LTC Workgroup Reports to Health Reform Commission

VHCA (6/15/2007)

On June 12th, the Long Term Care Workgroup made its recommendations to the full Health Reform Commission.  The recommendations, if ultimately endorsed and proposed by the Governor and implemented by the General Assembly, would require $120 million in additional general fund (GF) spending in the long term care area.  Because of the high price tag of the recommendations, the Commission may decide to suggest that the recommendations they include in their final report be implemented over a span of years.

For State Fiscal Year 2009 (SFY09) the LTC Workgroup recommended implementation of low or no-cost items that will improve long term care in Virginia and expand some “critical supports” necessary for system-wide transformation.  For SFY10 and beyond, the Workgroup recommended focus on system-wide changes that will continue to transform and improve Virginia’s long term care system.  Below are the details of the recommendations:

SFY09: Critical Supports for System-Wide Transformation ($49 million GF):

• Rebase personal care and private duty nursing reimbursement rates (limited to 10% increase)
• Provide an annual, automatic inflation adjustment to personal care and private duty nursing
• Expand No Wrong Door statewide by 2010
• Add case management to the Medicaid Elderly and Disabled Consumer Directed (EDCD) waiver 
• Support and create a housing partnership revolving fund
• Support expansion of the LTC Ombudsman program

SFY09: Low or No Cost Items Improving Long Term Care ($368,161 GF):

• Support continued integration of acute and long term care in the Medicaid program
• Support Money Follows the Person grant and consumer-direction
• Encourage all Virginians to plan for their future long term care needs in the future
• Improve state and local implementation and coordination by 1.) Governor designating a LTC lead, such as the Secretary of Health and Human Resources 2.) Creating LTC Coordination and Advisory Councils and 3.) Improving local long term care planning councils

SFY10 and Beyond: Implement and Benchmark ($77 million GF):

• Add assisted living to the Medicaid EDCD waiver
• Provide an annual, automatic inflation adjustment to all other home and community-based providers
• Add Medicaid case management to state plan for persons aged 60+ with 2 or more ADLs
• Improve the auxiliary grant program
• Improve mobility options (transportation)
• Support family caregivers

The recommendations of the LTC Workgroup and the other three workgroups will be considered over the summer by the full Commission; and staff will write the Commission’s draft report and develop cost estimates of all the recommendations.  The draft report will be released in August.  The final Commission meeting will be held in September at which time the Commission will identify priority options for the Governor’s biennial budget.