The federal Commission on Long-Term Care on Friday issued more than two dozen recommendations meant to bolster services for older Americans and people with disabilities, but stopped short of endorsing a new public or private program to help families pay for home health care, custodial care, assisted living or nursing home services.
"We're disappointed," said James Firman, president of the National Council on Aging. "They kind of ducked the most important issue."
The commission was established by Congress last January after the demise of the Class Act, a voluntary long-term care insurance program originally part of the Affordable Care Act. It was given limited resources, an ambitious agenda and a very tight timetable: the first meeting was held in June, three months before the deadline for issuing a report.
Many experts judged it a "semi-serious, halfhearted effort on behalf of the Congress," Mr. Firman said.
Yet how to pay for the rising costs of long-term care is a pressing problem. Public programs and families spent $317 billion on long-term care services — nursing homes, home health aides and so forth — in 2011, according to the Congressional Research Service. AARP estimates the yearly value of unpaid care provided by 42 million caregivers at $450 billion.
More than 12 million Americans rely on long-term care services, and the number is expected to expand sharply as baby boomers age. Only impoverished older Americans and people with disabilities receive funding for long-term care through state Medicaid programs. Medicare does not ordinarily pay for long-term care.
The commission was tasked with developing recommendations for addressing this need. The report announced on Friday was passed by the commission by a 9-to-6 vote.
Among other measures, it endorsed the delivery of more long-term care services in community settings, rather than institutions; integrating long-term care more closely with medical care; improving standards for home-care workers; and creating a standardized assessment of the need for services. But the members could not agree on a way to finance expanded long-term care coverage.
In a letter to President Obama and Congressional leaders released Friday, six commissioners emphasized their conviction that "the commission's recommendations should not increase the existing budgetary commitment to health care faced by both state and federal governments."
Separately, five commissioners issued a statement strongly supporting a more robust publicly financed long-term care program.
Judy Feder, a professor of public policy at Georgetown University and a commission member, was among those who voted against the recommendations because they did not go far enough.
"The major challenge for dealing with long-term care is that we've got no insurance mechanism to protect families," she said. "In the short time frame we had, the commission wasn't able to address this, and consequently we missed the ballgame."
Dr. Bruce Chernof, the commission's chairman and president of the SCAN Foundation in California, a research group focusing on the elderly, saw reason for optimism. The group's recommendations, he said, "represent a broad range of important ideas and solutions that could make a difference in the lives of vulnerable Americans today and tomorrow."
A version of this article appears in print on 09/14/2013, on page A13 of the NewYork edition with the headline: Report Issued on Long-Term Care.
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