Community Living: Report to Congress on Long Term Services & Supports

Over 12 million Americans receive long-term services and supports (LTSS) to meet their daily needs in a variety of settings, provided by family and/or paid workers. In late September, the bi-partisan Commission on Long Term Care issued its Report to Congress.

The Commission’s Report issued a “call to action,” declaring that:

• New approaches are needed to bring LTSS care integration, technology, and innovative workforce strategies together to reduce costs and improve outcomes.
• Creative financing efforts are needed to affordably insure the risk of needing LTSS and encourage higher levels of savings.
• A more accessible and sustainable Medicaid is needed to assure its continued role in guaranteeing the availability of LTSS.

The LTC Commission was formed by the “fiscal cliff” law in January 2013, and asked for a report within 6 months to "...develop a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports for individuals in need of such services and supports, including elderly individuals, individuals with substantial cognitive or functional limitations, other individuals who require assistance to perform activities of daily living, and individuals desiring to plan for future long-term care needs."

The LTC Commission’s report presented important findings and recommendations from a series of hearings conducted and written comments collected and analyzed over the summer. They recommended the creation of a national advisory committee, and the convening of a 2015 White House Conference on Aging in coordination with the National Council on Disability to focus on LTSS. The Commissioners, however, could not agree on which financial approach to recommend: private options for financial protection, or social insurance.

A week later, an alternative report was issued by five dissenting members of the Commission, recommending the social insurance financing approach, among other recommendations that they considered to reflect a more comprehensive view.

It is clear from both reports that there is a great and growing need for improving LTSS, for supporting service workers and family caregivers, and finding a way to pay for these services.