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The catalyst: Lelia Moore made the most of opportunities to benefit the most vulnerable in Guilford County

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Lelia Moore

Lelia Moore speaks during the homecoming for the Congregational Nurse Program through Cone Health in Greensboro, N.C, on Thursday, Jan. 3, 2019.

GREENSBORO — When Lelia Moore's mother died, the young nurse who was the eldest of her siblings and had dreamed of being a missionary overseas since childhood, decided to stay closer to home.

"I knew I couldn't leave my family," said Moore, the now-longtime coordinator of the Cone Health Congregational Nurse Program, whose father was a Lutheran pastor. "I remember thinking, 'God, where is it you need my hands?'"

That answer seemingly unraveled over the next 47 years through moments that sometimes even surprised her:

At the Greensboro Coliseum where rows of dentists with their chairs and assistants provided free care on a first-come, first-serve basis to those making up a line that snaked out the building's doors.

In the hotel room reserved for a terminally ill homeless man who had nowhere to go after being released from the hospital.

Within the hallways and the sanctuaries of local churches where nurses provide screening, referrals and often life-saving instructions to people where they worship.

Moore — soft-spoken, creative, yet practical and sharp — had her hands in it all.

The past UNCG Alumni of the Year and News & Record "Woman of the Year" has taken opportunities and used them to benefit the most vulnerable in the community say those who would know, because they work with them.

"She always, always plays in the shadow and allows the light to shine on others although we all know she is the one who did it," said Fran Pearson, the program director of the Congregational Social Work Education Initiative with UNCG and N.C. A&T, for which Moore planted the seed.

In a moment in 2012 that some say defines a career that's ending with her retirement this week, a photographer's lens caught 25-year-old Michael Shelton, who had all of his teeth extracted that day at a dental clinic at the coliseum, giving a hug to Moore, who stood grasping her walkie-talkie as hundreds waited outside.

"She is," Shelton wrote then, because he could only write and not talk, "an angel."

Lelia Moore

In this 2012 photo, 25-year-old Michael Shelton hugs coordinator Lelia Moore after all his teeth were extracted during the fourth annual Missions of Mercy free dental clinic at the Greensboro Coliseum. "She is an angel," Shelton wrote at the time because he could only write and not talk.

Winding down

These final days are bittersweet.

Moore is leaving Greensboro and moving closer to her son, daughter-in-law and grandchildren near Raleigh. And whatever she can get into there.

Just weeks ago she was having a long conversation with a homeless man afraid to get a flu shot.

Clients, even those she has just met, quickly trust her enough to share their stories of brokenness and overwhelming challenges, say those who work with her.

Those stories motivate Moore. Sometimes it's homelessness, hunger and not having enough food for the family, domestic violence, no means to get health care or to afford medications, or a lack of financial resources for basics. She realized long ago from watching her parents minister to others that people who are hurt or in need are grateful for simple things — listening with compassion, advocacy to address their needs, a hug and a prayer.

"He (then) let me give him the injection," Moore said of that homeless man, "and was surprised it did not hurt." 

After thanking her for caring, he asked if he could give her a hug. In doing so, he mentioned he did not get many hugs.

"I said sure and gave him another hug back for the next day," Moore said.

"That makes this hard."

Even before she sat in front of the committee interviewing for the coordinator of the then-newly created Cone Health Congregational Nurse Program in 1998, Moore was already familiar with the needs because of her work through the Moses Cone Health System in looking at the kind of issues that ended with people repeatedly seeking medical care in the emergency room. That put her in meetings with others in the health care and nonprofit field. Having started out as a young nurse on the floors of Moses Cone, she was later an outpatient clinic nurse manager working with those struggling through life.

In 1997, Bob Hamilton, then director of pastoral care at Moses Cone, and chief nursing officer Nancy Paxton began bringing people like Moore and others together to talk about congregational nursing, a concept rooted in the Midwest. The program, a marriage of health care and faith, is based on the premise that houses of worship are communities of people with lots of contact and lots of concern. That those in a congregation also often know when another member needs medical attention but is reluctant to get it. Having a nurse among them for a measure of preventative care might get to some of those issues before they become life-threatening.

Organizers got $500,000 in grants from the Wesley Long Community Health Foundation and the Duke Endowment to make it happen. And the committee that held the interviews for a coordinator to oversee it agreed on Moore, who already had built relationships in the community.

Lelia Moore expands congregational nurse program

In this 2012 photo, congregational nurse Marietta Douglas checks Felix Ware's pulse at the Interactive Resource Center. Ware was participating in the HOPES program with Cone Health, which Moore helped create when an anonymous donor provided funds that Moore suggested would be best used  to start a program to help people who leave the hospital homeless. It can provide a hotel room, bus pass and meal voucher. A nurse and a social worker are assigned to help participants navigate the system as they heal.

"She brought the right skill set, the right passion and the ability to relate to people across diversity," Hamilton said of entrusting Moore with the vision.

Moore took over leadership of the congregational nursing program with just a small office.

"I walked in my office and there was a computer and a blank piece of paper," Moore said. "I said, 'Lord, tell me what should go on that paper.'"

She started connecting with different community groups and who she needed to talk to in order to build rapport and trust. Those people not only supported her but brought along others.

"I think her passion catches them," Hamilton said of those early days, and even now. "It allows people to envision what is possible."

The program started with six churches participating in 1999, with each of the congregations deciding when the nurse would be there — whether right before Bible study or on a Saturday afternoon.

The grant money allowed those congregations to bring in a registered nurse with special training for 10 hours a week.

"I call us 'the silent miracle' because we are busy doing things people don’t notice," said Wanda Martin, a longtime congregational nurse stationed at the Salvation Army.

Prevention is a major part of the program's undergirding — before those most at risk can come down with debilitating, chronic diseases.

"They really are on the ground," said the Rev. Sandy Carver, one of the staff pastors at Holy Trinity Episcopal Church, where the congregational nurse gives flu shots and provides information, among other things. The nurse also works in a low-income housing community where she is more of a gateway to medical care.

"They really do bridge these gaps in the system," Carver said of what she's seen.

These congregational nurses may provide assessments, personal counseling, screenings for blood pressure and glucose and education about new or chronic diseases, among other things. They provide advocacy and case management. Their goal is access to care and in connecting people to resources.

They are good listeners and try to develop trust and relationships.

At one church, the nurse was working with a young man who had seizures but couldn't afford his medicine. She was able to go with him to his doctor to get forms the drug companies ask them to fill out for free medicine. The man began taking the medicine regularly, which eliminated ambulance visits to the emergency room and the trips to the doctor because the seizures aren't controlled.

What makes them different from nurses in other settings is the intentional care of the spirit as part of ministry to the mind, body and soul, which has been important to Moore.

"We might also ask if you would like to pray together," Moore said.

Sometimes that means responding to someone with cancer, who wonders what they did to deserve it. The nurse could explain the biology of cancer, which might ease the patient's mind.

By the time the grant was about to run out dozens of churches and faith-based organizations had shown interest or taken part.

Moore constantly wrote other grants, the majority of which were successful, but funding was a constant struggle. It has also expanded into Rockingham County.

In the last two decades the nurses have worked with refugees, immigrants and others through community sites like the FaithAction International House. At times churches have paid for the nurses out of their funds.

"I'm just a bridge builder," Moore said of her part. "I may be the face of the program, but it is a village."

It would take a continuing commitment from the Cone Health Foundation, which gets a number of worthy grant requests each year that cannot be funded, yet finds a way to keep funding the program along with church and public support. The Cone Health System and the Cone Health Foundation have been big supporters because of the impact in the community.

According to documented statistics, in the past two decades those congregational nurses logged 220,000 encounters, averted more than 3,500 non-emergency emergency room visits, provided 200 life-saving interventions and made nearly 38,000 referrals to primary care providers or agencies with nearly $14 million in health care savings to communities.

"The work is amazing and so are the results," said Susan Shumaker, the president of the Cone Health Foundation and a nurse by training, who got her license reinstated so that she could pitch in at some of the events.

'City of miracles'

The congregational nurse program led to other things, mostly from Moore listening to those around her.

In fall 2008, she was talking to homeless advocate Skip McMillan over a cup of coffee and he was telling her about the urgency of a new initiative he and some others were trying to get off the ground — a day center for the homeless that would open temporarily on the third floor of Bessemer United Methodist Church. It would provide washers and dryers and a place to shower. Within two weeks of its opening, she had a congregational nurse and social worker at what became the Interactive Resource Center.

Moore used an anonymous donor's gift to Cone Health to establish Healing Opportunities for People Experiencing Sickness. HOPES was an idea that got traction in 2011, when a social worker desperately and unsuccessfully tried to find a homeless man who had just had major surgery a place to go when he left the hospital. The shelters were full and the man slept under a bridge that night.

The man's dilemma wasn't uncommon.

The discussion prompted a frustrated Moore to organize a meeting with others who work with the homeless. But even when the shelters are not full, they told her, they are ill-equipped to handle someone with medical problems.

And then Moore got a call from a Cone Health executive.

An anonymous donor had given a substantial gift, and it was to be divided between Cone Health's social work department, and the congregational nurse's program.

"It was a 'God moment,' " she said of what she could only explain as divine intervention.

All her stories don't have a happy ending. But HOPES was born.

For the homeless, the money takes care of a room at an efficiency hotel, bus passes and visits from a social worker and nurse trying to connect them to services and a more permanent place to stay as they heal.

The program can't help everyone, including those with behavioral and substance abuse problems, because of safety issues. But there is a safety net that wasn't there before.

Lelia Moore expands congregational nurse program

In this June 2012 photo, Mable Scott takes notes during former President Barack Obama’s health care address. Scott and her husband, Moses, had no place to go after he left the hospital. They were helped by an anonymous donation to the Cone Health Foundation that Lelia Moore suggested could best be used to care for people who left the hospital with no place to go. The program paid for Moses and Mable Scott to stay in a room at Suburban Extended Inn while he was treated for bone and thyroid cancer. Moses Scott was uninsured.

"She likes to say she lives in a city of miracles," said Greensboro City Councilwoman Michelle Kennedy, who considers Moore a mentor.

Kennedy, executive director of the Interactive Resource Center, which is now on Washington Street, added, "She's been a catalyst for community initiatives more than anybody I know in the health realm."

Lasting legacy

Moore's work fed other projects in the community.

"If you had told me in 1998 what was going to be on those pieces of paper," Moore said, reflecting back to that first day on the job when all she had was blank sheets of paper on her desk, "I would have laughed and said, 'How?'"

Moore organized Missions of Mercy free dental clinic, for which people show up days in advance and form long lines. Despite the dentists and staff and other health care professionals donating their time, hundreds still have to be turned away. In this community it has provided care for more than 2,000 people at what would have been a cost of millions of dollars.

"It happened because of a retired dentist I go to church with," Moore said of the man, who had come across a free clinic for the poor elsewhere and was touched by what he saw.

"He didn't know how to go about it," she said before chuckling. "From that I naively said, 'We do health screenings, we can help with that.'"

Lelia Moore

Lelia Moore coordinated the Missions of Mercy free dental clinic at the Greensboro Coliseum in 2011, where hundreds were helped and hundreds more turned away. 

The congregational nurse program was expanding in ways she hadn't expected — including participation from UNCG and N.C. A&T in the first-in-the-nation venture pairing social work students with nurses from a problem she tried to resolve for a patient with a non-medical issue. Moore had even made "cold calls" to the local universities but got nowhere.

She was frustrated until a chance encounter at a meeting with Wayne Moore, who happened to be a professor in A&T's Department of Sociology and Social Work.

"This gentleman sits down beside me and he has the gifts to put that in place," Moore said.

Soon the initiative became a national model that she's been invited to discuss nationally and internationally. 

"And she’s so damn humble about it," said Pearson, the program director for what became the Congregational Social Work Education Initiative and who makes presentations alongside her. "I would have it on T-shirts saying, 'This is what I built.' "

At those presentations about faith community nursing, nurse consultant Alyson Breisch has watched people surround Moore with questions when it's over.

"It’s a combination of the fact that hers was one of the early programs that got started in this movement and she has continued to keep changing to respond to what is going on in health care," Breisch said.

That has expanded her influence and reach, Breisch said.

Breisch developed congregational nurse courses and health ministries continuing education courses at Duke University. Moore sent congregational nurses there for training.

When Breisch speaks of Moore she talks about how they together co-chaired the state's faith community nurse council, and how Moore worked with a lawyer to write the bylaws for a not-for-profit educational arm of the Carolinas Health Ministry Partnership for all health professionals who work in health ministries.

Her legacy, Breisch said, is ongoing.

"She's an encourager and looks at the skills of the nurses in her program and (is)  moving them to become people who have a voice," Breisch said.

Just last year Moore was selected the American Nursing Association's certified faith community nurse for 2018.

"If you wake up and are eager to go to work, it’s not work," said Moore's son Mac of ideas she would have. "That’s my mother."

Cone Health is in the process of filling the position. 

"How do you replace a Lelia Moore? There is no replacement for a Lelia," said Deborah Grant, Cone Health System's chief nursing officer for population health, ambulatory and clinical support. "She has been the extraordinary leader ambassador, engager, activator and innovator for our community."

Moore says she has a great staff and congregational nurses and has told them their success doesn't depend on her being there.

"It will be hard for me to take the badge off on Friday," Moore said with tears brimming her eyelids. "But I know I leave behind people who can move this forward."

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Contact Nancy McLaughlin at 336-373-7049 and follow @nmclaughlinNR on Twitter.

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