Food Insecurity and Social Determinants of Health

October 5, 2022

I attended the White House Conference on Hunger, Nutrition and Health last week, the first such conference in over 50 years. The conference focused on ways to end hunger where today over 10% of the U.S. population is food insecure, and where 80% of a person’s health is influenced by social determinants of health such as access to food, housing, transportation, equitable economic opportunities, and more.

Lutheran Services in America is a network where members provide a wide range of services so people can be healthy and lead their best lives. The ways we meet those needs vary widely from digital food pantries to connecting older adults in their homes, affordable housing and independent living to services they need to remain independent, connecting families in crisis to supports they need to remain together, empowering people with intellectual and developmental disabilities to reach their goals, providing healthcare and so much more.

Join us on October 7, 2022 at 2 pm ET, for a Strength & Service Series webinar on “Bridging the Great Health Divide:  Nutrition Security and Health Equity,” led by Dr. Sara Bleich, the first Director of Nutrition Security and Health Equity at the USDA Food and Nutrition Service. On leave from her position as Professor of Public Health Policy at the Harvard T.H. Chan School of Public Health, Dr. Bleich will share USDA’s work to end hunger, reduce diet-related diseases, and advance health equity.

Dr. Bleich will be joined by a panel of Lutheran Services in America members—from Lutheran Social Services of Central Ohio, Lutheran Social Services of Nevada, and Lutheran Social Services of Southern California—who will describe how they are strengthening food security and meeting the social determinant of health needs in their communities.

Join us to learn more about efforts at the federal level and in communities across the country.

The Robots are Here

September 28, 2022

This weekend the Washington Post ran an article titled “The robots are here. And they are making your tacos.” It was a story of how fast-food restaurants are addressing workforce shortages by using robots to fry French fries, tortilla chips and tacos. It’s seen as a wave of the future—even though the robots occasionally freak out when encountering tacos requiring a human worker to toss them in the garbage.

While there is increased technology, including robots, in Lutheran social ministry organizations, it’s not as straightforward given the “high touch” nature of our work in caring for people. It also takes capital to invest in technology—capital that is scarcer in the non-profit sector. Yet we know that increased and innovative technology is crucial to our future.

We have partnered with the Consumer Technology Association Foundation (CTAF) over the past few years to enable Lutheran social ministry organizations to innovate. Through our partnership with CTAF, Graceworks Lutheran Services is currently increasing access for low-income older adults to telehealth, cognitive tools and virtual visits with family and friends in its 17 affordable housing communities. Previously, Samaritas provided assisted reality devices to formal and family caregivers caring for older adults diagnosed with dementia so they could receive realistic dementia education and training through an evidence-based program. Bethany Village provided “mobile communication stations” to allow frail older adults to visit with loved ones and healthcare providers, and Lutheran Social Service of Minnesota provided technology for family caregivers in rural communities to access support groups, counseling, companionship programs, and other services during the early days of COVID.

We’ve also worked with technology providers to create solutions that allow our members, including Genacross Lutheran Services and Lutheran Social Services of Northern California, to evaluate the social determinant of health needs of their clients, connect them to services in the community and enable them to live in their home and community. And our CEO Summit and Strength & Service Series feature workforce experts as well as our members as they share their insights, experiences and innovations.

But there’s a long way to go. Join us by sharing your ideas, your innovations, and your experiences. Together we can advance the ability of Lutheran social ministry organizations to expand innovation and automation and enable all people to lead their best lives.

Joining the Fight to End Hunger—and Recognize Food as Medicine

October 4, 2022

On September 28, Charlotte Haberaecker, the president and CEO of Lutheran Services in America, and I joined hundreds of elected officials, advocates and activists, and leaders of business, faith, and philanthropy from across America in Washington, DC at the White House Conference on Hunger, Nutrition, and Health—the first such gathering since 1969.

The previous conference directly led to the creation of groundbreaking programs like Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP)—commonly known as “food stamps”—and the goals for this conference and the national strategy it rolled out are no less ambitious: ending hunger and increasing healthy eating and physical activity by 2030 so fewer Americans experience diet-related diseases— while reducing related health disparities.

Alongside representatives of other nonprofit organizations and every branch of government, we participated in small group sessions aimed at generating actionable ideas across the five major pillars of the new national strategy that can help make these goals a reality:

  1. Improving food access and affordability;
  2. Integrating nutrition and health;
  3. Empowering all consumers to make and have access to healthy choices;
  4. Supporting physical activity for all; and
  5. Enhancing nutrition and food security research.

We were also privileged to hear from President Biden himself about how a lack of access to healthy, safe and affordable food and places to be physically active contributes to hunger, diet-related diseases and health disparities. Other dynamic speakers throughout the day-long session included Rep. Rosa DeLauro, Chair of the House Appropriations Committee, and Sen. Debbie Stabenow, Chair of the Senate Agriculture Committee. We ended our day with a call to action from Second Gentleman Doug Emhoff and White House Domestic Policy Advisor Susan Rice, who led a conversation with Gen Z nonprofit leaders Joshua Williams and Avani Rai.

We’re looking forward to continuing the work we began at the Conference and implementing new strategies alongside our member providers, especially for integrating nutrition and physical activity with healthcare.

Learn more about our advocacy efforts to reduce health disparities for people in America.

Alligators and Lutheran Social Ministry

September 6, 2022

Last week the Washington Post ran an article titled “His emotional support animal is an alligator…” and it showed a photo of a man with a 70-pound, 5.5-foot alligator. It talked about how the alligator went everywhere with him and had even been approved as an emotional support animal.

I didn’t read on.  I only hoped not to meet the alligator on a plane someday.

Fortunately, Wendy, our Vice President of Marketing and Communications, read the rest of the article. It turns out that Wallygator visits schools and senior living facilities, among other educational venues. And one of the places he’s visited is SpiriTrust Lutheran in Pennsylvania (see photo above).

It reminded me of the extraordinary efforts Lutheran social ministry organizations make to care for people and ensure they live a full and abundant life.  It reminded me of the alpaca that visited Diakon residents and staff during the earliest days of the pandemic and the staff and certified courthouse dog from Lutheran Community Services Northwest that spend time with victims of sexual assault and so many more stories that I could share.

It reminded me that one of the special aspects of Lutheran social ministry is our emphasis on building deep and meaningful relationships with people—not transactional relationships—but relationships that reflect the dignity and value of people. Relationships that consider people’s whole needs and where we strive to remove the barriers that prevent them from leading their best lives. It reminded me how we put people at the center of our work.

It reflects who we are and what’s important to us.  And it makes a meaningful difference in the lives of one in 50 people living in America.

Heritage, Vision and Mission: How Lutheran Services in America is Building a Healthier Future

September 12, 2022

The Lutheran Services in America network has over 150 years of dedicated service in the way of caring for older adults in America. That sustained success is largely due to the Lutheran tradition of empowering people and communities. “What makes us unique is our shared heritage, vision and mission,” said Charlotte Haberaecker, president and CEO of Lutheran Services in America, on the LTC Heroes podcast.

It is that shared sense of duty that makes teamwork possible amongst the 300 health and human services organizations of the Lutheran Services in America network in over 1,400 communities across 45 states. “Our organizations trust each other, collaborate and innovate together,” Haberaecker told Experience Care’s Peter Murphy Lewis, who hosts the podcast.

Needless to say, that sort of reach results in making a positive impact on the trajectory of long-term care in the United States. “We utilize the collective power of our national network with national partners to advance innovation and achieve a healthier, more equitable future for people in America,” she said.

According to Ted Goins, the president and CEO of Lutheran Services Carolinas — a member organization of Lutheran Services in America — this camaraderie is faith-inspired. “We are all friends at Lutheran Services in America,” he said. “It’s just baked into the network, which was created by the Church. That sponsorship has taught us all to work closely together without hesitation.”

Perhaps most remarkable is that the Lutheran Services in America network has been able to maintain the highest standard of care for older adults with diverse needs despite a challenging environment and workforce shortage. “Our network has been caring for people with a broad range of continuum of services, from home community-based services to affordable housing and full senior living facilities,” Haberaecker said. “And we have cared for all of the older adults in our care with dignity, respect, health and independence for well over a century.”

Lutheran Services in America is sincerely dedicated to older adults across America. This means remaining humble, unselfish and well-coordinated across the nation to facilitate the most appropriate care for all our older adults.

The Power of Partnership

September 1, 2022

One of the key areas where Lutheran Services in America brings together our members—along with strategic national partners in philanthropy, academia, healthcare and more—to advance innovative solutions is in enabling older adults to live with dignity, health, meaning, and independence in a place where they call home.

We recently partnered with our member NYU Langone Family Health Centers (formerly Lutheran Family Health Centers), the University of North Carolina at Chapel Hill (UNC), and The Harry & Jeanette Weinberg Foundation to empower older adults in affordable housing—particularly those transitioning from the hospital or post acute care—to remain living independently in their community.

The work builds on a four-year partnership with UNC and The Harry & Jeanette Weinberg Foundation where we worked with seven members in seven states to successfully transition 875 older adults from post-acute care to home, demonstrating improvement in care transition and quality of life.

The current two-year project will expand UNC’s Connect-Home transition care model to strengthen the capacity of staff to identify affordable housing residents most at risk of hospitalization, address gaps in care that lead to increased isolation and emergency room visits and enable older adults to live independently. Genacross Lutheran Services is providing peer support and expertise based on the extensive work they have done to assess and connect their affordable housing residents to services in the community.

Why is this important? According to CMS, 76 percent of 30-day hospital readmissions are preventable.  And we know the transition from hospital to home places older adults at risk.  We also know that when we bring together our members with expertise and funding from partners in academia, philanthropy and healthcare that we can tackle tough challenges and make a meaningful difference in the lives of people.

We look forward to sharing with you the learnings and results of the work and partnership in the future.

New Board Member Eric Gurley Adds Unique Experience to our Unique Network

July 28, 2022

The Lutheran Services in America network is unlike any other nonprofit network in the United States. From the services we provide to the people for whom we care, we are a network with a unique approach to empowering people and communities.

That unique approach is built into our core, from the frontline workers in 1,400 communities across the country to our very leadership. Lutheran Services in America has a board of directors comprised of 10 to 13 members that brings together diverse insights to our work.

We are pleased to add yet another trusted member to the board with invaluable perspective and depth of experience: Eric Gurley, the president and CEO of our member Immanuel. Eric has worked in the senior living space for 31 years and has extensive experience with strategic planning, implementation and reporting in senior housing and healthcare.

A native East Coaster, Eric migrated to the Omaha-based Immanuel, where he expanded services to cover 2,500 older adults, up from 800. Under his leadership, Immanuel grew from 300 employees to 1,400 and expanded missional service to underserved populations through the implementation of three innovative models of care, including the Program of All-Inclusive Care for the Elderly (PACE). Eric also oversaw the creation of the Immanuel Vision Foundation, which has given more than $15 million to the Church and other nonprofits, and the Immanuel Community Foundation, which fulfills the promise that no one will be asked to leave Immanuel due to the inability to pay.

Eric has broad experience serving on the boards of directors of other nonprofit organizations, including Lutheran Giving, Nebraska Lutheran Outdoor Ministries, the Omaha Symphony and the Experimental Aircraft Association and its foundation (fun fact: Eric is a licensed pilot!).

Lutheran Services in America member CEOs elected Eric to the board at the Annual Meeting in January. Eric’s term, which began on July 1, runs through June 30, 2025. We look forward to the next three years of Eric’s talent and perspective!

Visit our Leadership page to meet our board of directors.

Frequently Asked Questions About the Broker Selection Process

July 21, 2022

Now that you’ve learned about the broker selection process, you may have additional questions. While JKJ is always available to answer questions that you might have, here are some that we commonly hear from other organizations.

At what point during the insurance renewal cycle should this process take place?

Under ideal circumstances, it should be completed by the time you are ready to consider getting options for your insurance program renewal and before your current broker begins the renewal efforts. Give yourself time to conduct this process. This is an important decision. Six months before your renewal is not too soon.

How frequently should the broker relationship be reviewed?

This varies. Management may wish to review the relationship every 3-6 years. If things are going along well in the partnership, there may not be any need to review the relationship unless there is a concern. A good broker should be performing a stewardship review with you annually, which will probably drive this decision.

Are there times when this system doesn’t work at all?

Yes. If you have a situation where none of the brokers are specialists in your line of work, you may very likely end up in a situation where no single broker has a wide array of insurance markets. If this is the case, you may need to consider the traditional selection approach, or you could use this approach to determine which two brokers will have a chance to bid on your program. Either way, the system gives you the tools to select quality brokers and limit the number of brokers involved.

Are there times when this system works particularly well?

Yes. If you have multiple brokers who generally all represent the same markets, this allows the brokers to differentiate on something other than the insurance company relationships.

What are some of the most important variables to consider when using this approach?

The Risk Management resources and services that the broker can provide can make or break a program.

Who actually will be available to you and what are their qualifications and experience?

The expertise of the broker when working with your class of business is critical. It is important to know that the broker that you ultimately choose actually represents the insurance companies who will be the more likely ones that you will do business with. If five insurers control 90% of the market and the broker you chose only represents two of the five, then this could be a big problem!

What markets do the broker represent? What volume of business does the broker have with each? What insurance companies are most likely to earn the business? Why? Discuss the relationships involved. The opinions of references are key. If good references that can vouch for all the promises that the broker is making are not available, then you may just be listening to a hollow sales pitch!

Do I tell the brokers how they will be scored? Why not?

Don’t make the broker be a mind reader. Be open to the brokers you will interview and let them know what is important to you. You can do this verbally, in the form of a form letter, or in the form of specifications that you want to be sure that they respond to in their interview. Or … you may want to just leave this to the broker. If they know their business, they will have a pretty good feeling for what the important variables are for your business. Whether or not you choose to communicate this prior to the selection process, it is obviously important that you ultimately communicate these areas of importance to your broker.

How do I know the broker is bringing the best alternative to me?

There are several ways to accomplish this. Require the broker to present alternatives to you and provide you with sound reasoning for the basis of their recommendation. Analysis of the options should be standard protocol. Most people can determine fairly quickly if their partners are being open and honest with them. At a point, you need to trust your broker. This individual should be a trusted advisor just like your attorney or accountant. If you don’t trust them, you should fire them. Compensation Disclosure of broker compensation is completely appropriate. Feel free to ask that it be disclosed when quotes are provided, or in advance if you would like.

Remember, though, that fees/commissions are determined in large part based on the services that are provided. If you expect the fee to be charged to be part of the initial broker presentation, you will need to have clearly communicated what services you want in advance so that these fees can be set appropriately. The “chicken or egg” scenario arises here, because you may not know what you want until you know what is available. We recommend that you save the compensation question until a second interview after you have a complete understanding of what services you want, the frequency that you want them, etc… While compensation is fair game for discussion, you want to be fair about it. In the end, you will get what you paid for.

Conclusion

Let this system work for you. Don’t make it too complicated. Ask brokers what variables they think are important. Most of the brokers will guide you to their strong points and what they think is important! It is good to get input on your comparison variables from numerous sources. When you have been through this process and see the results that it can produce, you will likely be hard pressed to go back to the way you use to do it. Good luck!

This is the third entry of a three-part series of blog posts. Read the first and second posts. Find out more from Johnson, Kendall & Johnson or contact Rafael Haciski.

Managing the Broker Selection Process Effectively

July 19, 2022

The broker selection process is a great tool for an organization to effectively and efficiently select the best broker and the best insurance company. The following outlines the steps that you can take to use the Broker Selection Process effectively:

#1: Management Commitment to the Broker Selection Process

It is important to determine in advance that you will either use or not use this process. You don’t want to get in a position where you start off using this process and then go back to the traditional way of selecting your insurance coverage during the same purchasing cycle. If you don’t like the end result, then you can go back to the traditional approach (or a hybrid scenario).

#2: Identify Potential Brokers

You might limit the number of brokers that you interview; however, this is the time to give a fair evaluation to many of the brokers/agents that call on you. However, many won’t know how to respond because they are just in the business of “quoting” insurance. This is a great time to hear what a few them have to say without having to go through “the quoting process” with all of them! Be reasonable with the number of interviews that you plan and don’t wear yourself out!

#3: Determine Selection Criteria

It is very helpful to do this in advance. Often, management will create a comparison tool to help fairly evaluate different brokers. After determining the variables to compare, you can give a weight to each variable in order to help you focus on the more important areas. Remember, this is your tool. You determine what variables are important and how important they are. We have provided a sample. Remember to think through all different dimensions of your broker relationship. In addition to the obvious insurance company considerations, policy differences and traditional agency services, consider risk management and claims management services as well. How can a particular broker assist you in managing all the costs of risk – both pre- and post-loss – not just your insurance premiums?

#4: Management Team Involvement

Consider incorporating your financial, clinical, and human resource staff into these presentations, as the material covered likely will affect all of these disciplines. All decision makers should be involved in the process. They will also benefit by learning what other services may be available in the marketplace.

#5: Interviews

Explain the process to the brokers who you will interview and let them know how much time that they will have with you for the interview/presentation. You might ultimately communicate what you are looking for from the brokers you will be interviewing in advance. This will involve far less time than you will spend with each broker if you have multiple brokers participate in “quoting” in the traditional sense. A broker that has a very thorough service driven program will likely need at least 60 minutes. Follow-up interviews may be granted to finalists if this will help.

#6: Rate Brokers

Some may prefer to use the tool more formally while others may allow instinct to guide them. Either way, be sure that you apply what works for you consistently.

#7: Communicate Decision

Upon selecting a broker, let all parties involved know your decision.

#8: Partnership

Your new broker should understand that they are now a partner with your organization in all aspects of your Risk Management and Insurance program. Your new broker should now solicit proposals from all appropriate companies and bring all proposals to you for your renewal along with an analysis of program options.

This is the second entry of a three-part series of blog posts. Read the first and third posts. Find out more from Johnson, Kendall & Johnson or contact Rafael Haciski.

Why Use the Broker Selection Process?

July 14, 2022

The broker selection process is a great tool for an organization to effectively and efficiently select the best broker and the best insurance company. There are several manners in which to choose an insurance brokerage and risk management partner. The words “insurance” and “partner” may seem like an unlikely pair, but the alliance can be one of the most important for a company’s executive team.

Selection Model #1: Selection by Quote Process

Some organizations will choose a few insurance brokers to “quote” their insurance program. Ultimately, significant work and resources are spent providing underwriting information, completing applications and hosting loss control visits for multiple brokers and insurance companies. Much wasted energy is consumed in the jockey for and allocation of insurance markets. Proposals must be reviewed from each of the brokers. At the end of the day, only one of the brokers is awarded the business.

This process does not place value on a long tenured partnership; instead, the model focuses on the premiums of the various insurance companies and broker services, putting the impact of total cost of risk are secondary.

In the unfortunate scenario in which the organization prefers to work with one broker but gets the “best quote” from a second broker, the organization is forced to either work with the broker that isn’t its first choice, or they resort to signing a “Broker of Record Letter” to give the work of one broker to another. This always leads to a difficult situation and hard feelings and a breach in trust is inevitable or they opt for “best quote” and second-choice broker. The organization can also develop a tarnished reputation in the underwriting community.

Selection Model #2: Broker Selection Process

A broker selection process can greatly simplify the process of looking at options and ultimately provide you with the best value for the insurance dollar or total cost of risk. In this model, an organization ends up with the best broker and the best insurance company per the organizations criteria. It allows the organizations to choose a broker through a competitive process that separately evaluates the benefits of each broker’s resources and services. Brokers can present their case for why you should do business with their organization and why they would make a good partner to develop and implement your risk management program.

Brokers should be your representatives. This becomes more critical as insurance companies continue to cut the services they provide. Once a broker is selected, you are in a position to have one broker clearly represent you to the insurance market. The insurance companies will know they have a fair chance of writing your business and will not have to be concerned that they are with the right broker. The entire process of selecting an insurance company is then the responsibility of your “best” broker. Management does not have to do analysis of all the different proposals. While management is welcome and should be a part of this process, the burden of the analysis rests on the part of your broker.

Ultimately, the organization seeking alternatives is guaranteed that they will end up doing business with the broker of their choice and the insurer of their choice. The elimination of agents is done early in process before significant work is requested of the agents, thereby creating a much more efficient process and much more effective result.

This is the second entry of a three-part series of blog posts. Read the second and third posts. Find out more from Johnson, Kendall & Johnson or contact Rafael Haciski.