OCTober 9, 2000

National Notes
NAELA Releases Final Proposal for Long-Term Care Financing Reform

The National Academy of Elder Law Attorneys (NAELA) has released a "White Paper on Reforming the Delivery, Accessibility and Financing of Long-Term Care in the United States©," which proposes developing a new system to offer long-term care through Medicare ("Medicare Part D"). 

The plan would provide a pool of money, $200,000 per person, to be used as needed at any level on a "continuum of care," including skilled nursing care, rehabilitative services, respite care, personal assistance with the activities of daily living, congregate living arrangements, adult day care services, assisted living facilities, home care, nursing home custodial care, and hospice care. This continuum of care would be coordinated by care managers trained to assess each individual’s condition, "to develop a written plan of care, to implement and coordinate a care plan, to monitor services, to make appropriate reassessments, and to discharge an individual" when care is no longer required.

According to the plan, after a patient pays a $10,000 deductible, Medicare Part D would pay for 80% of his or her care until the $200,000 pool is exhausted. At that point, the patient would have to pay privately, pay through private insurance, or apply for other government benefits for the poor (Medicaid).

To qualify, the beneficiary must be sixty-five or older or disabled, and must have paid into the system for ten years (unless the beneficiary is the child or spouse of a wage earner who has paid into the system for 10 years). The plan would be phased in over 20 years.

NAELA proposes paying for this new benefit through an increase in payroll taxes and through Federal Estate and Gift Taxes.

The White Paper is available on the Web by visiting www.naela.org