ADA REPORTS

Presidents Page: 1991-1992 Annual Report

n 1992, we celebrated the 75th Anniversary of The AmericanDietetic Association. The theme - Achievement, Action, Ex-celler lce... 75 Years of Food and Nutrition Leadership - launched

the year and carried us to our Annual Meeting in Washington, DC.It was a year of actions that built on the past and planned for

the future. The Board of Directors (BOD) and Association leadersand staff served as a leadership team with a common focus. We notonly addressed the challenges of the present, we also made majorstrides toward identifying future strategies.

Throughout the year, we benefited from theenergies and wisdom of current and former Asso-ciatiorl leaders and an extensive cross section ofmembers. The emphasis on Strategic Initiativesbegan with a leadership core group at the 1991Annual Meeting and spread outward to includemembers in all affiliate units and geographic areas.

Like the year, the 1992 Annual Meeting was acelebration of our history, our present, and ourfuture. More than 11,000 attendees joined us inWashington to begin our next 75 years. The firstEdna and Robert Langholz International NutritionAward was bestowed on Elsie May Widdowson, PhD, DSc, whocharmed the audience with stories of the past and present. And ahistoric( signing with an international flair took place at theCanadian Embassy: the presidents and executive directors ofboth the Canadian and American dietetic associations signed anagreement to cooperate on future position papers.

Keynote speakers offered two distinct perspectives. SallyHelgesen, author of The Feomale Advantage, reviewed leader-ship styles unique to women. Joel Barker, author of Futire ,Edge,challenged us to examine our paradigms.

A spirited group of members helped us blend 75 years ofldstory into a memorable opening-night event. Known as theCleveland Connection, in honor of the site of the first ADAmeeting, this group of Ohio members was joined by staff andleadership. Items collected to represent our history were en-closed in a time capsule. The capsule, a gift from a member, willbe sealed and put on display in our Chicago office.

As we move toward the 100-year milestone in our history, we

must capture the highlights of the 1991-1992 program year, butwith these caveats:* This brief review will miss some of the action.* Many of the efforts of this year built on successful programs andprojects initiated within the past 5 years. All the new projects willbe a part of future plans. It was a year of transition.* The sometimes-overused word team took on true meaningthroughout the year. Numerous team participants rose to the

challenge, but BOD members and our staff servedin extraordinary ways. Many people share the creditfor the accomplishments of the year.

ACHIEVING COMPETITIVE ADVANTAGE...STRATEGIC THINKING INITIATIVEA major emphasis for the year was the Association'sStrategic Thinking Initiative, the process of revis-ing the strategic plan. In 1989, the House of Del-egates (HOD) adopted Dietetics in the 21st Cen-tury. A Strategic Planfor TheAmerican DieteticAssociation. It stressed an external focus andrecommended ongoing evaluation and updates of

the plan. The dramatic changes in the environment, especiallythose in health care, signaled a need to renewthe cycle of strategicplanning. Internally, we needed to set priorities for resourceallocation. The Association is faced with increasing needs to fundfuture-oriented programs and projects in an era of shrinkingresources, both dollars and hours.

The first steps were taken by a representative group thatincluded the 1991 and 1992 Boards of both the Association andthe Foundation as well as key staff. As work continued to identifystrategies that would help every member gain a competitiveadvantage in a crowded marketplace, the HOD and other organi-zation units were involved.

The project was ambitious and exhilarating. The midyearmeetings of all organization units as well as meetings held bydietetic practice groups (DPGs) and at least 28 state associationsserved as forums to gather input. Leadership wove information onthe initiatives into both oral and written presentations to involveas many members as possible.

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In less than 6 months, the Association's mission, vision, andvalue statements were revisited and refined. A draft outline of astrategic plan was developed for review by Association units. Anew statement of philosophy emerged to reinforce our externalfocus.

By mid-1992, the BOD and HOD had approved the conceptsput forth in the Strategic Thinking Initiative. From these actionscame the identification of priorities for resource allocation. Themandates of day-to-day operation, particularly those in educationand member support, continued to be addressed through thebudgeting process. Funding for new initiatives was identifiedaccording to priorities outlined in the draft strategic plan.

During the remainder of the year, the strategic plan evolvedbased on the four market areas in which members are likely to be

to coordinate nutrition education and nutrition services for theschool-aged population.* We continued as a lead partner in the Nutrition ScreeningInitiative, a major effort to improve the nutritional status of olderadults. The NSI offered opportunities for all dietetics profession-als working with older adults to be a part of the testing of a new toolfor nutrition screening (J Am Diet Assoc. 1992; 92:163-167).

HEALTH CARE: ACUTE/LONG TERMPhysicians are the key linkage in this target market as thisinitiative explores the role of the dietetics professional in thehealth care medical model. Health care reform will also have animpact on this market area. Several key projects provide memberswith needed support.

practicing. The new initiatives, along with theongoing support of education, practice, andresearch, give each member access to pro-grams and strategies that can be used to meetADA's vision.

Common themes permeate our actions.Expanding and reinforcing key alliances andbuilding visibility through involvement in lead-ership development and media are objectivesin each of the market areas. Following aresome of the achievements of the first phase ofimplementation of the Strategic Initiativesgrouped by target markets.

Mission - TheAmerican DieteticAssociation is the

advocate of the dieteticsprofession, serving the

public through thepromotion of optimalnutrition, health, and

well-being.HEALTH CARE:PREVENTION/WELLNESS Vision -Government is the major link in this market Th A emarea. The Division of Government Affairs anda network of members are working for inclu-sion of nutrition services, provided by dietet- thefood cics professionals, in state and national health impact thecare reform legislation. Here are some of the stats ofaction items accomplished this year:* During the March Legislative Symposium,200 CapitolHillappointments were conducted P h kby 150 members ofADA. Members were armed of e

with a white paper on health care reform.Included were 10 Legislative Leaders, mem- Dietetic Abers specially trained to work with congres- serve the p?sional leaders on health care reform. by serving* A Legislative Platform on Health Care Re-form was developed and approved along with fta business plan for an expanded legislativeeffort.* At the Annual Meeting, 300 ADA memberspresented the newly approved Legislative Platform during nearly300 Hill appointments.· As a new administration moves into Washington, staff andmembers are drafting the next phase of this Strategic Initiative.* During the year, the ADA had several opportunities to presentcongressional testimony. Among these, testimony was presentedto the House Select Committee on Aging on the issues of diabetesand minorities(JAm Diet Assoc. 1992; 92:671) and nutrition andthe elderly (JAm Diet Assoc. 1992; 92:1064).· We continued to support involvement in Healthy People 2000,the national health promotion and disease prevention objectives.Much of the action in this area came in the form of additionalalliance activities, including our active participation in the Mater-nal Child Health Interdepartmental Nutrition Group.* ADA representation was a part of the strategic planning groupfor Nutrition Education and Training, an ongoing federal program

embers ofcan Dieneticn will shapehoices and, nutrtionalthe public.

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* The Nutrition Services Payment Systems(NSPS) program moved ADA toward its reiim-bursement goal. Intense workshops, called"The Power of Persuasion: Dialogue for Dol-lars," sharpened the negotiation skills of mem-bers and of state and DPG NSPS representa-tives in six regions of the country.* The Diabetes Guidelines Cost EffectivenessStudy steering committee approved draft prac-tice guidelines for nutrition care by dieteticspractitioners for outpatients with non-insu-lin-dependent diabetes mellitus (J Am DietAssoc. 1992; 92:1136-1142).* This committee also oversees the cost-ef-fectiveness studybeing conducted for ADA bythe International Diabetes Center. The studyresults, due in June, will be used to demon-strate the cost-effectiveness of nutrition ser-vices to the government and other payers.* This initiative also encompasses efforts inprofessional enhancement. As a first step, theCouncil on Practice (COP) Task Force Reporton Continuing Education, which will central-ize professional education efforts, was ac-cepted by the BOD. Progress on this initiativeis scheduled for the next program year asfunding becomes available.· Work was begun on the leadership develop-ment and professional enhancement compo-nent of this initiative in November 1992.

Xb. CONSUMER EDUCATIONBecause our organization has a focus on meet-ing the needs of the public, this initiative hasmany possibilities. The media was identified

as a key linkage to reach the consumer. The Association has inplace an expansive media program through the Division of Mar-keting and Communications and a successful consumer outreachprogram through the National Center for Nutrition and Dietetics(NCND). This year saw a number of achievements.* The NCND continues to expand services that provide valuabletools, including National Nutrition Month® and Project LEANmaterials, to the dietitian and dietetic technician. (For a full reportof NCND activities for the year, see the ADA Foundation [ADAF]Annual Report included in the October Courier.)* The NCND consumer hot line, initiated in December 1991,logged more than 250,000 calls and responded to more than78,000 requests for information in the first year of service. RDsstaff the toll-free line during ADA working hours, and recordednutrition messages are available to callers 24 hours a day, 7 daysa week. A message recorded in Spanish was added in the summer.

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* A companion service, a national referral network for RDs, beganin October. How to locate an RD continues to be one of the topquestions on the NCND hot line and from the media. Initially,1,500 RDs subscribed to this service.* News releases announced ADA's positions and timely state-ments to the media. Topics included labeling, the importance ofpreventive services in health care reform, men's health, sweeten-ers, and biotechnology.* ADA spokespersons continue to be in demand by the media.The 26 Ambassadors and other ADA spokespersons were fea-tured in more than 1.450 interviews in both print and electronicmedia.* Key coverage was provided in Newsweek, Essence, Shape,Self; Family Circle, Woman's Day, Ebony, lMen's Health,Madeozoiselle, and Child. Most metropolitan newspapers, in-cluding USA Today, The New York Times, The WashingtonPost, The Chicago Tribune, and The Wall Street Journal,covered ADA stories. CNN, "The Today Show," and "Good Morn-ing, America" continued to provide visibility for RI)s. The mediaestimates for this year include nearly 8 billion audience impres-sions for print media alone. ADA has received more than 17,000clippings from newspapers all across the country in which ADA orone of its spokespersons was mentioned.* In June, the second ADA men's nutrition survey was released.The press packet was a hot item that received coverage across thecountry. Over 2,000 major media outlets were included.* ADA cosponsored the fourth annual post-holiday hot line withUSA Today in January 1992. RD volunteers from Washington,DC, answered more than 950 calls in the 1-day operation.* The network of 72 state media representatives was supportedwith training and ADA media materials. Expansion of the networkis plan ned in the next program year.* A public relations handbook was distributed to more than 40district associations. State associations had already receivedcopies of this resource.* With the release of the new mandatory labeling guidelines, theAssociation's focus is on the public education component. Through-out the year, the divisions of Government Affairs and Marketingand Conmmunications, with NCND, coordinated the efforts of

more than 40 members and staff to respond to at least six calls forcomments on proposed labeling regulations.* ADA continues to be a member of several labeling-relatedalliances aimed at creating educational materials. These includecooperation with the American Heart Association, the FoodLabeling Education Dialogue Group, the Food Marketing Insti-tute, and the National Food Processors.

FOODSERVICECommercial, or retail, foodservice is the key linkage to thismarket; initiatives are planned to increase the nutritional qualityof foods prepared away from home. This initiative will be furtherdeveloped in the next program year. In 1992, the primary accom-plishments were two exciting alliances.* A project with the American Institute of Wine and Food com-bines the expertise of dietetics and culinary professionals. Effortsare under way to develop a skills-building course that will helpexpand the food choices of healthy people who want to meet thedietary guidelines.* At the same time, ADA continues to work with the AmericanCulinary Federation. At the ACF National Meeting, teams of chefsand dietitians competed to produce meals that met nutrition andculinary guidelines. Additional opportunities will be available todietetics professionals in 1993.

PROGRESS ON MEMBER SUPPORT AND PROGRAMSThe membership year ended in May 1992. At; that time ADA's62,604 members by category included:

48,51595

2.5948.6042.761

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Active membersAssociate membersTechnician membersAffiliate membersRetired membersHonorary members

By September 1992, membership renewals had exceededprojections by 2% in spite of tight economic constraints and aslight dues increase.

The 23 DPGs of the COP continue to provide benefits to

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Association members. Over 40,000 individual memberships in theDPGs indicate the interest in these groups. DPGs are majorresources for technical experts in alliance areas.

Along with the new member referral service, work continuedon two special member enhancements: recognition of advanced-level and specialty practice. A landmark role delineation studyprovided needed information to develop the recognition system(see the February 1993 JAmDietAssoc) .At the October meetingof the HOD, the designation "Fellow of The American DieteticAssociation" was approved. In addition, the HOD approved thedesignation of "Board Certified in Pediatric Nutrition, RenalNutrition, and Metabolic Nutrition."

The COP Quality Assurance Committee completed a 2-yearproject to develop clinicalnutrition indicators for care in oncology,cardiovascular, and surgery patients (see the March 1993 JAmDiet Assoc). These were recommended to the Joint Commissionon Accreditation of Heathcare Organizations for inclusion in theirmonitoring process. Members will have access to a workbook toassist in applying the standards.

The Council on Education (COE), working with the Commis-sion on Dietetic Registration (CDR), identified priorities andaddressed issues raised in the task force report "Critical Issues:Registration Eligibility and Licensure." The spring 1992 report putentry-level education in the spotlight. COE altered its agenda toexplore innovations in education standards and delivery systems.Work continues on these recommendations.

COE continued efforts to encourage practice grants and awards.During the year, 10 dietetics educator practice grants wereawarded. The Affirmative Action in Recruitment and RetentionGrant was awarded to Viterbo College Coordinated Program in LaCrosse, Wis. Educators' support of student applications for ADAFscholarships resulted in over 150 students receiving assistance.

The Council on Research and the NCND cosponsored the firstResearch Agenda for Dietetics Conference in May. This invita-tional conference brought 12 authors of research papers togetherwith 20 other experienced researchers. The results will serve asa blueprint for dietetic research in the future. The proceedings willbe published as a supplement to the Journal.

The HOD continued to be a productive and responsive forum.Most notably, in May the HOD approved ADA's Strategic Initia-tives. In addition, deliberations on position statements resulted infour new positions and five reaffirmed positions, and a newstreamlined Association Bylaws was approved.

Another area of member support is provided by the Publica-tions Division. This year marked a redesign of the Journal andexpanded issues of the Courier. The Bookmart at Annual Meetingfeatured the new edition of ADA's Manual of Clinical Dieteticsalong with 13 other new publications aimed to meet the needs ofdietetics practitioners and their clients.

FISCAL PERFORMANCEAt Annual Meeting, the report by Carol Hall, Secretary/Treasurer,began this way: "It is my pleasure to inform you that The AmericanDietetic Association is financially healthy. Faced with decliningrevenues caused by the slowness in the recovery of the economy,extraordinary efforts were taken by volunteer leaders and staff tominimize expenses without compromising progress and accom-plishments. We lived within our means."

This quote summarizes the year and the tone of our fiscalhealth. The following data reflect the year ending May 31, 1992.* The Association General Fund had a surplus of $156,023.Revenues reflected the national economy and were $900,090

under plan before capital gains. This was offset by a reduction inexpenses of $767,190 and realized capital gains of $288,686.* Audited financial statements for the year ended May 31, 1992,were presented to the joint ADA and ADAF Boards in August.Total ADA assets increased by $907,515 to $21,325,715 on May31. Overall fund balances increased by $593,322, with increases of$156,023 in the General Fund, $344,708 in the CDR Fund, and$92,591 in the DPG Funds.* Our long-term investment portfolio showed a return on invest-ments over the past 8 years of 12.8%, which exceeded ourstandards, the consumer price index and the return on USTreasury bills, by 9.0% and 5.5%, respectively.· During 1992, a staff task force identified several options forincreasing nondues revenue. There is an accompanying need toidentify start-up funds for new high-potential ventures.

The strategic planning process is an important component inthe management of our fiscal health. Like most associations, wehave limited resources and unlimited opportunities and needs.Focused Strategic Initiatives with accompanying operative plansfor each unit will be the basis for resource allocation in the future.

This year we were able to provide modest funding for newinitiatives. The HOD approved an allocation of $653,500 to ad-dress the Strategic Initiatives. Additional funding of $276,200 wasrequested to meet increased needs in NSPS, health care reform,and marketing and communications.

To meet our needs in a shrinking economy, it will be necessaryto set priorities as well as to abandon programs and projects. Wehave a successful record of staff and volunteer cooperation inapplying cost-containment and cost-reduction strategies. Thiswas a critical component of our success in 1991-1992 and in ourability to fund new priorities.

CHALLENGES AND COOPERATIONAs a result of the Strategic Thinking Initiative, we are reexaminingevery component of the organization. Organization structure isone area being carefully researched. We value member involve-ment, but many members report less time to devote to volunteeractivities. At the same time, it is critical that our structure beresponsive and efficient, mindful of time and talent. A task forceis examining options for a structure that provides maximummember involvement while meeting the other criteria importantto us.

Another task force is exploring the equity we have in our name.Nutrition is a word that has recognition in the media and by theconsumer. Although questions outnumber answers at this point,this is a major initiative for the new program year.

Dietetics is a multifaceted career with limitless options. Oursuccessful recruitment and retention efforts must be expanded.Increasingly, our members are entrepreneurs involved innontraditional career paths. We must encourage active careerrecruitment with special emphasis on minority recruitment tomeet the needs of a changing population. Leadership develop-ment and career enhancement are also needed.

Fully supporting these needs will require cooperation and acontinued focus on priorities. If we are to reach our vision, theAssociation must focus on opportunities that will position us forsubstantialand sustainable competitive advantage. Like ourmem-bership, the marketplace is diverse and requires responsive andresponsible action. This concept is the driving force behind theStrategic Thinking Initiatives. This was the focus for the year. AsWill Rogers put it, "Even if you're on the right track, you'll get runover if you are just sitting there." JUDITH L. DODD, MS, RD.

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