A national study of collaboration, sponsored by Catholic Charities USA
and the Catholic Health Association, was undertaken in 2002 to assess the state
of collaboration in Catholic ministries across the United States. The study
was conducted by Health Systems Research, Inc., and was funded in part by a
grant from SC Ministry Foundation. As part of the study, researchers visited
five sites (St. Petersburg/Tampa, FL; Cleveland; Wichita, KS; Orange County,
CA; and Albany, NY) to learn what makes for successful collaboration. This is
the last in a series of five articles highlighting the findings from this study.
The partners in the Albany Diocesan Community Health Alliance (DCHA) are:
- The area's four Catholic hospitals
- Fourteen Catholic Charities social service and housing agencies
- Nine Catholic long-term care and assisted living facilities
- Catholic schools
- Catholic parishes
In the Albany diocese, Catholic Charities uses a decentralized model to organize
and deliver services. There are nine county Catholic Charities agencies, some
of which are responsible for multiple counties. There are also five diocesan
Catholic Charities agencies, including AIDS services, disabilities services,
community maternity services, diocesan housing and property management services,
and Hispanic outreach services. A diocesan CEO/director in Albany oversees these
14 agencies.
The four independent Catholic hospitals are St. Peter's Hospital (a member
of Catholic Health East) in Albany, St. Clare's Hospital (which is diocesan-owned)
in Schenectady, Seton Health (a member of Ascension Health) in Troy, and St.
Mary's Hospital (also a member of Ascension Health) in Amsterdam. There are
several Catholic long-term care facilities in the area; some are sponsored by
the hospital systems, one is sponsored by the diocese, and some others are administered
by other religious communities.
Collaboration
A nine-member steering committee, composed of representatives of the Catholic
ministries noted above, was established to structure the DCHA's work. The committee
meets quarterly to discuss current interministry and intraministry projects,
as well as to plan for future initiatives. Every two years, five to eight top
executives from each of the entities come together in an all-day management
leadership forum to discuss current and emerging issues and propose projects
to address those issues. These project plans are then forwarded to the steering
committee for assignment to work groups for detailed planning and implementation.
For each collaborative project identified, the leaders of the Catholic entities
involved in the project specify the staff members who will participate. The
DCHA coordinator then meets with these people and briefs them on the new initiative.
To ensure clear communication and continuity, various groups within the alliance
meet on a periodic basis. These meetings include both regular sessions with
the hospital CEOs and semiannual sessions that enable the bishop to meet with
the sponsors, national health system representatives, and the Catholic Charities
CEO.
Another ongoing group is the Catholic school health collaborative, which focuses
on school health initiatives; this group brings together school, hospital, and
Catholic Charities representatives in the four cities with Catholic hospitals.
Another subgroup, the Residential Facilities Consortium, includes representatives
of both Catholic and other faith-based facilities. An implementation group has
been established to develop long-term care campuses and senior housing through
the collaborative effort of Catholic Charities, the diocese, health care organizations,
and religious orders. The goal of all these groups is to work together to develop
joint efforts that cut across Catholic institutional lines. Organizationally,
all the groups are linked and coordinated through the DCHA Steering Committee
and the efforts of the DCHA staff.
The members of the partnership work together in a variety of organizational
configurations, each determined by the nature of the initiative involved and
its geographical location. To promote and facilitate the process of collaboration,
the DCHA hired a coordinator whose role is to develop the agendas, chair the
meetings, and prepare the minutes of collaboration meetings. The coordinator
serves in this role for each of the groups that form the DCHA. The DCHA coordinator
has an assistant; the office has a budget that ranges between $190,000 and $210,000
a year. Catholic Charities, the hospitals, and the long-term care facilities
involved in the collaboration make annual contributions using a formula agreed
to by the partners. According to this formula, Catholic Charities contributes
17.5 percent of the total cost of maintaining the DCHA office, the long-term
care facilities contribute 17.5 percent, and the hospitals contribute 64 percent.
Results
The DCHA has been able to attain a number of achievements concerning a variety
of issues important to the residents of the greater Albany area.
Employment Services DCHA participants have been awarded several state
grants to fund employment services through the Temporary Assistance for Needy
Families (TANF) Program. St. Peter's Hospital developed a successful grant application
in partnership with Catholic Charities of Albany and Rensselaer County. With
this support, Catholic Charities recruit TANF participants and provide them
with job readiness training. The hospital then hires the TANF participants for
entry-level positions, which are subsidized by grant funds. The Catholic Charities
staff provides on-site case management to the participants for at least four
months.
Three other projects are funded directly by TANF. In one, TANF-eligible participants
are recruited for entry-level positions in long-term care facilities. A second
project is designed to develop a career ladder for certified nursing assistants
(CNAs) in the long-term care facilities. CNAs receive on-the-job training; as
their skills are upgraded, their salaries increase. The third project involves
the provision of on-site training to CNAs at the long-term care facilities,
enabling them to become certified as licensed practical nurses.
Subsidized Housing/Long-Term Care The implementation group for the
Catholic long-term care system has initiated a number of projects and is planning
others. The group identified the need for affordable housing for older persons
in the community with a continuum of residential options—independent living,
assisted living, and skilled nursing. The group conducted an analysis of all
properties potentially available from Catholic partners and discovered several
currently underutilized properties. The group is currently in the process of
constructing one facility and designing two others. All the facilities are campus-based,
targeted to older persons in a range of income levels, and include both market-rate
and subsidized housing. Some include intergenerational programs designed to
provide support and companionship for elderly residents. A goal is to use market-rate
housing as a revenue source that will help subsidize housing and other services
for low-income populations.
School Health and Day Care The Catholic Charities agencies, St. Mary's,
Seton Health, St. Clare's Hospital, and St. Peter's Health Care Services are
involved in collaborative efforts involving school health and day care. Seton
Health provides nursing services for Catholic Charities-administered day care
programs. Nurses visit the schools on a monthly basis and provide in-service
education and distribute health education materials. This enables Catholic Charities
to address the health education needs at the day care centers and to comply
with state licensing requirements at a very low cost.
Services Coordination—Subsidized Housing Seton Health and St. Peter's
have each contracted with the diocesan housing management corporation, which
administers subsidized housing, to provide service coordination for U.S. Department
of Housing and Urban Development Section 202 housing. It was through involvement
in the DCHA that Seton Health and St. Peter's indicated an interest in providing
these services. The hospitals have stepped in and offered to residents a level
of service that goes beyond the contract requirements.
Social Work Services at St. Clare's Hospital Catholic Charities provides
an on-site social worker who serves individuals and families at the Family Health
Center, which is located on the grounds of the hospital. This position, which
is supported by United Way funding, allows Catholic Charities and the hospital
to provide comprehensive on-site services to economically disadvantaged clients
who obtain health services at the center. In addition, a parish nursing program—under
the leadership of St. Clare's and using hospital, parish, and Catholic Charities
staff members—has recently been developed to work with the extensive elderly
population living in a community adjacent to the hospital.
Lessons Learned
The DCHA partners have learned a number of valuable lessons.
Flexibility in Collaboration Is Essential The original intent of the
DCHA was to create a health care network. However, as the local health care
environment evolved, the alliance's purpose was refined. Although a health network
was created independently of the DCHA, it is not the comprehensive vehicle that
the founding partners originally envisioned. The alliance has developed additional
strategies to build stronger relationships among Catholic ministries and health,
social service, housing, education, and parish organizations. The objective
of maintaining the viability of Catholic institutions in a challenging environment
remains strong, as does the objective of identifying strategies to support needed
community services. The means to accomplish these aims are constantly evolving
in relation to ever-changing environmental factors in the local church and in
the broader community.
Funders Like Collaboration The DCHA partners have also learned that
collaboration can create funding opportunities. Collaboration involving multiple
organizations is often looked upon favorably by funding agencies. Without the
alliance, the TANF funds would not have been forthcoming because funding required
documentation of the existence of a collaborative to manage the program. The
DCHA made it easier for the partners to develop a fundable grant application
that included the participation of multiple organizations and institutions.
Bring in Other-Than-Catholic Partners The Residential Facilities Consortium
has benefited tremendously from the participation of other faith tradition residential
facilities. This collaborative has also affected the overall environment for
collaboration in the greater Albany area. Many of the DCHA partners are involved
in the Healthy Capital District Initiative, which provides a variety of public
health services in collaboration with local health departments.
A Full-Time Staff Person Makes Collaboration Easier The partners have
had the interesting experience of jointly funding a staff position whose role
is to support cooperation and collaboration between organizations. Overall,
the participating organizations are comfortable with the idea that not every
organization is able to contribute the same amount in support of the DCHA office.
Although there have been a few years when some organizations were late with
their contribution, or when business conditions were such that adjustments had
to be made, the participants have on the whole seen the benefits that come from
providing resources to support a collaboration coordinator. The coordinator
makes collaboration easier. The coordinator can facilitate and manage logistics
and work directly with the staff of the partner organizations on approved projects,
relieving the CEOs of these responsibilities.
Commitment Is Needed throughout Each Partner Organization The partners
have learned that establishing a framework for collaboration does create opportunities.
They've also learned, however, that making sure that commitment to collaboration
spreads throughout each partner organization can be a challenge.
The DCHA has successfully strengthened relationships between Catholic partners
and sparked a variety of collaborative activities. Although the various partners
participate in DCHA meetings, and many show a strong commitment to this effort,
not all have taken the concrete next steps required to ensure that commitment
to collaboration extends throughout their organization. Many of the existing
long-term care facilities continually struggle with financial challenges that
make it difficult to devote adequate time, energy, and resources to building
a successful collaboration. One of the partners indicated that one risk posed
by the loose DCHA structure is that participants may develop the expectation
that "all we are supposed to do is just meet." This risk will be overcome as
long as someone takes the responsibility of translating the outcomes of meetings
into action.
The Future
The DCHA steering committee (as well as each of the groups formed under
the DCHA umbrella) plans to continue working together, seeking additional opportunities
for collaboration in support of its collective mission and in service to its
community.
Copyright © 2003 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.