States should coordinate LTSS programs, policies, and budgets. This can be done in one state agency or across multiple agencies.
All federal and state agencies with a key role in financing or delivering LTSS should coordinate their efforts.
States should consolidate or coordinate agencies responsible for LTSS, including Medicaid, state-funded programs, Older Americans Act programs, and the state agency on aging.
The operations and functions of each organization in an Aging and Disability Resource Center (ADRC) model vary greatly. States should streamline eligibility determinations for LTSS programs.
A centralized state LTSS agency or coordinated agencies should:
Conflict-free care management should be an essential part of any LTSS system.
States should ensure all LTSS programs use a person- and family-centered service planning process that reflects individuals' preferences and goals.
People should be eligible for LTSS on the basis of functional needs.
States should develop a comprehensive uniform assessment instrument to determine individual needs and develop a service plan. It should be used in all state LTSS programs.
Federal and state governments should develop comprehensive, coordinated approaches to financing and delivering care to individuals whose needs are currently met through multiple service systems.