Long-term care didn't get much attention during the debate leading up to passage of the ACA. However, there was a program created by the ACA to address the growing demand for long-term care services that is expected as the population ages. It was called the Community Living Assistance Services and Supports Act or CLASS Act. The CLASS Act created a voluntary long-term care insurance program, but federal officials determined it could not be implemented in a self-sustaining fashion as was intended. As a result, Congress repealed the CLASS Act and created a Commission on Long-Term Care to "...develop a plan for the establishment, implementation, and financing of a comprehensive,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...." The Commission released its recommendations last week.

While implementation of the ACA is dominating much of the health care policy landscape these days, long-term care will inevitably become a prominent issue in the near future as efforts to keep the aging population out of institutional care settings becomes increasingly necessary to control Medicare and Medicaid spending. Indeed, apart from the issue of government spending, AARP reports 9 out of 10 individuals would prefer to stay in their homes and communities as they age. This creates increased opportunities for occupational therapy professionals in the areas of fall prevention, home modification, driving and community mobility, caregiver training, and others areas of practice. AOTA policy staff will continue to monitor the Commission's activities as they may be developed into proposed legislation.