Emerging State Directions and Trends Implications for SHIPs

1. Emerging State Directions and TrendsImplications for SHIPs 13th Annual SHIP Directors Conference June 12, 2007 Bernice Hutchinson National Association of State Units on Aging (NASUA) Brian Webb National Association of Insurance Commissioners (NAIC)

2. Forty Years of Leadership State Units on Aging are the fifty-six state and territorial agencies officially designated by governors and state legislatures to administer, manage, design and advocate for benefits, programs and services for the elderly and their families and in many states for adults with physical disabilities.

3. An Indispensable Role State Units on Aging are located in every state in the country as well as territories and play a crucial leadership role in working with governors, state legislatures, other state agencies, local governments, provider organizations and consumers to promote comprehensive, high quality state aging policies and programs.

4. Part of a Dynamic National Network State Units on Aging are part of a collaboration of federal, state and local partners comprised of the federal Administration on Aging, 57 SUAs, 650 AAAs, 244 tribal organizations, 30,000+ local community based service providers and a vast network of volunteers.

5. Current Trends in Aging • Growing number of older persons. • Increasing diversity among older people. • Dramatic expansion in products, services and technologies. • Greater emphasis on long term care financing, options and regulation. • Balancing escalating long term care costs. • More prominent role in disaster preparedness, Medicare education. • Emphasis on home, community and family. • Focus on consumer choice and independence.

6. Emerging State Aging Directions • Building comprehensive and coordinated system of home and community based services. • Balancing long term care costs used in institutional and community settings. • Offering consumer centered services and supports. • Advancing systems change. • Ensuring streamlined access to services. • Enhancing quality in service delivery.

7. Public Policy • Older Americans Act Appropriations Strategy • The Elder Justice Act • SHIP Funding

8. Long Term Care • Consumer Direction • Cash and Counseling • Money Follows the Person • Real Choice Systems Change • LTC Ombudsman Role in Nursing Facility Transitions • Aging and Disability Resource Centers

9. Health Promotion/Disease Prevention • Chronic Disease Management • Senior Risk Reduction Grants • Medicare Prevention Initiative

10. Information, Outreach and Assistance • National Survey of I&R/As • Medicare Part D Implementation • Credentialing of I&R/A Professionals • Defining Diversity • Civic Engagement • Disaster Preparedness

11. Planning, Community and Elder Rights • National Model Planning Grants • Transportation Coalition Building • Livable Communities • Elder Abuse Prevention

12. Implication for SHIPs • Leadership • Comprehensiveness • Responsiveness • Integration • Sustainability • Skilled Personnel • Technology • Marketing • Coordination

13. Questions? Bernice Hutchinson, Director Consumer Information Outreach and Assistance National Association of State Units on Aging 1201 15th Street, N.W., Suite 350 Washington, DC 20005 202-898-2578 202-898-2583 (fax) bhutchinson@nasua.org www.nasua.org

14. The National Association of Insurance Commissioners • The National Association of Insurance Commissioners (NAIC), founded in 1871, is the oldest association of state officials. • The NAIC is a voluntary organization of the chief insurance regulatory officials of the 50 states, D.C., and 5 U.S. Territories. • The NAIC provides a national forum for regulators to discuss common issues and develop model laws and regulations. • The overriding objective is to protect consumers and help maintain the financial stability of the insurance industry in each state.

15. Emerging State and Federal Issues • Medicare Part D Implementation • Medicare Advantage Marketing • Medigap Reform • Long-Term Care • Health Care Reform

16. Medicare Part D Implementation • Handling Consumer Complaints • Memorandum of Understanding to share info • Coordination between states and CMS • Possible Reforms • Too many plans • Marketing reforms • SHIP Funding

17. Medicare Advantage Marketing • The Problems • Marketing guidelines • Marketing abuses • Lack of oversight • CMS Action • Congressional Action • Hearings in House and Senate • Possible legislation • Budget Reconciliation

18. Medigap Reform • Modification of NAIC Model • Process – usual cast of characters • Amendments • Benefit Changes • Plan Changes • Congressional action needed • Genetic Information Nondiscrimination Act • Mental Health Parity

19. Long-Term Care • Long-Term Care Insurance Complaints • NY Times article • Congressional investigations • NAIC activities • Long-Term Care Partnerships • Update • Issues • NAIC activities

20. Health Care Reform • Increasing Significance of the Issue • Large companies are clamoring for relief • Presidential politics • Increasing Activity in the States • Several states have enacted broad reforms • Many more are considering broad reforms • Congressional Action? • Bolder ideas being introduced • Empowering states a possibility

21. Questions? Brian Webb, Manager Health Policy and Legislation National Association of Insurance Commissioners 444 North Capitol St, NW, Suite 701 Washington, DC 20001 202-624-3543 bwebb@naic.org