By JULIE MINDA
Catholic health systems have been evolving their sponsorship structures for decades now. They've been increasing lay involvement and working hard to equip those lay sponsors for their crucial role in strengthening and perpetuating the health care ministry. They've been adjusting sponsorship structures as systems merge and affiliate in a dizzying array of ways with Catholic and other-than-Catholic partners. There is no road map for this work; the sponsor boards and the systems they guide are charting and adjusting course as they go.
Fr. Charles E. Bouchard, OP, recently became CHA senior director of theology and sponsorship. (He was CHA senior director of theology and ethics.) In his new role, he has been connecting in person and by phone with sponsors throughout the ministry to identify their concerns and prioritize the work ahead in strengthening the ministerial juridic person sponsorship model. Public juridic persons are bodies set up under canon law to establish the responsibility of sponsors for a ministry of the Catholic Church. A ministerial juridic person is a type of public juridic person that is not a religious order. Health system sponsors work with the Vatican to structure their ministerial juridic persons to best meet the needs of the sponsored works and the church. Eight of the 10 largest Catholic health systems use the ministerial juridic person structure.
Fr. Bouchard spoke with Catholic Health World about sponsorship.
The sponsorship role has been evolving in U.S. Catholic health care. Where are we in that trajectory?
There have been waves of changes in sponsorship from the time that Catholic health care first was established in the U.S. It began with the simple sponsorship of one religious community for its sponsored work — usually hospitals or other health care facilities. Then, multiple communities of religious would collaborate to jointly sponsor their shared works. About 20 years ago, we began seeing ministerial juridic persons, or bodies established to allow for greater lay involvement in sponsorship. In the fourth wave now, we have ministerial juridic persons merging as the health systems they sponsor merge. So, the models have been continuing to evolve.
What's at stake here in getting this model right? What makes sponsorship so central to Catholic health care?
The biggest question is whether our new models of sponsorship will succeed in sustaining the Catholic identity of the ministry organizations in the long term. Will we have Catholic health care or not? These ministerial juridic persons are the organizations that would make it happen.
Can these sponsoring bodies inspire others like the sisters before them did? Will their ministerial work become nominal or not? Will these models work?
What's the extent of lay involvement in health ministry sponsorship?
Nearly 75 percent of Catholic health ministry organizations in the U.S. have adopted the ministerial juridic person model. While almost all of these bodies still have involvement by women and men religious, the organizations have laid it out so that eventually they can go to full lay sponsorship if necessitated by the decline in the numbers of vowed religious.
There is some degree of concern at the Vatican about whether the laity is ready to have this level of involvement in sponsorship. We are all kind of figuring this ministerial juridic person model out as we go.
What has been the ministry's experience with the ministerial juridic person model?
It's been a slow evolution because it's been an inductive process. There was no blueprint for the model because this had never been done before in health care. We've been developing the theology and learning as we go. It's been a learning process because the laity has a different relationship to sponsorship than vowed religious, since men and women religious by virtue of their vows are carrying out the work of the church, whereas laity is not commissioned in the exact same way.
Also, there's an ecclesiological question about this type of sponsorship involving heavy lay participation: How is health care of this kind a ministry of the church? This was implicit before, when the sisters were the sponsors.
While ministry leaders understand that by virtue of their baptism, the laity is carrying out the ministry of the church, in the past it was not at all common for laypeople to formally sponsor a ministry of the church, such as a Catholic health facility. So we are still unpacking the theological and practical aspects of the laity serving in these roles.
What are the shared priorities articulated by ministry sponsors you've spoken with?
There are several major concerns on the minds of sponsors, from what I'm hearing. They are asking: What is the difference between the governance and sponsorship roles? What do sponsors need for formation and how should formation be provided? And, they are asking theological questions related to what lay sponsorship means. For instance, they're asking what lay involvement in ministry should look like and how laypeople will be able to replicate the sponsorship function held by vowed religious until recently.
Further, systems are asking how they should identify potential sponsor competencies. CHA has a sponsorship competencies document to offer as a resource.
Should there be a bright line between sponsorship and governance functions at Catholic health systems? How do the responsibilities differ?
Sponsors have a limited role with specific reserved powers focused on maintaining Catholic identity, ensuring accountability to the church and ensuring adequate formation for everyone at the sponsored organization. Governing boards are responsible for strategic planning, financial performance and organizational effectiveness.
The overlap between the sponsor and governing boards can come when high-level decisions, such as those around mergers or c-suite hiring, invite questions concerning Catholic identity.
When it comes to the interaction between sponsor bodies and governing boards of ministry systems, we don't yet know what level and type of interaction is most effective. At some systems, the systems and their sponsor bodies have regular interaction and at some they don't. Some have joint sessions of the governing board and the sponsors, and some don't. Some systems use mirror boards, in which the same people hold both the sponsor and the governance role. We don't yet know what's best.
What are some best practices in system-level formation of sponsors?
The best programs we've seen in the ministry are those that involve creating programming specifically for sponsors — programming that includes spiritual formation, reflection and prayer, and programming that emphasizes the spiritual role of sponsors. We're discovering little by little how to do this, like when we first got laity involved in ministry in general in the church.
CHA can provide the foundation when it comes to educating and forming sponsors. For example, CHA hosts a sponsorship institute for education, it offers formation programs through a ministerial collaborative and convenes an informal discussion group of members of ministerial juridic persons, including around the time of the Catholic Health Assembly in June.
But the systems need to develop their own ongoing formation programs as well. The lay sponsors need to discover their own vocation as sponsors. In some ways, in the recruiting, we almost need vocation directors, like the congregations have. The laity needs to discover its vocation because this is an important calling in the church — these sponsors fill an important role. I've seen very edifying examples of laypeople serving in the sponsor role, who truly see their role as a calling. And that is very encouraging to me.
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