HD33 - Monitoring Long-Term Care
Executive Summary: The Joint Subcommittee Monitoring Long-Term Care was created in 1983 by House Joint Resolution No. 37 (Appendix A). Its charge is to oversee the implementation of an integrated approach to long-term care by facilitating cooperation and exchange of information. It is to accomplish this by receiving regular reports of cooperative action and proposals for joint effort from agencies involved in the provision of long-term care. During 1983, the Joint Subcommittee heard reports on activities from agencies and groups active in long-term care service provision. The Department of Mental Health and Mental Retardation reported on the rationale for and community responses to deinstitutionalization of geriatric patients from the state hospitals in 1983 and 1984. The Department also discussed the needs of mentally ill children and the growing problem of serving chronically mentally ill young adults. The Long-Term Care Council presented its state plan to the Joint Subcommittee. The Council also discussed its efforts in developing alternative services to prevent unnecessary institutionalization of the elderly; these efforts include a study of costs of public and private community services for this population and a discussion of problems in cost-sharing between federal, state and local governments in service provision. The Department of Health presented progress reports on the status of relevant Medicaid waivers, includtng those related to case management and home and community-based services and on the accomplishments of the Nursing Home Preadmission Screening Program. The Department of Social Services discussed fire safety standards in homes for adults. The Joint Legislative Audit and Review Commission discussed its recommendations regarding level of auxiliary grants from its report on Local Mandates and Financial Resources. These grants are the major resource used by residents of homes for adults to pay their room and board. Finally, the American Health Care Association and its Virginia counterpart presented an overview of the system of life-care communities. The Joint Subcommittee received a report on the deinstitutionalization pilot project in the City of Richmond and the Department of Mental Health and Mental Retardation's report on census reduction at the state hospitals as requested in the 1984 Appropriations Act. The Joint Subcommittee was continued in 1984 for two years by House Joint Resolution No. 52 (Appendix B). The Joint Subcommittee at the beginning of 1984 identified several issues for intensive review by expert task forces organized by the Joint Subcommittee. These issues, discussed in detail in the findings of this report, are: 1. Need for state regulation of life-care communities in Virginia. 2. Need for and feasibility of a revised method of Medicaid nursing home reimbursement. 3. Housing for persons with special needs. 4. Post-education transition of the handicapped. In addition, the Joint Subcommittee has continued to monitor the Long-Term Care Council's study, pursuant to Senate Joint Resolution No. 30, of the cost-effectiveness of maintaining the frail and impaired elderly in community settings, to be determined through documentation of public and private costs associated with community placement. The Joint Subcommittee also held two public hearings to provide an opportunity for public comment on available effective services and services which are needed to serve all populations in need of long-term care. Finally, the Joint Subcommittee attended the working conference of the American Health Planning Association on "The Complex Cube of Long-Term Care." |
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