The number of Americans needing long-term care - also called long-term services and supports (LTSS) - is projected to more than double to 27 million by 2050. Approximately 70 percent of people over the age of 65 will rely on some form of LTSS for an average of three years. The latest issue of Public Policy & Aging Report (PP&AR) lays down a policy prescription for a sustainable system of LTSS in the U.S., using the Federal Commission on Long-Term Care's 2013 final report as its foundation.

With support from The SCAN Foundation, the issue presents nine articles under the theme of "The Federal Commission on Long-Term Care: Setting an Agenda and Moving It Forward." Among them are articles by Commission Chair Bruce Chernof, MD and Vice-Chair Mark Warshawsky, PhD, and Staff Director G. Lawrence Atkins, PhD, as well as interviews with two Commissioners, Carol Raphael, MPA, MEd, and Judith Feder, PhD.

"Addressing the financing, delivery and workforce issues around long-term services and supports is the next health policy frontier, and we cannot wait any longer for action," said Chernof, the president and CEO of The SCAN Foundation. "The bipartisan Commission laid out 28 realistic recommendations and a financing framework, providing groundwork for policymakers to build upon."

Highlights from the issue include:

  • Chernof and Warshawsky call for LTSS to be a major element of the next White House Conference on Aging, scheduled for 2015.
  • Atkins addresses the Commission's difficulty in moving beyond a financing framework toward more specific recommendations. He advocates the development of new mechanisms and incentives for individuals and families to meet and prepare for LTSS expenses.
  • Joe Caldwell, PhD, and Howard Bedlin, JD, MPS, agree that financing reform must have bipartisan support, further emphasizing the need for aging and disability communities working together.
  • Barbara Gage, PhD, MPA, highlights the benefit of integrated care, where traditional providers partner with others to achieve new quality mandates.
  • Charissa Raynor, RN, MHSA, addresses workforce development, showcases five training efforts: training at scale, setting minimum training and certification standards, leveraging emerging learning technology, supporting immigrants in home care work, and redesigning home care jobs.
  • Loren Coleman, CHNA, and LaRhae G. Knatterud, MAPA, demonstrate the effectiveness of LTSS at the state level, focusing on how Minnesota reduced its reliance on institutional care.
  • Michelle Putman, PhD, and Lex Frieden, MA, LLD, demonstrate the vital role a consumer control approach to LTSS can play in enabling individuals to engage in a full range of life's activities, including lifelong income generation and aging in place.
  • Lynn Friss Feinberg, MSW, addresses the contributions and needs of the 42 million informal LTSS workforce - i.e., family and friends ??" whose efforts are valued at an estimated $450 billion annually.