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The Catholic Role in Health Care
By Susan Hines-Brigger
This month, members of the Catholic Health Association gather in Chicago to reaffirm the Catholic role in health care. But Sister Carol Keehan, D.C., says we all should be involved.

Q U I C K S C A N

Current Pressing Issues
The Catholic Role in Health Care
Fulfilling a Need
A Host of Issues
Facing the Challenges of New Technology
We're All in This Together
Looking Ahead
The Faces Behind the Issues


Cherie Sammis, clinical administrator of Perry Family Health Center in Washington, D.C., is seen with a young patient of the clinic. Sammis calls her work at the Center her "passion."
PHOTO FROM CHA

FORTY-SIX MILLION Americans are without health insurance. Eighty percent of those uninsured are working one or two jobs and still can’t get health insurance. A study four years ago by the Institute of Medicine showed there are 18,000 unnecessary deaths every year because people lack insurance. That’s 49 people a day. And the majority of those uninsured are natural-born American citizens—not immigrants, as many believe. And, unfortunately, the list goes on.

Those facts and the people they represent are the everyday reality of Sister Carol Keehan, D.C., president and chief executive officer of the Catholic Health Association. They are why she has devoted 35 years of her life to health-care issues. They are why she is “platinum on three airlines and silver on two others” as she travels across the country, speaking to anyone who will listen about the need for better health care for all Americans. And they are why you will find her testifying before Congress on this issue.

They are also why Sister Carol spoke with St. Anthony Messenger by phone late last year from her office in Washington, D.C., about the current state of health care, why it needs to change and why Catholics are playing such a big role.

She says statistics like those above—and the people behind them—“drive so much of what we work on every day, trying to keep some kind of safety net intact for these people who are under such stress until we, as a nation, can deal with this problem appropriately.”

In a speech last year at the Catholic Media Convocation in Nashville, Sister Carol lamented the fact that those 49 people who die unnecessarily every day do not die from incurable illnesses or mistakes. Instead, she said, “They die because when they have a little blood in the urine they can’t get checked by a urologist or an internist. They push fluids or do some homegrown treatment. These are families who have to wait till they have tried over-the-counter remedies and their children become much sicker before they risk going to the emergency department.”

Current Pressing Issues

Sister Carol says there are also quite a few other issues that she and the association are addressing, among them, the complexities of insurance and a decline in health-care personnel.

“These jobs are vocations. Giving people the conditions in which to do their jobs well is an imperative. And that often means enough money for just salaries and benefits,” she says.

An aging population, with people living longer, is also presenting a challenge for the health-care industry, according to Sister Carol.

"We’re going to have many more older people. We’re going to have many more technologies that will help them into the future. It is going to be important that, as we talk about the dignity of the elderly, we back that up with services that are worthy of their dignity.”

Finally, she says, as Congress examines the tax-exempt status of not-for-profit hospitals, those hospitals “will have to explain our mission and the understanding of our mission to the public.”

It’s no wonder, then, why she laughs when asked if she ever has anything resembling a typical day.

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The Catholic Role in Health Care

For Sister Carol, the role of Catholics in the health-care industry is an absolute necessity. In fact, she says, it’s a response to the gospel.

“The Church has a long history of being with people when they’re needed and some of those key times are around health-care issues,” she says.

“It’s one thing to say I believe in the dignity of life and I don’t think you should have an abortion. But if you don’t offer quality maternity care and quality pediatric care, if you don’t get out there and advocate for job training and Medicaid coverage for women, it’s just talk. And so for credibility the Church has to be out there.”

She continues, “You can’t just say, ‘I think we should not have euthanasia.’ We have to be out there leading in support programs of care for the dying and having them available for people who need them.

“So, quite frankly, it’s critical to the Church’s faithfulness to the gospel that we are in the works of mercy and in them in a competent and compassionate way.”

Fulfilling a Need

Sister Carol is the ninth president of the Catholic Health Association (CHA). She took on her current role in October 2005 after devoting more than 35 years to working in the health-care field. She joined the Daughters of Charity of St. Vincent de Paul after earning a nursing degree in 1964 from DePaul Hospital School of Nursing in Norfolk, Virginia. Over the years she has served on numerous hospital boards and held influential roles in the governance of a variety of health-care, insurance and education organizations, and been on a number of committees of the U.S. bishops.

Prior to her position with CHA, she was the board chair of Ascension Health’s Sacred Heart Health System in Pensacola, Florida, after spending 15 years as the president and CEO of Providence Hospital in Washington, D.C.

The Association began in 1915 in Milwaukee, Wisconsin, as the Catholic Hospital Association of the United States and Canada. It was formed as a way for Catholic health ministry leaders to respond to technological advances that were changing health-care delivery in the United States. They wanted to make sure that, in the face of those advances, the ministry was able to maintain its mission and identity.

In 1929, the organization moved to St. Louis, where it is still located. It opened an office in Washington, D.C., in 1976. It is run by both religious and lay men and women.

CHA’s members comprise the nation’s largest group of not-for-profit health-care sponsors, systems and facilities. The ministry exerts itself through advocacy and by establishing clinics and other resources for those living in poverty.

“If you look at the history of Catholic health care, we’ve come into communities for the most part because there’s been a need,” says Sister Carol. “We came because there was no one to care for people and the bishop asked an order of sisters to come in and start a hospital. And so we’ve always looked at what was the need and what appeared to be the best way to fill that need.”

And Catholic health care is certainly filling that need. According to CHA’s Web site (www.chausa.org), one in six patients in the United States is cared for in a Catholic hospital each year. There are 615 Catholic hospitals and 62 Catholic health-care systems in the United States. Catholic health-care organizations are present in each of the 50 states.

“It is always our goal to be a healing ministry in the name of Jesus, following gospel precepts,” says Sister Carol. “So it is really important that our health care always be ethical and always be respectful of the dignity of life, whether that’s in an unborn person or a severely demented elderly person or anywhere in between.”

A Host of Issues

Of course, the issue of Catholics and health care does not come without its challenges. One of those is mergers between Catholic and non-Catholic hospitals.

Sister Carol says there are many reasons for such mergers, such as finding a way not to duplicate services or specialties. Often two hospitals cannot sustain themselves as separate entities. But no matter the reason, she says, mergers are not taken lightly.

“There’s usually a lot of study and a lot of effort to make certain, first of all, in the Catholic hospitals’ situation, that the ethical and religious directives can be followed.

“And secondly, there’s a lot of effort to talk about the culture that they want to have and to try to bring the best of both cultures and show a cooperative spirit as opposed to, ‘It’s our hospital; we’re just going to have our own independence, no matter what.’

“There is a challenge to diluting your identity if these things are not done with great care,” she admits. “On the other hand, when they are done with great care, there is the potential to deepen and expand your identity or share it with more people. But it should always be done after great thought and prayer and a lot of study.”

Facing the Challenges of New Technology

And then there are the challenges new technology brings to the table. Sister Carol mentions issues such as appropriate care for the dying, including pain management and nutrition and hydration, and larger issues such as stem cells. She says that, while “we want to be part of advancing the quality of health care, of stamping out diseases and genetic conditions and being able to replace or repair damage that’s been done by accidents and things like that,” it must be done “in a manner that is compatible with the dignity of the children of God.”

The challenge, she says, is “explaining our position in a way that continues to reflect our care for the patient and our compassion, as well as our desire to be part of medical advances.”

It is, Sister Carol says, a balancing act.

“We always want to be welcoming of new technology, new inventions, new discoveries that will help us advance the care of the People of God. But on the other hand, we need to be certain that every technology and every discovery is compatible with the dignity of the People of God.

“And sometimes that takes thinking out loud, theological reflections, clinical reflections, close collaboration with the bishops of the United States and with the Church in Rome. Sometimes that’s not as straightforward as we would like, but it’s always the right thing to do.”

We're All in This Together

So how do Sister Carol and the CHA keep on top of all of these issues? “You’re making an assumption that we do manage to keep up with it, which is very generous of you,” she says graciously.

The answer, she believes, is collaboration. “It’s why we need to pool all our resources. It is a huge, overwhelming problem and it does take our best efforts every day, but it also takes the best efforts of other hospital associations, of the bishops, of the Congress—all are members. Other Catholic organizations have been very helpful.

“And so when we look at these problems and break them down, we tend to use a combination of members’ strengths for input. We’re going to have to do a lot of care and feeding of health care if we want to have the kind of system that Americans want.”

On a personal level, Sister Carol finds her job and the collaboration that goes with it very rewarding.

“I really get a chance to meet some of the finest people in Catholic health care across the nation. I get to get an up-close look at what they’re doing and the creativity they’re showing, at the challenges they have to wrestle with. I get to talk to a lot of people who truly care about what goes on in this nation. And that’s really wonderful.”

She considers it a privilege to be able to work with Congress, the White House, Catholic bishops in the United States and, with less frequency, the Vatican, as well as other idea-sharing forums.

“I’m quite frankly very, very fortunate to have this position and to advocate for the future of Catholic health care because, if you look at what Catholic health care has contributed to this nation, just looking at the United States, it’s absolutely a breathless contribution to the development of this nation. It would be terrible to lose that,” she says.

Looking Ahead

But Sister Carol knows there is still much work to be done. And she promises that she and the Catholic Health Association will keep doing their part.

“Advancing the agenda of health care—affordable, quality health care for all Americans—is critically important to me,” she says.

But CHA also cannot do it alone. Finding a solution is a job for all Americans, she says. “They need to be demanding of their politicians. They need to be constantly raising this issue that we need quality, affordable and accessible health care for all Americans and we need it soon.

“We are the only First World country, the only industrialized country that doesn’t cover all our citizens. I think we’re as smart as any other nation, as creative, and as compassionate, and I believe that we can and will find a solution to this that is worthy of the dignity of the American people.”

The Faces Behind the Issue

FOR EVERY STATISTIC about health care, there is a person behind it. Cherie Sammis knows that all too well. As the clinical administrator of Perry Family Health Center in Washington, D.C., Sammis sees the issue of health care up close and personal—every day. Perry Health Center is a part of Providence Hospital, a member of the Catholic Health Association.

Sammis tells the story of a gentleman in his mid-60s who came to the clinic because of high blood sugar. He lived and worked in D.C., parking cars downtown for about 10 years. Because he couldn’t read or write, his supervisor would cash his paycheck each week. And the gentleman just assumed that the $6.00 an hour he was earning was the going rate.

“How did we find all this out?” asks Sammis. “We found all this out because he walked in with high blood sugar.” She says the man eventually established a relationship with workers at the clinic and confided in them that he couldn’t read or write.

“We got him into a safer place to live, got an attorney and he was able to get his back wages, got him on Medicare and taught him how to use his insulin with pictures,” such as a sun for the morning dose and moon for evening.

There is also the story of the young pregnant woman who ended up at Perry after she had been mistakenly sent to an abortion clinic because of a language barrier. The woman was actually seeking prenatal care. It was not until she was in a room being prepared for the abortion that a worker who spoke Spanish realized the miscommunication. She sent the woman to Perry.

Sammis says she will never forget when this very pregnant young woman and her mother walked into the health center. Sammis says she bonded with the woman and happily reports that the woman gave birth to a healthy baby. She went into school, learned English, got her papers straight and became a U.S. citizen. She then began working for Sammis as a community health worker.

Or the pregnant woman with a heart condition who was told by another health-care facility that “if she ever got pregnant she should have an abortion right away.” The woman came to Perry Family Health Center and talked to Sammis, who says she worked with the woman to get her on Medicaid and connected her with a cardiologist through the archdiocesan health network program. The result was “a very healthy baby and a healthy mother,” says Sammis.

That level of care is part and parcel of a Catholic facility, believes Sammis. “The work that we do isn’t just giving the immunization. It isn’t just writing the prescription. It’s, ‘Can you get this filled?’ ‘Do you have access to transportation?’— that kind of holistic care. What a change something like that makes to people.”

And Sammis says those are just a few of the many stories she could tell. “I’m exceptionally passionate about the work that we do. I get very carried away sometimes because I don’t always understand why everybody else isn’t jumping up and down with the rest of us.”

She calls Sister Carol Keehan “an incredible mentor in allowing me to do all the work that we do for the poor. That kind of support is critical to be able to have a successful outcome.” She and Sister Carol met when they were at Providence Hospital in Washington, D.C., in the early ’90s.

A Grassroots Effort
Perry Health Center is part of the Perry School Community Services Center, which was founded following a grassroots push by the community beginning in 1991 to save the historic Perry School from demolition. Perry School was built after the Civil War as the first publicly-funded African-American high school in the country. The building, however, had been vacant since 1973. Over the course of 10 years, the community banded together and raised over $5.6 million to convert the building into the Perry Center.

Sister Carol, according to Sammis, played a big role. “She was the one who said, ‘We can do this.’”

The Perry Family Health Center, a service of Providence Hospital, was the first organization to enter the facility in October 1998. Other services offered at the community center are day care, an after-school center, job counseling and placement, a peace room for violence prevention, an art room, a dance institute and other programs.

Sammis calls the center “a comprehensive one-stop-shop model” with health care as the anchor.

When the health center started, she points out, it served the predominantly African-American population of the surrounding neighborhood. It has now grown to include a 15- to 20-percent Spanish-speaking population and three-to four-percent Asian population.

“People find that we use their languages and their cultures, and they just trickle in.” She points out that the only advertising the health center does is by word of mouth, but the numbers keep growing.

“I think if we were not Catholic health care, and didn’t have a preferential option for the poor, reaching out to those in need, it could have and would have turned into a very different health center.”

A Personal Passion
Sammis says she “has an enormous passion for serving the poor. I’ve been doing it now for 25 or 30 years. I will tell you it’s one of the most gratifying experiences since I’ve come to Providence, because we’re able to actually live out our values in the work we do every day.”

In the face of such a seemingly overwhelming issue, how does she keep from getting overwhelmed? “I’m an eternal optimist,” says Sammis. She also tries to establish a relationship with each person so it’s not just another patient coming in. “They are very real people with real names and real stories,” she says. “That’s what keeps me going.”

 

Susan Hines-Brigger is an assistant editor of this publication. With three young kids, she and her husband are very aware of the importance of health insurance.


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