Honoring an Iowa Treasure

Chet Culver’s Plan for Iowa’s Seniors

Iowa’s seniors enrich our communities through their volunteer efforts, family ties and deep reservoir of Iowa’s culture and tradition. They coach, teach, mentor and contribute time, resources and energy, continuing to make Iowa a great place to live. Seniors also make up an ever-growing portion of the population, and with that trend comes challenges. Chet Culver has a plan to show Iowa’s seniors the honor and respect they deserve so that every Iowan can look forward to retirement with dignity. Chet Culver will take on the challenges we face in health care and long-term care, among others, focusing on quality of life. Iowa’s seniors truly are a treasure. Chet Culver will make sure Iowa’s seniors are never forgotten.

Better Health Insurance Options

Iowa has the 5th highest percentage of citizens aged 65 and older, and the 2nd highest percentage of citizens aged 85 and older, in the United States. Culver will work toward an Iowa in which our seniors live healthy, active lives for as long as possible, and do not have to worry about the burden of excessive health care costs, freeing them to spend more of their time enjoying their retirement, friends, and family.

Iowans who retire before the age of 65 may find themselves temporarily uninsured, because employers may not offer health benefits for retirees, they are not yet eligible for Medicare, and insurance on the individual market is unaffordable. However, health insurance coverage is especially critical during the early retirement years. Many chronic diseases, such as high blood pressure and heart disease, may begin to make their appearance around retirement age, and health experts recommend that many people obtain important health checkups, such as cancer screenings, during this time of life. As Governor, Culver will also open his Insure Iowa health plan to retired Iowans ages 55-64. Employers who currently offer retirement benefits will have the option of purchasing Insure Iowa coverage for their employees, but in order to ensure that they do not "dump" their retirement health coverage onto the State of Iowa, they will be required to offer the plan to all their retirees in this age group and pay the full State share of the premium.

Prescription Drug Assistance for Seniors

Rising prescription drug costs go hand-in-hand with the rise in overall health care costs. Total retail sales for drug prescriptions in Iowa totaled more than $1.96 billion in 2004. Iowa's seniors are especially vulnerable to this increase in costs, and the new Medicare prescription drug law is confusing and difficult to navigate. Furthermore, while many states have already acted in response to the new Medicare law to determine how their state laws can best help seniors, Iowa has not yet passed any laws to coordinate with the Medicare drug law. As Governor, Culver will help the Medicare law work for Iowans and take other steps to reduce the escalating prices of prescription drugs for Iowa seniors. He will initiate these programs and others to reach those goals.

• 24-Hour Hotline to Assist Iowa Seniors With Questions About Medicare Part D Program: Culver will launch a hotline available 24 hours a day for use by seniors who have difficulty understanding the provisions of the federal Medicare Part D prescription drug benefit. The program has resulted in confusion about which plans are best for which seniors. It has further complicated an already intimidating health care administrative process for many seniors.
  
  
• Senior Prescription Drug Information Program: Culver will start a public-private effort, including funds from Iowa's insurance companies and pharmacies, to help seniors get access to the information they need to choose the best drug plan for them. As part of this effort, he will look for ways to streamline information sources, provide training to volunteers and professionals who assist seniors, and improve Internet access for seniors through our schools, libraries, and other public places.
  
  
• Medicare Part D Supplemental Coverage Plan: This plan would provide supplemental or “gap” coverage to Medicare recipients, particularly low-income recipients and those with the highest drug costs, to help with co-pays and deductibles. The new federal Medicare program does not provide the kind of comprehensive coverage Iowa’s seniors need. We need to make sure that none of our seniors fall through the cracks of the program, and Culver has set aside $15 million in the budget for this assistance.
  
  
• Evidence-based drug purchasing: Iowa’s health care dollars should pay for prescription drugs that have been proven the most effective – which may often differ from the latest, most expensive version of a particular drug. Therefore, Culver will ask Iowa’s Quality Purchasing Initiative (see below) to review information from projects such as the Drug Effectiveness Review Project, a multi-state effort to review the evidence on the safety and effectiveness of various classes of prescription drugs, and incorporate this information into decisions about which drugs to purchase through all State programs, including Medicare prescription drug assistance programs, Medicaid, Hawk-I, and the Insure Iowa initiative. As opportunities arise, Culver will also make sure that Iowa participates in these types of multi-state quality improvement efforts, so that Iowa can be sure to incorporate the best evidence into its health care purchasing decisions. In this way, we can reduce trial-and-error prescribing and cut down on our state’s prescription drug costs.
  
  
• Enforcing ethical drug marketing practices: Drug companies spent $22 billion on direct marketing to doctors in 2003 - that's about $25,000 per physician per year. Research has shown that this direct marketing, which includes gifts and meals given to doctors, makes doctors more likely to prescribe the expensive medications the drug companies are selling. In some cases, these expensive new drugs are prescribed instead of cheaper drugs that have been shown to be equally effective, and even safer, for patients. We cannot hope to control drug prices in Iowa if doctors prescribe expensive medications based on sales pitches from drug companies, rather than drugs that are proven to be cheaper and as effective. Therefore, as Governor, Culver will require drug companies that sell their products in Iowa to disclose the nature, value, and purpose of gifts to doctors worth over $25. Companies that refuse will be fined, and the funds will be used to provide lower-cost drugs to Iowa seniors.

Iowa Senior Wellness Initiative

To help increase the proportion of Iowa seniors living healthy, active lifestyles, Culver will launch an Iowa Senior Wellness Initiative, a major public health initiative aimed at providing seniors and their families with the information and resources they need to stay healthy and prevent cancer and other chronic diseases. Culver will ask Iowa's Department of Elder Affairs to convene a group of relevant organizations, such as Iowa's AARP, senior centers, and health care providers, to design a program that will have a major impact on improving senior health in Iowa. For example, the program could include an 800 number and website, and be staffed by a mix of trained professionals and senior "Healthy Peer" volunteers who will provide wellness advice and direct seniors to resources they need to stay healthy. Other components of the initiative could include:

• Assistance with transportation to medical appointments.
  
  
• A secure, password-only website where seniors and their families can create a one-stop personalized wellness and medical plan including wellness goals, medical appointments, reminders, and medical bill tracking.
  
  
• Public health campaigns for seniors, including smoking cessation, weight loss, blood pressure screens, and flu shots.
  
  
• Funding for more senior centers to obtain automated external defibrillators to help save seniors' lives.

Iowa Pre-Medicare Initiative

If Iowans are going to live longer, healthier, and more active lives, they must engage in healthy habits starting as early as possible. Therefore, the Iowa Senior Wellness Initiative will include a component for Iowans aged 50-64, called the Iowa Pre-Medicare Initiative. Culver will work with key players - including employers, insurance companies, health care providers, the Department of Public Health, and community organizations - to make strategic changes focused on reducing the number of Iowans who enter Medicare with chronic diseases. Because this initiative should ultimately save the Medicare program money, he will also work with Federal partners and ask for Federal funding to help us launch this initiative. The Iowa pre-Medicare initiative will make strategic changes at all levels to help future senior populations in Iowa be as healthy and active as possible. For example, we will:

• Work with employers to create wellness programs for recent retirees;
  
  
• Get employers, insurers, and health care providers to talk to each other and implement standards for quality health care in this population;
  
  
• Create a clearinghouse to help Iowa communities apply for active living grant funding to plan communities around the needs of the senior citizens of today and tomorrow;
  
  
• Prioritize Iowa public health efforts to focus on those most likely to prevent the top causes of illness, disability, and death in Iowa.

Iowa Governor's Physical Activity Challenge

As part of the Iowa Senior Wellness Initiative, Culver will launch the Iowa Governor's Challenge, a physical activity program based on the President's Physical Fitness Challenge, in collaboration with the Department of Elder Affairs, Department of Public Health, senior centers, faith-based organizations, and organizations such as the AARP. We will build on the successful experiences of the Iowa Games and the Senior Olympics to promote physical fitness and wellness among Iowans of all ages.

Although all Iowans will be welcome to participate, Culver will focus this challenge on Iowans 50 and older. We need to get more Iowans moving to help prevent problems such as diabetes, heart disease, and cancer, and the Iowa Governor's Challenge will help make that happen.

Long-Term Care Solutions

Iowans value their independence, and as Governor, Chet Culver will take steps to help more Iowans be independent as they age. Therefore, Culver will take steps to help Iowa seniors live at home for as long as possible. For example, working with lenders and senior agencies to help seniors obtain low-cost home improvement loans to retrofit their homes with features that make it easier to live in their own homes if mobility declines. Culver also work to give Iowans better access to home-based long-term care services and reward employers who provide extra leave time to their employees to care for aging parents. Culver will make sure Iowans have the information they need to understand their options for long-term care and help them prepare for the possibility that they will need long-term care.

Chet Culver will work with care providers to grow efforts to give Iowa seniors greater freedom to access long-term care services on their terms. Culver also will fight to protect the rights of nursing home residents and to ensure maintain high quality nursing home care in Iowa.

• Personal Needs Allowance - We need to increase the personal needs allowance for long-term care residents in Iowa from $30-$50 per month so that they can meet costs of clothing and other items. We should create a Title XIX waiver to make that a reality. The number has not been adjusted in almost 20 years, not even to reflect inflation.
  
  
• Long-Term Care Insurance - Chet Culver will establish standardized plans for long-term care insurance offered in Iowa. There is much confusion among seniors about coverages available and premium prices. We can offer seniors clarity on this purchasing decision.
  
  
• Home and Community Based Waiver Services - We need parity in reimbursements for these services which allow seniors to stay in their home and in their community, which most seniors prefer to do. Without parity, more seniors could be forced into institutional care at a higher cost.
  
  
• Funding For Resident Advocates - Every licensed long-term care facility in Iowa is required to have a Resident Advocate Committee (RAC). There are more than 800 committees operating throughout the . The RAC meets regularly to share information gained during visits to the care center. Issues are then communicated with the facility staff to correct problems or implement suggestions for improvement. The Long-Term Care Ombudsman or Department of Inspections and Appeals if they are not resolved.

Elder Abuse Prevention

Chet Culver will focus on one of the most important initiatives in Iowa run by the Iowa Department of Elder Affairs. It provides education and develops programs and policies aimed at preventing elder abuse. Elder abuse appears in many different forms, including physical abuse, emotional abuse, financial exploitation, neglect, or abandonment. Culver will make certain state law enforcement and state department officials have the tools and training they need to investigate and prosecute all forms of elder abuse wherever they occur in Iowa.

Senior Safety Initiatives

Telephone service is essential for older Iowans to stay connected to the community, particularly in the case of health emergencies. As Governor, Culver will help ensure senior's access to emergency telephone service wherever they are by proposing a partnership with telephone companies to produce a low-cost, low-usage "emergency" cell phone service for seniors. For a low rate (e.g., less than $10/month), seniors who do not have cell phones could purchase a simple phone pre-programmed with emergency phone numbers in their areas, to which they could add several emergency contact numbers of their own. The phones could be made available at low or no cost through a statewide cell phone recycling effort, in partnership with organizations that already collect and reprogram phones for those in need, such as domestic violence victims.