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Policymakers should not expand work requirements for SNAP recipients.

States should make it as simple as possible for grandparents and other caregiver relatives to enroll children in their care in school or obtain medical treatment for them. 

States should distribute public revenue only to social service agencies that are formally accountable to taxpayers. This should be demonstrated by performance-based measures. 

Congress should mandate the use of the Supplemental Poverty Meas

Public-benefit programs should ensure that families headed by grandparents and other caregiver relatives receive sufficient support for economic security and well-being. 

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 governments should conduct regular, thorough, and consistent oversight. Oversight should include evaluation of consumer outcomes to the extent feasible.