Minnesota's Multisector Blueprint for Aging

Objective 1: Affordable Housing

1. Fund incentives for developers to work in rural areas, as benefits for developers in Greater Minnesota are not comparable to the metro area.
2. Ease and promote the production of Accessory Dwelling Units (ADUs), such as backyard cottages, above-garage apartments, etc.
3. Reduce zoning barriers to housing options such as ADUs and “Missing Middle Housing”, which includes a range of house-scale buildings with multiple units—compatible in scale and form with detached single-family homes—located in a walkable neighborhood.
4. Support funding for Housing Infrastructure Resources (no base budget, bonding bill or one-time appropriation). These state funds are eligible for certain projects related to affordable housing, including housing specifically for adults ages 55 years and older.

Objective 2: Housing for the Lifespan

1. Explore and invest in relevant housing models and options, such as ADUs, shared housing, intergenerational homesharing, cohousing communities, multigenerational housing, and care provider arrangements, including culturally specific approaches. 
   • Provide incentives and protections for intergenerational living – e.g., college student & older adult = mutually beneficial
   • Establish home-sharing matching services by engaging colleges, schools, resettlement programs, foster care transition programs, domestic violence support programs, and others.
   • Explore bringing services such as Nesterly (a homesharing platform that connects younger and older housemates and facilitates the ability to exchange a portion of rent for help with house/yard work, grocery shopping, etc.) to Minnesota communities.
   • Replicate programs that house college students in assisted living communities for reduced rent in exchange for volunteer hours (e.g., Watkins Manor/Winona State University model and elsewhere in the US).
2. Expand access to home modifications.
   • Pursue legislation to promote loans for rehab/retrofitting to older adults,
   • Increase availability of 0% interest home modification loans for low-income older adults to allow for aging in community (e.g., Rehabilitation Loan Program and Emergency & Accessibility Loan Program).
3. Provide diverse housing options and use universal design.
   1. Expand age-friendly housing choices, such as through support for home rehabilitation and retrofitting, use of universal design principles, and age-restricted housing.
   2. Support or offer incentives for builders incorporating universal design concepts, green space, and walkable community features in their projects as well as cottage design developments available for inter-generational residents (older adults, single parents, young adults).
4. Support and promote programs such as CAPABLE to coordinate services and home improvements.

Objective 1: Accessible and Age-Friendly Transportation Access

1. Boost volunteer driver reimbursement:
   • Increase reimbursement rates for volunteer drivers.
   • Support efforts at the federal level to make changes to legislation, such as the Volunteer Driver Tax Appreciation Act of 2023, that would raise the amount of mileage reimbursement that volunteers can claim exempt from federal taxes. 
2. Expand and promote volunteer driver programs. 

Objective 2: Safe and Active Transportation Options for All Ages

• Maintain and expand Greater Minnesota Transit, aligning with the MN Department of Transportation’s Greater Minnesota Transit Plan.
• Prioritize enhanced pedestrian safety measures in locations frequented by older adults, with a focus on active design choices (such as improved crosswalks) rather than passive choices (such as signage).

Objective 1: Age-Friendly Parks and Public Spaces

1. Built environment and programming:
   • Funding for communities to audit public spaces for age-friendly attributes (lighting, benches with backs, shelters, curb cuts, sidewalks, bike lanes, timely snow/ice removal). Funding to make public spaces welcoming to older adults. Adapt AARP’s Creating Parks and Public Spaces for People of All Ages resource to audit/assess state parks. Prioritize age-friendly improvements.
   • Increase shade and seating options across parks/public spaces. Offer rentals of adaptive equipment such as walking sticks.
   • Adopt universal design strategies at state parks to increase accessibility and inclusivity. Universal design is the design and composition of an environment so that it is usable to the greatest extent possible by all people without the need for adaptation or specialized design.
   • Encourage development of accessible bathrooms at all local and state park facilities.
   • Ensure parks/public spaces are accessible for assistive devices in the winter by partnering with neighborhood groups or task forces, subsidizing snowblowers or snow removal services (income-dependent), and accessibility-focused street markings that prioritize and/or subsidize plow service.
   • Fund training for volunteer companions who visit older adults to make nature accessible to older adults as part of their social visits in partnership with programs such as Lutheran Social Services of Minnesota’s Senior Companion Services, AmeriCorps Seniors, and Friends & Co. (e.g., planting or gardening, taking a drive to a nearby park or along a scenic route, or other activities suitable to the individual’s interests and abilities).
   • Increase/support the number of informal gathering spaces. Support programs like Culturally Responsive Elder Connections led by the Volunteers of America.
2. Offer age-friendly and accessibility training to city, nonprofit, and business staff to ensure public spaces meet community needs (e.g., benches, bathrooms, smooth walking surfaces).
3. Encourage multi-purpose, intergenerational community spaces by offering incentives for organizations such as developers, Chambers of Commerce, churches, parks and recreation entities, city and county health agencies, State Health Insurance Assistance Program (SHIP), and schools to open unused spaces for public use for free or reduced cost to enable public groups to meet up.

Objective 2: Community Connections and Programming

1. Implement a social prescription program that allows healthcare, social work or other professionals to refer individuals to non-clinical community resources—ranging from art classes to chronic disease management programs to financial services.
2. Engage older adults in volunteer opportunities, for individual and community benefit.
3. Promote and expand age-friendly framework and practices:
   • Raise awareness of the age-friendly community model and partnership opportunities (e.g., Project Blue Star) in collaboration with the MN School Boards Association, MN Department of Education, MN Association of School Administrators, and MN Administrators for Special Education. Explore toolkits to implement in K-12 schools to reduce ageism.
   • Support programs that create social engagement across the state, such as further developing senior centers, Let’s Go Fishing, Friends & Co., AARP Friendly Voice, Silverwood SPARKS, Men’s Shed, and congregate dining sites.
   • Partner with and fund faith communities to conduct a scan of local senior programs and activities and develop culturally responsive intergenerational programs that help foster a sense of belonging within the community. Partner with childcare centers, schools, etc.
   • Support programming initiated by age-friendly universities, libraries, historical societies, and museums to foster culturally-responsive intergenerational interaction and community building.
4. Encourage small towns to partner with YMCA, Friends & Co. or similar organizations to create accessible indoor spaces for wellness and socialization - especially during the winter months.

Objective 1: Digital Inclusion and Literacy

1. Expand technology training and education.
   • Provide education about artificial intelligence (AI) and its impact on social spaces and vulnerability.
   • Fund mobile digital learning labs that can operate throughout MN.
   • Fund technology lending libraries and staff to train people on different technologies and devices.
2. Increase access to devices, troubleshooting, and technical support to bridge the digital divide (e.g., Senior Community Services TECH program).
3. Support statewide broadband access—particularly in rural areas. 

Objective 2: Social Engagement through Technology

1. Enhance digital access, collaboration, mentoring, and toolkits.
   • Collaborate with technology companies to create affordable, accessible digital tools for social engagement. Expand access to voice-command digital devices.
   • Support peer-to-peer mentoring programs, where tech-savvy older adults help others navigate technology.
   • Develop a standardized home assessment toolkit for use by visiting nurses, waiver assessors, and service providers. The toolkit will include resources that promote virtual social engagement platforms where older adults can connect with family, friends, and their communities.

Objective 1: Community Education

1. Ensure communication access for all, related to emergency responders, translation, transcription, and people with hearing loss.
2. Emergency planning efforts:
   • Conduct a statewide emergency planning campaign.
   • Getting information to emergency responders (combined several tactics)
     • Create a toolbox/form for families to complete and post at their home that includes information relevant to the independent living status of all people residing in the home. This is particularly of concern to families of people living with dementia.
     • For those living alone in an apartment/home, emergency contact info for law enforcement /Fire/EMTs should be placed by the front door.
     • Develop a standard list of information to assist responders; File of Life is an existing program that could be referenced/utilized.
3. Fund organizations to educate all relevant professionals about Supported Decision Making (SDM), to help them understand the benefits/value of SDM without the need for guardianship, including legislators, special education professionals, judges, lawyers, case managers and supervisors, and health care professionals.

Objective 2: Integrated Emergency Response Systems

1. Ensure communication access for all: related to emergency responders, translation services, transcription services, people with hearing loss, FEMA disability experts, and others.
2. Develop integrated emergency preparedness planning for community members living with disabilities and older adults. Implementation with multi-disciplinary teams through intentional inclusion of government agencies, utilities, police, fire, EMT/paramedic, county attorney, health care, Tribal communities, and local media, plus community partners.
3. Work to expand across Minnesota the model developed by CARE Resource Connection, which reduces emergency calls for lift assistance (after a fall) both in long-term care and in the community by connecting people to the right resources at the right time and through training for fire departments and long-term care community staff.
4. Identify and be prepared to assist individuals who need extra assistance during an emergency.
   • Prepare for the growing number of people who may need greater assistance in emergencies; this should include identifying “solos” (e.g., Vermont CARE—Citizens Assistance Registry for Emergencies).
   • Develop a process for communities to identify where potentially vulnerable residents live (including people with disabilities and some older adults), and create networks, such as peer networks, to check on vulnerable residents.
   • Connect emergency responders to older adults living in their own homes (using programs/tools such as File of Life, lock boxes).
   • Provide funding for neighborhoods to improve connections with neighbors.

Objective 1: Protection from all forms of abuse and exploitation

1. Increase resources and support to county Adult Protective Services (APS) and Tribal nations to build their capacity to identify and support adults who are vulnerable to maltreatment.
2. Expand funding for victim services beyond those addressing intimate partner violence.
3. Involve Community Action Partnerships to deliver community appropriate services, including sustainable adequate funding to the community.
4. Advocate for more federal approaches to ending financial exploitation and strategies for recovering losses. 

Objective 2: Supported Decision-Making (SDM)

1. Explore ways that Supported Decision-Making can be financially viable for all Minnesotans.
   • Fund agencies and individuals to serve as supporters for those unable to afford professional healthcare agents or attorneys-in-fact.
   • Fund organizations to educate all relevant professionals, including legislators, special education professionals, judges, lawyers, case managers, supervisors, and healthcare professionals about the benefits of SDM in addressing the needs and challenges faced by clients/patients/students/consumers.

Objective 3: Long-Term Care Rights

1. Streamline transitions when the level of care changes (such as hospital to home health care). Create a more seamless transition from the first point of entry with a lens of person-centeredness. Keep all health information intact in a virtual database, as information does not follow patients.
2. Ensure resources are in plain language, age-appropriate, and easily accessible. 

Objective 4: Enhanced Access to Justice

1. Increase the availability of mediation and promote its use; provide training to adjacent service providers and education on practice, benefits, and outcomes. Mediation offers an alternative pathway and resource support for dispute resolution that does not involve the standard civil/criminal legal system and can offer remote availability, increasing accessibility for older Minnesotans in rural areas.
2. Expand education campaign regarding emeritus attorneys. Develop elder law and aging-specific continuing legal education materials for pro bono and emeritus attorneys that focus on substantive areas where there is a lack of free or reduced cost legal service attorneys, such as probate, homeownership/mortgage foreclosure, and capacity restoration.
3. Evaluate and update family preservation policies to include large-scale tactics applicable to all Minnesotans. These updates should address the number of children placed within the foster care system or for an adoption when a grandparent is available. (This is related to but different than grandparent rights).

Objective 1: Integrated and Coordinated Care

1. Prioritize caregivers:
   • Redefine care teams to include family and friend caregivers.
   • Educate healthcare staff on the importance of integrating caregivers as key sources of patient information, supporting their role in home-based treatment, and addressing their own health and wellbeing.
2. Fund non-governmental organizations (NGOs) and community organizations to support Care Coordinators in helping older adults and caregivers navigate systems and programs.
3. Implement Presumptive Eligibility (PE) in Minnesota. PE offers people temporary access to health care while application for a public healthcare program is being processed.

Objective 2: Strong Long-Term Services and Supports Systems

1. Support increased reimbursement rates for Elderly Waiver (EW) services to help individuals remain in their homes rather than moving into a licensed care setting, such as assisted living. (Licensed service providers may receive reimbursement from the State for providing EW services; reimbursement rates are periodically adjusted.)
2. Leverage existing resources and strengthen collaboration across DHS, State agencies, partners, and providers to maximize efficiency and effectiveness. MN Department of Human Services (DHS) is engaging in a collaborative effort to identify and leverage existing resources and initiatives within DHS, State agencies, partners and providers, so that they may be utilized more broadly, efficiently and collaboratively. DHS staff are currently identifying and gathering information on existing resources and initiatives.
3. Address costs and reimbursements:
   • Explore the development of a "Catastrophic Lite Benefit" program to reduce the strain of long-duration and intense claims and offset the need for families to spend down assets. This program would provide funds to help pay for long-lasting, long-term care expenses for five years after a two-year elimination period.
   • Increase state Medical Assistance reimbursement rates to align with national averages. (Wisconsin and Iowa reimburse $10.50 per prescription, while Minnesota reimburses $3.50).

Objective 3: Education and Awareness of Benefits, Services, Programs

1. Develop public awareness campaigns to promote available services such as the Senior LinkAge Line, Disability Hub, Minnesota Access to Communication Technology (MN ACT, formerly known as the Telephone Equipment Distribution (TED) program), and home and community-based services (HCBS).
2. Expand culturally-appropriate education materials, particularly regarding dementia, given higher Alzheimer’s rates among communities of color. 

Objective 4: Health Insurance Access and Navigation

1. Establish a one-stop resource to improve healthcare literacy for older adults and caregivers, ensuring they understand health insurance options and benefits. Increase the capacity of health insurance staff to respond to caregivers and patients in overcoming service or prescription barriers.
2. Enhance navigation support for health systems and insurance.

Objective 5: Promising Public Health Practices and Promotions

1. Fund and expand access to prevention programs:
   • Establish sustainable reimbursement to community-based organizations offering proven prevention programs through Medicaid, commercial payers, and Medicare.
   • Secure sustainable funding and efficient payment systems for chronic disease self-management.
   • Expand availability of chronic disease prevention and management programs in high-need communities.
2. Expand statewide falls prevention campaign efforts.

Objective 6: Person-Centered Practices and Individual Choice within Long-Term Care Communities.

1. Ensure access to quality residential care options for all Minnesotans, regardless of pay sources. Assess private charges, provider policies, and procedures that may limit consumer options.
2. Improve access to Elderly Waiver (EW) and Alternative Care (AC) services through ongoing rate evaluations and updates. Educate consumers on available programs that help older people living in their homes and communities, including Essential Community Supports (ECS), AC, EW, and Live Well at Home grants.
3. Ensure the Minnesota Department of Health (MDH) Health Regulation Division (HRD) has sufficient resources to manage an increased number of complaint investigations and enforcement activities effectively.

Objective 1: Increased Awareness and Adoption of Age-friendly Frameworks and Practices

1. Encourage collaboration between community partners and organizations to promote age-friendly practices and outreach programs—such as colleges/universities, senior centers, libraries, museums, community education, intergenerational organizations, and other community-based partners. Prioritize engagement with low-income, rural, communities of color, and other underserved populations.
2. Expand age-friendly frameworks across sectors:
   • Museums: Allocate funding to support age-friendly museum initiatives such as training programs for staff and volunteers focused on age-friendly practices, including communication strategies and accessibility considerations.
   • Libraries: Allocate funding to support age-friendly library initiatives, including grants for accessibility improvements, program development, staff training and outreach efforts.
   • Community Education: Allocate funding to support culturally-responsive community education programs. 3. Support efforts to address ageism and reframe aging.

Objective 2: Equitable Opportunities for Brain Health

1. Create awareness campaigns on cognitive health. Educate the public and healthcare professionals about brain health, risk factors for dementia, Parkinson’s disease, other brain disorders, and the importance of early diagnosis (e.g., Dementia Friends Minnesota). Reduce stigma and promote understanding through targeted messaging.
2. Establish metrics to determine status of the Minnesota Dementia Strategic Plan, developed by the MN Healthy Brain Partnership in 2023.

Objective 3: Equitable Opportunities for Physical and Mental Health and Well-Being

1. Expand holistic health programming with an equity focus--equity in grants, mental health, funding administration:
   • Expand the Mental Health Innovation Grant Program, issuing requests for proposals (RFPs) that focus on the mental health needs of older adults in communities facing inequities.
   • Provide grants/funding to expand community education focused on healthy aging, chronic disease management, and fall prevention.
   • Provide grant funding to faith-based organizations that develop programming for older adults.
   • Expand evidence-based health promotion programs, such as those offered through the Juniper Network, ensuring cultural relevance for Minnesota’s diverse communities.
2. Improve accessibility in community environments:
   • Support the development of accessible built environments (buildings, streets, sidewalks, open spaces, and other infrastructure) to promote safe and active living and community inclusion.
   • Add the Minnesota Department of Natural Resources (DNR) to the Governor’s Council for an Age-Friendly Minnesota to add their voice and expertise related to connecting and including older adults in the state’s parks systems and natural spaces.
   • Ensure that Senior LinkAge Line and MinnesotaHelp.info include comprehensive nature-based resources.
3. Enhance the role of technology in health and wellness.
   • Support/Expand telehealth services to improve access to care, including therapy, for those with mobility and transportation limitations.
   • Educate providers on the use of mobile apps for monitoring physical activity, mindfulness exercises, cognitive training, and symptom tracking.
4. Increase transportation access for older adults.
   • Partner with local organizations to expand transportation options for medical appointments, particularly in rural Minnesota.
   • Support intergenerational programs that foster connections across generations (e.g., The Pillars Child Care in Minneapolis).

Objective 1: Attract and Retain Direct Care Workers

1. Increase pay and benefits for direct care workers to better recognize their contributions and support their ability to provide quality care.
2. Support federal visa programs that allow skilled immigrants who have expertise working with older adults to help address the caregiver gap.

Objective 2: Training and Career Growth Opportunities

1. Promote/expand SCRUBS Camp model, to help students in grades 9-12 learn about careers in health care.

Objective 1: Caregiver Financial and Well-Being Support

1. Waiver programs and Medical Assistance:
   • Create a separate budget for caregiver support services in the Elderly Waiver (EW) and Alternative Care (AC) waiver programs to avoid reductions in the care recipient’s budget.
   • Separate caregiver services from the overall Medical Assistance budget, recognizing that caregiver burnout is the leading factor in care recipients moving to assisted living or skilled nursing community.
2. Strengthen caregiver relationships and social connections to reduce isolation and family strain. Caregivers are often burdened with decisions and lack of support from family and/or friends.
   • Ensure supports are inclusive of solos, LGBTQ+ individuals, and other underrepresented communities.

Objective 2: Caregiver training and education

1. Align caregiving and dementia data collection efforts with MN Department of Health initiatives.
2. Build awareness around the language we use and associate with caregiving, promoting cultural shifts in attitudes and understanding. Elevate the role of family, friend, and neighbor caregivers and improve proactive outreach to care partners.
3. Provide outreach to employers on supporting caregivers in the workplace. AARP will lead efforts to educate consumers about the new Paid Family and Medical Leave program taking effect in January 2026. Highlight caregiver education programs such as Trualta.

Objective 1: Meeting Basic Needs and Beyond

1. Alleviate food insecurity among older adults.
   • Advocate for innovation in meal delivery and Supplemental Nutrition Assistance Program (SNAP).
   • Explore new models to serve those aging in community, such as adding one meal a day to those receiving medications from long-term care pharmacies and developing innovative food access models.
2. Develop affordable, small-scale housing with universal design. Include examination of existing models.
3. Advocate for Social Security reform:
   • Prevent predicted cuts in 2033 to ensure a guaranteed income for all older adults.
   • Address disparities in Social Security benefits for individuals - especially in communities of color - who left the workforce to raise families.
   • Eliminate the tax on Social Security benefits.

Objective 2: Retirement and Financial Preparedness

1. Develop and promote programs that provide incentives for saving and financial education. Educate young people (starting in high school) about the importance of financial preparedness and retirement savings (e.g., MN Dept. of Health PREP Program). Work with MN Department of Education to ensure new required financial literacy classes include savings for retirement and financing long-term care needs.
2. Increase funding for lifelong financial training.

Objective 1: Vital Contributors to the Workforce

1. Expand ageism training for employers by increasing the number of trainings focused on:
   • Discouraging policies that push older workers out of the workforce.
   • Recruiting, hiring, and retention policies that promote age inclusivity.
   • Workplace culture, language, flexibility and scheduling options for older workers.
2. Demonstrate economic contributions of older workers: Produce a quarterly report (MN Department of Employment and Economic Development) that provides data on the number of individuals ages 50 and older in the workforce (full-time, part-time, small business owners) and their economic impact.
3. Combat ageism through community initiatives:
   • Develop community programs that raise awareness of ageism and promote older adults.
   • Develop culturally-relevant ageism outreach initiatives.
   • Promote the Certified Age-Friendly Employer program.
4. Expand employment opportunities for older adults:
   • Support the Veterans Employment Program through CareerForce (operated by Dept. of Employment and Economic Development).
   • Promote the Senior Community Service Employment Program, a community service and work-based job training program for older Americans.
   • Expand eligibility criteria for employment services training under the State’s Dislocated Worker Program (SF 4027), part of DEED.
   • Support AmeriCorps Seniors, a national network of volunteer programs for people 55 years and older, and other programs that offer stipends for service.
   • Support “returnship” programs by promoting RETURNSHIPS: A Toolkit for Employers, prepared by Northland Foundation. 

Objective 2: Valued Volunteerism for All Ages

1. Create a general funding program to financially support and train volunteers.
2. Increase the volunteer mileage reimbursement rate from $0.14 per mile.
3. Strengthen partnerships to support culturally-specific, faith-based, and intergenerational communities.
4. Recruit older adults as volunteers or employees to help address the childcare crisis. 

Objective 3: Essential Caregivers of Our Families

1. Expand the definition of family to allow employees to use Paid Leave Program benefits for a broader range of caregiving relationships.