AFSCME Information Highway

Source: Maribeth Bersani, Nursing Homes: Long Term Care Management, Vol. 56 no. 6, June 2007

Before January 2006 and the implementation of Medicare Part D, dual-eligible assisted living residents (those who receive Medicaid and Medicare benefits) were exempted from remitting co-payments for their prescription drugs. The exemption from co-payments was also applicable to individuals residing in skilled nursing homes, as well.

Under the new Medicare Part D program, however, dual-eligible residents in assisted living communities are not exempt from prescription drug co-payments. This has created a severe financial hardship for these residents who are already living on very low incomes. The only discretionary income most of these residents have is a Personal Needs Allowance (PNA)—frequently less than $60 per month. Residents use the PNA to pay for clothing, personal hygiene items, over-the-counter medications, and any other necessary items they need. To have to use this meager allowance to cover prescription drug co-pays is a true hardship.

Posted by Info Center at 2:10 PM in Assisted Living | Retirement | Social Services | Permalink

Source: Bernadette Wright, AARP Public Policy Institute, Research Report, April 2007

Assisted living is regulated differently in each state. In most states, assisted living is licensed as a single entity that provides housing and services to residents. However, in a growing number of states a new model of assisted living has emerged, in which the housing and services are separate. In this model, the building is not licensed, but instead makes arrangements with licensed service agencies to provide services to residents. Findings are based on a review of the laws and regulations and interviews with key informants in four states.

Posted by Info Center at 12:18 PM in Assisted Living | Permalink