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Thursday, April 11, 2013

The New Commission on Long-Term Care Has an Opportunity to Improve the Lives of the Elderly and People with Disabilities

Megan Salzman

Staff Writer

Last month, President Obama appointed the final members of the Commission on Long-Term Care. The purpose of this commission is to improve consumer choice and access to home- and community-based services (HCBS) for those who need long-term services and supports.

While nursing homes provide quality care for many people, low-income older adults and people with disabilities should have a choice about where and how they receive care. Unfortunately, Medicaid, the nation’s largest payer of long-term care services, continues to give preference to institutional care and nursing homes over home- and community-based care. With the creation of this new commission, we now have an important opportunity to change the way long-term care in Medicaid is paid for and delivered, which could improve the lives of millions of people who depend on these services.

The National Senior Citizen’s Law Center recently released an issue brief on this topic that gives the new commission seven recommendations:

  1. Every Medicaid program should be required to cover home- and community-based services. 
  2. The ability to receive financial assistance should be the same for institutional and home- and community-based services.
  3. Spouses of people receiving Medicaid assistance for long-term care should be allowed to keep the same level of assets, regardless of whether the spouse needing care is living in a nursing home or in the community.
  4. Medicaid’s financial eligibility requirements must allow people to keep enough money to pay for food and housing to allow them to take advantage of home- and community-based services. Therefore, Medicaid’s financial eligibility requirements should be adjusted to reflect the added costs of living in the community.
  5. The Centers for Medicare and Medicaid Services (CMS) should adequately fund activities to develop and enforce quality standards for home- and community-based services.
  6. Congress should prioritize home- and community-based services in the next reauthorization of the Older Americans Act (OAA).
  7. Adequate and sustainable funding should be secured to develop and support Aging and Disability Resource Centers, which provide care coordination for those who need long-term services and supports.

These recommendations are critical steps toward improving choice and access for people who need long-term services and supports. It is vital that these services be offered in a way that does not limit people’s independence, choice, or connection with their community.