Sept. 13, 2007

How do we stake political will? Yesterday, I had the privilege of attending an event co-chaired by Senate Majority Leader Harry Reid (D-Nev.) and Senate Steering and Outreach Committee Chair Debbie Stabenow (D-Mich.). A dozen other Senators made an appearance. Governor Kathleen Sebelius of Kansas was a featured guest. Forty or so aging-services leaders were there. The hour-long meeting was billed as an "idea exchange about our common priorities for the 110th Congress, as we work toward our shared goal of making quality long-term care more accessible and affordable for our seniors."

Senator Stabenow's Committee holds these events periodically, and though short, they are important for open communication — and to hear important messages. Several Senators spoke and several of us were given a few minutes to share our views.

Here are those messages. Read carefully:

Senators Kennedy (D-Mass.) and Rockefeller (D-W.Va.), the Senators with the most seasoned experience on health and aging issues, reflected their deep interest in values-driven care: quality, access and respect for paid and family caregivers. Senator Rockefeller reminded all of the Pepper Commission, on which he served. He reflected on the strong sentiment a generation ago for an integrated plan for long-term care that was funded as an insurable circumstance in life. He lamented that little progress has been made on that agenda.

Senator Kennedy's CLASS Act, recently introduced in the Senate, was mentioned several times by Senators and participants alike as a potential model for insuring for disability, allowing the benefits to follow the person — not the provider. The CLASS Act is consistent with AAHSA's thinking about the transformation needed in the financing of long-term care.

All who spoke voiced a commitment to lead health care reform, but Senator Kennedy pointed out that not one presidential candidate has included long-term care as part of that reform. Yet, several commented that health care cannot be reformed without long-term care

Another poignant reflection came from Senator Lincoln (D-Ark.). A relative newcomer, Lincoln is an impressive voice for our issues. She has recently authored bills related to elder justice and chronic care integration. But her most moving comments were about her personal experiences growing up in Arkansas "within walking distance of both sets of grandparents." She went on to say, "I didn't know at age 15 that I was a caregiver, but I was..." In fact, several who spoke talked of their personal experiences with elders who needed care — especially at home and the role facilities play in caregiving.

Governor Sebelius reported on an aggressive commitment to home-and-community-based services in her state. She reported on success in terms of choice, quality of life and cost control related to Medicaid. She stressed the pressure on states to adequately fund Medicaid on constricted budgets in addition to education, roads and other state responsibilities.

Senator Whitehouse (D-R.I.), a Senate freshman, was asked by Senator Stabenow to comment on health technology, especially the need for electronic health records and communications among providers about the health of the older people they serve. He commented, "the use of technology is worse in this industry than any other industry except mining."

Think of the mining metaphor for Alzheimer's disease victims lost in a dark mine shaft of health care with no mechanism to communicate about health conditions and treatment. Stark and stunning! But very fitting.

An overarching topic was the fact that these issues have been discussed for many years. Too much talk, too little action. The tone was a blend of hand wringing with urgent concern about addressing an emerging crisis for society in a national climate of war. One Senator said that the President threatened to veto spending bills on the children's insurance program, yet is asking for 200 billion dollars more for the war.

No question about the pressure we will continue to feel about cost. But there is an illusion that caring for an expanding chronically-impaired population will somehow cost less money than is spent today. Let none of us be naïve about that.

My comments to them, without repeating what others said, were that AAHSA has a plan to finance long-term care, that we must support caregivers because staffing is the best proxy for quality and that is it time to finally solve these issues — and that politically, they are indeed solvable.

Karyne Jones, CEO of one of our housing members, the National Caucus and Center on Black Aged, reminded the group about the importance of affordable housing and the issue of racial and socio-economic disparities to be addressed in reform.

I also stressed to them that we are not-for-profit. I told them many of your organizations have been in their communities for generations. You represent religious, fraternal, civic, government and locally-sponsored organizations who have stood the test of time. I reminded them that we can help them with the health and long-term care policy agenda that is so desperately needed.

As the hour came to a close, Senator Stabenow concluded with an encouraging comment: "it's about the political will it will take to make these changes…"

These Senators want our help in generating political will. How do we stake it? You'll be hearing a lot more from us about that in the months ahead, but here's where we start:

1. Find out which elected officials in your area have had personal experiences with aging parents or disabled family members and talk to them about the problems inherent in providing care.
   
   
2. Write your Senators about these issues today! Tell them:
• The time is now to reform health care.
• Not to freeze Medicare because it will hurt the lowest income and those who care for them.
• More capital for affordable senior housing is an investment, not a welfare obligation.
• We need technology support to make everyone's job easier.


3. Write each presidential candidate and ask them these three questions (courtesy of an article in last week's Parade Magazine about caregiving):
• How do you propose to relieve the financial burden on America's 44.5 million family caregivers?
• Do you believe there should be more tax credits for elder care?
• What steps can government take so the infirm need not spend down their assets to qualify for Medicaid?


4. Tell all of these people you represent not-for-profit values and organizations that stand the test of time in every community in America. Tell them how many people you serve, how many people you employ and how many people you lean on as volunteers.

Senator Stabenow is right: It's about political will. Do you know who political will is? Political will is you!

 

William L. Minnix, Jr.
President & CEO

AAHSA · 2519 Connecticut Ave. NW · Washington DC 20008 · www.AAHSA.org