Maryland Faith Health Network

Evidence-level

Promising (About evidence-level criteria)

Description

The 2014 change in Maryland's hospital payment structure provided incentives for improving population health. The Maryland Citizens' Health Initiative (MCHI) saw this as an opportunity to unite places of worship and healthcare systems to improve coordinated care for patients. MCHI sought out Maryland congregations and healthcare systems through their "Health Care for All!" Coalition. Many congregation leaders had already expressed interest in being a part of a structure that better supported their hospitalized congregants and were eager to partner with MCHI.

In February of 2016, MCHI launched the Maryland Faith Health Network (MFHN). Its purpose is to support formal collaboration between faith communities and hospitals in Baltimore City, Baltimore County, and Carroll County in order to achieve mutual goals. These goals include decreasing the amount of potentially avoidable hospitalizations, improving a congregant's overall wellness, and cutting down on the cost of medical services.

Current services are suspended due to COVID-19; however, the program has operated - and is expected to resume - as follows:

LifeBridge Health agreed to host the 2-year pilot project at their Carroll, Northwest, and Sinai Hospitals, widening MFHN's reach to include rural, suburban, and urban areas in central Maryland. Each hospital has Faith Community Health Navigators, employees of the hospital with backgrounds in pastoral care and/or nursing, as well as care coordination.

The navigators meet with the patient and coordinate with the congregational liaison. When a patient who has enrolled in the Network is admitted or discharged from the hospital, the Navigators notify their congregation's designated liaison.

Network liaisons are volunteers from congregations who are trained to be the point of contact for navigators and hospitalized congregants. The liaison also deploys other health volunteers to help the patient when they return home from the hospital. Liaisons are responsible for promoting wellness and educating congregants on the benefits of becoming Network members.

For patient privacy purposes, the navigators may only disclose information about each hospitalization to the liaison after the patient has given consent. Because patient privacy is of utmost importance in healthcare systems, MCHI and LifeBridge Health developed a form using HIPAA language for congregants to sign in order to join the Network. During a hospitalization, the patient must verbally give consent to the navigator to have their liaison notified about that specific hospitalization. The navigator does not disclose the reason for the hospitalization to the liaison.

MFHN is based on the Congregational Health Network, a successful healthcare and congregational partnership in Memphis, Tennessee. The MFCHN has received funding from The Abell Foundation, Community Catalyst, the Jacob & Hilda Blaustein Foundation, the France-Merrick Foundation and the Leonard and Helen R. Stulman Charitable Foundation.

Services offered

MFHN provides assistance to congregations in the following ways:

• Monthly conference calls with liaisons provide continued education, system navigation aid, answers to questions, and explanations of state-wide resources.
• Congregations are notified through liaisons in a timely manner when one of their congregants is hospitalized or needs follow-up care.
• As the MFHN matures, free health resources and events to educate congregants will be easily accessible.

MFHN helps patients in the following ways:

• Offers a way for patients to be ministered to by their own congregation during and after their hospital stay.
• Provides a direct line of support if questions or concerns arise after patients are discharged from the hospital.
• After a patient returns home, they may receive transportation to and from appointments and help with household tasks, meals, and other support services coordinated by the liaison.

Results

This model has given hospitals an avenue to connect with non-hospital social support groups like faith communities and congregations a starting point. Specific results are outlined in Maryland Faith Health Network's 2017 Evaluation Final Report:

• 70 congregations representing 11 Christian, Jewish, and Muslim denominations (41 in Baltimore City, 15 in Baltimore County, and 14 in Carroll County) are a part of MFHN.
• 1,818 congregants have been enrolled in MFHN.
• 173 congregant leaders and volunteers were trained to support fellow congregation members following a hospitalization.
• Hospitalized congregants enrolled in the program had a 75% lower inpatient utilization rate after one month and a 17% decrease after one year than those not enrolled.

When surveyed about the Network's influence, most faith leaders said they had a better understanding of health resources available. Most also agreed that the Network enhanced their ability to address their member's health needs as well as established their place of worship as a resource for wellness.

MFHN and LifeBridge Health are collaborating with the University of Maryland School of Pharmacy to design and implement an evaluation that engages all stakeholders through the PATIENTS program. Data will be collected from MFHN, LifeBridge Health, congregants, navigators, liaisons, and faith leaders.

On March 21^st, 2016 the County Commissioners of Carroll County made a proclamation celebrating the MFHN, while the Baltimore City Council unanimously passed a resolution and the Baltimore County Council offered a commendation in support of the Network. Below are additional publications about the MFHN:

• Faith Community Forming Network to Improve Health, Associated Press, CBS Baltimore
• Maryland Faith Community Health Network Brings Patients, Faith Together, WBAL TV
• LifeBridge Hospitals Partner with Faith Leaders to Improve Patient Health, Baltimore Sun
• Interfaith Health Network Serves Baltimore Communities, AFRO-American

Challenges

Finding a hospital system that would agree to pilot this model was a challenge. LifeBridge Health became an ideal candidate because of its locations in rural, suburban, and urban areas.

Several faith leaders were initially skeptical about the amount of work joining MFHN would entail. MCHI emphasized that the goal of the network was not to create additional work for faith leaders, but to streamline and support their existing ministries by facilitating direct connections between congregants in need of those ministries. Once they were assured of the benefits and well-coordinated structure, they were more willing to join.

Congregant enrollment rates was initially lower than the Network anticipated. Reasons included concerns about privacy, driving distance, missing sign-ups, an "invisible" mentality – not anticipating a future hospitalization, and incorrect completion of paperwork.

Replication

The following replication principles encouraged by MFHN can be applied to both rural or urban programs:

• Be intentional about bringing faith leaders together to hear their concerns about building a supplemental network.
• Look at your community's assets before its needs. Allow their strengths to guide your direction and the purpose you will serve.
• Take advantage of resources and expertise around you. Reach out to neighboring hospitals and community partners to ensure broad market share investment.
• Contact your state's faith leaders and denominational headquarters explaining your program and inviting them to take part.
• Foster relationships between hospitals and congregations before launching the program so that trust is built and teamwork becomes natural.
• Help congregations set up launches to announce the program to their congregations. Provide easy methods for congregants to enroll in the program at the launch.
• Collect data immediately upon launching the program in order to have a strong base when it comes time for evaluations.
• Make sure that front-line hospital staff knows about your program and are familiar with the communication process between the navigators and liaisons.

More recommendations can be found in the Maryland Faith Health Network's 2017 Evaluation Final Report.

Tools provided by MFCHN:

• The MFHN Informational Packet provides details about the program including background information, FAQs, and replicable documents.
• The MFHN Network Toolkit outlines resources that support the work of the congregations enrolled in the program.
• The MFHN Memorandum of Understanding is the agreement signed by MFHN, LifeBridge Health, MCHI, and participating faith leaders.

Contact Information

Vincent DeMarco, President
Maryland Citizens' Health Initiative
Maryland Faith Health Network
410.591.9162
demarco@mdinitiative.org