Changing Aging

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.  Caregivers
2.  Housing
3.  Health Care
4.  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, navigation

THIRD - 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 caregivers

LONG-TERM  CARE REFORMED

1.  Rebalanced Medicaid to emphasize home and community-based care

2. Single point of entry and navigation help

3.  Supports for informal caregivers

4.  Chronic care management under Medicare

5.  Quality improvement throughout

6.  Consumer-driven options

7.  Workforce development

8.  Insurance against disability for all

FINANCING THIS APPROACH

1.  Medicaid Rebalancing

- Older Americans Act and state funding

2.  Delivery System Reforms

- Medicare with chronic care funding

- Tax credits for caregivers

- Home equity options

- Private insurnance

3.  Federal Insurance

Value added tax dedicated to health care and long-term care

 

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This entry was posted on Friday, June 20th, 2008 at 10:28 am and is filed under Changing Aging. You can follow any responses to this entry through the RSS 2.0 feed.