriers to access. They believe the profiling should be more widely available, better reimbursed by insurers and used more often by providers. Bifulco and Piening practice at Providence’s Earle A. Chiles Research Institute in Portland, Oregon.
Bifulco says it is unique to have extensive and advanced research such as genomics studies conducted at a nonprofit health system. Piening says Providence leadership has prioritized investment into such research “because we thought we could make an impact.”
Bifulco adds that the cancer research “is crucial to improving patient outcomes.”
‘Groundbreaking discoveries’
According to the most recent statistics from the Centers for Disease Control and Prevention, there were 1.7 million new cancer cases reported nationwide in 2021 and 608,366 people died of cancer in 2022. The CDC says there are racial disparities when it comes to the prevalence of cancer. For instance, the agency says on its website, “compared to members of other racial and ethnic groups, Black and African American people have higher rates of getting and dying from many kinds of cancer.”
The Research Institute has been studying cancer since 1993, with immunotherapy its main area of concentration. Immunotherapy involves treatments that boost the body’s immune system against cancer. Bifulco and Piening are among the 200-plus investigators and research personnel practicing at the Research Institute, an arm of the Providence Cancer Institute. The Research Institute garners more than $10 million annually in federal, private and sponsored research funding.
The institute says on its website that advancements in genomic sequencing are
enabling clinicians to use immunotherapy and personalized precision medicine “to accelerate leading-edge research and groundbreaking discoveries for patients with cancer.”
Advancements in testing
Comprehensive genomic profiling is used to extract and analyze genomic information from cancerous tissue to more precisely target treatment.
A press release from the Research Institute explains that the profiling “assesses hundreds of cancer biomarkers across various tumor types in a single test.” This extensive assessment activity “can guide patients toward targeted treatments or immunotherapies that may not have been identified through more limited genomic testing approaches.” Artificial intelligence applications help scientists process the extensive information gained through the testing.
Piening explains that the more common genomic testing method uses “small panel” testing that looks at selected genes in isolation. This can be a very piecemeal approach, notes Bifulco, because scientists may need to repeat different assessments to home in on the correct biomarkers to target. Precious time can be lost as different assessments are completed one after another.
Around 2019, the Research Institute was one of the first labs to go live with comprehensive profiling, says Bifulco. Piening notes that it was quite an investment from Providence to equip a lab to do this profiling, since it requires a large software team, a large lab team and a lot of computing power. Any Providence facility can use the lab’s services; the lab only serves Providence facilities. Providence has 51 hospitals, more than 1,100 physician clinics and a network of other facilities across seven western states.
Evidence of benefits
Research Institute team members, including Bifulco and Piening, have been involved in two recent studies that have borne out or are bearing out the benefits of comprehensive genomic profiling. The newest study, “Widespread Adoption of Precision Anticancer Therapies After Implementation of Pathologist-Directed Comprehensive Genomic Profiling Across a Large US Health System,” is detailed in the Nov. 12 issue of the Journal of Clinical
Oncology — Oncology Practice
The report focused on the first two years of a five-year study involving 3,216 Providence patients with several types of cancer at an advanced stage. The researchers provided the results of comprehensive genomic profiling to patients’ clinicians 12 days before the patients’ initial oncology visit. The ongoing study is finding that receiving such results influenced the early clinical decision-making process and led to over half of the patients receiving biomarker-driven targeted therapy or immunotherapy. Patients who got this precision therapy had a longer survival period than those who had chemotherapy alone.
“
Cancer is considered to be a disease driven by our genes, but unfortunately, genomic testing is considered optional. We want to ensure it becomes part of the care for everyone.”
— Dr. Carlo Bifulco
Results of the prior study, “Clinical impact for advanced non-small-cell lung cancer patients tested using comprehensive genomic profiling at a large USA health care system,” were published in the September 2024 issue of ESMO Real-World Data and Digital Oncology. The study had similar findings to the latter one but was focused on a particular type of cancer, nonsmall-cell lung cancer.
Access disparities
Bifulco and Piening say this and other
research around targeted precision therapies represents a significant step toward more personalized and effective cancer treatment.
But, they say, there are many barriers to widespread adoption of these promising testing and treatment protocols. First, not all payers reimburse for this type of testing in part because it is not yet widely practiced and so does not yet have an extensive track record. Second, not all clinicians are aware of the testing and its benefits. Part of the Research Institute’s work is to educate and train oncology clinicians throughout Providence on the availability and promise of this testing.
Beyond these challenges that are particular to comprehensive genomic profiling are broader disparities, notes Bifulco. For instance, only a small percentage of people who are eligible for participation in potentially lifesaving research actually take part. People of color have an even lower participation rate than white people, he notes.
Bifulco says the Research Institute is working to understand and address these and other disparities around cancer care.
“Cancer is considered to be a disease driven by our genes, but unfortunately, genomic testing is considered optional,” he says. “We want to ensure it becomes part of the care for everyone.”
‘New era of cancer care’
Bifulco and Piening are very optimistic about the advancements that are possible with genomic profiling and other highly personalized treatments.
“Eventually I believe the genome will become part of a patient’s electronic medical record and (genetic profiling) will affect all care decisions” when it comes to cancer, says Piening.
He notes that comprehensive genomic profiling could provide important clues on genetic impacts for family members of people with advanced cancer.
He says advancements in this field are having a “pretty profound impact” on cancer treatment and there are countless possibilities for expanding this research and its applications.
“We’re clearly in a new era of cancer care based on precision medicine,” says Piening, “and that is very important.” jminda@chausa.org
Bifulco Piening
Mission services
strategic plan.
“We’re working to speak with one voice,” explains Diarmuid Rooney, CHA vice president, sponsorship and mission services. “We have more integration and collaboration, both within departments and with organizations outside CHA.”
Vision, strategic plan
Rooney took the helm of the 12-member sponsorship and mission services department over two years ago. Since then, Lori Ashmore-Ruppel has been promoted to senior director, mission services management; Darren Henson has been hired as senior director, ministry formation; and Sr. Teresa “Tere” Maya, CCVI, has been hired as senior director for theology and sponsorship.
The team has articulated its purpose through the departmental member statement: “Rooted in a spirit of excellence, we lead and nourish the ministry of Catholic health care through personalized service and innovative practices, enabling members to be effective and compassionate leaders in their commitment to wholeperson care and the transformation of the communities that they serve.”
The department already had been revitalizing its programming when the association released a new vision statement at the 2023 Catholic Health Assembly. That vision is: “We will empower bold change to elevate human flourishing.”
Based on that vision, CHA developed a strategic plan that it released at the 2024 Catholic Health Assembly. That plan focuses on three pillars: care for all, health reimagined and united for change. The “united for change” pillar is the main area of concentration for the department. The group is framing its work under the concept of a united voice for the ministry.
Top focus areas
To carry out the strategic plan, CHA’s sponsorship and mission services department continually facilitates virtual and inperson programming, both educational and formational, and provides resources for participants’ continued learning and growth. The goal is to help Catholic health systems and facilities remain committed to Jesus’ mission of love and healing.
Through its mission services function, the department supports mission leaders with a variety of tools, resources, programs
Lori AshmoreRuppel senior director, mission services management
The longest-serving member in the department, Ashmore-Ruppel brings her experience working with the Sisters of St. Joseph and her skill for relationship-building to each of the department’s focus areas.
and gatherings to stay informed and connected across the Catholic health ministry. Through its sponsorship function, the department provides ministry sponsors with consultation, programs, resources, sponsor formation and gatherings. The purpose is to assist sponsors in understanding and fulfilling their responsibilities with special attention to the formation of laypersons and vowed religious.
The department offers ministry forma-
Jill Fisk director, mission services
Before joining CHA, Fisk worked on the mission team for Mercy health system, writing and facilitating ministry formation and managing leaders’ personal formation plans. She is also a spiritual director and retreat leader, offering wholeperson care through yoga and contemplation.
Concentration on member priorities
Beyond the work that is core to their functional areas, the entire sponsorship and mission services department has been working together to address top member priorities.
Some recent programming includes the late January Sponsorship Institute in Albuquerque, New Mexico, that drew 76 attendees to discuss how sponsors can help bring about bold change in Catholic health care. Attendees reviewed results from a recent sponsorship survey that found a priority for respondents is that the ministry recruit the next generation of sponsors. The survey also revealed the need for a strong, collective voice for sponsors so that they can influence change.
tion experiences that allow Catholic health care associates to discover connections between their vocation and the healing ministry of Jesus. The department supports members with formation at all levels of the ministry, from bedside workers to executive leadership, board and sponsor members.
The ethicists in the department help member ministries navigate the complexities of providing Catholic health care in alignment with the Ethical and Religious Directives for Catholic Health Care Services and church teaching in service to the ministry’s shared commitment to upholding human dignity, promoting the common good, and providing whole-person care. CHA’s ethicists provide this support through consultations, ethics education and formation, collaborative dialogue, sharing of best practices, and research and writing.
The department’s spiritual care experts advocate for adequate staffing to ensure the sacramental and spiritual needs of patients and staff are addressed. Those experts consult with CHA members through advisory councils and board-certifying groups to address innovations and gaps that will better serve patients, families and co-workers. This includes addressing caregiver well-being.
And, through member advisory committees, CHA works with member systems to reimagine how they operationalize their commitment to human dignity, including through policies and programs.
CHA’S SPONSORSHIP AND MISSION SERVICES LEADERS
Dennis Gonzales senior director, mission innovation & integration
A former De La Salle Christian brother, Gonzales was a high school teacher before serving as an associate dean for academics at a small, private university. In health care, he started in quality and performance improvement and organizational development before moving into the mission role.
Darren Henson senior director, ministry formation
Henson received CHA’s first graduate student essay award in 2012 for research on the theological roots of palliative care. He later worked in systemwide leadership at two CHA member ministries and earned a bachelor’s degree in international business.
Nathaniel Hibner senior director, ethics
A licensed pilot, Hibner wrote his doctoral dissertation on the theological concept of scandal, “Discerning Scandal: Theological Scandal in Catholic Health Care Decision Making.”
Brian Kane senior director, ethics
While a dean at DeSales University, Kane also served as the director of international academic affairs and was legal representative to Italy and the Vatican.
Other programming CHA has offered recently is its live formation session, Foundations of Catholic Health Care Leadership, which included eight consecutive weekly virtual sessions that ran from Jan. 30 to March 20. A new topic covered in foundations in the latest live version was Catholic health care’s vision for eldercare and palliative care. Experts discussed how demographic, policy and societal forces are having an impact on care of elders and how the ministry can use palliative care and other practices to improve care for these elders.
A new offering is a series of weekly contemplations for the Lent and Easter season that the department launched on Ash Wednesday. Each of the 15 installments in the “Slow and Simple” series contains a card with images for people to reflect on as well as scripture, prayer and a link to an audio meditation.
Also, the department’s ethicists are continuing to offer the monthly webinar series, “Emerging Topics in Catholic Health Care Ethics,” which is in its second season. The most recent session, in March, featured Andrea Thornton, a theologian, bioethicist and mission director with Bon Secours Mercy Health, discussing the challenges of both honoring the dignity of all patients and also protecting health care staff from violence. (See story Page 2.)
Rooney says of the ongoing work in the department: “In partnership with our members, we are boldly reimagining and reshaping the way forward, responding to emerging realities with shared purpose and creative resolve.”
In the coming months, Catholic Health World is featuring a series of articles on the work of the sponsorship and mission department.
jminda@chausa.org
associate director, mission services
In addition to holding multiple master’s degrees, Keppel holds a bachelor’s in English literature and Spanish language and literature. She is passionate about the power of language. To complete her dual master’s programs, she wrote her final thesis on practical ways to intentionally build community in a multicultural church.
Sr. Maya has held many leadership positions, including congregational leader for the Sisters of Charity of the Incarnate Word in San Antonio and president of the Leadership Conference of Women Religious.
Rooney’s diverse background includes working as a regional mission formation leader for a ministry system, co-founding and directing a communitybased counseling and psychotherapy center, and living as a Benedictine monk.
Karla Keppel
Sr. Teresa “Tere” Maya, CCVI senior director for theology and sponsorship
Diarmuid Rooney vice president, sponsorship and mission services
Sr. Joy Rose, OSF, director of mission at Franciscan Care Services in West Point, Nebraska, speaks at a session that CHA’s sponsorship and mission services department offered at the 2024 Catholic Health Assembly in San Diego.
At the early March sponsor formation program in Chicago, CHA offered an Ash Wednesday service for participants.
Photo by Jerry Naunheim Jr./CHA
Photo by Stephen J. Serio
Sr. Barbara Schamber played key role in ushering in lay sponsorship for Providence St. Joseph
Sr. Barbara Schamber, SP, died March 23 at her home in Olympia, Washington. She had been a Sister of Providence for 62 years and had held multiple leadership positions in her congregation as well as governance and sponsorship roles with Providence St. Joseph Health.
“Sr. Barbara was indefatigable in supporting and defending and advancing what she knew was right and just and good for our ministry, and she will be deeply missed by all who knew her,” said Dougal Hewitt, Providence St. Joseph Health executive vice president and chief mission and sponsorship officer.
St. Joseph and health care in general was unequivocal.”
“Her passion for religious life as a Sister of Providence was inspirational,” said Sr. Kathleen Pruitt, CSJP, congregation councillor for the Sisters of St. Joseph of Peace. “Her commitment to Providence
Dover
From page 1
oversaw a 10-month process to develop a new strategic plan. The process involved input from 200 stakeholders from within the system and from its partner organizations. In December, Avera’s board approved the plan.
The strategic plan is the third for the system. The first one was called “Ignite” and the second, “Reignite.” This one is called “Illuminate.” Dover says that name reflects the aspirations of Avera to bring light through its care in the same metaphorical way that in the Bible God’s presence and goodness is often represented as light.
The plan has five pillars:
Exceptional patient, employee and community experience
Dynamic physician and provider enterprise
Innovative care models across the continuum
Broaden geographic reach
Leadership and essentiality in all the communities the system serves
Under the pillars are 102 initiatives that Avera will focus on for the next three years. Some initiatives are already underway, such as more than $300 million in capital projects in the Sioux Falls market and moving all health records over to the Epic electronic system.
“I feel we have the highest probability of success because this wasn’t a plan that was developed at the senior suite,” Dover says. “It was really written by our organization and so everybody owns the success of the plan.”
Return to Catholic health care
Dover has four decades of experience in health care leadership. From 2019 until his move to Avera, he was in the top post at the secular Sparrow Health System, which is based in Lansing, Michigan, and in April 2023 became part of University of Michigan Health. Before that, he worked at several Catholic systems. His previous positions include leadership roles at systems sponsored by the Sisters of Providence, Sisters of Mercy, Daughters of Charity, Sisters of St. Joseph of Carondelet and Hospital Sisters.
“When I was ready to exit Sparrow after putting the affiliation together with University of Michigan Health, the Avera opportunity came up and I always kind of feel like providence has a hand in it,” Dover says. “It’s great to be back in Catholic health care.”
Dover says the workforce challenges that health systems have faced since the COVID-19 pandemic persist, but Avera is seeing its retention rate rise and its turnover rate drop.
He considers the system’s Catholic mission to be one of its attractions for staff. “When we say that we’re a health minis-
According to an online biography, Sr. Schamber’s call to enter the congregation unfolded during her years as a student at Providence High School in Burbank, California. Once she decided to enter religious life, she was one of 22 postulants who in 1961 were the first class to enter the new College of Sister Formation at Seattle University’s Providence Heights campus in Issaquah, Washington. Sr. Schamber began her ministry as a teacher at Catholic elementary schools in Washington and California before becoming principal at the Providence Montessori School in Portland, Oregon.
In 1985, she became superior of the Sisters of Providence’s Sacred Heart Prov-
ince. After that, she became principal of St. Elisabeth School in Van Nuys, California. In 2000, she was part of a leadership team that merged the sisters’ two western U.S. provinces to form the Sisters of Providence Mother Joseph Province. According to an obituary posted by her congregation, Sr. Schamber was instrumental in the 2010 formation of the sponsorship model for the health care ministries that the sisters had founded and brought together as a system. She was one of five inaugural members of Providence Ministries, the ministerial juridic person of Providence Health & Services. Providence Health & Services merged with St. Joseph Health in 2016 to form Providence St. Joseph Health. Sr. Schamber helped to draft the “Hopes and Aspirations” sponsor document that still guides the system today.
Recently, she completed her latest five-
try rooted in the gospel and our mission is to make a positive impact in the lives and health of the people in the communities we serve, we are absolutely serious about it,” Dover says. “We are, what I would say, authentically living our core values and our Catholic values and that culture attracts people to our organization.”
Workforce development
Even so, Avera is putting programs into place to train and keep workers, especially in positions that remain hard to fill. One such program is Avera Nursing Advantage, a partnership with South Dakota’s Mount Marty University announced last fall. Nursing students at the Catholic university will be eligible for $30,000 scholarships in their last two years. In return, they commit to working for Avera for three years.
Dover notes that unlike systems in warmer states such as Florida, Avera has a hard time attracting nurses to the upper Midwestern region it serves. “We really are working very hard to grow the nursing cohort locally, because we know we have the highest probability of them staying for a long time,” he says.
Another challenge Avera is mindful of is keeping its rural hospitals, which is to say most of its hospitals, healthy. To do that, Dover says the system is following best practices around keeping care local. Among those practices is partnering with various clinics and with cohorts of physi-
year term as a leader of the Sisters of Providence Mother Joseph Province. That term had included work on implementing a new governance model for the province.
Sr. Schamber published a book last year called Gifts of Water & Mountains chronicling the first 150 years of the Sisters of Providence in the West.
Sr. Pruitt, who had often consulted her colleague and friend on a variety of topics, said Sr. Schamber’s “steadfast presence and wise counsel will be greatly missed.” She said she joins the Sisters of Providence in their grief and takes strength “from their celebration of Barbara’s life, gifts and presence among us all.”
Hewitt said, “The loss of Sr. Barbara is deeply felt across Providence St. Joseph, and I will especially miss her drive and determination to do what is right for Catholic health care.”
really easy,” Dover says.
Keeping an eye on D.C.
Even as Avera keeps its focus local, Dover acknowledges the system is well aware that decisions being made in Washington could affect its operations. For example, the cuts under discussion for Medicaid would affect many of Avera’s patients. He used CHA’s resources from its Medicaid Makes It Possible initiative to share some statistics for South Dakota. For example, across the state, 13% of the population is covered by Medicaid or the Children’s Health Insurance Program, including two of every seven children.
“These drastic cuts that are being proposed are going to have a very real impact on us and on access,” Dover says.
Another potential change in federal policy that could present challenges for Avera would be if coverage of telehealth services that was approved during the pandemic ended.
Dover says it would be “incredibly shortsighted” to end the coverage expansion. But even if that happens, he says Avera won’t give up on remote care. “We’ve found it to be an effective tool that keeps care local,” he says.
The system also is solid in its longestablished commitment to mental and behavioral health care. He notes that the system recently added 16 beds to the Helmsley Behavioral Health Center, which opened in Sioux Falls in 2022.
cians who are willing to care for patients in rural areas. To support those doctors, Avera provides patient transportation and telehealth services.
Another best practice is to keep hospital governance local, Dover says. He notes that many systems that operate rural hospitals have opted to have centralized boards and leadership teams. That loss of local control, he says, leaves patients feeling less connected to their local hospital and more likely to look elsewhere for care.
“ When we say that we’re a health ministry rooted in the gospel and our mission is to make a positive impact in the lives and health of the people in the communities we serve, we are absolutely serious about it.”
— Jim Dover
“I think if you were to do the study, results would show that when you lose that local community stickiness, that all of a sudden out-migration (by patients) becomes
He says many systems have backed away from mental health care. “It’s really hard work,” Dover says. “Funding can be really challenging. Some states are not very supportive.”
Dover says Avera has been fortunate in that the states it serves have been cooperative. For example, he says South Dakota has worked with the system to keep mental health care local and to ensure that best practices are followed.
“We’ve had a very supportive state, and that has been helpful,” he adds. “We have gracious benefactors, and we enhance our learnings to stay really good at it.”
Off-hours interests
When he’s not in the office, Dover engages in what he calls his lifelong passion for tennis. He hits the courts twice a week. He and his wife have four adult children, who are split between the East and West coasts, and a grandson.
In addition to visiting family, the couple like to travel the world. They are determined to visit every continent and have so far made it to five. One of the remaining two, which he hopes to visit before he retires, will require a potentially bumpy flight.
“I’m dreading crossing the Drake Passage to get to Antarctica,” Dover says. “I have severe motion sickness, so I’ve got to prepare myself for that one.”
leisenhauer@chausa.org
Sr. Schamber
Jim Dover, right, surveys damage at Avera St. Anthony’s Hospital in O’Neill, Nebraska, that was caused by an explosion at a nearby building last October. He is with John Kozyra, the hospital’s CEO.
KEEPING UP
PRESIDENTS/CEOS
Dr. Raymond Moreno to chief executive of Providence Oregon’s West Service Area, which includes Providence St. Vincent Medical Center in Portland, Oregon, and Providence Seaside Hospital in Seaside, Oregon. Previously, he was chief medical officer of Providence St. Vincent.
Steven Daniel to president of St. Luke’s Health — Patients Medical Center in Pasadena, Texas. He was president of CHRISTUS Surgical Hospital in Corpus Christi, Texas. St. Luke’s Health is part of CommonSpirit Health.
Daphne David to president and CEO of Ascension Saint Thomas Rutherford of Murfreesboro, Tennessee, effective May 1. She most recently was CEO of HCA TriStar Summit Medical Center in Hermitage, Tennessee.
Tony Beltran is departing as Pittsburgh Mercy President and CEO, effective May 3. He has accepted a position with a behavioral health care organization in California, to be closer to family. Pittsburgh Mercy and its parent company Trinity Health will begin a search for his successor in the coming months. The organizations will name an interim president and CEO in the future.
Jim Heckert has retired as CEO of CHRISTUS Southern New Mexico, formerly Gerald Champion Regional Medical Center. He had worked at the hospital for 47 years.
Power of presence
From page 1
Ostertag, regional director of clinical ethics at Intermountain Health, Peaks Region in Broomfield, Colorado.
At about 6 weeks, Hans failed another hearing test, and Ostertag began to worry in earnest. When Hans was 3 months old, geneticists finally diagnosed him with Zellweger spectrum disorder. The condition falls under the category of peroxisomal biogenesis disorders in which the body doesn’t produce parts of a cell vital to many biochemical processes. Only one in every 50,000 to 70,000 infants is born with Zellweger spectrum disorder.
“They told us it was a terminal condition, that there was no treatment for it,” Ostertag says. “It totally rocked our world.”
‘Tell me what a good day looks like’
Peroxisomal biogenesis disorders are characterized by neurological deficits, loss of muscle tone, liver dysfunction, kidney abnormalities, hearing loss and vision problems. Hans would ultimately lose all hearing and sight.
But even though Hans never sat up, crawled or talked, he responded joyfully to tactile interactions such as cuddling and playing.
“He loved to be tickled, to laugh and roll around,” Ostertag says, “and to hold your fingers and grab your glasses.”
As he grew and aged, Hans continued to interact much like a 6- to 9-month-old, Ostertag says.
When Hans was 2, the Ostertags met
“
One of the most important questions for parents is, ‘Tell me what a good day looks like for your child’ because it’s going to be different for everybody and it’s going to be different at different points in time.”
— Dr. Lauren Draper
Reuben Murray is interim CEO. Murray is chief financial officer of CHRISTUS St. Vincent Health System in Santa Fe, New Mexico.
ADMINISTRATIVE CHANGES
Cherodeep “Chero” Goswami to chief information and digital officer of Providence St. Joseph Health, effective May 12.
Kelley Kostich to system vice president, chief nursing executive of Hospital Sisters Health System of Springfield, Illinois.
Dr. David Hasleton to chief clinical officer for the Bon Secours Richmond, Virginia, market, part of Bon Secours Mercy Health.
Mary Lou Tate to chief financial officer of the Oregon network of PeaceHealth, effective April 7.
Erin Walker to vice president of planning and performance of Our Lady of the Lake Health of Baton Rouge, Louisiana, part of Franciscan Missionaries of Our Lady Health System.
Organizations within CommonSpirit Health have made these changes:
Stacey-Ann Okoth to chief nursing officer of CommonSpirit Health’s Mountain Region.
Kyle Sims to market vice president of ambulatory and post-acute services for St. Luke’s Health, with responsibility for the Houston, Brazos Valley, and East Texas areas.
Christi Whatley to market vice president of ancillary services for Arkansas, for
many special needs.
with Dr. Lauren Draper, a pediatric hematologist and oncologist who was then at SSM Health Cardinal Glennon Children’s Hospital. They wondered about a cochlear implant, hoping it would enhance Hans’ enjoyment of music. With Draper’s guidance, they decided the risks were too great.
The idea, even though they ruled it out, is emblematic of the family’s focus on giving Hans the best quality of life possible, Draper says. “One of the most important questions for parents is, ‘Tell me what a good day looks like for your child,’” Draper says, “because it’s going to be different for everybody and it’s going to be different at different points in time.”
No guidebook for care
After turning 3, Hans started having more issues. He required a feeding tube, needed frequent blood transfusions due to internal bleeding, and began sleeping more after medicine to combat seizures that left him lethargic.
As the years passed, the family had many conversations with Draper about Hans’ palliative care. Draper made a point of bringing up subjects before a situation became dire. For example, when Hans began having two blood transfusions a week, Draper asked the Ostertags to think about what would happen if he needed more — when would the suffering outweigh the benefits?
“It helps to illuminate where we may be
headed before we get there, to give parents time to absorb the information,” she says.
Draper, who is now at Akron Children’s in Ohio, had had one other patient with a different peroxisomal biogenesis disorder, but she’d never encountered the even more rare Zellweger spectrum disorder.
“With a rare disease, there’s no guidebook,” Draper says. “It keeps you on your toes as a doctor, and really makes you humble.”
An organization of parents and medical professionals called the Global Foundation for Peroxisomal Disorders served as a resource for Draper. For the Ostertags, it was a lifeline that pulled them out of isolation. Both Draper and Ostertag are now on the foundation’s board.
“That community has become family — and in some ways even closer than family — because there’s a shared experience that even my own parents and siblings don’t quite have,” Ostertag says. “And there’s a shared understanding where you can talk about things without a filter and you know people get it.”
Adapting and advocating Ostertag’s Catholic faith helped him navigate the difficulties of parenting a child with a rare, terminal illness. He says rare disease advocacy fits squarely within the tenets of Catholicism.
Ostertag points to the Ethical and Religious Directives for Catholic Health Care
CHI St. Vincent of Little Rock.
Dr. Joshua Keithley to chief medical officer of CHI St. Vincent Hot Springs in Arkansas.
Dr. Anjali Rao to chief medical officer of Dignity Health Sequoia Hospital of Redwood City, California.
NAME CHANGE
St. Dominic’s in Jackson, Mississippi, part of the Franciscan Missionaries of Our Lady Health System since 2019, now has a new name: St. Dominic Health. The new name and a refreshed logo reflect a shared mission as a healing ministry faithfully committed to the communities it is privileged to serve, according to a press release.
Services, which advocates for those vulnerable to discrimination, specifically mentioning “persons with mental and physical disabilities.”
“So I think caring for those with rare diseases is essentially right at the heart of the mission,” Ostertag says.
Hans changed the Ostertag family in innumerable ways. Before his son’s diagnosis, Ostertag was finishing up the first year of his Ph.D. program in health care ethics at Saint Louis University, imagining a career in academia, perhaps teaching bioethics. But as the family spent more and more time at Cardinal Glennon, Ostertag’s career aspirations shifted to hospital settings. Last summer, the family moved to Colorado for his job with Intermountain Health.
Hans had an enormous impact on his sister Sophia, not quite 2 when he was born. She spent her toddler and early school years learning to help care for a sibling with many special needs. As Sophia grew, her relationship with Hans went from bringing him toys to changing diapers and pushing his wheelchair.
“She was an amazing big sister,” Ostertag says.
Memories, lessons
In June 2023, 5-year-old Hans was hospitalized with sepsis, his organs failing. The Ostertags realized it was time to let him go, and that 7-year-old Sophia should be there. Draper helped Sophia give Hans his last bath, and make a bracelet with both their names. She arranged for an adult bed to be brought in so a family member, including Ostertag’s mother-in-law, could lie with Hans and encircle him. “Physical touch, hugging him, had always brought him comfort,” Draper says.
Hans died June 16, 2023. For Draper, it was important that the family experience as much beauty and meaning in Hans’ death as they did in his lifetime.
“There is nothing that takes away the trauma and the pain,” Draper says. “But we can alleviate some of the suffering for the family and also make a memory.”
Ostertag is left with many beautiful memories of his son, and lessons from his life.
“He taught us so much about the power of presence, the ways you can express love without words, and to appreciate the little things,” Ostertag says. “And also, that those little things aren’t really little things — they’re everything.”
Moreno
Kostich
David Walker
Heckert Sims
Daniel Hasleton
Beltran Okoth
Murray Whatley Goswami Rao
Big sister Sophia Ostertag, who was almost 2 when Hans was born, learned to help care for a sibling with
How to prevent violence in schools and communities? Be a green dot
By VALERIE SCHREMP HAHN
Picture a disease map: when a virus spreads, the dots on the map multiply, perhaps even bumping into and overlapping each other until the entire map is covered.
The result may be unsettling, even evoking fear.
But what if the dots on the map represented paying a compliment? Providing a ride home for someone who has had too much to drink? Answering a call for help?
That’s the idea behind the Green Dot initiative: to spur the spread of active bystander behaviors, in particular among high school and college students, by educating them on how to prevent violence and shift social and cultural norms.
Since 2013, the CommonSpirit Mission and Ministry Fund, the philanthropic arm of CommonSpirit Health, has provided $6.3 million to support Green Dot programs in eight high schools in three areas of Kentucky. The money goes toward salaries of violence prevention coordinators, training of school personnel, and supplies. The funds also support a program in three middle schools called Sources of Strength. That program promotes mental health care and suicide prevention. The schools work in cooperation with CHI Saint Joseph Health’s Flaget Memorial Hospital in Bardstown, Saint Joseph Mount Sterling, and Saint Joseph Berea as part of those three Kentucky hospitals’ violence prevention programs.
The Green Dot program is homegrown in Lexington. It got its start there in 2006 at the University of Kentucky. The city has a Green Dot Lexington page on its website encouraging “small, individual and manageable actions and behaviors that express intolerance for violence.”
Sherri Craig is market vice president, external relations for Lexington-based CHI Saint Joseph Health, part of CommonSpirit. She points out that while only about 20% of health outcomes are affected by traditional delivery of health care, about 55% can be affected by social determinants of health, including the environment where someone lives, attends school, or works.
“If you look at violence overall across our country, it really is an issue of public health,” she said. “I think there’s an important role for hospitals to play, to be proactive, rather than just to respond to situations when they occur.”
According to the National Center for Education Statistics, one in every five students ages 12-18 experiences bullying. According to the United Health Foundation, Kentucky outpaces the nation in suicide rates for adolescents ages 15-19.
How Green Dot works
In Green Dot terms, each positive, preventative action or interaction is considered a green dot. A harmful, negative action or interaction is considered a red dot. The idea is to cover the participating school and overall community in green dots.
“Every student in the school has an idea of the Green Dot program, and then our students actually use the language, and that’s kind of cool,” said Brian Hill, a CHI Saint Joseph Health violence prevention program manager who oversees initiatives in Madison County, Kentucky. “It’s like, ‘Hey man, that’s a red dot. You need to quit doing that.’ Or when we come to schools, we’ll see a student that we just trained who will say, ‘Hey, I did a green dot the other day. Let me tell you about it.’”
Hill explains to students that there are two types of green dots: reactive and proactive. A reactive dot is when people step in to help. “But we don’t want to be in reactive mode all the time,” he said. “We want to be proactive, so that these things don’t happen to begin with.”
For example, if a fight breaks out in a school, it’s a common bystander reaction for students to film the fight or encourage it with chants, he said. A green dot move would be to intervene using one of the program’s “three D’s”: distract, delegate or be direct.
Faculty and student ambassadors at schools are trained with the idea of spreading the Green Dot concepts to the rest of the school community. They meet regularly and come up with messaging and activities to draw awareness to Green Dot initiatives, such as a Green Dot Trot 5K hosted by Flaget Memorial Hospital in Bardstown. And, of course, there’s Green Dot merch, like sweatshirts and water bottles, to promote the program.
The training covers recognizing problems, identifying barriers to solutions, learning how to intervene, and strengthening positive community norms.
“We train 15% of the student population, and they go out and use their influence within their peer groups to create culture change,” explained Hill. “And the whole concept of the culture change is that violence is not OK and will not be tolerated.”
Making a change
Communities can tailor the program to meet goals. In Nelson County, Kentucky, about 40 miles southeast of Louisville, the focus of the Green Dot program is to reduce bullying, threats and unwanted sexual advances and assaults. In Berea, about 40 miles south of Lexington, the priority is reducing power-based violence. In Mount Sterling, about 40 miles east of Lexington, the push is to reduce student disciplinary events.
Surveys in Nelson County and Berea from 2021 show about 17% of students in grades 6-12 reported being bullied, a drop from a baseline of 24% from when the programs were first implemented. Results weren’t available yet for Mount Sterling programs.
Misty Roller is the CHI Saint Joseph Health violence prevention program manager for Nelson County schools. She explained that Green Dot training is meant to help students build a community, so they know they’re not alone as trained active bystanders.
Roller said she has more than 250 students on a waiting list to be trained. “And I think that’s what we all want,” she said. “We want to be part of something bigger, to make a change.”
Roller took on her current role in September after serving as the community relations lead for the school system. She’d like to use that background to bring Green Dot training to area businesses as part of onboarding new employees. “The strategies we teach in Green Dot are strategies that all of us adults could use as well,” she said.
Hill and Roller said students today struggle with cyberbullying, the sharing
of inappropriate or pornographic pictures on cell phones, and vaping — something they discuss as part of violence prevention because of the link between addiction and the potential for aggression, Roller explained.
Hill, who has worked with the program in schools for 10 years, said he’s also seen attitudes of students change since the COVID-19 pandemic.
“It’s almost like we’ve hit a reset button,” he said. “We live in a culture where kids are so in their own world and in their own bubble, to where (they) don’t care about anybody else: ‘I’m gonna do me, and you do you, and if something bad happens to you, so be it.’”
‘We’ve seen the impact’
Still, those who oversee Green Dot programs hear about results. Counselors report to them that students are increasingly pointing out other students who are struggling and may need help.
At one school, a student noticed that another student’s shoes were worn out, bought a new pair, and asked a faculty member to pass them to the student in
need, Hill said.
As to why students participate in Green Dot training, one wrote:
“I have been sexually assaulted, bullied, cyberbullied and mentally abused. I want to be able to do everything in my power to prevent other people from having to go through the gut-wrenching things I’ve had to experience. If I can help people who have been through those things, it would help heal my heart.”
Hill recalled a time when a female student showed up to school feeling upset and was crying in the bathroom, and she told other girls that she wanted to end her life. Those girls told a Green Dot-trained student about the distressed girl. The trained student stayed with the distraught student while another student fetched a counselor. The girl ended up going to therapy and has been doing great since this incident, Hill said.
“To me, the fact that I feel one student’s life was saved, everything else is just the cherry on top,” said Hill. “You know, we’ve seen the impact. We’ve seen students get help. We’ve seen the culture change at our schools.”
vhahn@chausa.org
Members of the baseball team of Madison Central High School in Richmond, Kentucky, play a game during training to become a Green Dot team.
Hill Roller