To address increased demand, the US needs a comprehensive national policy for long-term services and supports (LTSS). Without it, programs will operate in isolation and fail to best serve the millions of people with health care and LTSS needs. For too long LTSS have lacked a holistic focus to help people overcome the full range of obstacles to living in the least restrictive setting possible and maximize their potential for self-determination. A comprehensive, person- and family-centered LTSS policy would serve the needs of care recipients, would support family and friends in their caregiving role, and would create efficiencies in public spending. A system that starts with the needs of the individual would address personal care, nutrition, housing (including home modification), mobility, and medical needs. The end result: fewer people in institutions, more people in their homes and communities.