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Five Commissioners, Including the Center for Medicare Advocacy's Judith Stein, Present Alternate Recommendations

September 19, 2013

The federal Commission on Long-Term Care was created by the American Taxpayer Relief Act of 2012 (the so-called "Fiscal Cliff" bill).[1]  The Commission comprised 15 appointees, including Center for Medicare Advocacy Founder and Executive Director Judith Stein.  The Commission was tasked with developing "a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports for individuals in need of such services and supports …"[2]

The Commission first met on June 27, 2013,[3] and, following a deliberative, but truncated process, held a statutorily required final vote regarding a package of recommendations on September 12, 2013.  The Commission voted 9-6 to put forward a report "as the broad agreement of the Commission."[4] The Commission publicly released its full report on September 18, 2013.[5]                

Five of the six Commissioners who voted against the report issued alternate recommendations to address the challenges facing our country's long term services and supports (LTSS) system.  The five commissioners are: Judith Stein, Founder & Executive Director, Center for Medicare Advocacy, Inc.; Henry Claypool; Laphonza Butler, President, SEIU-ULTCW; Lynnae Ruttledge; and Judy Feder, Urban Institute Fellow and Professor, Georgetown Public Policy Institute.[6]

While recognizing the effort of the entire Commission and its staff during an unusually compressed three-month timeframe, along with the broad range of views among the Commissioners, these five Commissioners concluded that the recommendations of the Commission in its final report do not fulfill its comprehensive charge.

Shortly after the final Commission vote, the five Commissioners issued a statement "to express our shared vision of what is necessary to meet Congress's mandate to establish and finance a high-quality, comprehensive LTSS system for Americans who need such services. The [five Commissioners’] vision is to create such an inclusive LTSS system for people of all ages – a system that will meet individuals' functional and cognitive support needs with quality care in the most integrated setting. "We are convinced that no real improvements to the current insufficient, disjointed array of LTSS and financing can be expected without committing significant resources, instituting federal requirements, and developing social insurance financing."[7] Center Executive Director Judith Stein added, "The people I represent are crying out for a real LTSS system now."

The alternate recommendations offered by the five Commissioners are summarized here.  A more detailed report addressing these recommendations will be issued shortly, and will be available by Monday, September 23, 2013 on the Center's website

[1] American Taxpayer Relief Act of 2012, Pub. Law 112-240, Section 643; the text of the bill is available at:          
[2] American Taxpayer Relief Act of 2012, §643(b)(1). 
[3] See, e.g., Center for Medicare Advocacy’s Weekly Alert “Federal Commission on Long Term Care Holds First Meeting” (July 3, 2013), available at:
[4] Commission on Long Term Care media advisory “Federal Commission on Long Term Care Announces Vote on Recommendations for Inclusion in the Final Report” (September 13, 2013), available at:
[5] See Commission on Long Term Care website at:; pre-publication version of report available at:  
[6] Center for Medicare Advocacy press release, “Alternative Recommendations from Long Term Care Commission Members, Including the Center’s Judith Stein” (September 17, 2013), available at:
[7]Center for Medicare Advocacy press release, “Alternative Recommendations from Long Term Care Commission Members, Including the Center’s Judith Stein” (September 17, 2013), available at:




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