Providence Montana annual community report

Below is a raw transcript from the conversation Debbie had with Joyce and Merry. 

Debbie:

Hello, and welcome to our broadcast. Thank you so much for joining us today to learn more about community benefit in Western Montana. My name is Debbie Gibson and I lead operations for integrated leading investments at Providence. And with me today are Joyce Dombrouski, the Chief Executive for Providence, Montana. And Merry Hutton, our regional director for Washington, Montana region for Community Health investment. Today we are going to be talking about community benefit in Montana and the different programs, initiatives and investments that we made last year, to serve individuals and communities in proactive and strategic ways that address unmet medical community healthy. These investments really connect our community based economic commitments to our mission and our heritage, as well as to the social determinants of health and demonstrate how our work can really reach beyond and extend beyond the walls of our hospitals with the overall goal to improve health and well being in our communities. So again, thank you for being with us as we learn more. So to start us off, Joyce, can you first tell us a little bit about yourself? What brought you to your leadership role in Montana, and perhaps a little bit about the areas and the communities that we serve in Montana? 

Joyce:

Certainly, Debbie. Thanks for the opportunity. Good afternoon, my name is Joyce Dombrouski. I am the Chief executive for Providence, Montana. I've been in Providence for over 26 years I've been in this role about five, it's really compelled to be in this role, I think as an extension of serving a nurse. And so it just sort of all worked together for me. I think what's most important about the community needs assessment process that we go through. It's one that as a Catholic ministry we've gone through for years, I've had an opportunity to work with Merry across time as we go out and survey, not only Missoula County where St. Patrick is located but Lake County where St. Joseph is located. Our two organizations in the service area, asking what are the community needs? What, where is it that we could extend our reach outside of the walls of the hospital. And of course, we take that process very seriously, we get data, we come back and we say the work that we'll do in terms of investing in our community will be to meet those needs, that the individuals we're serving have identified. And so I know we'll get a chance to talk about those specific needs that we uncovered in 2020. 

Debbie:

Great, thank you, Joyce. So next, Merry can you tell us a little bit about yourself and your background, how you came into your position there, and also maybe a little bit more about the communities in Western Montana and the specific needs that we are hoping to address? 

Merry:

Absolutely. And thank you, Debbie. As Joyce mentioned this has been really foundational to the work that we have done over time. And I would just like to echo Joyce, brought up kind of that desire to be of service. And even throughout my career, whether I was teaching or whether I was a Peaceful volunteer. And now my work in Community Investment at Providence, where I've been for over 20 years. This work is definitely a calling and addressing community needs has is very much core and central to who I am. And I'm very blessed to work in an organization which it can put the intent of that mission into action. Our vision at Providence is health for a better world. And we know that we cannot do that by addressing only the clinical care factors that determine a person's length and quality of life but also the social and economic factors, the physical environment, health behaviors that all play an active role in determining health outcomes. In the Montana service area and Joyce mentioned we are that references both lake and in Missoula counties. We know that our economically vulnerable patient groups, those might be people who are disable, people who are experiencing homelessness or might have unstable housing; have high rates of mental health diagnoses and or substance use disorder as they present. For example,   in our emergency departments or in our inpatient settings. We know that we must address those particular areas where options are very limited for those services. As a result of our findings in our Community Health Needs Assessment this last year, and through a prioritization process, aligned with our mission, our resources and our hospitals strategic plan. In Western Montana, we will focus in the certain in these following areas, here in Missoula County. At St. Patrick hospital, we will address and work on access to mental health services, safe and affordable housing, access to substance abuse disorder treatment services, and addressing homelessness. And in St. Joseph Polson, we will work to address access to mental health services, access to substance abuse disorders treatment services, and safe and affordable housing. 

Debbie:

Great, thank you, Merry. So both of you talked about the needs assessments. So, once we did the needs assessments and now we've identified what those gaps are, that exists that we need to work on. Joyce, can you tell us a little bit about what why do we actually step into this community benefit work to meet those needs? And exactly what is our commitment to community health? What's what does that been in the past year? 

Joyce:

Yes Debbie, so why do we do it? Well it's core to our mission, its core to the fact that the Sisters of Providence have been in western Montana for 150 years serving the poor and vulnerable. So it's really part of what we do. And we're so excited to share that what we do really extends outside of the hospital. It also creates what we believe to be public trust between ourselves and those whom we serve. We want to be transparent and we want to be sitting at the community table with others who are serving to be a part of that conversation and to really extend what we can do. And thirdly, it is an IRS requirement it wasn't always that's sort of new to the world. But in fact, it does meet an IRS requirement in Section 501 are in case anyone wants to look that up. In 2020, we invested $26 million in community benefit in Western Montana, that's 26 million. We also had a generous donor. And that donor allowed us to expand our adolescent inpatient unit. We continue to collaborate and behavioral health across our really lake in Missoula counties, we've sat down at a table with others who are serving our behavioral health patients. So, beyond the inpatient adolescent unit, we've said, what else can we do to really prevent and shore up our behavioral health resources before anyone needs the crisis of our emergency department or inpatient units. That's been very gratifying. And we put a lot of time and attention into that work. And I think we've created that public trust with all of those entities who we've sat around the table, and food insecurity, we get down to those basic needs. If you're hungry, it's really hard to think about much else. And so, in response to COVID we proactively invested $46,000 in both Missoula and Lake County to alleviate the burden of the communities with food insecurity and childcare needs, again, getting at that sort of that young age where we can, we can feel like if we can correct correctly, and accurately put dollars towards prevention, it can really help us with our long term strategies. 

Merry:

And I would just like to add to that over this last year, as I referenced before we are committed to addressing not only those that are homeless, but might be house insecure. And some of the programs that we as evidence of that commitment, our partnership with the Parello, for the medical respite program, as well as our communities emergency winter shelter. And during COVID, we spent a significant amount of resources and time to ensure that our community partners had appropriate key PE. And in this last year we invested over $60,000 specifically to alleviate the burden of COVID on this high-risk population. 

Debbie:

So that is a certainly a considerable amount of financial commitment and listening to you both talk about all of those significant needs. And knowing that COVID last year or over the last 18 months has only increased those needs in our communities. It certainly seems like we need to be very strategic and targeted so that we know how to prioritize our efforts. So what would you both say most accurately summarizes kind of those areas of focus in Montana, and maybe sharing some highlights of the programs and the initiatives that were created, specifically, and we engaged in those as examples of those strategic economic investments. 

Joyce:

Debbie I think one thing that's really critical as our community needs assessment really had us focus on the poor and vulnerable and really our COVID patients are the most poor and vulnerable at this moment. So those two that really the macro level thinking and really, the boots on the ground came together almost easily, although it's been nothing short of a challenge to make sure that our poor and vulnerable have access to what they need to stay safe. Quite frankly to stay non exposed to COVID. So I take pride in that we're very nimble and responsive. When the community sort of asked us for an endorsement of a homeless shelter for non-congregate living about a year ago, we were able to say yes, we didn't necessarily have to apply funds but we applied resources and expertise so that we could make that happen. We were already focusing on behavioral health in general so, the mental health needs of not only our COVID patients, but really our caregivers was sort of easy for us to get our arms around, although it's been a continued challenge, and one that I think will carry us into the future. Behavioral Health is something that we feel proud about being a partner in and at the same time challenged. The basic health needs, we talked about the food security and our homeless population. Again, I've said it's really hard for individuals to think about taking good care of themselves, if they don't know where their next meal is going to come for themselves or their family, or they're not exactly sure where they're going to sleep that night. So that existed before COVID, and really was enhanced with COVID. And that we couldn't use the resources in the past with the way that we could. But we were nimble, we were responsive. And I really give credit to ourselves in Providence for knowing how to appropriately invest dollars in order to allow us to meet the needs of the COVID pandemic. And obviously, we're certainly continuing in those conversations and in that work. Merry is there anything you would add? 

Merry:

Yeah, I would add that creating and maintaining these effective partnerships. And as Joyce said, that was really critical to building that public trust. And it's really occurred over time. And as we've invested over time, in these community partnerships, it's really resulted in this nimbleness that Joyce spoke of. And we like to think of our proactive investments as those actions that we want to take to help our community to get and to stay healthy before they would need to otherwise seek treatment at our hospitals. And one of the programs that is a proactive investment in this regard is our medication assistance program. We have staff that help our patients and community members to get support, they need to access lifesaving medications that are just simply too expensive. By working with pharmaceutical companies. In 2020, we saved our patients and community members over $3.1 million in prescription costs. And I'd like to share just an example of one of our patients that we served through this program. There was a young diabetic male who was unable to afford his medications due to cost and the loss of his job and became hospitalized as a result. This assistant was the medication Assistance Program, he was able to obtain an immediate supply of insulin to get him by until he can obtain insurance. We also helped him secure insurance through our financial counselors who helped him get that health coverage. Once he obtained that coverage, we were able to work with pharmaceutical companies to get the copay cards, which over time would help lower the cost of future refills of his insulin. And by lowering the cost of his insulin, this patient has stayed out of the hospital because of those high-cost medications. That's really the type of proactive investment that we are. We are committed to here at Providence. 

Debbie:

You know, I love hearing about these specific programs and the examples because it reinforces for me specifically that we really are doing the right work at the right time. And it really makes me proud as well to work for an organization that prioritizes our commitment to the community. Are there any other examples that you would highlight in terms of programs where we really have gone above and beyond to meet the needs? 

Joyce:

Yes, Debbie, I'd like to add about our medical legal partnership that really is an upstream prevention intervention. So what is a medical legal partnership? It really has allowed us a partnership with the Montana Legal Services Association, to give our poor and vulnerable as were screened or triage or come across them access to quite frankly, attorneys and attorneys' advice. And so I'd like to just talk about what one example again like the patient that Merry described, this young adult was experiencing a lot of health issues. He was admitted to the hospital and rightly so for those issues. But as we started to work through how to create a good discharge plan, it became clear that he was facing eviction through COVID-19 he had lost his employment. And he was really struggling with where he was going to go when we were struggling with where we were going to have him go. So the hospital staff, well versed in the medical legal partnership idea called them. And this patient was able to secure an extension on his eviction notice, so that he could get out and go back to his home of record, had we not done that, the individual would really have not had a place to go. And that just seems so unacceptable to us, in the hospital. So the medical legal partnership really gives access to patients who probably never thought about having an advocate in the in the legal or civil system. They're well versed in what we can do. They're nimble, they're responsive and I would just have to say, I feel very proud of that effort in our continued focus on helping our patients at their most vulnerable moments. 

Debbie:

Yeah, that's an amazing example, Joyce, of really making a true difference in someone's life. And, you know, as I think about our heritage, and especially in the context of COVID, I can't help but think about the Sisters of Providence and how they were activated during the flu pandemic, back in 1918, when 21 million people worldwide were killed by that influenza pandemic. So as we think about our heritage, we think about the Sisters of Providence, what kind of parallels could you take from the sisters work back then and apply it to what we are engaging doing today? 

Joyce:

Good Debbie that's a great question. I think from the heart, I often think about the sisters and how did they even know where to begin? And how did they not get discouraged? How did they persevere? Part of it is creating a really good community. I think Merry and I are part of that community of leaders who have committed ourselves to being part of the solution and to really looking outside of the walls of the traditional hospital. And I believe that's what the Sisters of Providence did, they came in, they looked at the need, they talked to the community, and then they work to make it happen. And so it isn't always clear. The dollars are not always there. But really the need is, and as long as you create the communities and the relationships, and again I call it perseverance I think our community at Providence is we give each other strength, we give each other creativity and hope. And I believe the sisters did that every single day. And so, when you ask that question I go right to that there's a sense of community, there's this sense of perseverance and hope for the future. And then really there is a sense of doing, of problem solving, of not just sitting back and waiting but being part of really what it's going to take in order to improve the health of our entire community. 

Merry:

And Debbie, I would as Joyce referenced, our archives are full of stories of how the sisters as well as our caregivers have addressed the challenges of their times and we are called to do that. As a person of Providence. One of my favorite stories is about sister providential Tolan who worked tirelessly to address the unmet needs of the American Indians in Great Falls on health 57. She encountered their lack of adequate housing, their lack of access to education and health care, and even really sought to address their lack of running water. She was also very much a part of advocating for the rights and took her story and their story all the way to the halls of Congress in the early in the early century here, and I think that that is just illustrates, throughout time, there have always been very brave, and people that work at Providence, who have been willing to step up for those who, who need us to. 

Debbie:

Thank you. Well, that certainly does illustrate our rich heritage and how we live out those same core values today. So now that it's 2021, and we're still, you know, 18 months into the pandemic. What I would like to know from both of you is what are your hopes and visions and aspirations for community health in Montana going forward this year?  

Joyce:

That's a great question. I think a little bit of it is more of the same because we know that those are long term issues that we're very focused on our behavioral health, mental health, really of our community including our caregivers, continuing to think through how we can provide an effective safety net, that's housing, that's food security, access to medications like Merry talked about, and really to continue to think about our role in the community. I think what at least I've learned in the last few years is we don't have to do it alone. There are a lot of wonderful organizations in Missoula and Paulson and both of our counties that look to us for our leadership, that look to us for our strength and our stability, but at the same time are willing to sit at a table and think through how we can work together. I think that's a beautiful extension of this work. And I think that's really what's going to get us through, hopefully to another side of this pandemic, is that community commitment to serve our vulnerable residents better, and we are able and willing to take a leadership role in that. And I feel really again we use that word proud; I do feel proud to be part of Providence, who really expects us to do that work, right respect us invest in us, calls us out to talk about it. So like something like this to get the opportunity to really be out in the community and being open it at the same time very humbled that the people that we serve, our work is not done. 

Merry:

Well, you know, again, through our Community Health Needs Assessment, and through our community health improvement plan, we really want to make a significant and lasting impact on the health needs of our communities that t we serve in collaboration with these community partners. We also know that sometimes, for example in mental health, we have had that as a priority area on our Community Health Needs Assessment and hardship for years. And it shows that it takes time to really build that structure in, not only within ourselves in our response to the needs of our community, but also to assist our community partners as well in collaboration. Because when we help to build those social structures that help everyone thrive, regardless of their social status, we're enhancing the common good. The common good is really one of those foundational tenants of those of us in Catholic health care, really looking to the common good to everyone, and to bring everyone along with us. 

Debbie:

Thank you. Yes, Merry, we do we do talk a lot about the common good in our work. And it's a concept that we are very familiar with and that we embrace on a daily basis. So thank you very much. So that I think ends our time today. Thank you, Merry and Joyce, for being with me today and for talking about community benefit in Montana. If you are looking to learn more about committee benefit programs, please don't hesitate to visit our Providence annual report to our communities. And be sure to follow Providence on our social media platforms, Twitter and Providence health system on Instagram, Facebook, and LinkedIn. So thank you again for being with us today. Thank you. Thank you.