The major collaborative partners in the St. Petersburg/Tampa Bay area are
Catholic Charities, BayCare Health System, and the Diocese of St. Petersburg.
BayCare Health System is composed of two Catholic hospitals, St. Joseph's and
St. Anthony's. The Catholic Charities agency has regional offices throughout
the metropolitan Tampa area. Also involved in collaborative efforts in the community
are the St. Vincent DePaul Society, parish volunteers, Mercy Housing, and the
local public schools.
The St. Petersburg/Tampa Bay region served by the Catholic Charities agency
and Catholic health care is a study in contrasts. The region has a population
of approximately 1.5 million people and includes the counties of Citrus, Hernando,
Hillsborough, Pasco, and Pinellas. The area is racially, politically, and economically
diverse. For example, the city of St. Petersburg, located in Pinellas County,
is predominantly composed of elderly, white, and politically conservative residents.
Hillsborough County includes both the city of Tampa and a large area devoted
to agriculture. The rural section of the county includes a significant number
of Spanish-speaking migrant farm workers among its residents. A number of urban
problems, such as poverty, a high incidence of HIV/AIDS, the lack of affordable
housing, and limited access to preventative health care for low-income residents
are significant challenges for the city of Tampa.
In 1997, in response to pressure from for-profit managed care organizations,
St. Joseph's Women's and Children's Hospitals, St. Anthony's Hospital, and Morton
Plant Mease Hospital merged to form the nonprofit BayCare Health System. With
the merger, each entity maintained an independent board of directors that reviewed
its individual mission statements in light of its new role as a member of the
BayCare System. Around the same time, the Catholic Charities agency appointed
a new executive director who sought to reinvigorate the agency and embraced
collaboration as one of the key tools in achieving this goal.
During this period, Bishop John C. Favalora, bishop of the Diocese of St.
Petersburg, brought the Catholic Charities agency, hospitals, and the larger
Catholic community together to discuss the health and social service needs of
the area's most vulnerable residents. He inspired a spirit of collaboration
in the Catholic community with his motto: "You can't make community without
humility." His skillful work with parish priests, the Franciscan Sisters of
Allegany (St. Joseph's and St. Anthony's sponsors), the lay leadership of Catholic
Charities, and parishioner retirees fostered a spirit of commitment to collaboration
in both Pinellas and Hillsborough counties as well as the cities of Tampa and
St. Petersburg.
Collaboration
Although the bishop's leadership set the tone for collaboration, two other
factors contributed to the readiness of the partners to work collaboratively
on behalf of the community. First, it was recognized that the health and social
service needs of the poor in the area were too complex and costly to be addressed
by any one organization. Second, as a result of the Catholic organizational
focus on mission and community needs, direct services staff felt empowered to
work collaboratively in whatever ways possible to support the Catholic mission
and be responsive to community needs.
The phrase "trust-based partnerships," used by one of the hospital staff,
illustrates how the various Catholic stakeholders approach collaboration. Other
factors that promote working together include mutual respect for the contributions
of each individuaý or organization, a philosophy of open communication, and
assurance of follow-through on promises. This collegiality developed over a
long period of time and was nurtured by experiences with small but successful
collaborative projects. Relationships were established and often flourished
as a result of the mutual board and committee participation of partners. The
director of Catholic Charities invested a tremendous amount of energy in encouraging
collaboration, which paid off by creating a dynamic, growing agency that was
able to use the resources generated by its growth to develop more collaborative
efforts. Finally, BayCare Health System's commitment to the continuation of
its charitable endeavors was an essential contribution to the collaboration
efforts.
Although each of the collaboration projects was created and implemented in
its own unique way in accordance with the community need identified and the
resources available, commonalities do exist regarding the project development
process. First, a community need is identified either through a formal needs
assessment process or through the presence of indicators that reveal deficiencies,
gaps, or problems in the health and social services system. Next, a small number
of individuals come together to discuss and research the problem, explore potential
resources, and develop strategies to address the need. Finally, a committed,
broad-based group—a task force, committee, or coalition—emerges to assume leadership
of the new collaboration. Once launched, each collaborative establishes governance,
management, and funding mechanisms. In some instances, a 501(c)3 corporation
is formed to administer and execute the project.
The usefulness of this process is illustrated by efforts to meet the health
needs of undocumented migrant farm workers. Undocumented workers in need of
primary and emergency medical care had relied on local clinics and hospital
emergency rooms to obtain health services. Lack of access to adequate preventive
health care and nonemergency care was costly to the health care system and the
community. A handful of Catholic physicians became aware of this situation through
a sermon by the bishop and came together to discuss how best to meet the health
needs of this transient population. They recruited colleagues from other parishes,
the Catholic Medical Association of Florida, and the Catholic hospitals to work
with them. A two-year deliberative process follýwed, whereby the volunteer doctors
researched various health clinic models and other strategies to address this
problem. Focus groups were conducted with the migrant workers and their families
to obtain their ideas on ways to improve access to timely and effective medical
care. Finally, a collective decision was made to obtain and support a mobile
health clinic. A task force was formed to develop the project, and each of the
partners contributed resources to staff and equip the clinic.
Results
A number of successful programs have evolved from this collaborative process.
Several of these are summarized as follows:
The San Jose Mission This is a 96-unit residential community (under
construction) that will provide comprehensive on-site services to poor farmworker
families in the Dover/Plant City area. Services provided at the mission will
include a migrant Head Start program administered by the Redlands Christian
Migrant Association, which was founded by Mennonites. Other services to be provided
include adult education programs; English as a Second Language classes; a food
pantry and clothing closet; a mobile medical unit; and job, financial, and family
counseling. The mission is a partnership involving 12 social service and religious
organizations, including Catholic Charities, BayCare Health System, the Catholic
Physicians' Association, the St. Vincent de Paul Society, and local parish volunteers.
Christopher Center The center is a three-story, 16-unit residence for
persons living with AIDS. The first floor of the building houses the St. Anthony's
Health Care Clinic, which provides health services to the residents of Pinellas
County. The clinic staff also provide medical care to center residents.
Parish Elder Program This Catholic Charities program provides consultation,
technical assistance, and training to parishes seeking to develop or refine
parish-based volunteer programs for the elderly. The program links parishes
to community organizations and health care pr…viders serving elders. Activities
include hosting conferences, conducting regional training, and organizing forums
on elder issues.
UD Section 202 Elder Housing Services This program integrates volunteer,
parish-based elder services (noted above) into eight parish-sponsored HUD 202
residences for low-income elderly. The Catholic Charities agency provides social
services on-site. Efforts are underway to integrate services from local Catholic
health care organizations into the program.
Catholic Charities' Refugee Training for Health Care Professionals This
program falls under one of six national pilot projects facilitated by the Catholic
Collaborative Refugee Network to demonstrate the benefits of collaboration in
meeting the health and employment needs of refugees.
Housing Assistance for Nursing Shortage This is an incentive program
designed to encourage nurses and medical technicians to establish or return
to careers in Catholic hospitals. Employer-leveraged down payment assistance
and low-interest loans are provided to nurses working in BayCare hospitals.
Lessons Learned
Seek Synergy Create synergy around the collaborative process. Representatives
of each of the partner organizations serve on the governance or advisory boards
of the other partner organizations. Ideas are generated at board meetings, and
the sharing of information and participation in discussions about these ideas
strengthens relationships and brings synergy to the process.
Learn from Mistakes Failure can be a useful learning experience. An
early effort to establish a full ambulatory care service on the Catholic Charities
campus brought the partners together in an intensive and collaborative strategic
planning process. Later, when financial considerations made the project impossible,
the shared disappointment solidified relationships and strengthened a common
commitment to future collaborative projects.
Be Open about Turf Issues Turf is always an issue when working with
others. However, if this fact is acknowledged and attended to early in the process,
problems can be effectively managed. The partners understood that mergers are
always difficult, even when everyone agrees that it is the right course of action.
The two hospitals merged under BayCare Health System had to find a way to maintain
their individual integrity while crafting a common vision and mission for the
new hospital system. Similar issues were experienced in the development of relationships
among BayCare, the Catholic Charities agency, and the diocese. The key to successful
management of the turf issues related to these changes was the willingness of
the leadership of each organization to speak openly and candidly about their
concerns.
The Future
In addition to the collaborative efforts described, community partners are
also engaged in strategic discussions around an array of other issues. These
include the establishment of a family resource center on the campus of San Jose
Mission, the development of additional low-income and HUD 202 assisted living
housing units, the promotion of access to dental care, the expansion of joint
advocacy efforts, and increased availability of HIV/AIDS services in Pasco and
North Pinellas counties.
All partners view collaboration as an ongoing process in which they are continually
learning. They think comprehensively regarding the health and social issues
of their community and are always on the lookout for funding opportunities to
foster collaborative efforts that will meet the community's current and emerging
needs. Because many collaborative initiatives spin off into separate 501(c)3
organizations, the partners do not become overwhelmed with the management of
multiple projects. Rather, they canÌfocus on acting as the incubator for new
ideas that will foster the Catholic mission in the St. Petersburg/Tampa area
and improve the health and well-being of the community as a whole.
Copyright © 2003 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.