Long-Term Care Commission Issues Recommendations That Avoid Hard Questions

After only 100 days of deliberations, the National Commission on Long-Term Care, a blue-ribbon panel hastily created by Congress after it eliminated a proposed national long-term care insurance program as part of the last round of fiscal cliff negotiations, has released its recommendations for improving long-term care for people with disabilities and seniors. The panel, which approved the report by a 9-6 vote, agreed on a list of uncontroversial ideas that failed to include virtually any comprehensive suggestions for revising the nation's long-term care system and offered little guidance for funding reforms.

The term "long-term care" encompasses a host of services for a variety of consumers, including people with disabilities who require significant levels of assistance. The Commission's recommendations span the range of long-term care services and include many suggestions of interest to people with disabilities and their families.

Communities and Families

The report stresses the need for better access to community-based services, and it calls on Congress to streamline federal laws that make it difficult for states to implement Medicaid waiver programs that allow people with disabilities to obtain care at home. In addition, the Commission recommends that Congress pay for technology that will expand the nation's electronic medical record system and improve tele-medicine services.

Families of people with special needs spend incredible amounts of time caring for their loved ones, and the Commission's recommendations take this into account with a request for increased support for family caregivers. The Commission also suggests including family caregivers as members of the teams that develop plans for caring for people with special needs.

Provider Reform

Direct-care providers for people with disabilities are often under-paid and over-worked, and standards governing the level of training required to work with people with special needs vary depending on where one lives. The Commission's report calls for uniform national standards for caregiver training and asks Congress to fund a criminal background check system to make it harder for people with criminal records to get jobs caring for people with disabilities.

Funding Questions Remain

Prior to the release of the Commission's report, five of the Commission's members issued a separate statement arguing that the Commission's conclusions were cursory and did not recommend a comprehensive system for caring for people with long-term care. In addition, commentators, including Judith Graham who wrote about the Commission's report for the New York Time's New Old Age blog, pointed out that the report failed to tackle the difficult question of how families can afford long-term care if catastrophe strikes.

"We really need to struggle with how were going to pay for these services", said Commission member Henry Claypool, executive vice president of the American Association of People with Disabilities, at the panels final meeting. "We can't keep taking a pass on this issue."

The Commission did suggest several alleged cost-saving measures, including a call to make it harder for middle-class people to qualify for Medicaid and a recommendation that Congress provide tax incentives for people who purchase long-term care insurance or who pay for their care using retirement funds. The Commission also proposed the creation of a pilot program that would expand Medicaid access for people with disabilities who are working, although it offered no suggestion of how such a program would be paid for.

To read the Commission's full report, click here.