• We partnered with Angela Sullivan, Master’s Candidate at the Public Health and Administration MPH Program, on a policy analysis of the PACE program in Minnesota. Ms. Sullivan examined the benefits, logistics and past legislative efforts to establish PACE in our state, and made policy recommendations for the MN legislature as it considers implementing the program. 

 “I really enjoyed the opportunity to research an interesting and relevant topic outside of the scope of my day job. As our population ages over the coming decades, access to high-quality and affordable health care will continue to be increasingly important. To this end, I look forward to the day when Programs of All-Inclusive Care for the Elderly (PACE) is part of the healthcare portfolio for older adults in Minnesota.” Angela Sullivan

You can read the Ms. Sullivan’s final paper here. We hope that her research will serve to inform next steps for policymakers and make the case for adopting this important program in Minnesota.

Through the Fall, 2021 and Spring, 2022 academic semesters, the Equity and Community Engagement Core of CHAI partnered with three students in the Public Health and Administration MPH Program (PHAP): Raquel Motachwa, Mackenzie Heck, and Parker Anderson. These three students and CHAI collaborated on what became an exciting group Master’s thesis, “Academic Community Engagement Model Grounded in Equity, Community Partnerships, and an Asset-Based Approach to Collaboration.” Following a literature review of existing community-academic engagement models, a secondary analysis of interviews with CHAI community partners and stakeholders, and a review of existing University of Minnesota resources, the project team recommended a community-academic engagement model to guide CHAI’s ongoing and robust equity and engagement initiatives. The adaptive logic model developed as part of this project will help to advance CHAI’s commitments to community-centeredness.  To read their thesis, please see here.

In Fall of 2021, the Equity and Community Engagement Core of CHAI served as a key liaison matching Centro Tyrone Guzman, with four students (Elizabeth Mejicano, Emily Olinger, Audrianna Goodwin, & Ira Singhal) in the Program Evaluation course (PA 5311) offered in the Hubert H. Humphrey School of Public Affairs at the University of Minnesota. Centro Tyrone Guzman is an active Community Partner of CHAI and expressed interest in evaluating their Manos Montessori Microenterprise program (an intergenerational initiative that has participants from diverse age groups jointly create and sell handmade products). Working with Robbin Frazier and Elma Johnson of CHAI’s Equity and Community Engagement Core, Elizabeth, Emily, Audrianna, and Ira were able to use their group project assignment of PA 5311 to develop a detailed logic model and evaluation plan for Centro. The final report of this effort is available here. 

The student team (Emily, Audrianna, Elizabeth, and Ira) provided the following quote summarizing their experience: “Coming into this program evaluation, it was important for us to listen, honor, and uplift Centro Tyrone Guzman in a way that was meaningful to us and hopefully to everyone else involved.  Establishing a relationship based on mutual understanding of the things mentioned above, and more, was important for us to remember as we engaged in this semester-long process. We hope that others can foster positive relationships that help change the narrative in how evaluations are conducted, centering the people most affected by the research. Building connections like those Centro makes with the communities they serve, and the ones we made with them, are the kinds of actions that foster positive environments for future generations.”

Please see these slides for details on the project, and this recording of the UMASH Community Forum webinar. 

In July of 2019, Representative Jennifer Schulz (DFL, District: 07A; Chair: Long-Term Care Division) requested that the Robert L. Kane Endowed Chair in Long-Term Care and Aging convene a meeting of experts on long-term care (LTC) financing to provide policy ideas and solutions to “fund the LTC needs of the people of Minnesota.” To meet this request, the Robert L. Kane Endowed Chair in Long-Term Care and Aging assembled a group of faculty and external experts to identify long-term care refinancing policy options for the state of Minnesota. These efforts culminated in the January 2020 Forum on Long-Term Care Financing at the University of Minnesota, co-sponsored by the Robert L. Kane Endowed Chair in Long-Term Care and Aging and the State of Minnesota Departments of Health, Human Services and Revenue, and the Minnesota Board on Aging.

About

Long-term services and supports (LTSS) encompasses the broad range of paid and unpaid medical and personal care services for older adults and people with disabilities who need support because of age; physical, cognitive, developmental, or chronic health conditions; or other functional limitations that restrict their abilities to care for themselves.¹ Care is personal in nature and may be provided in the home, community-based settings, or in nursing facilities. These services may be needed intermittently for several weeks, or for longer periods of time such as months or years. The frequency of this care means it is expensive and potentially unaffordable for many people with low incomes and/or limited savings. 

The costs of LTSS affect us all.  From caring for our aging parents, to helping out an elderly neighbor, to paying for our own services, the costs of LTSS can drain not only the state Medicaid budget, but our own pockets. The costs are enormous and many can quickly spend their savings to pay for needed care.  Large out of pocket costs for health and LTSS create a growing crisis for our rapidly expanding population of older adults and their families. We convened a small group of University of Minnesota faculty and experts in the field to assess various LTSS financing options and make recommendations for policymakers to consider.  Our guiding principles included the following:

• The solution is multifaceted. There is no “magic bullet” to solve the complex challenge of LTSS financing in Minnesota. We believe multiple options are necessary to address the LTSS care needs of Minnesota across the income spectrum (e. g., Medicaid policy for low-income older persons, individuals with disabilities, employer-based and saving policies for working adults to help them prepare for LTSS costs in the future).   
• Use state dollars efficiently and effectively. This includes targeting scarce resources to the most vulnerable.
• Policy options must be feasible and Minnesota-centric. While it’s difficult to predict the future of financing of Medicaid and other health care services, it is important that options are developed with the needs of Minnesota and Minnesotans squarely in mind.  We will look at the activities and programs in other states but develop recommendations that fit Minnesota’s unique characteristics e.g. relatively higher incomes on average, longer life expectancy, good health outcomes, but also persistent disparities in access to care.  Minnesota also has a history of being a leader in the support of home and community based care as alternatives to institutionalized care. 
• Consider perspectives of multiple stakeholders. To be politically feasible, the opinions of engaged stakeholders should be considered in the development of viable financing options.  Stakeholders will include employers, state Medicaid, Medicare Advantage plans, consumers, providers and their associations to help shape our LTSS financing recommendations.
• Flexibility for consumers. Options should be meaningful and allow for as much consumer choice as possible.
• Address the shortage of care workers. For any proposal that increases access to LTSS, policies must include recommendations for addressing the direct care workforce, especially in rural areas.

¹https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/LTSS-TA-Center/info/ltss-overview

Members

Lynn Blewett, PhD
Jon Christianson, PhD
Joseph E. Gaugler, PhD (Director)
Carrie Henning-Smith, PhD, MPH, MSW
Christine Mueller, RN, PhD, FGSA, FAAN
Tetyana Shippee, PhD
Mary Jo George (Minnesota AARP)
LaRhae Knatterud, MAPA (Minnesota Department of Human Services)

Forum on Long-Term Care Financing

The Forum on Long-Term Care Financing was held on January 7, 2020 at the McNamara Center at the University of Minnesota. Approximately 150 individuals attended. The University of Minnesota Long-Term Care Refinancing Committee in collaboration with the Minnesota Department of Human Services convened the Forum to identify and explore implementation of possible policies to finance long-term care for older adults in Minnesota.

The Forum featured three plenary sessions involving national experts that addressed new funding strategies for long-term care in Minnesota. In addition, six concurrent sessions were held on more specific issues related to the financing of long-term care and related topics. Four legislators were invited to offer their comments on the options described at the Forum.

Please explore this page to learn more about the Forum presentations, view selected sessions, and read about the recommendations that emerged. Additional information about the Forum is available on the Own Your Future website.

McCarron, H., Birkeland, R., Baker, Z., Johnson, E., Nkimbeng, M., Stabler, H., Millenbah, A., & Peterson, C. (2020). Forum on Long-Term Care Financing: Summary Report. School of Public Health, University of Minnesota, Minneapolis, MN.

Presentations

• Forum on Long-Term Care Financing Agenda
• “A New Approach to Long-Term Care Financing” Marc Cohen, Co-Director, LeadingAge Long-Term Services and Supports (LTSS) Center at UMass Boston
• Full Presentation: Cohen, M. A. (2020).  A New Public Private Partnership: Catastrophic Public and Front End Private Long Term Care Insurance. Forum on Long-Term Care Financing, University of Minnesota, Minneapolis, MN. 
• “Could Minnesota Create a Statewide LTSS Program Like the State of Washington?” Catherine Kinnaman, Deputy Director of HQ Operations, Home and COmmunity Services Division for Aging and Long-Term Services Administration, Department of Social and Health Services, State of Washington
• Full Presentation: Kinnaman, C. (2020). Long Term Services and Supports Trust Act. Forum on Long-Term Care Financing, University of Minnesota, Minneapolis, MN. 
• “Status of Long-Term Care Insurance In Minnesota”
• “New Role for Medicare in Long-Term Care”
• “Designing Universal Family Care”
• “The Lifestage Product: Next Steps”
• “Society of Actuaries Catastrophic LTC Research”
• “What Do Consumers Want in a Long-Term Care Financing Product?”