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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 a public social insurance benefit that provides coverage for LTSS. It should be within Medicare or in a new public program.
Until a comprehensive national LTSS program is implemented, the following 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.