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States should require adequate numbers of appropriately trained staff to ensure a high quality of care.
Quality measures: Participant preferences and satisfaction should be used as key quality measures.
States should create a transparent and nonpartisan redistricting process. This process should be led by independent and diverse commissions that include representatives of groups.
Federal and state governments should ensure that long-term services and supports (LTSS) programs cover services that support and supplement caregiving by relatives, friends, and neighbors.
Federal and state governments should provide tax credits, other financial assistance, or both to caregivers.
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 basic level of LTSS.
Ideally, the federal government should finance LTSS through a universal, comprehensive, and publicly administered program such as Medicare or similar social insurance program of shared risk.