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Public retirement systems should establish a maximum vesting period of five years for DB plans and one year for employers’ matching contributions to defined contribution or hybrid plans. 

Minimum distribution requirements for retirement savings should periodically be examined to reflect changes in life expectancy and income needs at older ages while ensuring the collection of deferr

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. 

Defined contribution plan account holders should have to obtain written spousal consent to take payment from the account in a form other than a joint-and-survivor annuity.

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.

The federal government should assume a much stronger role in ensuring the quality of services paid for by Medicaid in residential care settings. 

Federal agencies should monitor the progress of state efforts in developing common definitions of, and minimum standards for, services and facilities in assisted living residences and other residen