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Urging Congress to Address CNA Training Penalty

November 20, 2024

BY: Sarah Dobson

Lutheran Services in America joined other faith-based organizations in sending a letter to House Speaker Mike Johnson (R-LA) and Democratic Leader Hakeem Jeffries (D-NY) to urge them to include the Ensuring Seniors’ Access to Quality Care Act (H.R. 3227) in any must-pass legislative package considered during the remainder of this Congress.

The bill addresses a longstanding problematic provision in federal law that penalizes skilled nursing facilities (SNFs) who are fined above a certain monetary threshold during their CMS survey by rescinding their authority to train certified nursing assistants (CNAs) for two years. This penalty stays in place for the entire two years, even if the SNF addresses the deficiency that resulted in the fine and regardless of whether the fine was related to the quality of resident care. H.R. 3227 would allow SNFs that have resolved their deficiencies to restart their CNA training programs before the end of the two-year period.

Lutheran Services in America has long supported making this change in the law. It is even more important now in light of the federal nursing home minimum staffing rule, which will require facilities to significantly increase their CNA staffing. The authority to train new workers is critical to facilities’ ability to potentially meet the new requirements.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

Early Post-Election Outlook on Health-Related Issues

November 19, 2024

BY: Sue Polis

With the 2024 presidential election decided, we know that Donald Trump will become President again in January, with clear victories in winning both the Electoral College and the popular vote. At the same time, we wait for final vote counts in races for the U.S. Congress – although it is clear that Republicans will control the Senate and also lead with a slim majority in the House of Representatives.

As we prepare for the new Congress and a new presidential administration, our public policy and advocacy team is tracking the key cabinet and agency nominations and Congressional committee positions that will have the most influence and impact on our collective work across service lines and for the people we work with in community. With many moving parts and decisions still unclear, we are seeing some high-level stakeholders and priorities beginning to come into focus, which we wanted to share with our network.

Congressional and Agency Leadership

In Congress, the committees with jurisdiction over health issues (and specifically Medicaid) will see new leadership: Rep. Cathy McMorris Rodgers (R-WA), current chair of the House Energy and Commerce Committee, is retiring from Congress, while Rep. Virginia Foxx (R-NC), current chair of the Education and Workforce Committee, will not be returning to that position. Their successors are not yet clear. In the Senate, with the majority flipping to the Republicans, Sen. Bill Cassidy (R-LA) is poised to lead the Health, Education, Labor, and Pensions Committee, with Sen. Mike Crapo (R-ID) in line to lead the Finance Committee.

President-elect Trump has announced his intention to nominate Robert F. Kennedy, Jr. to lead the Department of Health and Human Services (HHS) and Dr. Mehmet Oz as Administrator of the Centers for Medicare and Medicaid Services (CMS).  We will continue to monitor additional nominations at HHS among other key departments including the U.S. Department of Housing and Urban Development (HUD).

Policy Priorities

Prior to the election, we created a summary of what was potentially at stake for health & social service organizations specific to Medicaid under Republican rule. While it now seems more likely that these proposals will be considered, with slim Republican majorities in each chamber it remains to be seen if they will reach consensus to pass legislation, including: eligibility restrictions via work requirements, spending caps, and premium payments; a reduction in provider administrative burdens; modification of current waiver processes; a rollback of Medicaid expansion; and while unclear, changes to the way Medicaid is financed by moving to block grant the program’s funding. The first test will come in early 2025 as the 2017 Tax Cuts and Jobs Act is set to expire. As part of those negotiations, we expect changes to Medicaid funding to be in the discussion. We will continue to monitor and advocate on this issue.

For more information, contact Sue Polis, VP of Government Affairs and Public Relations, at Spolis@lutheranservices.org, Sarah Dobson, Senior Director of Public Policy and Advocacy, at SDobson@lutheranservices.org, or Bill Kallestad, Disability Network Director of Public Policy and Advocacy, at BKallestad@lutheranservices.org.

Lutheran Services in America Launches Pilot Policy Committee, Focuses on Medicaid

November 19, 2024

BY: Sue Polis

Our network is uniquely positioned to unite around cross-cutting advocacy priorities that are of common interest across service lines, given our collective work with all Medicaid beneficiaries. To better leverage the knowledge and work across the network, Lutheran Services in America is launching a pilot policy committee to help support and inform our policy priorities. The overall aim is to guide our core organizational strategies through a policy and advocacy focus, including: growing our individual and collective capacity to lead and effect policy & systems change; catalyzing innovation and impact across our network; and amplifying our united, faith-based voice. To ensure the committee is structured for long-term success, we are beginning this work with a pilot committee launching later this year, with an initial focus on Medicaid policy levers.

We are pleased to share that committee members for this initial pilot period are as follows:

  • Salah Ansary, Regional Director, Lutheran Community Services Northwest
  • LaSharnda Beckwith, President & CEO, Lutheran Social Services of Southern California
  • Stephanie Chedid, President & CEO, Luther Manor
  • Héctor Colón, President & CEO, Lutheran Social Services of Wisconsin Upper Michigan (LSS)
  • Shelly Griffith, CEO, Eben Ezer Lutheran Care Center
  • Julie Kaminski, Senior VP and COO, Immanuel
  • Chris Koenig, President & CEO, Niagara Lutheran Health System, Inc.
  • Adam Marles, President & CEO, Lutheran Senior Services
  • Ray Ratke, President & CEO, enCircle
  • Tom Syverson, Director, Government and External Affairs, The Evangelical Lutheran Good Samaritan Society
  • Christine Tappan, Chief, Strategy & External Affairs, Ascentria Care Alliance
  • Cheryl Wicks, VP of External Affairs, Mosaic

The committee will support aligned action across our network including through informing policy priorities drawing on relevant issue expertise based on social service practice and leadership; providing timely and relevant feedback on potential and pending federal legislation; identifying, exploring, and supporting consideration and discussion of future policy needs/areas related to ensuring social service sector innovation; supporting effective mobilization of broader LSA member network to advance key policy priorities; speaking and/or engaging in virtual and in-person meetings with policymakers, peers and other key stakeholders to share government relations and advocacy insights and expertise on behalf of the policy committee; and providing timely and relevant insights to connect and align across federal, state and local policy approaches.

We are excited about the launch of the Committee to amplify our united, faith-based voice and grow our collective capacity to lead and effect change.

Please contact Sue Polis, VP of Government Affairs and Public Relations at Spolis@LutheranServices.org or Sarah Dobson, Senior Director for Policy & Advocacy at Sdobson@lutheranservices.org or Bill Kallestad, Disability Network, Director of Policy and Advocacy at BKallestad@lutheranservices.org

Strengthening Families to Improve Health Outcomes

November 14, 2024

BY: Alesia Frerichs

Lutheran Services in America (LSA), in initial collaboration with UnitedHealthcare (UHC), is embarking on a multi-year initiative to reshape and foster alignment between health and social care systems through the “Strengthening Families Initiative.” We aim to improve outcomes for children, youth and families enrolled in Medicaid, with an initial focus on behavioral health conditions. Specifically, building upon LSA’s Results Innovation Lab and Family Stabilization Initiative, we seek to better leverage the capacity and leadership of the LSA member network, in alignment with key health and multi-sector stakeholders, to improve health outcomes.

Lutheran  Services in  America is one of the nation’s largest networks of health and human service providers with a mission to cultivate caring communities that advance health and opportunity for all. Together, we are 300 nonprofit organizations across 1,400 U.S. communities with more than $26 billion in combined annual services.

Lutheran social service organizations have been working by, in, with and for their communities for decades — and in some instances, for more than a century. This new initiative incorporates national and local efforts with the engagement of Lutheran Services in America member organizations, including Gemma Services in Philadelphia and enCircle in Roanoke, Virginia.

As faith-based, trusted and community-centered leaders our aim is to continue to develop and foster innovative national and local partnerships, including with Medicaid Managed Care Organizations (MCOs), to improve individual and community outcomes. We are pleased to announce our collaboration with UnitedHealthcare through a $1.5 million award as we seek to expand engagement with other MCOs along with philanthropic partners.

UnitedHealthcare (UHC) is a health care and well-being company with a mission to help people live healthier lives and make the health system work better for everyone. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.7 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide.

As part of this effort, we will:

  • Disseminate case studies and a series of briefs, based on LSA member organization efforts to innovate approaches that address behavioral health challenges and unmet health-related social needs, along with a literature review and environmental scan of on-going national, state and local efforts, to improve understanding and inform action that build upon successes and lessons learned in aligning health and social care.
  • Convene national and local leaders from health/behavioral health systems and providers, social service organizations, payers, community-based nonprofits, policymakers, people with lived expertise, along with community and other key stakeholders to foster coalition building and partnership towards aligned action; and
  • Disseminate a ‘blueprint’ to identify and define the policy, practice and system changes necessary to catalyze and foster coordination, connection and alignment that improve health so all families can thrive.

Goals of the Initiative

Through this initiative, our shared aim is to align data-informed, community-centered approaches that have sustainable reimbursement and financing mechanisms to better address social determinants of health (SDOH) and that improve outcomes for children and families. Specifically, our work is guided through the following areas of focus:

  • Spurring a shift from segmented services provided to individual family members to a family-centered orientation, that considers measures and metrics related to family-based and community outcomes.
  • Improving cross-system collaboration to ensure alignment to better address social drivers of family stability and well-being by meeting holistic health and mental health-related social needs, including:
    • Access to food, housing, employment, childcare, among other services.
    • Support to address substance use disorder and mental health challenges within families (across all life stages), including parents, caregivers and children.
  • Building capacity and enhancing the capability of providers, community-based organizations (CBOs), and payers to ensure resources, including adequate reimbursement, and coordination are in place to better address the holistic needs of families.
  • Applying a lens that considers family structure and traditions.

Guiding Principles

The following principles and objectives will guide the overall effort:

  • Articulate a clear value proposition to deepen and expand coordination and alignment of care with appropriate and equitable services and payment to better address the holistic needs families, especially those historically marginalized.
  • Identify practice, policy and systems changes needed to catalyze more efficient and effective approaches to improve outcomes for families.
  • Identify effective ways to engage community and family voice so efforts reflect and address the highest priority needs of historically and persistently marginalized people and places.
  • Explore the workforce, data and technology considerations necessary to support and better align the delivery of quality care and services.
  • Identify the critical success factors for high-performing partnerships and collaboration to advance policy and systems change, especially the ways in which CBOs and Medicaid Managed Care Organizations (MCOs) coordinate and align for improved outcomes.
  • Build support for federal, state and local policy changes necessary to broadly advance the conditions for families to have their needs met in a sustainable way.

Alesia Frerichs is President & CEO of Lutheran Services in America.

Building Community Through Our Family Stabilization Initiative: Reflections from a Site Visit to St. John’s United in Montana

November 20, 2024

BY: Renada Johnson and Liz Vetter

Through our Family Stabilization Initiative, we’ve committed ourselves to supporting families in crisis. Recently, Lutheran Services in America staff visited St. John’s United in Montana. The trip provided an important opportunity to reaffirm the importance of building community to support families. St. John’s United is leading significant community-building efforts that will strengthen resilience and resonate for years to come.

During our visit, St. John’s hosted a Family Night event that brought together over 60 families, a testament to the power of community. Families currently enrolled in St. John’s United’s high-fidelity wraparound program, as well as families who had successfully graduated from the program, came together for an evening of connection, games, and fun. It was heartwarming to see children laughing together, parents sharing their experiences, and families building bonds and memories that go far beyond the scope of any single program.

Many of the young people have formed friendships across families, learning the invaluable lesson of building community amongst themselves. These relationships help strengthen their sense of belonging and support, something that is vital for any child, especially those who have faced challenging circumstances.

Strategic Partnerships and Community Engagement
St. John’s United expands their work through key community partners, including one who recently opened a Family Resource Center through the local school system. The center is a direct result of their collaboration with St. John’s United. The partnership exemplifies the broader goal of our Family Stabilization Initiative—by connecting families with the right resources, we can create a network of support that extends far beyond any single organization.

A seminal moment of the visit was an event in honor of Missing and Murdered Indigenous People. It was a powerful reminder of the importance of supporting and standing with Indigenous communities. Through a moving drum presentation and the reading of the names of missing or murdered individuals, we took time to acknowledge the deep impact of these losses on the community. It was a humbling experience, reinforcing the need for accountability and the continued advocacy for equity and justice. St. John’s United exemplifies that broader commitment of our network as we extend our reach and support to improve health and opportunity for all.

Moving Forward Together

As we look ahead, it’s clear that the Family Stabilization Initiative is about much more than just addressing immediate crises. It’s about creating long-term, sustainable systems of care that empower families to stay together and avoid involvement in child welfare systems. It’s about fostering equitable outcomes for all, particularly for communities that have been historically marginalized.

The friendships formed among young people, the continuing collaboration with community partners, and the shared commitment to equity are essential as we come together to create change.

Together, as partners, advocates, and allies, we have the power to strengthen communities that uplift and support families in meaningful ways and ensure equity and justice to cultivate caring communities that advance health and opportunity for all.

Renada Johnson is Senior Director of Children, Youth and Family Initiatives. Liz Vetter is a Senior Program Associate.

November Elections: What’s in Play for Health & Social Service Organizations Specific to Medicaid

October 9, 2024

BY: Sarah Dobson

In one month, the results of the election will determine which party will hold the majorities in the House of Representatives and the United States Senate. Since the majority parties ultimately control the respective agendas for Congressional committees, the outcomes of the election can, and undoubtedly will, have markedly different impacts on policy decisions. Priorities drive agendas and as always, there are distinct differences between opposing parties. This is especially true on issues related to Medicaid.

Currently, Republicans hold the majority in the House, with Democrats narrowly controlling the Senate. This means that the Senate committees with jurisdiction over Medicaid including Finance and Health, Education, Labor and Pensions (HELP) are led by Democrats, while Republicans are leading key committees in the House including Ways & Means and Energy & Commerce. This divided control has led to something of a stalemate, with very little major legislation advancing.

If the election maintains the status quo (with divided control), many believe that we can anticipate a similar lack of movement. There are very few areas of agreement and those include enhanced funding for behavioral health and workforce development efforts, given the bipartisan support that exists for these issues. However, if either party gains control over both chambers, there are a number of changes including to Medicaid we would expect to see move forward.

Under unified Democratic control, legislation is likely to be introduced that would strengthen eligibility and enrollment (E&E) policies to reduce enrollee administrative burdens and improve coverage access. Efforts could include aligning E&E statutory requirements across healthcare programs as well as working to fill the Medicaid “coverage gap” for individuals living in the 10 states that have not expanded Medicaid eligibility under the ACA. Another area of focus is expected to be reforms to the provider tax and state directed payment policy.

Under unified Republican control, we could see bills to roll back E&E-related rulemaking and regulation. Efforts are likely to focus on eligibility restrictions aimed at shifting the “entitlement” nature of Medicaid including through instituting work requirements and premium payments. Other bills could seek to reduce provider administrative burdens; modify current waiver processes; repeal the Medicaid expansion program; and while less likely, change the way Medicaid is financed by moving to block grant the program’s funding.

In either case, finalizing these types of changes would also require the signature of the President—and if there are differences in control between Congress and the White House that will also certainly slow passage of bills with any major changes.

At present, given the makeup of which Senate seats are up for re-election this year, most polling anticipates a Republican-controlled Senate post-election, with the outcomes of the House and Presidential elections much less clear.

If you have questions or want to get more engaged with us in policy and advocacy, please contact Sarah Dobson at SDobson@lutheranservices.org.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

Advocacy in Action: Member CEO Ted Goins Uses Letter to the Editor to Urge Sen. Scott’s Support of YIGBY

October 9, 2024

BY: Sarah Dobson

With the support of Lutheran Services in America, Ted Goins, president and CEO of Lutheran Services Carolinas, recently had a letter to the editor published in The State newspaper in Columbia, South Carolina. Ted reflected on the shortage of affordable housing in the state and how faith-based nonprofits could be better supported in filling that gap.

Thanking Sen. Tim Scott (R-S.C.) for his longtime support of legislation addressing the housing crisis, Ted urged him to now support the “Yes in God’s Backyard” (YIGBY) bill (S. 3910,) a housing policy priority for our network. The bill aims to help faith-based institutions and churches use land they already own to ease the housing crisis in their communities.

Given Sen. Scott’s position as the senior-most Republican on the Senate Banking Committee, his support will play a key role in whether provisions of the bill are included in any housing legislation passed before the end of this Congress. To learn more or join us in these efforts, please contact me.

Sarah Dobson is Senior Director of Public Policy and Advocacy at Lutheran Services in America.

Capitol Conversations Policy Webinar Series Kicks Off with “Building a Workforce for the Future”

September 17, 2024

BY: Sarah Dobson

On September 11, the Lutheran Services in America public policy department launched a new “Capitol Conversations” webinar series aimed at informing and engaging the network in advocacy, with a session titled “Building a Workforce for the Future: Trends and Practice Shaping Policy.”  Following an overview presented by Sue Polis, vice president of public relations and government affairs, of the focus areas of Lutheran Services in America’s strategy to address the workforce shortage (recruitment and retention, strengthening the pipeline, and readiness to fill roles), a cross-section of network members heard from four speakers: Stephanie Badger, The Nickles Group; Ryan Kenyon, the office of Sen. Kevin Kramer (R-ND); Wanda Harris, The Evangelical Lutheran Good Samaritan Society; and Kelli Dobner, Samaritas.

Stephanie introduced members to the Healthcare Workforce Coalition, which she helps lead. The coalition advocates in three areas to address the shortage: education, recruitment and retention, and international workers. Their work supports classifying nurses as STEM workers for greater federal funding availability and advocating for better protection for healthcare workers from workplace violence and mental health challenges.

Ryan highlighted Sen. Kramer’s sponsorship of the Healthcare Workforce Resilience Act (HWRA), which would allow previously unused green cards to be distributed to up to 40,000 healthcare workers, while identifying the challenges ahead for passage. He also discussed the hardship imposed on nursing home providers by the Centers for Medicare & Medicaid Services (CMS) minimum staffing rule, urging continued efforts to advocate directly with the agency.

Network members Wanda and Kelli shared their experiences dealing with workforce shortages in the field, including the ways in which the crisis has reshaped their business, and the importance of addressing workplace culture and professional development in recruiting and retaining employees.

Next steps include urging your lawmakers to support the HWRA, joining Lutheran Services in America in asking CMS and Congress to better address staffing and reimbursement issues, and watching the recording of this event. If you would like more information about our policy engagement on workforce or other issues, or if you have requests for future topics for this series, please contact me.

Sarah Dobson is Senior Director of Public Policy and Advocacy at Lutheran Services in America.

Leadership Rooted in Lived Experience

August 26, 2024

BY: Alesia Frerichs and Renada Johnson

This month, the Lutheran Services in America team led the latest Lived Voices Fellowship convening in Washington, D.C., a cohort of 17 dynamic change leaders from across the network who are dedicating their careers to service in community. What sets this group of leaders apart is that they have navigated public systems and experienced poverty, substance abuse, housing insecurity and other challenges, and through their resilience, are committed to build on their experiences to drive positive change within their organizations and communities.

What is the Lived Voices Fellowship and who participates?

The fellowship offers these leaders an opportunity to make meaning of their own unique experiences, forge new connections, and hone skills that will empower them to effect meaningful change in their communities. The fellowship represents a departure from traditional leadership programs in that it is an exploration of resiliency, empowerment, and healing, with a focus on amplifying voices that have often been marginalized.

The roles of these change leaders across the network vary widely; some serve as counselors, program leads, brand ambassadors and community outreach specialists, while others lead operations or are in the C-suite. Through their work, they collectively support older adults, strengthen families and create pathways for employment and other services for new Americans. All are fueled by a commitment to make the world a better place.

What was the emphasis of the recent convening?

The convening was led by the expertise of our Lutheran Services in America staff and facilitators from Just Build Village Then, including a pivotal session with the Frameworks Institute.

“This fellowship changed my life forever! I’ve been to many trainings and conferences where the conversation has been about change in our systems and community, but very few focus on healing and change in ourselves,” said Jessica Strauch of the St. John’s United C.A.R.E.S Wraparound Program. “I had the opportunity to be in a space with other leaders with lived experience and together we had the opportunity to dig deep into what brought us to this work. I cried, reflected, and gave myself the opportunity and space to step into my story.”

What comes next?

As part of this fellowship, our fellows are currently engaging with professional mentors through the Lived Voices Fellowship Peer Mentoring Program. This key component is designed to foster meaningful connections between fellows and seasoned leaders within our network. Inspired by Marshall Ganz’s Public Narrative model, this journey includes shared self-discovery, collective identity formation, and actionable commitment. This mentorship phase will enable our fellows and senior leaders to identify collaborative opportunities for innovation and impact, driving positive transformation within Lutheran Services in America, our member organizations, and beyond.

Many thanks to Ascentria Care Alliance, Bethel New Life, Gemma Services, Lutheran Social Services of Illinois, Lutheran Social Services of Southern California, Lutheran Social Services of the Southwest, the Evangelical Good Samaritan Society and others for joining us. This is the Lutheran Services in America network!

Alesia Frerichs is President & CEO of Lutheran Services in America. Renada Johnson is Senior Director of Children, Youth and Family Initiatives at Lutheran Services in America.

Election Watch: What’s at Stake in November that may Impact Health Legislation?

August 26, 2024

BY: Sarah Dobson and Tony Brozey

As we are tracking the November elections with an eye toward impact on the work of the Lutheran Services in America network, we will be highlighting key races of members on committees with jurisdiction over issues that matter to us.  As you know, the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Energy and Commerce (E&C) Committee have jurisdiction over issues critical to our work. The HELP Committee plays a crucial role in shaping national policies related to healthcare and the workforce, while Energy and Commerce has broad jurisdiction over healthcare and the regulations and laws that govern the sector.

Senate HELP Committee

Sen. Bob Casey (D-PA), a senior member of the HELP Committee and chair of the Special Committee on Aging, is seeking re-election and is running against Republican Dave McCormick. Early projections and polls estimate that Casey is currently expected to beat his opponent, with some estimates giving Casey as much as a 10-percentage-point edge. Of course, Pennsylvania is a key battleground state in this year’s presidential election and so the race is expected to tighten. Lutheran Services in America and the Disability Network have worked extensively with Sen. Casey on legislation such as S. 100, the Better Care, Better Jobs Act; S. 762, the HCBS Access Act, and S. 4120, the Long-Term Care Workforce Support Act. We will continue to watch this race.

House E&C Committee

House Energy & Commerce (E&C) chair Cathy McMorris Rodgers (R-WA) is not seeking re-election. Her successor as leader of the committee will be determined first by whether the Democrats or Republicans have the majority in the House, and then through internal party deliberations. As chair, Rep. McMorris Rodgers has championed legislation addressing the needs of people with disabilities and served as a speaker at LSA-DN meetings. We will be closely monitoring who becomes chair of this committee, given the scope of their work, and ensuring an ongoing relationship for our network.

To learn more about our work with these lawmakers, or their legislation, please reach out.

Sarah Dobson is Senior Director of Public Policy and Advocacy.

Tony Brozey is a summer intern with the government affairs team at Lutheran Services in America.

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