Older Americans place a great premium on independent living, and we support their priority of independence whenever possible. AARP supports the creation of a comprehensive long-term services and supports system that provides coordinated, integrated, affordable and high quality services and supports. AARP promotes the values of independence, choice, dignity and privacy, whether in a home or institution.
Long-term services and supports should be easy to access, affordable and sensitive to cultural needs. Unfortunately, individuals and their caregivers face a confusing patchwork of programs that can make such help hard to find and pay for. High cost, limited financing options, and insufficient public funding are serious barriers. AARP supports a comprehensive approach that provides access to a full array of high quality long term services in the setting a consumer prefers and which is often less costly. In such a system, counselors would help families choose the supports that make sense for them. More help would be available for family caregivers, such as respite services to help relatives and friends avoid burn-out. Stable and adequate funding would help many more people get the services they need to stay independent and live more rewarding lives.
Individuals with chronic illness often navigate a maze of specialists and support services with little guidance. This disjointed system drives up costs, puts stress on families—and even jeopardizes health—through waste, duplication, gaps in care, and lack of patient-centeredness. AARP supports improvements that would place new emphasis on coordination, communication and guidance between the health and long term services and supports systems.
Shouldering the Cost
People should not have to go broke to get the supports they need. New sources of funding, both public and private, would ensure that people have access to necessary supports and services. The CLASS program, created under the Affordable Care Act, is an important, voluntary new option to help people cover these expenses.
Ideally, a universal program of social insurance financed by the public, like Medicare and Social
Security, could cover the long-term supports and services that will help our population age as independently as possible. By spreading the cost across the entire population, we could achieve universal protection—at a price households can afford. Private insurance could fill any gaps in the public benefit. All private insurance for long-term services and supports must be subject to strong consumer protections.
Care in Your Own Home
States can do much more to help people with chronic conditions remain in their homes. One key is to revamp state Medicaid policies that favor institutionalization over in-home services. Supports for independent living not only reflect the preference of most families, but save money over time, which makes this priority even more sensible for states with budget woes. Medicaid’s pro-institution bias is outdated and unresponsive to the needs of most beneficiaries. At the same time, independent living is not the right answer for everyone. Funding should support care in the most appropriate setting— home, community or institutional. Individual preferences should be respected whenever possible.
The bulk of long term services and supports in this country is provided by unpaid family and friends. Caregivers need support in providing this essential care, including training, respite and information and referrals to learn about the range of services available to their loved one and themselves.
Protecting the Frail
Our most vulnerable elders need protection. AARP urges more effective oversight of longterm services in all settings. We ask regulators to strengthen quality and safety protections—including prohibitions on criminals working in long-term care settings—and to hold providers accountable for any abuse. Standards should affirm the importance of safety, dignity and privacy. Standards should safeguard people’s freedom to assert all their rights without fear of reprisal, including the right to keep their personal possessions, their access to personal medical records, and their right to make complaints.
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