Lutheran Services in America Calls on CMS to Reconsider Minimum Staffing Mandate and Work Toward Meaningful Solutions
November 6, 2023
November 6, 2023
September 28, 2023
Our Results Network cohort, a part of our Results Innovation Lab, is a dynamic nine-month learning collaborative that brings together leaders from across the Lutheran Services in America network to explore and innovate new strategies and approaches that will reshape how we engage children and families, with a specific focus on racial justice.
Thanks to a new partnership between Lutheran Services in America and the ELCA, grassroots faith-based ELCA church-led organizations and congregations have joined our 2023–2024 cohort to help us answer the question: “What will it take to stabilize families in their communities, ensuring families remain intact, and children do not enter out-of-home care?”
The Results Network is designed to accelerate innovative approaches, revamp how we engage families in crisis, and create pathways to keep families together, especially children, youth, and families who are over-represented in the child welfare system.
This proven approach has produced tremendous results in past years, and we believe that this year’s cohort will contribute immensely to our efforts, having already reached over 25,000 children and families in our Lab to date.
Organizations that have joined this transformative journey will have the opportunity to:
Throughout the year, participants will create results-driven action plans through a step-by-step process by delving into key themes, incorporating and amplifying lived expertise, and utilizing plain language to engage a wider audience in addressing disparities. They will also examine and pursue opportunities to shift policies, practices, resources, and power structures all aimed at supporting and sustaining equitable outcomes for children, youth, and families. The goal is for each organization to consistently achieve measurable and impactful advancements by increasing equitable access to supports and strengthening community networks through a racial equity lens, advancing diversity, equity, and inclusion as a social norm.
Stay tuned for more information on this incredible journey of impact and transformation.
Renada Johnson is Senior Director of Children, Youth and Family Initiatives at Lutheran Services in America.
September 11, 2023
On September 1, the Biden Administration officially published for public comment a proposed rule that would mandate minimum staffing levels at skilled nursing facilities. A 60-day comment period began September 6 and will end with all comments due on November 6.
Lutheran Services in America will be submitting comments sharing our concerns about the proposed new requirement and helping you do the same. We are currently analyzing the full rule and what it means for our network, but our initial concerns include the 24/7 RN requirement, only allowing time-limited hardship exemption waivers, and lack of funding for implementing mandated staffing increases.
Since early 2022 when the Administration originally announced their intent to mandate minimum staffing levels, we have heard from many of you that the uniform application of this new requirement, on top of the enduring workforce shortage in direct care, will result in reduced access to long-term care for older adults in rural and underserved communities as providers continue to struggle to fill staffing vacancies. We have worked diligently to ensure that the concerns of our network are heard and incorporated into the new rule, including meetings with key senators, the White House Domestic Policy Council, and CMS Administrator Chiquita Brooks-LaSure.
Our collective voice is powerful, and we look forward to continuing to bring its impact to bear on this rule.
Sarah Dobson is the Senior Director of Public Policy and Advocacy at Lutheran Services in America.
August 30, 2023
Lutheran Services in America is currently seeking grassroots, faith-based organizations and initiatives affiliated with an ELCA church or community to join our 2023–2024 Results Network cohort, which starts September 28. Participation is free. The Results Network is a transformative opportunity for teams to advance racial equity for children and families in a high-support and high-accountability hybrid cohort experience. Participants work in fields as varied as child welfare, housing and economic empowerment, but are united by the goals of preventing or stabilizing families in crisis, strengthening communities and addressing racial disparities. Learn more about this opportunity and how to join.
Five years ago, I hit a wall professionally. I was exhausted by a four-year effort to transform an early childhood organization in Indiana and questioning my ability to lead teams. I did something that felt scary. With a second child on the way, I took a professional role with a lot less pay, but the flexibility to join a virtual cohort of changemakers I had long eyed as an opportunity to reinvigorate and refresh my purpose and my skills in advocacy and organizing.
The cohort, which was university-organized and crossed global boundaries, was a transformative experience that gave me the space to learn and safely practice new skills. One of my closest cohort relationships was with a young person working to create a new political party in Eastern Europe. We explored common challenges and solutions, despite our disparate focus areas. We provided each other candid, but empathetic coaching. I found my skill set growing exponentially, almost day-to-day. When the cohort ended, I used my new skills—and new energy—to grow a campaign to end smoking related death and illness in Indiana to 10,000 advocates.
Professional cohorts are amazing vehicles for change, in part because the act of joining one is motivated by courage. Courage to put yourself into a new and unfamiliar community. Courage to admit you need to grow professionally. Courage to explore what it means to move from the transactional (most of our day-to-day work, often by necessity) to the transformational.
I’m honored that Lutheran Services in America is host to the Results Network—a powerful annual cohort of child and family-serving organizations working toward transformative outcomes rooted in a focus on race equity.
In the past year, 41 Lutheran social ministry leaders across 10 U.S. communities took the courageous act of joining the Results Network and working through professional challenges. The results at the end of the year? Transformative change for over 8,300 children and families!
In coming together, participants in the Results Network—who work in teams of three—make the courageous commitment to:
When these commitments are made and supported by the cohort’s facilitation and coaching, transformation happens. Here are just a few of the remarkable results from last year’s cohort:
One of the amazing elements of the Results Network cohort is the integration of peer leadership. In the most recent cohort, six diverse peer leaders were engaged to formally share their expertise, coaching and guidance.
The coming year of Results Network—which begins September 28—holds such high promise. Through a partnership with the Evangelical Lutheran Church in America (ELCA), we are thrilled to welcome grassroots, faith-based organizations and initiatives affiliated with an ELCA church or community to join, contribute and transform. Their courageous work and presence will deepen and expand the experiences, expertise and diversity of the Results Network, yielding unexplored results. I cannot wait to see what results emerge from this coming together of the Lutheran Services in America and ELCA communities!
If you are a grassroots, faith-based organization or initiative affiliated with an ELCA church or community that is interested in joining this year’s Results Network, please take a moment to learn more about participation and reach out to Renada Johnson, Senior Director of Child, Youth and Family Initiatives (rjohnson@lutheranservices.org).
Onward, together, with courage!
Kent Mitchell is the Vice President of Strategy and Innovation at Lutheran Services in America.
August 25, 2023
You work hard to do what’s right — and do right by the broadest set of people.
It can be such a challenge keeping track of all the benefits and creative perks today’s workforce demands! What do employees want most: Flexibility? Better benefits? Robust mental health support? Did you ever think inclusiveness would top the list?
Consider the experience of an employee who is a victim of recent racial trauma, showing up for a video therapy session with a white therapist. Or an employee who needs a flexible schedule to fulfill responsibilities at home like caring for a disabled dependent. Is your organization adequately addressing the needs of an ever-evolving workforce?
Diversity, equity, and inclusion (DEI) is a hot topic for good reason. As you can imagine, DEI’s roots dig deep in the civil rights movement of the 1960s. Over many decades it has come to inspire conversations not only on diversity in race, but also gender and gender identities, life experiences, income levels, religious backgrounds, ages and stages of life, languages, and household family structures.
The May 2020 injustice of George Floyd’s arrest and consequential death, and the innumerable tragedies since then have amplified Americans’ awareness of the injustices around them. With this new awareness, many Americans look to their employers to take more action.
DEI intersects with everything that you’ve promised employees to care for their well-being.
So, you’ve successfully built a dynamic, diverse workforce. Benefits packages have been regularly updated with recruiting and retention in mind. But have you conducted a DEI audit lately?
Diversity experts will tell you that looking through the DEI lens more carefully at your employee benefits materials, policies and procedures, facilities, special events, and other employee-centered programs and perks should be a routine, ongoing effort.
Think about the importance of making health coverage, comfortable workspaces, leaves of absence, mental health support, and flexible schedules available to all on an equal level. Sounds straightforward, but it turns out, it can be all too easy to miss the mark for at least one subgroup of employees. The key is making a concerted effort to regularly review DEI efforts and your progress and grow in your knowledge of where gaps exist.
You can’t satisfy every need 100% of the time, but it’s important to start somewhere. Small but intentional changes can go a long way to convey an organization’s sensitivity and commitment to responding to employees’ needs with care. Consider how you can engage with employees to better understand what’s most important to them.
To ramp up inclusivity and equity efforts in the workplace, potential next steps might include:
This is just the tip of the iceberg! Sometimes, in a rush to meet the growing needs of one employee population, we miss the mark with another. Dissecting the needs of a multigenerational workforce, the World Economic Forum offers this perspective:
Don’t let your organization’s dedication to DEI lapse, no matter what events or distractions lie ahead. The greatest impact comes from ongoing effort. Successful DEI initiatives can set you up for:
Some tactics you may consider to stay on track:
Remember, to retain your best employees and attract new people, it’s important to remain committed to cultivating a warm, welcoming environment. Be well-intentioned, flexible, and ready for unexpected shifts in workforce demands. Above all, make diversity, inclusion, and equity a driving force at every level of your organization for a richer, more sustainable future.
Learn more about Portico Benefit Services.
1Chen, Jacklyn (2022). Here’s How to Tailor Employee Benefits to a Diverse Workforce. World Economic Forum. Retrieved January 25, 2023, from https://www.weforum.org/agenda/2022/09/employee-benefits-diversity/
2Diversity Equity and Inclusion: Why it Matters. St. Bonaventure University. Retrieved January 26, 2023, from https://online.sbu.edu/news/why-dei-matters
August 10, 2023
Recently, I had the privilege to speak with Lutheran Services in America members about how they approach achieving health equity in their communities. Recognizing the challenges community members face with housing and food insecurity, lack of transportation, challenges receiving behavioral health care, and loneliness and social isolation (also known as social determinants of health (SDOH)), five members of the Coalition for Better Social Care shared innovative and promising solutions. Thanks to their groundbreaking approaches, more than 11,000 people have been screened for SDOH risks. Their efforts laid the groundwork for reaching more people, identifying their needs, and providing the services and supports that help community members live independently and thrive.
Below is a snapshot of the conversation with:
Watch the full conversation.
A key insight offered was to integrate screenings for social determinants of health during regular interactions with program participants. While screenings are often conducted during initial interactions, needs can change over time. Updated information can help tailor programs to current needs, use resources more effectively, allow more people to receive services, and better connect people with appropriate services to support their specific needs.
For example:
During our conversation, members emphasized that addressing SDOH needs is the pathway to health equity. Lutheran Social Services of Illinois Director Matt Hammoudeh summarized: “Without stable and secure housing and other basic needs met, program participants struggle to focus on health matters such as doctor’s appointments and filling prescriptions.”
Our network excels at innovation in the face of challenging situations. Members of the Coalition for Better Social Care are seeking more reliable sources of funding to provide program sustainability, such as Medicaid reimbursements and contracts with health insurers. The mechanisms for reimbursement are still emerging, such as the Center for Medicare and Medicaid Service’s recently proposed Physician Fee Schedule that includes SDOH reimbursements under Medicare, and new partnerships are needed to scale services. Going forward, we will be convening thought leadership on reimbursement mechanisms and enabling conditions leading to partnerships with health insurers and others.
We invite you to join your peers to advance health equity: Susan Newton, Senior Director of Strategic Initiatives at Lutheran Services in America, will guide you to a Collaborative that best fits your strategic direction.
For more information, watch our Strength & Service Series webinar “Swap Shop: Innovative Strategies Across the Network to Address Social Determinants of Health.”
Looking for more information on social determinants of health? This easy-to-print graphic details what SDOH are and why they are important. We encourage you to utilize this resource and share it within your respective communities and organizations!
June 13, 2023
Participating members of our Family Stabilization Initiative united in Seattle to discuss how to raise the visibility and support the sustainability of our work to engage 580 families in crisis in Alaska, Montana, South Dakota and Washington state. Through this cohort—part of our Results Innovation Lab—we activate community networks to address the disproportionate number of children of color separated from their families. Key to our success are our valued partners. By building a broad base of support, we are expanding supports in underserved communities that empower families to stay together.
For three days, member collaborated on approaches for sharing our story to engage community partners, evaluated the impacts of the collaborative learning model on implementation and sustainability, focused on the urgency to engage families in crisis and reviewed best practices to support key components of sustainability. Cohort members also shared marketing and outreach materials with each other to spark ideas for raising the visibility of their programs and engaging key community stakeholders in this work to reach more families.
Through this close interaction in such a collaborative setting, the Family Stabilization Initiative is generating the momentum needed to make a quantifiable difference for leaders in their communities and incentivizing additional partners to join us in this work. The cohort challenges participants to step into the shoes of the families with whom they engage to provide additional perspective on their experiences.
Several of our partners joined us for the convening:
Collectively, we’re spearheading approaches that build on the strengths of families in ways we could not do on our own. When we come together, we create new pathways—and hope—for people and communities across the country.
Renada Johnson is the Director of Children, Youth and Families and Elizabeth Vetter is a Program Associate at Lutheran Services in America.
June 6, 2023
On May 28, House Speaker Kevin McCarthy (R-CA) and President Joe Biden released the Fiscal Responsibility Act of 2023, legislation to suspend the debt limit until January 1, 2025. The bill marked the culmination of weeks of negotiation between the two sides to agree on a way to suspend the debt limit and include other legislative provisions as well. Not included in the deal was a provision that had been discussed to increase administrative barriers to Medicaid participation via increased work requirements and reporting, which Lutheran Services in America had opposed.
The package passed the House of Representatives on May 31 by a bipartisan vote of 314 to 117 and the Senate on June 1 by a vote of 63 to 36. The President signed the bill into law on June 3, narrowly avoiding the June 5 deadline when the Treasury Department had indicated the United States would no longer be able to pay all of its bills.
Key elements of the legislation of interest to our network include:
Sarah Dobson is the Senior Director of Public Policy and Advocacy at Lutheran Services in America.
May 9, 2023
How can we maximize the value of this amazing network is a question we are asking. Like many of you, we are reevaluating our strategy and your perspectives shape the future of this network. You are sharing your visions of how collectively we can respond in ways that strengthen our communities and hold true to our collective mission of empowering people to lead their best lives.
After a thorough search, we engaged Collective Action Lab to guide us in this exploration. We are evaluating our capabilities and constraints: what we do well, what we need to stop doing and how we need to evolve. We have met with over 55 different groups to inform our strategy—some virtually, some in person—including Lutheran social ministry leaders, board members and current and future partners. As part of these conversations, we are examining the impact of near-term trends and future disrupters on our work together.
Our listening sessions identified a multitude of challenges and opportunities including workforce and changing demographics, inadequate public financing and reimbursement, trauma and fatigue in your communities, evolving models of care, organizational rightsizing, downsizing and consolidation, the need for affordable housing, and the impact of technology.
Your voice charts our future. You are sharing ways that you value coming together to strengthen our collective capacity to lead, amplify our unified, faith-based voice and catalyze innovation. United in our shared purpose and faith tradition of social ministry, our strategy work explores how we continue to evolve to meet the ever-changing needs of our communities.
Over the summer we will continue to build out our strategy and solicit input and perspective. Stay tuned!
Alesia Frerichs is President & CEO of Lutheran Services in America.
May 8, 2023
“What can we do at this critical moment in time, with a vulnerable population, with a workforce shortage and without more resources? Connect-Home empowers staff in affordable housing, focusing on getting the right people where they are needed and creating a community of care.”
This was the lead message of a joint presentation to Grantmakers for Housing Stability in Aging on April 12 by Susan Newton, Senior Director of Strategic Initiatives at Lutheran Services in America, about the innovative Connect-Home model. The model, which is being implemented with Lutheran Services in America support in two senior affordable housing units in Brooklyn, New York, aims to improve the health and social outcomes of older adults transitioning home from an acute care experience, including prevention of rehospitalization.
As Newton, Kathy Hopkins of our member Family Health Centers at NYU Langone, and Mark Toles of the University of North Carolina-Chapel Hill described, the model is uniquely working to partner with on-site resident service coordinators (RSCs) to build a caring community of support to the diverse and medically high-need populations—36 percent of whom are over age 86 and 45 percent of whom list a Chinese dialect as a native language—in the affordable housing units targeted.
Toles, who pioneered the use of Connect-Home for patients transitioning out of skilled nursing facilities, noted how adaptation to affordable housing has been an exciting and sometimes surprising collaborative process with RSCs, senior residents and Family Health Centers at NYU Langone.
“The staff really had minimal awareness of hospital stays. They had an intuitive sense that a recent hospital stay was something to be concerned about but did not have procedures to routinely identify and support [senior residents],” said Toles.
He noted that bringing rigor to the identification of residents with a recent acute care stay was one of the biggest hurdles for getting Connect-Home off the ground. A surprising asset was a log maintained at the front desk tracking ambulance visits to the facility. That list has become a key tool to identify vulnerable residents and engage in follow-up.
The essential transformation was with RSCs, who have started to embrace the model as a key, not ancillary, part of their role. As Hopkins noted, “They came from ‘I cannot add one more thing to my plate’ to ‘This is such a good way of working and prevents older adults in our community from going back to the hospital.’”
Toles noted some of the seemingly small tasks that RSCs help returning residents with that make a difference, such as tracking down lost discharge instructions or ensuring supportive home care is provided on schedule. RSCs are also being trained to connect residents with more complex follow-on needs to additional community support.
All partners noted how Connect-Home continues to evolve, with care teams meeting regularly to improve the process, analyze data and improve gaps in identification and services.
To learn more about this Lutheran Services in America-led learning collaborative, please reach out to Susan Newton.
Kent Mitchell is Vice President of Strategy & Innovation at Lutheran Services in America.
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