Monthly Update
America is changing demographically. How does your county compare? Now you can use Pew Research Center's interactive feature to see how demographic changes are playing out in your own community, and compare your county with others across America.    
Patient Profile
"Dan" immigrated to the United States and settled in Seattle before recently moving to St. Louis. He was struggling with a variety of adjustment issues, including culture shock. The stress of his job search and his disconnection from the psychiatry and counseling services he received in Seattle that were covered by the insurance of his previous employer made the transition event more difficult.  In fact,
Dan began having thoughts of harming himself.  
He and his partner searched for affordable counseling, and found out about the Mental Health Collaborative (MHC). 
Not long after, they walked in to the MHC and spoke with the program coordinator about the counseling and psychiatry services that were available, despite Dan's lack of insurance. A week later, he had his first appointment. Desiring to make sure that other people in his situation can also get help, Dan is making arrangements with his MHC therapist to transition to insured care outside of Casa as soon as an insurance policy from new employment is in place.
Volunteer Spotlight

This month our Spotlight shines on Esther Martin, M.D. She is the first person to be selected twice to be featured in the newsletter, based on her outstanding service to Casa and our patients.
Esther was born and raised in Colombia and moved to St. Louis after graduating from medical school to join the faculty at Saint Louis University (SLU). She worked as an Associate Professor in the Division of Nephrology, but due to health issues, she was not able to continue. 
Dr. Esther Martin   
She learned about Casa de Salud from faculty at SLU and, as a native Spanish speaker familiar with the field of medicine, felt she could contribute. 
In her more than three years with Casa, she has enjoyed working with all of the medical staff and volunteers while assisting patients in communicating with their providers. During her time at Casa, she has been impressed by the dedication demonstrated in assisting the underserved and immigrant communities in the St. Louis area.
Supporting Casa
We are extremely grateful to Wells Fargo  and Express Scripts Foundation 
for their respective financial contributions to our organization.
Please consider a tax deductible donation to Casa today. You can mail a check to our office at 3200 Chouteau Avenue, St. Louis, 63103, give on line, or by texting "casa" to 314-270-1992.
Your generosity makes Casa de Salud the premier resource for affordable and quality care for the foreign-born community in the St. Louis region!
The New Tax Law and Charitable Giving
As we move closer to the end of the year, more people will start to think about how their charitable giving will be impacted by the Tax Cuts and Jobs Act. The new tax law nearly doubles the standard deduction in 2018 to $12,000 for singles and $24,000 for joint filers younger than age 65, while capping or eliminating other deductions. That means it will no longer make sense for many taxpayers to itemize. The Tax Policy Center estimates that the number of households itemizing deductions for charitable giving will fall from about 37 million to about 16 million. 
If you still want to support organizations like Casa while also deriving as much benefit as possible, Kiplinger has a number of  suggestions, several of which are highlighted here:
Consider donating shares of appreciated stock or mutual funds. You can deduct the current value of the investment as a charitable contribution if you itemize, and you'll avoid paying capital gains taxes on the profits. Plus, the charity receives the full value of your investment.
If you're 70½ or older, you can transfer up to $100,000 from a traditional IRA tax-free to charity each year. It will count as your required minimum distribution (RMD) without being added to your adjusted gross income. Your charitable gift won't be taxed, as it would be if you were to take a distribution and then donate the cash to charity. Plus, keeping your RMD out of your adjusted gross income could help keep your income below the threshold for being subject to the high-income surcharge for Medicare parts B and D, as well as hold down the percentage of your Social Security benefits that are subject to taxes.
You can also name a charity as the beneficiary of your IRA. That way, neither your heirs nor your estate will pay income taxes on the assets, and the charity will receive the full value.
This material is intended to be informative, not tax advice. These are only some of the options available. You should consult a tax advisor for specific information. 
Watch Our Video!
Casa de Salud - Compassionate Path to Wellness 
Welcome Lori Lamprich
Lori Lamprich has been hired as the Development Coordinator for Casa. She will assist Casa's president to continue obtaining the contributions necessary for the organization to provide low cost services to immigrants, refugees, and other uninsured people throughout the region.

Lori Lamprich
Lori earned a bachelor's degree in Political Science from the University of Missouri and then spent several years working on political campaigns in various roles, including fundraising. She also worked in the private sector before shifting to the nonprofit world.
Lori loves visiting to museums, reading, watching superhero movies, going to concerts, and drinking craft beers.
She lives in the Dutchtown neighborhood in South St. Louis and has two Chihuahuas, Oscar and Rosie. She and with her fiancé, Nick, plan to wed next spring. 
Friends of Casa
The annual Friends of Casa Trivia Night came with a superhero theme this year and it was a super success! Twenty-five teams engaged in an epic battle for truth, justice and a winning score, while raising over $9,000 for Casa's mission.
Congratulations to the Apotheosis Comics team for winning the trivia contest!
Many thanks to Friends of Casa for all of their hard work, all of our table sponsors, those who donated to the silent auction, and to Mission Taco Joint and Anheuser-Busch for providing food and beverages.
We would also like to extend a special thanks to the Hacking Law Practice for having been our title sponsor for the event.     
Provider Anniversaries

Casa thanks the following provider who celebrates her anniversary with us this month:
 Julie Albsmeyer, PA - 3 Years
Donald Blum, MD - 6 Years
Suzanne Curtin, RN - 1 Year 
Nancy Enger, NP - 3 Years 
Gordon Goldman, MD - 5 Years
Jack Kelly, MD - 6 Years 
Dori Lingle, NP - 3 Years 
Larry Newell, MD - 2 Years
Stephen Pitchford, NP - 1 Year 
Court Singrey, NP - 5 Years
And a very special thanks to
Marcos Rothstein, MD 
one of our original medical volunteers who celebrates eight years serving patients at Casa de Salud.
Letter from the President
A lot of attention has been given in recent years to cultural competency and rightfully so. Being respectful and responsive to the health beliefs, practice, and linguistic needs of diverse population groups should be a priority.
But a Robert Wood Johnson Foundation article by Jennifer McGee-Avila that I recently read reminded me that just as important is the concept of cultural humility. As the article makes clear, seeking to understand how patients (and their culture) define them will have a big impact on how they receive and respond to their care.
One of my own relatives was diagnosed with cancer. Some of my family members did not want the patient to be told of the diagnosis, but rather asked that the physician say it was another, less malignant disease. It would be very easy for the doctor to condemn this and immediately insist that the patient be told the truth. But by trying to understand the underlying cultural components to the family members' attitude, the provider stands a better chance of being able to provide appropriate treatment and information.
Cultural humility isn't about studying someone to better figure them out. It's about acknowledging power imbalances, developing partnerships, and practicing self-reflection. When we integrate these concepts in the delivery of care, we lift up the voices of our patients.   
                                ~ Jennifer McGee-Avila 
This is only going to become more important as demographic trends in the U.S. take hold. It is a given that a majority of future health care providers will be called upon to care for many patients with backgrounds far different from their own. To do so effectively, as Jordan Cohen et. al. argue in an article for Health Affairs, these care providers "must have a firm understanding of how and why different belief systems, cultural biases, ethnic origins, family structures, and a host of other culturally determined factors influence the manner in which people experience illness, adhere to medical advice, and respond to treatment."
I'm proud that this is exactly how our volunteer providers and paid support staff strive to interact with our patients, and I believe that the regional healthcare system is also moving in this direction. If we're able to do so consistently, we will provide better care and create a more equitable experience for all patients. 
Jorge Riopedre
President & CEO, Casa de Salud

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