Progress report for ENE25-192
Project Information
Project Focus: Pennsylvania Farm Link is a 501c3 non-profit organization dedicated to ensuring farms successfully move forward to the next generation of farmers. PA Farm Link has brought topics such as Medicaid and the five year look back to the forefront educating ag professionals and farmers of the risk and potential impact to the security and sustainability of the family farm.
Farmers often lack savings to pay for long term care needs and when care is required, savings is quickly depleted as 2024 Pennsylvania median annual long-term care costs for at home care is $71,878, assisted living $68,598 and private nursing home room $142,861. (Genworth Financial, Inc.)
Proper planning is required to minimize the impact of long-term care costs on farm assets and farmland.
Once a person’s funds are spent down Medicaid will pay for care, however, a lien will be placed on assets the person owns to recover the care costs. This includes assets gifted or sold at discounted value within five years of requiring care.
Ag professionals and farmers require increased understanding and education of Medicaid in order to minimize the risk to the family farm assets.
Solution and Approach: Educating ag professionals and farmers on the topic is top priority, understanding how Medicaid works is the first step. However, more needs done.
Growing the Understanding of the Effects of Medicaid and Five Year Look Back on Family Farm Assets will empower ag professionals and farmers to estimate the potential financial impact to the family farm. An online calculator will be developed allowing ag professionals to assist farmers in determining the potential financial impact to farm assets. The calculator will also provide an option to determine likely care costs for the family member. This is the first tool of its kind to be developed for the agriculture community and can be adapted for use beyond Pennsylvania.
Small group training activities will ensure ag professionals are confident using the calculator while working with farmers. Ag professionals will work with farmers during succession planning workshops to demonstrate the value of the electronic calculator in determining the potential the risk to the farm.
The second largest farmer request and need will be addressed with a booklet developed providing steps to obtaining long term care. It will answer the questions: What steps to take when you know someone is declining? How are you going to pay for it? How to you prepare for that? What if someone requires care due to a sudden disability such as stroke or accident?
The booklet will provide answers and walk farm families through the process, lessening stress as they have a guide to follow when care is required.
60 ag professionals will utilize Medicaid knowledge and calculator to determine possible farm financial impact and educate farmers about the potential effect of Medicaid on farm assets.
100 farmers will take steps to minimize risk of Medicaid to the farm as a result.
32 farmers will seek to calculate potential financial impact of Medicaid to their farm.
Educational approach
As reported by the Administration of Community Living, a person turning 65 has a 69% of requiring some type of long-term care services as they age. In August 2024, The Henry J Kaiser Family Foundation reported 5 out of 8 (62.5%) nursing home residents’ expenses were paid for by Medicaid. Therefore, it is critical ag professionals understand Medicaid and related asset planning to ensure farms are not encumbered by Medicaid liens.
Two workshops, one in-person and one online will be held for 40 ag professionals in Pennsylvania. Participants will be recruited from previous participant lists, the PA Ag Professionals group, IFTN Certified Succession Coordinators, and PA Farm Link Board. Expert ag and long-term care attorney and nurse case manager will share strategies that preserve farm assets while allowing Medicaid eligibility.
Two tools will be created for ag professionals and farmers.
An electronic calculator will be developed to evaluate care costs vs available funds. This will provide a macro breakdown of information showing general categories. Guiding ag professionals through various asset categories inputs. The tool will also help to understand legal ownership of assets and five year look back.
Ag professionals will assist farmers following prompts to enter dollar figures for savings and assets which must be reported when completing a Medicaid application. Automatic calculations will provide the cash and liquid assets available to pay for care and assets that may have a lien put on them if care is paid for by Medicaid.
The calculator will also provide a link to Genworth Financial, Inc. to calculate potential cost of care and comparison of the two totals will give insight regarding need to plan for the expenses.
A guide to obtaining care will be developed by medical and ag professionals and answer questions received from farmers and ag professionals concerning steps to take when care is required, paying for care and handling a sudden disability. Farm families will face decisions with more clarity and less stress as the booklet walks them through the correct steps to get a family member care they require.
Two ag professional workshops will be held, one in person, one virtual. The program will begin with service providers sharing the impact of long-term care to farmers they advise. The professionals will be guided through electronic calculator use sharing tool benefits and establishing a foundation of knowledge and confidence in the professionals.
Service providers will work in small groups using the electronic calculator to solve case study scenarios. Groups will then present their results. Questions will be answered by project educators throughout the process. Once mastered ag professionals will utilize the tool to inform land stewards and advise them on long-term care’s potential financial impact to the farm.
Project educators will review the obtaining care guide with ag professionals helping them understand the best practices families should follow when someone requires long term care. The booklet will answer questions service providers receive about getting help for a loved one.
Two succession workshops for farmers will include review of the guide. Discussion will start with farmers sharing personal experiences obtaining care for family members. Followed by an overview of questions answered by the booklet and example of how it could have helped in those situations. Participants will receive a copy of the guide to obtaining long term care.
Ag professional led round table breakouts will introduce the online calculator to farmers and provide hands on experience utilizing the tool. Easy scenarios will demonstrate care costs estimates vs cash/assets to pay for the care. and offer to assist farmers with the calculation. Small groups will report back to the large group discussing results and how farmers may use that for planning purposes. Knowledge farmers gain will provide an understanding of the potential financial impact for the family farm and tools to develop plans.
Farmers planning to minimize the impact of long-term care on the farm will ensure farm and family sustainability and quality of life.
Event registrations will collect knowledge and experience of the subject matter. Follow up surveys will ask ag professionals the number of farmers they’ve assisted and related farm demographics for reporting purposes. Farmer follow up will ask steps they have taken in relation to Medicaid planning.
Breakout materials and resource booklet will be available for other states to adapt the program to their needs. The virtual meeting recording, electronic calculator and obtaining care guide will be available 24/7 online for use when time allows.
Milestones
- Engagement: September 30, 2025, June 30, 2026, 200 ag professionals will receive project announcement via newsletter, email, social media (determined by open rate) to PA ag professional group, IFTN Certified Succession Coordinators, and Board Members, in-person sharing at trade shows (count). Tracked by PA Farm Link staff. Status: in progress
- Engagement: October 15, 2025, July 15, 2026, 75 ag professionals will complete survey on their current expertise during registration as a baseline measurement. Project team will share information with team and program presenters. Status: Not Begun. The first ag professional training is scheduled for June 2026.
- Learning: October 30, 2025, July 30, 2026, 68 ag professionals will advance their knowledge and understanding of the potential financial impact of Medicaid to the farm and farm assets. They will learn how to use the online calculator to estimate probable impact to farms. Ag professionals will learn steps to take when someone requires long term care and receive the obtaining care resource to share with farmers. Status: In Progress
Accomplishments: Online Calculator and Obtaining Care Resources 01/14/26 update: The project plan requires that the two tools, online calculator and Obtaining Care Booklet, are created prior to the educational activities. Development is in progress therefore educational activities have not started yet.- Online Calculator: The online calculator is a complex resource that's being developed and the Medicaid/Medical expert is working with the IT professionals who are developing the online program pages including content for the pages and working on the required functions on each page as well as between pages. Several meetings have taken place with medical/Medicaid background professional project team and the IT professional team as the online calculator is being created. Aligning it with Medicaid application rules and farm family needs is complex. Progress is being made, and the team is confident it will be extremely beneficial to farm families. Families will be able to print required asset information pages to utilize them in their actual Medicaid application.
- Obtaining Care Resource In Progress: Project team members are working on the Obtaining Care booklet. Due to personal experiences, it has been deemed important to include an area on the soft skills that are helpful to communication between family members as well as the care options being considered/required. Project team members are working together, gathering information from other pertinent sources and are developing the Obtaining Care Resource.
- Evaluation: October 30, 2025, July 30, 2026, 68 ag professionals will complete the evaluation at the end of the educational programs to determine understanding and knowledge gained. Project staff will tally results. Project and advisory team members will review any reported learning challenges and provide follow up. Future training need requests will also be collected and evaluated by advisory team members. Status: Not Begun
- Evaluation: January 30, 2027 50 ag professionals will verify using their knowledge of Medicaid and the five year look back to educate farmers. They will report the number of farmers they've worked with on those that took steps to minimize Medicaid risk. Status: Not Begun
- Engagement: February 15, 2026, January 30, 2027, 70 farmers will complete survey on their current knowledge level during registration as a baseline measurement. Project team will share information with ag professional presenters. Status: Not Begun
- Learning: February 28, 2026, January 30, 2027, 55 farmers will advance their knowledge of the potential financial impact of Medicaid to the farm and farm assets and methods to protect them. Ag professionals will teach farmers how to use the online calculator to estimate potential risk to their farm assets. Ag professionals will provide learning support to farmers throughout the program. Status: Not Begun
- Evaluation: February 28, 2026, January 30, 2027, 50 farmers will complete an evaluation at the end of the educational programs to determine understanding and knowledge gained. Project staff will tally results. Ag professionals and project team members will review any reported learning challenges and offer follow up. Future training need requests will also be collected and evaluated by ag professionals and project staff. Status: Not Begun
- Evaluation: September 30, 2026, July 30, 2027, 35 farmers will report seeking to estimate the possible financial impact of Medicaid to their farm and farm assets during a follow up survey. PA Farm Link staff will tally the survey results and report to the ag professional and project team members for review. Status: Not Begun
Performance Target Outcomes
Performance Target Outcomes - Service Providers
Target #1
60
Utilize Medicaid knowledge and calculator to determine possible farm financial impact and educate farmers about the potential effect of Medicaid on farm assets.
100
Performance Target Outcomes - Farmers
Target #1
100
Take steps to minimize risk of Medicaid to the farm.
Target #2
32
Seek to calculate potential financial impact of Medicaid to their farm