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 to both individuals and the government.
Pursue private- and public-sector solutions financing of 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 be 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 accurately assess consumer and family experiences. Laws protecting consumers' health and safety must be vigorously enforced. Service coordination with health and social services must be effective, and providers reimbursed adequately.
Protect LTSS consumers' rights—consumers should receive timely information concerning services as well as clear and understandable information about how their functional needs will be assessed in the process to determine eligibility for LTSS. 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 both in the community and in facilities are among the most vulnerable members of society. In the event of an economic or public health crisis, it must be a state and national priority to ensure that LTSS consumers and providers, regardless of the source of payment, have the resources necessary to protect LTSS consumers' safety and maintain the delivery of needed services and supports. Emergencies should not be used to limit the rights and self-determination of LTSS consumers.