Second Medicaid Congress June 14, 2007 Emerging Private Long-Term Care Financing Innovations Jean Wood, Division Director, Aging and Adult Services Minnesota Department of Human Services Track1.02--Wood--6.14@10.45am MC

Long-Term Care Financing Innovations Project 2030 established: Increasing number of older persons which is permanent Medicaid was not sustainable as is into the future Home and community-based services were key Private financing strategies were necessary Highly data driven Next few slides show examples of measures used Track1.02--Wood--6.14@10.45am MC

Track1.02--Wood--6.14@10.45am MC Vision for 2030 “Long term care” becomes “long term support.” People take responsibility for their own self-care, with greater choice and access to individually controlled services. People obtain and pay for long term support with a variety of options. Increase Minnesota savings rate and level of long term care insurance coverage: Develop employer-based education programs for life-cycle financial and social planning. Develop and offer LTC insurance product to public employees in Minnesota. Trends For Future Aging Services More people--longer lives--more diverse Less family stretched further, not close by Small growth in public support (outside of Social Security, Medicare) More pressure on “quasi-formal” and community-based services DHS Redesign Priorities for 2030 Redesign of Nursing Facility Payments Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities. Reduce disability rates in Minnesota: Include monitoring of disability rates in Minnesota Milestones or Aging Report Card. Work with Department of Health and other partners on setting goals for reduction in disability rates. Track1.02--Wood--6.14@10.45am MC

Public Resources vs. Demand Vision for 2030 “Long term care” becomes “long term support.” People take responsibility for their own self-care, with greater choice and access to individually controlled services. People obtain and pay for long term support with a variety of options. Increase Minnesota savings rate and level of long term care insurance coverage: Develop employer-based education programs for life-cycle financial and social planning. Develop and offer LTC insurance product to public employees in Minnesota. Trends For Future Aging Services More people--longer lives--more diverse Less family stretched further, not close by Small growth in public support (outside of Social Security, Medicare) More pressure on “quasi-formal” and community-based services DHS Redesign Priorities for 2030 Redesign of Nursing Facility Payments Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities. Reduce disability rates in Minnesota: Include monitoring of disability rates in Minnesota Milestones or Aging Report Card. Work with Department of Health and other partners on setting goals for reduction in disability rates. Growing gap between needs and public resources for long term care. Track1.02--Wood--6.14@10.45am MC

Numbers of at Risk Elders Vision for 2030 “Long term care” becomes “long term support.” People take responsibility for their own self-care, with greater choice and access to individually controlled services. People obtain and pay for long term support with a variety of options. Increase Minnesota savings rate and level of long term care insurance coverage: Develop employer-based education programs for life-cycle financial and social planning. Develop and offer LTC insurance product to public employees in Minnesota. Trends For Future Aging Services More people--longer lives--more diverse Less family stretched further, not close by Small growth in public support (outside of Social Security, Medicare) More pressure on “quasi-formal” and community-based services DHS Redesign Priorities for 2030 Redesign of Nursing Facility Payments Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities. Reduce disability rates in Minnesota: Include monitoring of disability rates in Minnesota Milestones or Aging Report Card. Work with Department of Health and other partners on setting goals for reduction in disability rates. By 2050, numbers of 85+ in Minnesota will almost quadruple; the rest of the population will increase by only 25%. Track1.02--Wood--6.14@10.45am MC

Long-Term Care Financing Innovations Transform 2010 establishes a broad plan: Long-term care reform of 2001 Partnership of Human Services, State Unit on Aging and Health Department Local and state, private and public, all ages have a role Public presentations State agency group

Long-Term Care Financing Innovations Transform 2010 establishes areas: Redefining work and retirement Supporting caregivers of all ages Fostering communities for a lifetime Improving health and long-term care

Long-Term Care Financing Innovations Prevent hitting the safety net Helping people to help themselves Improving chronic care outcomes Building a sustainable long-term care system of care Labor shortages

Long-Term Care Financing Innovations Long-Term Care Insurance Partnership program (DRA) Affordable Attractive to middle income persons Long term savings Partnership with Health Care Eligibility and Commerce (insurance commission)

Long-Term Care Financing Innovations Caregiver support Debate of tax credit vs targeted program Implementation of a tax credit—who, how long, what level Full array of services covered by public programs Paid time off and cafeteria insurance benefits Employer support

Long-Term Care Financing Innovations Quasi formal service system Communities for a lifetime Volunteer and locally driven Faith-based organizations Sustainable Quality challenges

Long-Term Care Financing Innovations Reverse Mortgage Legislative proposal Connected to Alternative Care eligibility (state funded) Housing worth up to $150,000 Strong rural potential

Long-Term Care Financing Innovations Aging and Disability Resource Centers Good information leads to good decisions Helping people to help themselves LinkAge Line strategy—telephone and one on one Minnesotahelp.info as database Outreach and enhanced outreach and help Help in medical clinics

Long-Term Care Financing Innovations Contact: Jean Wood 651-431-2500 Jean.wood@state.mn.us