FORMATION AND GOVERNANCE

Health Progress, Sep/Oct 2004 by Homan, Ken

Catholic Organizations Should Institute Theological and Spiritual Formation Programs for Their Trustees

Do not cling to events of the fast or dwell on what happened long ago; watch for the new thing I am going to do, it is happening already, can you not see it?

-Isaiah 43:18-19

"What makes a Catholic hospital Catholic?" a student in my ecclesiology course recently asked. We were in the middle of a lively conversation about the catholicity of the church, and the students expanded the conversation to include two other major institutions that demarcate themselves as Catholic: health care and education, particularly Catholic higher education. If the church has identifying marks, my student reasoned, should not other Catholic institutions have them as well?

What makes an institution Catholic? Who makes an institution Catholic? Clarke E. Cochran, who has made a lifework of studying Catholic identity, particularly that of Catholic health care, contends that the aspects most characteristic of Catholic institutions are their incarnational and sacramental dimensions.1 If this is so, who is responsible for bearing and transmitting these sacramental and incarnational dimensions? Governance, I suggest, has a substantive role to play in this respect for Catholic health care organizations. How well equipped are our boards of trustees to play this role?

It used to be that the ministry of the sponsoring congregation manifested these sacramental and incarnational aspects. However, that reality has changed with the reconfiguration of diverse models of sponsorship and the increasing involvement of laypersons, some of whom may not be Catholic and whose identity is primarily formed by business values.

Most Catholic hospitals anchor their ministry in "continuing the healing mission and ministry of Jesus," a phrase that is not exclusively Catholic. Catholic health care typically employs some combination of three strategies to maintain its Catholic identity.

Sympathetic Administrators One strategy involves hiring administrators (Catholic or otherwise) who are sympathetic to the charism of the founding congregation and are respectful toward the tradition of Catholic health care. How theologically and spiritually fluent should such leaders be? Is it sufficient that a leader exhibit the operative values attached to the charism, even if he or she cannot articulate the theology undergirding the charism?

Mission Leader The second strategy designates a mission person who has some degree of authority concerning charism and catholicity. Of course, this strategy risks creating a ghetto for mission. A mission person raises the mission-and-identity question as a matter of duty. He or she becomes the conscience of the organization. One consequence is that, to the degree the mission person functions as organizational conscience, others are relieved of this fundamental responsibility.

In-House Formation The third strategy establishes a type of in-house formation program that fosters foundation and growth in Catholic health care identity and mission. The person in charge of mission frequently oversees this in-house formation program.

However, I would like to explore still another way of perpetuating mission: through governance. How might Catholic health care change if trustees were formed as leavening leaders?

THE MISSION OF GOVERNANCE

Sr. Jean deBlois, CSJ, PhD, argues, "Our capacity to sustain Catholic health care as a ministry of the Church depends on our realization that all our activities must flow from the core of who we are, that is, from our spirituality/" She goes on to say that, "as ministry, we must provide witness as well as service because the call to be MISSION in the world is also the call to build up the kingdom of God within."

But much of health care is caught up in the flurry of service delivery. Governance is uniquely postured to give witness and to establish accountability for witness. Governance, I suggest, is best positioned to be an agent of witness because it is not involved in direct health care service.

Governance's task is to hold the common good of mission as a value in itself and to create a mission "horizon" toward which policies and procedures move. Too often, mission and identity are seen as negative boundaries that the organization must not violate ("That would be contrary to our mission"). Unfortunately, governance, identity, and sponsorship tend to be seen as forms of oversight, often expressed by the principle: "Don't do anything that will upset the sisters."

If mission were articulated as a positive horizon, governance's role would be different. As a positive horizon, mission would serve a higher, transcendent purpose that prompts and invites others to share in the higher purpose of Catholic health care, witnessing to the love and the healing presence of God, while delivering excellent services. Trustees would be, not watchdogs, but leaven, animating the culture of Catholic health care.3 They would then remind Catholic health care of its sense of purpose and help keep the ministry focused on its fundamental, orienting values.4 In a negative-boundary model, governance functions as a shepherd who seeks the safety and survival of the flock; the shepherd trains the flock to go where the shepherd wants the flock to go. leavening governance, on the other hand, remembers that the ultimate task of health care ministry is to witness to and to serve the realm of God. Leavening governance would be open to discerning new ministry.