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1998 SESSION


SENATE JOINT RESOLUTION NO. 160
Directing the Joint Commission on Health Care's Long-Term Care Subcommittee to study reimbursement rates for adult care residences and adult day care.

Agreed to by the Senate, February 13, 1998
Agreed to by the House of Delegates, March 12, 1998

WHEREAS, in Virginia, adult care residences are a key component of the long-term care continuum; and

WHEREAS, these facilities provide care for individuals who are ambulatory in varying degrees, with assisted living and intensive assisted living residences providing more care for a population with greater needs; and

WHEREAS, recently, the Virginia Medicaid Program was directed, through budget language, to reimburse adult care residences on a per day basis for eligible residents; and

WHEREAS, in addition to the Medicaid reimbursement, clients of adult care residences may be eligible to receive auxiliary grants to pay for their care; and

WHEREAS, in addition to adult care residences and other mechanisms for delivery of long-term care, the Department of Medical Assistance Services conducts a program to reimburse adult day care through a waiver; and

WHEREAS, adult care residences care for individuals for 24 hours a day and adult day care programs care for individuals for much fewer hours than the hours caregivers work or shop; and

WHEREAS, the reimbursement for the care rendered by adult care residences is much lower than that for adult day care programs; and

WHEREAS, the reimbursement for adult care residences was set by law, with the Department of Medical Assistance Services having no discretion in setting the rates; and

WHEREAS, although the program to reimburse adult care residences is relatively new and the adult day care program has been in existence for some time, the differences in the reimbursement appear difficult to rationalize; now, therefore be it

RESOLVED by the Senate, the House of Delegates concurring, That the Joint Commission on Health Care's Long-Term Care Subcommittee be directed to study reimbursement rates for adult care residences and adult day care. The subcommittee shall examine (i) the basis on which reimbursement was established for adult care residences, (ii) the precise services for which reimbursement is made in the adult care residences, and (iii) the costs and other factors related to these issues. The subcommittee shall include representatives from the long-term care community, particularly adult care residences and adult day care, in this study. The subcommittee shall recommend an equitable solution to these reimbursement differences.

All agencies of the Commonwealth shall provide assistance to the Joint Commission or its staff for this study, upon request.

The Joint Commission shall complete its work in time to submit its findings and recommendations to the Governor and the 1999 Session of the General Assembly as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.