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MOD hears from many people with disabilities and their family members who want to know what options there are for individuals who either need help to live at home or in a residential setting. We thought it would be helpful to lay out and describe most of the major options in one place to make it easier to compare and navigate the various programs. This is Part Two of a two-part blog series on long-term home care and supported living programs for seniors and people with disabilities in Massachusetts.

Part One focused on Home Care options that exist for people who need services to help them live at home and in their communities. Part Two will focus on Residential Care and Supportive Housing. Supportive housing is an option for individuals who need support services but not 24-hour supervision or medical care. Residential care provides support services in a residential setting rather than at home.  The following are some options available in Massachusetts.

Assisted Living

Assisted living is a residential long term care option for adults who need assistance with daily living. Assisted Living Residences (ALRs) provide housing, meals and personal care to residents in a non-institutional setting. ALRs do not provide medical or nursing care. ALR costs vary but are typically very expensive.  Most residents pay ALR costs privately, but there is some financial help available to certain individuals.   Group Adult Foster Care (GAFC), which is covered in Part One, pays the service-related costs of Assisted Living for individuals who are financially eligible for Masshealth at ALRs that accept GAFC.  Also, some ALRs offer reduced rate units to low-income residents. The waiting lists for these affordable units are usually extremely long. You can contact individual ALRs to ask if they have any affordable units. To find ALRs in your area you may contact Elder Affairs at (617) 727-7750 or 1-800-AGE- INFO (1-800-243-4636) for a free copy of Assisted Living in Massachusetts: A Consumer’s Guide.

Congregate Housing

Congregate Housing is a shared living environment which integrates seniors and adults with disabilities. Support services such as transportation, meals, and housekeeping are provided to allow residents to live independently.  Residents each have their own bedroom along with access to shared living areas which may include kitchen, dining, or bathing facilities and community rooms. Congregate Housing does not provide medical or nursing care or 24-hour supervision. However, a Service Coordinator is on-site to arrange services, coordinate activities, develop individual service plans for residents, and to provide other supports. Congregate housing is made affordable to eligible individuals through state funding with Masshealth covering extra costs. Individuals must apply through local housing authorities and you may contact your area Aging Services Access Point (ASAP) for more information.

Permanent Supportive Housing

Permanent Supportive Housing provides safe, affordable community-based housing and support services for vulnerable populations facing persistent, serious challenges to maintaining housing.  Permanent Supportive Housing is for low-income or homeless individuals with severe mental illness, substance abuse issues, or HIV/AIDS. The various types of permanent supportive housing include group homes, subsidized units, and single room occupancies (SROs). Individuals can apply for permanent supportive housing by referral from a transitional housing program, homeless shelter, or a case manager from a state agency. You can also apply without a referral. Your local community health center can provide contact information for local supportive housing programs. DHCD administers the McKinney Shelter Plus Care Program.

Supportive Senior Housing

Created by the Supportive Housing Initiative, Supportive Senior Housing provides an “assisted living like” environment in state funded public elderly/disabled housing. The program offers case management for needs assessment, 24-hour on-site staff for urgent response, daily meals, medication reminders, and social activities free of charge to elders within their senior housing complexes. Further, personal care assistance, housekeeping, laundry, shopping, and transportation are available for purchase on a sliding scale or free to residents who meet income limits and demonstrate a need for those additional services.  To apply, individuals must be age 60 or over and contact the local housing authority in the community of their choice. You may contact DHCD’s Bureau of Housing Management at (617) 573-1150 for more program information.

Nursing Homes

Nursing homes don’t seem to fall under “residential care” or “supportive housing” because the services they provide are more comprehensive. Nevertheless, they are another option. Nursing homes provide residents with accommodations, meals, social activities, personal care, and 24-hour skilled nursing and rehabilitation services to people who cannot live on their own due to physical, psychiatric or emotional conditions. Nursing home costs are rather high, with some financial assistance available to individuals with limited income and assets and to veterans. Others must “spend down” their assets in order to receive financial assistance. Masshealth Standard members may get most costs covered as long as they choose a nursing home that accepts Masshealth. You must apply to each nursing home individually and there are often lengthy waiting lists for a room. See Choosing a Nursing Home or contact your ASAP for more information.

We hope this blog series will serve as a useful resource to people with disabilities and their families and caregivers. Please subscribe to our blog to continue receiving helpful disability information.


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