Alaska Pioneer Homes have a long history of offering Alaska’s elders caring, engaging places to age in place as their living and health care needs increase. Today, the average resident in a Pioneer Home is 87 years old and lives in one of the six homes for about two years. More elders are coming to Pioneer Homes with higher levels of need requiring greater assistance. This is in part due to elders who require less intensive care staying in their own homes longer thanks to a rise in community-based supports.
With elders entering our homes with more serious needs and the growing numbers of seniors in Alaska’s population, the Alaska Department of Health and Social Services (DHSS) is faced with the challenge of maintaining the high level of care for each and every Pioneer Home resident as costs continue to rise. That brings us to our current situation and the recent increases to the Alaska Pioneer Homes rates.
Understandably, these changes have resulted in a lot of talk and some anxiety about the future of Alaska Pioneer Homes and how older Alaskans will be served. Unfortunately, some of those concerns are based on inaccurate information or misunderstandings that need addressing so Alaskans can be assured they will continue to have options in our state as they age.
The increased rates reflect the actual amount it costs to provide services at each of the five designated levels of care. The previous rates did not cover the full cost of services, which meant the State of Alaska was subsidizing care for every resident, even those who were able to pay more towards their cost of service. DHSS paid more than $34.5 million to subsidize the Alaska Pioneer Home system in fiscal year 2019. The additional funds brought in through these increased rates will support only the actual care for that resident, and will not be used to provide for services outside of the Pioneer Homes or to subsidize the costs of other residents.
For those who are concerned that the increased rates will make the Pioneer Homes unaffordable to many older Alaskans, a person’s income or assets are not an eligibility requirement for entrance into a Pioneer Home. Regardless of income, Alaskans 65 years and older who have lived in the state for at least one year are eligible to live at a Pioneer Home. There is a waitlist for the homes, but applicants are chosen on a first-come, first-served basis on their original application date. The same is true for all current residents of the Pioneer Homes – under Alaska state law, no one can be evicted if their income and assets are insufficient to pay the monthly rate.
Help is available in many forms to Pioneer Home residents who need assistance in paying for their care. Many low-income elders with significant physical limitations and medical needs receive financial assistance through a Medicaid waiver and veterans at our Alaska Veteran and Pioneer Home in Palmer receive a per diem from Veterans Affairs.
Additionally, residents who can’t afford to pay the full amount of their rate can get help through the Alaska Pioneer Homes’ own Payment Assistance Program. Also mandated by state law, this program essentially creates a sliding fee scale. Residents pay the amount they can afford and payment assistance covers the remaining amount. There are built-in protections for residents who have spouses that live in the community so their spouse continues to have sufficient income to provide for their living expenses. This program will continue to help bridge the gap for our seniors in need.
Providing excellent care, to every resident, every day, every time, is one the core values of the Alaska Pioneer Home system. Being financially stable is an important part of being able to live up to that core value as it allows us to sustain operations of the Pioneer Homes into the future. Everyone at the Alaska Pioneer Homes and the Department of Health and Social Services – myself included – is proud to continue the tradition of caring for those who helped build our great state.
Adam Crum, M.S.P.H., is commissioner of the Alaska Department of Health and Social Services.