An interview with ArchCare President and CEO Scott LaRue, March 28, 2020

From Archways, the quarterly magazine of the Archdiocese of New York

As the deadliest pandemic in a century sweeps through New York, the caregivers of ArchCare, the multifaceted health- and eldercare agency of the Archdiocese of New York, are working tirelessly to protect their clients, most of whom are elderly or suffer serious medical conditions. Almost all of them are at high risk for life-threatening illness should they become infected with Covid-19, the disease caused by the novel coronavirus. 

This critically important effort is taking place on many fronts, because ArchCare serves a diverse patient population with a wide variety of needs. In the best of times, many clients would have no recourse other than ArchCare to receive the expert care they need. In the current crisis, the agency’s services have become even more indispensable. 

ArchCare’s programs (see “The Many Mercies of ArchCare,” Archways Spring 2019) include the Specialty Children’s Hospital, serving children and young adults with severe physical and neurological impairments; Huntington’s disease units in Manhattan and Dutchess County; a long-term care facility for HIV/AIDS patients; specialized long-term care for people with late-stage kidney disease, Alzheimer’s and other conditions; and a hospital devoted exclusively to palliative care for adult patients with advanced cancer (ArchCare at Calvary Hospital in the Bronx). 

Eldercare programs include traditional nursing homes; a skilled nursing center for people who require 24-hour care; and PACE, which delivers the care and expertise of a full-service nursing home through community-based centers that permit members to remain in their own homes.

In addition, the Chaplaincy Apostolate administered by ArchCare oversees the work of 22 Catholic chaplains at 27 hospitals around the Archdiocese of New York (see “A Healing Spirit,” Archways Winter 2019).

The agency is operating these programs in a region that has become the epicenter of the Covid-19 pandemic. On March 28, to find out how the crisis is affecting ArchCare and its clients, and how the agency is responding, Archways editor Michael S. Cain spoke with Scott LaRue, president and CEO of ArchCare. 

Scott LaRue, ArchCare’s president and CEO, delivering personal protective equipment supplies to Terence Cardinal Cooke Health Care Center in East Harlem on Sunday, March 29, 2020.

Archways: How is Covid-19 impacting the client base of ArchCare and its programs, and how is ArchCare responding? 

Scott LaRue: Covid-19 is impacting every one of our programs. It’s widespread in our community, and if it’s widespread in the community it’s going to be widespread in the programs for the people we serve. 

We enacted our disaster plan in the third week of February and created a three-phase response. Level one was preparation and planning, level two was when there were diagnosed cases within the city, and level three was when there were diagnosed cases within our programs. Each one of those levels required a different course of action. 

We actually implemented procedures before the CDC suggested them: We started screening all our staff for temperatures and international travel before they came into any of our facilities. We put infection control monitors in each of our program locations wearing red coats that said INFECTION CONTROL MONITOR, so that they could make sure that people were following proper procedures, and could also answer questions of family members. 

Eventually, we prohibited visits by anyone who did not work for ArchCare, which the state later came to require as well. We set up a special Covid-19 hotline [877-239-1998 or email [email protected]] for the people we serve, their families, employees and religious communities to call for information, and to get resources or supplies if they need them. We did a tremendous amount of training on infection control, what the coronavirus is, and how to prevent spread. We did that for staff, for religious communities, for the priests of the archdiocese and a number of the other ministries of the church. 

Currently we’re taking calls from people in need of answers to medical questions, guidance on what to do for those who are exposed, and getting resources to people who live in communities that are sheltered in place and unable to get out – especially the most vulnerable that we serve, the elderly and the chronically ill.

Our agency is caring for people with Covid-19 throughout the archdiocese. Our primary issue is access to resources and equipment, and assisting the system so that it doesn’t clog up and we’re able keep the flow of patients moving through.  

Archways: ArchCare administers the hospital chaplaincy program for the Archdiocese of New York. Is that program carrying on during the Covid-19 crisis?

Scott LaRue: With the hospital chaplaincy program, we’ve been working with the local hospitals to make sure that the priests can continue to visit patients and perform the sacraments if necessary. And at the request of Cardinal Dolan, we’re working with the city and the state to ensure that patients in the temporary hospitals that are being set up will have access to a Catholic chaplain. 

Archways: The eldercare programs of ArchCare – the PACE program, which has community centers where clients are transported for services and socializing, as well as the more traditional nursing centers – serve the populations most at risk for getting critically ill with Covid-19. How is the agency dealing with this challenge?  

Scott LaRue: In terms of our PACE programs, we have closed two of the four centers and consolidated services into the remaining centers; we have also redeployed our staff to support our participants in their homes instead of transporting them to the centers. 

In our nursing homes, we’ve deployed tablets so that our patients can Facetime or Skype with their family and friends. We’ve put together individual activity kits so that they can have things to do within their rooms, because even within the nursing home the patients are frequently isolated to their own rooms. There are no communal dining or group activities taking place during this crisis. 

The state has mandated that nursing homes continue a flow of patients into the home, and homes may not deny admissions to people with Covid-19. Not that we would, anyway. In New York, the Catholic Church, through ArchCare, was the first to provide long-term care for people with HIV. It was the first to step up to help the severely disabled children who had to be transferred out of Willowbrook [the Willowbrook State School on Staten Island, which New York State closed in 1987 after news reports revealed deplorable conditions there]. We were the first to offer expert long-term treatment of those with Huntington’s disease and other neurodegenerative conditions. So it’s not our intention in this time of need to turn our backs on people with Covid-19. 

Unfortunately, the nursing homes have been placed in a secondary position to the acute-care facilities in terms of access to personal protective equipment – even though we’re treating the same Covid-positive patients in the nursing homes that they’re treating in the hospitals. The only difference is the hospitals take ventilator-dependent patients and we cannot. If patients become ventilator-dependent, we would have to send them to a hospital. 

We’ve also pushed out a million dollars’ worth of appreciation bonuses to our front-line staff – the nurses, the housekeepers, the aides who are taking care of these patients at the bedside. They’re doing this at great risk to themselves and sometimes without the proper personal protective equipment. 

Archways: What steps is ArchCare taking to protect staff, clients and volunteers from Covid-19 infection? 

Scott LaRue: We’re not allowing volunteers into the buildings during the crisis. The steps we’re taking to protect our staff is training, in terms of proper infection control procedures, handwashing and what we call “avoiding the t,” which is not touching your face – your eyes, your nose and your mouth – where the transmission of this virus takes place. We’re also fighting for access to personal protective equipment from sources across the entire country. In fact, we were on the phone at 11:30 last night with a group that is accessing personal protective equipment in China that should be on a plane this morning at 10 o’clock on its way to our facilities. We’re trying to do everything that we can to ensure that our staff is able to care for these patients as safely as possible. 

Archways: Is ArchCare altering its facilities or adding capacity to help fight the pandemic? 

Scott LaRue: We’re increasing bed capacity at Terence Cardinal Cooke Health Care Center, in Harlem, by 67 beds, all for Covid-19 patients. That was approved by the health department this week so that we could help hospitals relieve the surge capacity. We’re just setting the unit up; it should open within the week. 

Every hospital in the state was mandated to increase its capacity by 50 percent. They had to submit a surge plan to the department of health last week. Including Calvary Hospital. They had to do the same: increasing access and adding beds. 

Preparing new in-patient facilities at Terence Cardinal Cooke Health Care Center, where ArchCare will add 67 beds for Covid-19 patients.

Regarding treatments: This past week, we spent significant time advocating with the state, who had prohibited nursing homes from dispensing hydroxychloroquine. We were dispensing that to our patients, and we thought it was having a positive effect – although the efficacy of it is still in question. You can’t make a definitive therapeutic judgment based on short-term use. But at least it gave us some hope, and it gave hope for the patients and the people we serve. Then the state prohibited nursing homes from dispensing the drug. We spent quite a bit of time advocating – in fact, His Eminence assisted me in advocating at the highest levels of state government, and we were really pleased that last night the governor reversed or modified his executive order, and we are able to begin dispensing the drug again in the nursing homes. 

We’re trying to make sure that the people we serve – even though they’re elderly, and they may be immunocompromised – get the same respect and access to care that anyone else in the community is getting. 

Archways: What can be done for families of Covid patients who are unable to visit their loved ones? 

Scott LaRue: We’re in a circumstance were it’s possible that a family member was not able to be with their loved one when they passed. That adds complexity and difficulty for everyone involved, and I think it requires additional support and caring. 

We are working with Calvary Hospital and their bereavement program so that we can offer bereavement services and support to any of the families who are affected by Covid-19. That task force is up and operating at this time. Referrals are being made and contacts are being made with families.

This bereavement support is virtual at this point. Over time it could become part of a bereavement support group, but right now you’re not allowed to do that. 

Archways: How can the archdiocese’s Catholics help right now? Where can they donate? Are there particular material items needed? And are there any places where they are needed as volunteers? 

Scott LaRue: If you go to our website, you’ll see our Covid-19 hotline [877-239-1998; [email protected]]. That’s a resource for anyone in the archdiocese if they have questions about the virus, if they need access to medical care and they don’t know what to do, if they have needs in their home that aren’t being met, if they need assistance getting supplies, whatever they might need to help them get through this crisis, that’s what the hotline is there for. They should feel free to call it. It’s staffed 24 hours a day.  

The hotline is also a resource if someone is trying to reach a patient in one of our programs and they can’t get through. If they call that hotline we’ll connect them to the right people so that they can get information about their loved one.

In terms of supplies, if there’s anyone who has connections that could get us personal protective equipment, and especially disposable gowns and/or face shields, that would be really helpful. We’re also encouraging individuals to write cards and mail them to our main address; we will share with our residents and participants who are isolated. 

We appreciate any prayers for the people that we care for. And I don’t want to make this a solicitation request, but if anyone wanted to donate money to our foundation to help support our efforts in the community, they can go to our website and click on the donate button. 

Archways: Anything else you’d like to say to sum up? 

Scott LaRue: I want to make sure that families know that everything that can be done is being done. No stone is being left unturned, whether it’s how we care for our patients or how we protect our staff. This is an unprecedented crisis, and what’s occurring is occurring everywhere in the community. People shouldn’t be overly alarmed if there is a patient with Covid-19 in any particular program, because there are Covid-positive patients everywhere, in every part of the community. 

We really just need to pull together and work together for the benefit of the people we serve and their families. 

Copyright March 2020, Archdiocese of New York