HD5 - The Consolidation of State Level Aging and Long-Term Care Services for the Elderly and People with Disabilities


Executive Summary:
House Joint Resolution No. 209 of the 1994 Session of the General Assembly requested the Secretary of Health and Human Resources to review the plan for state-level consolidation of certain long-term care and aging services within a single state agency and develop a plan for the coordinated delivery of such services at both the state and local levels. The resolution requested that the plan address the manner in which long-term care and aging services currently available through the State Department of Social Services and local departments of social services, including adult services, adult protective services and auxiliary grant payments, will be delivered and identify any state and local costs associated with the plan. This report presents the Secretary's plan for reforming the state level administration of aging and long-term care services for the elderly and people with disabilities. Recommendations regarding any needed changes in the delivery of services at the local level will be developed throughout the next year and submitted to the Joint Commission on Health Care, the Governor, and the General Assembly.

There are several trends which make long-term care a significant public policy issue and which suggest that changes are needed in the way in which aging and long-term care services are managed and delivered. Growth in the population needing long-term care, the diminished capacity of family members to provide long-term care to their loved ones on a full time basis, and high health care costs have all contributed to the increased cost of public and private expenditures for long-term care. This report reviews the numerous efforts that have been made since the early 1980s to improve the Commonwealth's long-term care system. It describes the inadequacies and duplication of effort in our system that consume substantial sums of money and yet offer the elderly and people with disabilities few choices in the provision of services.

This report presents a plan for reforming and simplifying the administration and management of state level long-term care services by consolidating aging and long-term care services for the elderly and people with disabilities. The plan creates a new division within the Department of Medical Assistance Services (DMAS) dedicated to aging, disability and long-term care services and identifies the functions, programs and services that are currently provided by six Health and Human Resources agencies that are to be consolidated within this Division. It describes the organizational structure and functions of the operating units within the newly established Division of Aging, Disability and Long-Term Care Services, and highlights the improved opportunities and efficiencies that can be achieved through enhancing the management of long-term care services.

In addition to simplifying the administration and management of long-term care, the plan for consolidation promotes consumer empowerment, enhances the state's ability to promote prevention, enhances quality, provides for the efficient delivery of aging, disability and long-term care services and allows for consideration to be given to including additional long-term care related programs and services within the Division of Aging, Disability and Long-Term Care Services. Finally, the consolidation of the services of the Department for the Aging with services now housed in other Health and Human Resources agencies strengthens the State's commitment to services to Virginia's elderly and disabled citizens.