Download - MN Leadership Council on Aging. 2010 Policy Summit: Caregiving Policy in Minnesota December 7, 2010
MN Leadership Council on Aging
.
2010 Policy Summit: Caregiving Policy in
MinnesotaDecember 7, 2010
Michele Fedderly
Mark Hoisser
Co-Chairs
MNLCOA
Welcome
MissionMinnesota Leadership
Council on Aging
The Minnesota Leadership Council on Aging (MNLCOA) coalesces the resources and power of consumer, advocacy, social and health service organizations, to advocate boldly for and achieve positive system changes for older adults and their families.
Mature Voices MinnesotaMinnesota Association of
Area Agencies on Aging Minnesota HomeCare
AssociationMinnesota Medical
Directors AssociationMinnesota Network of
Hospice and Palliative Care
Senior Community Services
Volunteers of America of Minnesota
AARP MinnesotaAging Services of
MinnesotaAlzheimer's Association
Minnesota -North Dakota
Amherst H. Wilder Foundation
Care Providers of Minnesota
DARTSElderCare Rights
AllianceLutheran Social Service
of Minnesota
MNLCOA Member Agencies
Welcome & Introductions
MNLCOA OverviewSupporting
Caregivers in Minnesotao Variety Stakeholder -
Broad Perspectives Public Sector -
Funding and Needs Caregivers –
Personal Stories and Issues
Leaders in Service - What’s Possible
BreakoValue of Informal System of Caregiving
Research on Effectiveness of Caregiver Support
o Reactor Panel Legislative Leaders Businesses and Employers Caregivers
Participation Survey
2010 Summit Agenda
Jean Wood, Director, Aging & Adult Services, Department of Human Services
and Executive Director, MN Board On Aging
Defining the Challenge: Need for Caregivers and
Their Relationship to Formal Services
Defining the Challenge:
Need for Family Caregivers and
Their Relationship to Formal Services2010 MNLCOA Summit
Jean Wood
Aging and Adult Services, MN DHS
Minnesota Board on Aging
Who are Minnesota’s Caregivers?
Source: 2005 Survey of Older Minnesotans
Who are Minnesota’s Caregivers?
Source: MN Behavioral Risk Factor Surveillance System
Many Faces of Caregiving
Between now and 2035, all regions of the state will become more racially and ethnically diverse.
Important differences exist regarding need for support, preferences for support and acceptance of support among caregivers from different race and ethnic groups.
Economic Value of Caregiving
Source: AARP Public Policy Institute, 2007
Demographic Pressures
Source: MN State Demographic Center, 2007
Demographic Pressures
Source: MN State Demographic Center, 2007
Demographic Pressures
Transform 2010 Baby Boomer Survey If faced with health change, most
would seek assistance in their home from family, friends and/or agency.
More than 1/3 expect to spend some time providing care for friend or family member by 2020.
Impact of Economic Downturn
Economic downturn has caused caregivers to:
Spend more of their own money and savings to cover caregiving expenses
Move into same household as loved one Ask for time off less often to provide care Experience more stress in caring for
their loved one Experience reduction in outside help
Our Challenge Today
We must reach more family caregivers with targeted and individualized support so that they can maintain their role longer and healthier.o Bring current evidence-based efforts to scaleo Support a portfolio of interventionso Reach across the lifespan to maximize
resourceso Maximize opportunity with health care
reform
David Foster, Spousal Caregiver
Caregiver Perspective
Dr. Ed Ratner, Moderator
Dawn Simonson, Overview of MN InitiativesKrista O’connor, Eldercare Partners
Susan Bulger, Evercare Caregiver Solutions
What’s New in the Caregiving World?? Recent Changes and
Trends in Caregiving and Caregiver Support
Overview of services delivered through Minnesota’s Aging Network
Decade of DevelopmentNational Family Caregiver Support Program
created in 2000 by CongressOlder Americans Act ProgramProvided a policy framework and funds for
services to support family caregivers, primarily of older adults
Necessitated a paradigm shift to focus on caregivers
Grounded in long-standing recognition of caregiver burden and need for respite
Caregiver Support – Service Development Policies
Recognizes the tremendous value of family caregiving
Strives to be person-centered, affordable and accessible
First sliding fee donation policy incorporatedImportant to meet unique needs of diverse
caregivers and their familiesGoal was to develop a network of support
through a statewide, coordinated system
Minnesota’s ApproachMinnesota Board on Aging and Area Agency on
Aging service development and provider Network
Services developed and subsidized by Older Americans Act funds. Most became available in the LTC Waiver menu.
Some expansion of existing models of respite care, education and training
Early focus areas included statewide awareness campaigns to spur caregivers to self-identify
Minnesota’s Approach
Core Services Developed Information about available services and supports Assistance in finding and arranging services Education and Training Coaching/consultation Support Groups Respite Adult Day Services Supplemental Services
Minnesota’s ApproachBy mid-decade, established Network began
integrating innovative practice models and evidence-informed and evidence-based services
Tailored Caregiver Assessment and Referral (TCARE)
Translation of the Mittleman-New York University caregiver counseling and support intervention
Powerful Tools for CaregiversRefined family caregiver coaching and counselingAdaptation of some services and supports for
ethnic caregivers
2010 MNLCOA Summit
Caregiving Policy in MinnesotaTuesday, December 7, 2010Wilder Center451 Lexington Parkway N. St. Paul, MN 55104
Changes & Trends in Caregiving & Caregiver Support – Provider Perspective
Krista O’Connor
Administrator
Eldercare Partners
www.eldercarepartners.org
Key Historical Events
ServiceDelivery
Transform2010
Research
National Award
MCSC
NFCSP
Caregiving
National Family Caregiver Support Program (NFCSP)
2000 Under Older Americans
Act Title III-E Funding Area Agencies on
Aging Program Development
for Family Caregivers
Metropolitan Caregiver Service Collaborative (MCSC)
December, 2002 Title III-E Funded 20 Organizations
Vision- Community will recognize, value and sustain the work of family caregivers.
Purpose Share knowledge Promote caregiver services Strengthen public policy
National Caregiving Award
November, 2006 National Alliance for Caregiving MetLife Foundation Innovation, Responsiveness, & Effectiveness Caregiver Coaching Program
Evidence Based Research
November, 2006 9.5 Year Study 406 Spouse Caregivers Community Dwelling Patients w/Alzheimer’s Six Sessions of Counseling Support Group Participation Ad Hoc Phone Support 28.3% Reduction of NH Placement Caregiver’s Satisfaction Key Component
Transform 2010
June, 2007 Five Themes Identified #2 Theme: Supporting
Caregivers of All Ages Increase Supply &
Types of CG Support Increase Public
Awareness
Caregiver Service Delivery
2000 – 2010 Title IIIE Funds EW/AC Coverage CS/SD Funding TCARE National Demonstration Project Minnesota Family Memory Care Creative Partnerships MSCS Provider Trainings
Barriers to Caregiver Support
ProfessionalAwareness
CaregiverAwareness
AdministrativeInefficiencies
Barriers
Administrative Inefficiencies
Authorization Requirements County Contracts DHS Registration MN-ITS & Claims Submission Health Plans Reporting Requirements Reimbursement per Session
Lack of Awareness – General Population
Role of the family caregiver NOT recognized Value and burden of family caregiving NOT
recognized/understood Effectiveness of caregiver support programs NOT
recognized/understood Messages must be heard several times Messages must be reinforced by health care
professionals, employers, community resources Restricts private pay market
Lack of Awareness - Health Care & Other Professionals
Focus is on the patient Disconnect between CG health and patient’s
health Limited contracts between health plans,
counties, DHS Limited referrals for caregiver support
services Benefits exhausted or not offered
MNLCOA Policy Proposal
Ensure Funding Ensure Availability of
Services Increase Awareness Address Administrative
Inefficiencies
Questions?
2010 MNLCOA Summit
What’s New in the Caregiving World?
• Employer and Employee Perspective
Sue Bulger, Sr. DirectorEvercare Solutions for CaregiversUnitedHealth Care
How Caregiving Impacts Employers Bottom Line: Productivity
Caregiving employees are costing U.S. businesses
$33.6 billion per year in lost productivity
• Almost all caregivers made informal adjustments to their work schedule – 84% phone calls
– 69% arrive late, leave early
– 67% time off during the day
– 29% make up work (evenings and weekends)
• 84% made at least one formal adjustment– 33% decreased hours– 22% leave of absence– 20% moved from full to part time– 16% quit job and 13% retired early
Met Life Caregiving Cost Study: Productivity Losses to U.S. Business (July 2006)
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How Caregiving Impacts Employers Bottom Line: Health Care Costs
The average additional health costs to employers is 8% more (or $13.4 billion annually) for employees with eldercare responsibilities
• Excess employee medical care costs associated with eldercare were higher among younger employees, males, and blue collar workers
• Excess Medical Costs reached almost 11% for blue collar caregivers and over 18% for male caregivers
• Eldercare may be closely associated with high-risk behaviors like smoking and alcohol consumption
• Younger caregivers (ages 18-39) demonstrated significantly higher rates of cholesterol, hypertension, chronic obstructive pulmonary disease (COPD), depression, and kidney disease, and heart disease, in comparison to non-caregivers of the same age.
Employers need to:• Recognize• Respond• Results = Reduced costs
Met Life Study: Working Caregivers and Employer Health Care Costs (February 2010)
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Findings from a Society for Human Resource Management Eldercare Survey Conducted in
2003• The greatest impact of eldercare issues in the workplace: 1)
absenteeism (partial and full days); 2) workday interruptions and 2) mental/concentrations issues (not being to focus on work).
• 27% of HR professionals “agreed” and 5% “strongly agreed” that employers have an obligation to provide resources and assistance for employees facing eldercare issues.
• Nearly half of HR professionals indicated that there has been an increase in the number of employees dealing with eldercare issues.
• Only 11% of organizations train managers to help them understand and deal with employee eldercare issues.
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Key Findings
• Job Situation
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Key Findings
• What Caregivers Are Sacrificing
Employees want…
• Benefits that are relevant to their life-stage needs (46%)
• Employer benefits objectives to align with Employee NEEDS
Benefits Strategies for Engagement and Personal Responsibility; MetLife 2009.
Why Employers Need Eldercare Initiatives
• Address the needs of aging workforce.• Decrease employee stress• Boost productivity• Support employee engagement and retention. • Reduce absenteeism and workplace disruptions.• Support Work/Life and “Great Place to Work.”• The total estimated annual cost of lost productivity to U.S.
businesses from full-time employees who are caregivers ranges from $17.1 billion for those with intense caregiving responsibilities to a total of $33.6 billion, for all caregivers.
Source: MetLife Mature Market Institute
Employer Recommendations:Integrated Eldercare Resources
• Position existing programs & resources to improve accessibility:– Information and Education (online resources, seminars/webinars, resource library) – Benefit Programs (Dependent Care Assistance Program, Flexible Spending Account) – Paid or unpaid time off (family leave, personal leave, sabbatical)– Employee Assistance Program (Resource & Referral, emergency and back up dependent
care, counseling services, Case Management)
• Explore and/or add new programs– Voluntary Benefits (Long-Term Care Insurance, Group Legal, Critical Illness Insurance)– Life Event Leave –personal leave focused on caregiving needs– Work/Life Expos, Eldercare/Caregiver Resource Fairs– Support Groups
• Leverage internal initiatives and programs– Health for Life (focus on health & well-being)– Flexibility (informal arrangements, telecommuting, reduced work schedule )– Digital Health (technologies)
Tips for Developing an Eldercare Program
• Conduct an employee survey– Assess current and future needs of employees
– Assess effectiveness of current programs
• Evaluate current Work/Life Programs– Reposition programs as part of eldercare and/or caregiving strategy
(health and wellness, flexibility, etc.)
• Explore no-cost solutions– Voluntary Benefits –employees pay vs. employer
– Host onsite events, fairs, seminars
• Leverage community and/or national partnerships– Explore programs and/or resources provided through local or national
organizations
Making it Work • Managers need to ENCOURAGE use of existing
services– Elder care issues won’t go away
• PARTICIPATE in an open dialogue about challenges of eldercare
– Employees need education on services
• EMBRACE flexibility in corporate culture
Caregiver Perspective
Warren Wolfe, Parental Caregiver
Research on Effectiveness of Caregiver Support
Joe Gaugler, Associate Professor/McKnight Presidential Fellow
at University of Minnesota
Presentation of Recommendations of Potential Changes to Public Policy on
Family Caregiving and Caregiver Support
Jeri Schoonover , Lutheran Social Services-MN
To protect and ensure current levels of funding for programs and services that support informal caregivers in their efforts to assist family, friends and neighbors to remain in their homes.
Policy Objective:
Recommended Actions:
Maintain current funding through the 2011-2013 biennium.
Assure continued state investment of match funds for caregiver services to assure continuing receipt of federal medical assistance funds.
Invest in an expanded, “statewide” caregiver support system to assure a full range of “core services” that are effective and sensitive to the diversity of caregivers to reflect the change in demographics.
Policy Objective:
Recommended Actions:
Encourage Minnesota State Agencies to work together in a planful way to develop a system that supports a diverse group of caregivers.
Advocate for continued support of programs that support caregivers.
Invest new funds to establish a Statewide Caregiver Coalition to develop new partnerships at the local and State levels with the purpose of presenting a coordinated approach to awareness building/ outreach, advocacy and service system development.
Recommended Actions:
Expand publicly funded service options to promote flexibility and consumer choice in service selection.
Increase awareness and promote the use of services that support self-directed care, i.e. Fiscal Support Entities, Support Planners.
Address administrative inefficiencies/barriers at the State level to increase flexibility for service providers which will enable caregivers increased access to services.
Recommended Actions:
Promote “Communities for a Lifetime” which offers seniors home and community supports for aging in place, emphasizing the availabilities of the right services at the right time. These services would include caregiver support, encompassing adult day programs, evening and weekend respite options.
Promote caregiver friendly work environments in Minnesota in
both the public and private sector (relates to the business community).
Policy Objective:
Recommended Actions:
Expand the approved use of existing sick leave benefits to include caregiving for adult son or daughter, spouse, sibling, parent, grand-parent, and stepparents both by passing legislation and encouraging employers to adopt these policies.
Provide incentives to encourage adoption of flexible workplace policies to support family caregiving.
Work with business community to share tools/information/best practices and policies.
Promote innovative service options and use of technology to maximize services which assist caregivers as they support older adults aging in their homes.
Policy Objective:
Recommended Actions:
Create incentives that support innovation and flexibility in the delivery of long-term care, to promote consumer choice, deliver better outcomes, and reduce cost.
Create a technology inventory for caregivers including technologies used in the disability community to identify those with greatest impact/success.
Maintain and promote funding within the public programs for the use/purchase of technology.
Reactor Panel to Potential Changes to Public Policy
Warren Wolfe, Moderator
Representative Diane LoefflerRepresentative Matt Dean
David Foster, CaregiverBill Blazer, MN Chamber Of Commerce
1. Please fill out the participant survey and leave it with us before you leave
2. Go to www.Mnlcoa.Org and fill out the survey on-line
What is YOUR Response?? We want your feedback….
Minnesota Leadership Council on Aging
THANK YOUSummit Sponsors
Amherst H. Wilder Foundation Minnesota
Area Gerontalogical Educational Center (MAGEC)
MN Leadership Council on Aging
Minnesota Leadership Council on Aging
Speakers And Panelists
Jean Wood, DHS David Foster, Caregiver Dawn Simonson, MAAA Krista O’connor, Eldercare Partners Susan Bulger, Evercare Caregiver Solutions Warren Wolfe, Star Tribune Joe Gaugler, Univ. Of Minnesota Rep. Diane Loeffler Rep. Matt Dean Bill Blazer, Chamber Of Commerce
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Minnesota Leadership Council on Aging
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