Bipartisan Policy Center Releases Report “Bipartisan Solutions to Improve Availability of Long-Term Care”
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5 … SUMMARY AND RECOMMENDATIONS
8 … BACKGROUND
13 … MEDICAID COVER OF THE LTSS
17 … TAX CREDITS FOR CAREGIVERS
20 … IMPROVE THE AVAILABILITY AND AFFORDABILITY OF PRIVATE DEPENDENCY INSURANCE
23 … RECOMMENDATIONS
35 … CONCLUSION
36 … APPENDICES
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For decades, policymakers have sought to improve access to, and funding for, long-term services and supports (LTSS). Today, about half of people aged 65 will need SLT at some point in their lives./1
This need will increase as baby boomers age and require more care.
LTSS refers to a wide range of paid and unpaid medical and non-medical services for people with functional limitations due to age, chronic illness or disability./2
LTSS includes assistance with activities of daily living (ADL), such as eating, bathing, or dressing, and instrumental activities of daily living (IADL), such as managing medication or preparing meals ./3
Those in need of SSLT may include children, adults, or the elderly with physical, cognitive, developmental, mental health issues, or other chronic health conditions ./4
In 2018, 14 million adults in
The challenges associated with providing care to those in need of LTSS include both the cost of care and the shortage of caregivers relative to need. The cost of residential and home care services has increased on average faster than the rate of inflation since 2004./6
Long-term care providers saw their costs increase dramatically from 2019 to 2020, as demand increased and the shortage of caregivers in facilities and in the community worsened. The median of the national annual cost of SSLT in 2020 ranged from
According to the office’s most recent data, these caregivers earn on average
By comparison, social workers and social workers – a similar profession with similar educational requirements – earn a median salary of
In addition to low wages, other factors contribute to direct care labor shortages, including labor recruitment and retention issues, high turnover rates, lack of access social benefits and lack of economic security. / 11
The COVID-19 pandemic has exacerbated these trends after nursing homes experienced high infection and death rates and the demand for home and community care increased.
No single solution will meet the needs of those who need LTSS. Improving access to these services will require a combination of public and private sector options and an investment of federal resources. Since 2014, BPC has been working on the development of bipartite solutions to extend access to LTSS. Our work began with a group of four leaders: Former Senate Majority Leaders
BPC’s work has focused on solutions designed to improve the availability of home and community services, improve a struggling private long-term care insurance market, and provide assistance to caregivers. This report presents policy recommendations, including new proposals to expand the availability of home and community services for low- and middle-income people. It also includes previous recommendations that BPC has developed to improve private sector options for those with more financial resources.
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I. Expanding access to home and community services
A. Congress should make Home and Community Services (HCBS) available to people in need of long-term care (LTC) who are not eligible for Medicaid. Services would be available through fully integrated models of care, including Enhanced and Fully Integrated Plans for Double Eligible Special Needs (FIDE-SNP), Comprehensive Care Programs for the Elderly (PACE), or other approved models. by the secretary of HHS, and would include degressive grants.
II. Address disparities in the delivery of HCBS
A. Congress should direct the secretary of HHS to collect data and publish an annual report on disparities in access to HCBS and make recommendations to Congress to address the inequalities.
III. Create a tax credit for caregivers
A. Congress should establish a refundable caregiver tax credit to help cover the cost of paid care related to SSLT.
IV. Improve the viability of
A. Congress should standardize and simplify private long-term care insurance to achieve an appropriate balance between coverage and affordability, through âlong-term care retirement insurance (LTCI)â. B. Encourage employers to offer an LTCI pension and automatically enroll certain employees (aged 45 and over with minimal retirement savings), with a withdrawal option like many employer-sponsored retirement savings accounts .
V. Establish a
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There is no politically viable solution to meet the country’s LTSS needs. Bipartite policy solutions that improve the LTSS delivery system could help meet the growing demand for these essential services in
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The full report, including footnotes, can be viewed at https://bipartisanpolicy.org/wp-content/uploads/2021/09/BPC_Health_Long_Term_Care_RV4-min.pdf
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