YOU’RE INVITED TO A CITIZENS LEAGUE WORKSHOP TO HELP SHAPE LONG-TERM CARE FINANCING INNOVATION IN MINNESOTA:

How to Participate

Please register online at: www.citizensleague.org/what/policy/aging    If you have questions about the project itself, feel free to contact Stacy Becker, the project manager, at 651-646-5288 or stacybecker@comcast.net

Project Sponsors

This project is being directed and organized by the non-partisan Citizens League in partnership with twenty-two funders representing senior service organizations (including Ecumen), care providers, the health and medical industry, senior housing, the insurance industry and the business community.

Project Summary

Through spirited discussions and a review of data and literature, a project Steering Team arrived at this framing of long-term care financing:  “What policy changes are needed to create incentives for personal responsibility for long-term care?”  In short, they agreed that while there are many public issues involved with long-term care, the key issue regarding financing is the likely explosive growth in publicly subsidized care (i.e., Medicaid) and its corollary that more and more people cannot afford the long-term care they need. 

Most important, the group has focused on influencing total costs, not simply on how to pay for those costs.   The policy variables are the incentives and disincentives in people’s lives that create or minimize public and personal costs in three key areas: financial behaviors, informal care and health and medical choices.  Please note that the emphasis on personal behavior does not preclude changes to the larger systems (i.e., Medicaid, Medicare and Social Security) that impact the well-being of the elderly.  Indeed, the workings of these systems have profound impacts on people’s choices and behaviors.  Furthermore, the emphasis on personal responsibility is not meant to deny the need for a safety net.  To the contrary, the pressures on public funding could well erode benefits for those who truly need help.

Project Participants

The success of the workshops will depend on having a broad range of perspectives so that participants can interact, share and learn from one another as they jointly develop ideas for long-term care.  The Citizens League has found from past workshops that collectively, participants have the expertise needed to develop solutions to tough problems.

Workshop Schedule and Location

Three workshops are scheduled.  You may sign up for one or more workshops.  Each workshop will consist of two sessions: an afternoon session followed by a morning session.  The Citizens League has found that the overnight breather helps to clarify thoughts and stimulate ideas. 

All workshops will be held at the Citizens League board room, 4th floor, 555 Wabasha Street, downtown Saint Paul.  There is some free parking behind the building; enter off 10th street.  There is also ample metered parking.  Map and directions can be found at: www.citizensleague.org/directions

Informal care, Monday Aug 3rd, 12-4 p.m. and Tuesday Aug 4th, 8:30-11:30 a.m.

This workshop will address questions such as:
• Has informal care-giving become a different type of family burden that it was in the past—does it exceed what should be expected of families and/or create longer-term societal problems?
• What role is desirable for informal care to play in our LTC system?  Necessary? What incentives, infrastructure or support is necessary in order for that role to be fulfilled?
• What does informal care provide that it alone can provide—there are no substitutes?
• Who in the community or what could reasonably substitute for family-provided informal care?  What would be needed to develop a “market” for such care? 

Health/medical choices, Monday Aug 17th, 12-4 p.m. and Tuesday Aug 18th, 8:30-11:30 a.m.

This workshop will address questions such as:
• What function does Medicaid serve for the low income elderly that could not be achieved by modifying Medicare? 
• Do people with chronic disease and disability lack incentives to manage their care, or the means?  What policies would be effective in redressing these shortcomings?
• Research is clear that past certain points, additional Medicare spending does not produce higher quality health outcomes.  How do we align personal interest with the public interest when people are making medical choices?
• What happens when someone goes from hospital to nursing home to home, or hospital to home?   What is the role of transitional care and good discharge planning? 
• Is our concept of nursing homes obsolete?  If so, what do they need to become?

Financial incentives, Monday Aug 24th, 12-4 p.m. and Tuesday Aug 25th, 8:30-11:30 a.m.

This workshop will address questions such as:
• Arguably, no generation has had to provide for LTC in the way that we do today—people living longer, with fewer children to care for them, both spouses working to make ends meet, and costly health care.  Do we need to rethink what “personal responsibility” means in this new environment?
• Do people with minimal retirement savings lack incentives to save, or the means? 
• What role should long-term care insurance play?  What design features are imperative in order for it to play this instrumental role?
• Should we consider Boomers, especially older Boomers, as a separate problem? Is it possible to design savings incentives that would work for them? Even if they work a few more years, is it too late?
• Under what conditions should LTC for all be financed through a public system (e.g., under Medicare?) 
• Medicaid takes an “on/off” approach—one is on Medicaid or not.  Does it make sense to start thinking about a system which encourages people to contribute what they can?  What would that look like?
• What types of assets should be fair game for contributing to one’s LTC (currently a house, car, farm, etc. can be retained).  Does the desire to leave a legacy have any social value?  For whom?  Is it possible to align personal and public interest here?  How?

What You Can Expect

Participant role:  Participants are the main feature in these workshops.  Participants will work in groups to discuss goals and outcomes, and then develop ideas to reach those outcomes.  A short brief will be prepared of research to help workshop participants brainstorm and to know what types of incentives may work.  But the true cross current of ideas is expected to come from participants—the workshops will host a diversity of perspectives, experiences and expertise.

Further, the Citizens League is interested in using these workshops to create a collective agreement on how Minnesota should address long-term care financing.  The broad range of participation is hoped to jump start the all-important process of reaching agreement on how Minnesota needs to move forward.

Meals: Lunch will be provided day one, and breakfast the following morning. 

Special arrangements: If you would like to participate but need help with special logistical arrangements, please call Cat at 651-293-0575.

How the Results Will Be Used

The Steering Team will review the ideas that emerge from the workshops.  Their charge will be to identify important linkages across the three workshops and to determine what if any additional information (such as actuarial analysis) is necessary to prioritize, test and refine the ideas.  Based on the analysis, the Steering Team will develop a proposed action plan of the most promising ideas.  We will post the draft plan on the Citizens League web site and notify workshop participants so they may comment on the plan.  The final plan will contain two to five ideas that Minnesota can implement to create a sustainable, viable LTC financing system that ensures quality care for all Minnesotans.