NCAL Releases White Paper on Importance of Expanding Affordable Assisted Living Options

Changing Needs of Senior Population Warrant Solutions for Improved Access to Care

Assisted Living; Programs and Resources

WASHINGTON, D.C. – The National Center for Assisted Living (NCAL) today released a new white paper, “The Importance of Expanding Affordable Assisted Living Options and Proposed Solutions,” as part of its efforts to meet the changing needs of the growing senior population. The document outlines challenges to offering more affordable assisted living for low- and middle-income seniors, as well as solutions that could help improve access to necessary care. 
“We know that the 80 and over population is projected to grow more than nine percent by 2027,” said NCAL Executive Director LaShuan Bethea. “Many of those seniors will not have family caregivers like generations before them, and financial resources will be more limited. NCAL and its members are dedicated to offering more affordable assisted living options to ensure seniors, no matter their circumstance, have access to high quality long term care.”
In the white paper, NCAL reinforces the need for public-private partnerships to identify opportunities that increase affordable assisted living options for low- to moderate-income older adults who can no longer live at home. Policymakers should consider expanding affordable assisted living through a variety of grants and programs available in states. Collaboration among the provider community, federal agencies, banking and financial institutions, and the construction industry could also help create new financing incentives for low- and middle-income senior housing and assisted living. 
NCAL also highlights Medicaid as one of the major challenges, as the program is chronically underfunded and limits access to assisted living care. Approximately one in five assisted living residents relies on Medicaid for their care, but the program covers services only; it does not cover room and board. Additionally, there are waiting lists for Medicaid beneficiaries to receive home and community‐based services (HCBS), such as assisted living, in various states across the country. As part of the solution, NCAL is supporting efforts to enhance Medicaid HCBS waiver initiatives and encouraging policymakers to expand and adequately fund Medicaid. 
“There is an urgent need for policymakers to take a hard look at and ensure Medicaid funding is appropriate,” said Julie Simpkins, Co-President at Gardant Management Solutions, an NCAL member and developer/operator of senior living, assisted living, and memory care communities. “Medicaid should be a viable program so that more assisted living providers are encouraged to participate and serve our most vulnerable seniors. We also need to continue education efforts at both the state and federal levels that expanding Medicaid for assisted living is not more Medicaid – it is smarter Medicaid. When individuals receive care in the most appropriate setting, it’s not only better for their own health, but more cost effective as well.” 
In addition to releasing this white paper, NCAL is developing resources to help its members explore the possibility and feasibility of moving into the affordable assisted living space. NCAL worked with certified public accounting and business advisory firm Plante Moran to develop a summary of key operating data and potential development characteristics of the assisted living marketplace to help members examine what it would take to offer more affordable assisted living communities. The suite of resources includes an executive summary highlighting important statistics about the growing senior population and state-specific data, as well as a financial modeling tool and accompanying user guide that are exclusive resources available to NCAL members. 
NCAL has also advocated for important federal legislation over the past several years that increases access to affordable assisted living options. In 2022, NCAL supported the Expanding Service Coordinators Act, which proposed critical investments and reforms in expanding service coordinator programs to serve more people in federally assisted housing. More recently in the current Congress, NCAL advocated for the Expanding Veterans’ Options for Long Term Care Act (S. 495), a bill that would create a pilot program for eligible veterans to receive assisted living care paid for by the Department of Veterans Affairs. 
“Our work will continue until everyone who needs assisted living care can access it,” said Bethea. “We will advocate, educate, and collaborate to ensure our profession can efficiently meet the current and future needs of our nation’s seniors.”