Rick Banks from Black Leaders Organizing for Communities, far left; Nate Gilliam, organizer for the Wisconsin Federation of Nurses and Health Professionals, center left; Melanie McCurtis of the Metcalfe Park Neighborhood Association, center right; and Jack Hansen. a research and policy analyst from Milwaukee Area Service and Hospitality Workers Organization, far right, all spoke at a meeting Oct. 1 to discuss Ascension Wisconsin's St. Joseph campus.(Photo: Talis Shelbourne / Milwaukee Journal Sentinel)

Three empty chairs at a community meeting epitomized the mistrust between the leaders of Ascension Wisconsin and the St. Joes Accountability Coalition.

The coalition, composed primarily of community leaders from Milwaukees north side, invited Ascension Wisconsin to that Oct. 1 meeting to press the health systemtosigna legal contractbinding it to a list of commitments. The commitmentsincluded keepingAscension St. Josephhospital openand providing an urgent care clinic, affordable housing assistance, local hiring, more employee training and living wages for all employees.

Ascension didnt show.

For one, Ascension Wisconsin officials said they were told they would not be allowedto speak at the event. For another, they said signing a contract was unnecessary because they have promised to keep the hospital open,already hire locally andprovide employee training.

The hospital, which employs about 800 people, is one of the neighborhood's largest employers.

The coalition wants the hospital to sign a community benefits agreement, known as a CBA, which is a contract between community groups and real estate developers or government entities.

Reggie Newson, Ascension Wisconsinsvice president of government and community services, said the health systemis proving its commitment to the community by expanding and adding services to St. Joseph.

For example, two certified nurse-midwives were just hired forthe hospital's new midwifery clinic and a third is being recruited. The hospital is also planning to hire a cardiac nurse practitioner and cardiologist.

But members of the coalition arent convinced, because they say there is no legal penalty if Ascension fails to follow through on its promises.

Nate Gilliam, an organizer with the Wisconsin Federation of Nurses & Health Professionals, advisory board member of the University of Wisconsin Population Health Instituteand coalition spokesman,said the coalition just wants accountability.

Its good that theyre saying all these great things on paper and to the media," he said. "But if they are going to do that, they shouldnt have a problem with signing a CBA.

The lack of trust between the coalition and Ascension Wisconsin started 18 months ago, when hospital administrators citing losses of roughly $30 million a yearproposed cutting some of Ascension St. Joseph's surgical and medical units and other services, such as cardiology support.

RELATED: Ascension Wisconsin cutting services at St. Joseph hospital

The hospital, at 5000 W. Chambers St., serves a majority African American population on the city's north side, an area facingsteep socioeconomic disadvantages. Decades of limited access to health care havecontributed to higher rates of chronic disease. Higher rates of poverty means many residents rely on Medicaid for health insurance.

Residents interpreted Ascensions proposal as a precursor to closing the hospital and in an area where transportation is scarce feared they would have to go farther for health care.

The proposalwas criticized by Mayor Tom Barrett, several aldermen and community leaders, including George Hinton, CEO of the Social Development Commission and former president of Aurora Sinai Medical Center, who wrote an op-edin opposition.

Ascension dropped the proposal.

But that was 18 months ago.

Reggie Newson, Vice President of Government and Community Services, Chief Advocacy Officer, Ascension Wisconsin.(Photo: The Refinery Photo Studio)

Since then, Newsonsaid the hospital surveyed more than 1,000people by telephone and held five community listening sessions. The information was used to develop priorities for the hospital and corresponding programs, such as the midwifery program and heart and vascular community care center.

Similarly, members of the coalition conducted their own survey, knockingon hundreds of doors and collecting 584detailed responses.

When surveyed on non-clinical services, over 40% of residents said housing assistance, local hiring and living wages were their top priorities.From the coalition's survey onclinical services,61.6% said access to urgent care was most important to them.

Kevin Kluesner, Ascension St. Joseph's chief administrative officer, said he and others arewell aware of the health disparities and disadvantages within the community they serve.

He saidAscension Wisconsin's pushto expand services is proof the hospital isnt going anywhere.

RELATED: New Women, Infants, and Children office opens at Ascension St. Joseph through Milwaukee Health Department partnership

Thatcommitment is despite the hospital'shaving lost roughly $150million since the 2012 fiscal year. In the 2018 fiscal year, the most recent for which information is available,Ascension St. Joseph lost $31.6 million.

By comparison,Froedtert Hospital reported $134 million in profits for the 2018 fiscal year, according to information filed with the Wisconsin Hospital Association.Aurora St. Lukes Medical Center reported $166 million in profits in 2018.

Gilliam said that since the hospital is a non-profit venture, lost profits shouldn't matter. He also said that Ascension Wisconsin hasmore profitable locations across the state, that can offset the losses at St. Joseph.

Markasa Tucker, executive director of the African American Roundtable and supporter of the coalition, reads the response from Ascension on her phone.(Photo: Talis Shelbourne / Milwaukee Journal Sentinel)

The results from the coalition's survey mirrored what residents at the Oct. 1 community meeting described.

Charles Hawkins said he likes his primary care physicians, but said they keep leaving.

Another resident who lives blocks away from the hospital, Arkesia Jackson, said when her brother-in-law experienced a flare-up of his COPD, or chronic obstructive pulmonary disease, she was thankful a community hospital was nearby.

"He ran inside the emergency and collapsed, car running," she said. "He is a patient at St. Joe's. They had all his records, they knew who he was, they knew what he was suffering from."

Newson said the goal isto provide consistent, quality care for all patients.

Gilliam acknowledged that details of what the coalition isasking for, such asracially equitable health care and helping with housing assistance, are somewhat vague. However, thats because its members said they want to sit down with Ascension and hammer out an agreement as long as Ascension commits to signing one.

Coalition members argue that other hospitalshave worked withcommunity groups on similarinitiatives.

Robert Silverman, a professor in the Department of Urban and Regional Planning at the University of Buffalo, said there are some rare examples of CBAs being used in the health care field.

For example, Yale University signed a CBA with the Community Organized for Responsible Development groupin 2006 regarding the construction of a new cancer center.

It still remains unlikely that Ascension, a national organization,would willingly set such a precedent for its hospitals.

Gilliam said he thinks it's important for hospitals to be accountable to the community.

I dont see why they see a community benefits agreement as adversarial off the top," Gilliam said. Whenever theyre ready to come to the table in earnest, well be there.Thats it."

But with the addition and expansion of several new programs, Kluesner said he's not sure what else hospital officials can do to prove they are serious about being a reliable anchor institution on the citys north side.

"We've signed 11 new providers. That's the best proof we could give of our commitment togrowing services here at St. Joseph. If people are wondering what are we doing at Ascension St. Joseph, I think that actions speak louder than words," he said.

Contact Talis Shelbourne at (414) 223-5261 or tshelbourn@jrn.com. Follow her on Twitter at @talisseerand Facebook at @talisseer.

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Trust issues plague the relationship between Ascension St. Joe's and the community it serves - Milwaukee Journal Sentinel