The National Academy of Elder Law Attorneys (NAELA) has issued a White Paper to identify the key components to the long-term care system, to analyze the problems that exist within its current structure, and to present recommendations of policy solutions for American citizens and government to consider. NAELA believes that "to insure access to quality and cost efficient long-term health care for all Americans, . . . there must be a comprehensive reform of our long-term health care system."

"Reforming the Delivery, Accessibility and Financing of Long Term Care in the United States" advocates a reform proposal with four main elements.

NAELA proposes that "Care should be coordinated by geriatric care managers trained to make an assessment of the individual’s condition, to develop a written plan of care, to implement and coordinate the care plan, to monitor services, to make appropriate reassessments, and to discharge the individual when services are no longer required."

The proposal points out that "Currently, the primary source of private financing of long-term care is the income and savings of the elderly and disabled and their families." NAELA suggest that long-term care insurance can play an increasingly important role, but certain concerns must first be addressed.

The authors propose that a new benefit known as Medicare Part D provide a pool of money (i.e., $200,000 in the year 2000 and indexed for inflation) "to be used as needed at any level along the continuum of care. After a $10,000 deductible is reached, Medicare Part D would pay 80% of the cost of care. "After the pool of money is exhausted, the beneficiary would pay privately or through private insurance."

The authors propose a number of recommendations relating to administration of the current Medicaid program and of the proposed Medicare Part D.

You can view the document on line at www.naela.org/pdffiles/whitepaperfinal.pdf.