On September 18, 2013, the Federal Commission on Long-Term Care submitted its final report to the President and the Congress as required by the American Taxpayer Relief Act of 2012 (P.L.112-240), signed into law on January 2, 2013.
The Statute directed the Commission to: “… develop a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high quality system that ensures availability of long-term services and support [LTSS] for individuals in need of such services and supports, including elderly individuals, individuals with substantial cognitive or functional limitations, others who require assistance in performing activities of daily living, and individuals desiring to plan for future long term care needs.”
The Commission’s work was completed in less than three months. It recognized that 62 percent of LTSS are paid by the Federal and State government at a cost of over a $130 billion a year. These costs will increase as the need grows for the oncoming retirement of the baby boomers.
The Commission’s 28 recommendations include promoting services for persons with functional limitations in the least restrictive setting appropriate to their needs; building a system, including Medicaid, with options for people who would prefer to live in the community; establish a single point of contact for LTSS; create a simple and more usable standard assessment mechanism across care settings (acute, post-acute, and LTSS); advocate for new models of public payment that pay for post-acute and long-term services and supports on the basis of the service rather than the setting.
An alternative report written by Commission members who felt the majority report fell short offers more recommendations, including a public social insurance program that could provide comprehensive or limited benefits; assurance that direct-care workers are paid a living wage, are well trained, and have opportunities for career advancement; public programs providing LTSS must appropriately engage family caregivers; current Medicare programs must reduce outdated and unreasonable barriers to outpatient therapies, home health and skilled nursing facility care; Medicaid must rebalance its LTSS financial incentives to states, and establish tax-preferred savings accounts for people and their families who are not currently receiving LTSS through Medicaid.
The report can be found at this link. The alternative report is at this link.
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