Coalition seeks binding community benefits agreement with Ascension for St. Joseph hospital

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A coalition of community groups and unions is seeking to negotiate a legally-binding agreement with Ascension Wisconsin to hedge against any potential cuts to services at Ascension SE Wisconsin Hospital – St. Joseph Campus on Milwaukee’s north side and hold the health system to providing specific community benefits.

St. Joe’s Accountability Coalition formed in response to Ascension’s announcement in April 2018 that it would scale back services on the hospital campus, a plan the health system soon after rolled back. Since then, Ascension has expressed its commitment to maintaining the campus as an “anchor” in the Sherman Park neighborhood by providing primary and acute care, prenatal, ICU, a level II NICU, and other health care services, along with non-health care programs aimed at addressing social determinants of health.

St. Louis-based Ascension Health assumed operations of the former Wheaton Franciscan Healthcare hospital, located at 5000 W. Chambers St., in 2016.

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As the health system has held community discussions to help guide its plans for the hospital – and sought partners to help with the effort – SJAC has separately convened meetings for neighbors to discuss the hospital’s future and its role as the only remaining inpatient hospital in the neighborhood.

The coalition includes Metcalfe Park Community Bridges, African American Roundtable, Black Leaders Organizing for Communities, Sherman Park Community Association, Wisconsin Federation of Nurses and Health Professionals, Milwaukee Area Service and Hospitality Workers Organization and Citizen Action of Wisconsin.

This week, the coalition announced it is launching a community survey to hear from area residents about their vision for the hospital, with plans to canvass neighborhoods in the zip codes surrounding the hospital. That input will inform what the coalition plans to put in writing as a community benefits agreement to “keep the hospital open, improve health equity and health outcomes and help revitalize Milwaukee’s north side.”

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Ascension at no point said it would close the hospital, and has committed to keeping it open.

The health system announced in early April 2018 that it would downsize services, including surgical and inpatient stays, at St. Joseph in an effort to stem losses at the hospital, which serves a high volume of patients who are not covered by commercial insurance. A few weeks later, officials said they were halting the plan, following mounting concerns from city and community leaders. In the year since, Ascension said it has conducted 161 community interviews, 27 stakeholder meetings and seven community conversations with elected officials and residents, as it continues to formulate a vision for the campus.

The system has also initiated several programs aimed at addressing some issues raised in those meetings. They include: a partnership with the city health department’s Office of Violence Prevention and other health care partners to prevent gun violence, hosting a new Milwaukee Health Department-run Women, Infants and Children outreach office at St. Joseph, piloting an opioid recovery coaches program in the hospital’s emergency department, hosting a Blanket of Love program to educate expectant mothers, and partnering with Hunger Task Force to enroll seniors in a free food staples program.

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St. Joseph’s emergency department sees about 70,000 visits annually and its OB/GYN and neonatal services has about 2,200 baby deliveries annually. About 80% of the hospital’s patients are covered by Medicare or Medicaid, which reimburse hospitals at less than cost. About 5% of St. Joseph’s patients are uninsured.

Nate Gilliam, an organizer for the Wisconsin Federation of Nurses and Healthcare Professionals who has spearheaded SJAC, said a community benefits agreement would make Ascension’s commitment to the public good explicit and binding.

Community benefits agreements are typically tied to specific projects, guaranteeing contributions to the community, and entered into by a developer and community stakeholders. A recent local example is the Milwaukee Bucks and the Alliance for Good Jobs’ community benefits agreement for the Fiserv Forum project, which guaranteed arena workers an initial minimum hourly wage of $12.50, and eventually $15 by 2023.

But an Ascension Wisconsin spokesperson said such an agreement does not apply to health systems.

“Community Benefits Agreements are between community groups and real estate developers,” the spokesperson said. “They identify a range of community benefits the developer agrees to provide as part of the development project in cases where the developer is seeking the community’s support of the project and may receive tax incentives or public funding to subsidize the project. These types of agreements do not apply to health systems.”

SJAC argues that because of Ascension’s tax-exempt status, it should be called upon to agree to specific enforceable community benefits.

Gilliam said the coalition would like to see the health system work to provide access to more people from the neighborhood to the job pipeline through partnerships with area colleges’ and universities’ health care programs. Other ideas that have emerged in discussions include establishing an urgent care center in the area, funding programs that address social and economic determinants of health and a commitment to hiring locally for Ascension jobs.

He said the coalition could build momentum for a unionization effort at St. Joseph’s, but it’s not the sole purpose.

“If we build a union or not, that’s not the point,” Gilliam said. “We do have two labor unions that are part of the discussion and the community meetings, but that is not the end goal.”

SJAC’s efforts coincide with a recent round of layoffs at Ascension St. Francis Hospital in Milwaukee, in which 21 positions were eliminated, Gilliam said.

“People need to know how business decisions from St. Louis impact our ability to care for our community,” said Connie Smith, a surgical tech at Ascension St. Francis Hospital and chapter president with Wisconsin Federation of Nurses and Health Professionals. “Layoffs, staffing decisions, corporate restructures and service cuts all impact how well we can care for patients. Ascension needs to be accountable to community needs, not a corporate business plan.”

In a statement Thursday, Reggie Newson, chief advocacy officer for Ascension Wisconsin, reiterated the health system’s commitment to addressing community needs.

“We recognize Ascension St. Joseph is an anchor in the Sherman Park community. As we’ve been listening over the last several months, the community clearly expressed the need for traditional health care services along with more access to programs that address health and wellness differently,” Newson said. “The information we heard through our community engagement process is guiding our vision for Ascension St. Joseph. In addition to the current services being offered at Ascension St. Joseph, we are taking the time to thoughtfully consider ideas that address these concerns and which ones can be implemented by us and/or through collaboration, strategic alliances and partnerships. In the coming weeks and months, we look forward to coming back to the community, sharing our ideas for improving health equity in the Ascension St. Joseph service area and continuing to engage the community throughout this process.”

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