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When economic conditions permit, states should accumulate budget reserves adequate to maintain services during recessions.

Deficit-reduction efforts should avoid cuts in programs that serve low- and moderate-income populations.

Federal policymakers should develop a comprehensive system for financing Long-Term Services and Supports (LTSS) that includes a new social insurance program to provide a bas

The cost of a new social insurance LTSS program should be paid for with premiums, individual contributions through cost-sharing requirements, and general revenues.

Program participant cost-sharing for either community or institutional services should be modest. It should not favor one type of service over another.

Some tax revenues for a new LTSS program should be earmarked to an LTSS trust fund. This would build adequate reserves to cover later generations.

The federal government should create some type of public social insurance benefit.

Until a comprehensive national LTSS program is implemented, intermediate steps should be taken:

The federal and state government should conduct regular, thorough, and consistent oversight.

Consumers and their family caregivers, as appropriate, should be the focus of all LTSS programs and services.