NCD #05–505
December 15, 2005
Contact: Mark S. Quigley
202-272-2004
202-272-2074 TTY
mquigley@ncd.gov

National Council on Disability Says Changes Needed Now to Address Long-Term Services and Supports for People with Disabilities and People Who are Elderly

WASHINGTON—The National Council on Disability (NCD) today released The State of 21st Century Long-Term Services and Supports: Financing and Systems Reform for Americans with Disabilities (http://www.ncd.gov/newsroom/publications/2005/longterm_services.doc), calling on the Administration and Congress to create reforms that would immediately address long-term services and supports (LTSS) issues for people with disabilities and people who are elderly.

NCD broadly defines LTSS to reflect people’s essential needs for maintaining a quality of life with maximum dignity and independence, including housing, transportation, nutrition, technology, personal assistance, and other social supports.

NCD undertook research for this report because it has grown increasingly concerned about the (a) lack of a coherent national LTSS public policy for all people with disabilities; (b) fragmented nature of service and support delivery systems, with uneven access and services provisions; and (c) LTSS costs of 22 percent or more of state budgets, which are fast becoming unsustainable. Additionally, NCD noted in undertaking research for this report that no single federal program, federal agency, or congressional committee is charged with the responsibility for the management, funding, and oversight of LTSS; however, 23 federal agencies are actively involved in LTSS using the NCD definition.

According to NCD chairperson Lex Frieden, “NCD’s groundbreaking report includes recommendations for incremental reform and clean slate reform.”

“NCD believes that America needs a coherent and comprehensive framework for its LTSS policies, programs, and funding based on five interrelated assumptions. First, that people who are elderly and people with disabilities both desire and deserve choices when seeking assistance with daily living that maintains their self-determination and maximum dignity and independence. Second, the current financing mechanisms (public and private) will become unsustainable in the near future without significant reform. The system must be affordable to all Americans regardless of income levels and must consider opportunities to leverage public and private support in new ways without impoverishing beneficiaries. Third, there is an opportunity with the changing demographic picture of the United States to explore the possibilities of a universal approach to the design and financing of supports that is responsive to individuals under the age of 65, as well as Americans over 65 who may or may not have disabilities, without sacrificing individual choice and flexibility. Fourth, formal and informal caregiving must be sustained, including examination of family needs and workforce recruitment and retention challenges. Fifth, the approach to quality must examine consumer direction and control of resources in addition to traditional external quality assurance mechanisms,” Frieden concluded.

For more information, contact Mark Quigley at 202-272-2004 or 202-272-2074 TTY.

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Note: NCD is an independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families.