LTC Bullet: The Center is Dead . . . Long Live the Center

Tuesday, May 3, 2005


LTC Comment: A personal message from Center for Long-Term Care Financing president Steve Moses.

Yesterday, we made the following announcement to Center donors: "The Center for Long-Term Care Financing ceased to exist on Friday, April 30." We hastened to add, however, that the work and the mission of the Center will continue. Here's what's happening:

I co-founded the Center for Long-Term Care Financing in April 1998 with David Rosenfeld (currently Health Counsel for the U.S. House Energy and Commerce Committee).

Our goal, achieved by February 2000, was to establish a 501c3 charitable nonprofit think tank and public policy organization that would fight for rational long-term care public policy and against the perverse incentives in current law that discourage responsible long-term care planning.

We reasoned that the only way to save Medicaid as a long-term care safety net for the poor was to divert as many Americans as possible to private LTC financing alternatives like savings, investments, insurance, or home equity conversion.

We reckoned that companies which market such products (financial advisers, insurers, lenders, etc.) and the companies that would benefit from their wider distribution (long-term care providers) would support an organization fighting for the socially desirable goal of saving Medicaid by encouraging the purchase of their products.

Financial support rolled in, but not enough and less and less over time. LTC insurers never made the connection between their disappointing sales and the fact that government gives away their product to most people. LTC providers were too focused on financial survival and maximizing reimbursements from Medicaid and Medicare to pursue a policy of targeting public financing toward the truly needy. Reverse mortgage lenders are only now beginning to take an interest in long-term care public policy.

Amy McDougall, the Center's executive director, and I struggled to keep the Center for Long-Term Care Financing viable under a nonprofit, contributory model for the past three years. We finally decided, however, that a different business structure is necessary in order to achieve the Center's goal: universal access to top quality long-term care for all Americans.

Therefore, we recommended dissolution of the Center, our Board of Directors concurred, and the Center for Long-Term Care Financing came to an end last Friday.

Here's what's coming next:

I have formed a new for-profit (more likely "no profit" but not technically nonprofit) company called the Center for Long-Term Care Reform, Inc. The new Center is purchasing the hard and soft assets (a computer, a printer, the website, copyrights, etc.) of the old Center.

Amy McDougall is moving on to new professional pursuits. You can still reach her at to wish her well and thank her for her service to the LTC mission.

My son, Damon, and I will carry on publishing news and views on long-term care daily, maintaining the website, working with the media, consulting, training, and working toward rational long-term care reform.

There will be changes. Instead of asking for "donations" to a charitable nonprofit, we'll seek to partner with individuals and companies who share our belief that major long-term care reform is on the brink of happening. (And that today it only needs a gentle push in the right direction to unleash the enormous potential of private financing alternatives and relieve the fiscal pressure on Medicaid and Medicare.)

So, over the next few months, we'll contact thousands of people who have received our publications free of charge in the past and ask them to pay a subscription fee. Our goal is 1000 paying subscribers to form the base of financial support for our ongoing public policy research and advocacy. ("LTC Bullets" will remain free of charge to bona fide media, legislators, and other public officials.)

We will transform the Center's publications and website to be more like a Web Log or "Blog" to make them more current, interesting, and interactive. We'll seek advertising support for the publications in addition to subscriptions.

We'll invite everyone to join the Center for Long-Term Care Reform, Inc. as members with password-protected access to our Members-Only website zone, where more and more of the most valuable content will reside.

We'll seek your support in the form of a "retainer" to help me fight in the halls of Congress, in the state legislatures, and in the public agencies that administer America's government-financed LTC programs for new policy directions that promote private financing alternatives as the means to save public financing for the needy.

We'll invite you to hire me to speak at your meetings and conferences (in person or by conference call) about the latest developments in long-term care public policy. Or to bring our highly acclaimed "LTC Graduate Seminar" to your auditorium or training room.

We'll continue to conduct studies and publish reports at the state and national level. From time to time, we'll invite companies, individuals, and public entities to commission such work or join together in supporting it.

We will continue and expand the critical expert witness work I have been doing in the field of nursing home litigation. Juries, tempted to pull millions of dollars in gigantic damages settlements out of the already financially starved LTC service delivery system, need to understand that bad outcomes in long-term care facilities are largely the result of excessive dependency on inadequate reimbursements from too many residents on Medicaid.

In a nutshell, the new Center for Long-Term Care Reform, Inc. will do mostly fee-for-service work on behalf of clients, subscribers, and members. We'll target our work to give value primarily to those who support it. We hope you will invest with your subscriptions, memberships, and contracts in what we're trying to achieve--quality LTC for everyone, especially those who cannot afford to buy it for themselves.

Thank you for your past, ongoing and future support for the Centers, old and new.

Stephen Moses