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AIDS Action Supports the “Community Living Assistance Services and Supports” (CLASS) Act

The “Community Living Assistance Services and Supports” CLASS Act would create a national, voluntary insurance program to facilitate long-term community living services and supports for people who meet state disability criteria, including people living with HIV. AIDS Action supports passage of the CLASS Act either as a stand-alone bill or as part of a health care reform package. The Problem: • Many people living with HIV/AIDS will ultimately be among the more than 10 million Americans who need long-term care. • The Ryan White CARE Act is not intended to provide long-term living assistance services and supports for People Living with HIV/AIDS. • Many people with disabilities may not be eligible for Medicaid or Medicare: o People needing long term care can only access Medicaid if they meet financial limits (e.g. if they are, or become, impoverished). o Medicare only covers short-term care for disability. • Paying for long-term services and supports costs an average of $70,000 for nursing homes for a full year and an average of $29 per hour for home health services. • As a consequence of living longer with HIV disease, increasing numbers of people living with HIV/AIDS show signs of dementia, bone weakness, cognitive motor disorders and other disabilities that require long-term care. • One multi-city study found that 50% or more of people who are HIV-positive experience some form of cognitive impairment. Doctors are also seeing comorbidities in middle-aged HIV-positive patients that are more typically seen in patients 80+ years of age. • With the relative success of antiretroviral treatment, many HIV-positive persons have either returned to the work force or have been able to continue working. While they may have health insurance coverage, many may either lack long-term disability coverage or the benefits of such coverage may not meet their HIVrelated needs. The Solution: • The CLASS Act will help: o People who are unable to perform two or more activities of daily living (ADL) e.g. eating, bathing, dressing, and transferring.

o People who have a cognitive disability requiring supervision or hands-on assistance such as traumatic brain injury, Alzheimer’s disease, multiple sclerosis, or mental retardation. o Many people living with HIV/AIDS who meet these criteria either now or in the future and who seek to remain in their communities. The CLASS Act will help eligible people living with HIV and with other disabilities by: o providing a cash benefit to purchase non-medical services and supports necessary to maintain community residence. o providing a financing alternative for long-term services and supports in their community that does not require them to “spend down” and become impoverished. The CLASS Act is financed by monthly premiums paid by voluntary, opt-out, payroll deductions. The Congressional Budget Office estimates that the CLASS Act would reduce the federal budget deficit by $74 billion between 2010–2019.