Advocates for seniors push for more Medicaid support for assisted living

Male caretaker helping senior man with walker in nursing home

Georgia lawmakers met at the Capitol Tuesday to develop ways to keep more older adults living at  home or in assisted living facilities as a less costly alternative to nursing care facilities.

Senior advocates and housing officials urged lawmakers to expand patient access to Medicaid funding for assisted living programs. The program pays for rooms and care for thousands of older Georgians each year.

The number of Georgians 65 and older is expected to nearly double over the next three decades, from around 1.5 million this year to more than 2.7 million in 2050, according to state budget office projections. The relatively slow population growth in young people means too few of them will be around in Georgia to care for their elders.

Older Georgians overwhelmingly prefer to stay in their own homes and local communities instead of more institutional group settings like nursing homes, said Abby Cox, the director of the state Department of Human Services’ Division of Aging Services. But eventually, those seniors end up needing a higher level of care than families and in-home services can provide, especially if they develop dementia or Alzheimer’s disease, Cox said. A large portion of the state’s senior population lives on $50,000 or less per year, Cox said, which puts nursing facilities that charge up to $80,000 or more per year out of reach.

About 8,000 Georgia seniors receive Medicaid benefits to offset assisted living costs, said Department of Community Health’s Catherine Ivy, director of the Medicaid waivers program. Another 6,000 seniors requested help and are parked on a waiting list, Ivy said.

State rules limit assisted living facilities to qualify for Medicaid reimbursement, Ivy said. She told lawmakers those caps are set by her department and could be changed, so long as the changes align with Medicaid rules that the senior living program “looks and feels and resembles” a residential setting as opposed to a nursing home, Ivy said.

“We have to reassure the federal government that (the program) is not institutional,” Ivy said.

Beyond those Medicaid-funded programs, tens of thousands of Georgia seniors currently live in affordable housing units funded by federal housing tax credits or by state low-income housing vouchers, according to officials with the Department of Community Affairs’ Housing Finance and Development division. Those living arrangements can house far more people than the state’s Medicaid-funded programs, but cannot tap into the same kind of in-home care services offered by those programs, said Ginny Helms, the president and CEO of the nonprofit senior advocacy coalition LeadingAge Georgia.

Georgia should expand senior housing that qualifies for Medicaid assistance to include places with more than 24 beds and to reach seniors who use housing vouchers to pay rent, Helms said. 

“This is already a community,” Helms said Tuesday. “These are already people’s homes.”

Increasing the number of people covered by Medicaid funding in group living arrangements also has the backing of Vicki Johnson, the Georgia Council on Aging’s chairwoman. She says the state can raise the 24-person cap and still provide quality senior care.

“We’re just trying to broaden the options through a combination of money and policy,” Johnson said.

State Rep. John Petrea, a Savannah Republican who sits on the study committee and chairs the House Human Relations and Aging Committee, expressed support for Medicaid-funded services to go toward more seniors. He said the state’s assisted living programs “need to do more” as the senior population grows.

“It’s powerful the impact that we can have with these budget items,” Petrea said Tuesday. “That is why our focus needs to continue to be on Medicaid with the people who need it most … before we start wandering into able-bodied people.”

Beau Evans
Beau Evans has covered local and state government and breaking news in New Orleans and California. He’s reported on immigration issues, the threat of rising seas to coastal areas, public safety and hurricanes. At The Times-Picayune in New Orleans, Evans detailed the critical role government plays to ensure that people in a community have access to clean water and other public needs. In 2018, his investigative reporting revealed top officials at New Orleans’ cash-poor water utility dealt themselves huge raises, prompting several to resign. Evans’ prior reporting was in West Marin north of San Francisco for The Point Reyes Light. Evans is an Atlanta native who graduated with honors from The Lovett School and is an honors graduate of North Carolina’s Davidson College. Beau was with the Georgia Recorder until January 4th, 2020.


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