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ALFA Initiative For Affordable Senior Housing

Wed, 10/25/2000 - 12:00am — Karen Stevenson
Description: 

The Assisted Living Federation of America (ALFA) has launched "ALFAcares - The Affordable Housing Initiative of the Assisted Living Federation of America." ALFA members are concerned about individuals who may be forced into institutional settings because affordable models are not widely available. For these reasons, ALFA is proactively supporting state, federal, and industry partnerships that will expand affordable housing opportunities for low-and-moderate income seniors.

They say that the dramatic growth of the assisted living industry has demonstrated the benefits of a residential environment where seniors can receive personal care assistance while maximizing their functional abilities and independence. Although assisted living is a more cost- effective model than institutional long-term care, the cost of private care in assisted living facilities remains out of reach for many low-and-moderate income seniors:

Current assisted living facilities have mostly been developed for higher income individuals residing in targeted urban and suburban communities throughout the country. Few models can be found for lower income seniors (income less than $30,000 per year) even though they outnumber higher income seniors 2 to 1.

Lower income seniors are often frailer than those with higher incomes, so they have a greater need for assisted living care. The most vulnerable group is single people over age 75. This group, which numbers 6.5 million, is projected to increase by 100,000 individuals each of the next ten years.

Seniors with income below $15,000 often qualify for various housing and entitlement programs, such as HUD Section 8 rent-subsidy vouchers, SSI welfare benefits and Medicaid. However, developers of affordable assisted living have difficulty utilizing these resources because of multiple funding streams and conflicting regulations within the state and federal agencies whose oversight complicates the delivery of housing and services in these type of publicly-supported environments.

The initiative goals are to:

Support federal legislation that promotes affordability
Facilitate national replication of "best practice" models of affordable assisted living through the combination of tax credits, subsidies, state programs, grants, etc.
Promote affordable assisted living through state reimbursement policies, including Medicaid waivers, state plans, and other long-term care benefits
Work at the state level to eliminate regulatory barriers that affect affordability while preserving resident rights and safeguards.
Encourage partnerships between HUD and HHS to coordinate the benefits of housing and health programs for low-income frail seniors.
Central to the success of these efforts will be the willingness of states to explore new models of affordable care, which are responsive to consumer preferences. One proposed new model is a Medicaid Consumer Account Program for Assisted Living. ALFA's Medicaid Consumer Account Program builds upon successful state programs that provide Medicaid reimbursement for assisted living services in residential settings. Features of the model program include:

Budget neutrality
An emphasis on consumer-directed decision making and independence
Funding that is "portable" because it will reimburse the consumer rather than the provider
ALFA also has tried to address people concerned about the "woodwork effect" which says that providing more home and community based services will increase overall costs because it will draw in thousands of people who are not receiving government-funded services now.

They say that there are examples which show that this has not happened. For instance, Oregon's use of home and community-based services instead of nursing facility care saved an estimated $227 million between 1981 and 1991 out of a projected direct service expenditure of $1.35 billion for the period. Additionally, the shift to home and community-based care has enabled the state to serve more beneficiaries with the Medicaid and state dollars they have available.

Maine actually reduced total long term care spending from $228 million in 1995 to $185 million in 1998 and served 3,700 more people by developing a comprehensive array of alternative services and by reducing the supply of nursing home beds.

The Assisted Living Federation of America (ALFA) has launched "ALFAcares - The Affordable Housing Initiative of the Assisted Living Federation of America." ALFA members are concerned about individuals who may be forced into institutional settings because affordable models are not widely available. For these reasons, ALFA is proactively supporting state, federal, and industry partnerships that will expand affordable housing opportunities for low-and-moderate income seniors.

They say that the dramatic growth of the assisted living industry has demonstrated the benefits of a residential environment where seniors can receive personal care assistance while maximizing their functional abilities and independence. Although assisted living is a more cost- effective model than institutional long-term care, the cost of private care in assisted living facilities remains out of reach for many low-and-moderate income seniors:

Current assisted living facilities have mostly been developed for higher income individuals residing in targeted urban and suburban communities throughout the country. Few models can be found for lower income seniors (income less than $30,000 per year) even though they outnumber higher income seniors 2 to 1.

Lower income seniors are often frailer than those with higher incomes, so they have a greater need for assisted living care. The most vulnerable group is single people over age 75. This group, which numbers 6.5 million, is projected to increase by 100,000 individuals each of the next ten years.

Seniors with income below $15,000 often qualify for various housing and entitlement programs, such as HUD Section 8 rent-subsidy vouchers, SSI welfare benefits and Medicaid. However, developers of affordable assisted living have difficulty utilizing these resources because of multiple funding streams and conflicting regulations within the state and federal agencies whose oversight complicates the delivery of housing and services in these type of publicly-supported environments.

The initiative goals are to:

Support federal legislation that promotes affordability
Facilitate national replication of "best practice" models of affordable assisted living through the combination of tax credits, subsidies, state programs, grants, etc.
Promote affordable assisted living through state reimbursement policies, including Medicaid waivers, state plans, and other long-term care benefits
Work at the state level to eliminate regulatory barriers that affect affordability while preserving resident rights and safeguards.
Encourage partnerships between HUD and HHS to coordinate the benefits of housing and health programs for low-income frail seniors.
Central to the success of these efforts will be the willingness of states to explore new models of affordable care, which are responsive to consumer preferences. One proposed new model is a Medicaid Consumer Account Program for Assisted Living. ALFA's Medicaid Consumer Account Program builds upon successful state programs that provide Medicaid reimbursement for assisted living services in residential settings. Features of the model program include:

Budget neutrality
An emphasis on consumer-directed decision making and independence
Funding that is "portable" because it will reimburse the consumer rather than the provider
ALFA also has tried to address people concerned about the "woodwork effect" which says that providing more home and community based services will increase overall costs because it will draw in thousands of people who are not receiving government-funded services now.

They say that there are examples which show that this has not happened. For instance, Oregon's use of home and community-based services instead of nursing facility care saved an estimated $227 million between 1981 and 1991 out of a projected direct service expenditure of $1.35 billion for the period. Additionally, the shift to home and community-based care has enabled the state to serve more beneficiaries with the Medicaid and state dollars they have available.

Maine actually reduced total long term care spending from $228 million in 1995 to $185 million in 1998 and served 3,700 more people by developing a comprehensive array of alternative services and by reducing the supply of nursing home beds.