CMS Final Medicaid Access Rule — Action Moves to States

May 29, 2024

What: In April, the Centers for Medicare & Medicaid Services (CMS) released the final Medicaid Access Rule. As you know from our recent update, many of our shared concerns across the network were not addressed in the final rule, including new requirements related to payment of the direct care workforce. Specifically at least 80% of all Medicaid payments must be spent on compensation for direct care workers and/or states must report annually on percent of payments that go to the direct care workforce.  Other provisions also include changes in access to home- and community-based services (HCBS), health and safety protections, and quality measures.   Given the scope and impact on our work and services, our work continues and also moves to the state level.

What Happens Now? Because the Access Rule requires states to make significant changes to their Medicaid programs, CMS is allowing states several years to implement the provisions. This is a time to consider strengthening your discussions with state-level decisionmakers to inform the implementation of the provisions.

Under the rule, states are required to create home care and rate-setting advisory boards made up of Medicaid beneficiaries, home care workers and others to advise states on provider payment rates and worker compensation. Thus, its important to be in conversation with state-level officials to inform the make-up and considerations of these boards. We will continue conversations with CMS as we learn more about guidance, timing and other considerations.

How to prepare: Given the rationale for the rule change is to improve job quality and pay for direct care workers to attract more people to those jobs, it will be important to articulate the impact to your organization, including how this makes it harder to deliver quality services. The rule will also require states to be more transparent in how they pay for home- and community-based services, as well as how they set rates.

The following are the key components of the rule to be aware of:

  1. at least 80% of all Medicaid payments must be spent on compensation for direct care workers and/or states must report annually on percent of payments that go to the direct care workforce,
  2. states must report information on HCBS wait lists (specifically timely and full access to services),
  3. prioritization of person-centered planning,
  4. states must demonstrate an electronic incident management system,
  5. states must establish and manage a grievance process and
  6. states must report on a set of nationally standardize quality measures.

For more information, please contact Bill Kallestad.

Bill Kallestad is the Director of Public Policy and Advocacy for the Lutheran Services in America Disability Network.

Day on the Hill: Lutheran Services in America Disability Network

May 28, 2024

Members of the Lutheran Services in America Disability Network gathered in Washington, D.C. earlier this month for their annual Spring Meeting. The DN policy & advocacy team advocated for congressional support for SSI Savings Penalty Elimination Act (SSI SPEA). Network members met with nearly 20 key lawmakers and their staff, including members of the Senate Finance Committee and the House Ways and Means subcommittee on social security.

The SSI SPEA ensures people with disabilities and older adults can prepare themselves for a financial emergency without putting the benefits they rely on to live at risk, by increasing the amount of money one can have in savings from $2,000 to $10,000 for individuals and from $3,000 to $20,0000 for married couples. The DN policy & advocacy team then created a plan to follow up on key legislators and identified strategies to further our advocacy on this key piece of legislation.

To learn more, contact Bill Kallestad.

Bill Kallestad is the Director of Public Policy and Advocacy for the Lutheran Services in America Disability Network.

Lutheran Services in America Raises the Profile of Key Housing and Services Priorities

May 28, 2024

During our recent Health and Housing Solutions Summit, network members met with the offices of eight key lawmakers, including Sen. Patty Murray (D-WA), the Senate Appropriations Committee chair; Sen. Sherrod Brown (D-OH) and Sen. Tim Scott (R-SC), the chair and ranking Republican of the Senate Banking Committee; and members of the House Appropriations Subcommittee with jurisdiction over housing funding.

Network members reiterated key housing priorities for their communities related to accessibility and affordability. These priorities include providing adequate funding to expand affordable housing in communities, incentivizing faith-based land conversions, increasing options for aligning housing and services, improving rural housing programs, and increasing the availability of the Low-Income Housing Tax Credit.

Next steps have included a formal endorsement of the Rural Housing Service Reform Act (S. 1389), bipartisan legislation that would improve federal rural housing programs, and network members will be inviting these key lawmakers and their home state lawmakers on site visits to learn more about their work and needs in their communities.

For more information, contact Sarah.

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

Transforming Child Welfare: Reflections from the Results Network Convening in Chicago

May 17, 2024

Members of our Results Network cohort gathered in Chicago this week to continue our ongoing journey to find innovative solutions for families that keep them together and change our nation’s child welfare system for the better.

Our United Commitment

With 41 participants from our member organizations as well as additional stakeholders and partners, the two-day session was a testament to our collective commitment to drive change. Guided by the Person Role System approach from the Results Count framework, we are not just dreaming of change, we are actively shaping it. By zooming in on our roles as change agents, we are reshaping systems and moving towards a future where every child has the opportunity to thrive.

During the morning session, we focused on somatic practices to foster resilience. Through activities such as centering and grounding, the introduction to somatic toys, and breathwork, we embraced the journey of personal care, healing, and recognizing the importance of nurturing our own well-being as we advocate for others.

Strategizing for the Future

One of the highlights of the convening was our data walk, where we reviewed the work of each organization, shared insights, and engaged in table conversations. This reflective exercise allowed us to celebrate past achievements and identify areas for growth, all while centering equity and justice in our discussions.

In our final session, we came together to understand and help develop a framing guide that is aimed at simplifying the complexities of our work into plain language. This guide will serve as a powerful tool, enabling us to communicate effectively and inspire others to join our efforts to advance equity in the child welfare space.

Cultivating Genuine Connections

Throughout the convening, we prioritized the cultivation of genuine connections. We know that only together do we as advocates, allies, and change agents have the power to create caring communities that advance health and opportunity for children, youth, and families across the country. We invite you to join us as we continue to be innovative in our pursuit of equity and justice in child welfare.

Renada Johnson is the Senior Director of Children, Youth and Family Initiatives at Lutheran Services in America.

Unlocking Opportunities: Join us at the Housing Solutions Summit

April 29, 2024

We’re excited to extend an invitation to all stakeholders interested in addressing housing challenges to join us on May 7 at the Housing Solutions Summit in Washington, D.C. This convening marks a crucial step forward in our collective efforts to tackle housing issues impacting children, youth and families across our communities.

At the summit, participants can expect an engaging dialogue that delves into the core reasons behind our commitment to addressing housing challenges. Through insightful discussions and collaborative sessions, we aim to not only highlight the pressing need for affordable housing but also to explore innovative solutions that can make a meaningful difference in the lives of those we serve.

One of the key highlights of the summit will be the release of the Abt Associates white paper, a comprehensive study that sheds light on the intricate dynamics of housing insecurity and offers actionable insights for policymakers, practitioners and advocates alike. This white paper serves as a cornerstone in our ongoing efforts to drive impactful change in the realm of housing and community development.

Furthermore, we’re thrilled to emphasize our partnership with the ELCA, a collaboration that underscores our shared commitment to social justice and community empowerment. Together, we’re leveraging our strengths to address the multifaceted challenges faced by children, youth and families, with a particular focus on ensuring access to safe, stable housing for all.

Join us as we march forward in our mission to create caring communities where every individual has the opportunity to thrive. Together, let’s harness the power of partnership and innovation to advance health and opportunity for all.

Allie Broxton is Director of Health & Housing at Lutheran Services in America.

Match with a Lived Voices Fellow!

April 29, 2024

In March, we were honored to launch our inaugural Lived Voices Fellowship, a new community of people within the Lutheran Services in America or ELCA community who serve in positions of leadership and bring lived expertise. Some fellows have been refugees to the United States. Others have navigated public systems for housing, food assistance and child welfare. Through the fellowship they are healing, expanding their village and growing new skills to affect change. That is where you come in!

We are inviting you to contribute to and learn from one of our 17 amazing fellows by becoming a peer mentor. As a peer mentor, you will be matched with one of the Lived Voices fellows and engage in a powerful series of mutually beneficial conversations to advance your collective leadership.

Peer Mentor Obligation

Peer mentors will engage in three 1-hour conversations with their matched fellow in June, July and September (self-scheduled by fellow and peer mentor). 

  • The conversations will give both fellow and peer mentor the space to explore their respective stories, identify and build collective identity and make an actionable commitment grounded in lived experience and strategy.  
  • A guide will be provided for the conversations, grounded in Professor Marshall Ganz’s public narrative framework of Story of Self, Us and Now 
  • While not required, peer mentors are also encouraged to attend the final fellowship session on Thursday, November 14 from 1 to 4 p.m., where fellows will make a final presentation. 

 Qualifications

Ideal peer mentors will meet the following qualifications:

  • Embrace the Approach: Learn about the Self, Us, Now framework and be open to sharing your personal and professional journey through story, discuss the community you are building and make commitments coming out of the process.  
  • Able to Fulfill the Time Commitment: Be able to fulfill the time commitment of three 1-hour conversations, recognizing the importance of accountability to a fellow. Peer mentors are encouraged to attend the November 14 fellowship session.
  • Bring Diverse Personal and Professional Experiences. We welcome peer mentors from diverse personal and professional backgrounds. While a minimum of 15 years of professional experience is encouraged, we also recognize the value of diverse perspectives and encourage anyone interested in becoming a peer mentor to apply.

How to Apply

To share your interest in serving as a peer mentor, please fill out the following brief application form.

Kent Mitchell is Vice President of Strategy and Innovation at Lutheran Services in America.

Funding Opportunities

March 12, 2025

View the latest grant opportunities.

Healthy Tomorrows Partnership for Children Program
Grants to support community-based projects that promote access to preventive clinical and public health services for children in rural and underserved communities.  Closing: March 17, 2025.

Crisis Counseling Assistance and Training Program
Grants and technical assistance to help individuals and communities recover from natural and human-caused disasters through community outreach and access to mental health services. On-going opportunity.

New Grant Opportunity to Advance Workforce Strategies
The National Alliance to End Homelessness is requesting proposals for a new opportunity that will award a one-time grant of up to $50,000 to start or continue initiatives that support the recruitment, promotion/advancement, and retention of high-quality homeless services staff. With a workforce under constant strain, this opportunity aims to encourage small-scale innovations in the homeless services workforce. Applications are due March 28, 2025 to hri@naeh.org.

Find more national, regional and federal funding opportunities from our partners at GrantStation Insider and sign up for our weekly GrantStation newsletter.

Taking Action to Advance Housing Solutions

April 30, 2024

To build on the work of our network to advance housing solutions in communities across the country, Lutheran Services in America is supporting the federal expansion of the Low-Income Housing Tax Credit (LIHTC). Provisions in pending legislation represent what would be the largest single investment in affordable housing in decades.

Earlier this year, the House passed with strong bipartisan support the Tax Relief for American Families and Workers Act of 2024 (H.R. 7024), which includes key provisions to expand LIHTC. Action has moved to the Senate, and we are asking you to contact your senators and urge them to pass this legislation to better address our nation’s housing crisis by meeting critical, urgent needs that have been under-resourced.

If passed, this bipartisan legislation will expand and strengthen LIHTC by financing the construction or preservation of an estimated 200,000 additional affordable housing units nationwide, generating more than $34 billion in wages and business income, supporting over 304,000 jobs, and generating almost $12 billion in federal, state, and local tax revenue.

We hope you will join us in raising our collective voice on this urgent issue. If you have any questions, please contact Sarah Dobson.

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

Results Network: A Journey to Transform Communities by Cultivating Caring Communities

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:

  • Access expertise from across the network and national thought leaders.
  • Become part of a learning community through the exchange of ideas and learning, building lasting, supportive relationships within the network.
  • Develop new approaches to achieve results and engage partners in moving the work forward.
  • Challenge the status quo and identify barriers to improving equitable outcomes for children, youth, and families.

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.

SNF Minimum Staffing Standard Published: Tell CMS How New Mandate will Impact your SNFs and Access to Care

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.

Supporting
Our Neighbors,

TOGETHER.

Our shared Lutheran tradition of service to our neighbor is more vital than ever.

Join us as we work to ensure our network continues delivering essential services to all in need.