Our Work

"The central challenge in eldercare is to respond to both the successes of American medicine and the changing demographics of the elderly. Medicine is keeping people alive longer. But with the increasing mobility of Americans, we have more and more people who are living into their advanced years, but without the kind of family structure needed to provide both medical and social supports."(a)

The challenge of an aging population is one of national scope:

  • In 1998, 1 in 8 Americans were 65 or older (12.5% of the population).
  • In 2050, 1 in 5 Americans will be 65 or older (20% of the population).
    6.5 million people today age 65 and over need assistance with activities of daily living. This number will double by the year 2020.
  • The 85 and older population will increase 33.2% between 2000 and 2010. This is the largest growing segment of the elderly age group.
  • Census estimates of population projections of persons age 85 and over range from 18.2 million to 31.1 million by the year 2050.
  • Of 10.2 million households of people 75 or older, 2/3 have incomes below $25,000 — too little to afford market rate assisted living.

"One of our first tenants was an emergency placement, a malnourished woman found sleeping on the floor with no heat. She was afraid to turn on the heat because she had no money. After moving in, she kept saying that she didn't deserve to live in so nice a place because she was so poor. She seems to be doing well, eating and putting on weight."(b)

The quality, safety, accessibility, and cleanliness of an elderly person's living environment has the ability to have a significant impact on their health. Good housing does not automatically equate to good health — but it does equate to a good setting for the delivery of both personal and health care services. It is safe to assume that most seniors who are economically comfortable live in a safe and clean housing environment, be it their home or apartment. In the case of low-income seniors, that assumption is not true. Low-income seniors are often forced by economics to live in housing that is not safe, not clean, not accessible, and for those reasons this poses a detrimental risk to their health. The Center for Excellence in Long Term Supports Innovations works to encourage and expand service-enriched housing so that seniors of today and of the future can live their lives affordably--never having to make the decision between housing or long term supportive services.

Projects

The following highlights some of our current and completed projects.

  • Coming Home Program
  • California Assisted Living Waiver Pilot Program
  • CMS Real Choices System Change Grant
  • California Department of Health Services
  • Long-term Care Authority-Oaklahoma

 

Coming Home Program

The Coming Home Program was designed to bring the benefits of assisted living to low-income, frail seniors living in rural areas. The Coming Home Program created models of assisted living that serve low-income seniors. To be successful, the Program had to reach Medicaid-eligible seniors, for they are the most "at risk" for premature institutionalization. This program is no longer in operation. To learn more about this past program, click here.

 

California Assisted Living Waiver Pilot Program

The Assisted Living Waiver Pilot Project (ALWPP) is the Medi-Cal program that pays for assisted living, care coordination and other specified benefits provided to eligible seniors and persons with disabilities who reside in one of the Project’s three target counties: Sacramento, San Joaquin and Los Angeles. The ALWPP was created by legislation to develop and implement the project. A key goal of the pilot project is to enable low-income, Medi-Cal eligible seniors and persons with disabilities, who would otherwise require nursing facility services, to remain in or relocate to the community. NCB Capital Impact was selected by the California Department of Health Care Services  as its contracted consultant to help develop and implement the ALWPP.

 

CMS Real Choices System Change Grant

NCB Capital Impact is working with Arkansas under the CMS Real Choices System Change Grant to lead a stakeholder workgroup, develop a county by county housing with services needs and resources analysis, craft small residential models to serve Medicaid eligible individuals, and expand the availability of affordable assisted living throughout the state through policy initiatives and direct technical assistance to demonstration projects.

 

California Department of Health Services

NCB Capital Impact is providing technical assistance to the California Department of Health Services (CDHS), helping them to both develop and implement the California Assisted Living Waiver Pilot Project, a Medicaid Home and Community-Based Services waiver program. NCB Capital Impact has worked with CDHS to conceptualize their waiver program and write their waiver application and has also helped CDHS to develop and operationalize their program.

 

Long-term Care Authority-Oaklahoma

NCB Capital Impact provided technical assistance to the Long-term Care Authority-Oklahoma to refine their Medicaid Home and Community-Based Services Program and their assisted living regulatory framework. NCB Capital Impact also consulted with the State regarding their housing finance policies and the development of affordable assisted living projects.


 

 

 

(a) Eldercare: Where Medicine, Economics and Demographics Collide, quote from Lewis G. Sandy, MD in Advances, The Robert Wood Johnson Foundation Quarterly 
(b), Excerpted from a 12/11/97 memo from Toby Saken, Director, Cache Valley Assisted Living, Ullin, IL