Earlier we blogged here about the long-term care financing forum at the University of Minnesota. One of the solutions put forward came from AARP. Here are highlights from Enid Kassner, director, Independent Living/Long-Term Care Public Policy Institute. Next we’ll share an approach from the American Association of Homes and Services for the Aging.AARP’s Goal:Create an affordable, consumer and caregiver-focused system providing coverage for, and access to, high quality long-term services and supports for independent living.1. Promote – nationally and in the states – reform of delivery and financing for long-term services and supports.2. REFOCUS reform debate on providing: long-term services and supports for independent living … rather than on ‘long-term care’ or ‘Medicaid Reform.’3. Include ALL opulations, people with: developmental disabilities and physical disabilities . . . while improving services for seniors.4. Defin ‘long-term services and support system’ as FOUR separate, but related components:1. Caregivers2. Housing3. Health Care4. Long-Term and Community-Based Supportive Services… . plus mechanisms to finance each component.FIRST: Revamp Medicaid– Revamp Medicaid as one vehicle for both: System financing —- structural reform.- See that proposed reforms: promote increased home and community-based services and cover additional services, populations- Eligibility: move from ‘categorical’ to ‘financial means plus functional need.’ Oppose restrictive changes to eligibility and services- Oppose mandatory, risk-based managed care, but recognize managed care can be vehicle for reform.SECOND – Delivery Reform– Support for family caregivers: respite services, financial help, single point-of-entry, navigation assistance- Workforce development and quality: recruitment, retention; enhancing image of workers; promote workforce training by U.S. schools, esp. community colleges- Consumer-directed programs for obtaining needed services- Quality measures and incentives- Regulations and standards- Support Innovative Models for long-term services and supports: – Endorse, help expand and fund effective, existing, new or demonstration models and promising state models for financing and care delivery. – Use states’ efforts as means for galvanizing a national FOCUS ON REFORM- Encourage personal planning for and family conversations about long-term care- Motivate consumers to demand more options for long-term services and funding- Promote products and services that help consumers with decision making, navigationTHIRD – System Reform– Federal disablity-based insurance system that protects ALL Americans.- Expanded chronic care coverage and management under all insurance programs- Navigation help – and financial help – for informal caregiversLONG-TERM CARE REFORMED1. Rebalanced Medicaid to emphasize home and community-based care2. Single point of entry and navigation help3. Supports for informal caregivers4. Chronic care management under Medicare5. Quality improvement throughout6. Consumer-driven options7. Workforce development8. Insurance against disability for allFINANCING THIS APPROACH1. Medicaid Rebalancing- Older Americans Act and state funding2. Delivery System Reforms- Medicare with chronic care funding- Tax credits for caregivers- Home equity options- Private insurnance3. Federal InsuranceValue added tax dedicated to health care and long-term care