The Joint Commission on Health Care held its final meeting for the year on December 7, adopting a series of recommendations emerging from the four studies the Commission conducted this year and approving a set of studies to be undertaken in 2023.
Of particular interest to local governments are the recommendations from the studies on affordability of assisted living facilities and the structure and financing of local health departments. (Summaries of the study findings and recommendations proposed by Commission staff earlier this year may be found in previous editions of County Connections at this link and this link.)
Affordability of Assisted Living Facilities – Adopted Recommendations
- Increase the base Auxiliary Grant rate to $2,500 per month from the current level of $1,609 per month outside of northern Virginia. This recommendation was proposed as a result of findings that the current rate falls short of facilities’ costs to provide care. VACo submitted public comments suggesting that the increase be funded with state dollars rather than the traditional 80 percent/20 percent state/local funding partnership, given the disproportionate impact of auxiliary grant payments in certain localities.
- Expand the list of eligible living arrangements for the Auxiliary Grant program to allow recipients to remain in the community; this proposal would require the Department for Aging and Rehabilitative Services to submit changes to the program’s eligible living settings to the Social Security Administration for approval. VACo’s public comments also included encouragement that any expansion of the Auxiliary Grant to other settings be state-funded.
- Increase the personal needs allowance for Auxiliary Grant recipients and require the allowance to increase at the same rate as future cost-of-living Auxiliary Grant rate increases.
- Direct the Department of Social Services to update assisted living facility regulations to require administrators to notify the appropriate local staff at least 60 days prior to closure if the facility currently houses residents supported by the Auxiliary Grant or Discharge Assistance Program funds.
Local Health Department Structure and Financing – Adopted Recommendations
Dr. Colin Greene, Commissioner of the Virginia Department of Health, addressed Commission members and encouraged a focus on stabilizing staffing at local health departments as a fundamental step that would be required before imposing any requirements on local departments to enhance services. Commission members adopted a recommendation to fund targeted salary increases for local health department staff to align with current industry salary benchmarks. The remaining policy options included in staff’s report will be addressed in a letter to the Virginia Department of Health indicating support for these goals and requesting the Department to convene the appropriate stakeholders to develop an implementation plan, to include priorities and cost estimates.
Key policy options to be addressed in the letter to the Department include requiring local departments to ensure the availability of clinical services and facilitate access to and linkage with clinical care and to address chronic disease and injury prevention; directing the Department to design a state performance management process for each local health department; directing the Department to submit a plan for a centralized data system; directing the Department to track cooperative budget funding per capita and make appropriate adjustments based on the identified needs of each local department; and directing the Department to update state regulations for environmental health services to increase inspection fees to account for the typical time required to conduct the inspection.
The Commission approved the following studies for 2023:
- Eating disorders and obesity prevention and treatment: Through this study, which was directed by legislation in 2022, the Commission will document the prevalence and incidence of eating disorders and obesity among Virginians; identify evidence-based strategies for their prevention, early identification, and treatment; document the extent to which Virginia’s Medicaid program and state-regulated private health plans cover the costs of these strategies; assess barriers to care; and identify policy options to improve the prevention, early identification, and treatment of obesity and eating disorders.
- Team-based care approaches to improve health outcomes: This study will review evidence-based models of team-based care, a delivery model in which two or more providers work collaboratively with patients and caregivers to coordinate care across several settings; identify which populations most benefit from team-based care; evaluate the extent to which team-based care models are being used in Virginia and any obstacles to their implementation; and consider policy options through which the state may incentivize or promote effective models of team-based care.
- Vertically integrated carriers and providers: This study will review the extent of vertically integrated carriers in Virginia’s health care market and the impact on patients. Vertically integrated carriers involve a joint ownership interest between payers and providers.
VACo Contact: Katie Boyle