The following principles reflect AARP’s vision for reforming the finance and delivery of long-term services and supports (LTSS) to promote consumer independence, choice, dignity, autonomy, and privacy, and to ensure that the financing system is fiscally sustainable and affordable to both individuals and the government.
Strategies for financing LTSS must include both private and public sector solutions—individuals, government, and employers can all play a role in providing a more secure system of financing 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 in the design and delivery of LTSS—services and supports 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, assistance in navigating and coordinating services, and other supports.
Ensure consumer choice—consumers have the right to determine and direct the LTSS they receive, including how and where LTSS will be delivered, and who will provide them. Services should be comprehensive, in accord with individuals’ values and preferences, and be provided in the least restrictive setting possible.
Ensure timely access to comprehensive LTSS—eligibility for LTSS benefits under a public program or through private long-term care insurance should be determined in a timely manner, and be based on a person’s functional limitations, irrespective of their cause.
Ensure the delivery of high-quality LTSS in all settings—quality assurance can be achieved through the following activities: the use of measures that capture consumer and family experiences; vigorous enforcement of laws protecting consumers’ health and safety; the provision of effective service coordination with health and social services; and adequate provider reimbursement.
Protect LTSS consumers’ rights—consumers should have the right to appeal LTSS coverage decisions; to receive timely information concerning services, to meet with advocates, to express grievances without fear of reprisal, to seek legal redress through the courts, and to have private accommodations, communications, and visits.