Minnesota needs a sustained commitment to reform older adult services and creating more care and living choices, according to James Ingersoll, administrator of St. Mark's Lutheran Home in Austin.

Ingersoll said the 2003 session of the Minnesota Legislature was one of the most difficult in our state's history for policymakers, as well as older adults.

"We appreciate everything the legislature did to protect resident of nursing homes in the face of a huge budget shortfall," Ingersoll said. "In particular, House Republicans kept Minnesota's 45,000 nursing home residents at the top of their agenda and refused to allow the rates paid by the state for long-term care to be cut."

That's a victory. However, there were defeats.

"Still, it is important for all Minnesotans to know that the state will pay nursing homes the same rates for the next two years that they are currently paid," he said. "Every nursing home will be forced to do more with substantially less."

The nursing home industry can't afford to be ignored, according to the administrator.

"With the huge increases that are coming in Minnesota's older adult population, the rising cost of providing care, and the growing demand for services to keep older adults living independently in their local communities, Minnesota needs a new approach to older adult services," Ingersoll added.

And who better to offer a solution than nursing homes themselves?

St. Mark's Lutheran Home is a member of the Minnesota Health

Housing Alliance, one of the state's two largest associations of long-term care services providers. The association, in partnership with Care Provider of Minnesota has created the "Long Term Care Imperative," according to Ingersoll.

The Imperative has been promoting reform that would create more care and living choices for older adults, including community-based services, assisted living and nursing home care.

"The Legislature in 2001 started Minnesota on the path to innovative reforms that promote independent living, greater personal responsibility for the cost of care, and more choices in care and living arrangements," said Ingersoll. "Unfortunately budget shortfalls in the last two years have put a hold on these reforms."

That worries Ingersoll.

"Without reform, Minnesota will see more and more nursing facilities and other adult service providers faced with difficult financial choices," he warned. "Many communities already are under-served by long-term care facilities and older adult service providers," he said.

That is a sure indicator of a worsening situation ahead, according to the administrator.

"Waiting lists will grow, more older adults will be forced to leave their life-long communities, and there will be fewer choices for an aging population that is growing larger," he said.

But there's more to consider.

"The solutions won't get any easier as the older adult population grows," said Ingersoll. "If Minnesota is committed to quality care, then it must be committed to reform."

Ingersoll said the first reform is an obvious choice.

One such reform is the need to remove senior services from the grip of the government finding with its uncertainty for senior citizens, according to Ingersoll and pointing again to the 2003 legislature's decision to leave nursing home reimbursement rates untouched.

That must end.

"We must be committed to making long-term care affordable through public/private partnerships which provide insurance-type protection to seniors so that they are not at the mercy of government sponsored welfare programs," said Ingersoll.

"Our association, the Minnesota Health and Housing Alliance, is focused on this compelling need, and we here at St. Mark's are also working on this critical reform."

Lee Bonorden can be contacted at 434-2232 or by e-mail at lee.bonorden@austindailyherald.com