Blue-Ribbon Coalition for LTC Financing Reform.

Could it be that groups representing disparate sides of the long-term care debate--the industry, consumers and labor--are finally coming together over a framework to develop a new funding system? Forget the old Pepper Commission of more than 10 years ago. Though lawmakers served on the commission, Congress never seriously considered the panel's laudable (albeit expensive) goal of a federally supported continuum of care. This new, 63-member coalition--called Citizens For Long Term Care--includes an array of nongovernment groups:

* American Health Care Association (AHCA)

* American Association of Homes and Services for the Aging (AAHSA)

* Aetna Insurance

* American Association of Retired Persons (AARP)

* Alzheimer's Association 

* The Arc of the United States

* National Committee to Preserve Social Security and Medicare

* National Association for Home Care

* Service Employees International Union (SEIU)

The coalition is headed by former Republican Senator David Durenberger, who in his years in the Senate (1978 to 1995), was known for his ability to bridge the political divide between Democrats and Republicans.

The coalition released a report at an April briefing entitled, Defining Common Ground: Long Term Care Financing Reform in 2001. It outlines how long-term care financing reform can be accomplished using our nation's current employment and financial security structures. The report includes a mix of private and social insurance solutions, including a revised role for Medicare in meeting the needs of those with chronic illness or disability. With a sense of conviction that didn't characterize this coalition before, Durenberger said, "There needs to be a strong emphasis on the purchase of private long-term care insurance, especially by younger workers, and employers need to be encouraged to play a bigger role in educating employees and offering it as a benefit.

"In addition, we believe there must be a uniform, national system of assessment that will help consumers not only learn about long-term care, but understand what their needs are and how to arrange for finding the help they need when they need it."

Another part of the report's framework recommends that federal financial assistance be tied to a disability model instead of the traditional model, i.e., reimbursement would be far more flexible for those with either extended or short-term needs. Medicare needs to be reformed "in ways that ensure more beneficiaries are able to either avoid or delay the onset of chronic and disabling conditions and to better define the separation between chronic health care and long-term care services so that the health needs of those with chronic conditions are better met," the report recommends. It adds, "Medicaid as a safety net must be available to those who need long-term care but have no other source of financial assistance, and it must expand the choices available for long-term care." This approach "offers the potential to pool public and private resources...."

Durenberger was joined on the panel by Dale Thompson, vice-chairman of the coalition, COO of Benedictine Health System and past AHCA chairman; John Rother, director of legislation and public policy for AARP; Frolly Boyd, senior vice-president of Aetna, Inc., and Steve McConnell, vice-president of public policy for the Alzheimer's Association. Each had participated in the development of the proposal. And Durenberger's career now comes full circle: He once served as vice-chair (1989 to 1990) of the Pepper Commission.