State view: Minnesota needs to prepare for aging surge

Patti Cullen, Gayle Kvenvold and Natalie Zeleznikar - 04/26/2010

Minnesota is aging. Unless we prepare for it, the unprecedented growth in the older adult population and the corresponding shrinking of the traditional work force will put significant strain on our state budget for decades to come. In just a few short months, the baby boomer generation starts turning 65. That means the biennial budget that is being put together at the Capitol this year will affect how prepared we are as a state to begin to deal with the surge of seniors in need of older-adult services. The good news is that Minnesota already has undertaken some necessary and foundational steps to handle the surge of baby boomers. We have taken steps to reform long-term care through our home- and community-based services programs. For nearly two decades, our state policy has encouraged the use of cost-effective home- and community-based services programs over institutional or nursing-home care whenever appropriate. As a result, nursing homes have become places where seniors and others receive rehabilitation services after a hospital stay - and then return home. Last year in Minnesota, the typical nursing home resident stayed less than a month; half of those discharged returned home. To cope with a strained state budget, we must carry on with reform and not resort to cuts. We must continue the trend of developing a spectrum of care options for older adults, allowing choices so they can receive the right level of service at the right location when they need it. Given the demographics, we also must reform long-term care financing if the state wants to have a sustainable, long-term care system that meets the diverse needs of all Minne-sotans. To be successful, the plan of action for financing reform must include essential components. Personal responsibility is one of those components. Individuals need to plan for and help finance their long-term care needs just as they do their retirements. Minnesotans should view this as an obligation, and policymakers need to establish mechanisms that both encourage and reward that behavior. Strategies include consumer education, tax incentives for personal savings, pooling risk to make purchasing long-term care insurance more affordable, and allowing private citizens to pay for their costs of care by phasing out the equal-rates law for nursing facilities. Public investment is another necessary component. Some additional public investment is essential to maintain our societal responsibility to care for our elders. Increased revenue will help the state continue to be a good partner in providing care and services, particularly to those who cannot otherwise afford quality care. And a third component is administrative alignment. The state should establish a new cabinet-level focus on aging, empowered to consolidate and coordinate multiple, cross-cutting programs now housed in separate agencies and administered by separate entities at separate levels of government. The efficiency created by proper administrative alignment would allow the state to go from *eactive to predictive in planning for the needs of seniors. This combination of short-term and long-term strategies will strengthen our promise to elders and give back some measure of what they have given to us over the course of their lifetimes. We also would leave the next generation a sustainable, long-term care system. Together, we can seize this opportunity to make real, sustainable change. It will take all of us - including providers, advocates, legislators and the executive branch - to get it done.

Patti Cullen is president and CEO of Care Providers of Minnesota, based in Bloomington, Minn. Gayle Kvenvold is president and CEO of Aging Services of Minnesota, based in St. Paul. And Natalie Zeleznikar is CEO of Keystone Bluffs Assisted Living and of Diamond Willows Advanced Care in Duluth. All three are members of the Long Term Care Imperative, a legislative collaboration between Care Providers of Minnesota and Aging Services of Minnesota, the state’s two long-term care trade associations. They wrote this exclusively for the News Tribune.