Trinity Health, the nation's newest Roman Catholic healthcare system, is awaiting clearance from Vatican officials to implement a new sponsorship model that gives the laity a more prominent role in ownership and governance.
The ownership structure that Trinity hopes to adopt is what the church calls a "public juridic person," a term that encompasses how a single religious institution owns and governs multiple Catholic healthcare facilities under church law.
Trinity, headquartered in suburban Detroit, would be the third healthcare system in the U.S. to use this kind of lay-sponsorship model.
The others are Denver-based Catholic Health Initiatives and Lexington, Mass.-based Covenant Health Systems.
In the case of CHI and Covenant, the religious institutions that sponsor the systems' facilities include laypeople. Typically, religious sponsors are entirely composed of only sisters or priests.
The move to give laity a more prominent role in Catholic healthcare is partly an outgrowth of declining membership in religious congregations.
Trinity officials declined to comment on the system's move to a new sponsorship model because approval from Rome is still pending.
Trinity, which began operations May 1, was created by the merger of Farmington Hills, Mich.-based Mercy Health Services and South Bend, Ind.-based Holy Cross Health System. The system owns or manages 43 hospitals. With $4.2 billion in annual revenue, Trinity is the country's third-largest Roman Catholic system.
Covenant made the switch to a lay-sponsorship model in 1996, says David Lincoln, the system's president and CEO.
Until then, Covenant had been sponsored by the Sisters of Charity of Montreal, the Grey Nuns.
Covenant has 10 laypeople on its 13-member board, which is appointed by members of a religious congregation.
Lincoln says Covenant changed its sponsorship model because the religious sisters were planning for the future.
"They said they wanted to make sure that they had a way to expand the role of the laity in the healthcare ministry," he says.
But this kind of sponsorship model comes with its challenges, says Larry Singer, an associate law professor and director of the Center for Catholic Health Care and Sponsorship at Loyola University in Chicago.
"The challenge is getting laity who are able to so deeply understand the (religious) mission that they cannot only keep it alive while they're in office but inculcate it in the second and third generation of leadership," Singer says.
Lincoln says his system has helped prepare laity for their role in sponsorship through a series of educational programs.
After all, Lincoln says it's "a pretty awesome responsibility taking on sponsorship as laypersons."
But Singer says more systems haven't rushed into the "public juridic person" ownership model because they are waiting to see how systems such as CHI and Covenant succeed.
At CHI, the system is governed by a 14-member governing board, with seven lay members and seven religious ones. Additionally, Patricia Cahill, CHI's president and chief executive officer, is an ex-officio member of the board.
That board has authority for CHI under both civil and church law. Religious congregations that merge their facilities into CHI agree that they will give up ownership of them to CHI.
One benefit of having this single sponsoring organization for a Catholic system is that it helps streamline management of the system.
For example, the CHI board can make decisions about the sale of church property, such as hospitals, and how to spend the proceeds without having to seek final approval from a religious congregation, which in turn would have control over the proceeds, says Paul Neumann, CHI's general counsel.
Neumann says he expects more Catholic healthcare systems may turn to this kind of lay-sponsorship model.
"I think it is not completely the wave of the future, but it's certainly a very beneficial way to sponsor healthcare systems, and therefore more will do that," he says.