AARP Long-Term Services and Supports Principles

These principles reflect AARP’s vision for reforming the financing and delivery of long-term services and supports (LTSS) to promote consumer independence, choice, dignity, autonomy, and privacy. They support efforts to ensure that the financing system is fiscally sustainable and affordable for individuals and the government. 

Pursue private- and public-sector financing solutions for LTSS—individuals, government, and employers can all play a role in providing a more secure system to finance LTSS. Financing LTSS should include a public social insurance program, supplemented by private expenditures and Medicaid for those with the greatest needs. LTSS financing should be equitable and broad-based to ensure that LTSS is affordable for all. 

Prioritize person- and family-centered care—LTSS should be tailored to meet the unique needs of the individuals receiving care and, when appropriate and necessary, their families. Both consumers and families need easy access to unbiased information. It should be culturally and linguistically appropriate. Individuals should also receive assistance in navigating and coordinating services and other supports. 

Ensure consumer choice—consumers have the right to determine and direct the LTSS they receive. That should include how and where LTSS is delivered and who provides them. Services should be comprehensive, in accord with individuals’ values and preferences, and provided in the least restrictive setting possible. 

Guarantee timely access to comprehensive LTSS—eligibility for LTSS benefits through a public program or private long-term care insurance should be determined in a timely manner. Eligibility should be based on a person's functional limitations, regardless of their cause. 

Ensure high-quality delivery in all settings—quality assurance must be guaranteed across all LTSS settings. Measures should be employed to assess consumer and family experiences accurately. Laws protecting consumers’ health and safety must be vigorously enforced. Service coordination with health and social services must be effective. Providers should be reimbursed adequately. 

Protect LTSS consumers’ rights—consumers should receive timely information concerning services. Information about how their functional needs will be assessed in determining eligibility for LTSS should be clear and understandable. They should have the right to appeal LTSS coverage decisions and express grievances without fear of reprisal. Further, they should have access to advocates and be afforded the right to seek legal redress through the courts. LTSS consumers have a right to private accommodations, communications, and visits. 

Ensure safety in emergencies—LTSS consumers are among the most vulnerable members of society. This is true whether they live in the community or in a facility. It must be a state and national priority to ensure the resources necessary to protect LTSS consumers’ safety. ’The delivery of services and supports must be maintained regardless of the source of payment. Emergencies should not be an excuse to limit the rights and self-determination of LTSS consumers. 

Advance equity in LTSS—All older adults, including those who have been discriminated against, should have equitable access to high-quality long-term services and supports in the setting of their choice.