Signature Series 2025

2025 Signature Series on Aging in America Congressional Briefing

September 2, 2025
12:00 pm-

1:30 pm

Register Now

What’s LTSS and Why It Matters for Millions of Americans
From home care to nursing homes: understanding the backbone of aging support in America.

Location: Rayburn House Office Building, Rayburn Banquet Room (2043-2045)

As America’s population ages, millions of people rely on Long-Term Services and Supports (LTSS) to fill the gaps in our healthcare system, whether at home, in the community, or in nursing facilities. But what exactly is LTSS, who needs it, and why is it central to today’s policy landscape?

Join the Alliance for Health Policy for a timely Hill briefing that breaks down what LTSS includes, how it’s financed, and why recent federal budget pressures are raising new questions about how we support aging, independence, and caregiving in America.

Every state and congressional district is impacted by the rising demand for long-term care, with caregivers, providers, and older adults facing unique pressures at the local level, and the briefing will help break down this national issue to county-level impacts.

Speakers

  • Mike Park, J.D., MPH, Partner, Alston & Bird (Moderator)
  • Alison Barkoff, J.D., Hirsh Health Law and Policy Associate Professor and Program Director, George Washington University Milken Institute School of Public Health
  • Kirsten Colello, MPP, Specialist in Health and Aging Policy, Congressional Research Service
  • Robert Espinoza, MPA, Distinguished Fellow & Senior Adviser, National Academy of Social Insurance
  • Anne Tumlinson, MM, Founder & CEO, ATI Advisory

Learning Goals

  • Understand the current structure of LTSS financing in the U.S., including how public (Medicaid, Medicare), private, and hybrid models are being used to meet growing demand.
  • Understand how many people in their state or county are using Medicaid LTSS to better understand how aging and long-term care issues impact individual districts and states.
  • Explore state-level innovations in LTSS delivery and financing, such as consumer-directed care, tax credit proposals, and private market strategies aimed at reducing costs and improving access.
  • Examine the dynamics of the LTSS workforce and caregivers, including the role of direct care workers, older workers, unpaid caregivers, and models that give care recipients more choice and control.

Speakers

Michael Park, J.D., MPH

Partner, Alston & Bird
Mike Park is a partner in Alston & Bird’s Health Care Legislative & Public Policy Group. He has more than 20 years of health law and policy experience. He focuses his practice on representing health care providers, insurers, and manufacturers before Congress and the administration on a wide range of health care legislative and regulatory issues and also counsels clients in connection with congressional investigations. Before joining Alston & Bird, Mr. Park served as health policy counsel to Senator Charles Grassley (R-IA) during his tenure as Chairman of the Senate Committee on Finance, where he developed legislation on issues including Medicare payment policy, health information technology, and program integrity and conducted congressional investigations on public and private health care stakeholders. Mr. Park also served as a policy coordinator in the U.S. Department of Health and Human Services Office of the Secretary, as a project officer for Medicare payment demonstration programs at the Centers for Medicare & Medicaid Services, and as a health research analyst at the Center for Studying Health System Change. He currently serves as an adjunct faculty member at George Washington University’s School of Public Health. He received his bachelor’s degree from Connecticut College, his juris doctorate degree from Penn State Dickinson School of Law, and his master’s in public health from Columbia University.

Robert Espinoza, B.A., B.S., MPA

Distinguished Fellow & Senior Adviser, National Academy of Social Insurance
Robert Espinoza is a Distinguished Fellow and Senior Advisor at the National Academy of Social Insurance, where he leads efforts to build broad, nonpartisan support for a sustainable long-term care financing system that meets the needs of older adults, people with disabilities, and the care workforce. He previously served as CEO of National Skills Coalition and as Executive Vice President of Policy at PHI, the nation’s leading authority on the direct care workforce, and was a Nonresident Senior Fellow at the Brookings Institution. His work has appeared in The New York Times, the Wall Street Journal, and NPR, among other major outlets. Named to the inaugural CARE100 list and recognized as a Next Avenue Influencer in Aging, Robert sits on the boards of FrameWorks Institute and the American Society on Aging, where he serves as board chair, and hosts the award-winning podcast A Question of Care.

Anne Tumlinson, MM

CEO, ATI Advisory
Anne Tumlinson is the Founder and CEO of ATI Advisory, a national healthcare research firm focused on improving how the U.S. finances and delivers long-term services and supports (LTSS). With deep experience in Medicaid, Medicare, and caregiving policy, Anne advises state and federal leaders on strategies to meet the growing LTSS needs of older adults and people with disabilities. She previously served in the office of Congressman John Lewis and on the healthcare team at the White House Office of Management and Budget.

Alison Barkoff, J.D.

Hirsh Health Law and Policy Associate Professor and Program Director, George Washington University Milken Institute School of Public Health
Alison Barkoff is the Harold and Jane Hirsh Associate Professor of Health Law and Policy and Hirsh Program Director at the George Washington University Milken Institute School of Public Health. Prior to joining GW, she led the Administration for Community Living (ACL) in the U.S. Department of Health and Human Services from January 2021 to October 2024, where she served as the advisor to the HHS Secretary on aging and disability policy, oversaw national disability and aging programs, and led cross-agency initiatives related to long-term services and supports (LTSS), civil rights, housing, direct care workforce, family caregiving, healthy aging and public health. She previously served as Special Counsel for Olmstead Enforcement in the Civil Rights Division of the U.S. Department of Justice, was a senior advisor at the Centers for Medicare & Medicaid Services and Department of Labor, and held leadership roles at the Bazelon Center for Mental Health Law and Center for Public Representation. For more than 25 years, Ms. Barkoff has focused on legal and policy advocacy to improve the lives of people who face the most significant challenges in accessing health care and other critical community services. She has testified before Congress and the U.S. Commission on Civil Rights and is a nationally recognized expert on LTSS, disability and aging policy, Medicaid and civil rights.

Kirsten Colello, MPP

Specialist in Health and Aging Policy, Congressional Research Service
Kirsten Colello is a Specialist in Health and Aging Policy with the Congressional Research Service (CRS). She covers a wide range of health and social policy issues that affect an aging population including home and community-based services authorized under the Older Americans Act and elder abuse prevention services authorized under the Elder Justice Act. Her work also includes eligibility, financing, and coverage of long-term services and supports. Kirsten received her master’s degree in public policy analysis (MPP) from the University of Michigan and a BA degree with concentrations in economics and sociology from Virginia Tech.

Event Resources

Key Resources

“Foreign-Born Workers Made Up Half the Increase in the Direct Care Workforce in Home and Community Settings, 2012–22.” Barnes, B.; Grabowski, D. Health Affairs. August 2025.
“Spending and Utilization for Medicaid Home‑ and Community‑Based Services.” Medicaid and CHIP Payment and Access Commission (MACPAC). July 24, 2025
“National Older Americans Act ROI,”ADvancing States. July 2025.
“What to Know About the Older Americans Act and the Services it Provides to Older Adults.” Freed, M.; Cubanski, J.; Neuman, T. Kaiser Family Foundation. June 3, 2025.
“Compendium of Federal Long-Term Services and Supports (LTSS) Financing Policy Options.” LeadingAge LTSS Center @ UMass Boston. April 18, 2025.
“Meeting All the Needs? The Role of HCBS for Older Adults with Functional Impairments and Mental Illness.” Zilkha, C. and Frank, R.G. Brookings Institution, April 4, 2025
“Addressing Problems With Medicaid Home and Community-Based Services in the Age of Rebalancing.” Rhode, K.; Coe, N. B.; Gonalons-Pons, P.; Miller, K. E. M.; Kreider, A. R.; Hoffman, A. K. Health Affairs. October 2024.
“Health Equity in Long‑Term Services and Supports: Robert Wood Johnson Foundation Project Results and Findings.” ATI Advisory. August 2024.
“10 Things About Long-Term Services and Supports (LTSS).” Chidambaram, P.; Burns, A. Kaiser Family Foundation (KFF). July 8, 2024. kff.org
“Financing Long-Term Care.” Warshawsky, M. J. American Enterprise Institute (AEI). June 18, 2024.
“Profile of Older Americans.” Administration for Community Living (ACL). May 29, 2024.
“Older Americans Act: Overview and Funding.” Colello, Kirsten J.; Napili, Angela. Congressional Research Service (CRS Report R43414). May 6, 2024.
“Long-Term Services and Supports: History of Federal Policy and Programs.” Colello, K. J. Congressional Research Service, Dec. 2023.
“Long‑Term Care: The Solution.” Moses, A. 2023. Paragon Health Institute. October 2023.

Experts

Mark J. Warshawsky, Ph.D.

Senior Fellow, American Enterprise Institute
Mark.Warshawsky@aei.org

Brian Blase, PhD

President, Paragon Health Institute

Marc Cohen, MA, PhD

Co-Director, LeadingAge LTSS Center, UMass Boston

Henry Claypool

Policy Director, The Heller School at Brandeis University

Judith Feder, MA, PhD

Professor of Public Policy, Georgetown University

Stephen A. Moses

President, Center for Long-Term Care Reform

Matt Fiedler, PhD

Senior Fellow, Brookings Institute
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