99121 t Prepared by the North Dakota Legislative Council staff for the Budget Committee on LongTerm Care September 1997 COMPARISON OF ASSISTED LIVING CONGREGATE HOUSING BASIC CARE AND NURSING HOMES Assisted L1vl ID: 43200
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991213Long-TermCareAssistedLivinl!Conl!rel!ateHousinl!BasicCareNursinl!HomesTheopinionalsostatesthatthequestionofwhetheraresidentialenvironmentis"institutional"innature,andaccordinglysubjecttolicen-surebythestate,isaquestionwhichmustbeansweredonacase-by-casebasis_ 991212Long-TermCare.-Assisted Livinl!Conl!rel!ateHousinl! BasicCare Nursinl! HomesIftheindividualqualifies,assistanceiftheyqualify.Thishousingassistanceprogramsassistanceonlyprovideshelpmaybeutilizedtohelpthewiththecostofthehousing.individualwithhousingcosts.Assistanceisnotprovidedtohelpdefraythecostofassis·Iftheindividualqualifies,thetancewithdailylivingMedicaidwaiverfortheagedactivities.anddisabled,SPEDprogram,andexpandedSPEDprogrammaybeutilizedtohelptheindividualwiththecostofdailylivingactivitiesassistance.LicenseBasedonaMay3,1994,CongregatehousingisnotBasiccarefacilitiesareNursinghomefacilitiesareAttorneyGeneral'sopinion,licensedbythestate.licensedbytheStateDepart·licensedbytheStateDepart-thefollowingcriteriadescribementofHealth.mentofHealth.residentialenvironmentswhichprovideassistedlivingbutwhicharenotbasiccarefacilities:•Thetenantmayfreelychoosepersonalserviceproviders.•Theapartment·likeunitinanassistedlivingfacilitymustincludeakitchen.•Thetenantdeterminestheservicesthatallowthetenanttomaintainthedegreeofindependencethetenantbelieves,appropriate.•Eachtenantmustbecompetentormusthaveanexistingonsitemethodorsubstitutedecision-making(live-inspouse,parent,oradultchild). ·'.99121 }t PreparedbytheNorthDakotaLegislative Council stafffortheBudgetCommitteeonLong-TermCareSeptember1997COMPARISONOFASSISTEDLIVING,CONGREGATEHOUSING,BASICCARE,ANDNURSINGHOMESAssistedL1vlnl!Conl!rel!ateHouslnl!BasicCareNursinl!HomesDefinitionAnenvironmentwhereaAnenvironmentwhereaAninstitutionalizedsettingAninstitutionalizedsettingpersonlivesinanapartment·personlivesinanindependentthatprovidesroomandboardthatprovidesroomandboardlikesettingahdarrangesforapartmentsellingwhichmaytoindividualswho,becauseofand24·hourcareundertheservicesnecessarytoaccom·includeacentrallobby,diningimpairedcapacityforsupervisionofalicensedmodatethatperson'sneedsroom,andactivityareas.independentliving,requirehealthcarepractitioner.andabilitiesinordertohealth,social,orpersonalmaintainasmuchindepend·careservicesbutdonotenceaspossible.requireregular24·hourmedicalor nursinl! services.ComparisonAssistedlivingenvironmentsIncongregatehousingBasiccarefacilitiesareanNursinghomefacilitiesareanemphasizethefreedomofenvironments,residentsinstitutionalizedsellingusedinstitutionalizedsettingusedchoice.Residentsliveinusuallyliveinindependenttoprovideroomandboard,astoprovidenursing,medical,apartment-likeunits.Theapartments.Theemphasisiswellashealth,social,andandrehabilitativecare,roomservicesprovidedvaryoncommunity/commonassistancewithdailylivingandboard,recreationalactivi·accordingtoindividualneedsspaceswhichmayincludeaactivities24hoursaday.ties,andassistancewithdailyandmayIncludemeals,centrallobby,diningroom,Otherservicesofferedincludelivingandprotectivesupervi·housekeeping,laundry,activi·andactivityareas.Usuallyrecreationalandtherapeuticsion24hoursaday.ties,24·hoursupervision,onemealadayisavailableinactivities,dietaryconsultation,personalcare,medicationacommondiningarea.Theandtheadministrationofreminders,andvaryinglevelsprovisionofotherservicesmedications.ofhealthcare.Residentsmaysuchastransportationandchoosetheirownadditionalminimalhousekeepingmayorhomehealthserviceproviders,maynotbeprovided.ifneeded.FundingSourcesAssistedlivingenvironmentsCurrentlytheMedicaidwaiverBasiccarefacilityresidentsNursinghomefacilityprovideandchargeresidentsfortheagedanddisabled,arechargedonerate,whichresidentsarechargedoneseparatelyforhousingcostsSPEDprogram,andexpandedprovidesforroomandboard,rate,whichprovidesforroomandforthecostofanydailySPEDprogramdonotpartici·personalcare,anddallylivingandboard,personalcare,andlivingactivitiesassistance.pateincongregatehousing.activitiesassistance.dailylivingactivitiesassistance.IndividualslivinginanTherefore,allindividualslivingBasiccarefacilityresidentsassistedlivingenvironmentinacongregatehousingcanbeeitherprivatepayorNursinghomefacilitymaybeprivatepayorutilizeenvironmentareprivatepaystatepaythroughthestate'sresidentscanbeeitherprivatepublicassistanceprograms.residents.Residentsofbasiccareprogram.payorstatepaythroughthecongregatehousingcanMedicaidprogram.receivepublichousing