Leaders in Minnesota healthcare met at the 2023 Minnesota State of Reform Health Policy Conference last month to discuss ways in which the state is caring for its aging population. About 20 percent of the state’s population is age 60 or above, and much of the conversation’s focus fell on the Older Americans Act and the Minnesota Board on Aging.
Reena Shetty, director of the Governor’s Council on Age-Friendly Minnesota, questioned whether the responsibility to provide home and community-based services to the older adult population should be left up to the state, or to friends, family, and neighbors. What’s needed, Shetty said, is a long-term services and support continuum.
“We have two entities that do this work—the Minnesota Board on Aging, that administers the Older Americans Act,” Shetty said. “DHS [the Minnesota Department of Human Services] administers all the other pieces.”
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Shetty brought up the state’s Senior Linkage Line, which is a front door to all services the state offers to older Minnesotans, including long-term care options, counseling, insurance, Medicare and service referrals, among others.
“Essentially, it’s our one-stop shop. In 2022, a majority of the calls that the Senior Linkage Line received were for housing and for Medicare,” Shetty said.
DHS programs for older Minnesotans include a robust waiver program for individuals who do not meet nursing home levels of care, essential community supports, alternative care, and elder waiver programs. Shetty said the investment into the system of friends, family members, and neighbors was estimated at $10 billion in 2021.
“To strengthen older adults’ rights, autonomy, and protection, we have the Office of Ombudsman for long-term care, who are advocates for residents in long-term care. These are the folks who are at the bedside of residents who are in long-term care,” Shetty said.
In 2022, 25 regional ombudsmen provided over 50,000 visits, phone calls, and emails to over 165,000 beds. Dawn Simonson, president and CEO of Trellis, said the agency is committed to reducing disparities. Simonson highlighted the Older Americans Act, which provides nonmedical, health-related social services, like meals, rides, chores and homemaker services, legal assistance, case management, and gathering opportunities.
“Older Americans Act services are available to anyone—technically 60 plus— but this is a discretionary federal program and we more and more are focusing our dollars on people who have faced disparities over their lifetimes and are in greatest social and economic need,” Simonson said.
Simonson believes there have been opportunities to respond to population growth in the state through healthcare reform for years, and said Trellis has learned the interdependence of social determinants of health and outcomes. The agency thought about ways to expand services and leverage the Older Americans Act, and developed a provider network across the state known as “Juniper.” The network is specifically focused on fall prevention, caregiver support, mental health and emotional support, isolation reduction, and illness care.
Emi Bennett Vo, state public programs manager for government programs at HealthPartners, brought up the Minnesota Senior Health Options Plan (MSHO), a plan for dual eligible individuals on Medicare and Medicaid.
“Every one of our MSHO members is assigned an individual care coordinator, so it’s their go-to person for anything they might have questions with. There are some formal requirements that care coordinators need to do, but I like to think of them as they’re your go-to support navigator,” Bennett Vo said.
When looking at policy from a broader perspective, Bennett Vo said the Centers for Medicare and Medicaid Services is working to create nationwide platforms that integrate Medicare and Medicaid.
“When I think about MSHO, it’s really about supporting our most vulnerable, low-income elders in the community,” Bennett Vo said. “It’s really a model to look at for how to serve some of our most vulnerable Minnesotans.”
Michael Cabonargi, region 5 director for the US Department of Health and Human Services, mentioned federal initiatives that look after caring for caregivers with the goal of keeping seniors in their homes for as long as possible, and emphasized the role that workforce issues play not just in elder care, but across all of healthcare.
“Workforce recruitment and retention is part of the social determinants of health. Secretary Becerra, this summer, created a task force because as he said, each of the operating divisions of HHS in the past year has come down with the same concern about the workforce,” Cabonargi said.