Presentation toAlaska Tribal Health Directors

August 9, 2010

100-bed long term facility in Anchorage Total Cost $43,310,905 - $37.1 M needed

◦ Green House model 10 homes, 10 beds each Community/administrative building

Culturally-appropriate nursing home units Target population

Alaska Native elders and people with disabilities residing in the Anchorage bowl who need nursing home level of care

Alaska Native elders and people with disabilities who are temporarily unable to return home because of a skilled nursing need

Alaska Native elders and people with disabilities from regions who don’t have a nursing or assisted living home.

Alaska Natives are 17.9% of the State Population◦ 26% of Alaska Native population live in Anchorage bowl◦ 11% of the Anchorage population is Alaska Native

Alaska has the fastest growing elderly population in the country◦ A 60% increase in the over 65 Alaska Native population is

expected between 2010 and 2020

Alaska Native migration from rural areas◦ 53% move to Anchorage◦ 23 % move to Fairbanks North Star Borough◦ 9% move to Mat-Su◦ 5% move to the Kenai Peninsula Borough◦ 10% move to other areas of the State

Nursing Home Resident, Alaska Native Female, 65 years old◦ Medical issues: diabetes, hypertension, right side paralysis from stroke,

overweight, incontinent, unable to transfer self from bed to chair◦ Nursing Needs: regular testing of blood sugar and insulin monitoring, physical

therapy to increase function, incontinence program, medication management, monitor weight, nutrition.

◦ Key factors in being able to return home: increased mobility, ability to use toilet independently or with limited assistance, family support.

Assisted Living Resident, Alaska Native Female, 89 years old◦ Medical Issues : Advanced dementia, Alzheimer’s, otherwise physically healthy.◦ Assisted Living Needs: All daily living activities, getting dressed, regular

toileting program, 24 hour supervision (prone to wandering), monitor food intake. Needs staff trained in behavior management and dementia to deal with abusive verbal behaviors, refusal to bathe, etc.

Nursing Home Resident, Alaska Native Male, 38 years old◦ Medical Issues: Quadriplegic (post snow machine accident). ◦ Nursing Home Needs: incontinence program, special chair/bed, special feeding

devices (pureed food), physical therapy.

Service Tribal Facility100% FMAP (no state general fund cost)

Non-Tribal FacilityState pays % based on FMAP

Number of Alaska Native Residents for SFY08

Total Medicaid Cost

Total Medicaid Cost

Nursing Home $3,945,812 $19,089,348 277

Assisted Living $8,450,286 254

Total $3,945,812 $27,539,634 531

ATHS Statewide Long Term Care Facility Plan

◦ Phase I projects Maniilaq – 18 bed nursing home wing – funded

YKHC – 18 bed nursing or assisted living home - funded

ANTHC – 100 bed nursing home in Anchorageto address statewide needs of ATHS – planning funds received

◦ Phase II projects – (preliminary) Prince of Wales Island – assisted living home Tok subregion Aleutian region

Nursing home beds 314◦ Providence plans to reduce by 90 beds in 2012

Assisted Living beds - 990◦ State Pioneer Home – 165 (few Alaska Native residents)

◦ Providence Horizon House - 82 (few Alaska Native residents)

◦ Marlow Manor - 112 (few Alaska Native residents)

◦ Private assisted living homes – 796 **Most Alaska Native residents are in small homes that accommodate

up to 5 people* At one point in time there were 150 Alaska Native residents in 66

different small assisted living homes in Anchorage (ANTHC 2005 report)

LTC is a tribal health system priority LTC is a state priority

Alaska Native elders and persons with disabilities deserve LTC services that respect their cultural needs and traditional values

Alaska Native elders and people with disabilities are currently residing in settings that are far from home, offer unfamiliar environments and foods, don’t speak their language and may not speak English well, making communication and quality care very difficult.