Studies and statistics are important, but the stories behind them are even more powerful. They transform numbers into names and facts into faces. And stories are essential for transforming the way America pays for long-term services and supports. The Community Living Assistance and Supports and Services (CLASS) act Coalition is asking you to share your story.
By sharing you story, you have the opportunity to speak up for your rights. Nobody knows better than you that our nation’s current system denies choice, impoverishes families and threatens to bankrupt the government.
Passing the CLASS Act would bring us closer to a solution. This bill would create a national insurance trust that is founded on choice, responsibility and fairness. Visit www.passtheclassact.org to learn more about this important legislation.
We’ve developed an online form you can use to share your experiences with us. Stories like yours will be collected from communities nationwide and shared with the people who need to hear them.
We will not use your story, or name without your permission.
1) First Name2) Last Name3) City4) State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareD.C.FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming5) Zip (Please include Zip+4 if you know it)Format: 99999-99996) Email address:7) Phone NumberFormat: 999-999-99998) What is your story about?Caregiving experience Medicaid Long-term care insurance Need for long-term services and supports Other (please specify) If you selected other, please specify:9) Who is the individual at the center of your story?Self Parent Child Sibling Friend Other (please specify)If you selected other, please specify:10) How old is this individual?11) Is this person currently or previously employed? Yes No Not Sure 12) If yes, for how long? 13) Could this person’s long-term services and supports need be a factor in them leaving a job?Yes No Not Sure 14) How much does this person's care cost every month?15) Who pays for the person’s care? How much do the following people, programs or policies pay? The individual's fundsFamily fundsMedicareMedicaidOther government programLong-term care insuranceOther16) How has the need for services and supports affected you and your family?Forced the person to quit his/her job. Had to take second job to pay for care. Had to spend down assets paying for care. Had to move self or loved one to nursing home or other care facility. Could not move because would lose Medicaid coverage. Depleted savings and retirement that spouse would have used. Forced a family member to quit their job. Had to divorce a spouse to qualify for Medicaid coverage. Other (please specify) If you selected other, please specify:17) What kind of care does this individual need and receive?18) What would you tell public officials about this person's story to help them?19) May we share your story with public officials or the media?Yes No Yes, but only anonymously Not Sure
Is this person currently or previously employed?
If yes, for how long?