In 2009, the National Advisory Board released a report, Declaration for Independence:A Call to Transform Long Term Services for Seniors and People with Disabilities.It included six principles necessary to modernize our health care infrastructure. These are still relevant today:

1. Enhance Self-care through improved coordination

• Transform Americas health care system from one that focuses on episodic illnesses to one that assists individuals in self-managing their whole health, with the support of providers and communities.
• Encourage the fundamental and financial investment in physicians to serve as the medical home for patients.

2. Encourage community integration and involvement

• Coordinate support services, housing, and transportation so people are able to participate in the social, economic, educational, and recreational activities available through community living.
• Promote data integration, continuity, and coordination of services through the use of health information exchange.

3. Expand accessibility of Services and Supports

• Retool programs and regulations to enable people to access the services they need to live independently without creating financial hardship for the family.

4. Uphold personal preference

• Leverage the success of long term service models that promote personal strengths and preferences and preserve dignity of participants.

5. Empower people to participate in the economic Mainstream

• Encourage the employment of people with disabilities and seniors by removing disincentives for people to work and redefine antiquated descriptions of disability.

6. Invest in improved technology

• Invest resources in the continued development of technology that improves individuals ability to self-monitor chronic health conditions and live independently.