Catholic Health Association of Texas

September - December 2008

Broussard Scholarship Winners Announced

The $1,000 Monsignor William Broussard Health Career Scholarship for 2008 has been awarded to Carina Pena, of the Diocese of El Paso.  Pena and other winners were honored at the Annual Meeting & Ethics Seminar held by the Catholic Health Association of Texas in August.  Other recipients, each awarded $500, include:

  • Stephanie Ramirez – Diocese of El Paso
  • Brandon Devers, Archdiocese of Galveston-Houston
  • Lilian Adaobi Obioha, Archdiocese of Galveston-Houston
  • Renata Maria Miller, Diocese of Fort Worth
  • Sonia Elizabeth Henriquez, Archdiocese of Galveston-Houston
  • Joanna Hargrove Thomas, Diocese of Lubbock

Monsignor Broussard served Catholics in Texas for five decades, both as a priest and as a leader in Catholic healthcare and services.  He died in a traffic accident in March, and this annual meeting was dedicated with a prayer service and a reading of the 23rd Psalm in his memory.  Reed Edmundson, chair of the CHA of Texas board of trustees, noted, “his gifts to us were many.”

 

CHA Has Redesigned its Website

The Catholic Health Association of Texas website, http://www.chatexas.org, was redesigned and the new site is now up on the web.  The new site features an Insuring Texas Children page with eligibility information and enrollment forms for the Children’s Medicaid and Children’s Health Insurance Program (CHIP) programs; an archive of our Mind, Body, and Spirit columns that are printed monthly in diocesan newspapers throughout the state; and a Resources page that includes an advocacy toolkit.  Please log on to the site and tell us what you think.

 

Healthcare Reform Requires Advocacy and Public Conscience

The healthcare system in the United States is “beyond the realm of political process” and needs a social movement, coupled with effective advocacy, to fix it, according to Jack Glaser, senior vice president for theology and ethics at St. Joseph Health System, and founder of the Center for Healthcare Reform.

The system has been “cobbled together and now causes deep suffering,” he said.  “But it’s vastly more than the problem of the uninsured.”

Glaser was a featured speaker at the annual meeting of the Catholic Health Association of Texas, held in Austin.

Glaser described the U.S. health system as being complex, lacking leadership, and outspending all other nations while ranking 37th in outcomes and 55th in fairness.

“We in Catholic health care have good reason to want to do something,” he declared.

Glaser called the system an example of “social sin,” which he described as – while not always being intentional – a system that does “systemic and structural harm to persons and society.” He told the audience that the nation has not reformed its ailing healthcare system “because we have failed to see social sin as a continuum, and its consequences.”

He related the issue of healthcare to the child labor era in the development of the U.S. economy. In the 1800s it was common for children as young as 5 and 6 to have to work from dawn to dusk in factories.  Families and society in general recognized that as the role of children. It was what Glazer described as chronic social in\justice, an accepted part of the culture with “no single villain, no single accountable reformer.”

Child labor reform required directed advocacy by reformers along with years of public conscience work that resulted in society’s “viewing childhood in a new way.”

It takes decades or longer for society to develop a new consciousness and overcome such chronic issues, he noted.  There must be the development of a “broad discontent with the status quo,” but then there is required a “comprehensive, shared vision – clear enough in specifics, and powerful enough in conviction to overcome the enormous social forces that anchor the status quo in place.”

Along with powerful advocates for change, the actual movement from chronic social injustice to reform requires the work of what Glaser called “public conscience.” That movement goes from concern and confusion to “clear, convinced, purposeful conscience on a given issue.”

In recent decades, healthcare reform has been focused on development of new programs, he said.  But Glaser advocates more fundamental change through a bottom-up approach that begins with substantial community engagement to determine healthcare priorities.  He called this the foundation of a pyramid model for reform.  Once a vision has been established, the next step is to create the infrastructure to support that vision – and the community’s priorities.  Programs, he said, belong at the top of the pyramid – and at the end of the creation of supportive infrastructure.  “Too much reform today starts at the top,” he said.

 

Advance Directives: More Than a Legislative Issue

“Dying is not about fighting over technology,” said Ron Hamel, Ph.D., senior director of ethics for the Catholic Health Association of the United States.  He was in Austin as a keynote speaker at the annual meeting and ethics seminar of the CHA of Texas.

As the Texas State Legislature prepares for another year of action, advance directives will again be a topic of contention, he noted.  Hamel summarized advance directives practices throughout the nation and said in Texas some of the key issues will include questions about providing nutrition and hydration as basic care, extending the time period for use of life sustaining equipment, clarifying the definition of “irreversible condition,” and improving communications with families and patients.

Hamel urged Catholic hospitals in Texas to develop their own procedures and deal with questions and communications issues whether or not the Legislature acts on the matter. Catholic hospitals are “obliged to do what offers reasonable hope of benefit without imposing excessive burdens,” he said. But he added, “That duty is limited because human life, while sacred, is not absolute.”

Catholics are concerned, he said, that legislative approaches can leave hospitals dealing with ambiguous terminology, dependence on value judgments and potential bias and discrimination.

Hamel said what is needed is an assessment of benefits and burdens for each patient – just how much technology should be used, and will that spark false hopes of survival, for example.  Communication is really the key, he observed.  Hospitals and professionals must take care to know that families are informed about and understand the patient situation, and be clear on the reasonability and goals of treatment.

Basic to Catholic care, he said, is “care for the whole person.  The focus is not on organs or organ systems, but on the good of the whole person – physical, psychological, social, spiritual.” He reminded the audience that Catholics “view death as a fact of life, as inevitable.” A focus on technology at the end of life can “leave little or no space to prepare…to do the work of dying well,” he said.  “Technology dominates when it should fade into the background.”

 

Barriers to End-of-Life Care

As medical technology develops, so do ethical and philosophical issues related to palliative care for patients who are near death.

Sometimes the belief that “We’ve got to keep the patient alive because the cure may be just around the corner” gets in the way of compassionate, end-of-life care, according to Ryan R. Nash, M.D., director of Birmingham’s Balm of Gilead Jefferson Clinic, said at the Catholic Health Association of Texas annual meeting and ethics seminar.  It can also cause ethical and moral issues for Catholic hospitals because their commitment to the teachings of the Catholic Church might be counter to legislative efforts to preserve life at all costs.

“Medical technology is not the source of eternal life,” Dr. Nash observed.  He said that despite media stories about searching for cures, “most promises will fall short.  Denying death is fruitless.”

The Christian approach to caring for very ill patients should be “cure when possible, but care always,” he said.  At that point, “medical technology can be used to relieve suffering.”

Families who ask hospitals to do “everything” to care for a dying patient must be told that there is a limit to what medical professionals and technology can do, Dr. Nash suggested. The application of technology may only serve to extend the suffering of the dying patient.

“Palliative care for most patients is simple,” he stated. “It’s just good medical care.”

“When we realize death is near, we need to communicate that to the patient and family members so they can talk, share, and pass on blessings,” Dr. Nash said. “We should not forget to give comfort to those who mourn.”

 

Community Benefits Can Help Drive Strategic Plan

Catholic hospitals should start thinking of community benefits requirements as strategic opportunities as they develop community health plans.  That was the advice of Michael Bilton, executive director and co-founder of the Association for Community Health Improvement.  Community benefit programs can link the needs of the community with the hospital, he explained.

Bilton spoke at the recent annual meeting and ethics seminar of the Catholic Health Association of Texas.

For many years federal law has required that nonprofit hospitals demonstrate what they do to serve their communities in exchange for their nonprofit, tax-free status. Such programs may take the form of educational classes, clinics and disease prevention efforts. Many hospitals have complied with minimal responses.  Bilton noted that Washington is increasing its focus on this issue.  This year a new tax form has been added to force nonprofits to spell out in greater detail what they are doing to entitle them to nonprofit status.  In the case of hospitals, the form is known as Schedule H, and must be filed along with the standard Form 990.  Bilton advocated that hospitals see this greater emphasis as a chance to look at the strategic value of community benefits efforts.

In part, the higher level of transparency is the result of the public not understanding that many hospitals are in fact nonprofit organizations, he explained. Greater numbers of Americans are losing faith in the American healthcare system, and see hospitals as business enterprises, rather than nonprofit institutions, Bilton said. In addition, community activists are seeing community benefits requirements as “a lever to drive change.” He noted that the new Schedule H would standardize reporting of community benefits across the nation and make assessment and evaluation more meaningful.

Bilton advised Catholic hospitals to make certain that their community benefit programs:

  1. Address an identified community need
  2. Support the hospital’s community-based mission
  3. Produce measurable health benefits
  4. Focus at least in part on uninsured and low-income people

He offered what he called five core principles for an ethical response to community benefits requirements:

  • Emphasize disproportionate unmet health needs
  • Emphasize primary prevention
  • Build a seamless continuum of care
  • Build community capacity
  • Emphasize collaborative decision-making

Bilton emphasized that hospitals should do more than meet minimum requirements, by tying community benefits programs to community needs and hospital strategies and policies.  He urged high standards of quality in planning, implementing and evaluating community benefits programs, and then sustaining them.  Some hospitals will be developing community benefits departments run by professionals in the field.

 

Roundtable Sessions

In addition to the keynote speakers, attendees at the annual meeting and ethics seminar of the Catholic Health Association of Texas enjoyed two breakout sessions.

Gentry Woodard, chair of the association’s Advocacy Committee, and Hank Fanberg, of CHRISTUS Health Advocacy, led a roundtable discussion about “Advocacy: 2009 – “Year of Transformation for Texas Health Care.”

Cookie Gender, Chief Nursing Officer for CHRISTUS St. Michael Rehabilitation Hospital, led a roundtable on “A Vision for Health Care in the Future – A Look Around the World at How Health Care is Delivered.”

 

ADVOCACY UPDATE

Association Advocacy Committee member Gentry Woodard was invited by Bishop Pfeifer and Father Voity of San Angelo to be the keynote speaker at the White Mass on October 16th in San Angelo.  The White Mass is celebrated in recognition of health care workers and all of those in the health care industry. St. Luke is the patron saint of physicians.  As chair of the Catholic Health Association of Texas Advocacy Committee, Gentry has made several keynote presentations to statewide Catholic organizations and works with key elected officials on behalf of the Catholic Health Association of Texas.

The Catholic Health Association of Texas had a booth at the Diocese of Austin’s 2008 Ministry Conference, The Symphony of the Faith, on October 17-18, 2008.

CATHOLIC HEALTH ASSOCIATION LEGISLATIVE UPDATE

Texas is expected to have an $11.8 billion surplus going into the 2009 legislative session. Much of that is dedicated to the property tax relief fund and the rainy day fund. Historically, the state of Texas has worked to keep the price of government low. In that vein, Texas Comptroller Susan Combs is expected to tell all state agencies to cut their budgets by at least 5% for the upcoming fiscal cycle.

The Health and Human Services Commission (HHSC) submitted its biennial 2010-11 Legislative Appropriations Request (LAR) in August of 2008. It will conduct joint hearings with the Legislative Budget Board (LBB) through the month of September 2008. The HHSC consolidated budget recommendations are due in October 2008. The LBB will make its recommendations in January when the 81st Legislative session gets under way (convenes January 13).

81st Legislative Session

The Catholic Health Association of Texas will pay particular attention to:

  • The House Committees on Public Health, Insurance, and Appropriations.
  • The Senate Committees on Health & Human Services and Finance.
  • The Joint Committee on Medicaid Reform Legislative Oversight Committee, and Oversight of the Health & Human Services Eligibility System.

For more information please visit our web site at http://www.chatexas.org or http://www.house.state.tx.us or http://www.senate.state.tx.us.

Important Legislative Priorities

Making Health Care Available & Affordable

The Catholic Health Association will be working on an agenda designed to make access to health care available to everyone. Our goal is to make certain consumers are well informed and able to purchase insurance products that provide the protections they need at a price they can afford. We will be joined in these efforts by several groups, including Texas Impact (http://www.texasimpact.org), Center for Public Policy Priorities (http://www.cppp.org), American Association of Retired Persons (http://www.aarp.org) and Texas Watch (http://www.texaswatch.org) and the Texas Public Health Coalition (http://www.texmed.org).

More and more Texans are unable to afford the insurance coverage they need, but Texas has in place the structures necessary to strive for a healthy balance between consumers and industry. We work with the Department of Insurance (TDI), which oversees the market and the Office of Public Insurance Counsel (OPIC), which is designed to act as independent advocate for policyholders.

The TDI is under review by the Sunset Commission (http://www.sunset.state.tx.us), which determines how a department or agency in the state of Texas might be improved. As the review proceeds, our Legislature will have an opportunity to strengthen TDI and OPIC to help re-establish the balance we need in our insurance marketplace.

Other Legislative Priorities

Medicaid

CHA is committed to:

  • Fully funding Medicaid and advocating for 100% enrollment in the Children’s Health Insurance (CHIP) Program.
  • Supporting maximized federal Medicaid drawdown dollars to expand coverage to more individuals and increase spending per enrollee.
  • Favoring restoration of funding for Medicaid programs, and opposing any reductions in reimbursements or changes in eligibility that reduce caseloads.

Texas Advance Directives Act

  • Include nutrition and hydration as ordinary care;
  • Revise the definition of “irreversible condition” to clarify and tighten language to address the concerns of the disability community;
  • Revise the process to provide better and more compassionate communication to the family; and
  • Extend the period of time of transfer to a minimum of 21 days.

We believe that the patient and his or her family should be the first concern of any legislation impacting end-of-life care. Further, we believe that natural death with dignity is the primary goal of every individual and institution engaged in this process, and that issues related to the death experience are profoundly important not only to patients, families and communities, but also to the healthcare professionals who are involved, and who want to provide the most compassionate care possible.

Adult Stem Cell Research

  • Encouraging the state to adopt a policy for adult stem cell research that draws down federal funds, attracts private venture capital, and establishes Texas as a national leader in adult stem cell research.
  • Supporting a state policy that would substantially increase funds for adult stem cell research and clinical applications, including adult stem cells found in cord blood.

Charity Care/Uncompensated Care

  • Encouraging standardization of reporting requirements.

Freedom to Serve

  • Advocating adequate legal protections for faith based providers that would not require them to provide services inconsistent with their beliefs.

 

Other News

The Texas Medicaid Waiver was submitted to the Centers for Medicare and Medicaid Services (CMS) on April 16, 2008, with an anticipated September 1, 2008, implementation date.  CMS responded to the THHSC with numerous concerns and issues.  Many of the issues are the same ones that were identified in the public hearing arena.  Democratic members of Congress also submitted their own letter expressing concerns they have heard from their provider constituents.  Negotiations are taking place regarding the waiver, focused on what proposed sections are potentially worthy of approval.  CHA of Texas will continue to monitor the progress of the waiver review and the negotiations between the state and federal agencies.

 

Upcoming Committee Hearing/Meeting Alerts:

ALL HOUSE AND SENATE MEETINGS ARE OPEN TO THE PUBLIC

HHSC/LBB LAR Meeting: September 11, 2008, Reagan Building Room 140, Austin, Texas
Agenda: Discuss HHSC LAR request

Senate Committee on Finance and Health and Human Services: September 16, 2008, Capitol Building Complex, E1.036, Austin Texas
Agenda: The Senate Finance Committee will hold a joint hearing with the Senate Health and Human Services Committee to hear invited and public testimony regarding the Joint Committee Charge to review Medicaid provider reimbursement rate methodologies.  The committees will also hear invited and public testimony about the creation of the Texas Cancer Research and Prevention Institute.

House Committee on Insurance: September 19, 2008, Capitol Building Complex, E1.036, Austin Texas
Agenda: Study the practice of balanced billing by medical providers and determine which portions of the cost of out-of-network patient’s insurers and providers should ultimately be responsible for paying.

Texas Public Health Coalition: September 25, 2008, Texas Medical Association May Owen Board Room, Austin, Texas, 11 a.m. to 2 p.m. All subcommittees will present their recommendations for the 81st legislative session.

Texas Sunset Advisory Commission: September 23-24, Capitol Building Complex, E1.030, Austin, Texas, 9 a.m. The Texas Department of Insurance and Office of Public Insurance Counsel will hear testimony regarding Sunset Advisory Commission’s recommendations.

Senate Committee on Health and Human Services: October 13, 2008, Capitol Building Complex, Senate Chamber, Austin, Texas
Agenda: The committee will hear invited and public testimony on Charge #3 related to studying the effectiveness of the Resiliency and Disease Management (RDM) program in the mental health service delivery system, implementation of changes to the crisis care program, and recommendations for appropriate use of the mental health transformation grant; and Charge #11 related to monitoring the collection and availability of cord blood stem cells for treatment and research and reviewing the current state of basic and clinical research using these and other types of adult stem cells.

 

MEMBER UPDATE

St. Joseph Health System Welcomes Paula Zalucki

imageIn a press released issued on October 7, 2008, St. Joseph Health System President and CEO Jack Buckley announced that Paula Zalucki has joined St. Joseph as the Senior Vice President of Business Development and Chief Strategy Officer.  In that position, Zalucki will oversee and coordinate the strategic planning process and serve as the principal advisor to the leadership team on business opportunities, business growth and development, communications, marketing and advocacy.

Zalucki is a healthcare strategist with over 20 years experience and is the founding principal for Salus Strategy Group, LLC, a consulting firm specializing in healthcare strategic planning, business development and marketing strategy.  Paula has served in leadership positions in hospital marketing and strategic planning at facilities in Georgia and Texas.  She has worked in a variety of health care settings, including investorowned, community-based, faith-sponsored, academic and public hospitals/health systems.  Paula’s experience also includes work with Santa Rosa Health Care (now CHRISTUS Santa Rosa) in San Antonio, VHA Inc. and the Editorial Board where she led the research efforts for an annual publication of healthcare industry tends.

Paula will have responsibility for system-wide strategic planning and business development, as well as have oversight for the communications and marketing office, which includes advocacy and grants.

BE SURE TO SEND YOUR NEWS ITEMS TO US SO THAT WE CAN INCLUDE THEM!

 

NEWS TO USE

SETON hosting Fall Sports Clinic: Next-Day Care Available for Friday Game Athletes

Each Saturday through November 8th Seton Medical Center Williamson and Dell Children’s Medical Center of Central Texas will host fall sports medicine clinics to support injured student athletes.  Both clinics will offer on-site imaging, evaluation and treatment provided by board-certified orthopedic surgeons.  Note: Patients with fractures and potential concussions should proceed directly to the emergency department.

The clinics – aimed to help those with injuries not severe enough to warrant a visit to the emergency room but still need to be examined – are available for athletes in grades 7-12.  No appointments are needed.

Hours:

Seton Medical Center
201 Seton Parkway
(corner of University Blvd. and FM 1460)
Round Rock, TX 78665
(512) 388-BONE (2663)

Saturdays
8 – 11 a.m.
Sep. 20, Sep. 27, Oct. 4, Oct. 11, Oct. 18, Oct. 25, Nov. 1, Nov. 8

Dell Children’s Medical Center
Marine Paul Specialty Care Center
4900 Mueller Blvd.
Austin, TX 78723
(512) 324-0137

Saturdays
8 – 9:30 a.m.
(Patients will start to be seen at 9 a.m.; no patients will be registered after 9:30 a.m.)
Sep. 20, Sep. 27, Oct. 4, Oct. 11, Oct. 18, Oct. 25, Nov. 1, Nov. 8

End-of-Life Conference

Friday, October 31 and Saturday, November 1
Hosted by: The San Antonio Archdiocese and Archbishop Jose H. Gomez, S.T.D.

Place: University of the Incarnate Word, San Antonio

Official Conference Sponsors:

  • The Archdiocese of San Antonio
  • University of the Incarnate Word
  • CHRISTUS Santa Rosa Health Care
  • The Texas Catholic Conference

Presenters include:

  • Dr. John Haas, Ph.D. S.T.L.-President, The National Catholic Bioethics Center
  • Rev. Tadeusz Pacholczyk Ph.D.-Director of Education, Neuroscientist and Staff Ethicist, The National Catholic Bioethics Center
  • Christina McClean, R.N., M.S.N., C.H.P.N.-Director, CHRISTUS VNA Hospice and Palliative Care
  • Andrew Rivas, Executive Director and Jennifer Carr-Allmon, Associate Director, Texas Catholic Conference
  • Douglas Deffenbaugh, Partner and Lisette Lange, Partner in the Law Firm of Deffenbaugh & Lange, P.L.L.C.
  • Deacon Pat Rodgers, Master of Ceremonies Director of Communications, Archdiocese of San Antonio

Contact Hours Are Available:

Nurses:
CHRISTUS Homecare is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Social Workers:
The Texas State Board of Social Worker Examiners has approved CHRISTUS VNA - Homecare as a continuing education sponsor for Social Workers.  Social Work CEU Sponsor Number: 3573.

Professional Counselors:
The Texas State Board of Examiners of Professional Counselors has approved CHRISTUS VNA - Homecare as a continuing education sponsor for Professional Counselors.  Professional Counselors Sponsor Number: 203

Registration:
Additional Cost for obtaining professional licensure continuing education credit is $50.00 for attending entire conference.  No partial credit will be awarded.  Payment by check or cash on first day of conference, please make checks payable to CHRISTUS Homecare.

Conference Registration Fee:
$155 For both days
$80 For one day
(Registration includes two luncheons and welcome cocktail reception)

To register, please contact Basilica Press at 888-570-5182 or go online to http://www.basilicapress.com