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Making Home-Based Long-Term Care Services More Accessible

Many older adults can't afford long-term care at home


Few of us dream of spending our later years in a nursing home. Yet millions of older adults do — simply because they can’t get or pay for the care they need at home.

The National Council on Aging is leading a national, collaborative effort between the aging and disability organizations to make it easier for individuals to get help with daily living — right in their own homes and communities.

What Are LTSS?

Long-term services and supports, or LTSS, help older adults and people with disabilities accomplish everyday tasks that many of us take for granted. Tasks like bathing, getting dressed, fixing meals and managing a home.

As our population ages, the number of individuals needing this kind of help is projected to double. Long-term services and supports allow millions of individuals to live healthy, secure and independent.

Protecting LTSS for People in Need

The National Council on Aging leads a national coalition of aging and disability organizations, called the Friday Morning Collaborative, which is working to protect LTSS for those who need it.

The collaborative helped ensure that the Affordable Care Act includes provisions to expand LTSS through Medicaid and other programs. Now, we’re working to make sure that these provisions are put in place in states nationwide.

LTSS in Health Reform

The Affordable Care Act includes several provisions that will make it easier for people to access LTSS. Learn more about these programs:

  • Money Follows the Person. 
MFP gives states an enhanced federal Medicaid match to help people transition from a nursing home or other institution back into the community.
  • Balance Incentive Payments Program
. Eligible states can apply for federal grants to direct more money to community-based care instead of institutions.
  • Community First Choice Option. 
States can choose to provide a broad range of personal attendant services and supports to eligible individuals and receive additional federal money.
  • Medicaid HCBS State Plan Option
. States have gained greater flexibility with this Medicaid state plan option thanks to health reform.
  • Community Living Assistance Services and Supports. 
CLASS is a new voluntary, federally administered, consumer-financed, long-term care insurance program established under the Affordable Care Act.
  • Duals Integration
. The ACA established a new Medicare-Medicaid Coordination office that has issued guidance and awarded design contracts to 15 states to improve integration of care for individuals who are eligible for both Medicare and Medicaid.

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