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 HIV-
related 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.