Toward a model long-term services and supports system: State policy elements. The Gerontologist

In response to a new Federal initiative to improve the U.S. long-term services and supports (LTSS) system, this commentary discusses an array of policies and prac-tices that could potentially improve LTSS provision by shifting from institutional to community-based services, increasing equity across populations, offering consum-ers more choice and control, improving conditions for workers and caregivers, and promoting improved con-sumer-level outcomes. Policy areas include access to publicly funded LTSS, support for consumer direction, workforce development, caregiver support, transition from institutions to the community, diversion from insti-tutional placement, and quality and outcome measure-ment. Policy considerations apply both to programs and to the managed care organizations that ar