HD57 - The Feasibility and Desirability of Creating a Continuing Care Advisory Council
Executive Summary: House Joint Resolution No. 169, passed by the 1992 General Assembly, requested the Secretary of Health and Human Resources to "study the feasibility and desirability of creating a continuing care advisory council." continuing care retirement communities are the "fastest growing segment of the senior citizens housing market" (Consumer Reports, February 1990). In Virginia, thirty-nine continuing care retirement communities (CCRCs) serve more than 8,500 residents. As the number of older persons continues to increase, both in numbers and as a percent of the total population, it is anticipated that the continuing care retirement community is an option that more people will choose. Virginia is one of thirty states which, to some extent, regulate CCRCs. Virginia's Continuing Care Provider Registration and Disclosure Act (Code of Virginia) 38.2-4900 et seq.) defines a continuing care retirement community as a place in which a person undertakes to provide continuing care to an individual. Continuing care is defined as "providing or committing to provide board, lodging and nursing services to an individual ... (i) pursuant to an agreement effective for the life of an individual or for a period in excess of one year ... and (ii) in consideration of the payment of an entrance fee." The State Corporation Commission is the primary mechanism for enforcing CCRC regulatory requirements governing financial stability, protection of consumers from unsound decisions, financial disclosure and content of resident contracts. In addition, continuing care retirement communities must also meet the Commonwealth's regulations which govern the levels of long-term care they provide. For example, the Department of Health licenses the nursing home component of the communities and the Department of Social Services licenses the homes for adults component. In 1991, the Virginia Department for the Aging was requested by the Virginia General Assembly, through HJR 372, to conduct a review of consumer protection provisions for residents of continuing care facilities. The Department offered seven recommendations to improve consumer protection for residents of continuing care retirement communities. One of the recommendations was for a study of the possible creation of a state level continuing care committee. This led to the introduction of HJR 169 requesting the Secretary of Health of Human Resources to study the feasibility and desirability of creating a continuing care advisory council. To assist in completing this study, an advisory group was convened. The group included continuing care residents and providers, their advocates and state and local agencies which regulate or interact with continuing care retirement communities. The group reviewed the roles of responsibilities of the Long-Term Care Ombudsman Program and Long-Term Care Council as they relate to continuing care retirement communities. The Long-Term Care Ombudsman Program, operated by the Virginia Department for the Aging, serves as a focal point for complaints made by or on behalf of consumers of long-term care services. The program investigates and seeks to resolve the complaints. In addition, a major component of the program is consumer education, including educating consumers of long-term care services about their rights, and how to advocate on their own. The Ombudsman also works to identify issues and concerns impacting older persons, and recommends changes in the long-term care system which will benefit these individuals as a group. The legal base for Virginia's Long-Term Care Council is included as Appendix D of this report. The Council has been charged by the Virginia General Assembly with the responsibility of recommending standards, policies and guidelines for the development and implementation of a continuum of statewide long-term care services. The study group also reviewed the statutes from the states which have continuing care advisory councils. The model statutes proposed by the American Association of Homes for Homes for Aged and the Columbia Law School were also reviewed. The study advisory group concluded that a mechanism with the ability to monitor and act on emerging trends related to CCRCs and other retirement communities was warranted. For example, the definition of a CCRC is blurring as more communities offer a "continuum of care" rather than "continuing care. This distinction can have enormous financial consequences for consumers. Thus, a forum for ongoing review of resident and provider concerns is suggested. This suggested "environmental scanning device" could funnel questions from the public and from policymakers and develop recommended public policies regarding CCRCs, CCRC ''look-alikes'' and other residential type facilities offering long-term care. Members of the group, for example, expressed concerns about consumer misunderstanding about facilities offering services similar to CCRCs but not meeting the legal definition of a "continuing care provider" and therefore not being subject to regulation under the continuing Care Provider Registration and Disclosure Act. A mechanism for monitoring and acting on emerging trends related to CCRCs and similar residential facilities is therefore recommended. The structure, functions and scope of responsibility of such an advisory body were identified by the study group and are included in this report. It is further recommended that the proposed functions of any continuing care advisory body be assigned to the Long-Term Care Councilor incorporated in any planning for the restructuring of the state's long-term care services, as recently proposed by the Joint Commission on Health Care. |
Menu
Published Documents
