Why St. Francis is making housing and community services priorities at the hospital

Perched on a small hill in Wilmington's Little Italy neighborhood, St. Francis Hospital overlooks what may be Wilmington's most diverse community — and a community with a great amount of need.

To address these needs, Delaware's only Catholic hospital has announced plans to treat much more than medical conditions with the inception of its Healthy Village, an endeavor that intends to locate organizations offering community services inside the 98-year-old hospital.

"Taking care of someone's medical needs is really only 20% of their care," said Lillian Schonewolf, Trinity Health Mid-Atlantic's Vice President for Community Health and Well Being and Healthy Village's Executive Director. The other 80% includes addressing a person's behavioral, social and environmental well-being.

Based on research the hospital conducted that focused on Wilmington's west side, Schonewolf said they found the area's top concerns include trauma from gun violence, lack of healthy food options, housing issues, and behavioral and mental health treatment. Additional interviews with residents in the hospital's surrounding neighborhood also identified education, job training and senior care as desired services.

One-stop shop for vital resources

Through partnerships with community organizations, service providers will occupy whole floors or just an office inside the hospital to allow St. Francis' patients — many of whom do not own vehicles — a convenient one-stop shop of sorts for vital resources. Healthy Village partners will pay for their space inside the hospital, along with electricity and water. Administrators said they also anticipate increased usage of the hospital's cafeteria and environmental services.

Lorine Townes, who lives within walking distance of St. Francis Hospital, said many in the neighborhood do not have transportation to visit state social service offices. Having just walked home from the hospital, Townes said she likes the idea of Healthy Village.

"I think I would use the services," Townes said. "It's convenient."

Partnerships with community groups

The plans for Healthy Village began about a year ago, in the wake of health care industry workforce shortages and an eye on ChristianaCare's increased regional presence.

With only about 70 of St. Francis Hospital's 400 available beds occupied at any given time, Schonewolf said the use of their space by partners is welcomed.

While most services identified as vital are not yet in place at Healthy Village, Delaware Hospice is already providing hospice and respite care, and NovaCare Rehabilitation is offering physical therapy. St. Francis Hospital also has an existing partnership with West End Neighborhood House called Cornerstone West Community Development Corporation to provide housing for low and moderate-income families and now, as a part of Healthy Village's commitment to senior care, the corporation is developing plans to add senior housing atop the hospital's parking garage with a skyway bridge to connect the two facilities.

Additional plans include addressing the health care staffing shortage and the community's desire for education and job training, according to Schonewolf.

She explained that Healthy Village's education programs would allow someone who is working to move on from substance abuse or someone who has aged out of foster care to gain valuable, hands-on training in the hospital.

"NovaCare [is] having a really hard time employing homegrown individuals from Wilmington to work there," Schonewolf said. "So, they're very interested because they want to be able to mentor and to help these students to learn about physical therapy or occupational therapy."

There will be training for many non-medical-related careers found in a hospital setting such as food service, environmental services and public safety constables, and there will also be training that culminates in certifications for certain medical positions.

"We're struggling across the country with a shortage of nurses. [Due to] a shortage of CNAs, [it] definitely would be advantageous to grow our own employees out of our communities," said Schonewolf.

To address the local shortage, St. Francis Hospital is in talks with two Catholic high schools to create an education center inside the hospital where they hope to develop middle school and high school students' interest in the health care field. High school students would receive mentoring and training while working toward earning professional certifications while still in high school.

Creating trust between the hospital and the community it serves

Wilmington is the state's largest city and the majority of residents identify as Black or African American. The West Side of Wilmington specifically is home to a diverse population where many speak languages other than English and many are low-income. Research shows that there is a general mistrust of the medical system among low-income and racial minority populations.

Schonewolf said her team spoke with local organizations that work directly with people in need, as well as traveled with the EMS team around different neighborhoods, particularly where drug activity and evidence of homelessness are found, to talk with residents.

"We probably took about six months solely interviewing those in the community. ... It literally took people on the team knocking on doors, providing education," Schonewolf said.

Olivia Clark, who lives four blocks from the hospital, said she is unaware of St. Francis Hospital's efforts to include neighborhood residents' input.

"No one has come to my door," said Clark, who is semi-retired. She said she has lived across the street from Judy Johnson Park for 20 years and has "not seen anyone."

Though no shootings have been reported so far this year, according to Delaware Online/The News Journal's gun violence database, Judy Johnson Park is oftentimes at the center of nearby shootings.

Clark said the idea of Healthy Village "sounds fabulous" but questions how effective it will be in connecting people to resources and treating people with dignity and respect.

"You know, people out here are yearning for a lot of stuff and they don't need somebody judging them," said Clark.

Even Lorine Townes, who had said she looks forward to making use of Healthy Village, said that she knows many people who feel that St. Francis Hospital is "not a life-saving hospital" and do not want to engage services there.

Contrary to what Clark and Townes stated, Schonewolf said neighborhood interviews conducted by the hospital revealed that people felt safer going to St. Francis Hospital because they had less fear of being turned away or judged negatively for whatever was going on in their lives.

She did admit that some expressed concern that leadership at the hospital did not include anyone who understood life on the West Side.

After getting this feedback, Trinity Health named Christopher Cullom, an African American, as president of the system's Mid-Atlantic South Region, which also includes Mercy Fitzgerald Hospital in Darby, Pennsylvania.

While not from the West Side, Schonewolf said Cullom is enthusiastic about learning more about Wilmington's residents and will be joining the hospital's health and well-being team for EMS ride-alongs, as well as walks through the area.

The future of community health care

As St. Francis Hospital is nearing its 100-year anniversary, many changes have impacted the health care field and St. Francis Hospital's survivability.

In her work as vice-president of Community Health & Well-Being at Trinity Health, Schonewolf said the hospital system was already working to support community health, but acknowledged that the COVID-19 pandemic helped convince clinicians that disease is connected to a patient's behavioral, social and environmental circumstances.

She also noted that the hospital's transition to a whole-person health care model comes at a time when many small hospitals are closing or being absorbed into larger hospital systems.

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St. Francis Hospital's Health Village has received a $5 million investment from its corporate parent, Trinity Health Mid Atlantic, but the additional income from partner organizations will be an added boost.

"This is the way we're going to do health care for the next 50 to 100 years," Schonewolf said.

If successful, Healthy Village will also become a model for Trinity Health's approach to providing health care at other hospitals in its network, as well.

As far as Clark's participation, "I'll try it out," she said. "But not at the beginning because it's always good at the beginning. So I will try in the middle when it has been there a minute and see what they're talking about."

Contact reporter Anitra Johnson at 302-379-5786 or ajohnson@delawareonline.com with tips and story ideas. Follow her on Facebook.

This article originally appeared on Delaware News Journal: St. Francis to focus on community health with partners inside hospital