In­novAge as­sets must help el­derly, dis­abled

The Denver Post - - PERSPECTIVE - By Elis­a­beth Are­nales Elis­a­beth Are­nales is the di­rec­tor of the Colorado Cen­ter on Law and Pol­icy’s Health Pro­gram.

Colorado is a young state that is get­ting old fast. By 2030, Colorado’s pop­u­la­tion of res­i­dents older than 65 will be 125 per­cent larger than it was in 2010, grow­ing from 550,000 to more than 1.2 mil­lion.

With the prospect of an ag­ing Colorado quickly be­com­ing a re­al­ity, vir­tu­ally ev­ery­one would pre­fer to re­main at home and in­de­pen­dent. We hope our fam­ily and friends can do so as well.

Help­ing to ful­fill that hope for the frail el­derly and dis­abled, Pro­grams of All-in­clu­sive Care for the El­derly (PACE) of­fers a range of ser­vices to peo­ple over 55who qual­ify for nurs­ing-home level care but wish to re­main in­de­pen­dent. PACE pro­grams pro­vide en­rollees with doc­tor vis­its, med­i­ca­tions, day pro­grams, be­hav­ioral ser­vices, hos­pi­tal care, and long-term ser­vices and sup­ports. Most PACE par­tic­i­pants are en­rolled in both­Medi­care andMed­i­caid.

Dur­ing the last Colorado leg­isla­tive ses­sion, Den­ver-based In­novAge backed a bill that­would let non­profit PACE providers op­er­ate as for-prof­its— an­tic­i­pat­ing a par­al­lel change in fed­eral law. In­novAge is Colorado’s largest PACE provider and among the largest na­tion­ally. The bill­was ap­proved and made ef­fec­tive ear­lier this year.

Con­cerned about con­ver­sion

In late Oc­to­ber, the non­profit In­novAge filed a plan with the Colorado at­tor­ney gen­eral to con­vert to a for-profit com­pany. Of­fi­cials from In­novAge say con­ver­sion is nec­es­sary for the com­pany’s growth. But In­novAge’s pro­posal has raised con­cerns with ad­vo­cacy groups, in­clud­ing the Colorado Cen­ter on Law and Pol­icy, Colorado Con­sumer Health Ini­tia­tive and Colorado Cross-Dis­abil­ity Coali­tion. Ad­di­tion­ally, sev­eral pub­lic char­i­ties— in­clud­ing the Rose Com­mu­nity Foun­da­tion, The Colorado Trust and the Colorado Health Foun­da­tion— have voiced their con­cerns through writ­ten pub­lic com­ments and tes­ti­mony at a pub­lic hear­ing in De­cem­ber.

Why are th­ese or­ga­ni­za­tions con­cerned? In short, the con­ver­sion af­fects thou­sands of el­derly and dis­abled Coloradans and in­volves hun­dreds of mil­lions in com­mu­nity as­sets. Among the is­sues at stake:

• In­novAge­wants to ded­i­cate pro­ceeds from the con­ver­sion to its own foun­da­tion, with a self-ap­pointed board. An or­ga­ni­za­tion with direct ties to In­novAge­may not be the ap­pro­pri­ate cus­to­dian be­cause there is a risk it could in­ap­pro­pri­ately fa­vor the newly formed for-profit. It is crit­i­cal to in­volve af­fected com­mu­ni­ties re­gard­ing how they­would best be served by the hun­dreds of mil­lions of dol­lars of com­mu­nity as­sets thatwill be re­al­ized by the con­ver­sion.

A new in­de­pen­dent foun­da­tion may bet­ter serve el­derly and dis­abled Coloradans, or an ex­ist­ing foun­da­tion may be able to dis­burse funds more ef­fi­ciently. Colorado has sig­nif­i­cant ex­pe­ri­ence with con­ver­sion foun­da­tions, and we should learn from that ex­pe­ri­ence. For ex­am­ple, pub­lic in­put had a sub­stan­tial pos­i­tive ef­fect on the cre­ation of the Car­ing for Colorado Foun­da­tion, re­al­ized as a re­sult of the con­ver­sion of Blue Cross Blue Shield of Colorado.

Re­view In­novAge as­sets

• An in­de­pen­dent val­u­a­tion ex­pert should re­view the as­sets stated by In­novAge. While In­novAge es­ti­mates the value of its as­sets at $213 mil­lion, the val­u­a­tion might be closer to $400 mil­lion by the time the trans­ac­tion oc­curs be­cause the po­ten­tial mar­ket for PACE ser­vices is grow­ing and Den­ver’s real es­tate mar­ket is boom­ing. Un­der com­mon law, such as­sets be­long to the peo­ple, and should ben­e­fit the pop­u­la­tions that the con­vert­ing non­profit was es­tab­lished to serve.

• If the con­ver­sion is ap­proved, the qual­ity of care should be mon­i­tored. Any change of own­er­ship in an or­ga­ni­za­tion that serves a frag­ile pop­u­la­tion raises con­cerns.

Coloradans should en­cour­age Colorado At­tor­ney Gen­eral Cyn­thia Coff­man to con­sider whether In­novAge’s as­sets are val­ued fairly and al­lo­cated ap­pro­pri­ately and to en­sure that the level of care pro­vided by the new for-profit en­tity is not de­graded. The at­tor­ney gen­eral will ac­cept writ­ten com­ments on the con­ver­sion pro­posal on her web­site un­til Jan. 8.

In­novAge’s sub­stan­tial value— which was built through pub­lic fund­ing and years of tax-ex­empt sta­tus— should be used to ben­e­fit the frail el­derly and dis­abled.

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