Margaret Mead once said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has.”
So, when we embarked on the mission to create a sustainable funding model for aging services through public insurance instead of government imposed welfare, we soberly asked ourselves, “What can AAHSA — with our 5,800 members and $3 million dollars in funding — do to change the world of long-term care?”
A year into this transformational agenda we now call the “Long-Term Care Solution” made possible by members like you — we offer this report of our efforts:
Presidential Campaign Awareness
Both Sens. John McCain (R-Ariz.) and Barack Obama (D-Ill.) now recognize that long-term care must be included in health reform, as evidenced by position statements on their Web sites. This is a major achievement, as the previous prevailing wisdom (or lack thereof) was that the country needs to “fix” health care first. We constantly hammer the proposition that “health care” and “long-term care” are inextricably intertwined.
We met with Sen. McCain’s top domestic health advisor, who has actually written articles about long-term care financing. We have his attention, but he warns we cannot create an “entitlement.” We agree.
We have been promised a meeting with Sen. Obama’s top person as well. Sen. Obama has endorsed Sen. Edward Kennedy’s (D-Mass.) CLASS Act, which began as a disability benefit and now more closely aligns the principles espoused in the Long-Term Care Solution to embrace both elderly and younger disabled populations. Sen. Kennedy has touted our Moran Report study as evidence of the feasibility of creating a sustainable financing model.
Therefore, we have achieved, at least with verbal commitments, our initial goal of including long-term care in health reform. Our next goal is to get a statement in both party platforms to this effect.
Congressional Interest
The CLASS Act is a potential vehicle for the addressing financing of long-term care. Sen. Kennedy chairs the Senate Committee on Health, Education, Labor, and Pensions. We continue to work with the senator’s staff while he recovers from his illness. Sen. Kennedy is one of the few heirs to the Great Society vision, and he is a stalwart in his commitment to this country successfully addressing the problems you and I see everyday.
Sen. Max Baucus (D-Mont.) chairs the Senate Finance Committee. The credibility that our Montana members have with Baucus is commendable. We met with Sen. Baucus and he wants to conduct a forum on this issue in Montana. He has also asked his staff to work with us and Sen. Kennedy’s staff to refine our framework around the CLASS Act principles. This is great news. Sen. Baucus believes long-term care must be included in overall health reform, and he was complimentary of the quality and seriousness of our work. Meetings with other senators are being planned, but the combined interests of Sens. Baucus and Kennedy are powerful because health reform inevitably flows through their key committees.
On the House of Representatives side, we are working through several of our members to schedule meetings with key leadership. We have already met with Reps. Henry Waxman (D-Calif.) and Rep. F. Allen Boyd (D-Fla.) with subsequent meetings planned. These are in addition to the over 100 meetings that AAHSA members have had with their members of Congress.
State and National Forums and Speaking Engagements
A major public and political awareness strategy provided for in the money you gave us is the hosting of forums in strategically selected states. The goal is to generate pressure to reform long-term care financing through local consumer understanding and political action. Two forums have been held in Michigan and Minnesota, with forums scheduled in California and New York. Additional forums are being planned in other states. The plan is to conduct between eight and 12 forums in the next year.
The most recent Minnesota forum at the Humphrey Institute was a home run. More than 200 participants listened to three panels of thought leaders, which included AAHSA members Dan Lindh and Kathryn Roberts, Minnesota State Executive Gayle Kvenvold, and AARP. Three state commissioners and elected representatives from both parties participated and there was excellent press coverage. The event did what it was supposed to do: gin up interest to be cultivated. The Minnesota “formula” for a forum holds much promise.
On Friday, July 11, we will participate in a forum on Capitol Hill entitled, “Reforming Long Term Care: Improving Quality and Ensuring Sustainability.” The forum is sponsored by the Engelberg Center for Health Care Reform at the Brookings Institution and will be co-chaired by former Sen. Bob Kerrey (D-Neb.) and former Speaker of the House Newt Gingrich (R-Ga.), who chaired the National Commission on Quality Long-Term Care. The Engelberg Center, which is under the leadership of Dr. Mark McClellan, expects to draw 175 congressional staff members, media and other leaders.
We have now trained more than 80 ambassadors who have made dozens of presentations on our behalf. Jo-Ann Constantino, CEO of The Eddy in Albany, N.Y., was on the panel at the New York Association’s Spring Institute to discuss the initiative. Constantino has also given the presentation to her organization’s board and members of the Health Care Association of New York State. David Bannerman, CEO of The Ohio Masonic Home, has traveled across his state speaking to Masonic lodges.
In addition, Bannerman gave a presentation about the Long-Term Care Solution to Ohio state Senator Steve Austria (R-Beavercreek), who is also candidate for the U.S. House of Representatives. Jerry Kuyoth from National Church Residences in Columbus, Ohio, has given presentations on the initiative to the Chillicothe Rotary Club as well as the Kiwanis and Rotary Clubs in Waverly, Ohio. Several ambassadors have placed letters to the editor in their local newspapers.
Ambassador training events have taken place in Washington, D.C., Denver, and Atlanta. We have future trainings coming in Seattle, Sacramento and San Diego. More to come!
Focus Groups and Polling
A big question going into this project is whether or not the public is aware of long-term care financing problems and/or whether they would pay for a solution. Political leaders have wondered why there is no public out cry for change. So, we retained two experienced polling groups to discover answers.
The Mellman Group, a noted Democratic firm, and American Viewpoint, their Republican partner on this project, just concluded their focus group work, which centered on Baltimore, Detroit, and Philadelphia, and included caregivers, non-caregivers and two special groups of 20-30 year olds.
Selected findings thus far:
So, there is significant public awareness because of personal experience, and there is emerging support for change.
Polling comes next. In September, Mark Mellman and Gary Ferguson, our lead pollsters, will be discussing the project and its findings on a conference with all those interested. Stay tuned!
Fund Raising
A total of $2.7 million has been committed by our members toward this 3-4 year campaign. Several member decisions are forthcoming to reach our $3 million goal. The money is being spent boldly yet wisely to get the issue of financing long-term care on the front burner of national reform.
Perspective and What’s Next
Our efforts are creating a buzz and our plan is being referenced in public media and professional publications. A recent example is an article by former Business Week writer Howard Gleckman, who is now with the Center for Retirement Research at Boston College. Gleckman cites Dr. Barbara Manard’s work and mentions our frameworks throughout his article. Our work is being taken seriously, and the initial hurdle of whether or not long-term care is part of health reform debate has been overcome in many circles.
The next steps are party platform inclusion, search for a legislative vehicle (such as the CLASS Act), continued cultivation of stakeholder interest/support, and the stoking of public and political awareness.
So, why is AAHSA doing this? Well, Ronald Reagan’s quote, paraphrasing the great Rabbi Hillel, comes to mind: “If not us, who? If not now, when?”
David Ferguson, CEO of American Baptist Homes of the West (ABHOW), recently told a small gathering of our colleagues, “I support this effort because I want my association to be thought leaders on major problems and issues that we face in our work.”
If small groups of people change the world, I wonder what we can accomplish with 5,800 members and $3 million. It is us who must transform how long-term care is financed, because if not us, then who?
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July 10, 2008 at 8:31 pm
Long-Term Care Financing Progress Report » Changing Aging - Ecumen
[...] CEO Larry Minnix has just blogged an update on the work in this reform area, including discussions with the McCain and Obama [...]
July 11, 2008 at 7:55 pm
Richard Schafer
America’s messed up long-term care service delivery and financing system is self-inflicted by perversely counterproductive public policy. The good news is we can fix it over night. Just stop doing what we’ve always done and we’ll get a different result. Albert Einstein called that the definition of sanity.
To wit: stop giving away most home care and nursing home care through inadequate public programs. Make middle class and affluent people pay their own way, either up front or later through estate recovery. Stop using Medicaid as free inheritance insurance for the baby boom generation. Use the savings to pay for tax incentives for LTC insurance, LTC education programs and to promote the use of home equity to fund LTC.
You can do that through responsible public policy. Or you can stay on the same course we’re on, let the long-term care system collapse altogether, hurt poor people most, and end up with the middle class and affluent having to use their home equity to get decent care in the long run anyway. Long-term the outcome will be the same.
Plan early. Save. Invest. Insure.