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1999 Auxiliary Grant Rate

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The Alzheimer's Association supports an increase in the auxiliary grant rate -- the state/local funding source for low income ACR (Adult Care Residence) residents - and exploration of other means to make high quality and local assisted living options affordable for older Virginians with low or moderate incomes.

Background:

The "auxiliary grant" is "a state (80%) and local (20%) funded financial assistance program, administered by the Department of Social Services. It provides additional income for a Supplemental Security Income (SSI) recipient (or an adult who would be eligible for SSI except for excess income) who resides in an adult care residence with an approved rate" (JLARC, Services for Mentally Disabled Residents of Adult Care Residences, p. 9, House Document No. 4, 1998). It is "auxiliary" (in addition) to SSI payments. The Appropriations Act sets the auxiliary grant rate -- in 1998, $737/month ($848 for Northern Virginia). ACRs provide residents shelter, food, activities, supervision, and assistance with up to one activity of daily living (ADLs include feeding, toileting, dressing, walking, bathing, etc.). Residents needing assistance with more than one ADL may be eligible for an additional Medicaid supplement.

Many older Virginians could not live in ACRs but for the auxiliary grant. "This funding stream has resulted in the continued development of ACRs across the state" (JLARC, p. 11). Virginia made $19.5 million in auxiliary grant payments to roughly 6950 recipients in FY 1996 (JLARC, p. 9). 62% of ACRs have at least one auxiliary grant resident (JLARC, p. 65).

Auxiliary grant recipients are unevenly distributed throughout Virginia. 35% of auxiliary grant recipients are concentrated in Richmond, Washington County, Roanoke, Roanoke County and Petersburg (JLARC, p. 67). In Northern Virginia, basic costs range from $1,014 to $4830 monthly with additional fees (Adult Care Residence Study Group: Final Report, Fairfax County, February 1998); very few Northern Virginia facilities can afford to accept auxiliary grants in lieu of charging residents the full rate. Zero to ten auxiliary grant recipients each are in Arlington, Falls Church and Prince William; 11 to 50 in Fairfax and Loudon counties (JLARC, p. 68).

Many low-income elderly are placed away from their families and communities. Of the 134 people from Fairfax receiving the auxiliary grant, 98 had to be placed in facilities outside the county (ACR Study Group Report, p. 18). "This dislocation can be problematic for aged and mentally disabled persons . . ., can make it difficult to maintain continuity of care" (JLARC, p. 69). Community services boards in the receiving localities may become overburdened - leading to concerns about "warehousing" elderly clients with high intensity needs (JLARC, p. 69).

SJR 160 mandates examination of auxiliary grant rates, as part of the ACR-adult day care reimbursement study. The JLARC and Fairfax County reports recommend increasing the auxiliary grant rate and the Alzheimer's Association concurs. A small increase such as in 1998 would not make a tangible difference to Northern Virginia families or the communities where auxiliary grant recipients are concentrated. The auxiliary grant rate problem is part of the larger crisis across Virginia and the nation - the paucity of high quality affordable assisted living. The Housing Study Commission is exploring ways to make Virginia assisted living affordable and the Alzheimer's Association urges the Commonwealth to take a leadership role in devising innovative approaches to "bricks and mortar" and costs of staffing and training.

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Last updated: September 24, 1998

Please return to https://www.alz-nova.org or
call 800-207-8679 or 703-359-4440
for more information about services in Northern Virginia.

© 1997, 1998 & 1999 Alzheimer's Association, Northern Virginia Chapter. All rights reserved.

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