Introduction Long Term Care

Long Term Care
Task Force Report

Fairfax is a suburban community of over one million residents, with a thriving and capable system of non-profit, private and public providers of long term care services. However, this community has come together to address a number of trends and critical issues affecting the ability of our system to effectively respond to residents’ need for long term care and supportive services. Most urgently, the growth over the next decade of the baby boomers and the over 85 age group and younger adults with disabilities will tax the system’s infrastructure and capacity to meet the need for services in a variety of areas. Also of importance, the increasing diversity in our community is already challenging providers’ ability to offer language and culturally appropriate services. In addition, the system’s breadth of resources is also one of its weaknesses, as the array of services can be overwhelming and difficult for families to navigate. And lastly trends that are affecting our nation are also greatly impacting Fairfax’s long term care system. The general lack of long term care insurance coverage, new medical advances and technologies which are extending and sustaining life and the high percentage of women in the workforce who in the past were the primary caregivers have all contributed to this emerging crisis. In response to these challenges, the Fairfax County Board of Supervisors chartered the Long Term Care Task Force to identify strengths and areas for improvement and to develop a Strategic Plan to meet the needs of our community for the next ten years.


The Board of Supervisors established the Long Term Care Task Force on March 22, 1999, when it endorsed a recommendation, which was developed by the Fairfax County Advisory Social Services Board and the Commission on Aging. These citizen boards recommended that a citizen study group be empowered to develop a strategic plan for long term care in Fairfax. In accepting this recommendation, the Board requested that a charter be developed for the Task Force. A working group consisting of representatives from the Advisory Social Services Board, the Commission on Aging, the Disabilities Services Board and the Health Care Advisory Board collaborated on developing a charter for the Task Force, which was endorsed by the Board of Supervisors on August 2, 1999.

Long Term Care Task Force Charter

The number of Fairfax residents who are unable to perform the essential activities of daily living is growing rapidly. Without adequate planning, existing agencies and institutions will be unprepared to effectively respond to residents’ need for long term care. Those seeking help may fall into gaps of service delivery or endure needless duplication of administrative prerequisites. Major issues of service requirements, accessibility, affordability, eligibility, and quality must be addressed.

With the goal of improving the quality of long term care-related decisions, the major elements of the strategic plan should include: A system for periodically assessing Fairfax residents’ needs for long term care and how best to respond to them.

Methods for determining the range of specific long term care services utilized or desired by individuals, their families, and others as supporting caregivers. This includes developing care plans, marshalling required resources, arranging financing, and educating and training family members and other volunteer providers to furnish as much of the care as they can.

Identification of difficulties encountered in delivery of services and development of better practices and approaches to meeting long term care needs

Finding ways to overcome barriers to accessing needed services including language and cultural issues, affordability, transportation requirements, housing arrangements, age based eligibility requirements, etc.

Establishment of principles that guide the role of local government, the private sector, and the community, and that support individuals and families in providing care.

Ensuring preventative and rehabilitative services to promote good physical, mental, and emotional health, including community education, health screening, and recreation.

Development and implementation of best practices and other care performance standards for the different groups of adults receiving long term care in institutional, home, and community based settings.

Development of specific recommendations for action on long term care issues.

A citizen study group supported by staff and other resources of private and public long term care constituencies will develop the strategic plan. The group will be comprised of approximately 30 representatives, including interested citizen groups, relevant County boards and commissions, long term care provider agencies, business, and academic interests. The group will work with identified expert resources. Throughout the process, periodic reports on status, interim findings and recommendations will be provided to the Board of Supervisors for consideration.

The working group identified approximately 40 organizations and interested groups to be represented on the Task Force. The working group also specified that the Task Force would address Fairfax County, Fairfax City and Falls Church City. One of the first tasks of the Task Force was the establishment of a nominating committee, which recommended nominees for the Chair and Vice Chair of the Task Force. The Task Force began meeting in November 1999, focusing on completing the necessary organizational and definitional work required to complete its assignment. Among these tasks were defining "long term care" and its mission for Fairfax residents as well specifying the of Task Force time frame to be addressed by Strategic Plan.

Definition of Long Term Care

Long term care is the sum of policies and programs that provide social, health, rehabilitative, and supportive services over an extended period of time to those individuals who are limited in performing major life activities.

Mission of Long Term Care for Fairfax County, and Fairfax and Falls Church City Residents

The mission of Long Term Care is to provide community-based, individualized, and comprehensive services that promote consumer choice and independence for adults, eighteen and over, who require support services. These services should have the following attributes: availability, accessibility, acceptability, cost-effectiveness, continuity, and quality.

Task Force Mission

The Mission of the Long Term Care Task Force is to develop a Strategic Plan to develop and maintain long term care services described in the definition and mission of Long Term Care.

Time Frame

The Strategic Plan will address the improvement and quality of long term care-related decisions for the following ten years.

Work Process

The first few meetings of the Task Force were spent on learning about the demographic and socioeconomic trends in Fairfax as well as local, state, and national service delivery issues. Once this essential background had been established, the first major task undertaken by the Task Force was an identification of the gaps in Fairfax’s continuum of long term care services. In order to carry out this task, the Task Force divided into five content area-specific committees: Housing; Transportation; Supports to Families; In-home Services and Community Based Services. In addition, a series of four Community Forums were held at various sites around the County to learn directly from the community where it believed there were gaps. The five committees collectively identified a total of 190 service gaps. These gaps were then prioritized in a process that utilized the County’s Group Decision Support Center.

At this point, in October 2000, the Phase One Report, "Report on Trends and Service Gaps" was published. This included a summary of the trends reported by staff and listed the service gaps uncovered by the five committees. A copy of the committee reports is included in Appendix A. The Task Force then developed a list of assets in the community that could be utilized in helping to developing solutions for the Strategic Plan. A copy of this list is found in Appendix B. It then regrouped for the purpose of identifying strategies to address the service gaps. For this task, the Task Force divided into ten "incubator groups," which were tasked with brainstorming solutions and researching best practices around a particular set of gaps. The ten incubator groups focused on: Developing the Long Term Care Workforce, Expanding Third Party Coverage, Improving Access to Transportation Services, Improving Mental Health, Mental Retardation and Substance Abuse Services, Overcoming Language and Cultural Barriers, Creating Housing Options, Improving Public Awareness and Education, Increasing Health Care Capacity, Maximizing Independence, and Strengthening Community Care.

The Incubator Groups reported back to the Task Force in May 2001. Approximately 70 different strategies were proposed to address the Service Gaps identified by the Task Force. These strategies were organized into four theme groups based on the approach recommended: Increasing Public Awareness, Connecting People to Services, Promoting Independent, Supportive Living, and Improving the Quality of the Long Term Care Workforce. At this point, the Task Force divided into four committees one last time to finalize the recommendations in each category and eliminate duplicate or contradictory strategies. The strategies were presented to the community in a Town Meeting on November 30, 2001. The Task Force officially endorsed the recommendations in December 2001 and made some minor additions at its final meeting in January 2002.

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