LTC Bullet:  LTC Embed Reports from the Policy Front, MD and DC 

Thursday, July 6, 2006 


LTC Comment:  Our fight for rational long-term care policy moves to Maryland and Washington, DC next week from which we'll send daily reports to members.  What's up?, after the ***news.*** 

*** TAKE AWAY from today's Bullet:  If you are within reach of Hagerstown, MD, please attend the hearing described in today's Bullet to show your support for rational LTC policy.  Key facts:  "Roundtable About the Future of Long-Term Care and Medicaid" on Monday, July 10, 1:00 p.m. - 4:00 p.m. at the Washington County Commissioners Meeting Room, 100 West Washington Street, Hagerstown, MD, 2nd floor, Room 227, July 10, 2006, 1:00 p.m. - 4:00 p.m.  Now, please read the following Bullet to know why we want and need you there.  If you are willing to help defray the cost of the Center's participation in this hearing, please send your contribution to the Center for Long-Term Care Reform, 2212 Queen Anne Avenue North, #110, Seattle, Washington, 98109. *** 

*** TODAY'S LTC BULLET IS SPONSORED BY OAK STREET FUNDING.  Oak Street Funding meets the unique borrowing needs of insurance agency owners to secure affordable financing without selling their books of business.  By lending against policy renewal commissions, Oak Street Funding provides the liquidity owners need to pay off debt, hire additional staff or invest in serious marketing initiatives to propel continued growth.  For details, check out and contact Curt Vahle, Field Sales Manager, at 317-428-3806 or  We thank Mr. Vahle and Oak Street Funding for sponsoring today's LTC Bullet and for supporting the Center for Long-Term Care Reform.  To sponsor a Bullet yourself, please contact or 206-283-7036. *** 

*** NEW LTC FORUM.  Don't miss the Center for Long-Term Care Reform's new LTC Forum for members.  After you register with Damon at 206-283-7036 or, you'll be able to post messages, ask questions, or respond to other members in a private, members-only online "bulletin board."  For details, consult "LTC Bullet:  The New LTC Dialogue," June 29, 2006 in The Zone at  Not yet a member?  That's easy to fix.  Contact Damon as above and he'll have you in The Zone, receiving all our daily publications, and posting to the new LTC Forum in a jiffy. *** 



LTC Comment:  People who love the dysfunctional long-term care status quo because they profit from it are bashing members of Congress for their votes on the Deficit Reduction Act. 

We reported on this problem in "LTC Bullet:  Let's Fight Back!," Tuesday, June 13, 2006.  Read it here: . 

In a nutshell, our "Let's Fight Back" Bullet recounted the dilemma of a Maryland Congressman who voted for the DRA in order to preserve Medicaid LTC benefits for people truly in need and to encourage private financing alternatives like insurance and reverse mortgages. 

Instead of plaudits, that vote earned him attacks from Medicaid planners in his district who saw their cash cow--Medicaid planning--being gored. 

Here's one example from an op-ed in a newspaper in the Congressman's district:  "The legislation [DRA] now penalizes individuals for making gifts to a citizen's church and favorite charity.  Additionally, the act punishes routine Christmas and birthday presents of cash to family members." 

That claim is preposterous of course because the Social Security Act clearly states that assets must be transferred for the purpose of qualifying for Medicaid to cause a penalty.  Gifts or donations for other purposes are exempt.  Nothing in the DRA changed that fact.  In truth, the DRA strengthened "hardship" protections to prevent unfair or arbitrary imposition of Medicaid eligibility rules. 

Unfortunately, this kind of irresponsible demagoguery scared the Congressman's constituents who followed up with letters full of complaints about problems that don't exist. 

To get the facts straight, correct the record, and fight back, the Congressman contacted the Center for Long-Term Care Reform.  We advised the Congressman and his staff about Medicaid and LTC financing policy.  We published an op-ed telling the truth about the DRA in the same local newspaper that had run the Medicaid planner's broadside.  And we agreed to come to Maryland to testify at a hearing and to help in other ways. 

That hearing is scheduled for Monday, July 10 in Hagerstown, Maryland.  Details follow.  Witnesses will include myself AND the Medicaid planning attorney who lodged the public attack on the Congressman.  That should be interesting! 

But besides us, witnesses will include some big guns in LTC policy:  Dennis Smith, the head fed for Medicaid at the Centers for Medicare and Medicaid Services (CMS); Tony McCann, Secretary of the Maryland Department of Health and Mental Hygiene (which includes the state's Medicaid agency); and Grace-Marie Turner, President of the Galen Institute and a voting member of the national Medicaid Commission. 

Following below is the press release announcing the hearing or "roundtable."  Although addressed to "constituents," this is an open meeting.  Please attend if you can.  Medicaid planners will be well-represented in the audience.  It would sure help to have friends and supporters of the Center for Long-Term Care Reform there also. 

Besides participating in this hearing, I will be in the Maryland and DC area most of the week.  I'll attend part of the Medicaid Commission meeting taking place in Arlington, VA.  I'll meet one-on-one with Secretary McCann.  I'll visit with the President and CEO of the American Health Care Association.  I'm setting up meetings on the Hill with members of the new "Long-Term Care Caucus" in the House of Representatives and their staffs.  And I'll be doing some briefings in the area for senior financial advisers. 

Your support for this work is much appreciated. 


For Immediate Release:  June 30, 2006 

Contact:  Lisa Lyons Wright at 202-225-2721 or 202-225-9554 or  

Congressman Roscoe Bartlett Invites Constituents to Attend a Roundtable about the Future of Long-Term Care and Medicaid on Monday, July 10, 1:00 p.m. - 4:00 p.m. in Hagerstown, MD 

Washington, DC - Congressman Roscoe Bartlett invites constituents to attend a Small Business roundtable about the future of long-term care and Medicaid on Monday, July 10 between 1:00 p.m. and 4:00 p.m. in Hagerstown, Maryland.  Congressman Bartlett is Vice Chairman of the House Small Business Committee that will conduct the roundtable.  The roundtable will take place in the Washington County Commissioners Meeting Room located at 100 West Washington Street on the second floor in room 227.  A list of invited witnesses is attached. 

Congressman Bartlett said, "Congress recently made changes to the Medicaid program as part of the Deficit Reduction Act.  The Deficit Reduction Act is projected to save taxpayers $39 billion over the next five years.  This roundtable is designed to answer questions about these changes and how they will affect the future of Medicaid and long-term care for many senior citizens." 

Long-term care is one of the most significant demographic and fiscal challenges of this century and of particular importance because of America's rapidly aging population.  In 2000, there were an estimated 9.5 million people with long-term care needs in the U.S., including six million elderly and 3.5 non-elderly.  These numbers are projected to grow dramatically in the coming years, especially after 2030 when the baby boom generation begins to reach 85.  The senior population-12.4% in 2000-is predicted to rise to 20.6% by 2050.   

Medicaid paid for by federal and state taxpayers has become a primary way of financing long-term care for elderly people in nursing homes.  Medicaid's mission is to provide a safety net of healthcare for those who truly need it.  The current mix of financing for long-term care, in which a significant share of financing comes from government programs, adds to the pressures that the federal budget will experience with the aging of the baby-boom generation.   

Medicaid has been the federal entitlement program with the fastest rate of spending increase.  Expenditures are topping $300 billion and rising 8% annually.  In total, Medicaid's expenditures for long-term care for elderly people since 1992 have grown at an average annual rate of about 5 percent.  The Congressional Budget Office estimates that in 2004, Medicaid's payments for institutional care for seniors, including both state and federal expenditures, totaled about $36.5 billion or about 77% of all Medicaid long-term care spending.  Accounting for about 40 percent of total expenditures on nursing facilities, Medicaid's payments cover the care of more than half of all elderly nursing home residents. 

The Future of Long-Term Care and Medicaid
Small Business Roundtable

Washington County Commissioners Meeting Room
100 West Washington Street, Hagerstown, MD
2nd floor, Room 227
July 10, 2006
1:00 p.m. - 4:00 p.m.

The Honorable Donald Manzullo (R-16-IL)
Chairman of the House Small Business Committee

The Honorable Roscoe Bartlett (R-6-MD)
Vice Chairman of the House Small Business Committee

Invited Witnesses 


Mr. S. Anthony ("Tony") McCann
Secretary, Department of Health & Mental Hygiene
Baltimore, Maryland
Member, President's Commission on Medicaid

Mr. Dennis Smith
Director, Center for Medicaid and State Operations Centers for Medicare and Medicaid Services
Baltimore, MD
Grace-Marie Turner
President, Galen Institute
Alexandria, VA
Member, President's Commission on Medicaid


Mr. Stephen Moses
Director, Center for Long-Term Care Reform
Seattle, WA

Mr. Gregory Stangel, II
Stangel & Stangel Financial Services
Cresaptown, MD

Mr. Jim Mitchell
Administrator, Moran Manor
Westernport, MD

Mr. Michael G. Day
The Law Offices of Michael G. Day and Associates, P.C.
Hagerstown, MD