Long-Term Care Financing Reform Has a Big Day
- It's a long way from passage, but long-term care financing reform is gaining momentum . . .Yesterday President Barack Obama publicly backed efforts to create a new government program to provide long term care insurance as part of the broader health care overhaul. Health and Human Services Secretary Kathleen Sebelius said in a letter to Sen. Ted Kennedy, who is chief author of the CLASS Act, that the administration supports the program because it would help elderly and disabled people stay in their own homes.
- Ecumen supports the CLASS Act and long-term care financing reform. Kathryn Roberts opined yesterday in the Minneapolis Star Tribune on the issue.
Health Care Reform Must Include Long-Term Care, By Kathryn Roberts
Nearly 3.5 million Minnesota adults are uninsured for long-term care and supportive services, meaning that many of us cannot afford the cost of a longer life or long-term disabilities. Long-term care services and supports must be part of meaningful health care reform.
In public policy, payment and perception, we've mistakenly segregated acute care and chronic care. For example, if someone over 65 suffers a stroke, Medicare jumps in with procedures and payments attempting to save the person. But upon release from the hospital, Medicare ignores that person's less expensive, longer-duration supportive services, such as a home aide or assisted living. Nor does it pay for such things as Alzheimers care or other intensive long-term care that a young adult with a disability may need.
Nearly 70 percent of those who turned 65 in 2005 will need some long-term services. The average time: three years. Contracting with a home aide just three days per week for two to three hours at a time to provide basics such as meal preparation and help with dressing can easily cost $1,000 per month. Nursing home care is much more expensive, $50,000 or more a year in Minnesota.
The status quo means many will continue impoverishing themselves and turning to Medicaid, a government program and de facto long-term care provider. Primarily paying for institutional care, its "payments" already fall far short in meeting true costs. Without financing reform, we are simply cost-shifting and avoiding the main issue -- finance reform for longevity and chronic care.
One approach is cutting Medicaid (called elderly waiver in Minnesota) for people in assisted living. In many cases this means another family member misses work juggling care for a loved one, or a person lives without supportive services, beginning the more arduous, expensive volley between home and hospital.
Another policy idea would require seniors to undergo precertification before choosing assisted living. Just because you're older and want to privately pay for housing with supportive services, you'd need state approval. The premise: State certification will "save" you money for when you "need" a nursing home. Precertification is ageism missing the fact that supportive services empower people while keeping them out of much more expensive government institutions.
Our overriding goals should be empowering people to live in the most independent setting possible; transforming nursing homes into right-sized, very specialized chronic-care centers; taking a personal share in costs of chronic care and supportive services, and ensuring a strong safety net for people who never will be able to pay for such care and services.
If America were creating a chronic care system today, we'd never duplicate Medicaid as primary payer. We'd never require people to impoverish themselves to get coverage. And we'dnever rely simply on the hope that people would purchase private care policies. We'd create a solution balancing personal responsibility and a secure safety net.
The CLASS Act (Community Assistance Living Services & Supports) introduced by the Senate Committee on Health, Education, Labor and Pensions is that opportunity. In the opt-out insurance plan, people would pay a premium of approximately $65 per month in return for a minimum daily benefit of $50 that they can self-direct. It would make private wrap-around insurance policies appealing because consumers would easily understand what their dollars buy and they'd know such a product could guarantee quality of life and fiscal security. It also could gain a state good housekeeping seal.
The Congressional Budget Office's evaluation of the CLASS Act shows no cost to the government over the next 10 years, a positive savings of $2.5 billion in Medicaid in the first 10 years alone, and long-term sustainability. This would transform financing of long-term services and supports, assist America's workers and future retirees, enhance intergenerational financial security, and promote choice and independence.
Without a long-term care financing solution, America doesn't have health care reform, and Minnesota has an extremely large and immediate problem to solve.
A Memory Care Memory
Last Thursday I began my Independence Day celebration with Ecumen colleagues and customers at a celebration of the grand opening of Ecumen's new memory care community in Apple Valley. It wasn't the wonderful food or that big red scissors above held by Apple Valley Mayor Mary Hamann-Roland, Ecumen's Janis Rivers and Chamber of Commerce prez Edward Kearney that will stick with me.
Rather, the memory that will stick is of two women carrying their purses, holding hands, smiling and walking inside from the Centennial House garden and essentially "working" the room. After I was greeted by the women and they moved on to greet someone else, one of my colleagues at Centennial House told me that every day these two ladies walk together, visit with each other and others, and tell everyone they are going to catch the bus to Brainerd, which is a getaway destination for many Minnesotans. As they day comes to a close, they always tell the Centennial House employee that they "missed the bus" and are "wondering if they could spend the night here at this nice place." I laughed as she told me this story. And as I grabbed another cookie, I looked across the room, there were the travel buddies smiling, too.
Medicaid Planners And The Great American Rip-Off
Someone recently told me they know a lawyer who can help with Medicaid planning. Basically this "professional" helps people hide assets so they qualify for Medicaid and get their care paid for by government.
Such "professionals" are ripping off America and are a slap in the face to the thousands of real professionals who provide stellar care and services across the United States in an underfunded system and to the people who save and plan for their own care and services.
Absent a full-coverage national insurance plan, all of us who are not in poverty (real poverty, not the artificially-induced kind) need to share in responsibility for our own care or supportive services. That's one reason why long-term care financing reform must be part of comprehensive health care reform.
Earlier today, this showed up in my inbox. It's from a "professional." It's entitled "How to Let Medicaid Pay for Your Own Long-Term Care." It's certainly not what America will celebrate this Saturday, July 4th.
Centenarians and 20-somethings: What age gap? (Part 2)
When Evercare released findings from its fourth annual 100@100 survey in June, they shook things up a bit by comparing beliefs of 20-somethings with centenarians as we examined in Part 1 of this topic. Turns out these two cohorts surprisingly have a lot in common.
Think technology and pop culture belong only to the young? Not quite. Centenarians report using the latest technology to stay connected with friends and family much like the 20-something millennials. Twenty-one percent of centenarians go online, with 12% using the Internet to share photos, 10% using email weekly, 5% watching TV, and 4% downloading music. Additionally, 3% even use Twitter! More than half the centenarians were familiar with Nintendo Wii Fit.
If given a choice from a list of famous celebrities to have as a dinner guest, Bill Cosby was a top choice among both the centenarians (63%) and the millennials (72%). Centenarians reported being familiar with Madonna (78%) and NBA all-star LeBron James (34%).
Evercare notes the survey indicates taking a holistic approach to staying connected beyond nutrition and exercise emerges as a key to longevity. “(Centenarians) are using new technologies, staying abreast of news and current events, and engaging in social networking – all of which help to prevent chronic illnesses and contribute to greater longevity,” states Dr. Mark Leenay, senior medical director and vice president of clinical affairs at Evercare by UnitedHealthcare.
The survey, conducted by GfK Roper in April 2009, interviewed 105 active and healthy American centenarians (age 99+ at the time of the interview) and carried out an online survey of 1,036 U.S. residents ages 20-22 who expected to graduate a four-year college or university in 2009. Be sure to check out Evercare's videos from the survey. –Helen Rickman
Centenarians and 20-somethings: What age gap? (Part 1)
Think a 22 year old has nothing in common with a 100 year old? Think again.
Last week, Evercare of UnitedHealth released findings from its fourth annual 100@100 survey. New to the survey this year was the unique comparison of the beliefs of centenarians and college seniors. Surprisingly, the two groups were in agreement on a number of things. Concerning the economy, both overwhelmingly agree that they, and not U.S. policymakers and business leaders, are responsible for their own economic future. The majority of the centenarians (89%) and college students (93%) believe home ownership remains an essential part of the American dream. Both groups feel talking with friends and family as the best way to relieve stress. Volunteering in the community is another shared value, with a third of centenarians and half of college seniors actively involved in volunteerism. Check out this YouTube video on centenarians & college seniors volunteering.
The survey, conducted by GfK Roper in April 2009, interviewed 105 active and healthy American centenarians (age 99+ at the time of the interview) and carried out an online survey of 1,036 U.S. residents ages 20-22 who expected to graduate a four-year college or university in 2009.
Part 2 will look at the survey's surprising findings regarding technology use & pop culture among these two age cohorts. -Helen Rickman
Jim Klobuchar: Moving Into a Smaller World
A few weeks ago I attended a reunion of our basic training company formed at Fort Riley, Kansas in the early months of the Korean War. This was in November of 1950, and the roll call of the neophyte soldiers who piled out of their barracks into the company street at 6 o,clock each morning was close to 160.
The count at our reunion in the central Minnesota town of Willmar was 22, almost all now 80 or 81. Most of the others were gone, as many as 30 of them lost in battle in Korea. Some of us spoke for a few minutes, telling very briefly of our lives since that first day in the company street in Kansas when a bulky master sergeant welcomed us with the comforting news that “this is the Army, you men. From now on, your minds move on one track. From now on you can give your soul to God because your butt is mine.”
He didn’t say butt. Nobody argued, for sure. Nearly 60 years later we remembered that terse introduction to this new, one-sided reality. They barked, and we jumped, the sergeant said. “You’re soldiers now.” That we were. We shared with each other what came after Kansas; Korea for some, Europe for others, death in an infantry attack for some, a full life for others. We offered a digest of our lives, but this was no poll of what we had accomplished in the years that came after, or how we identified ourselves and our journeys. Success stories were basically avoided. This was reminiscence, awkward at first because not many of us recognized each other although we certainly remembered the names and some of the faces. And after the stories, slowly at first and then with clear and unapologetic emotion, came the thanksgivings.
Our lives had been good: marriage, children, work, reasonable comfort and fulfillment..Some farmed, others worked and lived in the big city or in the rural towns. Nobody talked about the by-pass surgery and the pharmaceutical potions as common common as Social Security to practically all of us. Since almost all of us had been conscripted out of Minnesota , it went unspoken that most of the credit for our gathering belonged to the part of the world where almost all of us still live, and to its conviction that life-saving medicine and care should be available to all.
And so for three or four hours, we were a community. I regretted leaving. It was impossible to ignore the reality of age but a gift to spend at least three or four hours out of what we now see as a precious time and a kind of watershed in our lives.
It was also a gift to recognize once more that in the deepening of our time,, most of the other rewards and urgencies of our later years dwindle beside the rewards of nurturing the relationships in our lives—the ultimate gift of re-discovery.
Bacardi Rum Embraces Go-Go Boots and 1860s, But Forget About Baby Boomers and Seniors
If you get a second watch this new Bacardi ad. Then read marketer Brent Green's analysis at Boomer. Brent is a boomer. Brent is insightful. Brent has a blog. Marketers who ignore that consumers are aging do so at their own risk.
Elder Innovators - A Benefit of the Age Wave
Do you know elder innovators?
There are a lot of them. Increasingly I'm seeing "work related" news stories of people working, innovating, growing and contributing in their senior years. For example, here are three older people featured just yesterday in the Twin Cities newspapers Minneapolis Star Tribune and Saint Paul Pioneer Press - doing big time stuff:
- John Morrissey, 79, just invented the GameDoctor Video Game Timer What a timely tool for parents who want to moderate gaming by their children. You can read his story here.
- Warren MacKenzie, 85, legendary potter makes pots 7 days a week. He calls himself a "mud person." Read his story and watch video of him here.
- Bob Albertson, 72, has built a fully electric Ford Ranger pickup truck. Yes, a fully electric pickup truck. Too bad Detroit didn't know about him earlier. This was a Sunday "newspaper only" feature that will hit the web later this week at www.startribune.com.
So many people point to the "drag" of the age wave. Elder innovation is a whole different side of the coin that's only increasing and we're better off because of it.
To Solve Long-Term Care Financing, You have to Ask the Right Question: Here's How You Can Help
You can read Stacy Becker's article here (scroll to page 5). There's also a great article on Page 1 by LaRhae Knatterud, who has one of the coolest titles in America: Director of Aging Transformation at Minnesota's Department of Human Services.
Stacy, who is the Citizens League's director on this project advises local and regional governments, non-profits, foundations, and private companies on issues of economic development, community building, and innovation. She was the budget director for the City and County of San Francisco. She also served in the administrations of Saint Paul mayors Jim Scheibel and Norm Coleman.
Stacy was the first non-engineer to hold the title of Saint Paul Public Works Director. She streamlined the department, improved its credit rating, improved citizen participation, and resolved long-standing controversies around key infrastructure projects. Becker also served as the director of research and development for the Saint Paul Police Department and as budget director for the City of Saint Paul. She has degrees from Macalester College, Harvard’s John F. Kennedy School of Government and the London School of Economics, where she was a Bush Leadership Fellow.
How the Public Can Participate
The League is now bringing the project to the public. Stacy will be leading several citizen workshops. Learn more about them and how to sign up here.