Better Health for All
When each member of our community has access to care, everyone
benefits. Here’s why—and what Providence is doing about it.
Story by Stephanie Conner | Photos by Catholic Health Association and Gary Matoso
Health care organizations are responsible for ensuring they have the expertise and technology to diagnose and treat disease. But care in medical facilities is just part of what contributes to our overall health. In fact, experts say only about 20 percent of a community’s welfare can be attributed to access to quality health care resources.
“Clinical care is extremely important,” says Joel McCullough, M.D., MPH, medical director for community health and epidemiology at Providence Health Care. “But in terms of improving the health of the population, we also have to address health behaviors, the physical environment and socioeconomic factors in a strategic way.”
To positively influence these many factors of a community’s health, Providence Health Care is working with a wide variety of partners.
“One of the things that we do well at Providence is collaboration,” says Elaine Couture, RN, BSN, MBA, chief executive at Providence Health Care. “We have to look to other agencies in the community that we can partner with that bring in their own expertise.”
Why does it matter? Because when you build a healthy community, you have residents who are vibrant and able to contribute to the community, and you can lower health care costs over the long term, Dr. McCullough says.
Here is a look at a few of the innovative ways Providence is working to improve the community’s health.
Providing a Place to Heal
People who leave the hospital and enter Catholic Charities’ Transitional Respite Care Program also receive on-site follow-up appointments with Providence providers.
About 5 percent of people who are seen in the emergency department at Providence Sacred Heart Medical Center are homeless. When you leave the hospital after an illness or an injury, you’re typically still in a phase of healing. You need rest and comfort and, often, followup care. Those who are homeless have nowhere to go.
In November 2012, Providence Sacred Heart Medical Center teamed up with Catholic Charities to create the Transitional Respite Care Program for the homeless. It started with just one bed and grew to three within the first few months. Today, a total of 20 beds at Catholic Charities’ House of Charity and at Volunteers of America’s Hope House are set aside for homeless men and women who have been discharged from hospitals.
“We’re providing space and a helping hand, so they’re not so medically vulnerable,” explains Pete Lockwood, program coordinator at House of Charity.
When people are able to heal, they are less likely to return to the hospital emergency department for care. And that’s both a moral and a financial issue for the community.
Respite beds are set aside for homeless people who have been discharged from area hospitals.
Doctors reluctant to discharge a homeless patient to the streets might keep the person in the hospital for a few extra days. That costs roughly $3,200 per day, according to a Kaiser Family Foundation estimate. An overnight stay at the respite program at House of Charity, meanwhile, costs $60, and it’s even less ($7.26) for people not needing respite care.
When people recover at House of Charity, they also get three meals a day, showers, clothing, transportation to follow-up appointments and access to a nurse.
“One of the catalysts for getting this program up and running was saving money, because it costs a lot to have them in the hospital,” Lockwood says. “But it’s about more than money. It’s about people.”
Getting ahead of health issues for the homeless goes beyond respite care. The goal is to eradicate homelessness. In Spokane, there are about 360 chronically homeless individuals. “These are the street homeless,” says Rob McCann, executive director for Catholic Charities of Spokane. “They are the people you see pushing shopping carts, carrying everything they own on their backs or living in shelters.”
Also, these people frequently face mental health issues and addiction.
“Our homeless population in Spokane uses an inordinate amount of taxpayer-funded services and other local services,” McCann says. Between the hospital, social services and possibly even jail, a homeless person could cost between $50,000 and $200,000 a year, he adds.
“But if we’re able to house them, we can keep those costs down,” he continues. That’s why Catholic Charities is working to provide permanent housing for homeless individuals. “By 2020, our plan is to have built an apartment for every single homeless person in Spokane,” he says.
When people have housing, they can focus on their health and other issues. Plus, McCann explains, “it’s saving a person’s human dignity.”
One chronically homeless person who was well-known by Sacred Heart emergency department physicians illustrates the benefit. He had been to the emergency department 61 times in a single year. In the first year that he had permanent housing at Catholic Charities, he went to the emergency department only twice.
“It is part of our Mission to take care of the poor and vulnerable,” Dr. McCullough says. “And if we and our community partners are successful, it will improve health care costs, too.”
Supplying Food Security
Other collaborative efforts address physical environment and health behaviors. In 2011, Michele Sakurai, manager of pastoral care for Providence Health Care Stevens County, was asked to lead an initiative to address hunger.
In the tri-county area, she says, there are about 15,000 people who lack reliable access to affordable, nutritious food.
In her early discussions with other community groups, she learned that the problem went beyond hunger. Not having healthy food was putting people at risk for obesity, diabetes and other health problems.
North Eastern Washington (NEW) Hunger Coalition was born to address hunger throughout the region. It brings together about 25 partners, including several food banks, Washington State University Extension, Rural Resources Community Action and Northeast Tri County Health District.
One solution was bringing fresh fruits and vegetables to people who needed them. But an obstacle, Sakurai uncovered, was that food banks can’t receive fresh produce unless they have refrigeration. Sakurai and others through the Hunger Coalition trained food bank staff on grant writing to help them procure funds they needed. And Providence took care of refrigeration applications for seven food banks in the first year. The Hunger Coalition also has contracted with local farms to get food and secured a donated refrigerated truck from Second Harvest for transport.
“The greatest success for the Hunger Coalition is the relationship we’ve built with Northwest Harvest and Second Harvest for the delivery of food to the food banks,” Sakurai says. “The Hunger Coalition doesn’t itself feed people. We have developed a network so that people have easier access to healthy food.”
Screening for Prediabetes
Participants of a yearlong diabetes prevention ;class learn how to change their behavior and reduce their risk for disease.
Community outreach and education is another key to improving the overall health of our community. In a new pilot program, Providence health educators trained Second Harvest volunteers on administering a basic prediabetes risk assessment with customers of the food bank. In a month and a half, volunteers conducted a number of screenings at the food bank.
“If someone was determined to be at risk, they were given information on our diabetes prevention program,” says Emily Fleury, director of community wellness and health training at Inland Northwest Health Services, an affiliate of Providence.
Those enrolled in the diabetes prevention class will attend sessions at Second Harvest. The class is free to them and lasts a year.
Throughout the class, participants track their weight, physical activity and blood pressure. By understanding these measurements, learning about nutrition and gaining support, people can begin to change their behavior and reduce their risk for disease, proving the effectiveness of this research-based program.
Continuing to Tackle the Big Issues
By helping to provide community education on healthier living, ensuring people have access to healthy food and working to help the homeless in our community, Providence Health Care and its partners are driving better health for all.
Wanting to Create a Healthier Community
Earlier this year, Joel McCullough, M.D., MPH, joined Providence Health Care as medical director for community health and epidemiology. He had previously been health officer for the Spokane Regional Health District, where he was widely respected for his work.
Board-certified in preventive medicine and internal medicine, he also has master’s degrees in public health as well as community health and preventive medicine.
At Providence, his role is to help the organization determine where to invest community health dollars for maximum impact.
“Community health … is the health of everybody in
our geographic area,” he says.
And it goes beyond what Providence’s doctors, nurses and staff do every day. Addressing community health, he adds, also involves where people live, how they access health resources and what actions they take each day.
“How do we create a healthier community through policies and changes in our environment?” Dr. McCullough wonders. In his new role, he hopes to uncover some answers and make a difference.