SD4 - Report on the Licensure of Adult Care Residences


Executive Summary:
Senate Joint Resolution 119 directs that the "Department of Social Services report to the Chairmen of the House Committee on Health, Welfare and Institutions; the Senate Committee on Rehabilitation and Social Services; and the Joint Commission on Health Care by October 1, 1998, regarding the status of its implementation of recommendations made by JLARC, the extent to which the licensure process is being used to encourage continuous quality improvement; and staffing and training needs with the adult care component of the DSS licensure program (See Appendix I for the complete resolution)." This report responds to the SJR 119 directive.

The Adult Care Residences (ACR) industry continues to be characterized by growth in the number of facilities and beds statewide. In 1997, when the Joint Legislative Audit and Review Commission (JLARC) conducted the study discussed in this report, there was a total of 612 licensed facilities with 27,537 beds. As of June 30, 1998, the number of ACRs had increased 7% to 654 facilities with a total of 31,989 beds (*1), a 16% increase.

The Department of Social Services (DSS) carries the regulatory responsibility for ACRs. The Code of Virginia mandates all ACRs receive at least two inspections annually. Licensing staff, based in eight field offices across the state, are responsible for: on-site inspections; issuing both new and renewal licenses; monitoring for on-going compliance; conducting complaint investigations; and sanctioning facilities that pose a risk to resident health and safety. In addition, these inspectors investigate all reports of illegally operated facilities.

The Department also sponsors approximately 50 provider training sessions annually for ACR administrators and staff to enhance service delivery through care giver skills development. Further, quarterly training is provided for facility staff on use of the Uniform Assessment Instrument (UAI) for private pay residents. The UAI is the screening and evaluation tool used to determine an individual's care needs, service eligibility, and appropriate level of care. While only staff of public agencies are allowed to conduct assessments for auxiliary grant recipients, trained facility staff may complete private-pay resident assessments.

Since the 1970's, ACRs have been of concern and interest to the General Assembly and to the Joint Legislative Audit and Review Commission (JLARC) because these facilities represent an important segment of the long-term care continuum. As well as the elderly, ACRs serve adults with physical, mental and developmental disabilities.

The 1998 JLARC study focused specifically on ACR services for the mentally disabled. Senate Joint Resolution 119 directed DSS to report to the Chairs of the House Committee on Health, Welfare and Institutions, the Senate Committee on Rehabilitation and Social Services and the Joint Commission on Health Care the actions that have been taken, or are being planned, as a result of that study.

The Resolution also calls for a report on the training needs of the adult care component of the DSS licensing program and on the extent to which the licensure process is being used to encourage continuous quality improvement.
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(*1) Includes pending new applications