faith&inspired.health:.reason,.risk.and.responsibility … · 2019. 1. 10. · by adverse...
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Faith-‐Inspired Health: Reason, Risk and Responsibility
Sept. 5-‐6, 2017 Blackburn Center Howard University Washington, DC
Tuesday September 5th 1-‐1:10 pm Welcome Jim Diegel (CEO Howard University Hospital)
• Formerly CEO of St. Charles Health System, Central Oregon • Howard University (HU) is one of only 2 federally chartered Universities in US: Howard
and Gallaudet • HU was chartered by an Act of Congress and signed into law on March 2, 1867 by
Abraham Lincoln’s Vice President and successor, President Andrew Johnson; celebrating its 150th year anniversary in 2017
• Howard University Hospital (HUH) was founded as Freedmen’s Hospital in 1862 and became the training facility of HU’s clinical professional programs upon HU’s founding.
• HUH boasts many firsts: First African Americans trained as physician. First African American woman and first Jewish physician trained at Howard.
• Also, has a School of Divinity and School of Law 1:10-‐1:25 pm Welcome: Jerry Winslow (Loma Linda Institute for Health Policy and Leadership; Stakeholder Health Advisory Council Chair)
• Healing caregivers is Jerry’s interest. • He was asked by his CEO to lead community benefit. • Focuses on 3 requirements from the Lord: ”Do justice, love kindness, and walk humbly
with your God” (Micah 6:8). • Stakeholder Health is a learning collaborative of over 50 health systems whose basic
commitment is to human decency, social justice. We represent systems who call for the inconvenient pleas for mercy. Mercy seasons justice.
1:25-‐1:30 pm Introduction to Liberating Structures: Tom Peterson (Thunderhead Works, Stakeholder Health)
• The Surprising Power of Liberating Structures, book by Lipmanowicz and McCandless. • liberatingstructures.com website explains how to use exercises/tools
1:30-‐2:00 pm Speed Networking: Emily Viverette (Wake Forest Baptist Medical Center)
What brought you here today? What do you wish to share? What do you wish to learn? 2-‐2:10 pm Greetings: Wayne Frederick (President, Howard University)
• Seventeenth President of Howard University and a cancer surgeon • His own health journey includes having Sickle Cell Disease • Masters Public Health program starting next fall • Largest class ever entered in 2017: 2200 students • Howard Dentistry produces 33% of all new dentists in USA. • Ezekiel 47, about healing and mercy; the river of life becomes more abundant the
further you get from the altar or the business side of health care. 2:10-‐2:45 pm Framing : Gary Gunderson (Wake Forest Baptist Medical Center and Stakeholder Health)
• Conference purpose is discernment to the pathway that leads to partnership between faith and health. Our group is learning in real time; we do not have a PowerPoint with the answers. “We make each other braver and smarter.”
• Review of key chapters of Stakeholder Health: Insights into New Systems of Health book with our faith community leaders.
• What is necessary from faith leaders for the appropriate management of the institutions of healing in our time? We cannot afford decorative faith if it is a distraction from the requirements of mercy inside our health systems. Do not give credit to the obligations of the past, but instead focus on what is necessary for mercy and justice in the future in our institutions.
• Our charge: Live into assumption we are all experts in a facet of the same discipline: faith-‐health. When someone says health, instead hear: “bio-‐psycho-‐social-‐spiritual” with religious implications extended over time.
• Our task is walking humbly with all of created life. Its wholeness is there for us to recognize.
• Four levels of collaborative work: Projects
Committees
Limited domain collaboration blends “boundaries.” It’s important to have a safe space and trust as you collaborate. Poesis: Convening when work is play, (Greek rhetoric). We come together driven because of difficult circumstances but find an upsurge of life here)
2:45-‐3:45 pm Stakeholder Health Key Chapters (see all powerpoints uploaded at www.stakeholderhealth.org\Howard meeting; TOM, help put the right link here, please) Community Navigation: Nancy Combs and Nada Dickinson (Henry Ford Health System)
• Navigation needed, but simple navigation not enough • Why should Community Health Workers (CHWs) receive standardized training? Because
you have more credibility, more weight in the clinical world. It is great to have our champions, but employers need standardization in order to understand who they are hiring and what they can do. Professionalism is key.
• CHWs go beyond the “compass” to work in relationship. • Role on team improves health, increases patient satisfaction • Quadruple Aim: equity, along with cost, quality care, improved patient experience • Connectedness in community is key • Payment model reform is needed so that CHWs can be reimbursed as part of care
delivery processes, and not be grant-‐dependent. • Others types of navigators have roles in the emerging health system (health insurance,
faith community nurses, Health Leads, etc.) • Due to the incredible work of the CHWs as part of WIN Network in Detroit, since the
program began in 2012 there have been NO infant deaths among women participating in the program. This, in a city that has had some of the highest infant mortality in the U.S.! Also, 100% of participating women have initiated breast feeding.
Nada Dickinson
• Evolved into her work as a CHW because of her parents’ roles and values • Is involved in community, faith-‐based peace rallies, backpack programs, had a
background in resource centers in schools and learned to resource students • “You have to hold the hand of person to help them make their journey.” • Make sure you have the right resources. You need an up-‐to-‐date data base of
community resources which Health Leads provides. • Our work is relational, not transactional. • We partner widely, with churches etc. Cannot grow without partners. • Why is sustainability important? It keeps us from going from grant to grant and allows
us to develop better metrics to measure the success and ROI of CHWs. • Social determinants are also determinants of life success.
Community Health Mapping: Teresa Cutts (Wake Forest School of Medicine)
• Conducted 18 mapping workshops in Memphis using Community Health Asset Mapping
Partnerships (CHAMP), Access to Care Model which originally came from South Africa • Conducted 24 in North Carolina, including specialty mapping workshops in behavioral
health, food pathways, and cycles of incarceration • Hot spotting, with participatory overlay of human relationships in areas where data
exists and humans live, work, worship, play, etc. • Incorporate mapping findings into your community health needs assessment (CHNA)
processes, with a focus on assets not deficits or gaps • Avoid “checking the box” on CHNAs and mapping; focus instead on truly implementing
community voices into a health systems’ strategic plan • Be careful not to “use” community; needs to be stressed. • Instead we seek partnerships. • Can address historical trauma; helps to “name” it and begin to address it. (Eugenics in
North Carolina, for example) • Basis for participatory research vs. extractive “studying” of a community
• Share resources, consequences and continue in relationship. • Case study, Hispanic mapping in Forsyth County: Seekers reported one safety clinic
assessed costs of visits based on poverty scales, not accounting for additional persons cared for at home in another country and reported that having no photo ID limited access to emergency services and pharmacy pick up. Noted lack of respect by providers, changing attitudes toward prenatal care of Latinas. Big win: FaithAction ID, was led through partnership with local Hispanic league, January 2014. Issue is not documentation, but protecting health care of citizens
• What you can do as a faith community leader with mapping? Find a need Publish and share reports Follow through with named needs of the seekers Keep building on momentum Help like-‐minded stakeholders
Trauma, Resilience and Mental Health: Kirsten Peachey (Advocate Health Care)
• This is deeply spiritual work: suffering versus overcoming • Defined trauma at both individual and community levels (e.g., historical trauma, racism,
genocide, etc.) • Trauma: organic spectrum, Adverse Childhood Experiences (ACES) • Review of classic ACEs study (1997) • Women are more likely to have an ACE score >5 • If one ACE present, an 87% chance at least one other ACE is present and a 50% chance
of 3 others. • 6 or more may result in a 20 year decrease in life expectancy. • Philadelphia study, asked about community violence, feeling unsafe, foster care, more
diverse sample racially with more poverty. 83% of people reported one of these experiences, clustered in areas of higher poverty and more economic stress in the community.
• Stress pathway from brain to body. Neuroscience confirms: experiences we have impact critical pathways in our brain.
• ACEs are interrelated, and have a cumulative stressor effect and cross generations. • ACEs are associated with higher rates of chronic disease, some cancers injuries, liver
disease, $2.6 trillion associated with trauma in USA. • Interrelation between chronic disease and trauma. • Neuroplasticity, new circuitry in brain or life-‐long plasticity. Brain remains plastic in our
lives, we grow new neurons as adults.
• The 4th VITAL SIGN: Relationships, #1 protective factor is the safe and stable and nurturing relationships at all levels.
• Frederic Norstad, Lutheran General Hospital, 1966. Human ecology is a guiding principle; care of humans as whole persons so all the dimensions of who we are attended to.
• Be trauma informed. Realize, recognize, respond, resist re-‐traumatization and repent • Assess, ask and integrate care deliberately. • High users who get care they need reduce their need for resources in health care.
Kaiser Permanente study: All practitioners asked ACES questions, and then asked, “I see these experiences, how has it affected you in your life?” Results in reductions in office visits and ED visits.
• Socio-‐ecological model: how to get to the outer ring of care? Leading causes of life: Connection, Coherence, Hope, Agency, Blessing.
• Power of love, moral, and Spirit Power —concepts used in Chicago. How do we work in partnerships to bring people to the fullness of life that God intended? Questions and Answers. Detroit: Trained 18 CHWs (Nancy) and integrated training module into the grant they wrote. CHWs, more trained than were hired, other organizations could hire them. Where did you recruit CHW candidates from? Ads, word of mouth, used partnerships as well Nada: Her training was revelatory, regarding infant health where African-‐American college educated women would lose their children, too, due to the life-‐course of racism. Diagram of ACEs (childhood and community environments) Political power for policy change that gets at the improved community? Faith and health partnership has to come first, come to common language and common understanding of what the work is. In Chicago that is already happening. Church leaders are becoming familiar in recognizing trauma as well as community development and job training. The mapping relationships made it clear that policies needed to be changed. Portland, Oregon Superintendent of Schools learned about ACEs, focusing on teacher education to identify a troubled child. Launched the program, many of the teachers going through training had ACEs experiences themselves. Building resiliency is everyone’s job. 3:45-‐4:00 pm Break 3:45 pm Conversation Café What have we heard? And what does it have to do with the current realities, challenges and opportunities for the "communities of Spirit" at congregational and community levels? (The point is to shift the focus from the hospitals to the partnerships.) 5-‐6 pm Networking Reception Light appetizers
6-‐ 7 pm Community Worship Led by Howard University Chaplain Michael Dickerson
Praise Team: Jamel Evans and Faith Worship.
Voice of the Spirit: Fred Smith (Houston Theological Seminary) preaching.
Scriptures Jeremiah 8:22 and 1 Corinthians 13:4-7 Title: There is a Balm in Gilead: The Spiritual Determinants of Health Thesis Statement: At root the health of poor people is ultimately determined not by adverse social circumstances (determinants) but how those circumstances are experienced (Antonovsky, Unraveling the Mysteries of Health, 1987). 1. The Balm in Gilead are the spiritual resources to overcome the toxic emotions caused by adverse social conditions that are the result of our idolatry (profits, race, ideology etc..) which contributes to health disparities and inequities in healthcare. “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”– Dr.
Martin Luther King, Jr.
2. This Idolatry in revealed in our language. This especially true in healthcare as Stakeholder Health, chapter 11 illustrates. Faith communities who created healthcare as we know it today began with the language of ministry and service to the poor. But this gave way to the idols of war and adopted its language, then came the foreign images of Industry and the language of the market making health a commodity rather than a gift from God. The transformation of the healthcare system begins with linguistic issues. 3. The Balm in Gilead are the spiritual determinants of health. 1 Corinthians 13 offers the language of the Spirit Faith, Hope and Love. Of these, Love is the greatest. We witness what the spiritual forces of love can do in Hurricane Harvey in Houston. In this Adverse Community Experience of tragedy and heartbreak came a sign and a peek of what the Beloved Community of Health could look like in the language of love in action. People were kind, not envious or boastful, self-important, rude to one another etc. Nowhere were the toxic emotions expressed. The worse social condition existed but it was the healthiest anyone has ever seen Houston. Conclusion: The Beloved Community of Health is a social utopian vision that may never be fully realized. But we can begin speaking it into being, with the language of love and the spiritual resources of faith and hope. Wednesday, September 6th 8:00-‐8:30 am Networking Breakfast 8:30-‐8:45 am Meditation on Diversity Kevin Barnett (Public Health Institute)
Diversity, Inclusion, and Engagement: A Meditation As one who is inexperienced in the art of putting together a meditation, I would first request your patience with what may be an unusual, and perhaps even inappropriate approach to the practice.
• My exposure to religious traditions has been many faceted, and I embrace this diversity of experience as a gift that has enriched my life.
• Raised by a mother who devoted her life to working hard and raising three children without a supportive partner, which shaped my ethical standards.
• Adult journey of faith has been informed by exposure to the communitarianism and pacifism of Quakerism. study of Buddhism and the embrace of a stillness of spirit after my arrival on the left coast.
• Over the last two decades I’ve had the privilege of working relationships with the Sisters of the Catholic tradition.
• My passion is to work for social justice, and it has focused on the role of our charitable hospitals and health systems in the optimal expression of that commitment through engagement of our communities.
• Just as we encourage our hospitals and health systems to set aside their insular tendencies and fully engage their communities to build health and well-‐being, we call upon our religious leaders to look beyond their own flock to build common cause towards a greater good.
• As a people and a nation, recent events present us with an opportunity to advance a narrative that draws from both religious and social practitioners, one that sees our diversity as a core strength, as articulated by Bell Hooks:
“Dominator culture has tried to keep us all afraid, to make us choose safety instead of risk, sameness instead of diversity. Moving through that fear, finding out what connects us, reveling in our differences; this is the process that brings us closer, that gives us a world of shared values, of meaningful community.”
• To revel in our differences… what a wonderful heart-‐filling alternative to
prejudice, fear, and mistrust! It of course is not a new idea, nor is the recognition that we are bound together, as described in Corinthians 12:12-‐30:
“For just as the body is one and has many members, all the members of the body, though many, are one body, so it is with Christ. For in one Spirit we were all baptized into one body – Jews or Greeks, slaves or free—and all were made to drink of one Spirit. For the body does not consist of one member but of many. If the foot should say, “Because I am not a hand, I do not belong to the body,” that would not make it any less a part of the body. And if the ear should say, “Because I am not an eye, I do not belong to the body,” that would not make it any less a part of the body.”
• Working for justice, and seeking to bring people together is not a task for the weak of
heart, and requires a courage to pursue our convictions, as we are reminded by Maya Angelou:
“Courage is the most important of all virtues, because without courage, you can’t practice any other virtue.” • Choosing such a path requires not only courage, but a clarity of spirit, as articulated by
the Dalai Lama:
“Internal peace is an essential first step to achieving peace in the world. How do you cultivate it? It's very simple. In the first place by realizing clearly that all mankind is one, that human beings in every country are members of one and the same family.”
• As we consider our options, we find inspiration from Pope Francis to take action:
“Today’s world demands that you be a protagonist of history, because life is always beautiful when we choose to leave a mark. Some things seem distant until, in some way, we touch them. We don’t appreciate certain things because we only see them on the screen of a cell phone or computer. The times we live in do not call for couch potatoes, but for people with shoes, or better, boots laced.”
• Cesar Chavez, reminds us of the rich opportunities before us, and the rewards of
engagement:
“It is possible to become discouraged about the injustice we see everywhere. But God did not promise us that the world would be humane and just. He gives us the gift of life and allows us to choose the way we will use our limited time on earth. It is an awesome opportunity.”
“Let us begin…” A Meditation from the Baha’I Faith: Soma Stout (Institute for Healthcare Improvement’s 100 Million Healthier Lives)
• Baha’i, one human family, stronger in our diversity. Need one another to be whole
within ourselves. • Do we see our work in equity as us as privileged helping others or walking alongside
people who are noble and together we are stronger? • We are interconnected as a human family and we each hold a piece of puzzle for healing
and peace. • In Baha’i, it is our job to create the beloved community; therefore, we need
detachment, love, a belief in one another, etc. 8:45-‐9:15 pm How the Past Helps Us Imagine the Future: Jerry Winslow
• What in your faith sustains hope? • If the Good Samaritan went down every week, if he did nothing to stop injury, would
that still be neighborly love? In Stakeholder Health we want to be like the Good Samaritan. (But we need to move upstream and prevent the injury.)
• Mother Joseph, from the order of the Sisters of Providence, credited with raising money but also designing and helping build the first hospital in WA State, 1856.
• Test for a decent society, how does it treat its most vulnerable citizens? • Adventist Health-‐first purpose was to help people stay healthy so they wouldn’t need
acute care. Adventist built institutes, like sanitariums. Plan B is rescue medicine, health systems, what you build when you fail to keep people healthy.
• Loma Linda, pastor bought a failed hotel and converted to Loma Linda Health Institute. Rich people gained health with outside gardening.
• Adventist faith reacted to medicines to focus on more on health and wellness. The medical missionaries were created by W. Kellogg.
• Book: The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest. You can keep people healthier longer if you focus on preventative care.
• Dr. Ruth Jeneta Temple’s Clinic still exists in LA. She was the first African American woman to be licensed as a physician in California and provided care for the poor virtually all of her career.
• Model community of Bithlo, Florida. Created infrastructure to support health. • Loma Linda, Summer Gateway Program, health care worker development. • No one competes for caring for the poor and vulnerable. When we address their needs,
all the health systems benefit.
Gary Gunderson To tune in is to do the opposite of how we normally think about our institution. Hospitals are the place where good things are supposed to happen to you. Opposite thinking, how do institutions become generative? 9:15-‐10:15 am Generative Nodes of Spirit Fish Bowl Exercise in the Round-‐With Audience Question and Answer Share a specific experience in your efforts to build transformative partnerships between generative nodes of faith communities and health systems (including the good, the bad and the ugly).
Angel Coaston (Azusa Pacific University)
• Began with a community survey. Through Dora Barilla, learned about GIS system at Loma Linda, beginning of connecting health system with the community work. Identified churches to partner with in the identified hotspots.
• Bring faith and hope before medicine. Faced a church-‐state challenge with her funders, which was resolved by using common language. Just built a second mobile clinic.
• Approached pastor in Ontario CA to have a healing ministry. Have been with that church 13 years. 911 calls for that area have decreased because of that ministry.
• Her next goal: How to measure the impact we have had. Design an evaluation methodology and tool that will inspire health systems to pour their community benefit dollars into the most needed work.
Richard Joyner (Conetoe Baptist Church and Family Life Center)
• Found myself running away from religion and from childhood trauma. Grew up in community of sharecroppers; 13 children in my family. Experienced death and racism.
• Hated farming, and shared his journey to becoming a pastor. Developed Agri-‐business alongside the church. 100 children turned up to farm and he enlisted an Imam, a Muslim cleric, who became a friend affiliated with the church. Addressed racism, through food, addressed 95% of diseases. Brought hospitals and school systems to the community as a model for healing. Used grants for added value, not to sustain program.
• Goal: make health system part of the community. Now they have a mental health clinic and a PCP, who come in Sunday morning to worship and incorporate clinic visits with church services.
• Trauma of not being able to enjoy his childhood, including seventeen years of watching the humiliation of his own parents by racist neighbors. Now, he has his childhood years restored and sees farming to be the solution they were seeking all along. LGBTQ and Muslim community can come together to produce good outcomes; it happens in these fields. This is the hardest calling in my life to sit down with racist farmers and to see the injustices. (e.g., Section 8 Housing vs. free $1M tractor).
Leland Kerr (WFBMC and North Carolina Baptist State Convention)
• Former pastor and now Wake Forest Baptist Hospital liaison to the North Carolina Baptist State Convention and Cooperative Baptist Foundation
• North Carolina Baptist State Convention is WFBMC’s founding partner, funding the health system since 1920.
• Baptists still fund the community engagement work. Trying to get partner churches engaged in faith/health ministries to create a better health environment.
• Churches set aside one day a year, Mother’s Day, to raise dollars to support patients who cannot pay their bills. Raised $500,000 last year. Leaders need to be proactive in churches to help explain what is going on.
Clarifying Questions Posed to the Panel: Can we start with children everywhere to heal communities?
How do you keep volunteers motivated? In competitive world of healthcare, how do you convince administration that this isn’t just a marketing ploy? How do you get city planners and real estate investors to stay involved in the process and not just be an afterthought? What happened in relationship with the LGBTQ and Muslim communities (in Conetoe, NC)? How did community projects affect church membership? Did you do health programming for congregations and did that impact congregations? Please offer more details about church training and outreach. Internal change is necessary for external change. How have you paid attention to internal change and how do we do this in an institution? 10:15-‐10:30 Break 10:30-‐11:00 am Public Health and Healthcare Respondents Response to the prior fishbowl conversations by thought leaders from Stakeholder Health, including public health and healthcare perspectives.
Eileen Barsi (Consultant, Formerly of Dignity Health): Panel Facilitator\
Kevin Barnett (Public Health Institute) He feels a sense of deep gratitude to Angel, Richard and Leland in their comments. There is an opportunity to fund spiritual care within health. Faith institutions are struggling to put the pieces together too. Challenges between pastoral and doctrinal aspects of faith tradition. People come to places of worship to escape the racism and other oppressive challenges that trouble
them in daily life. He will try to identify testimonies for government and health system leaders to help them understand the spiritual challenges.
Dora Barilla (Providence Health and Services) When we look down from earth there are no lines, which supports the interconnectedness of all humanity. In order to heal and strengthen our communities we will need to come together from all sectors. There used to be only 5 CPT codes to charge for prevention and well-‐being, our health system was designed as a sick care system. As we transition to a more value based health system we are faced with many social issues and need to now begin the process of working together with non-‐traditional community partners, but in many ways are coming back to the roots of why our health systems began years ago. We are currently experiencing the messy space of connecting and in some cases re-‐connecting to address the totality of health. There are now imbalances of power and resources among community partners and we are all experiencing the complexity of this journey and the uncomfortable space of working together.
Leslie Mikkelsen (Prevention Institute) I was trained as a public health nutritionist nearly 30 years ago. My first work was with food banks. Listening to the panel reminded me how the anti-‐hunger movement was started by people of faith and how this movement went through a transformation to take a stronger stance around social justice and policy. In the beginning, food pantries gave out “emergency food,” yet people were coming every month, every week. Many faith leaders began asking the question why are there so many regulars? And the answer was because rents were rising, or there was an unexpected medical bill, and wages were too low to cover basic expenses. The ant-‐hunger movement started speaking up around these fundamental issues, just as healthcare is beginning to speak up around social determinants of health. The conversation today convinces me, FaithHealth has the strongest potential to be leaders in truth telling -‐-‐ as Richard noted, in being real in recognizing racism, classism and other biases, and taking a stand, first within their institutions and then in the broader community to change practices and eliminate structural discrimination.
Eileen: Any surprises about what the fishbowl people discussed? Dora: Heard nothing on EBIDA, margins, operating expenses and financial reporting. The core of addressing chronic disease is about addressing community conditions that allow us all to live healthy fulfilling lives. Dora’s office in Renton currently is next to Sister Susanne, the last employed Sister of Providence working in the system. Sister Susanne reminds her often that the early beginnings of Providence were to meet the needs of the community and that included addressing poverty, housing, and hunger. Understanding and being grounded in the “WHY” and mission of the organization is the key to living into the future. Leslie: Heard some rich opportunities for strengthening our communities. We now have a public health research base that lifts up the community conditions needed for health, and we have a tool like THRIVE where community members can think through which of the people, place and opportunity factors are most important for their collective health. And build a plan about how to get there. Health and faith professionals have incredible credibility and if they walk in humility there is incredible power here. How do we create the power to complement the day-‐to-‐day work of care with advocacy for policies that fostering healthy communities and social justice? Kevin: Excited to hear about the hope being expressed. It is a rich area to explore. Dignity Health has been in this work for over 30 years. Really important area to explore together to improve health and well-‐being in our community. Not tied to immediate ROI, but other metrics. There are examples like University of Vermont Medical Center, who reduced ED utilization through providing an option for overnight stays at a local hotel versus the emergency room. 11:00-‐12:15 Public Scale Partnerships (ppts available at xxxxxx)
Julie Trocchio (Catholic Health Association or CHA): “Improving the Lives of Older Adults through Faith Community Partnerships: Healing Body, Mind and Spirit”
• In 2012, she read AARP report, Home Alone, about seniors at home with a caregiver. In response, CHA developed a booklet, “Improving the lives of older adults through faith community engagement” Video on line: “Faith Community Partnerships” (Catholic Health Association; chausa.org/elder)
• Problem: 13 million Americans are needing personal assistance and that will double by 2050. 80% are living alone.
• Making visible the love of an invisible God. (Senior Care) • Faith Community Partnerships can be used upon dIscharge of a patient for follow up. • Part of our community health needs assessment and community benefit efforts can be
done through congregational work.
• Seniors still want reconnection and community with their faith congregation. • Opportunities exist to coordinate the care of congregants, (e.g., orthopedic with cardiac) • Parish nurses annual training, can incorporate volunteers and clergy. • Some examples: Philadelphia and Memphis train congregants to help others navigate
the health system. What health organizations can do to engage with churches:
• Reach out to clergy, hosting meetings of clergy • Hold wellness programs in church spaces • Offer hospitality, parking and resources to clergy and volunteers. • Train clergy and lay volunteers to visit patients. • Convene area faith community nurses and volunteers for education and
networking. • Help support faith nurse programs, or provide rotation for seminarians in hospitals. • Get started by identifying needs and finding champions and partners in
community. • To heal is to do God’s holy work.
Heidi Christensen (Center for Faith-‐based and Neighborhood Partnerships at the U.S. Department of Health and Human Services): “Hope and Healing: Faith and Community Organizations Respond to the Opioid Crisis” Three top clinical priorities from HHS Director: Childhood Obesity, Serious Mental Health, Opioid Addiction Crisis. First ask: what’s already happening in the community? When the Center starts to build a strategy, we want to understand what is already working and what would be helpful to strengthen existing efforts and catalyze new ones. We talk with pastors, faith-‐based organizations, community and youth serving organizations, providers that work with community, etc. Four general areas for focus of HHS on Opioid addiction:
• Reduce stigma associated with substance use disorders – educate to gain acceptance and support. The West Virginia Council of Churches say, “Recovery is not about bad people becoming good, but sick people becoming well.”
• Increase access to community-‐based support and recovery programs • Build community and capacity and expertise • Strengthen coalitions and align community health assets.
Tennessee has the Lifeline Peer Project and it provides technical assistance to all; they opened 300 new support groups over the last three years in the state. SBIRT is a public health approach building support groups in community Peer recovery models are blossoming through providing alternate ways to manage pain. Tennessee: Certified Peer Recovery Specialist Program is available. SAMSHA has said that the first step in the recovery process can be to stabilize the person with housing.
Foster care caseloads up with overdoses on the rise. New faith community models have come out of the reality that not all people can become foster care parents but communities can help support foster families and strengthen their ministry to support families and children. (See Vault Fostering Community) Communities need to focus on youth and building resiliency among young people. “Relationships” are prevention. Strengthening coalitions and aligning community assets: we need to view opioid abuse as an emergency and long-‐term health condition. There is a Practical Toolkit, Opioid Epidemic Practical Toolkit: Helping Faith and Community Leaders Bring Hope and Healing to Our Communities, which is live online now to help faith communities support the recovery of persons. September 27, live stream 1-‐2 pm EDT on Opioid addictions. This event will build support networks. Hosted conversations help bring community partners together. To be live streamed on Facebook. 12:15-‐1:00 pm Lunch Self-‐selected seating to facilitate networking by generative nodes, issue related (Elder Care, Opioid, Behavioral Health/Mental Health/ACEs/Resilience, Food, Explicit Faith Community Leadership to Create Health) or others 1:00-‐1:15 pm Brief Reports from Lunch Conversations
• Conduct cross-‐site research on elders who had 3 or more ACEs, but thrived • Have faith community gardens work explicitly with government, policy makers, food
retailers, to create a sustainable system of food security, workforce development and improved health outcomes.
1:15-‐1:30 pm Collective Transformation The work or poesis (shared creative work and play) of collective transformation 25-‐10 Crowdsourcing
What’s your most powerfully generative idea gleaned from the conversations thus far? Stakeholder Health subgroup could explore ways our institutions can intentionally and practically and bravely/courageously address racism as a social determinant of health The opportunity to leverage the complementary expertise and power of the faith community and health and health system leadership to advocate for policies at the local level jointly for investments to increase equity Relationships cause some of the pain and destruction, but also hold potential for healing and restoration, for wholeness Internal change before social change. A need to convene within the African-‐American community to discuss our own approach to health and healing for better health Put a child, a teenager an adult and a senior together to brainstorm the best approach to meet the needs of the community The use of youth in guidance of programmatic development, leading to both policy and fund development We need to develop new language that speaks to the spirit of individuals and new or renewed partnerships. We have to be more invitational to faith communities and consider them as a health system in itself. Farming to change the health of the community and bring all faiths and all cultures together Having mobile clinic come to congregations on a Sunday. Providing care to those who can’t make regular appointments. We have to confront the policy sources driving health inequity and that starts with inconvenient honesty. Adapting is not sufficient. FaithHealth fostering relationships for justice. The healing role of hope could forge the bonds between the faith and health providers Bring the right people to the table. If we want to implement mental health support, we have to bring faith leaders and community leaders to the table with us. Establishing powerful relationships that would indeed contribute to the necessity of hope and healing of all humans.
How to expand our current ministry within our church to include the surrounding community? Real change in minority communities will begin when there is a transfer of power and resources. Until then, we will continue to do programs and projects, with the same suffering populations. The importance of justice, proactive mercy vs. reactive charity and humility; Faith organizations and health organizations must trust each other in order to impact health and disparities in a big way. They need each other. Empower our faith leaders to be promoters of health (including their own health) Use ACEs as a way to educate the community collectively Need for faith communities' voices to be heard at the legislature and at other policy making venues Find an effective and acceptable way to bring state and church/faith together when emphasis for years has been separation of these entities. Healing is not just physical, but an emphasis on physical health can open doors to relational healing, also. The need to have the religious community work close with health care providers Being able to apply and measure impact of ACE studies and innovative approaches to address personal and community conditions for those with chronic health problems Small and relatively low-‐cost interventions can make a big difference in health status The power of love is transformational. Power the poesis movement. How can we help churches stop worrying so much about how to do church and start thinking about how to be church? It takes all of us-‐-‐everyone has a role to play in community transformation. Transformation flattens hierarchy! The FaithHealth movement is a perfect driver! Developing outcome measures and return on investment to convince health systems to move forward with faith health programs. We cannot NOT be connected: the idea that organizations and communities (even unlikely partners) have a lot to offer each other and have the most impact when working together, BUT trust first, relationship first, reconciliation first...
Hope in an increasingly chaotic world, is within our power to share Ensure that community life lines are well thought out as new communities are developed and designed. Make online health minister's certificate available to our staff How faith communities can help those affected by ACES, leading to healing/restoration of relationships Faith community nursing: its continued relevance and importance in healthcare today. Being in touch with one's own truths about racism. A learning network of faith communities' priorities that are in creating health to exchange ideas, build tools and strengthen capacity I can only be open to new ideas, perspectives and relationships if I am practicing prayer and reflect on my life, individually and communally. I need to be grounded spiritually to engage in this work. A number of ideas have resonated during the conference, but I have most enjoyed the discussions/examples of how people have brought "healthcare" to the churches/faith-‐based communities. Examples include the agricultural camp (Richard Joyner in Conetoe, NC) and the health mobile vans brought to churches (Angel Coaston in California) Adapt Howard Stakeholder Health meeting format to West Coast faith networks Community Faith Nurses, Community Garden, Resource Centers Be brave, not just smart...as you meet the physical needs of individuals first and then meet the soul needs. Healthcare doesn't begin at the hospital 1:30-‐2:00 pm The Horizon We Now Can See: Gary Gunderson. How we are becoming accountable for what is possible visible partly in the Stakeholder book? What is language, embodied actions and voice that helps the convergent generative nodes witness naturally about what is possible? That is, how do we move beyond mere hospital operations on the one side or religious projects on the other?
2:00-‐2:30 pm Next Steps/Personal Commitments 15% Solution What do you plan to do with already existing resources when you return home?
• Get more community partners around the table.
• Use ACEs as a way to educate a community collectively.
• Create forums or town halls that invite pastors, universities, and community organizations to join the two health systems in a conversation about the determinants of health.
• Work with more churches and youth and youth departments
• Engage city planners and real estate developers into the partnership to insure a healthy environment
• 2:30-‐2:45 pm Blessing of the Hands
Emily Viverette (WFBMC), Dennis Stamper (Carolinas Blue Ridge) and James Garrison (Mission Health) collectively led the blessing of the hands and work going forward. Below is the shared litany. Litany (Unison) Blessed be the works of these hands, O Holy One. Blessed be these hands that have touched life. Blessed be these hands that have crafted and created. Blessed be these hands that have held pain beyond words. Blessed be these hands that have planted new seeds. Blessed be these hands that have cultivated and harvested. Blessed be these hands that have embraced passion and courage. Blessed be these hands that have taken risks. Blessed be these hands that have reached out with compassion. Blessed be these hands that have received strangers. Blessed be the work of our hands, O Holy One. (Adapted from “In Praise of Hands” by Diann Neu, Waterwheel, Winter, 1989)
2:45-‐3:00 pm Benediction and Closing
Sheilah Easterling Smith (Methodist Le Bonheur Healthcare) “prayed us home.” Huge Thanks to proceedings/Report Scribe: Jackie Ostrum (Carol Milgard Breast Center, Tacoma, WA) with Teresa Cutts and Nancy Combs’ editing.