THE AUXILIARY GRANT PROGRAM

An Auxiliary Grant (AG) is a supplement to income for recipients of Supplemental Security Income (SSI) and certain other aged, blind, or disabled individuals residing in an assisted living facility (ALF) or in adult foster care (AFC). This assistance is available from local departments of social services to ensure that recipients are able to maintain a standard of living that meets a basic level of need. 

Before being admitted to an ALF or an AFC, an individual is assessed to determine eligibility and level of care. Other service options, such as the provision of home- and community-based care services or nursing facility placement, will be explored. The AG program is specifically for individuals who reside in an ALF licensed by the Virginia Department of Social Services, Division of Licensing Programs, or in an AFC home approved by the local department of social services. Not all ALFs or AFCs accept AGs.

The AG program is a state- (80 percent) and locally- (20 percent) funded financial assistance program administered by the Virginia Department of Social Services. Its purpose is to provide supplemental income for an SSI recipient or an adult who would be eligible for SSI except for excess income who resides in an ALF or AFC. The maximum rate is determined by the Virginia General Assembly and is adjusted periodically. 

Individuals receiving an AG also receive a monthly personal needs allowance. The current monthly personal allowance is $57 per month. The personal allowance is used by the resident for such things as medical co-payments, over-the-counter and non-prescription medications, prescriptions not covered by Medicaid, dental care, eyeglasses, clothing, personal toiletries, snacks and sodas, provision of a personal telephone and long-distance service, personal transportation, and activities outside of what is offered by the ALF or AFC provider. Regulations do not allow the personal needs allowance to be used for required recreational activities, administration of accounts, debts owed the ALF for basic services, or charges for laundry that exceed $10 per month. 

For ALFs, there are two levels of care, residential and assisted living, and two levels of payment. Before being admitted to an ALF, an individual must be assessed using the Uniform Assessment Instrument (UAI) to determine his or her level of care. Individuals meeting the residential level of care require minimal assistance with activities of daily living (ADLs) such as bathing, dressing, eating, transferring, toileting, and bowel and bladder continence or need assistance with medication management. Individuals in this category receive the AG payment directly from the local department of social services and pay the ALF for their care. 

Individuals who meet the level of assisted living that requires assistance with more ADLs or who are dependent in behavior pattern receive the AG payment from the local department of social services, and the ALF receives an additional $3 per day (up to $90 per month) as an add-on payment from the Department of Medical Assistance Services (DMAS).

Based on a survey of approximately 400 licensed ALFs participating in the AG program conducted by the Virginia Department of Social Services Division of Finance, there were 7,495 individuals reported as residing in an ALF in 1999 who received AG and/or assisted living public-funding assistance. Of these residents, about 60 percent were at the residential living level of care and received AG funds only, and 40 percent received assisted living assistance. In FY 2001, $24.5 million was expended in the AG program.

As of August 1, 2001, there were 34,277 licensed capacity ALF beds in Virginia, located in 676 facilities (Virginia Department of Social Services Division of Licensing Programs). Of these, approximately one-fourth was for public pay residents. This is compared to over 30,000 nursing facility beds with over 68 percent of nursing facility beds for public pay residents (Joint Commission on Health Care, 7/27/99 presentation).

HOW IS ELIGIBILITY DETERMINED?

Before an individual can receive assistance from the AG Program, the local department of social services in the locality where the individual has residence must determine eligibility for the program. Residence for AG eligibility is determined by the city or county within the state where the person last lived outside of an institution or adult foster care home. Any records or statements can be used to determine residency. If residency cannot be determined, or if the individual is from out-of-state, residency is where the individual is living at the time of application.

To be eligible for an AG in Virginia, an individual must meet all of the following:

• Be 65 or over or be blind or be disabled.
  

• Reside in a licensed ALF or approved AFC home.
  

• Be a citizen of the United States or an alien who meets specified criteria.
  

• Have a non-exempted (countable) income less than the total of the AG rate approved for the ALF plus the personal needs allowance.
  

• Have non-exempted resources less than $2,000 for one person or $3,000 for a couple. *
  

• Have been assessed and determined to need ALF care or adult foster care placement.

[*These figures are current, but are subject to change. Contact the eligibility section of your local department of social services for current information.]

The local department of social services pays AG benefits where recipient eligibility has been established. Checks are mailed directly to the recipient or a payee, who in turn pays the ALF for services provided. 


WHAT IS COVERED UNDER THE AUXILIARY GRANT?
Room And Board

• Provision of a furnished room in a facility that meets applicable building and fire safety codes.
  

• Housekeeping services based on the needs of the resident.
  

• Meals and snacks, including extra portions and special diets.
  

• Clean bed linens and towels as needed by the resident and at least once a week.

Maintenance and Care

• Minimal assistance with personal hygiene including bathing, dressing, oral hygiene, hair grooming and shampooing, care of clothing, shaving, care of toenails and fingernails, arranging for haircuts as needed, care of needs associated with menstruation or occasional bladder or bowel incontinence.
  

• Medication administration as required by licensing regulations including insulin injections.
  

• Provision of generic personal toiletries including soap and toilet paper.
  

• Minimal assistance with the following: care of personal possessions; care of personal funds if requested by the recipient and residence policy allows it; use of telephone; arranging transportation; obtaining necessary personal items and clothing; making and keeping appointments; and correspondence.
  

• Securing health care and transportation when needed for medical treatment.
  

• Providing social and recreational activities as required by licensing regulations.
  

• General supervision for safety.

WHOM TO CONTACT FOR INFORMATION

To determine eligibility for an Auxiliary Grant or other funding sources and to obtain current funding levels, please contact the local department of social services in the city or county where the individual lives. The telephone number is available in the government section (blue section) of your local telephone directory. 

An ALF provider interested in participating in the Auxiliary Grant (AG) program should contact the Virginia Department of Social Services, Division of Finance, 730 East Broad Street, Richmond, VA 23219-1849 (telephone 804-692-1300).

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