by Marshall Scott
A few years ago, while I was President of the Assembly of Episcopal Healthcare Chaplains, I was contacted by a person with the Church Pension Group. She called to ask me if I knew just how many Episcopal hospitals there were.
Now, this was something officers of AEHC had been thinking about for a while. The sense among chaplains was that there were fewer hospitals than there had been, and probably more retirement communities and nursing homes. On the other hand, we didn’t have hard numbers about hospitals.
In part, that was because we had trouble with the definition. What would be required to identify a hospital or other health care institution as “Episcopal?” As we discussed it, we came to three large categories. There were those hospitals that still had some official relationship with a diocese or other institution within the Episcopal Church. While no money might go back and forth, they were still considered explicitly as ministries of the diocese; the diocesan bishop was an ex-officio member, if not chair, of the hospital’s board; and there were positions that required an Episcopalian (for example, a chaplaincy program directed by an Episcopal priest, or a percentage of board members). There were also hospitals that had been founded by an institution or by members of the Episcopal Church, and had since changed hands; but that still had a visible expression of Episcopal heritage (for example, again, requirement for an Episcopal chaplain, or certain board memberships). Finally, there were those hospitals that had been founded by Episcopalians and had since changed hands; but had no visible expression of Episcopal heritage, except perhaps in the name of the institution and the memories of area congregations. Yet, with those significant differences, all might be called, at least in some contexts, “Episcopal hospitals.”
With all the changes in health care, and especially the mergers, centralization, and corporate changes of the past generation, there are fewer hospitals still owned or otherwise officially related to dioceses or other institutions of the Church. At the same time, with changes in demographics, both in the Church and in society at large, Church institutions have built more retirement communities and long term care centers, most connected in multilevel facilities.
On my own blog I’ve done some reflecting on what might describe an Episcopal culture for health care. I came to that question in part from the original question from the employee of the Church Pension Group, and in part from watching colleagues in other hospitals. Institutions connected with the Roman Catholic Church and with the Seventh-day Adventist Church have distinct ideas of what describes, respectively, a Catholic or an Adventist institution. I continue to think about how we would identify an Episcopal culture for health care.
But in thinking about that, I wondered just how involved the Episcopal Church is in health care. Now, there are a number of things one might measure, but I thought a simple place to start was in The Episcopal Church Annual. Within the Annual is a section titled, “Social Agencies and Institutions.” While there other things to note in that section, I moved to the subsection, “Health & Welfare Agencies Related To Dioceses or Parishes of the Episcopal Church.” There, listed by diocese, are a number of ministries, some of which are explicitly related to health care. To begin with, I simply went through and counted, and came up with the following numbers:
Hospitals: 17
Retirement and Long Term Care facilities: 145
Other Residential Facilities: 36 Other: 47 That comes to a total of 299 ministries. Now, there are some observations to be made about those numbers. The number of hospitals is low. In two dioceses with related hospital systems, the numbers represent the single system rather than the multiple institutions in each system. It also doesn’t include at least one specialized hospital in Haiti largely supported by parishes in the United States, or one hospital related to a religious order. At the same time, taking those that I know of into account, the number is still perhaps 30 throughout the Episcopal Church. The other categories are also interesting. For example, while most retirement communities include some assisted-living and long term care beds, I’m not certain that all do. I included them anyway. By the same token, there are some social service agencies that might provide counseling and might have been included in that category; but because the description didn’t suggest that I didn’t include them. I noted in several dioceses free-standing chaplaincies serving hospitals that had once been owned by dioceses but were no longer – a sense of Episcopal presence without organic Episcopal connection. Some substance abuse ministries were inpatient, and so listed as “Other Residential;” while others were outpatient, and so listed under “Other.” Some diocesan ministries did stand out for me. The Diocese of Honduras supports twelve medical clinics. The Diocese of Spokane supports ten residences for senior citizens. Many dioceses support various ministries to persons with AIDS. One other number did interest me: the number of dioceses represented. In the list in the Annual, only 85 of the 111 dioceses of the Church list any Health and Welfare ministries. Of the 85 that do, eight don’t list any that I could identify with health care. So, these 299 ministries represent seventy-seven dioceses, or about 70% of the dioceses of the Episcopal Church. It’s not that I don’t think there are health care ministries in the other 34 dioceses. As I said, I know of some that aren’t listed, and I’m sure there are others I don’t know about. At the same time, I’m also sure there are some in listed dioceses that aren’t listed in the Annual, and so I might speculate that the proportions are roughly appropriate. That is, the health care ministries in unlisted dioceses are not likely to be so numerous as to radically change the rough proportions of what ministries are supported, and where we would find them. Another limitation of these numbers is that they don’t represent significant programs of and groups within the Episcopal Church functioning on a national level to support local ministries. The work in supporting health ministries of the Office of the Suffragan Bishop for Chaplaincies and significant programs in support of persons with AIDS, addiction, and disabilities are listed in other places, and so are not in this list. The same is true of the Assembly of Episcopal Healthcare Chaplains, of which I am a member, and of National Episcopal Health Ministries, a network supporting parish-based health ministers and parish nurses. We can also appreciate the focus of the Office of Government Relations and the Episcopal Public Policy Network, especially as we get closer to national elections. However, my guess is that the 299 ministries identified in those seventy-seven dioceses are those most likely to be visible to Episcopalians and to others in their daily lives (with the possible exception of parish nurses and health ministers). While the national programs are important, they are primarily ministries and organization within the Church to support ministries of the Church. I think the separate institutions and ministries are more tangible expressions of the Episcopal Church’s work in health care. They incarnate the concerns of the Episcopal Church for health care. I’m still working on what “an Episcopal culture for health care” might look like. However, it is clear that the Episcopal Church is concerned about health care and involved in providing it. While my review is hardly exhaustive, it is sufficient to make that clear. As we “seek to serve Christ in all persons,” and to “proclaim by example the Good News,” we are caring for bodies as well as souls. We can appreciate these Episcopal ministries in health care. We can pray that over time we will see more. The Rev. Marshall Scott is a chaplain in the Saint Luke’s Health System, a ministry of the Diocese of West Missouri. A past president of the Assembly of Episcopal Healthcare Chaplains, he keeps the blog Episcopal Chaplain at the Bedside.