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Twenty years ago, the Pontifical Council for Justice and Peace issued the document, "Water, an Essential Element for Life." It outlines the Catholic Church's position on water, stating that "The management of water and sanitation must address the needs of all, and particularly of persons living in poverty. Inadequate access to safe drinking water affects the well-being of over one billion persons and more than twice that number have no adequate sanitation. This all too often is the cause of disease, unnecessary suffering, conflicts, poverty and even death. This situation is characterized by countless unacceptable injustices."

In early 2021, Avera — along with other Catholic health systems throughout the country — joined CHA's We Are Called initiative.1 As Avera's service region in five states continues to reflect greater cultural and religious diversity, ongoing education and formation around diversity, equity and inclusion (DEI) is essential to faithfully live our identity, demonstrating Christ's healing compassion in the world. Knowing that good intentions are not sufficient to ensure positive outcomes, Avera's boards and employees need up-to-date information to guide decision-making and effective action.

One of the things I love most about my work at CHA is the opportunity to meet a multitude of colleagues from across the Catholic health care ministry. It never ceases to amaze me when I see the great work so many are doing across the country in extending the healing ministry of Jesus in our communities, especially for those who are underserved and vulnerable. I encountered one such example on a recent visit I made to San Diego. The mission team at Scripps Mercy Hospital, led by Mark Zangrando, extended a generous welcome as I toured their facilities and met a wide variety of staff.

Over the past several years, Catholic health care has faced unprecedented challenges. From the start of the COVID pandemic and the severe financial and workforce strains that followed, to the ongoing polarization in society that has led to attacks on our Catholic identity, it became clear that external pressures were thrusting us into a time of transition and much-needed change. With this new reality in mind, CHA's Board of Trustees and leaders from across our membership recognized that in order to serve in dynamic ways and meet the needs of our patients and community, we must change how we approach our work. There was a strong feeling that in this profound time of transformation, we must let go of what has been while actively embracing what is to come.