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Commission on LTC tackles tough issues but can't agree on financial support system

September 13, 2013
by Pamela Tabar, Editor-in-Chief
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After months of discussion, the federal Commission on Long-Term Care has voted on set of recommendations for improving the pressing issue of long-term services and supports (LTSS). More than 12 million people rely on LTSS to assist with activities of daily living or to maintain independence, but little structure exists to mitigate the burden on families amid the limited resources, high costs and extensive time investments that long-term care requires.

The commission’s approach to LTSS included adding options for those who prefer to live at home, aligning goals toward person-centered care delivery, and improving care coordination among acute care, post-acute care and LTSS, noted the commission’s summary of recommendations. 
The commissioners reached bipartisan agreement on some topics, but could not agree on others, including how to restructure the way LTSS are paid for. “The need for extensive and expensive long-term services is a catastrophic risk for people both under and over age 65. Today, neither private insurance nor public programs protects us against that risk," said commission member Judy Feder, professor at the Georgetown Public Policy Institute, in a statement. "Private insurance has demonstrated it can't, by itself, do the job. A public program has to be the bedrock on which we build an effective LTSS financing system.”
Ironically, the commission couldn’t find consensus on the role of its own final report: six of the 15 commission members voted that the final report should not “be put forward as the broad agreement of the Commission” and chose to release an alternate set of recommendations.
The commission was given six months to research the multiple challenges faced by the LTC industry and to vote on an action plan by Sept. 12. Delays in selecting the commission members cut the group’s work session to just 13 weeks. By law, the commission’s final report is due by Sept. 30.
"This is an issue that has been brewing for decades, and this heterogeneous group had less than 100 days to craft solutions,” said Commission Chair Bruce Chernof, in the news announcement. “I am pleased that a majority of the Commission has agreed on a number of thoughtful recommendations that serve as a launching pad for future action by Congress and the Administration. I hope both the bipartisan nature of this report and the suite of ideas garnering broad agreement dispels the myth that our nation's long-term care crisis is just too hard a problem to tackle.”
The commission’s last official meeting was in late August, and all business must be concluded by the end of September. 
Commission members, as of the Sept. 12 vote:
Javaid Anwar: Nevada Physician

Judith Brachman: Jewish Federations of North America, Aging and Family Caregiving Committee

Laphonza Butler: United Long Term Care Workers Union

Bruce Chernof: SCAN Foundation

Henry Claypool: American Association of People with Disabilities

Judith Feder: Georgetown Public Policy Institute
Stephen Guillard: Belmont Nursing Center Corp.

Chris Jacobs: Heritage Foundation
Neil Pruitt, Jr.: UHS-Pruitt Corporation

Carol Raphael: American Association of Retired Persons (AARP) Board of Directors and former CEO and President of Visiting Nurse Service of New York
Lynnae Ruttledge: Co-Vice Chair of the National Council on Disability
Judith Stein: Center for Medicare Advocacy

Grace-Marie Turner: Galen Institute 
George Vradenburg: the Vradenberg Foundation 
Mark Warshawsky: Former Treasury Department Official in the Bush Administration