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The Center for Long-Term Care Reform's

LTC Graduate Seminar

The Center for Long-Term Care Reform offers a one-day, graduate-level long-term care education program. The cost per enrollee is $225. Details on the program, including a course description, syllabus, curriculum vitae for the seminar leader, and testimonials follow. For questions or to secure a reservation and arrange payment, email or call 206-283-7036.

SCHEDULE: The Center will conduct LTC Graduate Seminars in major cities throughout the United States as arranged with sponsors and attendees, but with no set schedule. Precise dates and locations will be announced in LTC Bullets as we determine them. If you would like to attend or sponsor a program, please contact us at 206-283-7036 or  

WHY HAVE AN LTC GRADUATE SEMINAR?: Center president and seminar leader Stephen Moses explained:  "Long-term care beginners have many excellent education and certification programs to choose from. But where do you go once you've learned the basics and achieved some success? How do you go to the next level? The Center for Long-Term Care Reform's 'graduate seminar' is for experienced professionals in all aspects of long-term care."

COURSE DESCRIPTION: Long-Term Care Intensive for Senior Advisers

This course tackles critical questions that anyone who serves or advises seniors should understand in depth. For example:

* How did America's LTC service delivery and financing system come to be so dysfunctional, e.g. nursing home and home-health bankruptcies, unprofitable assisted living facilities, collapsed LTC stocks, institutional bias, quality problems, staff shortages, low government reimbursements, skyrocketing liability insurance premiums, slow LTC insurance sales, etc.?

* Can the current non-system survive and how will it change?

* Will services be available when seniors need them in the future?

* Who will pay?

* What will happen to the government's LTC financing programs?

* What is the real reason so few people save, invest and insure for LTC expenses?

* What are the prospects for "above-the-line tax deductibility" for LTC insurance premiums in the coming year?

* How can advisers help more seniors protect themselves from the LTC risk?

* How can we build a "phalanx of professionals" around seniors to help them protect themselves from the legal and financial risks of aging?

* What changes in public policy (state and federal) would have to be made to move LTC in America from a wobbly welfare base to a solid foundation in private insurance?

* How has the Deficit Reduction Act of 2005 created a "brave new world of long-term care"?

TARGET AUDIENCE: financial planners or consultants, attorneys, accountants and CPAs, long-term care insurance agents, geriatric care managers, long-term care providers (home care, assisted living or nursing home care), social workers, medical professionals and home equity conversion specialists.

STYLE OF INSTRUCTION: This course will be conducted as a graduate seminar. Seminar leader Stephen Moses will present several modules of instruction followed by guided discussion. Every attendee will have ample opportunity to ask questions and share ideas. Participants are urged to challenge the instructor and each other with questions and comments.

TEXTBOOKS: Textbooks for The LTC Graduate Seminar are the Center's major reports including "LTC Choice: A Simple, Cost-Free Solution to the Long-Term Care Financing Puzzle," "The Myth of Unaffordability: How Most Americans Should, Could and Would Buy Long-Term Care Insurance," "The LTC Triathlon: Long-Term Care's Race for Survival," and "The Realist's Guide to Medicaid and Long-Term Care." All four reports are available free of charge in .pdf format at Printed and bound copies of the texts are available for $150. We will provide additional handouts of current interest at the time of the seminar.  Enrollees will also receive a free three-month trial subscription to the Center's popular members-only website zone (a $37.50 value), including daily LTC E-Alerts and archived LTC Reader, LTC Data Base and Embed Report  publications.

SYLLABUS: The Center for Long-Term Care Reform's LTC Graduate Seminar covers each of the following points and provides detailed historical and documentary evidence at every step of the presentation.

The Problem of Long-Term Care

o Americans are living longer, but dying slower often in need of expensive long-term care (LTC).

o Trends in aging demographics guarantee that LTC will become a much bigger and more expensive, possibly catastrophic, social and political challenge in the future.

o America's LTC service delivery and financing system is severely dysfunctional in terms of access, quality, reimbursement, discrimination, and institutional bias.

o LTC places a huge financial burden on U.S. social programs (principally Medicaid and Medicare) while private financing of LTC, especially insurance, is very limited.

o In the absence of adequate public and private third party financing for professional LTC services, American families struggle to provide informal care at home with little help.

o Related problems are growing, such as, physical and financial abuse of the elderly exacerbated by economic and emotional pressures on the "sandwich generation."

The Reason Long-Term Care Service Delivery and Financing Have Become Such Big Problems for America

o Ironically, well-intentioned public financing of LTC since 1965, although helping many people in need, has inadvertently created and exacerbated the status quo.

o Medicaid financing of nursing home care led to institutional bias. Neither Medicaid nor Medicare can afford to provide the community care most seniors prefer.

o Simultaneously, public financing of LTC inhibited the growth of a private market for home care, assisted living and the private insurance products to pay for them.

o Limited provider reimbursement by Medicaid and Medicare caused access and quality problems, which led to discrimination against public recipients and in favor of private payers.

o Consequently, private payers are migrating to home care and assisted living leaving public payers and nursing homes with the highest acuity, most expensive patients.

o Ramifications for staffing, litigation, liability insurance, capital financing, stock prices, and viability of the system are approaching the end game.

o In the meantime, relatively easy access to Medicaid nursing home care and Medicare home care has desensitized the American public to the risk and cost of formal LTC.

o Thus, most people who need formal long-term care still end up in nursing homes paid for by Medicaid and very few Americans plan, save or insure for LTC.

The Solution

o The good news is that America's LTC crisis is relatively easy to solve, because it is self-inflicted by well-intentioned, but negative incentives in public policy.

o In America today, one can ignore the risk of LTC, avoid premiums for private insurance, qualify much more easily for public benefits than is commonly understood, or dodge "spend-down" requirements entirely.

o Stricter eligibility rules (e.g., "Throw Granny in Jail") and mandatory estate recovery have failed to save Medicaid or encourage individual responsibility because they come after it is too late to save or insure.

o To solve the LTC crisis, we should

(1) educate everyone by age 50 about the risk and cost of LTC,

(2) enforce "LTC Contracts" before retirement whereby everyone acknowledges the personal responsibility to save or insure for LTC,

(3) reduce or eliminate the Medicaid home equity exemption so that more people use their home equity to purchase long-term care and/or buy long-term care insurance to protect their home equity,

(4) more faithfully recover from the estates of deceased Medicaid recipients to replenish the programs resources and prevent its remaining free "inheritance insurance" for boomer heirs who should be preparing responsibly for their own long-term care someday, and

(5) use the savings to enhance Medicaid as a safety net for the truly needy and to fund the cost of tax incentives for the purchase of long-term care insurance and the use of reverse mortgages.

o With these positive programs and incentives in place, fewer people will depend on Medicaid or Medicare for their LTC and those programs will be better able to serve their legitimate recipients and beneficiaries.

SPONSORING ORGANIZATION: The Center for Long-Term Care Reform is a private, nonpartisan think tank and public policy organization headquartered in Seattle, Washington. The Center's mission is to ensure access to quality long-term care for all Americans. Center representatives speak at conferences, write for publication, testify in state legislatures, and conduct training for professional financial advisers of the elderly throughout the United States. Details on the Center for Long-Term Care Reform, including the bona fides of the organization and its principals, may be found at The seminar instructor's curriculum vitae follows.


Stephen Moses is president of the Center for Long-Term Care Reform in Seattle, Washington. The Center promotes universal access to top-quality long-term care by encouraging private financing and discouraging welfare financing of long-term care for most Americans. Previously, Mr. Moses was Director of Research for LTC, Inc., a Medicaid state representative for the Health Care Financing Administration and a senior analyst for the Inspector General of the U.S. Department of Health and Human Services.

Mr. Moses is widely recognized as an expert and an innovator in the field of long-term care. McKnightís Long-Term Care NEWS named him "one of the 100 most influential people in long-term care." Nursing Homes magazine reported "there is probably no more articulate spokesperson for privately financed long-term care than Stephen Moses."

Steve Moses has directed numerous national studies for the federal government, state governments, and private organizations on Medicaid nursing home eligibility, asset transfers, estate recoveries and long-term care financing. He specializes in problems associated with "Medicaid estate planning," the practice of artificially impoverishing affluent people to qualify them for public assistance.

Moses is credited with having "forged the framework" for the Omnibus Budget Reconciliation Act of 1993, which attempted to bring Medicaid eligibility loopholes under control. He played a critical role in the design and passage of the Deficit Reduction Act of 2005.  He helps state Medicaid programs curtail Medicaid estate planning and encourage private insurance as an alternative to public welfare financing of long-term care for the middle class.

Mr. Mosesí articles appear often in distinguished publications like The Gerontologist, The Journal of Accountancy, Contemporary Long-Term Care, Bestís Review, National Underwriter and LTC News & Comment. He is the author of "Health and Long-Term Care Insurance," a chapter in Clark Boardman Callaghanís legal treatise, Advising the Elderly Client. He has testified before Congress and two-thirds of Americaís state legislatures. He frequently addresses professional conferences in the fields of law, aging and insurance.

Steve Mosesí recommendations are quoted often in the national media including the "CBS Evening News," PBSís "Frontline" and "The Financial Advisors," CNN, National Public Radio, The New York Times, Newsweek, USA Today, Forbes, The New Republic, Smart Money, National Journal, and Jane Bryant Quinnís syndicated column. He appears in a public television documentary entitled "The Aging of America: The Dilemma of Long-Term Care." His talk radio appearances on health care reform are unique, provocative, and increasingly in demand.

Mr. Moses wrote the chapter on long-term care financing for a new anthology entitled Toward Healthy Aging, edited by best-selling author Ken Dychtwald of Age Wave renown. His chapter in an anthology on the Long-Term Care Partnerships was published in 2001. He is also the author of LTC Choice: A Simple, Cost-Free Solution to the Long-Term Care Financing Puzzle, The Myth of Unaffordability: How Most Americans Should, Could and Would Buy Private Long-Term Care Insurance, The Realist's Guide to Medicaid and Long-Term Care, and Aging America's Achilles' Heel:  Medicaid Long-Term Care.


"Thank you for the excellent job you did here in Portsmouth on August 10.  Your seminar exceeded our expectations.  This kind of in-depth training is what I think every LTC/LTCI business needs, if it is to manage effectively in a complex environment.   Several people remarked to me afterwards that it was impressive that you could hold people's attention for almost seven hours.  I told them it was because you really knew your subject and would have made a very good professor."  Paul Forte, Chief Executive Officer, Long Term Care Partners, LLC; comment on LTC Graduate Seminar for LTC Partners in Portsmouth, New Hampshire, August 10, 2006)

"Every word was relevant.  Encore!  Couldn't get enough.  Thank you for sharing this deeply valuable resource with us.  Should have continual follow-ups.  . . .  Great presentation!  Loved the way it was done!  . . .  Very knowledgeable & effective presenter.  Steve was able to get across somewhat dry material in a very interesting & compelling way.  Would definitely recommend this program to anyone in the LTC industry!  . . . I have never seen someone so passionate about an issue and I think that is great."  (Comments on the LTC Graduate Seminar for LTC Partners in Portsmouth, New Hampshire, August 10, 2006)

"Steve Moses has extensive and excellent skills in analyzing the historical and conceptual issues around Long-Term Care. The most transferable analogy is the overview of the Elephant, the Blind Men and LTC. With the coming collapse of public programs nearer and nearer, the obvious need to get out the message of planning needs, personal responsibility and accountability take on an immediate sense of urgency." (Comment from the Tacoma, Washington, Graduate Seminar, February 23, 2005)

 "Wonderful course-best Iíve ever attended re long-term care and benefits. . . . GOOD - TERRIFIC! Material and presentation in a useful and motivating manner. . . . Amazing amount of historical as well as current information presented in detail. . . . Outstanding course and perspective on the topic." (Comments from four of the attendees at the Pasadena, California, LTC Graduate Seminar, January 6, 2005)

"This course brought a level of expertise in the LTC funding arena that surpassed any training Iíve had over the last 15 years."  (Comment from the Boston, Massachusetts LTC Graduate Seminar, November 11, 2004)

"With 15 years of experience exclusively working in the ltci industry this course and material ranks as one of the true highlights. Steveís 'inside' information needs to get 'outside' to those in govít, ltc, industry, media, to expose the problem and possible solutions. A 'must' for the serious professional."  (Comment from the Boston, Massachusetts LTC Graduate Seminar, November 11, 2004) 

"The session was powerful and a rare opportunity to gain insights from a major participant with first hand knowledge of the evolving LTC challenge facing our country. After 15 years of benefiting from Steve's written information, it was an honor and extremely helpful to hear in person a summary of the past, present and future scenarios so clearly articulated."  (Comment from the Costa Mesa, California LTC Graduate Seminar, October 13, 2004)

"There needs to be more seminars such as this. Being aware of the serious issues confronting nursing homes and government assistance."  (Comment from the Sacramento, California LTC Graduate Seminar, October 8, 2004)

"I recommend this course for all LTC insurance professionals." "The best 12 hours yet !!! and I've done these things for decades." "Vast amount of relevant material presented." (Comments from the Birmingham, Alabama LTC Graduate Seminar, February 18-19, 2004)

"Stephen Moses was an excellent presenter, knowledgeable, very experienced in the field, innovative, practical, and he tried to be very helpful to attendees."  (Comment from the Milwaukee, Wisconsin LTC Graduate Seminar, June 2, 2003)

"The course is extremely educative . . ..  I've never received so much information in a single seminar!"  "This is an advanced course . . ..  [I]t provides (1) important historical perspective [and] (2) reality-based concepts that will be invaluable in selling the product."  (Comments from the Green Bay, Wisconsin LTC Graduate Seminar, March 25, 2003)

"I was one of the privileged attendees at a meeting on February 21, 2003 at the Seattle General Office with Stephen Moses. His presentation was interesting and generated a great deal of thought. In 24 years of being in the NYLIC [New York Life Insurance Company] family I cannot remember a more worthwhile time spent. I would encourage, highly recommend, everything short of making this information mandatory for anyone who has any interest working in the LTC market." (Bellevue, Washington LTC Graduate Seminar, February 21, 2003)

"I thoroughly enjoyed the experience of Grad School. While I have prided myself on 'being in the know' after 34 years in the LTCi business, it was both a shock and a welcome wake-up call to view the macro implications of past and current trends. Sometimes we do get so caught up in our own silos that we forget the forces that will indeed affect our future and transcend our little fiefdoms. Thanks for an enlightening, entertaining and fruitful pedagogical experience."  (St. Louis, Missouri LTC Graduate Seminar, November 20, 2002)

"Your seminar is one that anyone who wants to stay abreast of LTC and what is going on absolutely needs to attend. I always appreciate hearing from the experts and learning and I received both in Portland. . . . My time and expense [traveling from North Dakota to attend] was well worth it."  (Portland, Oregon LTC Graduate Seminar, August 28, 2002)  

"Just a brief note to let you know that the Portland, OR seminar was without a doubt the best money I have spent in my 28 years as an agent. The material was well organized, relevant to the long-term care problem and very helpful to me as an agent."  (Portland, Oregon LTC Graduate Seminar, August 28, 2002)

"Thank you for a great seminar. I really enjoyed an entirely different perspective on what is happening in the way of LTC health issues and demographics. It was refreshing to get information beyond what carriers typically present, and look at why consumers really don't make the commitment to a LTC policy."  (Seattle LTC Graduate Seminar, August 26, 2002) 

"Your presentation yesterday was excellent!  I have read your 'LTC Bullets' for years but I knew that I would REALLY understand the problems with Medicaid, Medicaid planning and how all that relates to the sale of LTCI if I attended your one-day school.  I feel that much more empowered in talking to prospects or for training other agents. Keep preaching your message!  Anyone who is truly serious about selling LTCI needs to hear it."  (Philadelphia LTC Graduate Seminar, May 14, 2002)

"Thank you for an insightful and thought provoking day . . ..  The ideas presented and the different perspective will certainly assist me in my role here in helping agents sell more long term care insurance.  This is the kind of information that more people involved in the sale of long term care insurance should have."  (Philadelphia LTC Graduate Seminar, May 14, 2002)

"Although I have attended many workshops on the topic of long-term care, your superb presentation offered a unique and enlightening perspective.  Stepping beyond the facts that the public, as well as professionals in the field have been fed, you addressed the hidden reasons behind the challenges we face as long-term care specialists.  With this newfound understanding, I hope to better assist clients in making truly informed decisions about their financial future, and the quality of their years ahead."  (Philadelphia LTC Graduate Seminar, May 14, 2002)

"Just wanted you to know that the Graduate Seminar was everything we hoped for....a day to "invest in ourselves", to get away from the trees and 'see the forest' and to co-mingle with like-minded LTC professionals. . . . Based on the information you shared, we are more committed than ever in the LTC insurance side of our business to focus on quality of care (as opposed to asset protection) and especially to find more ways of using the powerful stories of our clients who are successfully using benefits from their LTC insurance."  (Pittsburgh LTC Graduate Seminar, May 13, 2002) 

"WOW! what a great meeting.  I really appreciate your insight.  I think many times, those of us that are focused on selling LTCI need to take a step back and see the big picture.  You helped me do that and motivated me even more to 'tell the LTC story' as we say."  (Pittsburgh LTC Graduate Seminar, May 13, 2002)  

"I thought the seminar was excellent.  Thank you very much.  I could not have gotten that information anywhere else.   Understanding the history of the issue is key."  (Baltimore LTC Graduate Seminar, April 22, 2002)

"This was wonderful because it broadens perspective and helps us to educate consumers more fully.  Scare tactics won't push most people into being responsible by buying LTCI or personally funding care.  But--reason--well articulated--may appeal to each individual's higher purpose and help them to choose accountability.  Many thanks for your energies and education on this most important subject."

"Very much enjoyed course, content and delivery. Helpful to look at this level and intellectual perceptions of the problems.  Looking forward to follow up on your web site and would like to be on your mailing list. I like your style!"

"My attendance at your seminar contributed immeasurably to my understanding of what LTCI has done in the past, now, and will do in the future."  

"I found it especially interesting and helpful to gain an historical perspective on what got us to where we are today."

"I can't tell you how much I enjoyed the seminar Monday with Steve in Chicago.  His knowledge of this subject is unsurpassed . . .. You've increased my ability to champion the LTCI cause and sell the product."

"I enjoyed the graduate seminar very much. What it gave me was a sense of the real importance in the relationship between the care delivery system sector and the [insurance] sector. I saw tremendous potential from a marketing standpoint and a strategic positioning initiative for my company."   

"I have a pretty good understanding of product knowledge but your seminar gave me a much broader understanding of LTC. . . . You have also given me good ideas about how to train our reps in the future and change how we are presenting LTCI. I would recommend your seminar to anyone who is passionate about marketing LTCI to their clients and wants to get a better understanding of the big picture."

"The format was very good and the information received contained materials, ideas and implemented thought on a wide variety of issues affecting long term care, seniors and their families (and the government both state and federal) that I NEVER would have received from another source (or even from many sources)."

2212 Queen Anne Avenue North, #110, Seattle, Washington 98109 ~ Phone (206) 283-7036 ~ Fax (206) 283-6536

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