Making room in the marketplace: a special initiative for the poor.

Faced with increased concern over the role of the voluntary healthcare sector, specifically Catholic providers, in the care of the poor, Mercy Health Services (MHS), a healthcare system, established a two-year, three-phase planning and development effort known as the Special Initiative for the Poor (SIP). Established in March 1986, SIP was designed to find out: Who are the poor? What are their needs? What is MHS's responsibility in meeting these needs? Among its objectives, SIP was charged with: 1. Educating and raising awareness of governance and management staffs. 2. Developing a way to assess human needs. 3. Determining the financial implications of the organization's commitment to the poor. 4. Recommending ways to enhance the understanding, energy, and commitment to the poor throughout the system. During the first six months, SIP staffers traveled to hospitals and subsidiaries throughout the system, meeting with management and staff, explaining the project, laying the groundwork, and gaining support. In the development phase, SIP created the Community Assessment of Human Needs, a systematic approach to identify and understand the unmet human needs of the poor. It also developed a simple inventory formula to help hospitals determine which of their programs were specifically for the poor and determine what these programs cost. Finally, in the implementation stage, several of SIP's recommendations are challenging the organization to move beyond its current commitments.

New accountabilities, challenges for trustees.

Trustees can no longer view their responsibilities as passive or symbolic. The health care ministry today demands trustees who can articulate their convictions to colleagues and administration. Clarifying and implementing this new role is a challenge--perhaps even a key to survival--for Catholic health care organizations in the next 10 years. Trustees hold "a charter of public trust" and therefore are accountable to three distinct but concentric constituencies: Society. Socially accountable to trustees must be financially honest, ensure competent administration, and make certain their services enhance the common and social good. Church. Trustees, in being accountable to the Church, must ensure that their organizations comply with canon law and do not violate Church teachings. Religious institute. Trustees must assist religious institutes to ensure that collaboration occurs among Catholic systems and facilities as well as with all persons of good will. From these three forces flow five crucial challenges for trustees of Catholic health care organizations: Ensure that their organization's allocations for charity care are specific and clear to maintain not-for-profit, tax-exempt status. Lower costs but ensure high-quality care. Champion issues of economic social justice, especially access to health care. Work to manifest Christ's mission in the world. Commit to collaboration with all other Catholic organizations in such a way as to serve people in the most effective manner. Seeing God as the center of these challenges can help trustees and providers to move mountains.