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TRANSCRIPT
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Aging Services of Minnesota
Caregiving Counts2014 Advocacy Tool Kit
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TABLE OF CONTENTS
This legislative session Aging Services of Minnesota will be relying on you to communicate with your legislators about your role caring for seniors in your community This Advocacy Tool Kit has been designed to help you build and maintain a relationship with your legislators and share your story caring for Minnesotas seniors
Page
RESEARCH Make sure you know who yourlegislators are and what the important issues are
INTERACT Create a relationship with your legis-lators so they know how important you are to the community
BUILD Involve your community and share the importance of caring for seniors
ADVOCATE Engage the media and public on our issues and value
RESOURCES Tools and information you need to successfully advocate
3
4
5
6
7
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RESEARCH Make sure you know who your legislators are and what the important issues are
It is important to do your homework to better understand who your legislators are and what issues are important to them There are many online resources to accomplish this You should also get some background on the legislative issues affecting long-term care
bull WhoaremylegislatorsCheckoutour advocacy page to find out who your legislators are
My House member is ________________________________________________________________
My Senate member is ________________________________________________________________
bull UnderstandImportantLegislativeDates(seeResource2)
bull Mylegislatorsrsquocampaignwebsites(useGoogletofindthisinformation) o______________________________________________________________________________________ o______________________________________________________________________________________
bull Whatisthenewspaperinmycommunity o FindtheEditorrsquosphoneandemail Name ____________________________________________________________________________ P _________________________________________________________________________________ E _________________________________________________________________________________
bull Knowtheissuesaffectinglongtermcare o CaregivingCountsLegislativeAgenda(seeResource3) o Long-TermCareImperativeMessagePlatform(seeResource4) o Factsheetsonourkeyissues(seeResource5)
RE
SE
AR
CH
4
INTERACT Create a relationship with your legislators so they know how important you are to the community
INTE
RA
CT
The best way to successfully advocate for long-term care issues is to build a relationship withyourlegislatorsReachouttothemcommunicateregularlywiththemvisitthemand ask them to visit you
bull Beginbyemailing your legislators and introducing yourself and what is important to you Continue to communicate via email throughout the legislative session and year
bull AgingServicessendsoutactionalertseachweekduringthelegislativesessionbased on activity at the Capitol This is an easy way to contact your lawmakers Check out our Take Action page
bull ParticipateinDayattheCapitol and visit your lawmakers in person
bull CanrsquotmakeitalobbydayScheduleameetingwithyourlegislatorsonyourown Here is the House directory and the Senate directory or contact the ASM advocacy team to help you
bull Inviteyourlegislatorstovisityourfacility(seeResource8)
5
You are a leader in your community and your community cares about the seniors you take care of everyday Involve key community leaders in your advocacy and share with them your role in caring for the seniors in your community
bull Identifykeycommunityleadersthatcareaboutqualitycareforseniors
o Family member of resident or former resident ____________________________________________________________________________________ o Religiousleader
____________________________________________________________________________________ o Localgovernmentofficiallikemayororcitycouncilmember
____________________________________________________________________________________ o Another business leader
____________________________________________________________________________________
bull Regularlyinformthesecommunityleadersaboutisgoingonforwardactionalerts and other information Create an email list to use to make this easier Feel free to forward along Aging Services newsletters actions alerts and other information we share with you
bull ScheduleregulartimestocommunicateandormeetwithoneanotherThiscould beatyourlocalRotaryorChambermeetings
bull Planacommunityeventatyourfacilityandinvitecommunityleadersandyour legislators(seeResource8)
BUILD Involve your community and share the importance of caring for seniors
BU
ILD
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
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Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
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Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
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2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
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Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
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Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
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BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
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Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
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State of MinnesotaPlant Management Division
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Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
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Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
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Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
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2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
2
TABLE OF CONTENTS
This legislative session Aging Services of Minnesota will be relying on you to communicate with your legislators about your role caring for seniors in your community This Advocacy Tool Kit has been designed to help you build and maintain a relationship with your legislators and share your story caring for Minnesotas seniors
Page
RESEARCH Make sure you know who yourlegislators are and what the important issues are
INTERACT Create a relationship with your legis-lators so they know how important you are to the community
BUILD Involve your community and share the importance of caring for seniors
ADVOCATE Engage the media and public on our issues and value
RESOURCES Tools and information you need to successfully advocate
3
4
5
6
7
3
RESEARCH Make sure you know who your legislators are and what the important issues are
It is important to do your homework to better understand who your legislators are and what issues are important to them There are many online resources to accomplish this You should also get some background on the legislative issues affecting long-term care
bull WhoaremylegislatorsCheckoutour advocacy page to find out who your legislators are
My House member is ________________________________________________________________
My Senate member is ________________________________________________________________
bull UnderstandImportantLegislativeDates(seeResource2)
bull Mylegislatorsrsquocampaignwebsites(useGoogletofindthisinformation) o______________________________________________________________________________________ o______________________________________________________________________________________
bull Whatisthenewspaperinmycommunity o FindtheEditorrsquosphoneandemail Name ____________________________________________________________________________ P _________________________________________________________________________________ E _________________________________________________________________________________
bull Knowtheissuesaffectinglongtermcare o CaregivingCountsLegislativeAgenda(seeResource3) o Long-TermCareImperativeMessagePlatform(seeResource4) o Factsheetsonourkeyissues(seeResource5)
RE
SE
AR
CH
4
INTERACT Create a relationship with your legislators so they know how important you are to the community
INTE
RA
CT
The best way to successfully advocate for long-term care issues is to build a relationship withyourlegislatorsReachouttothemcommunicateregularlywiththemvisitthemand ask them to visit you
bull Beginbyemailing your legislators and introducing yourself and what is important to you Continue to communicate via email throughout the legislative session and year
bull AgingServicessendsoutactionalertseachweekduringthelegislativesessionbased on activity at the Capitol This is an easy way to contact your lawmakers Check out our Take Action page
bull ParticipateinDayattheCapitol and visit your lawmakers in person
bull CanrsquotmakeitalobbydayScheduleameetingwithyourlegislatorsonyourown Here is the House directory and the Senate directory or contact the ASM advocacy team to help you
bull Inviteyourlegislatorstovisityourfacility(seeResource8)
5
You are a leader in your community and your community cares about the seniors you take care of everyday Involve key community leaders in your advocacy and share with them your role in caring for the seniors in your community
bull Identifykeycommunityleadersthatcareaboutqualitycareforseniors
o Family member of resident or former resident ____________________________________________________________________________________ o Religiousleader
____________________________________________________________________________________ o Localgovernmentofficiallikemayororcitycouncilmember
____________________________________________________________________________________ o Another business leader
____________________________________________________________________________________
bull Regularlyinformthesecommunityleadersaboutisgoingonforwardactionalerts and other information Create an email list to use to make this easier Feel free to forward along Aging Services newsletters actions alerts and other information we share with you
bull ScheduleregulartimestocommunicateandormeetwithoneanotherThiscould beatyourlocalRotaryorChambermeetings
bull Planacommunityeventatyourfacilityandinvitecommunityleadersandyour legislators(seeResource8)
BUILD Involve your community and share the importance of caring for seniors
BU
ILD
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
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Ramp
10th St
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HEALTH
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East Central Park Place
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Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
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P
Lot
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NORTH
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FORD
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P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
3
RESEARCH Make sure you know who your legislators are and what the important issues are
It is important to do your homework to better understand who your legislators are and what issues are important to them There are many online resources to accomplish this You should also get some background on the legislative issues affecting long-term care
bull WhoaremylegislatorsCheckoutour advocacy page to find out who your legislators are
My House member is ________________________________________________________________
My Senate member is ________________________________________________________________
bull UnderstandImportantLegislativeDates(seeResource2)
bull Mylegislatorsrsquocampaignwebsites(useGoogletofindthisinformation) o______________________________________________________________________________________ o______________________________________________________________________________________
bull Whatisthenewspaperinmycommunity o FindtheEditorrsquosphoneandemail Name ____________________________________________________________________________ P _________________________________________________________________________________ E _________________________________________________________________________________
bull Knowtheissuesaffectinglongtermcare o CaregivingCountsLegislativeAgenda(seeResource3) o Long-TermCareImperativeMessagePlatform(seeResource4) o Factsheetsonourkeyissues(seeResource5)
RE
SE
AR
CH
4
INTERACT Create a relationship with your legislators so they know how important you are to the community
INTE
RA
CT
The best way to successfully advocate for long-term care issues is to build a relationship withyourlegislatorsReachouttothemcommunicateregularlywiththemvisitthemand ask them to visit you
bull Beginbyemailing your legislators and introducing yourself and what is important to you Continue to communicate via email throughout the legislative session and year
bull AgingServicessendsoutactionalertseachweekduringthelegislativesessionbased on activity at the Capitol This is an easy way to contact your lawmakers Check out our Take Action page
bull ParticipateinDayattheCapitol and visit your lawmakers in person
bull CanrsquotmakeitalobbydayScheduleameetingwithyourlegislatorsonyourown Here is the House directory and the Senate directory or contact the ASM advocacy team to help you
bull Inviteyourlegislatorstovisityourfacility(seeResource8)
5
You are a leader in your community and your community cares about the seniors you take care of everyday Involve key community leaders in your advocacy and share with them your role in caring for the seniors in your community
bull Identifykeycommunityleadersthatcareaboutqualitycareforseniors
o Family member of resident or former resident ____________________________________________________________________________________ o Religiousleader
____________________________________________________________________________________ o Localgovernmentofficiallikemayororcitycouncilmember
____________________________________________________________________________________ o Another business leader
____________________________________________________________________________________
bull Regularlyinformthesecommunityleadersaboutisgoingonforwardactionalerts and other information Create an email list to use to make this easier Feel free to forward along Aging Services newsletters actions alerts and other information we share with you
bull ScheduleregulartimestocommunicateandormeetwithoneanotherThiscould beatyourlocalRotaryorChambermeetings
bull Planacommunityeventatyourfacilityandinvitecommunityleadersandyour legislators(seeResource8)
BUILD Involve your community and share the importance of caring for seniors
BU
ILD
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
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HEALTH
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Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
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Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
4
INTERACT Create a relationship with your legislators so they know how important you are to the community
INTE
RA
CT
The best way to successfully advocate for long-term care issues is to build a relationship withyourlegislatorsReachouttothemcommunicateregularlywiththemvisitthemand ask them to visit you
bull Beginbyemailing your legislators and introducing yourself and what is important to you Continue to communicate via email throughout the legislative session and year
bull AgingServicessendsoutactionalertseachweekduringthelegislativesessionbased on activity at the Capitol This is an easy way to contact your lawmakers Check out our Take Action page
bull ParticipateinDayattheCapitol and visit your lawmakers in person
bull CanrsquotmakeitalobbydayScheduleameetingwithyourlegislatorsonyourown Here is the House directory and the Senate directory or contact the ASM advocacy team to help you
bull Inviteyourlegislatorstovisityourfacility(seeResource8)
5
You are a leader in your community and your community cares about the seniors you take care of everyday Involve key community leaders in your advocacy and share with them your role in caring for the seniors in your community
bull Identifykeycommunityleadersthatcareaboutqualitycareforseniors
o Family member of resident or former resident ____________________________________________________________________________________ o Religiousleader
____________________________________________________________________________________ o Localgovernmentofficiallikemayororcitycouncilmember
____________________________________________________________________________________ o Another business leader
____________________________________________________________________________________
bull Regularlyinformthesecommunityleadersaboutisgoingonforwardactionalerts and other information Create an email list to use to make this easier Feel free to forward along Aging Services newsletters actions alerts and other information we share with you
bull ScheduleregulartimestocommunicateandormeetwithoneanotherThiscould beatyourlocalRotaryorChambermeetings
bull Planacommunityeventatyourfacilityandinvitecommunityleadersandyour legislators(seeResource8)
BUILD Involve your community and share the importance of caring for seniors
BU
ILD
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
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Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
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Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
5
You are a leader in your community and your community cares about the seniors you take care of everyday Involve key community leaders in your advocacy and share with them your role in caring for the seniors in your community
bull Identifykeycommunityleadersthatcareaboutqualitycareforseniors
o Family member of resident or former resident ____________________________________________________________________________________ o Religiousleader
____________________________________________________________________________________ o Localgovernmentofficiallikemayororcitycouncilmember
____________________________________________________________________________________ o Another business leader
____________________________________________________________________________________
bull Regularlyinformthesecommunityleadersaboutisgoingonforwardactionalerts and other information Create an email list to use to make this easier Feel free to forward along Aging Services newsletters actions alerts and other information we share with you
bull ScheduleregulartimestocommunicateandormeetwithoneanotherThiscould beatyourlocalRotaryorChambermeetings
bull Planacommunityeventatyourfacilityandinvitecommunityleadersandyour legislators(seeResource8)
BUILD Involve your community and share the importance of caring for seniors
BU
ILD
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
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HEALTH
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Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
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Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
6
The media can play an important role in educating the public including legislators about your importance role caring for seniors in your community
bull Writealettertotheeditorofyourlocalpaperremindingthecommunityabout the importance of long-term care for our seniors (see Resource 7)
bull Afteranycommunityeventmeetingorvisitfromalegislatorfollowupwith asubmissiontolocalmediadescribingthemeetingConsiderinvitingthelocal mediatoyourevent
bull Scheduleameetingwithyourlocalnewspaperrsquoseditorialboardandeducate them on your role caring for seniors in your community
bull Usesocialmediatocontinuetodemonstrateyourrolecaringforseniorsin your community (see Resource 9)
ADVOCATE Engage the media and public on our issues and value
AD
VO
CAT
E
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
7
Hereisalistofresourcestohelpyoubesuccessfulasyouadvocateforprovidingquality care to seniors across Minnesota
1 Usefulwebsitesforadvocacy2 Keydatesforthe2014legislativesession3 CaregivingCountsLegislativeAgenda4 Long-Term Care Message Platform 5 Factsheets on our key issues 6 Map of the State Capitol7 Howtowritealettertotheeditorofyourlocalnewspaper8 Keytipsoninvitingyourlegislatorstoyourfacility9 Social media tips to keep the momentum going
RESOURCES Tools and information you need to successfully advocate
BU
ILD
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
8
Aging Services Public Policy website wwwagingservicesmnorgpublic-policy
MinnesotaLegislaturewwwlegstatemnus
HouseDirectorywwwhouselegstatemnusmembershousemembersasp
SenateDirectorywwwsenatelegstatemnusmembers
LocateyourLegislatorswwwgislegmnOpenLayersdistricts
LegislativeSessionCalendarwwwlegstatemnuscalendardayaspx
Smart Politics httpbloglibumneducspgsmartpolitics
BloisOlsonrsquosMorningTakemorningtakebitlyjoinmorningtake(subscribetodailyemailupdate)
Capitol View httpblogsmprnewsorgcapitol-view
Pioneer Press Political Animal httpblogstwincitiescompoliticsPolAnimal
Star TribuneHotDishPoliticshttpwwwstartribunecompoliticsblogsHot_Dish_Pol-iticshtmlRachelSB
Facebook pages to followwwwfacebookcomMNLTCIwwwfacebookcomAgingServicesMN
Useful Websites for Advocacy
RESOURCE 1
RE
SO
UR
CE
S
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
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St
Cedar St
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Garage
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Parking Ramp
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amp
STASSEN
TRAN
SPOR
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ON
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I-35E
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ARMORY
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ing
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PP
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Rev Dr MLK Jr Blvd
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STATE CAPITOL
VETERANS SERVICE
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Andersen
Ramp
10th St
AG
HEALTH
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East Central Park Place
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Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
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LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
9
Key Dates for the 2014 Legislative Session
Spring Break 410-422This is a great time to invite your legislators to visit your facility
2014 Session Ends 519ThisisthedateonwhichtheLegislatureisconstitution-allyrequiredtoadjournHoweverHouseandSenateDemocratshaveindicatedthattheyplantoadjournsooner ndash some say within 6 weeks
2015 Session Begins 162015
Key Dates for Elections
627ndashAbsenteeballotsavailablefortheprimaryelection812ndashPrimaryElection919ndashAbsenteeballotsavailablefortheGeneralElection114ndashElectionDay
2014 Legislative Session Started 225
State Budget Forecast 228The ongoing budget forecasts give legislators a sense of howtaxrevenuesandplannedandunplannedexpensesaretrackingwiththeirexpectationsThisisarefinednumber from the Novemer forecast which showed a size-able surplus This February forecast will be the number theLegislatureworksfromtomakedecisionsinthe2014legislative session
Billsmovingthroughthecommitteeprocessmustmeetthe following deadlines before being voted on by the full House and Senate
bull FirstCommitteeDeadlineis321 o The first deadline is for committees to act favorably on bills in the house of origin bull SecondCommitteeDeadlineis328 o The second deadline is for committees to act favorably on bills or companions of bills that met the first deadline in the other house bull ThirdCommitteeDeadlineis44 o The third deadline is for the House Committee on WaysandMeansandtheSenateCommitteeon Financetoactfavorablyonmajorappropriation and finance billsbull NoteTherearecertainexemptionstothecommittee deadlines
RESOURCE 2
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
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age
MINNESOTA HISTORY CENTER
Orange
Level
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Level
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Level
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Level
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Level
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Ramp
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s
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erParking
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Sherburne AvePark
StreetLotRice St
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Irela
nd B
lvd Cedar St
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Irel
and
Blvd
I-35E and I-94
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I-35E and I-9
4
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I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
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Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
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P
PP
P
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Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
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NORTH
LOT CLOT B
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LOT DLOT AA
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LOT XLOT G
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LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
10
Caregiving Counts 2014 Legislative Agenda
Investing in the Quality of Life for SeniorsAsmoreMinnesotansmoveintoretirementandthenextstageoftheirliveswehaveasharedresponsibilityfortheplanningandcareofouragingpopulationNopersonshouldspendtheirretirementyearslackingadequatecare
An investment in caregiving will support adequate services throughout Minnesota so people can live in their communities as long as possible and guarantee that all aging Minnesotans are receiving safe and quality care from experienced caregivers
Increased Investments in Quality Care bull 5COLAforcarecentersplusadditionalrateincreasetoaddressimpactsfromanincreasedminimumwage bull 5rateincreaseforhomeandcommunity-basedservices
Increasing Quality in Long Term Care CommunitiesEnsuringabetterqualityoflifeforMinnesotarsquosseniorsisthetoppriorityoflong-termcareprovidersacrossthestate
Increased training requirements will help provide quality care and safe environments for those who cannot live independently either temporarily or for the rest of their lives
Enhanced Training for Quality Care bull Increasedtrainingrequirementsformanagersandsupervisorsindementiacaresettings bull Increasetrainingrequirementsfordirectcareemployeesandnondirectcareemployees
Creating a Stable Experienced WorkforceThe workforce crisis in long term care is not a health and human services issue but a statewide problem that could impactthequalityoflifeforseniorsnowandinthefuture
An integrated approach will help retain current staff attract new individuals to the field of senior care and establish career ladders for individuals in older adult services
Addressing the Workforce Crisis bull IncreaseutilizationandeffectivenessofNursingFacilityEmployeeScholarshipProgram bull IncreaseparticipationandeffectivenessofNurseLoanForgivenessProgram bull CreatenewHomeandCommunity-BasedServicesScholarshipProgram bull ExplorefundingforinnovativeadulttrainingprogramthroughFastTRACorotherDEEDgrants bull CreateApprenticeshipRateIncentiveprogramtosupportnewcareerpathladders
RESOURCE 3
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
11
2014 Long-Term Care Imperative Key Messages
Make caregivers a budget priority in the 2014 legislative sessionThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversNursinghomesassistedlivingsettingsandhomecareprovidersstruggletohireexperiencedqualitycaregiversintheirsettingsdueinparttothelowwagesandbenefitstheyareabletooffergiveninadequatestatefundingCare-giversarethecornerstonetoprovidingqualitycareforMinnesotarsquosseniorsItisuptolawmakerstoinvestinthesejobsandthecaregivingprofessionbypassingrateincreasesthatpayforthelongtermcareservicesandsupportsthatseniors need
Minnesota must maintain its tradition of supporting quality home and community-based care for seniors MinnesotansshouldreceivethecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleinsettingstheycallhomeWhenMinnesotansareabletostayintheircommunitiesforaslongastheyareabletheystayconnectedtofamiliesfriendsandthelifechoicestheyhavemadeLawmakersshouldsupportthespectrumofhomeandcommunitybasedserviceswithadequatefundingandwithoutadditionaleligibilityrestrictions
As more Minnesotans retire and enter the next stage of their lives they deserve a healthy safe and quality life in the place they call home OurretiringpopulationandtheirfamiliesprovidersandthestateofMinnesotaallshareresponsibilityfortheplanningand care for aging Minnesotans Planning for the future is an important first step and new tools are needed to help families understand the costs and options available for the care of their loved ones
Minnesota needs to build a strong caregiving workforce for the futureThestateofMinnesotashouldensurethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcare-giversSeniorcareprovidersstruggletorecruitandretainexperiencedqualitycaregiversintheirsettingsduetolowerwagesandbenefitsAstableworkforceisakeyingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
The Long Term Care Imperative encourages lawmakers to support our 2014 legislative proposals to ensure seniors have access to quality care and quality caregiving
LTCI February 2014
RESOURCE 4
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
12
Workforce Solutions for Long Term Care
Caregivers must be a priority in the 2014 legislative sessionThe state of Minnesota should ensure that all aging Min-nesotansreceivesafeandqualitycarefromexperiencedcaregivers Senior care providers struggle to recruit and retainexperiencedqualitycaregiversintheirsettingsdueto lower wages and benefits A stable workforce is a key ingredienttoprovidingqualitycareItisuptolawmakerstoinvestinthesejobsandthecaregivingprofession
TheLongTermCareImperativewillpresentacomprehen-sive package of proposals to address the workforce crisis and to highlight the needs of long term care employers to policymakers both within the Health and Human Services and outside this traditional policy arena The package will address three main areas retention of current staff attracting new individuals to the field of senior care and the establishment of career ladders for individuals work-ing in older adult services
Retention of CaregiversNursing Facility Employee Scholarship Program This is a proven program used by nursing facilities to retain employees while they are working and receiving an educationTheLongTermCareImperativewilladvancea package of policy enhancements designed to increase utilizationandeffectivenessoftheexistingprogramincluding
bull RemovaloftheexclusionforRegisteredNurses allowing them to participate in the programbull Reductionofthehourthresholdparticipantsmust workfrom20hoursto15hoursbull Increasetotheallowablescholarshipexpenses(child caretransportation)andbull Establishanoptionalrateadd-onincentive (25residentday)fornursingfacilitiescommitted to establishing or enhancing a scholarship program
Home and Community Based (HCBS) Scholarship ProgramCreateanewHCBSscholarshipprogramExploreprogrammodelsthatdonotrequirefederalmatch and may offer contracted administration by third party(egMHArsquosleadershipoftheSummerHealthCareInternshipProgram)
Attracting New Employees to the Senior Care FieldTargetedfundingtoMinnesotaDepartmentofEmploymentandEconomicDevelopment(DEED)for promotion Propose funding that furthers the advancement of long-term care careers includ-ing grants to employers for employee training and education grants to individuals to seek additional education grants for conferences grants to highlight long-term care career week and grants for funding of innovative adult training programs such as those which help train low-income and under employed individuals funding for mentorship models and funding for simulation centers at local community colleges etc
Target K-12 funding to support Nursing Assistant train-ingentrylevelhealthcarecurriculumwhichcouldincludetraining costs
Higher Education Seek funding targeted to growing gerontological capacity within health care education programming
Nursing Assistant Training Costs Seek funding for reimbursement of Nursing Assistant training costs that employersarerequiredtoreimbursefornewlytrainednursing assistants
Nurse Loan Forgiveness Proposechangestotheexist-ing program to increase participation and effectiveness of this program through policy changes including increased funding and removal of impediments for eligibility such as allowing new graduates to apply for the funds
Support New Career LaddersApprenticeshipRateIncentiveCreateanoptionalrateadd-on incentive to assist organizations in implement-ing leadership and apprenticeship models Modeled after the cost-based reimbursement policies of the Nursing Facility Scholarship Program organizations would report increasedcoststoDHSandrecoupexpensesrelatedtoimplementing higher level staff training and care delivery models built around state-recognized registered appren-ticeship and leadership training programs
RESOURCE 5A
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
13
Help Minnesotarsquos Seniors Live IndependentlyIncrease Funding for Home and Community Based Services
TheLong-TermCareImperativesupportsthegoalsofcreatingafinanciallystablecaresystemthatprovidesqualitycareinahome-likeenvironmentforMinnesotarsquosseniorsFundingforourstatersquosElderlyWaiverprogramiscriticaltomeetingthisgoalA5increaseforHomeandCommunity-BasedServices(HCBS)improves the lives of these individuals and the state of Minnesota
Minnesotarsquos Elderly Waiver Program What is it TheElderlyWaiver(EW)programfundshomeandcommunity-basedservicesforpeopleage65andolderwhoareeligibleforMedicalAssistance(MA)andrequirethelevelofcareprovidedinanursinghomebutchoosetoresideinthecommunityTheMinnesotaDepartmentofHumanServicesoperatestheEWprogramunderafederalwaivertoMinnesotarsquosMedicaidStatePlanCountiestribalentitiesandhealthplanpartnersadminister the program
Investments in the Elderly Waiver program support state budget stabilityThestatersquosElderlyWaiverprogramhelpslow-incomeseniorsaccesshomeandcommunitybasedservicesInrecentyearsthisprogramhasreceiveddoubledigitcutsandthesecutsthreatenseniorsrsquoabilitytoaccesshome and community based services If this trend is not reversed seniors will be forced to seek more expensive alternatives at a higher cost to the state
Funding the statersquos Elderly Waiver program is cost effectiveMinnesota saves $275 million a year by using the Elderly Waiver as an alternative to nursing home care Wecurrentlyservemorethan22000seniorsthroughtheEWprogramversusapproximately17000seniorswho access Medicaid in nursing homes
MinnesotahasbeenrecognizedbyAARPandtheSCANFoundationforprovidingthebestlongtermcareservices in the nation A key reason for this recognition is the availability of a variety of home and community based services
The State of Minnesota must meet its commitment to aging Minnesotans It must treat all aging Minnesotans fairly so they all can live independently for as long as they are able andmustguaranteethatallagingMinnesotansreceivesafeandqualitycarefromexperiencedcaregiversAdequatelyfundinghomeandcommunitybasedserviceshelpsmeetthisgoal
RESOURCE 5B
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
14
BackgroundTheLong-TermCareImperativeispursuinglegislationfornursingfacilitiestoreceivea5percentrateonOctober12014Thisincreasecontinuestherequestfrom2013toaddresstheneedsthathavebuiltupduringthefouryearsoffrozennursingfacilityrates(2009-2012)andtotakeasmallsteptoaddressthehugegap(morethan$34perresidentperday)that has developed between the MA rates and the actual cost of care
Ourrateincreaseproposalfor2014willallowproviderstocontinuetoaddressthecrucialstaffingissuesthataredevelopingasLTCprovidersfallbehindintheabilitytorecruitandretainthestaffthatisvitaltoqualitycareMostofthefundingwearerequestingisrequiredtobespentonemployeewagesandcompensation
Weestimatethatthisrateincreasewillcostapproximately$147millioninstatefundingannually
ProposalUsingthesamemethodutilizedinthe2013increasepassedbytheLegislatureunderourproposalnursingfacilitieswouldreceivearateincreaseaveraging5effectiveonOctober12014Therateincreaseismadeupoftwocompo-nents-oneforemployeecompensationandgeneralcostincreases(375)andonetiedtoqualityperformance(125)
Employees75ofthe375rateincreasefornursingfacilitiesisrequiredtobeusedtocoverincreasesincompensationincludingwagesbenefitsrecruitmentandotherstaffcostsNursingfacilitiesarerequiredtosubmitacompensationplantobeapprovedbyDHSbeforereceivingthisportionoftheincreaseCombinedwiththe25toaddressincreasesinareaslike food and utilities this portion of the increase will allow facilities to address growing costs and position themselves to be more competitive in the labor market
QualityTheremainderoftherateincreaseisaqualityadd-onincreasethataverages125ThisportionoftheincreaseisbasedonMinnesotaNursingHomeReportCarddataandprovidesnursingfacilityrateincreasesrangingfrom00to32Nursingfacilitiesperformingbetteronthefollowingmeasureswillreceivelargerincreases
bull Minnesotaqualityindicatorsscore bull Residentqualityoflifescore bull Stateinspectionresultsscore
Provider Rate Increases
Prepared by the Long Term Care Imperative February 21 2014
RESOURCE 5C
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
15
Investing in the Nursing Facility Moratorium
TheLong-TermCareImperativeisseeking$1000000inannualfundingfornursingfacilityexceptiontothemorato-riumprojectsByprovidingfundingformajorcapitalprojectsonanannualbasistheproposalwillallownursingfacili-ties to continue to improve their settings
Inordertoreceivearateincreaseforaprojectcostingmorethan$1451303nursingfacilitiesmustreceiveapprovalthroughthemoratoriumexceptionprocessThemoratoriumexceptionprocessisfundedbyalegislativeappropriationto the Medicaid funding base If no appropriation is made nursing facilities that need to significantly update or even replace their buildings to prepare to serve the growing senior population will be unable to do so
Becausethestateneedonlyappropriatefundstocoverthestatersquosshareoftheamortizedcostoftheprojectarela-tivelysmallappropriationgeneratesasizablereturninconstructionprojectsInthelastapprovedroundofthemora-torium14nursingfacilitiesthroughoutthestatehad$139361683inprojectsapprovedatannualcostof$1165268tothestatebudgetUsingthesameratioitislikelythat$1000000infundingwillcreatenursingfacilityconstructionprojectsof$120million
Duetothefailuretofundmoratoriumexceptionsprojectsinthelastcoupleoflegislativesessionsandthecontinuedagingofthestatersquoscurrentsupplyofnursinghomesweanticipatethatanannualappropriationof$1millionwouldeasilybefullyutilizedbynursingfacilitieslookingtoupgradetheirphysicalenvironmentsButtheproposalisstruc-tured so that in the event the full amount of a years moratorium round is not spent that the amount carried over to thenextroundislimited
InadditiontoremodelingrenovationandreplacementofMinnesotarsquosstockofnursingfacilitiestheprojectswillalsopositivelyimpactMinnesotarsquoseconomyA$1millioninvestmentinstatedollarswillyieldthefollowingdirectandindi-rect impacts
bull 1854newjobs bull $232millionintotaleconomicactivity bull $74millioninwages bull $67millionofindirectbusinesstaxes
RESOURCE 5D
1GrossEconomicImpactsontheStateofMinnesotawaspreparedforTheLong-TermCareImperativebyECONorthwestusingdata from IMPLAN IMPLAN Professional Version 20 User Guide Analysis Guide Data Guide
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
16
State of MinnesotaPlant Management Division
wwwadminstatemnuspmd
Rice
St
Cedar St
Cedar St
11th St
11th St
Garage
STATE OFFICE
State Office
BuildingParking Ramp
Parking Ramp
Centennial
14th St R
amp
STASSEN
TRAN
SPOR
TATI
ON
Gar
age
MINNESOTA HISTORY CENTER
Orange
Level
Red
Level
Purple
Level
Blue
Level
Green
Level
Centennial Parking
Ramp
Sear
s
SearsCustom
erParking
History Center Parking
KellyInn
AURORA AVE
Cedar St
N Robert St
Jackson St
14th St
University Ave
Cedar St
Capitol Blvd
Park Street
Sherburne AvePark
StreetLotRice St
Rice St
University Ave
John
Irela
nd B
lvd Cedar St
John
Irel
and
Blvd
I-35E and I-94
I-35E and I-94
12th St
I-35E and I-9
4
I-35E and I-94
I-35E and I-94
12th St
I-35E
I-94I-94
I-94
I-94
I-94I-94
St Peter St
Wabasha St
Cedar St
Minnesota St
N Robert St
I- 35E
I- 35E
691 N ROBERT
ST PAUL
ARMORY
Rev Dr MLK Jr
Blvd
MHC
Load
ing
Dock
10 th St
Aurora Ave
JUDICIAL CENTER
P
P
PP
P
P
Rev Dr MLK Jr Blvd
Rev Dr MLK Jr Blvd
STATE CAPITOL
VETERANS SERVICE
ANDERSEN
Andersen
Ramp
10th St
AG
HEALTH
LAB
FREEMANCENTENNIAL
Bridge
East Central Park Place
West Central Park Place Columbus St
Minnesota State Capitol Complex Parking denotes public metered parking section within lot
Centennial Ramp Public Parking on Orange Level onlyCOMPLEX01
10-12
P
Lot
BB
NORTH
LOT CLOT B
LOT Q
LOT N LOT O
LOT F
LOT DLOT AA
LOT L
LOT XLOT G
LOT I LOT J
LOT K
LOT W
FORD
ADMINISTRATION
LOT U
LOT H
P
Map of the capitol
RESOURCE 6
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
17
Sample letters to the Editor
Elderly Waiver Should be a Funding Priority
In a mere seven years we will have more citizens in Minnesota that are over the age of 65 then we will have school-agedchildrenThereforeseniorsandtheircaregiversneedtobeatopprioritylookingforwardinMinnesotarsquosfutureOneoftheprogramsthathelpssupportthispopulationiscalledtheElderlyWaiverprogramTheElderlyWaiverprogram(EW)fundshomeandcommunitybasedservicesforindividualsthatareovertheageof65Theindividualsthat this program covers are currently eligible for Medical Assistance but instead choose to reside in their community insteadofanursinghomeorotherinstitutionalsettingEWalsoprovidesseniorswithvariouscareoptionsthatwithouttheprogramrsquossupportwouldnotbeavailableCurrentlytheprogramservesatotalof22358individualsTheprogramisverycostefficientasithastheabilitytoservicethreeseniorsonanElderlyWaiverforeveryoneseniorresidinginanursinghomefacilityInadditiontoitscosteffectivenessMinnesotanssupportthisprogram85ofMinnesotans are in favor of increasing funding for in-home and community based programs in order to allow our seniors to stay independent for a longer period of time Minnesota legislators and the Governor should provide a 5 percent rate increase for home and community based services this year It is the smart thing to domdashfor our seniors and for our state budget
Senior Service Jobs Are Available but Positions Are Still Vacant
In one nursing home in the state of Minnesota the facility is looking to lay away ten available beds This means that theywillturnawaytenpotentialelderlyresidentsinthefutureWhywouldtheydoawaywithtenbedsItisnotbecauseoflackofneedingresidentsndashasMinnesotarsquosagingpopulationcontinuestogrowndashbutratherthatseniorcareservicescannotfindenoughstafftomeettheneedsoftenresidentsCurrentlytherearealmost1500jobvacanciesinMinnesotaCareCentersinonlythreepositionsndashRNrsquosLPNsandNursingAssistantsHoweverweneedtheseworkersbecause in a mere seven years Minnesota will have more senior individuals then school-aged children Therefore by thetimetheyear2020hitsdirectworkersinseniorserviceswillbethelargestneededoccupationgroupintheUnitedStates The reason that these positions have not been filled is simple the wages given to these positions are not high enoughForexampleintodayrsquosworkforceregisterednursesthatareworkingincarecentersmake1707dollarshouror35505dollarsayearlessthanaregisterednurseinhospitalsettingAdditionallynursingassistantsinnursinghomesmake558dollarshouror11606dollarsayearlessthantheircounterpartsinthehospitalsettingsWithoutmorefund-ing for senior services these facilities will face more vacant positions in the long term Therefore seniors and their caregivers need to be a bigger priority in this legislative session
RESOURCE 7
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
18
Inviting your local legislators
Inviting local legislators to your facility is an important way to provide perspective on what the facility means to its residentstheirfamiliesandthecommunityBelowareafewtipstokeepinmindwheninvitingyourlegislators
1 InvitelegislatorstovisityourfacilityearlyinlegislativesessionLegislatorsrsquocalendarsfill-upquicklyandtheyoften run out of meeting time as session draws to a close2 Wheninvitingyourlegislatorsfeelfreetousetheirlegislativeemailbutbesuretomakeafollow-upcallWhether you make a follow-up call to the legislator or their legislative assistant it will go a long way in getting a meeting time scheduled Click here for their email addresses and phone numbers3 WheninvitinglegislatorssetparametersonthetimecommitmentForexampleacknowledgethattheyhavea busyscheduleandoffera30-minutemeetingiftheyarehesitanttocommit4 Bepersistent
DRAFT Email to LegislatorDearRepresentativeSenator
Asthe______________(positionieadministrator)at________________(nameoffacility)in_____________(nameoffacilitylocation)IwritetoyoutodaytoaskthatyouchampioneffortstoprovideagingMinnesotanswiththecaretheyneedtopreservetheirqualityoflifeforaslongaspossibleAsyouknowthelegislatureplaysalargeroleinthelivesofagingMinnesotansandensuringthattheyreceivesafeandqualitycarefromexperiencedcaregiversAsthissessionprogresses please consider my colleagues and myself as a support system for you in the community when it comes to long-termcareWeareheretoassistyouinmeetingoursharedgoalofsupportingMinnesotarsquosagingpopulationastheoutcomeofthislegislativesessionwillhaveamajorimpactonthebothusandourcommunity
To help you better understand our important role in caring for seniors in our community I would like to invite you to visit______________(nameoffacility)duringSpringRecessApril10-22Ourstaffandresidentswouldliketomeetwithyou and share how important our facility is to our community
RESOURCE 8
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg
19
Social Media Instruction amp Tips
Visit our Facebook Page httpswwwfacebookcomMNLTCI or by clicking on the image above
bull FirstloginasyourselfandldquoLikerdquoourpagebull HowtoPostpicturesofyourlegislativeencounterandldquotagrdquousinthem o GototheLongTermCareImperativersquospageandclickPhoto at the top o Click Choose File to add a file from your computer o Addanoptionalcaptioninthetextbox o ldquoTagrdquotheLongTermCareImperative o Click on Tag Photo button o ClickanywhereinthephotoandtypeldquoLongTermCareImperativerdquo o Choose the full name of the person you want to tag when it appears o Click Done Tagging o Click Postbull Assumingyourlegislatorisinthephotographbesuretoldquotagrdquohimheraswellbull SendthelinktoyourstaffandcolleaguesinthecommunityandlinktoitonyourpersonalFacebookpage
Visit our Twitter feed wwwtwittercomLTCImperative or by clicking on the image abovebull Firstclickonldquofollowrdquobull TweetaboutyourupcomingLegislativevisitandldquocopyrdquotheLongTermCareImperativebyendingyourtweet withldquoccLTCImperativerdquobull AlsondashcopyyourlegislatorTheyaremostlikelyonTwitterAdirectoryisattachedforyourreferenceoryou maysimplysearchforthemintheldquosearchrdquofieldatthetopofthepagebull EncouragemeetingparticipantstoTweetduringampafterthemeetingwiththeLegislatorndashandincludepicturesbull ToincludepicturesclickontheldquocamerardquoiconwhileTweetingandincludepicturesofthemeeting
RESOURCE 9
2550UniversityAvenueWestSuite350SouthSt Paul MN 55114-1900
P 6516454545 TF 8004625368 F 6516450002 AgingServicesMNorg