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Advocating for older adults

Rajean Moone, PHD, LNHA, FGSA

Minnesota Leadership Council on Aging

What is the mission of the Minnesota Leadership Council on Aging (MNLCOA)?

The Minnesota Leadership Council on Aging is a coalition of 34 nonprofit organizations dedicated to creating communities and systems that support aging with dignity and a spirit of well-being in Minnesota. Our members represent more 1 million older Minnesotans and 100,000 aging services professionals. MNLCOA supports positive systems change and policy for older Minnesotans, their family members, and aging services professionals.

How was this organization formed?

MNLCOA was formed in 2004 by the Metropolitan Area Agency on Aging and the former Minnesota Senior Federation to coordinate the efforts of organizations that support and advocate for older adults and their caregivers, and to develop common ground and achieve collective impact around systems and policy issues. One of its first initiatives, “Communities for a Lifetime,” provides information, resources, and assistance to improve the quality of life for people of all ages and abilities.

Please describe your advocacy before the Minnesota Legislature.

MNLCOA takes a strong education and awareness approach with the Minnesota Legislature. We do that in several ways. First, MNLCOA develops fact sheets on topics important to older Minnesotans, their families, and people that work in aging services. Fact sheets include topics such as dementia, family caregiving, transportation, and equity. Second, MNLCOA endorses policies that bring positive system change to Minnesota, with unanimous “yes” votes from all 34 nonprofit organizations that comprise our membership. Third, MNLCOA hosts an annual Minnesota Leadership Council on Aging Summit. Each year, the Summit brings together older adults, advocates, community members, government officials, and elected officials. At the December 2019 Summit, Gov. Walz signed an Executive Order to establish the Council on an Age-Friendly Minnesota.

​We need to work together to ensure that Minnesota remains a great place to age well.

Please tell us about the Elder Care and Vulnerable Adult Protection Act of 2019.

The Star Tribune’s “Left to Suffer” series, published in November 2017, as well as a report from the Minnesota Office of the Legislative Auditor, provided a troubling look into elder abuse in Minnesota’s formal, licensed settings, along with inconsistencies in systems designed to investigate reported instances of maltreatment. Maltreatment of vulnerable adults—whether abuse, neglect, or financial exploitation—is unacceptable. The administration, state Legislature, and stakeholders convened and established guidelines in response. Those guidelines formed the foundation for the Elder Care and Vulnerable Adult Protection Act of 2019.

What should physicians know about this legislation?

While the Act is lengthy, there are some salient points for physicians. It is important to note that provisions are being negotiated in rulemaking and there could be changes as a result of these discussions. Important information for physicians includes:

By Aug. 1, 2021, most registered housing with services establishments in Minnesota will be subjected to one of two levels of a new assisted living license regulated by the Department of Health: assisted living and assisted living with dementia care.

By July 1, 2020, any assisted living facility must be administered by a Licensed Assisted Living Director regulated by the Board of Executives for Long Term Services and Supports (formerly the Board of Examiners for Nursing Home Administrators).

There are new procedures for the use of electronic monitoring (cameras in resident rooms), including informing facilities of the placement of a camera. Consumers have a 14-day grace period in which they do not have to inform a facility in order to investigate suspected maltreatment, but they must inform the Long Term Care Ombudsman.

There is a host of new consumer protections in the law, including expansion of the Office of Ombudsman for Long-Term Care, uniform disclosure forms, Department of Health surveys, intake assessments, daily “I’m okay” checks, discharge protections, and protections against deceptive marketing.

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The establishment of a new Assisted Living Report Card. This Report Card, modeled after Minnesota’s Nursing Home Report Card, will help consumers make informed decisions about assisted living by allowing comparisons on quality indicators found to be important in research, as well as data from focus groups that included consumers, advocates, families, and providers.

Please tell us more about these new Assisted Living Report Cards.

The Assisted Living Report Card is being spearheaded by the Department of Human Services in partnership with the University of Minnesota. Our state has always been on the cutting edge of quality indicators and measures in long-term care. While most of the country must rely solely on the Medicare Compare website for nursing homes, Minnesota established a Nursing Home Report Card that goes above and beyond the results of surveys and health status data to include quality surveys and measures directly from consumers and families. The Assisted Living Report Card is being modeled after this successful tool. Currently the University of Minnesota is completing a comprehensive meta-analysis of research on quality in assisted living as well as talking directly with consumers, families, and providers to learn directly from them important factors in determining what is quality. These will be modeled into the new Report Card.

Please tell us about your work with the Minnesota Gerontological Society.

The Minnesota Gerontological Society—which strives to bridge research and practice in the field of aging—is one of our nonprofit member organizations, as is the Minnesota Association of Geriatrics Inspired Clinicians. Together, they provide a practitioner’s perspective on our goals and mission.

What difficulties do older adults in Greater Minnesota face in accessing services?

While a patchwork of services (at times fragile) typically exists in a network across all 87 counties, these services can be quite distant for some rural older adults, making it challenging to access supports to age in place. Very often, the older adult’s family can also be a great distance away, making it difficult to find informal supports from family and friend caregivers. Older adults and family caregivers that experience access issues should contact the Senior LinkAge Line at 800-333-2433, where a neutral, trusted voice right here in Minnesota can help troubleshoot and navigate options to make informed decisions about needs and wants, as well as availability of services.

What else would you like physicians to know about your work?

For the last few decades, those working in aging painted a picture of our rapidly changing Minnesota. They targeted 2020 as a key year—the first year we will have more adults over age 65 than children in school. Twenty years ago this seemed so far way, but we are now just months from this demographic reality. The question is … are we ready? While Minnesota is a great place to age for many, this is not true for everyone. Significant health, economic, and social disparities exist in communities of color, LGBTQ communities, Native American communities, and rural communities. These disparities result in lower life expectancies, increased rates of institutionalization, decreased access to a full range of long-term services and supports, and poverty. The communities often lack a voice in designing systems and policies created for them. Another challenge is that investments in services and supports for older adults and their families have not kept pace with growing demand. We need to work together to ensure that Minnesota remains a great place to age well and live well!

Rajean Moone, PHD, LNHA, FGSA, is executive director of the Minnesota Leadership Council on Aging