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Affordable Assisted Living Long Term Care Demonstration Program Program Development Update 11/6/08 MALA/MAHSA Assisted - PowerPoint PPT Presentation

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Affordable Assisted Living Long Term Care Demonstration Program Program Development Update 11/6/08 MALA/MAHSA Assisted Living. Tim McIntyre – DYNS Services, Inc. AAL Initiative .

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Affordable Assisted Living Long Term Care Demonstration ProgramProgram Development Update11/6/08 MALA/MAHSA Assisted Living

Tim McIntyre – DYNS Services, Inc.

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AAL Initiative

  • The project was initiated by MSHDA via a work group exploring Aging in Place issues. Partnering agencies include MDCH, DHS & OSA

  • The project’s intent is to successfully combine housing & services as a new LTC component in MI that is cost effective & meets consumer satisfaction requirements

  • Consistent with the principles & approaches of national AL efforts (ALFA), other state AAL pilot programs and national AAL experts, the MI model is purpose driven and promotes tenant dignity, privacy & prolonged independence

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AAL Initiative continued

  • The partners established baseline components of an AAL demonstration & requested concept papers from housing developers and local human service partners

  • The state partners established agreements defining agency commitments including;

    • MSHDA to facilitate inter agency cooperation & dedicated funding for TA to develop and support the demonstration

    • MDCH seeking approval of a special Medicaid waiver and

    • MDHS utilization of existing food assistance services to support AAL consumers

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AAL Model Components

  • Promotes Continuing Care Retirement Community model – a range of housing & health options on site.

  • Combines affordable housing with access to community-based AL Medicaid services.

    • Affordability – a minimum of 20% of total units must shelter persons aged 55 years and older with incomes at or below 50% of the Area Median Income.

  • Addresses multiple consumer directed initiatives

  • Targets LTC consumers unable to remain at home, NFT consumers & those who meet LOC & prefer housing with services setting

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AAL Project Initiation

  • Housing developers & local community service partners selected will serve the Detroit, Battle Creek, Grand Rapids, Grand Haven & St Ignace areas.The first site is located in Grand Rapids and will be accepting tenants in Spring 2009

  • DYNS serves as the TA contractor to develop the demonstration initiative and support all phases of implementation.

  • DYNS is facilitating a collaborative process to define the AAL model & produce the tools & resources to be utilized in the program.

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AAL Steering Committee

  • A state level AAL team was assembled to envision, plan & implement the demonstration project.

  • The team has been defining AAL services & promote housing features that support aging in place.

  • The group will increase the collective understanding among stakeholders regarding housing, Aging & Medicaid service opportunities.

    • The committee organized a stakeholder event that brought experts in aging in place housing design & AAL programming

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Working - AAL Philosophy

To provide a community-based LTC program in a home-like apartment style residence that facilitates person centered planning self direction, and managed risk to maximize tenant independence, dignity, privacy and aging in place in an accessible environment.

  • Person centered planning – a process to build on consumer capabilities & honors preferences & choices

  • Self direction - a program option that supports consumers in planning & directing their own care through an individual budget.

  • Risk management – promoting autonomy means allowing tenants to take some risk which may be managed through care planning

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Full bathroom

Kitchen area

Lockable doors

Private sleeping and living space

Individual temperature controls

Personal furnishings

Community space for dining, laundry, living room, library, TV lounge

Access/walkability to surrounding community activities for:

Health (pharmacy, physicians, etc)

Dining; groceries, restaurants

Social & Cultural opportunities

Consumer Centered Design Elements

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Aging in Place Considerations - Housing

  • The steering committee encourages designers of AAL physical environments to go beyond local code and federal laws:

    • Openings wider than 32” with zero height thresholds

    • Power assisted & weather shielded entries & exits

    • Lever hardware for doors

    • Rooms large enough to provide accessibility routes & turnaround space with furnishings in place.

    • Flooring with nonskid surface, direct glue carpeting and transitions between floor types

    • Zero clearance roll in showers & vanity, combination tub shower units, & reinforced shower & tub walls

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Aging in Place Considerations - Services

  • The committee supports a comprehensive Medicaid service package to minimize tenant moves due to an unavailability of needed services

    • Arrangements have also been made to access AAA & local service resources to support AAL consumers

  • Some sites may employ staff to broker services & supports from area community based providers. Others will contract with home health or other providers to be on-site. Regardless, choice is required

  • To promote the specialized nature of this LTC option, the Steering Committee has recommending that MI pursue an AAL specific Medicaid waiver for FY ‘09

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Project status & challenges

  • AAL MA funding was not available in FY 2007 or 2008 prompting delays in the development of the demonstration

    • The AAL project was removed from the 2009 budget and reinstated in late 2008

  • The 1st site is opening without an AAL waiver or MA dedicated funding

    • Other developers are waiting for guaranteed service funding

  • MDCH is exploring amendments to MI Choice

    • And if MSA project trade off decisions are needed

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Contact Information

  • Tim McIntyre, Project Director


    • 269/317-3654

  • J.T. Johnston, MSHDA-AAL Project Director


    • 517/335-0973