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Two federal programs help states provide a broad range of social services important to older adults.

Nearly one in four older adults lives in a rural area. Rural residents are at risk of becoming isolated without adequate transportation opportunities.

All people, regardless of their ability level, should have access to convenient and safe transportation options. Mobility is an essential component of quality of life.

Food and nutrition programs should have adequate funding to engage in robust outreach efforts. 

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. 

States should require that all beds in a nursing facility be certified for Medicaid and Medicare as a condition for the facility’s participation in Medicaid. 

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.