New reports (here and here) on the changing landscape of long term services and supports (LTSS) for older adults continue to drive home the need for a national strategy to finance and develop a functional and affordable LTSS network. Their publication provides an interesting backdrop to the initial meetings of the new Commission on Long-Term Care. The 15-member commission remains one of the best kept secrets on the Hill (and in the nation), and not surprisingly the constant drumbeat of skepticism regarding its ability to deliver any meaningful recommendations continues (here and here).
Let's face it, although one-third of those over the age of 65 (and two-thirds of those over 85) report functional limitations of one kind or another, Americans do not have much interest in facing the likelihood that they will need LTSS and are content to leave the cost of care to the state and federal governments. Moreover, although the need to plan, fund and implement a LTSS network capable of coping with the aging baby boom generation is great, but there is little appetite in Congress to consider any new "big" initiatives. With an indifferent public, and a dyspeptic Congress, the commission is left with considering how to promote innovations and greater efficiencies within the confines of the existing LTSS ecosystem.
Bruce Chernof, the commission's chairman and chief executive of the SCAN Foundation, along with the other board members convened its initial meeting in late June, and most recently met on Wednesday, July 17. The expert testimony continues to cover many of the often sited challenges that are well known by all in the LTSS field: exploding demographics of older adults, the complexity of quality service delivery and the affordability of services. The list goes on...and on...and on.
Facing a statutory deadline to have its business complete by September 30, 2013, the Commission is expected to issue a draft report in mid-September. It is said by some, that the commission will work by consensus, leading one to believe although its final report will offer few specific recommendations, it may elucidate general outlines of policy initiatives that future policy makers can consider.
In May, while attending a conference on LTSS, one expert opined that the window to initiate the development and funding of a LTSS network capable of meeting the needs of baby boomers, will close in five to seven years. If true, I wonder whether we have the will to move forward in a meaningful way. What do you think?
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