Long-Term Care Commissioner: Major Changes Could be One Year Away

Recommended changes to help improve long-term services and supports for seniors and people living with disabilities could arrive within the next year, said a member of the Commission on Long-Term in a webinar Tuesday.

George Vradenburg, chairman of USAgainstAlzheimer’s, a national advocacy group committed to stopping Alzheimer’s disease by 2020, is optimistic that many of the Commission’s recommendations from a report submitted to Congress in late September will be implemented come 2014.

“There’s a good prospect that those recommendations that could be implemented without significant budget impacts could be implemented within the next year or so,” Vradenburg said during the webinar hosted by the National Alliance for Caregiving.

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Recommendations included in the report stressed the necessity of an alternative financing solution, as well as the importance of family caregiving to ensure elderly and people living with disabilities receive the LTSS they need.

Funding certain solutions to improve LTSS is an area of concern, as those recommendations that require significant funding or greater federal oversight will be “held hostage,” Vradenburg said, as deep divisions on entitlement reform continue to be an issue.

On September 30, the Commission submitted a report to Congress outlining several recommendations to improve access to long-term services and supports (LTSS). Less than a week later, another report emerged from five dissenting Commission members who said the initial report did not fulfill the group’s mission to devise a comprehensive solution.

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Working within only a three-month timeframe to devise a set of possible solutions, the 15-member Commission hopes to integrate as many of its recommendations into the current healthcare delivery system as possible, while still maintaining its bipartisan structure.

One of the main issues that divided the Commission, comprised of six Republican appointees and nine Democrat appointees, was how to reinforce and stimulate the long-term care insurance market.

“We really ran out of time in discussing the mix of public and private financing solutions,” Vradenburg said. “There were some members who would only support a private solution, some who would only support a public solution, whereas others were in the middle.”

As the “I don’t think about this” mentality continues to play a role in why many people are ill-prepared when it comes to their long-term care needs, as noted in the Commission’s report, finding a way to help individuals pay for LTSS poses significant challenges, especially as the costs of long-term care are labor intensive and can last a long time, according to the Commission’s report.

Approximately 12 million people across all ages have long-term functional and cognitive limitations, according to the Commission’s report to Congress. Of this group, 2% represents the ages 18-64 population, while 13% of those are age 65 and older.

Despite differences within the Commission, the recommendations should be seen as progress in improving the current delivery of LTSS, regardless of major concerns over funding for the proposed solutions with structural changes in the near future.

“The nation has to adjust a healthcare system that’s been focused on acute care,” Vradenburg said. “Our system is going to have to deal with the chronic care of an aging and disabled population. It’s not just a medical issue, but also a social supports issue.” 

Written by Jason Oliva

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