DMAS Issues Long Term Care Blueprint Draft

On Tuesday, November 28th, the Virginia Department of Medical Assistance Services (DMAS) announced that it is moving forward with the development of a blueprint for the integration of acute and long term care by issuing a draft of a recently completed report.  The report includes a number of specific plans for transitioning away from the traditional model of funding long term care services in the Commonwealth.  In the 2006 General Assembly Session, Governor Kaine and the General Assembly directed DMAS “to develop a plan which will serve as the blueprint for moving toward an integrated, acute and long term care delivery system for elderly and disabled Medicaid recipients.”  Following this mandate, DMAS researched and held public meetings to discuss how the Virginia Medicaid program can best accomplish this goal.

The 78-page draft report can be downloaded from the DMAS website.  (Please note that this draft report is contained within a Word file that unfortunately is very large (4.7 MB) due to the inclusion of a number of scanned pages of public comments.  It is suggested that those downloading the file save the file to their computer or network prior to opening it and not attempt to review the document “online”.

Our initial assessment of the draft report is that the Kaine administration plans to aggressively pursue changes to the current state-funded (Medicaid) long term care delivery system within the Commonwealth.  An initial step in this plan includes the development of seven new sites operating as Programs of All Inclusive Care for the Elderly (PACE).  Within the next several years, Virginia plans to add additional PACE sites as well as develop regional managed care models that will include both elderly and disabled Medicaid beneficiaries (including dual eligibles) who are receiving all forms of Medicaid services – including long term care services provided in both nursing facilities and in home and community-based settings.  The DMAS blueprint draft reveals a phased approach to these changes but lacks the specificity that will be necessary to fully comprehend how the Commonwealth will implement the changes.

VHCA plans to submit comments on the draft in accordance with the DMAS instructions that they be provided no later than 5:00 p.m. on Monday, December 4, 2006.  Members of VHCA’s Payment for Services Committee have been asked to provide their comments, questions and concerns for inclusion in the association’s comments to be submitted on Monday.  We would welcome any input from other members about any aspect of the report.  Many of our comments will echo previous observations and concerns expressed in a document provided to DMAS last month.  A copy of those comments along with just the Executive Summary portion of the DMAS draft report announced on Tuesday is available on the VHCA website.   

In addition to supporting our development of a comprehensive set of comments, all VHCA member facilities are encouraged to submit their own individual comments as they see fit.  Comments on this report may be sent directly to DMAS at ALTC@dmas.virginia.gov.  Please keep in mind that only those comments provided by this coming Monday at 5:00 PM will be accepted.