A statement regarding the establishment of a strong consumer protection infrastructure for all of long-term care should be added. The use of sliding fee scales to ensure choice for all consumers should be added. An acknowledgement that long-term care insurance is not the only option should be added. Add a statement regarding the need to balance autonomy and risk. The quality of information provided to consumers is a critical component to striking the right balance.
Any setting can be institutional.
Agree that labor force training and other labor supports are critical components of a quality long-term care system, but question whether or not these issues should be included in a vision statement. Labor issues also extend beyond direct care workers. Add a specific statement about the role of government. Changes to this role are implied in the vision statements but need to be clearly articulated. Consumers should decide on price, quality, etc. of services, they should have a right to choose with the constraints of rate equalitization.