More Choice with New Medicaid Assisted Living Program

Overwhelmingly, I’m told, older adults have a common ground when it comes to aging – they want to stay in their own homes for as long as possible.

Ideally, they say, that’s where they’d like to stay right up until the day they pass on.

Because of that desire, a whole structure has emerged over the past two decades built around services such as home care, which enable those who are frail, or becoming frail, to continue to live in familiar surroundings.

There often comes a time, however, when remaining at home just isn’t an option any longer.  That time can arrive for many different reasons, and it’s often tied to a family’s concern for the safety and well-being of someone living alone with chronic health issues.

For many years, the only solution people could find when confronted with this need was placement in a nursing home.  Alternative solutions, especially for those with few resources to begin with or whose resources have been depleted in paying for caregiving, have been hard to come by.

One of the responses that New York State has embraced is the creation and expansion of the Medicaid Assisted Living Program (ALP), which provides residential care and services for persons whose only other option would be a nursing facility.

Four years ago, Village Care of New York was selected by the State for a long-term care demonstration program to “develop, evaluate and implement programs to test new models” for the delivery of long-term care.  We gave the name “SeniorChoices” to the demonstration effort, which has a number of components, one of which is the development of a Medicaid ALP.

The state Department of Health has approved 80 “beds” or “slots” for our ALP, and we will be opening the first 40 this summer at our senior residence, The Village at 46th & Ten, which is located in the Clinton neighborhood.

Our Medicaid ALP at 46th & Ten will serve two purposes.  First, it will expand the availability of this needed option to more individuals in the communities we serve in Manhattan.  It will also provide a safety net for those living at the residence who are using up their own resources and would otherwise have to find alternative living and care arrangements.

In Village Care’s demonstration to the State, we are “rightsizing” our institutional capacity by replacing the aging 200-bed Village Nursing Home with a new, state-of-the-art, 105-bed center that will open next year on West Houston Street.  In exchange for the reduced nursing home capacity, the State has encouraged and allowed us to develop more “user friendly” options such as the Medicaid ALP and a Long-Term Home Health Care Program, among others.

Based in part on our experiences, the Health Department is expanding the underlying concept of our SeniorChoices demonstration, having announced in this year’s state budget that it will expand the Medicaid ALP statewide by 6,000 new beds over the next five years, while reducing nursing home capacity by the same number.

Services provided by a Medicaid ALP, besides residence and meals, can include personal care, home health aide care, personal emergency response services, nursing services, medical supplies and physical, occupational and speech therapies.

The Medicaid Assisted Living Program is part of Village Care’s service reconfiguration that reduces reliance on more costly and more intensive care options in favor of services that offer greater independence and choice while still meeting the health and well-being needs of older adults, no matter how considerable those needs might be.

Even in the case of the replacement we are building for Village Nursing Home, patients and residents can expect big changes.  The new Village Center for Rehabilitation and Nursing will break in major ways from the traditional concept of a nursing home, with intimate and home-like areas that will function as neighborhoods, with all dining and recreational experiences taking place in these “neighborhoods” on each floor.

No longer will we see the nursing home as an “end point” in long-term care.  Instead, it will be just one of a number of integrated care opportunities offering the right service in the right place at the right time.

We want to make growing old a better proposition, with services and supports that are responsive and safe, effectively combining medical and non-medical interventions in the most appropriate setting, all with the goal of offering our community the best means to better health and well-being.