Author: DW Admin

By Edlín Maldonado-Fuller, collaborative grants specialist

"Financial empowerment services help our patients see the bigger picture, to help them plan for the long term." – Monica Lucero, Behavioral Health and Social Work Supervisor

While access to care plays an essential role in helping to improve the overall health of our communities, even greater are the non-clinical factors, such as income and employment. Earlier this year, Methodist Healthcare Ministries of South Texas, Inc. partnered with the Family Service Association of San Antonio's Financial Empowerment Center to offer one-on-one financial counseling to Wesley Health & Wellness Center patients as part of our holistic approach to care.

Many times, when patients meet with a Methodist Healthcare Ministries social worker, financial issues and concerns arise. The social work case manager works with the financial empowerment counselor to help patients engage in support services, such as individual financial counseling. With an on-site financial empowerment counselor, patients benefit by having access to services and not needing to travel. In addition, there are educational workshops for small groups.

As the program is in its pilot year, Methodist Healthcare Ministries is monitoring levels of depression and anxiety to determine whether these concerns, associated with financial stress, can be lowered over time – thus improving a patient's overall health. Methodist Healthcare Ministries and the Financial Empowerment Center hope to take this information and work to improve services to achieve better health and financial outcomes of individuals. Clinical care contributes about 20 percent to someone's health, while social and economic factors contribute about 40 percent. By bringing two different sectors together– a social worker and financial empowerment counselor – to address a patient's needs, the partnership has the potential to achieve greater, significant impact in an individual's life.

The Financial Empowerment Center is a national initiative that launched in 2013 with support from Bloomberg Philanthropies. San Antonio was blessed to be one of five initial cities selected. Since opening its doors on the city's West Side, the Financial Empowerment Center has helped families reduce over $5 million in debt, accumulated over $400,000 in savings, and helped 20 families buy a home. This is extremely remarkable given the average annual income for Methodist Healthcare Ministries' patients is about $23,000. For many families, this figure is below the federal poverty level. Fortunately, these services do not have income restriction or eligibility requirements and anyone in the community can access the service for free. In addition to being co-located at Wesley Health & Wellness Center, Financial Empowerment Services has several sites throughout the city. A true community partner, they have connected with local organizations such as Haven for Hope and the Westside Education & Training Center.

In November, Family Service Association's Financial Empowerment Center received an honorable mention for Mutual of America's 2016 Community Partnership Award. It is truly exciting patients are receiving services from a national, award-winning program. Join us in congratulating an outstanding organization of our community!

Edlín Maldonado-Fuller is the Collaborative Grants Specialist for Methodist Healthcare Ministries. She provides technical assistance to community partners in Methodist Healthcare Ministries' service regions, ranging from grant-writing, vetting grant opportunities, supporting collaborative funding initiatives and sharing information about development resources.

By Janet Crain, RN, Wesley Nurse

November is American Diabetes Month® and the beginning of the holiday season! As hard as you've worked to stay on course with managing your diabetes throughout the year, the holiday season has the potential to throw you off. Travel, parties, big meals, snack foods at the office and drinking all create a challenging environment for eating healthy. Add to that the days of travel with little scheduled exercise, and it becomes a real effort to stay on track. "How can I eat healthy during the holidays?" It's one of the most common questions asked by people with diabetes—or anyone who's made a commitment to eating with their health in mind.

If you follow these strategies, you can maintain your blood sugar levels and enjoy the parties and gatherings along with everyone else. However, just like everything else with diabetes, you have to take a few extra steps:

• Eat breakfast or snacks earlier in the day and avoid the idea of sav­ing carbs for the big feast later on. Eat a small, balanced meal before you leave home to avoid overindulging. If you skip meals, it may be harder to manage your blood sugar.
• Limit the number of serv­ings of starchy foods on your plate. It might be tempting to have some mashed potatoes, sweet potato casserole and rolls; however, try to choose just one of these items. If you have a sweet treat, cut back on other carbohydrates (like potatoes and bread) during the meal.
• Choose vegetables first and choose fruits and vegetables served raw, grilled or steamed. Avoid vegetables in creams, gravies and butter.
• Stick to calorie-free drinks such as water, tea, selt­zer or diet sodas instead of punch or mixed drinks. Sip a large glass of water or mineral water to keep you hydrated and provide you with a better option than alcohol.
• If you choose to drink alcohol, limit the amount and have it with food. Talk with your health care team about whether alcohol is safe for you. Women should drink no more than one alcoholic beverage a day and men should drink no more than two.
• Enjoy your favorite holi­day treats, but take small portions, eat slowly and savor the taste and texture. Offer to bring a healthy dish along to the party so that you will have more healthy food choices.
• Try not to hang out near the food to avoid grazing. Find a comfortable spot across the room and focus on socializing instead of eating.
• After your meal, take a walk with family and friends. Exercise will also get you moving, keep you focused on your goals, and give you a welcome break from being surrounded by treats. Exercise is also a great way to lower blood sugar levels.
• If you overindulge, don't beat yourself up. If you eat more carbs or food than you planned for, don't think you have failed, just make a plan to get back on track.
• If you go out more often and stay out later during the holidays, you're likely to get less sleep. Sleep loss can make it harder to control your blood sugar. Also, when you're sleep deprived you'll tend to eat more and prefer high-fat, high-sugar food. Aim for 7 to 8 hours per night to guard against mindless eating.

Most of all, remember what the season is about—celebrating and connecting with the people you care about. When you focus more on the fun, you won't focus as much on the food!

Learn more by visiting the following websites:
https://www.diabeteseducator.org/docs/default-source/legacy-docs/_resources/pdf/general/AADE_Holiday_toolkit.pdf 
http://www.cdc.gov/features/diabetesmanagement/ 

Janet Crain, RN, is a Wesley Nurse with Methodist Healthcare Ministries of South Texas, Inc. Methodist Healthcare Ministries' Wesley Nurse program is a faith-based, holistic health and wellness program committed to serving the least served through education, health promotion and collaboration with individual and community in achieving improved wellness through self-empowerment. Learn more at www.mhm.org. 

By Carol Chavez, regionalization & partnership specialist

On my first day as a regionalization & partnership specialist for Methodist Healthcare Ministries, I hit the ground running and traveled to Brownsville, Texas, on a Sunday afternoon to attend our Sí Texas Project Convening and Evaluation Learning Collaborative sessions. Throughout the four-hour drive, I kept mentally going over potential topics of conversation. I was excited to meet our funded partners and start developing a rapport. I took that first opportunity to network with key individuals and began building relationships with sub-grantees, executive directors and other associates from partner nonprofits. Nearly a year later that continues to be the foundation of my role: forming long-lasting, valuable and trustworthy relationships with our funded partners and with community members in our 74-county service area in South Texas.

Part of my job is to also assist in managing Methodist Healthcare Ministries' Eugene Washington Patient-Centered Outcomes Research Institute (PCORI) award. The community engagement five-part series titled, Advancing Health in South Texas, aims to gather patients and key stakeholders across a 20-county area to develop a coordinated regional approach for patient-centered research and evaluation among university systems, academic institutions, managed care organizations and public health systems. The objective is to learn about patients' perspectives and important health issues in their communities to better frame conversations with stakeholders.

A month into my position, in early February 2016, I coordinated the first PCORI Engagement Series Session: What Matters to You? Methodist Healthcare Ministries, along with our partner Health Resources in Action (HRiA), hosted six, two-hour focus groups in Cameron, Hidalgo, Jim Wells, Nueces, Webb and Zavala counties. I called this trip the "South Texas county tour." Our ambitious goal was to complete all six focus groups in three days.

Hearing firsthand from community members was a great learning opportunity. I learned that wait times to see a doctor ranged from one month to six months. Some patients shared that after hours of waiting for a doctor they'd be called in only to be left confused and frustrated because the doctor didn't speak the same language. Patients expressed that they did not have a trusting relationship with their providers. It was heartbreaking to also learn that critical prenatal care was not easily accessible.

Many communities both in the Rio Grande Valley and Coastal Bend areas have a great need for Methodist Healthcare Ministries' services – to facilitate health care access, to convene key stakeholders, and to connect communities with local not-for-profits and health care providers. Being part of Methodist Healthcare Ministries' community engagement work allows me to be an advocate and bring community voices to the forefront. It enables me to be part of the conversation of health inequalities so I can work on solutions for better health services in rural areas. I believe Methodist Healthcare Ministries is creating a significant platform by bringing down communication barriers between patients and system level stakeholders so that together they can discuss opportunities to increase access and improve health.

In my new role I have a new lens and I can see our organization is on the path to implementing groundbreaking initiatives between health care systems and regional communities to impact many lives. By continuing to connect with communities, we truly bring our organizational mission into action: Serving Humanity to Honor God by improving the physical, mental and spiritual health of those least served.

By Deborah Laurents, Wesley Nurse in Elgin, Texas

A gentleman I know, Greg Silkenson, has a ministry called "Church on the Street." Greg goes to Veteran's Park almost every Friday and provides breakfast tacos, coffee and juice to anyone who shows up. The ministry usually serves the men who wait there for someone to give them a job. Greg is very faithful, caring and compassionate and has built strong relationships.

A few weeks ago, I visited with Greg and the men there. Greg introduced me to Mr. J, a gentleman who receives life-saving health care treatments three days a week in Austin.

Mr. J told me his treatments were Tuesdays, Thursdays and Saturdays. Mr. J. said he rides the bus for $7.00 round trip on Tuesdays and Thursdays, but on Saturdays, the bus does not provide transportation. In order to make it to his appointments, he has to pay someone $50.00 to take him.

With Mr. J's permission, I called his case manager and asked if Mr. J's treatment days could be changed to Mondays, Wednesdays and Fridays. I pointed out the financial hardship it was causing. I was told it was unlikely his schedule could be changed.

As a Wesley Nurse, I help community members obtain access to resources. I felt I couldn't give up. I had to help. God and persistence won. The third time I called, the regular case manager was not there and another case manager returned my call. When I explained to him the hardship Mr. J. was having, the case manager immediately said, "Traveling from Elgin gives him priority in getting his schedule changed. I will see what we can do."

Shortly afterwards, I stopped by to let Mr. J. know about the conversation. I was very happy to learn his schedule had been changed. With a big smile, Mr. J. said "thank you."

Deborah Laurents, RN, is a Wesley Nurse with Methodist Healthcare Ministries of South Texas, Inc. Methodist Healthcare Ministries' Wesley Nurse program is a faith-based, holistic health and wellness program committed to serving the least served through education, health promotion and collaboration with individual and community in achieving improved wellness through self-empowerment. Learn more at http://www.mhm.org/programs/health-ministries. 

By Edlín Maldonado-Fuller, collaborative grants specialist

The United States leads the world in medical research and medical care. This would make you believe we are the healthiest people on Earth. Surprisingly, however, the U.S. isn’t even in the top 25 countries on some of the most important health indicators, like how long we live. We’re behind Bosnia and Jordan! We have the most expensive health care system in the world, yet rate 33^rd in quality of care (read more). The majority of our health care costs go to direct care to manage the “downstream” consequences. Not much is invested in the “upstream” factors like housing, education and employment. Yet, years of research tell us good health depends on many things beyond health care.

Our ZIP code is a strong predictor of how long we live and of our quality of life. Health care (clinical care) is not the only aspect that determines our health and is not the sole answer to better health. Nonmedical factors play a substantially larger role (read more). Even if every individual in Methodist Healthcare Ministries’ 74-county service area in South Texas could afford to see a doctor when they were sick, it would not necessarily result in healthier communities. If we look closer, we learn that various factors within our communities truly influence both our health and our ability to make healthier choices.

Health starts outside of the doctor’s office – in our homes, workplaces, schools and places of worship. We need to enable people to choose the best path to health and ensure that everyone has the tools and resources to make healthy decisions. As a health care system, I believe we should seek upstream solutions to drive vast improvements in health. We should consider promoting health as a community, and unite health and other sectors and disciplines. We need to focus on the nonmedical determinants of health present in our communities, such as social, environmental and behavioral factors.

As an organization, we acknowledge achieving healthy communities takes different, localized approaches. The needs and resources of urban areas vary from rural areas. And not all rural areas face the same challenges. How we work together with communities is changing and is moving toward intentional partnerships to address the Social Determinants of Health (read more). Thankfully, various interventions exist to help our health care system address the nonmedical factors, both within the system and externally.

Still, how do we best address the other factors beyond clinical care that greatly impact our health? Methodist Healthcare Ministries is hard at work meeting with partners across the Rio Grande Valley and greater Coastal Bend regions to understand the needs and resources of communities. We ask questions and listen attentively to identify opportunities for collaboration, alignment, and new ways to leverage resources. Guided by our community partners, we seek to build cross-sector partnerships and promote health. We are also committed to identifying different ways to collect and use determinants of health data to inform and create transformational change.

God intertwines our talents with the needs of others to allow us the privilege of touching, serving, and inspiring others as they journey to become healthier communities. Imagine what could happen if we focused our efforts on preventive measures and upstream factors to keep people healthy!

Edlín Maldonado-Fuller is the Collaborative Grants Specialist for Methodist Healthcare Ministries. She provides technical assistance to community partners in Methodist Healthcare Ministries' service regions, ranging from grant-writing, vetting grant opportunities, supporting collaborative funding initiatives and sharing information about development resources.