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With a growing need for affordable community-based housing for older adults, a new report delivers to Virginia lawmakers strategies to increase the affordability and accessibility of assisted living communities in the state. 

The Virginia Joint Commission on Health Care’s report contains suggested changes to the state’s current structure, financing and regulation of assisted living facilities.

Auxiliary grant is underfunded

Virginia Assisted Living Association Executive Director Judy Hackler told McKnight’s Senior Living that the report makes several accurate points, especially “recognizing the auxiliary grant as a severely underfunded program that is hindering the freedom of choice in senior living housing.”

Hackler said that VALA looks forward to working with the commission and the Virginia General Assembly on the document’s recommendations, particularly increasing the auxiliary grant rate to cover the basic cost of care.

The commission found that the number of assisted living communities in the state has declined over the past 20 years but that the number of total residents requiring assisted living services increased — and that 47% of residents have behavioral health diagnoses.

Addressing longstanding concerns about the state’s auxiliary grant program, which provides cash payments to certain individuals to pay for assisted living costs, the commission reported that the monthly grant rate does not come close to covering the typical cost of assisted living. In fact, the rate remained relatively flat for the last 13 years, with the exception of small cost of living adjustments. 

The result is that fewer providers participate in the program. The commission reported a 41% decrease in communities participating in the auxiliary grant program since 2010. Providers cited increases in operating costs, including costs related to insurance, utilities, groceries, facility upkeep and state regulations as reasons for abandoning the program, along with “cumbersome” administrative processes.

The current auxiliary grant rate is set at $1,609 — well below the median monthly assisted living cost in the state, which ranges from $3,000 for a lower-needs population to $5,100 for higher-needs populations. 

Amy Hewett, vice president of strategy and communications for the Virginia Center for Assisted Living, told McKnight’s Senior Living that the association has advocated for years for a substantial increase in the auxiliary grant rate.

“The study recognizes the need for rate improvements so more Virginia seniors can have access to assisted living facilities,” Hewett said, adding that VCAL is hopeful that lawmakers will take action on the report’s recommendations.

“The most direct strategy to increase auxiliary grant bed availability is to significantly increase the [auxiliary grant] rate, closer to the cost of care,” the commission recommended, proposing a monthly rate of $2,500 based on discussions with assisted living administrators.

Another strategy to increase the number of grant-funded beds available for older adults is to incentivize assisted living communities with a one-time $21,000 lump sum — similar to what a community would expect when accepting a private-pay individual for two years — to help offset the loss in revenue.

Expanding alternative settings for grant recipients

The commission also recommended legislation that would expand the list of eligible living arrangements under the auxiliary grant program — including group homes, boarding homes and rented rooms in private homes — to allow grant recipients to remain in the community and coordinate their own care. 

LeadingAge Virginia President and CEO Melissa Andrews told McKnight’s Senior Living that the study highlights the inadequacies of the auxiliary grant rate while also providing ways to cover services, increase allowances and consider cost-effective alternative community settings in which to use the grant.

“This is a positive step towards providing needed care for older adults in the commonwealth,” Andrews said.

The recommendations also address expanding the personal care allowance for grant recipients to meet their daily living needs, requiring notification when an assisted living community serving auxiliary grant recipients is closing, and providing real-time access to assisted living community licensure status to auxiliary grant program staff.