public juridic person in action, The

Health Progress, May/Jun 2001 by Stephens, Bob

An Interview with Sr. June L. Ketterer, SGM, and David R. Lincoln of Covenant Health Systems

In its January-February 1996 issue, Health Progress published an article (Nancy Mulvihill, "Public Juridic Person Ensures Catholic Presence," pp. 25-27) describing the process whereby the United States St. Joseph Province of the Sisters of Charity of Montreal (Grey Nuns) transferred sponsorship of its U.S. health care facilities to Covenant Health Systems (CHS), Lexington, MA.

Five years later, Health Progress talked to Sr. June L. Ketterer, SGM, provincial superior of the Grey Nuns, Lexington, MA, and a CHS board member, and David R. Lincoln, CHS's president and chief executive officer, about how the public juridic person concept has worked in practice. The interview took place in Lexington.

HP: Sr. Ketterer, as you look back on the way the Grey Nuns decided to transfer sponsorship of their U.S. health care facilities to CHS, can you think of anything you should have done differently?

Sr. Ketterer: No. We were very deliberate and thoughtful in the process. Although we began discussing the issue in June 1992, we didn't actually implement the sponsorship transfer until October 14, 1996.

Our main goal was to ensure the continuation of our mission and the Catholic identity of our health care organizations. At the time, we had only 69 sisters, with an average age of 72, in our province. We knew it was the right time to begin to look to the future of our institutions.

We set up what we called a Sponsorship Discernment Task Force to examine our options. That group eventually listed 12 options, ranging from doing nothing to transferring the assets of CHS and its institutions. In the end, however, our decision was unanimous: We would seek approval -- from the Grey Nuns' provincial and general administration and from the Vatican-to transfer sponsorship of our health care ministries to CHS. CHS would become a public juridic person of pontifical right, a lay board of directors that would assume responsibility for our Catholic health care ministries.

HP: Can you explain why you chose this option?

Sr. Ketterer: The public juridic person model, which was admittedly innovative, seemed to us to best fit the objectives and goals we had set out to accomplish. First, and perhaps most importantly, it meant that the 139-year-old Grey Nuns mission in this country would remain alive and vital and that our health care facilities would remain totally within the Catholic Church.

Second, by establishing CHS as a public juridic person of pontifical right we made it possible for other institutes, congregations, and dioceses to join and/or partner with us, thereby further strengthening Catholic health care in the United States.

And, third, CHS's assumption of sponsorship of our facilities would also, for the most part, mean "business as usual" in our health care institutions' decision-making and information-sharing structures. This model would best ensure that the Grey Nuns' established mission, values, reputation, and heritage would continue.

HP: The public juridic person is "of pontifical right," which means that you are accountable to the Vatican Congregation for Institutes of Consecrated Life and Societies of Apostolic Life (CICLSAL). Do you submit an annual report?

Lincoln: Yes, according to the organic documents approved in Rome in 1995, the board as representative of the juridic person is committed to submitting an annual "stewardship accountability report" to the Vatican congregation. The report reviews the past year's activities; documents the ways the mission has been strengthened; and lists special programs established to bolster Catholic identify, pastoral care, ethics, and access to care for the poor. The report also includes a statement of the ownership of assets and outlines some goals and challenges for the coming year. We have made such annual reports since 1997, our first year as a juridic person.

HP: Has filing the annual report perhaps been a learning experience for both CHS and the Dicastry (as the Vatican congregation Is known)? What have you learned from it?

Lincoln: The report has been a learning experience for CHS because everyone in the system reviews what we have achieved as sponsors and participants in the Catholic health ministry.

We present this report at CHS's Annual Leadership Forum (attended by senior managers and trustees from throughout the system) and also send copies to the CHS board as the juridic person; the Sponsors' Council, which is an advisory group made up of the sponsoring congregations and dioceses we relate to; the Grey Nuns' general administration; and the bishops in each of the dioceses in which CHS has sponsored works.

We believe that a very important element of our success to date has been our commitment to keeping the lines of communication open and to be forthcoming in our struggles, not only with the Dicastry in Rome but also with the diocesan bishops. So, in effect, we have the same reporting accountability on Catholic identity to our diocesan bishops as we have to the Vatican. In fact, each local CEO and I meet at least once a year with the diocesan bishop. The agendas for those meetings tend to be issue specific. For example, we just finished discussing the proposed changes to the Ethical and Religious Directives for Catholic Health Care Services.