Performance Improvement 2005. Using Medicaid to Cover Services for Eldery Persons in Residential CARE Settings: State Policy Maker and Stakeholder Views in Six States


The purpose of this study was to examine current state policies and practices regarding Medicaid funding for services in assisted living and other residential care settings for older people. The Secretary and the Department need better information about Medicaid’s current and potential role in providing services in this increasingly popular option. The report describes current practice in six states that pay for assisted living using Medicaid. Findings indicate that (1) stakeholders all believed that their state’s decision to use Medicaid to provide services in residential care settings was the right one; 2) there is considerable confusion about residential care options, primarily due to the use of the term “assisted living” to market different types of facilities; 3) there are concerns about regulatory and licensing issues, both overly prescriptive regulations and the lack of enforcement of existing ones; 4) there are significant staffing concerns, both quality and quantity; 5) there are concerns about the ability to age in place in practice; and 6) inadequate service rates and a general lack of funding for long-term care programs are significant barriers to expanding Medicaid coverage.

PIC ID: 8033; Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy; Federal Contact: Kennedy, Gavin, 202-690-6443; Performer: RTI International, Research Triangle Park, NC

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