There we were. In the parlor of the church all sitting around the room for an informal conversation in which I had been invited to share about the ministry of United Church Homes, one of the 73 organizations that is a covenanted member of the Council for Health and Human Service Ministries of the UCC. Our organization provides housing and health care for older adults. In the early ‘60’s the members of this congregation where I had been invited to preach later that morning, had been very involved in the establishment of one of our retirement communities about 20 miles down the road.
In the middle of the conversation, the lawyer who sat across the circle from me leaned in and asked rather abruptly, “What difference does being faith-based and non-profit make? We have several new health care facilities in our own town. When we go in they look lovely and our neighbors and friends seem to get just as good care here than if we sent them to your closest community.” I sat back and took a deep breath.
In a way it was a bit like the lawyer who questioned Jesus to test him, “Teacher which commandment…is greatest?” We weren’t talking about commandments in the church parlor that day, or were we?
Haven’t we all seen this in our own communities? Haven’t we wondered the same thing? We are lured into the shiny amenities that newly built structures provide. We look at how close these nursing care facilities and retirement homes are to where we live and we think, “If I had to use these services, I wouldn’t mind living here”!
And yet, when my parishioner needed temporary rehab following an illness, they were told that the new for-profit organization doesn’t admit individuals who are on Medicaid and it becomes apparent that their business plan does not include care for the poorest among us. Or when your loved one doesn’t have the right Medicare part B for that new modern facility and they end up in an older facility that doesn’t smell so new and doesn’t offer the new care options, it is easy to see that this facility is concerned about expenses more than patient centered care. It is at times like these when most people begin to see the difference between non-profit and for-profit institutions. Or you notice that the lovely new care facility that was built just a few years ago has a new name, and a new owner. Was the enterprise not profitable enough? Had the original owner met their return on their investment and moved on, not having any loyalty or commitment to the larger community? One facility in my hometown has had at least five owners in the past 20 years.
I can’t speak for all of the CHHSM organizations, but as faith-based organizations most of us are concerned about extending the same extravagant welcome to all who are in need. Yes, we must be good stewards and utilize good business practices, but these are balanced by our commitment to love our neighbors, as ourselves, as Jesus responded to the testy lawyer.
Take a look at this figure that was shared at the CHHSM annual meeting earlier this month: $857 million dollars were reported in 2016 as care that was provided by CHHSM agencies in spite of the fact that they were not reimbursed for those services. We call this “Uncompensated” Care. We also embrace this as a significant part of our mission that is grounded in the faith-based heritage of our organizations.
Eight hundred and fifty-seven million dollars is a lot of money. In fact that is up from $728 million of uncompensatated care from the previous year. These expenses include the difference between the reimbursements that we receive from Medicare and Medicaid. At current levels of funding, these programs do not pay for the quality of care that we expect and that we choose to provide to those who are in need, no matter who they are or where they have been.
These expenses include the cost that some of our organizations provide for individuals who have outlived their own resources and for those young who have no family support at all. These dollars include the fact that we provide services and support that are not reimbursed by any insurance or government program and yet are important to our understanding of health and well-being. Things such as providing chaplains and spiritual care for residents and staff, providing internships and teaching opportunities for students and young professionals, reaching beyond our own walls and helping to improve the health of the communities in which we are located as we continually strive to improve the quality of life for all.
And how do we pay our bills when $857 million of our expenses is not directly reimbursed? Some of this is covered by the return on investments that previous generations may have left us. Some of this is absorbed from the fact that portions of our mission do provide a profit and thus lead to the phrase, “No margin, no mission”. And still another portion is covered through the generosity of individuals and congregations who are as passionate about our mission today as were those generations who had the vision to start these ministries in the first place.
Back to the church parlor and the long deep breath that I took trying to answer the faithful lawyer’s question. I suggested that to really see the difference between non-profit and for-profit providers of care, you needed to talk with the staff, particularly those who have had the experience of working over the course of their career in both types of organizations. The difference is in how the organization respects the workplace and the ways in which they honor the staff. It is a visceral quality. Sometimes it can be explained in data as in how many residents one nurse aid responds to and other times it can be described in the way in which the employees are empowered to care for the individuals around them. Is this true of all non-profits? Probably not. And aren’t there some for-profit companies that are good employers? Probably.
But for those of us whose organizational visions come from the Gospel’s command as shared in Jesus’ response to the lawyer, to love our neighbors as ourselves, our employees know that they can have greater alignment between what they believe and what they do every day. At United Church Homes we invite our employees to participate in a liturgy of a blessing of their hands, acknowledging that through their direct care, they are instruments of healing and reconciliation. They are invited to make connections between their work and their sense of God’s leading them in their life. Most of our employees are not technically members of the United Church of Christ, and yet, they are connected and united with our vision to do justice in the world each day they come to work.
I thanked the lawyer and the members of that congregation for their continued support to our ministry. We could not provide the ministry we provide without the financial gifts from congregations and individuals. I cannot emphasize this enough. Our ministries are your ministries—extensions of the UCC’s commitment to build a just world. Everyday. By providing direct care. Through advocacy and education. And through our commitment to embody the gospel in the world. Thank you for your on-going financial support, for your prayers and for the many ways in which your members and your congregation volunteer alongside of us.
Rev. Beth Long-Higgins serves as Director of Outreach and Mission Integration at United Church Homes in Marion, Ohio, a member organization of the United Church of Christ Council for Health and Human Services Ministries.