A significant number of frail elders with Medicaid coverage choose to live in an assisted-living facility as an alternative to a nursing home. Yet, low-income older adults who are dually eligible for Medicare and Medicaid (known as dual eligibles) face many challenges in obtaining Medicaid coverage for high-quality assisted living services.
In addition, though Medicaid has been paying for assisted living services for over 20 years, either through Home and Community-Based Services (HCBS) waivers, demonstration waivers, or state-plan services, to this day there exist no federally established standards for assisted living facilities. This lack of federally established standards leaves some residents in danger of discriminatory practices. As the program grows it becomes more important to address how Medicaid funding for assisted living operates in practice in order to identify the appropriate consumer protections required to rectify existing problems.
With support from The Commonwealth Fund, the National Senior Citizens Law Center undertook an extensive study of federal and state Medicaid policies for assisted living coverage, with a special focus on how such policies affect the lives of dual eligibles. The research included a survey of respondents in the 37 states that pay for assisted living services through a federal Medicaid Home and Community-Based Services waiver, as well as more in-depth research of policies and practices in five of those states: Arkansas, New Jersey, Oregon, Texas, and Washington. The research was conducted in cooperation with the University of California at San Francisco.
Policy briefs and white papers from this study, the “Medicaid Payment for Assisted Living Policy Issue Brief Series,” are published as a resource for advocates, policymakers, state Medicaid officials, assisted living facility operators, and others on http://medicaidalseries.org/.
The publications include:
To read these publications, visit http://medicaidalseries.org/, a National Senior Citizens Law Center Web site.