1. Expand Home and Community-Based Services (HCBS)

Increase Funding for HCBS Waivers: Advocate for increased federal and state funding for HCBS waivers to provide services like personal care, adult day care, and respite care to a broader population.
Broaden Eligibility Criteria: Expand the eligibility criteria for HCBS waivers to include individuals who are just above the Medicaid threshold, ensuring they have access to necessary services.

2. Develop Sliding Scale Programs

Income-Based Fees: Implement sliding scale fee structures for community-based services and long-term care, where individuals pay based on their income levels, making these services more affordable for those with moderate incomes.
Subsidy Programs: Create state or local subsidy programs that provide financial assistance to individuals who are not eligible for Medicaid but still need support for long-term care services.

3. Enhance Long-Term Care Insurance Options

Public-Private Partnerships: Promote the development of public-private partnerships to offer affordable long-term care insurance options that are accessible to middle-income individuals.
Tax Incentives: Provide tax incentives for individuals purchasing long-term care insurance, as well as for employers who offer long-term care insurance as part of their employee benefits package.

4. Strengthen Community Support Services

Community-Based Organizations: Support and fund community-based organizations that provide essential services such as meal delivery, transportation, and in-home care to seniors and those with disabilities.
Volunteer Programs: Develop and expand volunteer programs that provide companionship and non-medical support to those in need, helping to reduce the burden on formal care systems.

5. Advocate for Legislative and Policy Changes

State and Federal Advocacy: Work with legislators to advocate for policies that increase funding and support for long-term care services outside of Medicaid. This includes advocating for higher income and asset limits for assistance programs.
Policy Reform: Push for reforms that allow for more flexible use of funds from existing programs (e.g., Older Americans Act programs) to cover a broader range of services and individuals.

6. Increase Awareness and Education

Public Awareness Campaigns: Conduct public awareness campaigns to inform individuals about available community-based services and financial assistance programs.
Education for Caregivers: Provide education and resources for family caregivers to help them navigate available services and support options.

7. Support Caregiver Programs

Financial Support for Family Caregivers: Establish programs that provide financial stipends or tax credits to family caregivers, recognizing their role and easing their financial burden.
Respite Care Services: Increase the availability of respite care services to give family caregivers a break and prevent burnout.

8. Encourage Innovative Care Models

Co-housing and Shared Living: Promote innovative housing models such as co-housing and shared living arrangements that can reduce costs and provide mutual support among residents.
Technology Solutions: Invest in technology solutions that support aging in place, such as telehealth, remote monitoring, and smart home devices.

Example Legislative Language

To support these initiatives, legislative proposals could include:

HCBS Expansion: “Effective [date], funding for Home and Community-Based Services (HCBS) waivers shall be increased by [specific amount], and eligibility criteria shall be expanded to include individuals with incomes up to [specific percentage] of the federal poverty level.”

Sliding Scale Programs: “The Department of Health and Human Services shall implement sliding scale fee structures for community-based services, ensuring affordability for individuals with incomes between [specific range].”

Long-Term Care Insurance Incentives: “Tax incentives shall be provided to individuals purchasing long-term care insurance, with a tax credit of up to [specific amount] per year, and to employers offering long-term care insurance as part of their benefits package.”

Caregiver Support: “A program shall be established to provide financial stipends and tax credits to family caregivers, along with increased funding for respite care services.”